Depressed Patients Research Articles

Electroconvulsive Therapy Regulates the Interhemispheric Functional Connectivity of the Dorsomedial Prefrontal Cortex in Depressive Patients: Evidence from 2 Independent Samples.

The dorsomedial prefrontal cortex (dmPFC) is considered a crucial node in emotional and cognitive processes. Voxel-mirrored homotopic connectivity (VMHC) is a validated methodology for investigating interhemispheric coordination. This study aims to elucidate the effects of electroconvulsive therapy (ECT) on the interhemispheric connectivity of the dmPFC in patients with depression, using VMHC as a measure of bilateral neural coordination. Thirty-three patients with depression, screened at the University of Science and Technology of China (USTC), and thirty-five patients with depression, screened at Anhui Medical University (AHMU), were selected as the subjects of this study. VMHC was employed to investigate the effects of ECT on bilateral hemispheric functional connectivity. The Hamilton Depression Rating Scale (HAMD) was used to assess depressive symptoms, and the relationships between changes in HAMD scores and VMHC values were examined. Following ECT, the depressive symptoms of all participants decreased (p < 0.001). The VMHC values in the dmPFC were significantly increased in both groups after ECT (p < 0.01). No significant correlation was found between the increasing VMHC values in the dmPFC and the changes in HAMD scores in depressed patients (p > 0.05). These results show that ECT regulates interhemispheric functional connectivity in depressed patients, and significantly increases the VMHC values in the dmPFC. Our findings may provide a useful method for optimizing the treatment of depression.

8561 Association Of Alopecia And Hirsutism With Severity Of Depression In A Sample Of Hispanic Women With Polycystic Ovary Syndrome

Abstract Disclosure: C.M. Casas Loyola: None. Y.G. Rivera-Rodriguez: None. B. Marin Rodriguez: None. J.A. Roque Torres: None. L.A. Gonzalez Rodriguez: Research Investigator; Self; Lilly USA, LLC. J. Romaguera: None. Purpose: Polycystic ovary syndrome (PCOS), a highly prevalent endocrine disorder in females has been associated with several chronic diseases. Females with PCOS have been found with a higher prevalence of mental disorders. Depression and its severity have been associated with the development and progression of cardiovascular disease. We aimed to assess depression severity and its association with PCOS related comorbidities such as alopecia and hirsutism. Methods: A cross sectional study of females aged 21-45 years was conducted in the endocrinology clinics at the RCM-Clinics. PCOS was diagnosed using the Rotterdam criteria, hirsutism was defined by modified Ferriman-Gallwey score (mFG ≥ 9), alopecia was defined using the Ludwig scale and Depression using the Patient Health Questionnaire (PHQ9). Severity of depression and presence of alopecia and hirsutism were compared among groups. Results: A total of 112 patients were included in this study (85 patients PCOS+ and 27 patients PCOS-). Mean age was 32 ± 6 years. Severity of depression in PCOS- patients was: 44% none to minimal, 30% mild and 27% moderate to severe. Severity of depression in PCOS+ patients was: 28% none to minimal, 35% mild and 36% moderate to severe. Participants with alopecia and PCOS+ had a greater percentage of moderate to severe depression (58%) compared to the control group without alopecia (30%) (p value&amp;lt;0.05). No differences were observed between hirsutism and severity of depression among groups. Conclusion: Our study showed an association between alopecia and severity of depression in patients with PCOS+. The presence of hirsutism was not associated to severity of depression. Currently, there are more available treatments for hirsutism than for alopecia. For this reason, patients with hirsutism have more opportunities to manage their condition than patients with alopecia, which often require more invasive procedures. The presence of alopecia can be considered a risk factor for developing major depressive disorder in patients with PCOS. Treatment of PCOS-related abnormalities should be emphasized soon after diagnosis. Evaluation of mental health is imperative in our PCOS patients. Presentation: 6/3/2024

A graph-based method for automatic graded diagnosis of depression using EEG signals

Depression is a common psychological disorder typically categorized into four grades according to the symptom severity. Accurately diagnosing different grades of depression is significant for taking appropriate treatment strategies to prevent the condition from worsening. Electroencephalography (EEG) has the potential to mirror the prevailing mental state of patients, providing a possible way to diagnose depression. However, it is still a challenge to extract EEG features that reflect varying degrees of depression for automatic grading diagnosis. It has been pointed out that depression involves the intensification of abnormal interactions among distinct brain regions as it advances, which suggests that brain spatial information may play a key role in tracking different grades of depression. Based on this, combined with deep learning models, this paper proposes a new graph-based method for automatic grading diagnosis of depression. A novel graph-based brain network (BN) construction method is first proposed to convert EEG into graph structure containing brain spatial information, where the individual-level (IBN) and group-level brain networks (GBN) are constructed respectively. Next, a new deep learning model P-I-GAT is built based on graph attention networks (GAT) for identifying EEG signals from depression patients with different severity. In specific, the “P” represents the prior information integration capability, synthesizing attribute information from the IBN and structural information from the GBN. The resulting synthesized brain network contains prior information from these two different scales, referred to as the prior brain network (PBN). “I” denotes the multi-rhythm interaction capability, which adaptively assigns learning weights to each rhythmic PBN to fully exploit the information embedded within the PBNs. Ultimately, the proposed method is validated on the open dataset MODMA, achieving an accuracy of 88.57% and a specificity of 91.97%.

Not all types of depressed patients who persist with their antidepressant treatment improve in side effect complaints: A comparison of treatment completers and dropouts in the STAR*D trial.

There is a "traditional belief" that antidepressant side effect complaints improve with medication persistence; however, support for this theory has remained inconclusive. We aimed to examine if side effect complaints improved over time by modeling the relationship between side effect complaints and time at dropout for patients receiving citalopram during the first level of acute treatment in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. We categorized the 2833 patients into five patterns by week of dropout. We used pattern-mixture modeling to model change in side effect complaints (frequency, intensity, and burden) over the 12-week course of treatment, while accounting for attrition and depressive severity. Using post-hoc linear contrasts, we compared the attrition patterns with the completers' pattern for severity of side effect complaints at each respective last visit prior to dropout as well as averaged side effect complaints across the duration of treatment. We also reported frequencies and tolerability of side effects for nine organ/function systems over the course of treatment. Patients who dropped out early exhibited worsening side effect burden and patients who dropped out later showed improvements in side effect frequency and intensity. Treatment completers improved in all side effect complaints over the course of treatment. Early attrition patterns had more severe side effect complaints for both tests of post-hoc linear contrasts than later attrition patterns and completers. Side effect complaints from antidepressant treatment improve over time, but only for some types of patients. As a precaution for early dropout, clinicians should monitor patients who exhibit worsening and more severe side effect complaints-especially in the first 6 weeks of antidepressant treatment. In addition, clinicians may want to consider changing the type of treatment early on for these patients, rather than encouraging them to persist with their current medication.

Why Do Some Depressive Patients Have Suicidal Ideation but Others Not? Suicidal Ideation From the Perspective of Affective Neuroscience Personality Traits.

Although major depression is the disorder most frequently associated with suicidal behavior, it is unclear that major depressive disorder patients may develop suicidal ideation. Basic affective system theory may provide a novel and beneficial viewpoint in this field. The goal of this study was to investigate the basic affective system in relation to suicidal ideation in individuals with depression. The study population comprised 160 participants who had been formally diagnosed with major depressive disorder. Participants were divided into two groups according to whether they had suicide ideation (depression with suicide [DS]) (N=93) or not (depression with no suicidal ideation [DNS]) (N=67). The Beck Depression Inventory (BDI), the Suicide Probability Scale (SPS), the Beck Hopelessness Scale (BHS), and the Affective Neuroscience Personality Scale (ANPS) were applied. Statistical Product and Service Solutions (SPSS) 24 and the SPSS macroprocess, which were specifically developed for assessing complex models including serial mediators, were used to analyze the data. The mean age of all participants was 31.1±11 years, and most of them were female (65%). The DS group had a higher family history of psychiatric medication use and suicidal attempts. In addition, BDI, BHS, and SPS total scores were higher, as well as ANGER subscale scores were higher in the DS group. In mediation analysis, the ANGER subscale significantly predicted the presence of suicide ideation. We observed a direct effect of the ANGER subscale score on suicide ideation as well as an indirect effect of the ANGER subscale score on suicidal ideation via depression severity. Higher scores on ANGER are associated with suicidal ideation. Neurobiological correlates, including the ANGER system, may be promising in understanding suicidal behaviors.

Abnormal beta bursts of depression in the orbitofrontal cortex and its relationship with clinical symptoms

BackgroundRecent researches have reported that frequency-specific patterns of neural activity contain not only rhythmically sustained oscillations but also transient-bursts of isolated events. The aim of this study was to investigated the correlation between beta burst and depression in order to explore depressive disease and the neurological underpinnings of disease-related symptoms. MethodsWe collected resting-state MEG recordings from 30 depressive patients and a matched 40 healthy controls. A Hidden Markov Model (HMM) was applied on source-space time courses for 78 cortical regions of the AAL atlas and the temporal characteristics of beta burst from the matched HMM states were captured. Group differences were evaluated on these beta burst characteristics after permutation tests and, for the depressive group, associations between burst characteristics and clinical symptom severity were determined using Spearman correlation coefficients. ResultsAt a threshold of p=0.05corrected, burst characteristics revealed significant differences between depression patients and controls at the group level, including increased burst amplitude in frontal lobe, decreased burst duration in occipital regions, increased burst rate and decreased burst interval time in some brain regions. Furthermore, burst amplitude in the orbitofrontal cortex (OFC) was positively related to the severity of sleep disturbance and burst rate in the OFC was negatively related to the severity of anxiety in depression patients. ConclusionsThe findings highlight OFC may be a targeted area responsible for the anxiety and sleep disturbance symptom by abnormal beta burst in depressive patients and beta burst characteristics of OFC might serve as a neuro-marker for the depression.

The differences in testosterone and stress hormones between unipolar and bipolar depression in adolescents and adults

BackgroundWhile patients with major depressive disorder (MDD) and bipolar disorder (BD) often exhibit aberrant hormones, it is still unknown whether the hormones differ between MDD and BD across the age spectrum. We aimed to investigate the differences in testosterone and stress hormones between depressed patients with MDD and BD in adolescents and adults, and the impact of suicidal ideation on these. MethodsA total of 432 depressed patients (270 MDD and 162 BD) were recruited, including 177 adolescents and 255 adults. Plasma levels of adrenocorticotropic hormone (ACTH), cortisol (CORT), testosterone (T), and prolactin (PRL) were measured in all patients. Suicidal ideation was assessed by item 3 of the Hamilton Depression Rating Scale. ResultsIn adolescents, plasma T levels were higher in MDD than in BD (p=0.018), MDD patients with suicidal ideation exhibited higher T levels than BD patients with suicidal ideation (p=0.036), and plasma T levels were associated with diagnosis (ORadjus=0.777, p=0.023). In adults, plasma ACTH levels were elevated in MDD versus BD (p=0.012) and were also diagnosis-related (ORadjus=0.972, p=0.019). Plasma levels of other hormones were not significantly different between MDD and BD in adolescents or adults (all p>0.05). ConclusionsThere was an age-specific difference in the T and ACTH between depressed patients with MDD and BD. Suicidal ideation was linked to T in adolescents.

An observational study on variations of serum uric acid level in patients of depression and healthy controls and its correlation with hidden bipolarity

Background: Bipolar disorder (BD) is one of the most studied psychiatric disorders, this being one of the leading causes of disability in young individuals. In search for its predictive biomarker, serum uric acid (UA) level was seen to have a pathophysiologic role in the genesis of BD through oxidative stress and other mechanism. Aims and Objectives: The aim of the study was to estimate serum UA levels in patients with 1st episode depression, to compare serum UA levels between patients and matched healthy controls and to compare serum UA levels between patients with and without hidden bipolarity and therefore, and to evaluate whether it can be used as a predictor of bipolarity. Materials and Methods: A study was conducted in a tertiary care center in Eastern India for a duration of 3 months with a sample size of 92, comprising 46 cases with major depressive disorder (MDD) and 46 control groups of healthy subjects. Their serum UA levels were estimated. The study population was subjected to a mood disorder questionnaire (MDQ) and Montgomery–Asberg Depression Rating Scale (MADRS) scoring. All these data were tabulated in a master sheet and analyzed using Statistical Packages for the Social Sciences 25 software. Results: The mean age of the study population was 32 years with 46 males and 46 females. The mean UA levels for MDD group was 5.27±1.14 mg/dL and for control group was 4.6±1.2 mg/dL, which was seen to be statistically significant (P=0.001). No statistically significant association was seen between the group with a high likelihood of bipolarity versus a low chance of bipolarity with respect to UA levels. A positive correlation was seen between MDQ scores and UA levels of depressed individuals (using Spearmen’s rho: rs=0.345, P=0.019), but not with their MADRS scores. Conclusion: Serum UA levels are significantly higher in depressed patients as compared to healthy subjects. A non-statistical association was seen between UA levels and their bipolar tendencies, owing to a small sample size of comparable groups. However, a higher MDQ score was associated with high UA levels. A larger study population is needed to conclusively establish the predictive role of UA with respect to BD.

The impact of whole-process visualization collaborative nursing discussions education on perioperative symptoms and emotional well-being in radical prostatectomy patients.

Prostate cancer is one of the most common malignant neoplasms in elderly males, with radical prostatectomy being the established therapeutic approach for localized disease. Patients undergoing this surgical procedure frequently experience increased negative emotions and symptomatology during the perioperative period, likely due to concerns about the illness and its treatment. The present study aims to investigate the effects of a novel educational approach involving a whole-process visualization and collaborative nursing discussions on perioperative symptoms and emotional well-being in radical prostatectomy patients. Data were prospectively collected from 310 patients admitted to the hospital between June 2021 and December 2023, all of whom were scheduled to undergo radical prostatectomy. These patients were randomly assigned to either the intervention group (receiving new model education) or the control group (receiving conventional education), with 155 patients in each group. The study compared basic demographic information, anxiety and depression scores, fear of disease progression scores, quality-of-life scores, main symptom scores, and changes in perioperative vital signs between the two groups. No statistically significant differences were observed between the two groups in terms of age, comorbidities, insurance type, education level, income, and tumor history (P > 0.05). Similarly, there were no significant differences in anxiety and depression scores, proportion of patients with anxiety and depression, vital signs, and fear of disease progression scores between the two groups at Time 1 stage (P > 0.05). During stages Time 2 and Time 3, the intervention group exhibited lower anxiety and depression scores, a lower proportion of anxious and depressed patients, as well as significantly reduced blood pressure and heart rate fluctuations compared to the control group (P < 0.05). Following radical prostatectomy, the main symptoms of patients, such as pain, nausea, and fatigue, were assessed using the MADIS Symptom Assessment Scale on days 1-3 post-surgery. The intervention group exhibited significantly lower scores for three symptoms compared to the control group (P < 0.05); at Time 4 stage, the patients in the intervention group also demonstrated significantly improved quality-of-life scores compared to the control group (P < 0.05). Additionally, blood pressure and heart rate of patients returned to baseline levels at Time 4 stage, with no significant difference between the two groups (P > 0.05). Nevertheless, the anxiety and depression scores in the intervention group at the Time 4 stage remained significantly lower than those in the control group (P < 0.05). Additionally, the fear of disease progression scores in both groups were lower than those at the Time 1 stage, with a more pronounced improvement observed in the intervention group compared to the control group (P < 0.05). Patients diagnosed with malignant tumors often experience fear and anxiety regarding the progression of their disease and upcoming surgery, as well as uncertainty surrounding their treatment and prognosis. This heightened emotional distress can contribute to a greater symptom burden during the perioperative period. Utilizing a whole-process visualization and collaborative nursing discussion approach, as compared to traditional communication methods, has been shown to alleviate patients' fears, reduce anxiety and depression, and ultimately lessen the symptom burden experienced during the perioperative phase. Ultimately, this approach can enhance the overall quality of life for patients facing malignant tumors.

Alterations in orbitofrontal cortex communication relate to suicidal attempts in patients with major depressive disorder

BackgroundInvestigating how the interaction between the orbitofrontal cortex (OFC) and various brain regions/functional networks in major depressive disorder (MDD) patients with a history of suicide attempt (SA) holds importance for understanding the neurobiology of this population. MethodsWe employed resting-state functional magnetic resonance imaging (rs-fMRI) to analyze the OFC's functional segregation in 586 healthy individuals. A network analysis framework was then applied to rs-fMRI data from 86 MDD-SA patients and 85 MDD-Control patients, utilizing seed mappings of OFC subregions and a multi-connectivity-indicator strategy involving cross-correlation, total interdependencies, Granger causality, and machine learning. ResultsFour functional subregions of left and right OFC, were designated as seed regions of interest. Relative to the MDD-Control group, the MDD-SA group exhibited enhanced functional connectivity (FC) and attenuated interaction between the OFC and the sensorimotor network, imbalanced communication between the OFC and the default mode network, enhanced FC and interaction between the OFC and the ventral attention network, enhanced interaction between the OFC and the salience network, and attenuated FC between the OFC and the frontoparietal network. LimitationsThe medication and treatment condition of patients with MDD was not controlled, so the medication effect on the alteration model cannot be affirmed. ConclusionThe findings suggest an imbalanced interaction pattern between the OFC subregions and a set of cognition- and emotion-related functional networks/regions in the MDD-SA group.

Distinct prefrontal cortex alterations in confirmed and suspected depression individuals with different perceived stress during an emotional autobiographical memory task: One fNIRS investigation

BackgroundPrevious research showed that perceived stress was strongly linked to depression, little is known about the underlying neurological mechanism of different depression subtypes with different perceived stress, and there is currently no classification of stress-based subtypes of depression. This study aimed at using fNIRS to uncover the neuromechanism of confirmed and suspected depression with different perceived stress, hence providing neurobiological evidence for the classification of stress-based depression subtypes. It is a significant target for effective depression treatment. MethodThe study included 551 young adults: 256 healthy control individuals, 62 confirmed depression patients, and 233 suspected depression participants. A 53-channel fNIRS imaging system was used to gather the average oxyhemoglobin level in the PFC during EAMT. ResultsCompared with HC, confirmed and suspected depression group show significant lower hemodynamic activation in right frontal lobe of frame under high loss of control. Confirmed depression with high sense of tension had higher activation than with high loss of control in right dlPFC, while for suspected depression, the activation with high sense of tension was lower than with high loss of control in left broca's area (BA) and front polar cortex (FPC). ConclusionAll perceived stresses were not equal in their impacts on different depression types. The confirmed and suspected depression were two different depression subtypes sharing distinct activation pattern under different perceived stress in PFC, which may be an important target for stress-linked psychopathology. Depression can be further classified precisely based on stress. fNIRS can provide neuroimaging evidence for classification of stress-based depression subtypes.

USING (GEN)OMICS TO DISENTANGLE DEPRESSION'S HETEROGENEITY

Psychiatric disorders are heterogeneous conditions with diverse symptom and course profiles. This complicates pathophysiology studies as different biological and environmental mechanisms could lead to the same disorders. Unravelling this heterogeneity is important to be able to provide precision medicine. Penninx focuses on further unravelling the heterogeneity of depression using genomics (DNA, RNA, epigenetics) as well as other ‘-omics’ (metabolomics, proteomics). In her Netherlands Study of Depression and Anxiety, detailed phenotyping is combined with biobanking in seven waves covering 15 years of data collection. Using these rich resources, it has been shown that about one-third of all depressed patients illustrates an immunometabolic depression profile, where atypical, energy-related symptoms (fatigue, hypersomnia, weight increase, leaden paralysis) are predominant and co-occur with higher (genetic vulnerabilities for) immunometabolic dysregulations. The other two-thirds of all depressed patients can be characterized by a more typical depression profile, with e.g. melancholia, and pathophysiology that is more characterized by HPA-axis dysregulations, adverse life events and a genetic vulnerability that is more overlapping with e.g. schizophrenia. Penninx's work illustrates that genomics in combination with other detailed phenotyping contributes to further disentangle the heterogeneity of mental disorders, paving the way towards personalized medicine.

Efficacy and Safety of Transcranial Direct Current Stimulation as an Add-On Trial Treatment for Acute Bipolar Depression Patients With Suicidal Ideation.

Bipolar depression poses an overwhelming suicide risk. We aimed to examine the efficacy and safety of transcranial direct current stimulation (tDCS) combined with quetiapine in bipolar patients as a suicidal intervention. In a single-center, double-blind, treatment-naive bipolar depression patients with suicidal ideation were randomly assigned to quetiapine in combination with either active (n = 16) or sham (n = 15) tDCS over the left dorsolateral prefrontal cortex for three consecutive weeks. The 30-min, 2-mA tDCS was conducted twice a day on the weekday of the first week and then once a day on the weekdays of the two following weeks. Primary efficacy outcome measure was the change in the Beck Scale for Suicidal Ideation (BSSI). Secondary outcomes included changes on the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Outcome was evaluated on Day 3 and weekend. Safety outcome was based on the reported adverse reactions. Active tDCS was superior to sham tDCS on the BSSI at Day 3 and tended to sustain every weekend during the treatment process, compared to baseline. However, no difference between active and sham in HDRS-17 and MADRS was found. Response and remission rate also supported the antisuicide effect of tDCS, with higher response and remission rate in BSSI, but no antidepressant effect, compared to sham, over time. Regarding safety, active tDCS was well tolerated and all the adverse reactions reported were mild and limited to transient scalp discomfort. The tDCS was effective as an antisuicide treatment for acute bipolar depression patients with suicidal ideation, with minimal side effects reported.

A preliminary comparison of the clinical efficacy of repetitive transcranial magnetic stimulation with facial feature point localization and navigated localization in the treatment of depression

ObjectiveTo compare the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) under facial feature point localization (FFP) localization versus neuro-navigated localization for depression. Methods42 depressed patients were randomly assigned to two groups, received 10 Hz rTMS twice daily for 10 consecutive days. Relevant symptom scale assessments were conducted by professionals at baseline, after 10 sessions, and at the end of treatment. The confidence interval was calculated at a 95 % confidence level. The significant level was set at p < 0.05. ResultsThe absolute change in HAMD total score from baseline to the end of therapy did not differ significantly between the groups. The generalized estimating equation showed the main effect of time was significant, which showed improvement of depressive symptoms in patients throughout treatment. Upon completion of the treatment, FFP group showed a response rate of 64.7 % and a remission rate of 29.4 %, whereas the navigated group exhibited a response rate of 61.1 % and a remission rate of 44.4 %. There was no serious adverse events occurred during the treatment process. Throughout the study, no intervention was made on the normal medication treatment, and some patients had concomitant antidepressants and benzodiazepines. ConclusionThere was no significant difference in clinical efficacy between FFP localization and navigation localization in the small-sample study. However, due to the limited sample size and lack of rigorous non-inferiority testing, the superiority of one over the other remains uncertain, necessitating rigorous experimental design to validate the efficacy difference between the two localization methods.

Depressive self-focus bias following failure: an eye-tracking study among individuals with clinical depression.

Depression is often characterized by a persistent sense of failure. Cognitive theories of depression suggest that depressed individuals may exhibit a maladaptive cognitive style, characterized by increased self-focus following personal failure. The validity of this proposition, however, is yet to be fully examined. This study aimed to identify the relation between symptoms in major depressive disorder and increased self-focus in failure situations. This clinical study involved a cohort of 30 patients diagnosed with and treated for depression. We used an eye-tracking paradigm to observe and analyze gaze direction - indicative of either self-focus or self-avoidance - after remembering a significant failure event. Contrary to the maladaptive cognitive style hypothesis, a majority of the depressed participants demonstrated an inclination towards self-avoidance following failure. Nevertheless, approximately 30% of the patient group - those with the highest scores of guilt, punishment, and self-blame - displayed a self-focused attentional bias post-failure. The presence of a maladaptive self-focusing style may be confined to severely depressed patients with high levels of guilt, punishment, and self-blame. These findings could have substantial clinical implications, as attention bias modification interventions could be particularly beneficial for this subgroup of patients.

May high mobility group box protein-1 be a biomarker for major depressive disorder?

High Mobility Group Box Protein-1 (HMGB1), which has proinflammatory properties, is known to be involved in psychiatric disorders as far as we know, there are only one clinical studies investigating the role of HMGB1 in major depressive disorder (MDD). In this study, we aimed to investigate the role of HMGB1 in the etiopathogenesis of MDD and whether HMGB1 can be used as a biomarker in MDD by measuring the serum HMGB1 levels of depressed patients in the episode and remission periods. This study included 30 patients diagnosed with MDD in episode, 30 patients in remission and 30 healthy controls. Each group comprised 20 female and 10 male participants. In this study, serum HMGB1 levels were found to be lower in the patient group in the episode compared to the patient group in the remission period and the healthy control group. There was no significant difference between the patient group in remission and the healthy control group in terms of serum HMGB1 levels. The fact that serum HMGB1 levels were lower in the patient group in the episode compared to the patient group in the remission period and the control group may be related to the neuroprotective effects of HMGB1. HMGB1 may be used as a biomarker for MDD.

Discontinuation of Therapeutic Intervention among Depressive Patients: A Phenomenological Study

Discontinuation of Therapeutic Intervention among Depressive Patients: A Phenomenological Study

Effect of slow breathing exercise on heart rate variability: A non linear analysis in female major depressive disorder patients

Background: Major depressive disorder (MDD) is a mental health problem, associated with cardiac autonomic dysfunction. Cardiac autonomic function (CANF) can be assessed by non linear analysis of heart rate variability (HRV), a simple non-invasive software based analytical method. Yoga based slow breathing exercise (SBE) has role to improve autonomic dysfunction in some disease condition. Objective: To observe the effect of SBE on non linear measures of HRV in newly diagnosed female MDD patients. Methods: The quasi-experimental study was conducted in 2023 on sixty (60) newly diagnosed female MDD patients of 20-40 years aged, collected from the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU). Among them 30 were assigned with SBE and remaining 30 patients without SBE were followed up after 90 days. Both patient groups received conventional treatment during this period. Thirty apparently healthy female subjects with similar age &amp; BMI were included as control for comparison and they did not perform breathing exercise. Data were taken at baseline and after 90 days in all the subjects. CANF was assessed by analysing non linear (poincare plot) of HRV by using ECG based data acquisition device, Power lab 8/35. Data were expressed as mean±SD. For statistical analysis, ANOVA followed by post hoc Bonferroni test and paired sample “t” test were used. Results: At baseline pulse rate and BP were significantly lower in both group of MDD patients compared to control. The pre-intervention values of standard deviation of short term RR interval variability (SD1), standard deviation of long term RR interval variability (SD2) and ratio of short term and long term RR interval variability (SD1/SD2) were found significantly (p&lt; 0.001) lower in MDD patients compared to healthy control. Following 90 days of SBE, significant (p&lt; 0.001, p&lt; 0.05) rise of these poincare plot parameters was noted in MDD patients whereas no significant changes of these parameters were observed in patients without SBE after 90 days of follow-up. Moreover, the pulse BP almost reached control level though the non linear parameters were still below control level after 3 months of SBE.. Conclusion: Autonomic dysfunction occured in MDD patients SBE can improve cardiac autonomic dysfunction and sympathovagal balance in female MDD patients. J Bangladesh Soc Physiol 2023;18(2): 45-52

Brain electrical activity in female Major Depressive Disorder patients

Background: Quantitative EEG provides insight to the brain activity associated with depressive illness. Frontal asymmetry and changes of slow wave frequencies brain activity have been found as the characteristic features of Major Depressive Disorder (MDD). Objective: To assess the brain activity by power spectral analysis of EEG in female patients with MDD. Methods: This observational study was carried on 20 female MDD patients (age 20-40 years) enrolled from the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka. Twenty (20) healthy volunteers of the same age were considered the control group. For the study, EEG was recorded for 3 minutes in eye closed position by EEG data acquisition device, EEG Traveler BrainTech 32+ CMEEG-01, India. Power spectral analysis of EEG data was done by BT40 analysis software. For statistical analysis, the Mann-Whitney U test was done. Results: Significantly higher Absolute power of delta and theta brain wave, and lower alpha and beta brain wave activity was observed in female MDD patients compared to control in all most all electrodes in all cortical regions. Conclusion: MDD patients showed low excitable brain state and characteristic feature of high slow frequency wave and low fast frequency wave in MDD which can be diagnosed by quantitative EEG analysis. J Bangladesh Soc Physiol 2023;18(2): 53-62

Prevalence of Antidepressant Prescriptions for Community-Dwelling Adults Diagnosed with Depressive Disorder in the UK: A Systematic Review.

The UK National Institute for Health and Care Excellence (NICE) guidance for the treatment of depression is widely followed and has international influence. According to these guidelines, antidepressant medications are recommended for moderate to severe depression. Nonetheless, antidepressants are increasingly prescribed, including for cases of subthreshold and mild depression. This may indicate that a proportion of depressed patients uses pharmacological interventions with unclear evidence-base, though other factors such as physical and mental health comorbidities need to be accounted for. This study aims to investigate the prevalence and trends of antidepressant prescriptions among community-dwelling adults diagnosed with depression according to NICE recommendations. We conducted a systematic review of PsycInfo, PubMed/MEDLINE, and Scopus databases. Observational studies reporting on the prevalence of antidepressant treatments in UK adults diagnosed with depression were sought. Fifteen studies were included. The prevalence of antidepressants for depression treatment ranged from 30.8 to 95% and mainly concerned selective serotonin reuptake inhibitors (SSRIs) among classes of antidepressant drugs. Little information about depression severity as well as comorbid conditions was reported. High prevalence rates of antidepressant drug use highlight the widespread adoption of pharmacological interventions, while also raising concerns about compliance with NICE guidelines. Careful assessment of depressive illness severity and comorbidities is needed to ensure the delivery of adequate care to people with depression. Systematic Review Registration Number (PROSPERO) CRD42023448152.