Recurrent Depressive Patients Research Articles

HERV-E ƛ 4-1 activation in peripheral blood mononuclear cells of the recurrent depression patients under the influence of human recombinant IL-1β

IntroductionMental disorders represent complex phenotypes and are the leading causes of global disease burden. Human endogenous retroviruses (HERVs) are ancient retroviral DNA sequences established into germline. Their tight regulation is mainly achieved by epigenetic mechanisms, which can be altered by environmental factors - viral infections, inflammation, leading to HERV activation. The aberrant expression of HERVs associates with neurological diseases and mood disorders. We showed earlier that HERV-E ƛ 4-1 activation is associated with the recurrent depression stage of exacerbation and are accompanied by a pronounced increase in the proinflammatory activity of the peripheral blood mononuclear cells (PBMC).ObjectivesThe purpose of the study was to evaluate the activity of HERV-E ƛ 4-1 on PBMCs of patients with recurrent depression in remission, including under the influence of recombinant human IL-1β.MethodsThe study included 30 patients with an established diagnosis of recurrent depression (F 33.0) aged 26–45 years. PBMC were isolated using the Ficoll density gradient method and further cultured in the presence or absence of 1 mkg/ml of recombinant human IL-1β for 24 hours. HERV-E λ 4 – 1 env gene expression was determined by the PCR. Cells proliferative activity was determined by H3-thymidine incorporation. Cytokines content in culture supernatants was assessed by ELISA.ResultsIt was shown that in all samples of PBMC cultured without IL-1β the HERV-E λ 4 – 1 env expression was not determined. After the PBMC cocultivation with recombinant human IL-1β, HERV-E λ 4 – 1 env gene expression was determined in 86,7% of cases. The HERV-E ƛ 4-1 activation in PBMC after IL-1β influence was accompanied by increased cells proliferative activity and production of IL-1β, IL-6.ConclusionsOur data indicate that the HERV-E λ 4 – 1 env expression in PBMC of recurrent depression patients in the stage of remission induced by the influence of proinflammatory cytokines, such as IL-1β. This mechanism may be one of the possible regulators of HERV-E λ 4 – 1 activation in recurrent depression.Disclosure of InterestNone Declared

Changes of anhedonia and cognitive symptoms in first episode of depression and recurrent depression, an analysis of data from NSSD

BackgroundAnhedonia and cognitive impairment are core features of major depressive disorder (MDD), and are essential to the treatment and prognosis. Here, we aimed to investigate anhedonia and its cognitive correlates between first episode of depression (FED) and recurrent depression (RD), which was part of the National Survey on Symptomatology of Depression. MethodsIn this study, 1400 drug naïve FED patients and 487 on medicine RD patients were included. Differences of anhedonia, cognitive symptoms and other clinical characteristics between groups were compared via Student's t-test, or the chi-square test as appropriate. Partial correlation analysis was used to analyze the correlations between anhedonia and cognitive symptoms after adjusting for potential confounders. A stepwise logistic regression analysis was performed to identify relapse risk factors among symptomatic variables, demographic factors, clinical characteristics and medication use. ResultsCompared to FED, RD patients displayed more comprehensive depressive, impaired cognitive and anhedonia symptoms. Cognitive symptoms were significantly related with the anhedonia symptoms with varying aspects. Patients taking emotional stabilizers displayed more abnormal cognitive symptoms, followed by benzodiazepines, and finally SSRIs, SNRIs and TCAs. The effect of drug use on anhedonia is not as extensive as that of cognitive symptoms. ConclusionCollectively, the results of this investigation advance the knowledge on changes in anhedonia and cognitive symptoms in MDD. LimitationsAs this is a cross sectional study, it is difficult to draw any causal conclusions between cognitive impairment and anhedonia in MDD, and to ascertain the worse cognitive performances identified here were induced by current drug use.

Quantitative Susceptibility Mapping of Brain Iron Deposition in Patients With Recurrent Depression.

Objective Recurrence is the most significant feature of depression and the relationship between iron and recurrent depression is still lack of direct evidence in vivo. Methods Twenty-one patients with depression and twenty control subjects were included. Gradient-recalled echo, T1 and T2 images were acquired using a 3.0T MRI system. After quantitative susceptibility mapping were reconstructed and standardized, a whole-brain and the regions of interest were respectively analyzed. Results Significant increases in susceptibility were found in multiple recurrent depression patients, which involved several brain regions (frontal lobes, temporal lobe structures, occipital lobes hippocampal regions, putamen, thalamus, cingulum, and cerebellum). Interestingly, no susceptibility changes after treatment compared to pre-treatment (all p>0.05) and no significant correlation between susceptibility and Hamilton Depression Rating Scale were found. Besides, it was close to significance that those with a higher relapse frequency or a longer mean duration of single episode had a higher susceptibility in the putamen, thalamus, and hippocampus. Further studies showed susceptibility across the putamen (ρ2=0.27, p<0.001), thalamus (ρ2=0.21, p<0.001), and hippocampus (ρ2=0.19, p<0.001) were strongly correlated with total course of disease onset. Conclusion Brain iron deposition is related to the total course of disease onset, but not the severity of depression, which suggest that brain iron deposition may be a sign of brain damage in multiple recurrent depression.

Sociodemographic, personality and symptomatologic profiles associated with an increased likelihood of suicidal risk in patients hospitalized for recurrent depressive disorders

IntroductionAccording to WHO statistics, 800,000 suicides occur annually, representing the second leading cause of death in people aged 15 to 29. The contributing factors for suicidal risk are multifactorial and multileveled.ObjectivesWe aimed to analyze the predictive value of distinct sociodemographic, personality and symptomatology characteristics in predicting the presence of suicidal risk in patients hospitalized for the analyzed mood disorder.MethodsA longitudinal retrospective case-control study was performed on medical data records of 90 patients admitted in the Timisoara Psychiatric Clinic during 2018 – 2020. Besides the parametric and non-parametric statistical analyses, logistic binary regression analyses were done.ResultsPatients with suicide risk tended to be younger (p = 0.039), without intimate partnership (p &lt; 0.001), current smoker (p = 0.038) and to present psychotic symptoms at some moments during the psychiatric disorder. 51 (56.7%) of the total patients have presented different degrees of suicidal risk (from suicidal ideation to suicide attempt). Patients with suicide risk tended to be younger (p = 0.039), without intimate partnership (p &lt; 0.001), current smoker (p = 0.038) and to present psychotic symptoms at some moments during the psychiatric disorder. Personality traits has not influenced suicidal risk. Presence of intimate partner (OR = 0.135; p &lt; 0.001) and the presence of psychotic symptoms during recurrent depression (OR = 7.309; p = 0.004) have presented predictive value on suicide risk.ConclusionsPsychiatrist practitioners should be aware of the clinical and sociodemographic characteristics that put recurrent depressive patients at risk of suicidal behaviors.DisclosureNo significant relationships.

Neurocognitive profiles of patients with first-episode and recurrent depression: a cross-sectional comparative study from China

BackgroundAccumulating evidence has shown that cognitive deficits are prevalent among patients with major depressive disorder (MDD). However, the pattern and extent of cognitive deficits in patients with first-episode and recurrent depression remain unclear. MethodsObjective measures of cognitive function were assessed in 433 first-episode of depression (FED) patients, 206 recurrent major depression (RMD) patients during the acute phase and 287 healthy controls (HCs). Five domains of cognition (speed of processing, attention, verbal learning, visual learning and execution function) were assessed by seven neuropsychological tests. Neuropsychological data were transformed into T scores according to the Chinese norm. ResultsBoth FED and RMD patients displayed deficits of mild-to-medium severity across all cognitive domains and their subtests, relative to HCs (Cohen's d = 0.12-0.62). Among MDD patients, RMD patients exhibited poorer verbal learning (Cohen's d = 0.17) and visual learning (Cohen's d = 0.21) than FED patients. ConclusionsMDD patients in the acute phase exhibited broad cognitive impairments, and there were significant differences in verbal and visual learning between FED and RMD patients. Our findings indicate that more attention should be paid to the domains of verbal and visual learning in future screening assessments and targeted interventions.

Expression of SIR1-SIR7 genes in the course of recurrent depressive disorders.

The role of sirtuins as a pathogenetic element of some mental disorders is becoming increasingly more common. They participate in many cellular processes, such as ageing, transcription, apoptosis, inflammatory processes, post-translational modification of proteins, gene transcription silencing, activation of DNA repair mechanisms, and regulation of many metabolic processes. The aim of this paper is to verify the statistical hypothesis assuming the difference in expression at the level of mRNA in genes for sirtuins 1-7 between patients with recurrent depressive disorders (rDD) and patients from the control group, and the hypothesis assuming the relation between the expression at the level of mRNA for these genes and clinical variables in the course of recurrent depressive disorders. A total of 198 individuals took part in the study (rDD gropup, N=99; control group, N=99). SIR-1 and SIR-6 expression at the mRNA level was significantly higher among the people with rDD as compared to the subjects from the control group. A reversed relationship was observed for SIR-2, SIR-3, SIR-4 and SIR-5. Statistically significant correlations were observed only in the case of SIR-1 and the number of depression episodes (negative relationship), as well as SIR-5 and the severity of depression measured by the Hamilton Depression Rating Scale (positive relationship). Expression at the mRNA level for selected sirtuins is a factor that significantly differentiates people with depressive episodes from healthy ones. SIR-1 and SIR-6 expression at the mRNA level was significantly higher among the people with depression as compared to the subjects from the control group. A reversed relationship (also statistically significant) was observed for SIR-2, SIR-3, SIR-4 and SIR-5.

Impaired reward-related learning signals in remitted unmedicated patients with recurrent depression.

One of the core symptoms of major depressive disorder is anhedonia, an inability to experience pleasure. In patients with major depressive disorder, a dysfunctional reward-system may exist, with blunted temporal difference reward-related learning signals in the ventral striatum and increased temporal difference-related (dopaminergic) activation in the ventral tegmental area. Anhedonia often remains as residual symptom during remission; however, it remains largely unknown whether the abovementioned reward systems are still dysfunctional when patients are in remission. We used a Pavlovian classical conditioning functional MRI task to explore the relationship between anhedonia and the temporal difference-related response of the ventral tegmental area and ventral striatum in medication-free remitted recurrent depression patients (n = 36) versus healthy control subjects (n = 27). Computational modelling was used to obtain the expected temporal difference errors during this task. Patients, compared to healthy controls, showed significantly increased temporal difference reward learning activation in the ventral tegmental area (PFWE,SVC = 0.028). No differences were observed between groups for ventral striatum activity. A group × anhedonia interaction [t(57) = -2.29, P = 0.026] indicated that in patients, higher anhedonia was associated with lower temporal difference activation in the ventral tegmental area, while in healthy controls higher anhedonia was associated with higher ventral tegmental area activation. These findings suggest impaired reward-related learning signals in the ventral tegmental area during remission in patients with depression. This merits further investigation to identify impaired reward-related learning as an endophenotype for recurrent depression. Moreover, the inverse association between reinforcement learning and anhedonia in patients implies an additional disturbing influence of anhedonia on reward-related learning or vice versa, suggesting that the level of anhedonia should be considered in behavioural treatments.

O-14 Does rTMS targeting with individual functional connectivity analysis improve the efficacy in recurrent depression?

Background Clinical efficacy of rTMS in recurrent depression (RD) is highly variable. It is important to search for approaches improving the efficacy, and choosing the target based on functional connectivity (FC) is promising. We aimed to compare the effects of the standard and FC-based rTMS targeting in RD patients. Methods 30 pharmacoresistant RD patients (17 women, age median 40, quartiles 28, 44) were divided into two groups comparable in age, sex and RD severity. All patients received 20 sessions of high frequency rTMS of lDLPFC (20 Hz, 100% RMT, 3200 stimuli/session). In the standard targeting group, the stimulation points were 5 cm anterior to the individual APB muscle hotspots. In the FC-based targeting group, rTMS was targeted to the individual points in the left DLPFC with maximum negative correlation to subgenual cingulate (10 mm radius sphere at MNI coordinates (6,16,−10)). We used Beck depression inventory (BDI) and SF-36 questionnaires before rTMS, after 10 and 20 sessions of rTMS for clinical evaluation. Results In the FC-based targeting group, significant decreases in both BDI and SF-36 scores were observed after 10 rTMS sessions (Wilcoxon, p 0.05). Conclusions Both methods of rTMS targeting are effective in depression, but the use of FC analysis allows accelerating the onset of the effect.

Association study on interaction effects of CREB1 gene and BDNF gene polymorphisms and recurrent major depressive disorder

Objective To investigate the interactions between cAMP-response element-binding protein 1(CREB1)gene polymorphisms (rs889895, rs3770704, rs2551645, rs4675690)and brain derived neurotrophic factor(BDNF)gene polymorphisms (rs7124442, rs10835210) and the association with recurrent major depressive disorder. Methods The blood samples were taken from 768 recurrent major depressive disorder patients and 511 healthy controls.The DNA was isolated from blood samples and was detected by SNP Sequenom Mass Array analysis. Chi-square test was used to compare differences in the frequency distribution of alleles and genotype between depression and controls.The generalized multifactor dimensionality reduction (GMDR) method was used to analyze the gene-gene interaction.Binary logistic regression was used to verify the optimal model. Results After adjusting the factors of sex and age, the GMDR analysis showed rs10835210 was the optimal model.In this model, the testing balanced accuracy was 0.5319 and cross-validation consistency value was 10/10.And rs10835210 had a statistically significant effect on the risk of recurrent major depressive disorder(P=0.0107). There was no significant gene-gene interaction of five tag SNPs on recurrent major depressive disorder(P>0.05). Binary logistic regression analysis showed the AC contributed to a significantly lower risk of recurrent major depressive disorder than did the CC(OR=0.772, 95%CI=0.608-0.980, P=0.033). It was failed to find the genetic polymorphism of CREB1 rs889895. Conclusion BDNF rs10835210 may be one of the biological markers of recurrent major depressive disorder. Key words: Recurrent major depressive disorder; cAMP-response element binding protein; BDNF; Tag SNP; Generalized multifactor dimensionality reduction

Association Between Mental Health Staffing Level and Primary Care-Mental Health Integration Level on Provision of Depression Care in Veteran's Affairs Medical Facilities.

We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1.00, 1.03) depression patients (p < 0.05). No effects were found for antidepressants. Mental health staffing and PCMHI utilization explained only a small amount of the variance in the adequacy of depression care.

Optic coherence tomography shows inflammation and degeneration in major depressive disorder patients correlated with disease severity

BackgroundPrevious research has consistently detected inflammation in the etiology of depression and neuroimaging studies have demonstrated gray matter abnormalities implying a neurodegenerative process in depression. The aim of this study was to compare ganglion cell layer (GCL), and inner plexiform layer (IPL) volumes and retinal nerve fiber layer (RNFL) thickness between first episode and recurrent major depressive disorder (MDD) patients and controls using optic coherence tomography (OCT) in order to detect findings supporting a degenerative process. Also choroid thicknesses of the same groups were compared to examine effects of inflammation on MDD. MethodsThis study included 50 recurrent MDD patients, 50 first episode MDD patients and 50 controls. OCT measurements were performed by a spectral OCT device. GCL and IPL volumes and RNFL and choroid thicknesses were measured automatically by the device. ResultsGCL and IPL volumes were significantly smaller in recurrent depression patients than first episode patients and in all MDD patients than controls. Also there were significant negative correlations between their volumes and disease severity parameters such as Ham-D and CGI scores, and disease duration. RNFL thicknesses were also lower in recurrent MDD patients than first episode patients and all MDD patients than controls but statistical significance was achieved only for global RNFL and temporal superior RNFL. Mean choroid thickness was higher in MDD patients than controls and in first episode MDD patients than recurrent MDD patients. LimitationsCross-sectional design of our study limits conclusions about progressive degeneration during the course of MDD. Lack of a control neuroimaging method like magnetic resonance imaging makes it hard to draw firm conclusions from our results. ConclusionsOCT finding of decreased GCL and IPL volumes supports previous research suggesting degeneration in MDD. OCT may be an important tool to track neurodegeneration in patients with major depression. Considering RNFL to be the latest layer that will be affected during course of degeneration, GCL and IPL volumes appear to be better parameters to follow. In addition, choroid may be an important structure to detect acute attack period and to follow inflammatory process in MDD like in systemic inflammatory diseases.

Correlation of cognitive function and dystrobrevin binding protein 1 gene polymorphisms in patients with recurrent depressive disorder

Objective To investigate the relationship between dystrobrevin binding protein 1(DTNBP1) gene polymorphisms and cognitive function in patients with recurrent depressive disorder. Methods 49 recurrent depressive disorder patients and 60 age-, gender- and education-matched normal controls were recruited in this case-control study.Clinical symptoms were evaluated by HAMD and Wechsler adult memory scale, Wisconsin card sorting test, trail making test(TMT), verbal fluency test (VFT), Stroop color-word test were used to evaluate cognitive function. The gene polymorphisms of DTNBP1 were determined by PCR-RFLP technique. SPSS 16.0 was used for statistical analysis. Results The distributions of genotypes in the patients and controls were consistent with Hardy-Weinberg equilibrium(P>0.05). The time in trail making A task (73.4±30.5 vs 56.2±11.7), the digital Span (9.6±2.3 vs 8.1±3.0), visual reproduction (9.6±2.3 vs 7.4±3.1), paired association learning (9.7±2.2 vs 6.1±4.2) and Spilling forward (9.1±2.4 vs 7.2±2.9) in Wechsler adult memory scale, the categories completed (1.8±1.6 vs 2.5±1.8), total trials (47.6±1.1 vs 47.3±0.7) and error numbers (28.5±5.3 vs 24.1±9.3) in WCST performs, and the word meaning interference score (18.4±9.0 vs 25.3±9.5) in Stroop color-word test were monitored.Patients with the genotype of rs9476867 G/G got higher interference number than patients with DTNBP1 rs9476867 C/G and C/C , and patients with the genotype of rs16876738 A/G spent more time to finish TMT-A than patients with rs16876738 G/G and A/A. G/G single nucleotide polymorphism (SNP) of rs9476867 and A/G SNP of rs16876738 affected attention ability. Conclusion DTNBP1 gene polymorphisms are correlated with cognitive function in recurrent depressive disorder patients. Key words: Recurrent depressive disorder; Cognition; DTNBP1; Gene polymorphisms

Recognizing Emotions by Euthymic, Bipolar and Recurrent Depressed Patients

Recognizing Emotions by Euthymic, Bipolar and Recurrent Depressed Patients

Comparisons of clinical features of female recurrent major depression patients with and without suicidal ideation

Objective To explore the clinical features of female recurrent major depression(MD) patients with and without suicidal ideation. Methods 301 female recurrent major depression patients were interviewed by specially trained interviewers using computer evaluation system and divided into suicidal ideation group and non-suicidal ideation group according to suicidal ideation. The comparisons between the two groups were investigated on items of demographic, clinical data, assessment of psychopathology, Eysenck neuroticism questionnaire, stressful life events. Results 66.4% of MD patients have suicidal ideation. Compared with non-suicidal ideation group, there were more total number of MD symptoms (8.58±0.77, OR=2.476, P=1.154×10-9) and melancholia symptoms (6.74±1.07, OR=1.546, P=0.001) and it was more common in the factors of less appetite (OR=2.201, P=0.011), lose weight (OR=2.030, P=0.004), early morning awakening (OR=1.774, P=0.045), worthless (OR=2.352, P=0.014), impaired decision-making (OR=2.044, P=0.018), hopelessness (OR=7.130, P=6.651×10-9), helpless (OR=2.046, P=0.049) in suicidal ideation group. Also in suicidal ideation group the scores of neuroticism dimension (OR=1.631, P=0.024) were higher, and they were more suffered from stressful life events (OR=1.302, P=0.008). Binary logistic regression analysis indicated that total number of MD symptoms (OR=4.840, P=1.154×10-8), stressful life events (OR=1.392, P=0.014) and hopelessness (OR=3.528, P=0.008) were significantly associated with suicidal ideation. Conclusion Specific clinical features are associated with suicidal ideation among female patients of recurrent depression disorder. Hopelessness, stressful life events are risk factors of suicide ideation in female recurrent major depression patients. Integrated clinical assessment should be taken for recurrent major depression patients with suicidal ideation. Key words: Recurrent major depression; Suicidal ideation; Female; Clinical feature

Cognitive impairment in remitted and non-remitted depressive patients: A follow-up comparison between first and recurrent episodes

Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.

LONG-TERM OUTCOME OF MINDFULNESS-BASED COGNITIVE THERAPY IN RECURRENTLY DEPRESSED PATIENTS WITH AND WITHOUT A DEPRESSIVE EPISODE AT BASELINE.

In a previous randomized controlled trial in patients with three or more previous depressive episodes, mindfulness-based cognitive therapy (MBCT) appeared to be equally effective in those who were depressed and those who were in remission at the start of the trial. The aim of this study is to compare the 1-year outcome of MBCT in 124 remitted and 58 depressed patients who participated in the original trial and who were all offered MBCT either immediately or after a waiting period of 3 months. The course of depressive symptoms, rumination, mindfulness skills, and quality of life over the course of treatment and the 1-year follow-up period was analyzed. Linear mixed modeling was used to compare the outcome between remitted and depressed patients at baseline. In the whole sample, levels of depression and rumination decreased and mindfulness and quality of life increased over treatment. Levels of depressive symptoms, mindfulness, and quality of life remained stable over the 1-year follow-up period. Rumination further decreased. Remitted and depressed patients at the start of the trial did not differ in terms of outcome during or after treatment. Long-term outcome after MBCT in depressed patients was comparable to those who were in remission at the start of the trial. These findings lend further support to the notion that recurrent depressed patients meeting the criteria of a depressive episode do not need to be excluded from MBCT.

Multi-dimensional modulations of α and γ cortical dynamics following mindfulness-based cognitive therapy in Major Depressive Disorder.

To illuminate candidate neural working mechanisms of Mindfulness-Based Cognitive Therapy (MBCT) in the treatment of recurrent depressive disorder, parallel to the potential interplays between modulations in electro-cortical dynamics and depressive symptom severity and self-compassionate experience. Linear and nonlinear α and γ EEG oscillatory dynamics were examined concomitant to an affective Go/NoGo paradigm, pre-to-post MBCT or natural wait-list, in 51 recurrent depressive patients. Specific EEG variables investigated were; (1) induced event-related (de-) synchronisation (ERD/ERS), (2) evoked power, and (3) inter-/intra-hemispheric coherence. Secondary clinical measures included depressive severity and experiences of self-compassion. MBCT significantly downregulated α and γ power, reflecting increased cortical excitability. Enhanced α-desynchronisation/ERD was observed for negative material opposed to attenuated α-ERD towards positively valenced stimuli, suggesting activation of neural networks usually hypoactive in depression, related to positive emotion regulation. MBCT-related increase in left-intra-hemispheric α-coherence of the fronto-parietal circuit aligned with these synchronisation dynamics. Ameliorated depressive severity and increased self-compassionate experience pre-to-post MBCT correlated with α-ERD change. The multi-dimensional neural mechanisms of MBCT pertain to task-specific linear and non-linear neural synchronisation and connectivity network dynamics. We propose MBCT-related modulations in differing cortical oscillatory bands have discrete excitatory (enacting positive emotionality) and inhibitory (disengaging from negative material) effects, where mediation in the α and γ bands relates to the former.

Poster #T206 POSSIBLE ASSOCIATION BETWEEN ITIH3 GENE POLYMORPHISM AND SCHIZOPHRENIA IN A JAPANESE POPULATION

Cognitive impairment is a core symptom of depressive disorders associated with poor social function. New research is needed to analyze depression-related symptoms in cognitive impairment and to observe if they are reversible or not during clinical remission in patients with or without previous episodes. None of the previous studies has analyzed the differences between first and recurrent episodes in a long-term follow-up study related with remission state. The aim of our study was to compare cognitive performance and assess the impact of previous depressive episodes in a sample of patients in acute phase and in remission six month later. 79 depressive patients were assessed at baseline. The instruments used for clinical and cognitive assessment were: Hamilton Depression Rating Scale, Mini-Mental State Examination and the Clinical Global Impression Rating Scales, Trail Making Test parts A and B, Digital Span subtest of WAIS, Stroop Colour Word Test, Tower of London, Controlled Verbal Fluency Task, Semantic Verbal Fluency and Finger Tapping Test. A repeated measures MANCOVA with education as covariate was used. No differences were found at baseline between first episode and recurrent depressive patients. At six month, remitted patients scored significant better in TMT-A, TMT-B, Animals and Tower of London total time. Remitted first depressive patients scored significant worse than remitted recurrent depressive patients. The main finding of the study is the effect of remission on cognitive function despite previous episodes. However first episode remitted patients seemed to have poor access to long term memory than recurrent remitted patients.

EPA-1038 – From the first episode to recurrences: the role of automatic thoughts and dysfunctional attitudes in major depressive disorder

Introduction - Objecives According to the cognitive theory, negative automatic thoughts (NAT) and dysfunctional attitudes (DA) are important causal factors for the onset and maintanence of depression. There is limited data on the effects of NATs and DAs on the recurrence of depressive episodes. This study aims to compare the NATs and DAs of first versus recurrent episode depressive patients. The hypothesis of the study is that the intensity of negative cognitions will parallel the number of recurrences. Methods For the study, 100 first episode and 100 recurrent episode major depressive disorder diagnosed outpatients and 100 healthy volunteers presenting to the psychiatry clinics of three hospitals in Turkey were recruited. The participants were diagnosed by MINI, asked to complete the BDI, ATQ and DAS. Statistical analyses were undertaken to predict the variables affecting recurrence. Results The groups were not statistically different on sociodemographic variables. The mean NAT and DA scores were highest in the recurrent depression group. Regression analyses for the prediction of recurrence revealed that perfectionistic attitude, severity of depression and number of hospitalizations were the most correlated variables. The number of recurrences was correlated with the perfectionistic attitude scores. Conclusion These results show that the NATs and DAs of first episode depression patients differ from those of the recurrent episode depression patients, and the number of recurrences are predicted by perfectionistic attitudes. This has clinical implications in the treatment of depression, particularly points out to the need to manage perfectionistic attitudes to prevent recurrences.

İlk atak ve rekürren major depresyon hastalarının kognitif işlevler açısından karşılaştırılması

Comparison of first episode and recurrent major depression patients in terms of cognitive function Objective: Cognitive impairment is one of the most important causes of disability in depression. There are conflicting results about the nature of cognitive impairment with some studies finding a difference between first episode (FE) and recurrent depression (RD) and a correlation between cognitive impairment and depression severity while others do not. Our aim was to compare cognitive function in FE and RD patients and to see if cognitive impairment is correlated with depression severity and number of depressive episodes. Method: Unmedicated 33 FE and 37 RD outpatients with no additional Axis I disorder or physical disorder likely to affect cognition were included into the study and cognitive function was evaluated with verbal memory, verbal fluency, Stroop, Benton facial recognition and Boston naming tests. Results: There were no cognitive differences between FE and RD groups or between RD patients with more or less than 3 depressive episodes. But severely depressed patients had lower naming and immediate memory scores. Depression severity was positively correlated with Stroop color word reading time and negatively correlated with verbal memory learning score. Perseveration scores were positively correlated with total depressive episode duration. Discussion: Depression severity seems to be more effective on cognitive function than the number of depressive episodes. Results indicate that simple attention, encoding, learning, naming and mental speed is affected negatively from depression severity and cognitive flexibility was negatively affected by total