Depressed Patients Research Articles

Are BDNF and Stress Levels Related to Antidepressant Response?

A total of 40 depressed adults were included. We evaluated initial serum BDNF, anxiety through the State-Trait Anxiety Inventory (STAI), and the severity of depressive symptoms by the Hamilton Depression Rating Scale (HDRS). Participants received antidepressant treatment for 8 weeks, and response to treatment was evaluated according to the final HDRS scores. Basal BDNF was higher in responders compared to non-responder depressed patients, in addition to being inversely associated with the severity of anxiety and depression. Baseline BDNF serum is an adequate predictive factor for response to antidepressant treatment with SSRI, with lower pre-treatment levels of BDNF associated with higher anxiety symptoms after treatment. Stress levels could influence the response to treatment, but its association was not conclusive.

Opioids Diminish the Placebo Antidepressant Response: A Post Hoc Analysis of a Randomized Controlled Ketamine Trial.

The endogenous opioid system is thought to play a role in the placebo antidepressant response. A recent trial comparing the rapid antidepressant effects of ketamine versus placebo in surgical patients, some of whom were on chronic opioid therapy, revealed a substantial placebo effect. This finding provided an opportunity to test the hypothesis that opioid agonist exposure interacts with placebo antidepressant responses. This post hoc analysis utilized data from a previously reported randomized, anesthesia-blinded, placebo-controlled trial of intravenous ketamine in depressed patients undergoing routine surgery. Mixed-effects models were used to determine whether baseline opioid use influenced antidepressant responses to the trial interventions, as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) over 1 to 14 days post-treatment. The analysis showed that baseline opioid use significantly reduced post-treatment depression severity in patients who received placebo, but not in those who received ketamine. This reduction was independent of baseline depression severity, baseline pain intensity, and ethnicity. Additionally, there was negligible correlation between postoperative pain intensity and depression severity. This analysis was unregistered and conducted on a small sample; the findings need to be confirmed by prospective controlled studies. Opioid use at baseline attenuated the placebo antidepressant response independently of pain in depressed patients who received the study treatment under general anesthesia for routine surgery. The antidepressant response was preserved in opioid users who received intravenous ketamine.

Seasonality in mood disorders: Probing association of accelerometer-derived physical activity with daylength and solar insolation

Mood disorders are the leading cause of disability worldwide. Up to 30 percent of individuals with major depressive disorder (MDD) and bipolar disorder (BD) display a seasonal pattern of onset, a phenomenon now recognized in the official diagnostic manuals (DSM-5 and ICD-11). Very little is known about the influence of day length (photoperiod) and sunlight intensity (solar insolation) on seasonal patterns in MDD and BD. Here we report a quantitative approach to examine the relationship between sunlight measures and objectively measured motor activity patterns to understand environmental factors driving seasonality in MDD and BD. Our generalized linear model (GLM) assessment of the Depresjon dataset, which includes short-term (up to two weeks) motor activity recordings of 23 unipolar and bipolar depressed patients and 32 healthy controls recruited to the study at the University of Bergen Norway (60.4° N latitude, 5.3° E longitude), revealed significant association of accelerometer-derived daytime physical activity with participant’s depressed state (p<0.001), photoperiod (p<0.001), and solar insolation (p<0.001). Our study presents a generalizable strategy to decipher the complex interplay between sunlight, physical activity, and depressed state using open-source digital tools. The ability to identify mood disturbances, particularly in seasonally susceptible individuals, using passive digital biomarker data offers great promise in informing next-generation predictive, personalized diagnostics in mental health.

Effects of acupuncture combined with five-element music for people with mild/moderate post-stroke depression: A randomized controlled trial

ObjectivesTo evaluate the efficacy and safety of acupuncture combined with five-element music (FEM) as an therapeutic strategy for the physical and mental state of Post-stroke depression patients. Design and settingMulticenter, randomized clinical trial conducted at 3 hospitals in China and enrolling 237 patients with PSD between June 2019 and April 2021. Participants mild/moderate PSD (17-item GRID Hamilton Depression Scale (HAMD) score 7–24) were randomly assigned (1:1) to acupuncture combined with FEM (AFEM) group or cognitive behavioral therapy (CBT) group. Main outcome measuresThe primary outcome was change and differences between the groups in HAMD-17 from baseline to week 12. Secondary outcomes included Fugl-Meyer Assessment Scale score and Stroke-Specific Quality of Life Scale (SS-QOL) score. ResultsThe 237 patients in this intention-to-treat analysis were randomized into either the AFEM group (n=119) or the cognitive behavioral therapy (CBT) group (n=118). Of these 237 participants, 225 (94.9 %) completed all outcome measurements at week 12. The AFEM and CBT groups both showed significant improvement in HAMD-17 from baseline to week 12. Patients in the AFEM group had significantly lower HAMD-17 scores of −3.56 at week 8 (95 % CI,-4.59 to −2.53; p <.001) and −3.50 at week 12 (95 % CI,-4.53 to −2.46; p<.001) than patients in the CBT group. The SS-QOL score improved significantly at week 12. The Fugl-Meyer score was significantly lower in the AFEM group than in the CBT group at week 4, but this difference was not statistically significant upon follow-up at weeks 8 and 12. The incidence of treatment-related adverse events was 2.1 % in the AFEM group, with no serious adverse events reported. ConclusionsThe results suggest that acupuncture and five-element music significantly improve the depressive symptoms in this cohort of Chinese PSD patients, and the toxicities were similar with CBP group. RegistrationThis study registered with the ClinicalTrials.gov Identifier: ChiCTR1900023741.

“A Study To Assess The Effectiveness Of Music Therapy On Depression Among Depressive Patients In Selected Community Areas”

“A Study To Assess The Effectiveness Of Music Therapy On Depression Among Depressive Patients In Selected Community Areas”

A Retrospective Study of Pattern of Abnormal Findings in Routine Screening Investigations Done of Psychiatry Inpatients in Tertiary Care Teaching Hospital

Abstract Introduction: Physical comorbidity in persons with mental illness is a rule rather than exception. Hence, regular screening investigations in psychiatry inpatients help to detect physical illness at early stage. Aims and Objectives: The aim of this study was to evaluate the results of various screening investigations, referral patterns, and physical comorbidities in psychiatric inpatient records. Methodology: This was a descriptive, analytical, record-based study conducted in the psychiatry department of a tertiary care teaching hospital, wherein case notes of all inpatients admitted to the psychiatry unit during 6 months (January–June 2023) were studied. Inpatient records were evaluated for sociodemographic details, indication for admission, investigations as needed, any physical comorbidity, treatment history, referral patterns, and their outcomes. Records with incomplete details and known physical illnesses mentioned were excluded. Results: Total 100 patients’ records (63 males; mean age = 35 years, 37 females; mean age = 41 years) were included in the study. The common diagnosis was mood disorder 36% (n = 36), followed by substance use disorder 30% (n = 30) and schizophrenia 22% (n = 22). On evaluating investigations, abnormalities found were anemia, diabetes mellitus, hypertension, and thyroid disease (42% [n = 42/100], 24% [n = 24/100], 22% [n = 22/100], and 22% [n = 22/100], respectively). Magnetic resonance imaging (MRI) brain changes were seen in 75% of patients with acute behavior disturbances (n = 4) and MRI spine changes in all major depressive disorder patients presented with backache (n = 4). Ultrasonography abdomen findings were abnormal in 68% (n = 26/38), of which 80% (n = 21/26) had substance use disorder. For the management of abnormal findings, the referral consultation rate was 76% (n = 76/100); 86% (n = 66/76) of patients required more than one consultation with total 154 referrals. Conclusions: The investigations as indicated help in early detection and management of physical illness which mostly remains out of sight due to psychiatry illness.

Phase angle as an indicator of depression in maintenance hemodialysis patients

Introduction: Depression is a common psychiatric problem in maintenance hemodialysis (MHD) patients. Recent studies have begun to explore the relationship between body composition and depression. Phase angle (PhA), a core parameter for assessing body composition, has been observed to be associated with frailty and cognitive dysfunction. The aim of this study was to investigate the association between PhA and depression in MHD patients. Methods: This multicenter, cross-sectional study included 843 MHD patients from seven dialysis centers in Shanghai, China. Depressive symptoms were evaluated using the Patient Health Questionnaire (PHQ-9), with a score of ≥10 indicating depression. PhA was measured by bioelectrical impedance analysis. Nutritional status was assessed by Malnutrition inflammation score (MIS) . Multivariable logistic regression models were used to investigate the association between PhA and depression. Restricted cubic spline (RCS) analysis was utilized to examine the association. Receiver operating characteristic (ROC) curve was used to identify the cut-off value of PhA for depression. Results: 15.2% of patients (62.8% male, median age 66 years) had depression. Median PhA level (interquartile range, IQR) of depressed patients was 4.4° (3.9-4.9°) for males and 3.9° (3.2-4.7°) for females. There was a significant decrease in the prevalence of depression with increasing quartiles of PhA levels. In multivariable logistic regression analyses, after adjusting for age, sex, education level, spkt/v, dialysis vintage, Charlson comorbidity index, hemoglobin and serum albumin, lower PhA levels (lowest quartile group) were significantly associated with depressive symptoms (adjusted odds ratio, 2.19; 95% confidence interval, 1.07 to 4.48), compared to higher PhA levels (highest quartile group). RCS analysis showed a relatively inverse linear association between PhA and depression. The optimal cut-off value of PhA for depression was 4.9° for males and 3.5° for females. Subgroup analyses validated the findings across patient characteristics, including age, sex, diabetes, education and malnutrition. Conclusion: Our findings indicated an inverse association between PhA and depressive symptoms in Chinese MHD patients, suggesting that PhA could serve as a valuable indicator for assessing the risk of depression in this population. Further studies are needed to explore the potential of PhA as a prognostic tool and its implications for intervention strategies.

Incidence and Risk of Depressive Disorder in Patients With Retinitis Pigmentosa

There is a lack of large-scale clinical studies exploring mental health among patients with retinitis pigmentosa (RP). Additionally, few studies have evaluated the associations of visual impairment with mental health in young patients. To investigate the association between depressive disorder and RP. This was a retrospective, nationwide, population-based cohort study using data obtained from the Health Insurance Review and Assessment service in Korea between 2008 and 2022. A total of 10 879 individuals who were newly diagnosed with RP between January 2011 and December 2021, as verified by both the RP registration code (National Registry of Rare and Intractable Disease in Korea code V209) and diagnostic code (International Statistical Classification of Diseases, 10th Revision code H35.51), were included. Data analysis was performed from October 2023 to January 2024. Diagnosis of RP. Participants were categorized into 3 groups based on age at diagnosis (<20, 20-39, and ≥40 years). The incidence of depressive disorder in RP was determined after excluding those diagnosed with depressive disorder prior to RP diagnosis. Age- and sex-adjusted standardized incidence ratios (SIRs) of depressive disorder in patients with RP compared with the general population were calculated. Subgroup analyses by sex and age group were conducted. A total of 10 879 patients (638 aged <20 years, 2233 aged 20-39 years, and 8008 aged ≥40 years; 5710 [52.5%] female) newly diagnosed with RP between 2011 and 2021 were included. The 10-year cumulative incidence of depressive disorder was 17.67% (95% CI, 16.57%-18.84%) in patients with RP. Subgroup analysis showed higher incidence of depressive disorder in female patients (hazard ratio [HR], 1.46; 95% CI, 1.29-1.65; P < .001) and those aged 40 years or older (HR, 1.93; 95% CI, 1.63-2.29; P < .001). The overall SIR of depressive disorder in patients with RP was 1.19 (95% CI, 1.12-1.27; P < .001), indicating a higher risk of depressive disorder compared with that in the general population. Both male and female patients with RP showed increased incidence rates of depressive disorder (17.53 [95% CI, 15.91-19.27] and 25.57 [95% CI, 23.58-27.67] per 1000 person-years, respectively) and increased SIRs of depressive disorder (1.21 [95% CI, 1.10-1.33] and 1.18 [95% CI, 1.09-1.28], respectively) (all P < .001) compared with the general population. Subgroup analysis by age group showed that the SIR peaked in patients in their 20s (1.50; 95% CI, 1.17-1.90; P = .006) and aged 60 years or older (1.25; 95% CI, 1.14-1.37; P < .001). Individuals diagnosed with RP had a higher risk of developing depressive disorder. These findings support consideration of providing emotional and social support to patients with RP.

Intron retention as an excellent marker for diagnosing depression and for discovering new potential pathways for drug intervention.

Peripheral inflammation is often associated with depressive disorders, and immunological biomarkers of depression remain a focus of investigation. We performed RNA-seq analysis of RNA transcripts of human peripheral blood mononuclear cells from a case-control study including subjects with self-reported depression in the pre-symptomatic state of major depressive disorder and analyzed differentially expressed genes (DEGs) and the frequency of intron retention (IR) using rMATS. Among the statistically significant DEGs identified, the 651 upregulated DEGs were particularly enriched in the term "bacterial infection and phagocytosis", whereas the 820 downregulated DEGs were enriched in the terms "antigen presentation" and "T-cell proliferation and maturation". We also analyzed 158 genes for which the IR was increased (IncIR) and 211 genes for which the IR was decreased (DecIR) in the depressed subjects. Although the Gene Ontology terms associated with IncIR and DecIR were very similar to those of the up- and downregulated genes, respectively, IR genes appeared to be particularly enriched in genes with sensor functions, with a preponderance of the term "ciliary assembly and function". The observation that IR genes specifically interact with innate immunity genes suggests that immune-related genes, as well as cilia-related genes, may be excellent markers of depression. Re-analysis of previously published RNA-seq data from patients with MDD showed that common IR genes, particularly our predicted immune- and cilia-related genes, are commonly detected in populations with different levels of depression, providing validity for using IR to detect depression. Depression was found to be associated with activation of the innate immune response and relative inactivation of T-cell signaling. The DEGs we identified reflect physiological demands that are controlled at the transcriptional level, whereas the IR results reflect a more direct mechanism for monitoring protein homeostasis. Accordingly, an alteration in IR, namely IncIR or DecIR, is a stress response, and intron-retained transcripts are sensors of the physiological state of the cytoplasm. The results demonstrate the potential of relative IR as a biomarker for the immunological stratification of depressed patients and the utility of IR for the discovery of novel pathways involved in recovery from depression.

Remission and follow-up of a bipolar depression patient treated with Accelerated Intermittent Theta Burst Stimulation protocol.

No abstract available.

Disrupted basolateral amygdala circuits supports negative valence bias in depressive states

Negative bias is an essential characteristic of depressive episodes leading patients to attribute more negative valence to environmental cues. This negative bias affects all levels of information processing including emotional response, attention and memory, leading to the development and maintenance of depressive symptoms. In this context, pleasant stimuli become less attractive and unpleasant ones more aversive, yet the related neural circuits underlying this bias remain largely unknown. By studying a mice model for depression chronically receiving corticosterone (CORT), we showed a negative bias in valence attribution to olfactory stimuli that responds to antidepressant drug. This result paralleled the alterations in odor value assignment we observed in bipolar depressed patients. Given the crucial role of amygdala in valence coding and its strong link with depression, we hypothesized that basolateral amygdala (BLA) circuits alterations might support negative shift associated with depressive states. Contrary to humans, where limits in spatial resolution of imaging tools impair easy amygdala segmentation, recently unravelled specific BLA circuits implicated in negative and positive valence attribution could be studied in mice. Combining CTB and rabies-based tracing with ex vivo measurements of neuronal activity, we demonstrated that negative valence bias is supported by disrupted activity of specific BLA circuits during depressive states. Chronic CORT administration induced decreased recruitment of BLA-to-NAc neurons preferentially involved in positive valence encoding, while increasing recruitment of BLA-to-CeA neurons preferentially involved in negative valence encoding. Importantly, this dysfunction was dampened by chemogenetic hyperactivation of BLA-to-NAc neurons. Moreover, altered BLA activity correlated with durable presynaptic connectivity changes coming from the paraventricular nucleus of the thalamus, recently demonstrated as orchestrating valence assignment in the amygdala. Together, our findings suggest that specific BLA circuits alterations might support negative bias in depressive states and provide new avenues for translational research to understand the mechanisms underlying depression and treatment efficacy.

Disrupted functional connectivity of bilateral nucleus accumbens in major depressive disorder with and without melancholic features.

Our study aims to explore the differences in functional connectivity in the nucleus accumbens (NAc) between patients with melancholic depression and non-melancholic depression (NMD) and their relation to melancholic depression's pathogenesis. We recruited 60 melancholic depression, 58 NMD, and 80 healthy controls, all matched for gender, age, and education. Functional connectivity analysis focused on bilateral NAc as the region of interest, comparing it with the whole brain and correlating significant differences with clinical scores. Melancholic depression patients showed reduced functional connectivity between the left NAc and anterior brain regions, and between the right NAc and temporal and frontal areas, compared to healthy controls. In contrast, NMD patients displayed reduced functional connectivity only between the left NAc and the posterior cingulate cortex. Melancholic depression patients also exhibited increased functional connectivity between the right NAc and the middle frontal gyrus, unlike NMD patients. The findings suggest that melancholic depression patients exhibit unique NAc functional connectivity patterns, particularly with the default mode network and prefrontal areas, suggesting atypical reward-circuitry interactions. The right NAc's connection to the prefrontal gyrus may distinguish melancholic depression from NMD.

The relationship between chronotype and treatment time of day on post-treatment depression symptom severity for depressed patients receiving cognitive behavioural therapy

BackgroundMajor depressive disorder (MDD) represents a serious public health problem that affects a quarter billion individuals worldwide. Consequently, there is a need to identify modifiable factors of services that support treatment success. The relationship between circadian preferences (i.e., chronotype), treatment time of day, and outcomes is an understudied research area. Executing optimal treatment timing based on these factors could lead to substantial returns on a modifiable variable. MethodThe present study evaluated the associations between chronotype and treatment time of day on post-treatment depression symptom severity. In a tertiary setting, outpatients with MDD (n = 227) received 14 sessions of cognitive behavioural therapy in a group format, at one of three time of days: morning, afternoon, or evening. Participants completed measures of depression and chronotype at baseline and post-treatment. ResultStatistically significant increases in morningness were found for the afternoon and evening groups, but not the morning group. There was no significant interaction effect between pre-treatment morningness-eveningness scores and treatment time of day on post-treatment depression scores nor treatment response. However, there was a significant interaction effect of change in morningness-eveningness scores and post-treatment depression severity in the afternoon group. LimitationsThe lack of a control group limits conclusions drawn. ConclusionThe results suggest that individual circadian phase may impact treatment outcomes in relation to time of day. Further intentionally designed research is warranted to improve understanding of predictors, moderators, and mediators of patient outcomes based on treatment time of day and circadian phase and amplitude.

A randomized proof-of-mechanism trial of TNF antagonism for motivational deficits and related corticostriatal circuitry in depressed patients with high inflammation.

Chronic, low-grade inflammation has been associated with motivational deficits in patients with major depression (MD). In turn, impaired motivation has been linked to poor quality of life across psychiatric disorders. We thus determined effects of the anti-inflammatory drug infliximab-a potent tumor necrosis factor (TNF) antagonist-on behavioral and neural measures of motivation in 42 medically stable, unmedicated MD patients with a C-reactive protein >3 mg/L. All patients underwent a double-blind, placebo-controlled, single-dose, randomized clinical trial with infliximab (5 mg/kg) versus placebo. Behavioral performance on an effort-based decision-making task, self-report questionnaires, and neural responses during event-related functional magnetic resonance imaging were assessed at baseline and 2 weeks following infusion. We found that relative to placebo, patients receiving infliximab were more willing to expend effort for rewards. Moreover, increase in effortful choices was associated with reduced TNF signaling as indexed by decreased soluble TNF receptor type 2 (sTNFR2). Changes in effort-based decision-making and sTNFR2 were also associated with changes in task-related activity in a network of brain areas, including dorsomedial prefrontal cortex (dmPFC), ventral striatum, and putamen, as well as the functional connectivity between these regions. Changes in sTNFR2 also mediated the relationships between drug condition and behavioral and neuroimaging measures. Finally, changes in self-reported anhedonia symptoms and effort-discounting behavior were associated with greater responses of an independently validated whole-brain predictive model (aka "neural signature") sensitive to monetary rewards. Taken together, these data support the use of anti-inflammatory treatment to improve effort-based decision-making and associated brain circuitry in depressed patients with high inflammation.

Personalized therapy and its side effects in patients with multiple sclerosis with depressive disorders

Depressive disorders in multiple sclerosis are the leading syndrome, but they have not been sufficiently studied. The clinical recommendations contain only a list of medications that were previously prescribed to patients with depression. To date, there is no description of the preferred groups of drugs for the treatment of depressive disorders, the starting dosage and timing of use, as well as possible adverse reactions when prescribing therapy to multiple sclerosis patients with depression. The purpose of this study is to search for optimal therapy for the relief of depressive disorders in patients with multiple sclerosis. Patients and methods: The study involved 203 patients with a confirmed diagnosis of multiple sclerosis (MS). The age of the patients at the time of examination ranged from 15 to 60 years, with the mean age of 39.7±10.91 years. Taking into account the type of course of the disease, MS patients were distributed as follows: 179 patients with relapsing remitting multiple sclerosis (RRMS) and 24 patients with secondary progressive multiple sclerosis (SPMS). The mean age of the examined patients with RRMS was 38±10 years; the duration of the disease was on average 8.23±6.57. The mean age of the onset of the disease was 30.2±10.5. The average disability index was EDSS 2.30±1.40. The age of the examined patients with SPMS was 46±9.00 years. The average age of onset of the disease was 33.33±8.02 years, and the level of disability was EDSS 5.70±0.30. All participants received multiple sclerosis disease modifying drugs (DMDs) and signed informed consent before being included in the study. The Beck's Depression Inventory was used to identify depression. The diagnosis of depressive disorder was established in accordance with the criteria of ICD-10 by a psychiatrist. Results and discussion: The choice of an antidepressant was made taking into account the type and degree of depression. Preference was given to the group of selective serotonin reuptake inhibitors (SSRIs), since MS patients poorly tolerate drugs with a strong sedative effect. Escitalopram was more often prescribed for anxiety depression, agomelatine for melancholic and hypochondriac depression, sertraline for asthenic depression, and fluvoxamine for adynamic depression. The starting dosage of the antidepressant in MS patients was almost twice as different from the dosage in the clinical recommendations for the treatment of depressive disorder. Due to the severity of neurological disorders, in a number of MS patients with the introduction of the starting dosage of an antidepressant, signs of sensitive ataxia, increased anxiety, and headaches were noted, therefore, the administration of an antidepressant was performed with slow titration. The association of side effects with periventricular foci in the frontal and parietal lobes of the brain has been revealed, which must be taken into account when prescribing therapy. Conclusion: Starting from the period of diagnosis of multiple sclerosis, patients need to be diagnosed for affective disorders, and risk factors that can cause depression need to be identified. When prescribing antidepressant therapy, it is necessary to take into account the type of depressive disorder, as well as the dosage of the drug, in order to exclude undesirable side effects.

Dynamics of following and leading: association of movement synchrony and depression severity.

Depression negatively affects interpersonal functioning and influences nonverbal behavior. Interpersonal theories of depression suggest that depressed individuals engage in behaviors that initially provoke others' support and reassurance, but eventually lead to rejection that may also be expressed nonverbally. This study investigated movement synchrony as a nonverbal indicator of support and rejection and its association with depression severity in a sample of depressed and healthy individuals. Semi-standardized diagnostic interview segments with N = 114 dyads were video recorded. Body movement was analyzed using Motion Energy Analysis, synchrony intervals were identified by computing windowed cross-lagged correlation and a peak-picking-algorithm. Depression severity was assessed via both self-rating (BDI-II) and clinician rating (HAMD). Both self-rated and clinician-rated depression severity were negatively correlated with patient-led, but not clinician-led movement synchrony measures. The more depressed patients were, the less they initiated movement synchrony with their clinicians. These correlations remained significant after controlling for gender, age, gross body movement, and psychopharmacological medication. Findings suggest that depression may negatively affect patients' active initiative in interaction situations. Automatized methods as used in this study can add valuable information in the diagnosis of depression and the assessment of associated social impairments.

Study of Life Events and Quality of Life in Patients of Major Depressive Disorder

Abstract Background: Depression is one of the most common mental illnesses found across all ages, genders and socioeconomic status. It has significant health, psychosocial, and economic impact. It is worse than many chronic medical diseases and has a negative effect on quality of life which persists even after remission. Objectives: The aim of this research was to study the relationship of major depressive disorder with quality of life and stressful life events in adults. Materials and Methods: This was a cross-sectional study wherein purposive sampling method was employed. Patients from psychiatry outpatient department who fulfilled the criteria for major depressive disorder and belonging to the age range of 18–75 years were shortlisted and requested to participate in the study. After taking informed consent, data on quality of life, enjoyment and satisfaction, stressful life events and severity of depression were gathered using questionnaires and a semi structured interview. Results: Severity of depression was found to be negatively correlated with quality of life, enjoyment and satisfaction P = 0.001 level of significance. There were no significant correlations between severity of depression and stressful life events. Pearson’s Chi-square indicated that the severity of depression has a significant association with highest educational qualification, occupation, marital status, and socioeconomic status. Conclusion: Measuring and keeping track of quality of life through self-report levels is important in improving depressive disorders and should be integral part of management. Other steps comprise of starting early treatment, ensuring treatment adherence, reducing severity, and reducing relapse. Psychosocial interventions should also be taken into consideration.

Disrupted brain functional asymmetry at rest in patients with major depressive disorder associated with sleep disturbances.

Sleep disturbances (SD) are common in major depressive disorder (MDD) patients. Brain functional asymmetry is crucial for understanding MDD pathophysiology. Previous studies using the parameter of asymmetry (PAS) approach have found brain functional asymmetry disruption in MDD. However, this has not been explored in MDD patients with SD. This study examined 26 MDD patients with SD, 34 MDD patients without SD, and 34 healthy controls using resting-state functional magnetic resonance imaging scans. SD symptoms were quantified using the 17-item Hamilton Rating Scale for Depression. PAS approach was used to evaluate functional asymmetry. MDD patients with SD displayed increased PAS in the left middle frontal gyrus (MFG)/inferior frontal gyrus (IFG) and decreased PAS in the left parahippocampal gyrus (PHG) compared to MDD patients without SD. Increased PAS in the left MFG/IFG was positively correlated with SD severity, and a negative correlation was found between decreased PAS in the left PHG and SD scores in all MDD patients. Receiver operating characteristic analysis indicated that increased PAS in the left MFG/IFG and decreased PAS in the left PHG may serve as potential neuroimaging markers to differentiate MDD patients with SD from those without SD with Area Under Curve values of 0.8157 and 0.8068, respectively. These results highlighted that increased PAS in the left MFG/IFG and decreased PAS in the left PHG may be considered a prominent feature associated with SD symptoms of MDD patients, potentially serving as imaging markers to discriminate between MDD patients with and without SD.

Lysosomal TFEB-TRPML1 Axis in Astrocytes Modulates Depressive-like Behaviors.

Lysosomes are important cellular structures for human health as centers for recycling, signaling, metabolism and stress adaptation. However, the potential role of lysosomes in stress-related emotions has long been overlooked. Here, it is found that lysosomal morphology in astrocytes is altered in the medial prefrontal cortex (mPFC) of susceptible mice after chronic social defeat stress. A screen of lysosome-related genes revealed that the expression of the mucolipin 1 gene (Mcoln1; protein: mucolipin TRP channel 1) is decreased in susceptible mice and depressed patients. Astrocyte-specific knockout of mucolipin TRP channel 1 (TRPML1) induced depressive-like behaviors by inhibiting lysosomal exocytosis-mediated adenosine 5'-triphosphate (ATP) release. Furthermore, this stress response of astrocytic lysosomes is mediated by the transcription factor EB (TFEB), and overexpression of TRPML1 rescued depressive-like behaviors induced by astrocyte-specific knockout of TFEB. Collectively, these findings reveal a lysosomal stress-sensing signaling pathway contributing to the development of depression and identify the lysosome as a potential target organelle for antidepressants.

B - 62 Cognitive Training Targeting Reward Responsiveness Promotes more Efficient Affective Processing in an Interference Go/NoGo Task

Abstract Objective Abnormalities in emotional processing are commonly seen in depression and anxiety, disorders also associated with decreased reward sensitivity i.e., anhedonia. We tested a noninvasive, cognitive training program aimed at boosting reward responsiveness and gaged if it may also improve affective processing efficiency. Methods Individuals (N = 50; 54% Female; 18–65 yo) with low hedonic tone (Positive and Negative Affect Scale/PANAS score &amp;lt; 25) and diagnostic levels of depression and/or anxiety (Patient Health Questionnaire-8/PHQ-8 or General Anxiety Disorder-7/GAD-7 score ≥ 10) who responded to community-posted flyers completed an affective go/no-go (AGN) task before and after completing an exploratory reward learning task, i.e., a multi-arm bandit (MAB). Participants were randomly assigned to a high-reward MAB training with either high variance (HV) or low variance (LV) in reward rates, HV being expected to boost reward maximization. In the AGN, participants saw negative and positive pictures and had to respond as fast as possible to pictures of a given target category (positive or negative). Results Following the HV vs LV training MAB, participants were more accurate (higher likelihood of hits), which was more evident in negative target blocks relative to positive target blocks (odds ratio/OR:0.61, 95% CI = [0.38,0.98]; z = −2.045, p = 0.041). Participants exhibited stronger decreases in hits response times following the HV vs LV training MAB, but across all target blocks (B:-37 ms, 95% CI = [−56,-18]; t = −3.806, p &amp;lt; 0.001). Conclusions A novel cognitive training program aimed at boosting reward sensitivity may help improve patients’ processing of emotionally taxing stimuli. Targeting reward sensitivity is a critical component of improving clinical outcomes in depressed and anxious patients..