Nondepressed Subjects Research Articles

Zinc monotherapy increases serum brain-derived neurotrophic factor (BDNF) levels and decreases depressive symptoms in overweight or obese subjects: A double-blind, randomized, placebo-controlled trial

ObjectivePrevious studies have shown a positive effect of zinc as an adjunctive therapy on reducing depressive symptoms. However, to our knowledge, no study has examined the effect of zinc monotherapy on mood. The aim of the present study was to determine the effects of zinc monotherapy on depressive symptoms and serum brain-derived neurotrophic factor (BDNF) levels in overweight or obese subjects.MethodsFifty overweight or obese subjects were randomly assigned into two groups and received either 30 mg zinc or placebo daily for 12 weeks. At baseline and post-intervention, depression severity was assessed using Beck depression inventory II (BDI II), and serum BDNF and zinc levels were determined by enzyme-linked immunosorbent assay and atomic absorption spectrophotometry, respectively.ResultsThe trial was completed with 46 subjects. After a 12-week supplementation, serum zinc and BDNF levels increased significantly in the zinc-supplemented group compared with the placebo group. BDI scores declined in both the groups at the end of the study, but reduction in the zinc-supplemented group was significantly higher than the placebo group. More analysis revealed that following supplementation, BDI scores decreased in subgroup of subjects with depressive symptoms (BDI ≥ 10) (n = 30), but did not change in the subgroup of non-depressed subjects (BDI < 10) (n = 16). Moreover, a significant inverse correlation was observed between serum BDNF levels and depression severity in all participants. Interestingly, a significant positive correlation was found between serum BDNF and zinc levels at baseline.ConclusionZinc monotherapy improves mood in overweight or obese subjects most likely through increasing BDNF levels.

Diagnose of Depression in Subjects with Sleep Disorders using Analysis of REM Sleep Electroencephalogram signals

By considering the prevalence of depression in subjects with sleep disorders, our purpose is diagnosis of depression in these subjects. Shortened REM latency (i.e, the interval between sleep onset and the occurrence of the first REM period), increased REM sleep duration and increased REM density (i.e., the frequency of rapid eye movements per REM period) have been considered as biological markers of depression, so to diagnose of depression in subjects with sleep disorders we used analysis of EEG signal in REM sleep. The features of frequency and time domains in four channels (C3-C4-O1-O2) and four bands (delta, alpha, beta ,gamma) of REM sleep EEG were compared in 10 depressed (37.5 ± 8.34 years; mean ± standard deviation) and 14 non-depressed (36.6 ± 11.1 years; mean ± standard deviation) subjects with sleep disorders. According to results, most of the significant differences (P<0.05) have related to C3 and O1, in first stage and first period of REM sleep. Our results also show significant increase of beta activity in depressed subjects. Mahalanobis distance has classified 91.7% of the depressed and non-depressed subjects correctly.

A Comparison of Clinical Features of Depressed and Non-Depressed People Living with HIV/AIDS, in Nigeria, West Africa

Objectives: Depressive disorders are a significant public health issue. They are prevalent, disabling, and often chronic, with a high economic burden to the society. Depressive illness is the most common psychiatric disorder in HIV/AIDS with prevalence 2 to 4 times higher than the general population. It’s still questionable whether HIV related depression is clinically different from sero-positive patients without depression. Studies comparing the clinical features of depressed and non-depressed People Living with HIV/AIDs are limited, hence the need for this study. Methods: This was a hospital based, cross sectional, descriptive study of three hundred adult HIV/AIDS patients attending the HIV clinic of Kwara State specialist hospital, Sobi, Ilorin. The PHQ-9 was administered to the respondents to screen for depression. A pre-tested PHQ-9 questionnaire was used to collect data. Subject who scored one and more were assessed clinically for depression. The three keys of social determinants of depression (SDS) were assessed and the association with depression sought. Results: One hundred and seventy (56.7%) satisfied the criteria for a depressive disorder using the PHQ-9 score. Compared to non-depressed sero-positive patients, depressed HIV patients were more likely to be female, single, unemployed, with below average year of schooling, low social economic status, low social cohesion and more stressful life events. They are more prone to hopelessness, thought of taking life and plan to commit suicide. Conclusion: These findings, show that the clinical and associated features of depression differ between depressed and non-depressed sero-positive subjects, thus requiring different management.

No Association between Depression and Risk of Hepatocellular Carcinoma in Older People in Taiwan.

Objectives. The objective of this study was to determine whether there is a relationship between depression and risk of hepatocellular carcinoma (HCC) in older people in Taiwan. Methods. A case-control study was conducted to analyze the database from the Taiwan National Health Insurance program. We selected 1815 subjects aged 65 years or older with newly diagnosed HCC as the case group and 7260 subjects without HCC as the comparison group, from 2000 to 2010. Both groups were compared to measure the risk of HCC. Results. After controlling for confounders, the odds ratio of HCC was 0.81 in subjects with depression (95% confidence interval = 0.59, 1.11), as compared with nondepressed subjects. Conclusions. We conclude that no association is detected between depression and risk of hepatocellular carcinoma in older people in Taiwan.

Psychometric properties of the Beck Depression Inventory-II: a comprehensive review

To review the psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-report measure of depression in a variety of settings and populations. Relevant studies of the BDI-II were retrieved through a search of electronic databases, a hand search, and contact with authors. Retained studies (k = 118) were allocated into three groups: non-clinical, psychiatric/institutionalized, and medical samples. The internal consistency was described as around 0.9 and the retest reliability ranged from 0.73 to 0.96. The correlation between BDI-II and the Beck Depression Inventory (BDI-I) was high and substantial overlap with measures of depression and anxiety was reported. The criterion-based validity showed good sensitivity and specificity for detecting depression in comparison to the adopted gold standard. However, the cutoff score to screen for depression varied according to the type of sample. Factor analysis showed a robust dimension of general depression composed by two constructs: cognitive-affective and somatic-vegetative. The BDI-II is a relevant psychometric instrument, showing high reliability, capacity to discriminate between depressed and non-depressed subjects, and improved concurrent, content, and structural validity. Based on available psychometric evidence, the BDI-II can be viewed as a cost-effective questionnaire for measuring the severity of depression, with broad applicability for research and clinical practice worldwide.

Increased brain amyloid deposition in patients with a lifetime history of major depression: evidenced on 18F-florbetapir (AV-45/Amyvid) positron emission tomography

The literature suggests that a history of depression is associated with an increased risk of developing Alzheimer's disease (AD). The aim of this study was to examine brain amyloid accumulation in patients with lifetime major depression using (18)F-florbetapir (AV-45/Amyvid) PET imaging in comparison with that in nondepressed subjects. The study groups comprised 25 depressed patients and 11 comparison subjects who did not meet the diagnostic criteria for AD or amnestic mild cognitive impairment. Vascular risk factors, homocysteine and apolipoprotein E (ApoE) genotype were also examined. The standard uptake value ratio (SUVR) of each volume of interest was analysed using whole the cerebellum as the reference region. Patients with a lifetime history of major depression had higher (18)F-florbetapir SUVRs in the precuneus (1.06 ± 0.08 vs. 1.00 ± 0.06, p = 0.045) and parietal region (1.05 ± 0.08 vs. 0.98 ± 0.07, p = 0.038) than the comparison subjects. Voxel-wise analysis revealed a significantly increased SUVR in depressed patients in the frontal, parietal, temporal and occipital areas (p < 0.01). There were no significant associations between global (18)F-florbetapir SUVRs and prior depression episodes, age at onset of depression, or time since onset of first depression. Increased (18)F-florbetapir binding values were found in patients with late-life major depression relative to comparison subjects in specific brain regions, despite no differences in age, sex, education, Mini Mental Status Examination score, vascular risk factor score, homocysteine and ApoE ε4 genotype between the two groups. A longitudinal follow-up study with a large sample size would be worthwhile.

Physical Activity Impairment in Depressed COPD Subjects

Limited exercise tolerance is a cardinal clinical feature in COPD. Depression and COPD share some clinical features, such as reduced physical activity and impaired nutritional status. The aim of the present study was to evaluate maximum and daily physical activities and the nutritional status of COPD patients affected or not by depression. In 70 COPD out-patients, daily and maximum physical activities were assessed by multisensor accelerometer armband, 6-min walk test, and cardiopulmonary exercise test. Mental status, metabolic/muscular status, and systemic inflammation were evaluated using the Hospital Anxiety and Depression Scale, by bioelectrical impedance analysis, and with regard to fibrinogen/C-reactive protein, respectively. Depressed subjects (27% of the sample) showed a similar level of respiratory functional impairment but a higher level of shortness of breath and a worse quality of life compared to non-depressed subjects (P < .05). Specifically, they displayed a physical activity impairment consisting of a reduced number of steps per day, a lower peak of oxygen consumption, an early anaerobic threshold, and a reduced distance in the 6-min walk test (P < .05) but the same nutritional status compared to non-depressed subjects. In the multivariate analysis, a reduced breathing reserve, obesity, and a higher level of shortness of breath, but not depression, were found to be independent factors associated with a reduced daily number of steps. Our study found that depressed COPD patients have a reduced daily and maximum exercise capacity compared to non-depressed patients. This further suggests the potential utility of screening for depression in COPD.

Reliability and Validity of Turkish Version of the Caregiver Quality of Life Index Cancer Scale

Measuring effects of cancer on family caregivers is important to develop methods which can improve their quality of life (QOL) . Nevertheless, up to now, only a few tools have been developed to be used in this group. Among those, the Caregiver Quality of Life Index-Cancer Scale (CQOLC) has met minimum psychometric criteria in different populations in spite of conflicting results. The present study was conducted to evaluate reliability and validity of CQOLC among Turkish cancer family caregivers. The CQOLC was administered to 120 caregivers, along with Beck Depression Inventory (BDI), Medical Outcomes Study MOS 36- Item Short Form Health Survey (SF-36), State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS). Internal consistency and test-retest stability were used to investigate reliability. Construct validity was examined by using known group method, convergent, and divergent validity. For the known group method, we hypothesized that CQOLC scores would differ between depressed and non-depressed subjects. We investigated convergent validity by correlating scores for CQOLC with scores for other similar measures including SF-36 and STAI. The MSPSS was completed at the same time as CQOLC to provide divergent validity. The values for internal consistency and test-retest correlation were 0.88 and 0.96, respectively. The CQOLC discriminated those who were depressed from those who were not. Convergent validity supported strong correlations between CQOLC scores and two main component scores (PCS, MCS) in SF-36 although there was a weak correlation between CQOLC and STAI scores. Regarding divergent validity, the correlation between CQOLC and MSPSS was in the low range, as expected. The Turkish CQOLC is a reliable and valid tool and it can be utilized to determine QOL of family caregivers.

Subcortical biophysical abnormalities in patients with mood disorders

Cortical-subcortical circuits have been implicated in the pathophysiology of mood disorders. Structural and biochemical abnormalities have been identified in patients diagnosed with mood disorders using magnetic resonance imaging-related approaches. In this study, we used magnetization transfer (MT), an innovative magnetic resonance approach, to study biophysical changes in both gray and white matter regions in cortical-subcortical circuits implicated in emotional regulation and behavior. Our study samples comprised 28 patients clinically diagnosed with major depressive disorder (MDD) and 31 non-depressed subjects of comparable age and gender. MT ratio (MTR), representing the biophysical integrity of macromolecular proteins within key components of cortical-subcortical circuits-the caudate, thalamic, striatal, orbitofrontal, anterior cingulate and dorsolateral regions-was the primary outcome measure. In our study, the MTR in the head of the right caudate nucleus was significantly lower in the MDD group when compared with the comparison group. MTR values showed an inverse relationship with age in both groups, with more widespread relationships observed in the MDD group. These data indicate that focal biophysical abnormalities in the caudate nucleus may be central to the pathophysiology of depression and critical to the cortical-subcortical abnormalities that underlie mood disorders. Depression may also accentuate age-related changes in the biophysical properties of cortical and subcortical regions. These observations have broad implications for the neuronal circuitry underlying mood disorders across the lifespan.

Zinc in Depression: A Meta-Analysis

Zinc is an essential micronutrient with diverse biological roles in cell growth, apoptosis and metabolism, and in the regulation of endocrine, immune, and neuronal functions implicated in the pathophysiology of depression. This study sought to quantitatively summarize the clinical data comparing peripheral blood zinc concentrations between depressed and nondepressed subjects. PubMed, Cumulated Index to Nursing and Allied Health Literature, and PsycINFO were searched for original peer-reviewed studies (to June 2012) measuring zinc concentrations in serum or plasma from depressed subjects (identified by either screening or clinical criteria) and nondepressed control subjects. Mean (±SD) zinc concentrations were extracted, combined quantitatively in random-effects meta-analysis, and summarized as a weighted mean difference (WMD). Seventeen studies, measuring peripheral blood zinc concentrations in 1643 depressed and 804 control subjects, were included. Zinc concentrations were approximately -1.85 µmol/L lower in depressed subjects than control subjects (95% confidence interval: [CI]: -2.51 to -1.19 µmol/L, Z17 = 5.45, p < .00001). Heterogeneity was detected (χ(2)17 = 142.81, p < .00001, I(2) = 88%) and explored; in studies that quantified depressive symptoms, greater depression severity was associated with greater relative zinc deficiency (B = -1.503, t9 = -2.82, p = .026). Effect sizes were numerically larger in studies of inpatients (WMD -2.543, 95% CI: -3.522 to -1.564, Z9 = 5.09, p < .0001) versus community samples (WMD -.943, 95% CI: -1.563 to -.323, Z7 = 2.98, p = .003) and in studies of higher methodological quality (WMD -2.354, 95% CI: -2.901 to -1.807, Z7 = 8.43, p < .0001). Depression is associated with a lower concentration of zinc in peripheral blood. The pathophysiological relationships between zinc status and depression, and the potential benefits of zinc supplementation in depressed patients, warrant further investigation.

Negative life stress and longitudinal hippocampal volume changes in older adults with and without depression

Major depressive disorder is associated with smaller hippocampal volumes but the mechanisms underlying this relationship are unclear. To examine the effect of environmental influences, we examined the relationship between self-reported stressors and two-year change in hippocampal volume. Seventy elderly nondepressed subjects and eighty-nine elderly depressed subjects were followed for two years. The number of negative stressful life events (nSLE), perceived stress levels, and cranial MRI were obtained at baseline and at the two-year assessment. For secondary analyses, subjects provided blood for 5-HTTLPR polymorphism genotyping. After controlling for covariates including presence or absence of depression, greater numbers of baseline nSLEs were significantly associated with greater baseline hippocampal volumes bilaterally. Greater numbers of baseline nSLEs were also associated with reduction in hippocampal volume over two years in the right but not the left hemisphere. Neither perceived stress levels nor changes in stress measures were significantly associated with hippocampal volume measures. However, in secondary analyses, we found that increases in perceived stress over time was associated with volume reduction of the left hippocampus, but only in 5-HTTLPR L/L homozygotes. Our findings suggest different short- and long-term effects of negative life stressors on hippocampal volumes in older adults. These effects appear independent on the presence or absence of depression. Furthermore, these effects may be moderated by genetic polymorphisms in key neurotransmitter systems. These novel findings have important implications for understanding environmental influences on brain aging.

The effect of sunlight exposure on interleukin-6 levels in depressive and non-depressive subjects

BackgroundThe objective of this epidemiological study was to evaluate the effect of length of sunlight exposure on interleukin 6 (IL-6) levels in depressive and non-depressive subjects.MethodsThis was a cross-sectional study with 154 subjects (54 males, mean age: 43.5 ± 12.8 years) who were living in a rural area in south Brazil. Chronobiological and light parameters were assessed using the Munich Chronotype Questionnaire. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index. Depressive symptoms were assessed with the Beck Depression Inventory. Plasma levels of inflammatory cytokines (IL-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon) were collected during the daytime and measured.ResultsIL-6 levels showed a positive correlation with light exposure (r = 0.257; p < 0.001) and a negative correlation with the mid-sleep phase on work-free days (r = -0.177; p = 0.028). Multiple linear regression analysis showed that only the length of light exposure was an independent factor for predicting IL-6 levels (ß = 0.26; p = 0.002). In non-depressed subjects, exposure to a different intensity of light did not affect IL-6 levels (t = -1.6; p = 0.1). However, when the two depressive groups with low and high light exposure were compared, the low light exposure group had lower levels of IL-6 compared with the high light exposure group (t = -2.19 and p = 0.0037).ConclusionsThe amount of time that participants are exposed to sunlight is directly related to their IL-6 levels. Additionally, depressed subjects differ in their IL-6 levels if they are exposed to light for differing amounts of time.

Cortical Thinning in Patients with Late-Life Minor Depression

Clinically significant minor depression is among the most common mental disorders in the elderly individuals and is associated with considerable medical and psychosocial morbidity. Despite its clinical impact, the biological basis of minor depression in the elderly individuals remains poorly understood. The purpose of our current study was to examine cortical thickness in a sample of patients with late-life minor depression and non-depressed comparison subjects using magnetic resonance imaging (MRI). Cross-sectional analysis. Community. Patients (n = 16; mean age = 76.2 ± 7.5) met modified DSM (Diagnostic and Statistical Manual of Mental Disorders) criteria for minor depression and were free of other brain diseases. Healthy comparison subjects (HC; n = 16) were of comparable age and gender distribution. All subjects were scanned on a 1.5-Tesla GE scanner and brain regions were outlined using Freesurfer Image Analysis. Results show that patients with minor depression have cortical thinning in the right cingulate cortex compared to HC. These findings indicate that abnormalities in specific structures and associated neural circuitry may underlie minor and major depression in the elderly individuals and the pathophysiological abnormalities are comparable in major and less severe forms of the disorder.

White Matter Tract Integrity of Anterior Limb of Internal Capsule in Major Depression and Type 2 Diabetes

A number of studies have shown an association between diabetes and depression. However, the underlying mechanisms are still unclear. Previous findings indicate a role for the prefrontal cortex and subcortical gray matter regions in type 2 diabetes and major depressive disorder (MDD). The purpose of this study was to examine the white matter integrity in the fibers that are part of the anterior limb of internal capsule (ALIC) in MDD and diabetic subjects using diffusion tensor imaging tractography. We studied 4 groups of subjects including 1) 42 healthy controls (HC), 2) 28 MDD subjects (MD), 3) 24 patients diagnosed with type 2 diabetes without depression (DC), and 4) 22 patients diagnosed with diabetes and depression (DD). Results revealed significantly decreased fractional anisotropy (FA; P=.021) and a trend towards significant increase in radial diffusivity (RD; P=.078) of the right ALIC in depressed subjects (MD+DD) compared to non-depressed subjects (HC+DC). While there were no significant diabetes effects or interactions between depression and diabetes, subjects with high depression ratings and high hemoglobin A1c levels had the lowest mean FA values in the right ALIC. In addition, we found a significant negative correlation between FA of the left ALIC with hemoglobin A1c in diabetic subjects (DC+DD; P=.016). Our study demonstrated novel findings of white matter abnormalities of the ALIC in depression and diabetes. These findings have implications for clinical manifestations of depression and diabetes as well as their pathophysiology.

Population-Based Cohort Analyses of the Bidirectional Relationship Between Type 2 Diabetes and Depression

OBJECTIVEThis study addresses the strength of association for the bidirectional relationship between type 2 diabetes and depression.RESEARCH DESIGN AND METHODSWe used two cohort studies with the same source of database to determine the link between depression and type 2 diabetes. The data analyzed included a random sample of 1 million beneficiaries selected from the National Health Insurance claims in 2000. The analysis of diabetes predicting the depression onset consisted of 16,957 diabetic patients and the same number of sex- and age-matched nondiabetic control subjects. The analysis of depression predicting diabetes onset included 5,847 depressive patients and 5,847 sex- and age-matched nondepressive control subjects. The follow-up period was between 2000 and 2006, and onset of end points was identified from ambulatory care claims. The Cox proportional hazards regression model adjusted for potential confounders was used to estimate relative hazards.RESULTSThe first cohort analysis noted an incidence density (ID) of 7.03 per 1,000 person-years (PY) and 5.04 per 1,000 PY for depression in diabetic and nondiabetic subjects, respectively, representing a covariate-adjusted hazard ratio (HR) of 1.43 (95% CI 1.16–1.77). The second cohort analysis noted an ID of 27.59 per 1,000 PY and 9.22 per 1,000 PY for diabetes in depressive and nondepressive subjects, respectively. The covariate-adjusted HR was stronger at 2.02 (1.80–2.27) for incident diabetes associated with baseline depression.CONCLUSIONSThe two cohort studies provided evidence for the bidirectional relationship between diabetes and depression, with a stronger association noted for the depression predicting onset of diabetes.

Depression as a Risk Factor for Diabetes

The present meta-analysis aimed to assess the risk of incident diabetes associated with clinical depression, depressive symptoms, or both in nondiabetic subjects. We performed a MEDLINE search for studies published in the English language using the search string diabetes AND (depression OR antidepressant). The search included studies from any date to December 30, 2011. 1,898 studies were independently assessed for eligibility, and longitudinal studies that assessed the risk of incident diabetes in subjects with or without clinical depression were selected. Study design and characteristics were verified for each study. A meta-analysis was performed for unadjusted and adjusted risk ratios of incident diabetes in subjects with depression by using a random-effects model. Additional analyses were performed to assess heterogeneity, publication bias, and specific hazard ratios for diabetes associated with antidepressant drug use. The 23 studies included in the meta-analysis enrolled 424,557 subjects, with a mean follow-up of 8.3 years and 19,977 cases of incident diabetes. A higher incidence of diabetes was found in depressed versus nondepressed subjects (0.72% vs 0.47% yearly), with unadjusted and adjusted risk (95% CI) of 1.56 (1.37-1.77) and 1.38 (1.23-1.55), respectively (both P values < .001). The use of antidepressant drugs and untreated depression were associated with an adjusted risk of diabetes of 1.68 (1.17-2.40) (P = .005) and 1.56 (0.92-2.65) (P = .09). Depressive symptoms are associated with a significantly increased risk for incident diabetes. This association cannot be entirely explained by the use of antidepressant drugs or being overweight. Pathogenetic mechanisms connecting depression with diabetes deserve further exploration. Depression should be included among risk factors that indicate intensified screening for diabetes.

Association of Five-Factor Model Personality Domains and Facets with Presence, Onset, and Treatment Outcomes of Major Depression in Older Adults

To assess the relationship of multiple domains and facets of the five-factor model of personality with presence, onset, and severity of late-life depression.Cross-sectional analysis of depression status, and age of onset. Retrospective analysis of baseline severity. Longitudinal analysis of severity after 3 and 12 months of psychiatric treatment.Private university-affiliated medical center in the Southeastern United States.One hundred twelve psychiatric patients with a current episode of unipolar major depression, and 104 nondepressed comparison subjects, age 60 and older (mean: 70, SD: 6).Revised NEO Personality Inventory, Diagnostic Interview Schedule, and Montgomery-Åsberg Depression Rating Scale.Binary logistic regression found that depression was related to higher neuroticism (and all its facets) and to lower extraversion (and facets of assertiveness, activity, and positive emotionality) and conscientiousness (and facets of competence, order, dutifulness, and self-discipline). Multinomial logistic regression found some of these relationships held only for depression with onset before age 50 (hostility, self-consciousness, extraversion, assertiveness, positive emotions, order, and dutifulness). Linear regression found that personality was unrelated to depression severity at the beginning of treatment, but improvement after 3 months was related to lower neuroticism (and facets depressiveness and stress-vulnerability) and higher warmth and competence. Improvement after 12 months was related to lower neuroticism, depressiveness, and stress-vulnerability.Specific personality facets are related with depression and treatment outcomes. Screening for certain personality traits at the start of treatment may help identify patients at risk of worse response to treatment after 3 months.

Neuropsychological functioning in late-life depression

Background: The literature describing neurocognitive function in patients with late-life depression (LLD) show inconsistent findings in regard to incidence and main deficits. Reduced information processing speed is in some studies found to explain deficits in higher order cognitive function, while other studies report specific deficits in memory and executive function. Our aim was to determine the characteristics of neuropsychological functioning in non-demented LLD patients.Methods: A comprehensive neuropsychological battery was administered to a group of hospitalized LLD patients and healthy control (HC) subjects. Thirty-nine patients without dementia, 60 years or older meeting DSM-IV criteria for current episode of major depression, and 18 non-depressed control subjects were included. The patient group was characterized by having a long lasting current depressive episode of late-onset depression and by being non-responders to treatment with antidepressants. Neurocognitive scores were calculated for the domains of information processing speed, verbal memory, visuospatial memory, executive function, and language. Number of impairments (performance below the 10th percentile of the control group per domain) for each participant was calculated.Results: Nearly half of the patients had a clinically significant cognitive impairment in at least one neurocognitive domain. Relative to HC subjects, LLD patients performed significantly poorer in the domains of information processing speed and executive function. Executive abilities were most frequently impaired in the patient group (39% of the patients). Even when controlling for differences in processing speed, patients showed more executive deficits than controls.Conclusions: Controlling for processing speed, patients still showed impaired executive function compared to HCs. Reduced executive function thus appears to be the core neurocognitive deficit in LLD. Executive function seems to be an umbrella concept for several connected but distinct cognitive functions. Further studies of neuropsychological functioning in LLD patients are needed to characterize more specific what kinds of executive impairments patients have. Additional studies of remitted LLD patients are needed to separate episode-related and persistent impairments.

Use of Antidepressant Medications To Improve Outcomes After Stroke

Interest in the use of antidepressants after stroke has been renewed by better knowledge of poststroke depression, but mainly by the capacity of some of them to promote functional recovery of nondepressed subjects. Recombinant tissue plasminogen activator thrombolysis within the first few hours after the stroke is currently the only validated treatment able to improve the spontaneous--and most of the time incomplete--recovery of neurological functions after stroke. However, we have learned from research over the last decade, in part based on the considerable improvement of neuroimaging techniques, that spontaneous recovery of neurological functions is associated with a large intracerebral reorganization of the damaged human brain. The question of whether lesioned-brain plasticity can be modulated by external factors such as pharmacological antidepressant agents is now being addressed with the aim of improving recovery and reducing the final disability of patients. Poststroke depression is known to be frequent and deleterious for patient outcome. We review the interest in the use of antidepressants after stroke in classic but often neglected poststroke depression and we strongly underline the action of some antidepressants in promoting functional recovery of nondepressed patients after stroke.

Neuropsychological deficits in drug naïve, non-depressed obsessive-compulsive disorder patients

There are several studies that compared neuropsychological performance of OCD patients with healthy controls. However, there are hardly any studies which have used drug-naïve as well as non-depressed OCD subjects in their studies. The present study compared eighteen drug-naïve non-depressed OCD patients with similar number of age, education and sex matched healthy controls on neuropsychological tests. The tests used are block design, object assembly, Visuospatial Working Memory Test, Verbal Working Memory Test, Complex Figure Test, Stroop Test and Wisconsin Card Sorting Test. In addition to usual significance testing, Effect Sizes were calculated. In addition, correlation was done between neuropsychological test variables and clinical variables. The results did not show any significant correlation between any of the clinical variables and neuropsychological test variables. On the other hand, patients showed significant deficits mainly in executive functions and organizational strategy with respect to visuospatial functions. The observed deficits can be attributed to both dorsolateral prefrontal cortex and orbitofrontal cortex involvement.