Previous Depressive Episodes Research Articles

Anhedonia is associated with a specific depression profile and poor antidepressant response.

Anhedonic features within major depressive disorder (MDD) have been associated with worse course and outcome and may predict non-response to treatment. However a detailed clinical profile of anhedonia in MDD is still lacking. One thousand two hundred ninety-four patients with MDD were selected from the cross-sectional European multicenter Group for the Study of Resistant Depression (GSRD) study. Anhedonia was assessed through the Montgomery-Åsberg Depression Rating Scale anhedonia item "inability to feel". Clinical and demographic features were then analyzed. The presence of anhedonia related to a distinct demographical (living alone) and clinical profile (thyroid diseases, diabetes, suicide risk, high number of previous depressive episodes, more severe MDD and more frequent inpatients status). Furthermore, anhedonia was associated with non-response to treatment and treatment resistance, even after adjusting for confounding variables. Our findings support the role of anhedonia as a modulating feature of MDD, being associated with a more severe depression profile. Moreover, anhedonic features are independent predictors of poor treatment response.

Examining what works for whom and how in mindfulness-based cognitive therapy (MBCT) for recurrent depression: moderated-mediation analysis in the PREVENT trial.

Personalised management of recurrent depression, considering individual patient characteristics, is crucial. This study evaluates the potentially different mediating role of mindfulness skills in managing recurrent depression using mindfulness-based cognitive therapy (MBCT) among people with varying depression severity. Data from the Prevention of Depressive Relapse or Recurrence (PREVENT) trial, comparing MBCT (with antidepressant medication (ADM) tapering support, MBCT-tapering support) versus maintenance-ADM, were used. The study included pre, post, 9-, 12-, 18- and 24-month follow-ups. Adults with ≥3 previous major depressive episodes, in full/partial remission (below threshold for a current episode), on ADM, were assessed for eligibility in primary care practices in the UK. People were randomised (1:1) to MBCT-tapering support or maintenance-ADM. We used the Beck Depression Inventory-II to evaluate depressive symptom changes over the six time points. Pre-post treatment, we employed the Five Facets of Mindfulness Questionnaire to gauge mindfulness skills. Baseline symptom and history variables were used to identify individuals with varying severity profiles. We conducted Latent Profile Moderated-Mediation Growth Mixture Models. A total of 424 people (mean (s.d.) age = 49.44 (12.31) years; with 325 (76.7%) self-identified as female) were included. A mediating effect of mindfulness skills, between trial arm allocation and the linear rate of depressive symptoms change over 24 months, moderated by depression severity, was observed (moderated-mediation index = -0.27, 95% CI = -0.66, -0.03). Conditional indirect effects were -0.42 (95% CI = -0.78, -0.18) for higher severity (expected mean BDI-II reduction = 10 points), and -0.15 (95% CI = -0.35, -0.02) for lower severity (expected mean BDI-II reduction = 3.5 points). Mindfulness skills constitute a unique mechanism driving change in MBCT (versus maintenance-ADM). Individuals with higher depression severity may benefit most from MBCT-tapering support for residual symptoms. It is unclear if these effects apply to those with a current depressive episode. Future research should investigate individuals who are not on medication. This study provides preliminary evidence for personalised management of recurrent depression. ISRCTN26666654.

Brainstem raphe hypoechogenicity is an independent predictor of post-stroke depression.

Post-stroke depression (PSD) is a common complication after stroke and has a substantial effect on the quality of life of patients. Nevertheless, reliable individual prediction of PSD is not possible. As depressive symptoms have been associated with brainstem raphe (BR) hypoechogenicity on transcranial sonography (TCS), we aimed to explore the association of BR hypoechogenicity and the occurrence of PSD. The Prognostic Markers of Post-Stroke Depression (PROMoSD) study is a prospective, observational, single-center, investigator-initiated study that included patients with acute ischemic stroke (AIS) to investigate the presence of BR hypoechogenicity by TCS early after symptom onset. The primary outcome was the presence of PSD assessed at the three-month follow-up investigation by a blinded psychiatrist and defined according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V criteria). From 105 included AIS patients, 99 patients completed the study. AIS patients with a hypoechogenic BR developed a PSD at three months more frequently compared to patients with normal echogenicity (48.0% versus 4.1%, P <0.001). After adjustment for confounders (sex, mRS at follow-up, previous depressive episode), a hypoechogenic BR remained independently associated with a substantial increase in the appearance of PSD (adjusted OR: 6.371, 95%-CI: 1.181-34.362). A hypoechogenic BR is a strong and independent predictor of PSD at three months after AIS. TCS could be a routine tool to assess PSD risk in clinical practice, thereby streamlining diagnostic and therapeutic algorithms.

A machine learning model to predict the risk of perinatal depression: Psychosocial and sleep-related factors in the Life-ON study cohort

Perinatal depression (PND) is a common complication of pregnancy associated with serious health consequences for both mothers and their babies. Identifying risk factors for PND is key to early detect women at increased risk of developing this condition. We applied a machine learning (ML) approach to data from a multicenter cohort study on sleep and mood changes during the perinatal period (“Life-ON”) to derive models for PND risk prediction in a cross-validation setting. A wide range of sociodemographic variables, blood-based biomarkers, sleep, medical, and psychological data collected from 439 pregnant women, as well as polysomnographic parameters recorded from 353 women, were considered for model building. These covariates were correlated with the risk of future depression, as assessed by regularly administering the Edinburgh Postnatal Depression Scale across the perinatal period. The ML model indicated the mood status of pregnant women in the first trimester, previous depressive episodes and marital status, as the most important predictors of PND. Sleep quality, insomnia symptoms, age, previous miscarriages, and stressful life events also added to the model performance. Besides other predictors, sleep changes during early pregnancy should therefore assessed to identify women at higher risk of PND and support them with appropriate therapeutic strategies.

Relationship between sense of coherence and depression, a network analysis

The “sense of coherence” incorporates the notion that when life seems comprehensive, manageable, and meaningful for an individual, even under tremendous adversity, this accounts for stamina and confidence. Its absence is associated with mental health problems, including depression. The current analysis aimed to explore the relationship between the sense of coherence and depression through a network analysis approach in a sample of 181 people with depression. The mean age of the individuals in the sample was 35.59 (11.50) years, and 76.8% were females (n = 139). All participants had at least one previous depressive episode; the duration of the current episode was 30.30 (77.30) days. Sense of coherence was assessed using the 13-item Sense of Coherence Scale (SOC-13). The severity of depression was quantified with the Beck Depression Inventory (BDI-I). The correlations between the two scales, three networks (i.e., SOC-13; BDI-I and joint SOC-13/BDI-I), and their centrality indices were calculated. The mean SOC-13 was 40.56 ± 9.99, and the mean BDI-I was 49.90 ± 9.26. There was a strong correlation-concordance (− 0.65; 95% CI: − 0.72 to − 0.55) index between the two scales. We identified detailed relationship dynamics between symptoms, clusters, and domains through the novel network analysis approach. The analysis of SOC-13 nodes revealed the pivotal role of social relationships in the network. However, in the depression network, we found a role for affection (in contrast to neglect) and joy (as opposed to boredom). In conclusion, solid and sustainable personal relationships in distress and adversity stand against the burden of depression.

Treatment of Patient with Recurrent Major Depressive Disorder: A Case Report

Introduction: The alteration of biogenic amines, in particular norepinephrine and serotonin, is a hypothesis that is frequently put forward in relation to the etiology of major depressive disorder. This study was aimed to present the recurrent major depressive disorder in a forty years old woman. Case presentation: A 40-year-old woman, presented to our mental health unit with symptoms of a low mood, which she described as similar to previous episodes of depression. Two decades ago, she underwent an evaluation and received a diagnosis of severe depression for the first time. Throughout that duration, she received imipramine (tricyclic antidepressant/TCA) at dosages of up to 150 mg per day, resulting in favorable outcomes. She claimed that she abstained from illicit substances and has not undergone any distressing events in the recent past. Although she was confident that she was experiencing another severe depression, she expressed a desire to avoid using imipramine this time due to its adverse effects, including dry mouth, dry eyes, and diarrhea. The patient was diagnosed as recurrent major depressive disorder without psychotic symptoms. Conclusion: The likelihood of experiencing additional bouts of major depression is higher when there have been multiple prior episodes, residual symptoms of depression between episodes, and the coexistence of other psychiatric or chronic medical conditions. Prior episodes of serious depression that responded well to treatment have a greater probability of reaching remission in future episodes. First-line treatment options for major depressive disorder include selective serotonin reuptake inhibitors (SSRIs) such as bupropion, venlafaxine, mirtazapine, and duloxetine.

Effect of Psychotic Symptoms on Suicide Event in Patient with Severe Depression at Sanglah General Hospital

Introductions: WHO states that the suicide rate in the world is still high; most of them had a previous depressive episode. In depressed patients with psychotic symptoms, psychomotor disturbances were more severe, feelings of guilt were higher, and there was an increase in suicidal ideation and attempts. Several studies have tried to find out whether there is an influence between psychotic symptoms and the incidence of suicide in patients with depressive disorders. However, the number of available studies is still limited and controversial. The purpose of this study was to determine the effect of psychotic symptoms on the incidence of suicide in patients with major depressive disorders. Methods: This is an observational analysis with a case-control approach. The sample was obtained from the Udayana Psychiatric Resident Duty Report in 2019 in a purposeful manner that already met the inclusion and exclusion criteria. Test the hypothesis using chi-square and logistic regression. Results: A total of 70 samples were used in this study. Chi-squared showed there was a relationship between psychotic symptoms and the incidence of suicide in patients with major depression (p = 0.016). Logistic regression showed that a history of drinking alcohol (OR 55.058; CI 2.975-1018.8; p = 0.007) and psychotic symptoms (OR 9.237; CI 1.86-45.875; p = 0.007) were shown to affect the incidence of suicide in patients with major depressive disorders. Conclusion: There is an effect of psychotic symptoms on the incidence of depression in patients with major depressive disorders.

Neuropsychiatric symptoms and arachnoid cysts: tracing the association regarding a case report

IntroductionIn the review of recent literature, we found very few presentations of case reports in which the presumed association between psychiatric disorders and arachnoid cysts is discussed. Arachnoid cysts are rare brain tumors with little apparent symptomatic impact and in most cases, they are diagnosed incidentally. We present the case of a 15-year-old adolescent with a personal history of a previous severe depressive episode, as well as suspicion of serious mental pathology in the family. It presents a subacute onset episode, in the context of regular cannabis consumption, consisting of intense emotional lability and psychomotor restlessness, a tendency toward irritability, decreased sleep needs, and the appearance of delusional ideas of harm and self-referential interruption. During the study of the case, and incidentally, the cranial magnetic resonance imaging revealed the presence of an arachnoid cyst located in the left frontotemporal location, approximately 4 cm in diameter.Objectives(1) To describe the clinical particularities of this case, focusing on the diagnostic difficulties we faced. (2) To review current scientific evidence regarding the possible association between neuropsychiatric symptoms and arachnoid cysts.MethodsA review of the patient’s clinical history was carried out and complementary tests were performed. Likewise, a review of the available scientific literature was also performed in relation to the appearance of neuropsychiatric symptoms associated with the presence of arachnoid cysts.ResultsThe literature regarding the possible association between psychosis and arachnoid cysts is scarce. However, it is proposed that arachnoid cysts may be associated with various neuropsychiatric alterations, such as affective alterations, schizophrenia-like psychosis or amnestic symptoms. The atypicality in the symptoms sometimes leads us to suspect an organic origin of the condition, with some features such as associated memory deficits, emotional incontinence, movement disorders or neurological focal data; some of which are present in the case at hand.ConclusionsThere is controversy among different sources regarding the role of the cyst in the development of symptoms or, on the contrary, its presentation only as a chance finding. Further investigation focusing on clinical observations and neuroimaging is needed.Disclosure of InterestNone Declared

An Insidious Comorbidity: Depression and Chronic Heart Failure

Depression and heart failure (HF) are in a close bilateral relationship: the appearance of one is potentiated by the other entity and the effects on the outcome are amplified within this ”dangerous liaison”. Depression is present in about one in five HF patients and is severe in almost half of them. The risk factors for depression in HF are female gender, elderly, the severity of HF symptoms, a history of isolated systolic hypertension or coronary heart disease (CHD), previous hospitalization and previous depressive episodes. Depression in HF patients increases medication non-adherence, is associated with poor outcomes after heart transplantation and is predictive of events and mortality in cardiac resynchronization therapy (CRT). The current assumptions related to the physiopathological mechanisms include a common genetic polymorphisms, inflammation, generalized immune system disturbance, disturbances of platelet function, increased catecholamine levels, deamination of monoamines linked with monoamine oxidase activity, a dysregulation of the autonomic nervous system, increased serotonin levels, ischemia, life-style and medication non-compliance, a poor familial support and social isolation. Assessment of cognitive functioning should be part of routine clinical examination in HF, the diagnosis of depression is based on questionnaires (e.g. Patient Health Questionnaire-2 - PHQ-2) and on clinical interview. There is still no consensus on the best therapy for HF patients with depression (non-pharmacological and pharmacological therapies) but, for sure, depression in HF is harder to treat.

Change in Cognitive Function over the Course of Major Depressive Disorder: A Systematic Review and Meta-analysis.

Major depressive disorder (MDD) is associated with significant cognitive deficits during the acute and remitted stages. The aim of this systematic review and meta-analysis was to examine the course of cognitive function whilst considering demographic, treatment, or clinical features of MDD that could moderate the extent of cognitive change. Databases were searched to identify studies that reported on cognitive function in MDD with a ≥12-week test-retest interval. Relevant studies were pooled using random effects modelling to generate an inverse-variance, weighted, mean effect size estimate (Hedges' g) of cognitive change for each cognitive variable and for an overall composite cognitive domain. Of 6898 records, 99 eligible studies were identified from which 69 were meta-analysed, consisting of 4639 MDD patients (agemean = 40.25years, female% = 64.62%) across 44 cognitive variables. In over 95% of cognitive variables, improvements were either of non-significant, negligible, or of a small magnitude, and when compared to matched healthy controls, the possibility of practice effects could not be precluded. Depressive symptom improvement and the number of previous depressive episodes moderated the extent of cognitive change, demonstrating state- and scar-like features for one-quarter of the cognitive domains. Further longitudinal studies are required to elucidate the MDD cognitive trajectory from initial onset. Findings nonetheless suggest that following pharmacological and non-pharmacological treatment, cognitive change in MDD is typically small, but the capacity for change may be less with episode recurrence. Targeting cognition early in the course of illness may facilitate better prognosis and support a more complete functional recovery.

Factors associated with the discrepancy between objective and subjective cognitive impairment in bipolar disorder

ObjectiveThe aim of this study is to evaluate the discrepancy between objective cognitive measures and cognitive subjective complaints in a sample of euthymic patients with bipolar disorder (BD). MethodsOne hundred and sixteen participants (83 euthymic patients with BD and 33 healthy controls) were enrolled for this study. Patients were assessed with a comprehensive neuropsychological battery and they also reported their subjective cognitive complaints with the Cognitive Complaints in Bipolar Disorder Rating Scale (COBRA). The discrepancy between objective and subjective data was calculated using a novel methodology proposed in a previous study (Miskowiak, 2016). Statistical analyses included Pearson correlations and multiple linear regression. ResultsHigher number of previous depressive episodes was identified as one variable associated with the global sensitivity composite score (Beta = 0.25; t = 2.1; p = 0.04) and with the verbal learning and memory sensitivity score (Beta = 0.26; t = 2.16; p = 0.03). That is, patients with more previous depressive episodes tend to over-report cognitive complaints. In contrast, higher number of previous hospitalizations was associated with stoicism in the global total score (Beta = −0.27; t = −2.24: p = 0.029) and in the domain of attention/processing speed (Beta = −0.34; t = −2.52; p = 0.016), indicating patients with more hospitalizations tend to report less cognitive complaints. DiscussionOur study identified some factors that might help to explain the discrepancy between objective and subjective cognitive measures in BD, including number of previous depressive episodes and number of previous hospitalizations. This highlights the need of the combined use of both types of cognitive measures to make an accurate assessment of cognitive dysfunctions and their effective treatment.

Risk and protective factors for postpartum depression among Polish women – a prospective study

This prospective study conducted at a single center in 2022 aims to identify risk and protective factors for postpartum depression (PPD) in Polish women and to assess the impact of pregnancy, delivery, the postpartum period, and psychosocial factors on PPD. After delivery and 4 weeks later, 311 women filled out two questionnaires of our design related to risk factors for PPD. Immune Power Personality Questionnaire, Walsh Family Resilience Questionnaire, and Edinburg Postnatal Depression Scale were also applied. The predictors of PPD identified at two time points included: use of antidepressants, previous depressive episodes, family history of depression, risk of preterm delivery, anxiety about child’s health, and breastfeeding and sleep problems. Risk factors for PPD found only after delivery were: suicidal ideation before pregnancy, stressful life events, premature rupture of the membranes, and cesarean section. Inhalation analgesia during labor reduced the PPD frequency. At 4 weeks’ postpartum, regular physical activity was also predictive of PPD, while breastfeeding, financial satisfaction, and sufficient sleep duration were protective factors. PPD after delivery was negatively correlated with capacity to confide, hardiness, assertiveness, self-complexity, and communication. PPD at 4 weeks postpartum decreased belief systems, organization patterns, and communication. Two proposed self-designed questionnaires can be useful for effectively screening PPD in the Polish population.

Mediterranean diet-based intervention to improve depressive symptoms: analysis of the PREDIDEP randomized trial

ABSTRACT Background: The effect of an intervention based on Mediterranean diet on reducing recurrence risk or subsyndromal depressive symptoms in recovered depressed patients has not been explored. Methods: The PREDIDEP study was a two-year randomized trial designed to assess the effect of the Mediterranean Diet enriched with extra virgin olive oil on depression recurrence. At baseline and at four, eight, 16, 20, and 24 months of follow-up, depressive symptoms were evaluated through the Beck Depression inventory. Cox regression analysis was fitted to assess the role of dietary intervention on the risk of depression recurrence. Mixed effects linear models were used to assess changes in depressive subsyndromal symptoms according to the intervention. Results: After two years of intervention, the dietary intervention group (n = 103) compared to the control group (n = 93) showed no differences regarding depression recurrence risk as main outcome. As secondary outcomes, an improvement of depressive symptoms was yielded at four (−2.15; 95% CI = −4.00 to −0.29) and eight months (−2.42; 95% CI = −4.17 to −0.67) in the intervention group, with no changes in control group. Moreover, at 20 months, significant differences were found between groups (−3.35; 95% CI = −6.08 to −0.61). Conclusions: An intervention with Mediterranean diet in patients with previous depressive episodes might contribute to the reduction of depressive subsyndromal symptoms.

POSTPARTUM DEPRESSION AND ANXIETY: A COMMUNITY-BASED STUDY ON RISK FACTORS BEFORE, DURING AND AFTER PREGNANCY

Postpartum anxiety and depression are a significant public health concern as it is the leading cause of maternal morbidity. It is associated with adverse effects on the cognitive and social development of the infant. The primary aim of the study is to find postpartum depression and anxiety as a community-based study on risk factors before, during, and after pregnancy. The prospective cohort study was conducted in Khyber Teaching Hospital Peshawar from April 2023 to July 2023. A total of 320 pregnant women were recruited for this study. Participants were enrolled during their antenatal visits to healthcare facilities within the community, ensuring representation across diverse demographic and socio-economic backgrounds. Data collection for this community-based study on postpartum depression and anxiety was executed meticulously across three distinct phases: before, during, and after pregnancy. Data was collected from 320 pregnant females. The mean age of participants was 28.5±4.2 years. Most participants had at least a high school education (65%) and reported a moderate household income (55%). 18% of participants had a history of previous episodes of depression or anxiety. 35% reported experiencing significant life stressors before pregnancy, with financial concerns being the most common (62%). 24% had a family history of mental health disorders. It is concluded that this study has revealed a significant prevalence of postpartum depression (22%) and anxiety (18%) among participants. The identified risk factors, including prior mental health history and high prenatal stress, emphasize the need for early intervention and targeted support systems during the perinatal period.

The Impact of Postpartum Depression on Socio-professional Integration

The modern woman nowadays is subjected to more and more challenges. Whether it is due to her work, her appearance or her marital status, she must always show that she is coping in the most efficient way. This constant measurement and confrontation of the performance achieved in a certain field leads to the perception of otherwise normal, physiological actions as stressful. The mother who raises her child wants to face the multiple challenges, even when she is being subjected to pressures from the family, her own requirements, values ​​and beliefs and at the same time from the micro group she belongs to or from society. That's why her slip into depression is extremely easy. The support she might receive from family, friends, professionals can save her from further complications such as deepening depression, job loss, long-term loss of self-esteem, child neglect and child abuse, the transition to a suicidal act in a moment of imbalance or the transition to alcohol misuse, sometimes witnessed by the child. Identifying factors involved in the onset and maintenance of postpartum depression can help prevent it and provide early intervention within vulnerable families with the aim of making women stronger and children healthier and happier. Postpartum depression is a fairly common phenomenon in the female population, the cumulative forms giving a percentage of 31%, of which minor forms occupy 19% and moderate and severe forms 12%. Among the factors that have an important influence we list: a weaker support of the mother by her support group, problems related to the mother's low self-esteem, the more difficult temperament of the child who can be more agitated and disrupts the mother's sleep-wake rhythm, but also the existence of other previous episodes of postpartum depression of the mother and the number of previous births.

Depression and Pseudodementia: Decoding the Intricate Bonds in an Italian Outpatient Setting.

In spite of the uncertainties of its diagnostic framework, pseudodementia may be conceptualized as a condition characterized by depressive symptoms and cognitive impairment in the absence of dementia. Given the controversies on this topic, the aim of the present study was to assess neurological and cognitive dysfunctions in a sample of elderly depressed subjects, and the eventual relationship between cognitive impairment and depressive symptoms. Fifty-seven elderly depressed outpatients of both sexes were included in the study. A series of rating scales were used to assess diagnoses, depressive and cognitive impairment. Comparisons for continuous variables were performed with the independent-sample Student's t-test. Comparisons for categorical variables were conducted by the χ2 test (or Fisher's exact test when appropriate). The correlations between between socio-demographic characteristics and clinical features, as well as between cognitive impairment and depressive symptoms were explored by Pearson's correlation coefficient or Spearman's rank correlation. Our data showed the presence of a mild-moderate depression and of a mild cognitive impairment that was only partially related to the severity of depression. These dysfunctions became more evident when analyzing behavioral responses, besides cognitive functions. A high educational qualification seemed to protect against cognitive decline, but not against depression. Single individuals were more prone to cognitive disturbance but were similar to married subjects in terms of the severity of depressive symptoms. Previous depressive episodes had no impact on the severity of depression or cognitive functioning. Although data are needed to draw firm conclusions, our findings strengthen the notion that pseudodementia represents a borderline condition between depression and cognitive decline that should be rapidly identified and adequately treated.

Relationship between COVID-19 Pandemic Confinement and Worsening or Onset of Depressive Disorders.

Several studies indicate that the pandemic and associated confinement measures may have had an impact on mental health, producing the onset or persistence of symptoms such as stress, anxiety, depression, and fear. This systematic review aims to identify the factors influencing the onset or worsening of depressive symptoms during COVID-19-related confinement. Our systematic search produced 451 articles from selected databases, 398 of which were excluded based on established criteria, while 53 were selected for review. Most studies have reported an increase in the prevalence of depressive symptoms in the general population during the first weeks of confinement. The predominant risk factors associated with the appearance of depressive symptoms included female sex, low educational level, young age, economic difficulties, comorbidities, and a history of previous depressive episodes. People with a pre-existing diagnosis of depressive disorder generally experienced a worsening of their symptoms during confinement in most of the reviewed studies. Moreover, symptomatology persisted at higher levels post-confinement, without significant improvement despite relief in confinement measures. Therefore, ongoing evaluations of post-pandemic depressive symptoms are necessary to advance the knowledge of the relationship between pandemics and depression, allowing accurate conclusions and associations to be made.

Suicidal risk in Latino patients with schizophrenia

IntroductionSchizophrenia is a highly debilitating disorder afflicting more than 24 million individuals worldwide. In Mexico, the Ministry of Health estimates that it affects more than 1 million people. Suicide is one of the main causes of death among people diagnosed with schizophrenia, their risk is 12 times higher than in. the general populationObjectivesTo evaluate the clinical characteristics of schizophrenic patients at risk of suicide in the Latino population.MethodsWe included 130 patients recruited from genetics studies in Latino patients with schizophrenia from the outpatient and inpatient psychiatric ward of the University Hospital “Dr José E. González” in Monterrey, Nuevo Leon, Mexico. Beck Depression Inventory (BDI-II), the Convergent Functional Information for Suicidality (CFI-S) were applied to all participants. We compared the sociodemographic and clinical characteristics of patients with suicidal risk (measured by history of suicidal attempt or current suicidal risk) and present depressive episode.ResultsOf the 130 participants, 66.9% were male, the median age was 38 years. We found 11(14.3%) patients with suicidal risk and 119 (91.5%) without suicidal risk. Sociodemographic and clinical characteristics of the study population at risk of suicide are described in graphic 1. Patients with a history of suicide attempt scored higher on the CFI-S scale with a median of 0.5 (q1=0.45; q3=0.54) vs. 0.31 (q1=0.22; q3=0.45) (p= 0.004)(Graphic 2). Based on the BDI-II we found 2.30% patients showed a mild depression, 20.0% moderate depression and 4.61% severe depression (graphic 3). Schizophrenic patients with a previous suicide attempt and depressive episode had higher score range in CFI-S, median .65 (q1=.65; q2=.59, p=0.000). Also, 63.60% were severely depressive (p=0.000) when they compared with patients with low risk of suicide. Schizophrenic patients with suicidal risk were characterized by: age &gt;=60 years old, unemployment, no children, single, without religion, family history of suicide, previous suicide attempt, depressive episodes, substance abuse, auditory hallucinations and referential delusions.Image:Image 2:Image 3:ConclusionsIn our study with Latino population, we observed similar clinical characteristics predictive of suicide risk described in the international studies. Our study is relevant to applied preventive measures in groups of schizophrenic patients with risk factors and their relatives.Disclosure of InterestNone Declared

Effects of early life stress and subsequent re-exposure to stress on neuronal activity in the lateral habenula

Early life stress can result in depression in humans and depressive-like behaviour in rodents. In various animal models of depression, the lateral habenula (LHb) has been shown to become hyperactive immediately after early life stress. However, whether these pathological changes persist into adulthood is less well understood. Hence, we utilised the maternal separation (MS) model of depression to study how early life stress alters LHb physiology and depressive behaviour in adult mice. We find that only a weak depressive phenotype persists into adulthood which surprisingly is underpinned by LHb hypoactivity in acute slices, accompanied by alterations in both excitatory and inhibitory signalling. However, while we find the LHb to be less active at rest, we report that the neurons reside in a sensitised state where they are more responsive to re-exposure to stress in adulthood in the form of acute restraint, thus priming them to respond to aversive events with an increase in neuronal activity mediated by changes in glutamatergic transmission. These findings thus suggest that in addition to LHb hyperactivity, hypoactivity likely also promotes an adverse phenotype. Re-exposure to stress results in the reappearance of LHb hyperactivity offering a possible mechanism to explain how depression relapses occur following previous depressive episodes.

Obsessive-Compulsive Disorder in Patients with Mild Cognitive Impairment: A Comparative Study with Healthy Older Adults.

Mild cognitive impairment is considered a prodromal state and a risk factor for dementia. To the best of our knowledge, no previous studies have examined the relationship between obsessive-compulsive disorder and mild cognitive impairment. One of the risk factors for the development of mild cognitive impairment may be obsessive-compulsive disorder. In this study, we hypothesized that the patients with mild cognitive impairment had a significantly higher rate of obsessive-compulsive disorder than healthy elders, and some types of preexisting obsessive-compulsive symptoms may be associated with mild cognitive impairment. A total of 66 subjects (mild cognitive impairment = 35; healthy elderly = 31) were assessed for severity of cognitive impairment using the Mini-Mental State Examination, Clinical Dementia Rating Scale, and Addenbrooke's Cognitive Examination III tests. Lifetime diagnosis of obsessive-compulsive disorder was assessed through Structured Clinical Interview of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I disorders. The severity of the obsessive-compulsive disorder and the content of previous obsessive-compulsive symptoms were measured by Yale-Brown Obsessive-Compulsive Scale. Mild cognitive impairment patients had more previous depressive episodes and a lifetime diagnosis of obsessive-compulsive disorder when compared with healthy subjects, P = .023. Educational level was significantly lower in mild cognitive impairment patients than in healthy elders, P = .037. The contamination obsessions and cleaning and checking compulsions were significantly higher in the patients with mild cognitive impairment than in healthy subjects, P = .044. Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores were significantly higher in patients with mild cognitive impairment, P = .009 and P = .045 respectively. Lower educational level, previous obsessive-compulsive disorder, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores, and checking compulsions significantly predicted the patients with mild cognitive impairment, P = .044. Our findings may demonstrate that lower educational level, previous obsessive-compulsive disorder, checking compulsions, and current anxiety and depression severity appeared significantly associated with mild cognitive impairment. We suggest that previous obsessive-compulsive disorder and checking obsessive-compulsive symptoms may be related to earlier stages of memory dysfunction.