Recurrent Major Depression Research Articles

Changes in leukocytes and CRP in different stages of major depression

BackgroundWe recently reported increased levels of neutrophils, monocytes and C-reactive protein (CRP) correlated with symptom severity in acute schizophrenia. Here, we investigated if a similar pattern of innate immune system activation occurs in major depression (MD).MethodsWe assessed differential blood counts, CRP, depression symptoms (HAMD-21) and psychosocial functioning (GAF) in controls (n = 129) and patients with first (FEMD: n = 82) or recurrent (RMD: n = 47) disease episodes of MD at baseline (T0; hospital admission) and after 6-weeks treatment (T6).ResultsConsidering smoking, BMI and gender as covariates, neutrophils (FEMD: p = 0.034, RMD: p = 0.034) and CRP (FEMD: p < 0.001, RMD: p = 0.021) were higher, and eosinophils (FEMD: p = 0.005, RMD: p = 0.004) lower in patients versus controls at T0. Baseline lymphocyte counts were elevated in RMD (p = 0.003) but not FEMD. Results were confirmed by analyses of nonsmokers. At follow-up, eosinophils rose significantly in FEMD (p = 0.011) but no significant changes were observed in RMD. Improvement in HAMD-21 correlated with T0–T6 changes of neutrophil counts in FEMD (r = 0.364, p = 0.024). Compared with our previous schizophrenia study, raised baseline neutrophil and reduced eosinophil counts in MD had smaller effect sizes and treatment had a weaker association with T0-T6 changes in neutrophils. In addition, lymphocytes were elevated at T0 in recurrent MD but not in schizophrenia patients.ConclusionsThese findings suggest that innate immunity may be involved in early stages of MD, and adaptive immunity may be involved in chronic disease. Thus, further studies may lead to new disease stage-dependent MD treatment strategies targeting different aspects of immune system activation.

Brief CBT Interventions May Stop Depression Before It Starts

Brief CBT Interventions May Stop Depression Before It Starts

The structure of the symptoms of major depression: Factor analysis of a lifetime worst episode of depressive symptoms in a large general population sample

BackgroundA range of depressive symptoms may occur during an episode of major depression (MD). Do these symptoms describe a single disorder liability or different symptom dimensions? This study investigates the structure and clinical relevance of an expanded set of depressive symptoms in a large general population sample. MethodsWe studied 43,431 subjects from the Dutch Lifelines Cohort Study who participated in an online survey assessing the 9 symptom criteria of MD (DSM-IV-TR) and additional depressive symptoms during their worst lifetime episode of depressive symptoms lasting two weeks or more. Exploratory factor analyses were performed on expanded sets of 9, 14, and 24 depressive symptoms. The clinical relevance of the identified symptom dimensions was analyzed in confirmatory factor analyses including ten external validators. ResultsA single dimension adequately accounted for the covariation among the 9 DSM-criteria, but multiple dimensions were needed to describe the 14 and 24 depressive symptoms. Five dimensions described the structure underlying the 24 depressive symptoms. Three cognitive affective symptom dimensions were mainly associated with risk factors for MD. Two somatic dimensions –appetite/weight problems and sleep problems—were mainly associated with BMI and age, respectively. LimitationsRespondents of our online survey tended to be more often female, older, and more highly educated than non-respondents. ConclusionsDifferent symptom dimensions described the structure of depressive symptoms during a lifetime worst episode in a general population sample. These symptom dimensions resembled those reported in a large clinical sample of Han-Chinese women with recurrent MD, suggesting robustness of the syndrome of MD.

Potential Synergy of Lithium and Ketamine in Treatment of Recurrent Major Depression

Combination pharmacotherapy has proven to be effective in the treatment of major depressive disorder (MDD), particularly when medications from different drug classes are combined. Lithium and ketamine, although typically not prescribed as first-line treatments, have been used individually to augment the effects of antidepressants; however, little is known about the efficacy of combined lithium and ketamine therapy in treating MDD. We present a patient diagnosed as having MDD whose biweekly ketamine infusions augmented with lithium resulted in an improvement of depressive symptoms, leading to a successful discharge following 2.5 months of hospitalization, during which the patient failed to show improvement with both electroconvulsive therapy and trials of multiple classes of antidepressants. [ Psychiatr Ann . 2022;52(4):170–172.]

Self-Compassion and Its Association With Ruminative Tendencies and Vagally Mediated Heart Rate Variability in Recurrent Major Depression.

BackgroundRecurrent Major Depressive Disorder (MDD) is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility (indexed by a higher vagally mediated heart rate variability; vmHRV) in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion would associate with (1) lower ruminative tendencies and (2) higher vmHRV in a sample of adults with recurrent MDD.MethodsWe included a sample of 63 patients (46 females) between 20 and 71 years old (M = 40.24, SD = 12.8) with a history of three or more depressive episodes. They filled out the Self-Compassion Scale (SCS), Beck Depression Inventory (BDI), and Rumination Rating Scale (RRS). ECG (used to derive vmHRV) was acquired while resting and the square root of the mean squared differences of successive RR interval values (RMSSD) was calculated as measure of vmHRV.ResultsAs hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses.ConclusionThe results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response (as indexed by higher vmHRV). Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies.

Special Report: Stress and Distress During Pregnancy—How to Protect Both Mother and Child

Special Report: Stress and Distress During Pregnancy—How to Protect Both Mother and Child

Prevention of Incident and Recurrent Major Depression in Older Adults With Insomnia

Older adults with insomnia have a high risk of incident and recurrent depression. Depression prevention is urgently needed, and such efforts have been neglected for older adults. To examine whether treatment of insomnia disorder with cognitive behavioral therapy for insomnia (CBT-I) compared with an active comparator condition, sleep education therapy (SET), prevents major depressive disorder in older adults. This assessor-blinded, parallel-group, single-site randomized clinical trial assessed a community-based sample of 431 people and enrolled 291 adults 60 years or older with insomnia disorder who had no major depression or major health events in past year. Study recruitment was performed from July 1, 2012, to April 30, 2015. The trial protocol was modified to extend follow-up from 24 to 36 months, with follow-up completion in July 2018. Data analysis was performed from March 1, 2019, to March 30, 2020. Participants were randomized to 2 months of CBT-I (n = 156) or SET (n = 135). The primary outcome was time to incident major depressive disorder as diagnosed by interview and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. Secondary outcome was sustained remission of insomnia disorder before depression event or duration of follow-up. Among 291 randomized participants (mean [SD] age, 70.1 [6.7] years; 168 [57.7%] female; 7 [2.4%] Asian, 32 [11.0%] Black, 3 [1.0%] Pacific Islander, 241 [82.8%] White, 6 [2.1%] multiracial, and 2 [0.7%] unknown), 156 were randomized to CBT-I and 135 to SET. A total of 140 participants (89.7%) completed CBT-I and 130 (96.3%) participants completed SET (χ2 = 4.9, P = .03), with 114 (73.1%) completing 24 months of follow-up in the CBT-I group and 117 (86.7%) in the SET group (χ2 = 8.4, P = .004). After protocol modification, 92 (59.0%) of the CBT-I participants and 86 (63.7%) of the SET participants agreed to extended follow-up (χ2 = 0.7, P = .41), with 81 (51.9%) of the CBT-I participants and 77 (57.0%) of the SET group completing 36 months of follow-up (χ2 = 0.8; P = .39). Incident or recurrent major depression occurred in 19 participants (12.2%) in the CBT-I group and in 35 participants (25.9%) in the SET group, with an overall benefit (hazard ratio, 0.51; 95%, CI 0.29-0.88; P = .02) consistent across subgroups. Remission of insomnia disorder continuously sustained before depression event or during follow-up was more likely in CBT-I participants (41 [26.3%]) compared with the SET participants (26 [19.3%], P = .03). Those in the CBT-I group with sustained remission of insomnia disorder had an 82.6% decreased likelihood of depression (hazard ratio, 0.17; 95%, CI 0.04-0.73; P = .02) compared with those in the SET group without sustained remission of insomnia disorder. The findings of this randomized clinical trial indicate that treatment of insomnia with CBT-I has an overall benefit in the prevention of incident and recurrent major depression in older adults with insomnia disorder. Community-level screening for insomnia concerns in older adults and wide delivery of CBT-I-based treatment for insomnia could substantially advance public health efforts to treat insomnia and prevent depression in this vulnerable older adult population. ClinicalTrials.gov Identifier: NCT01641263.

Transformer les pratiques entre la psychiatrie de l’enfant et de l’adolescent et la psychiatrie de l’adulte pour une réelle prévention

It is estimated that around 20% of children in the general population have a parent affected by a major psychiatric disease such as schizophrenia, bipolar disorder or recurrent major depressive disorder. Nevertheless, we face the “medical paradox” in which these children most at risk, born to an affected parent, are overlooked by our health systems. These children are indeed 15 to 20 times more likely to develop a psychiatric disorder as young adults, and 50% of them present childhood developmental or behavioural problems deserving treatment. Several indicators of brain dysfunctions, or risk endophenotypes, carried by adult patients can be detected early in the life of these children, thus making it possible to differentiate the child at highest risk among the siblings in the same family. These discoveries support the neurodevelopmental hypothesis of schizophrenia, bipolar disorder and recurrent major depression and the partially shared origin of these three disorders. In this selective scientific review, we will discuss data suggesting that, among children at risk, those who progress towards the illness cumulate risk indicators during their early trajectory. This aggregation phenomenon can serve as an empirical ground for the definition of preclinical stages in the risk trajectory and the development of clinical practice guidelines regarding surveillance or prevention in these children. Governmental legislations have already been promulgated in several countries with mitigated success to change the situation for these high-risk children and families. Based on existing scientific data, we thus propose that clinical practice guidelines be delivered by national medical academies so as to bring about the needed changes, improve communication between primary care, and specialized care and foster functional connections between child and adult psychiatry.

Older Adults and Serious Mental Illness: What We Know and What We Imagine

Older Adults and Serious Mental Illness: What We Know and What We Imagine

End of life breast cancer care in women with severe mental illnesses

Little is known on the end-of-life (EOL) care of terminal breast cancer in women with severe psychiatric disorder (SPD). The objective was to determine if women with SPD and terminal breast cancer received the same palliative and high-intensity care during their end-of-life than women without SPD. Study design, setting, participants. This population-based cohort study included all women aged 15 and older who died from breast cancer in hospitals in France (2014–2018). Key measurements/outcomes. Indicators of palliative care and high-intensity EOL care. Multivariable models were performed, adjusted for age at death, year of death, social deprivation, duration between cancer diagnosis and death, metastases, comorbidity, smoking addiction and hospital category. The analysis included 1742 women with SPD (287 with bipolar disorder, 1075 with major depression and 380 with schizophrenia) and 36,870 women without SPD. In multivariate analyses, women with SPD had more palliative care (adjusted odd ratio aOR 1.320, 95%CI [1.153–1.511], p < 0.001), longer palliative care follow-up before death (adjusted beta = 1.456, 95%CI (1.357–1.555), p < 0.001), less chemotherapy, surgery, imaging/endoscopy, and admission in emergency department and intensive care unit. Among women with SPD, women with bipolar disorders and schizophrenia died 5 years younger than those with recurrent major depression. The survival time was also shortened in women with schizophrenia. Despite more palliative care and less high-intensity care in women with SPD, our findings also suggest the existence of health disparities in women with bipolar disorders and schizophrenia compared to women with recurrent major depression and without SPD. Targeted interventions may be needed for women with bipolar disorders and schizophrenia to prevent these health disparities.

Sex differences in predictors of recurrent major depression among current-era military veterans.

Although major depressive disorder (MDD) is a frequent diagnosis among women seeking care in the Veterans Health Administration, little is known about its course. For example, recurrence of MDD and its predictors have been investigated in civilians, but not among female veterans. Because female veterans differ from their civilian counterparts and from male veterans on demographic variables, including race, ethnicity, marital status, and educational level, it is important to identify factors affecting MDD course within this population. We investigated frequency and correlates of recurrent MDD among female veterans and their male counterparts. From a postdeployment research registry of 3,247 participants (660 women and 2,587 men), we selected those with a current episode of MDD (141 women and 462 men). For each sex, we compared those diagnosed with recurrent MDD with those experiencing a single episode on demographics, comorbid diagnoses, family history of mental illness, traumatic experiences, combat exposure, and social support. In contrast to findings in most civilian samples, recurrent MDD was significantly more frequent in female (70.2%) than in male (45.2%) depressed veterans, χ²(1) = 26.96, p < .001. In multivariable analyses, recurrence among women was associated with greater experiences of childhood abuse and more trauma during military service and with lower rates of posttraumatic stress disorder. Among men, recurrence was associated with older age, family history of psychiatric hospitalization, more postmilitary trauma, and lifetime anxiety disorder and with lower likelihood of war zone deployment. Trauma was associated with recurrence in both sexes, but the features of traumatic events differed in women and men. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Characteristics of patients with major depressive disorder switching SSRI/SNRI therapy compared with those augmenting with an atypical antipsychotic in a real-world setting

Background Following a partial response of first-line antidepressant therapy for the treatment of major depressive disorder (MDD), there is a choice to augment treatment with another agent or switch to a different antidepressant. Objective To report the prevalence and compare the characteristics of patients switching from their initial selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor (SSRI/SNRI) to a new SSRI/SNRI versus those augmenting SSRI/SNRI therapy with a second-generation antipsychotic (SGA). Methods MDD patients receiving first-line SSRI/SNRI treatment were identified from a large US-based claims database during 2000–2019. Patients augmenting therapy with an SGA were compared with those who switched to a new SSRI/SNRI. The date of the treatment change was the index date. Previously diagnosed comorbid conditions, medication use and demographics were captured. Treatment patterns following the index date were also captured. Standardized differences (StdDiff) were used to quantify dissimilarities between the two groups. Results There were 4572 SGA add-on and 24,409 switching patients identified. SGA augmentation patients had more severe disease (diagnosed severe recurrent major depression: 24.7% vs. 9.5%, StdDiff = 0.41) and more diagnosed psychiatric conditions, including: suicidal thoughts (10.7% vs. 3.2%, StdDiff = 0.29), post-traumatic stress disorder (6.1% vs. 2.6%, StdDiff = 0.17) and alcohol abuse (5.4% vs. 2.7%, StdDiff = 0.14). SGA augmentation patients had higher rates of prior use of anxiolytics (37.4% vs. 28.2%, StdDiff = 0.20) and anticonvulsants (26.0% vs. 13.1%, StdDiff = 0.33). Conclusions Patients adding an SGA to their SSRI/SNRI therapy appeared to have more severe depression and comorbid psychiatric profile than those switching their SSRI/SNRI. These differences are important to consider and adequately control for in any future comparative outcome research between these two groups.

Suicide attempts in women with severe mental illness in the perinatal period

Suicide is one of the leading causes of perinatal maternal mortality (1). Maternal suicidality has a negative impact on the mother-baby relationship and child development. However, little is known about specific risk factors for perinatal suicide attempts in women with severe mental illness. In a sample of 1439 women with severe mental illness in the perinatal period and jointly admitted with their baby in a mother and baby unit, 154 (11.7%) attempted suicide, 49 in pregnancy (3.7%) and 105 (8.0%) in the post-partum period (2). Suicide attempt in pregnancy was related to alcohol use, smoking during pregnancy and a history of miscarriage, and in the post-partum period to major depressive episode or recurrent depression and younger age. Women who attempt suicide either in pregnancy or in the postnatal period could have different psychopathological and environmental profiles. Past obstetric history and addictive behaviours during pregnancy are essential elements to explore. In addition, depressive symptoms should be assessed in all women to treat major depression, as a means of preventing suicide attempt. Special attention to risk of suicide is needed during the perinatal period for women with severe mental illness. For women suffering from an acute psychiatric disorder, or a history of mental illness, multi-disciplinary management should be implemented. 1. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-81. 2. Gressier F et al. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. J Psychiatr Res. 2017;84:284-291.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.

Using machine learning to predict suicide in the 30 days after discharge from psychiatric hospital in Denmark.

Suicide risk is high in the 30 days after discharge from psychiatric hospital, but knowledge of the profiles of high-risk patients remains limited. To examine sex-specific risk profiles for suicide in the 30 days after discharge from psychiatric hospital, using machine learning and Danish registry data. We conducted a case-cohort study capturing all suicide cases occurring in the 30 days after psychiatric hospital discharge in Denmark from 1 January 1995 to 31 December 2015 (n = 1205). The comparison subcohort was a 5% random sample of all persons born or residing in Denmark on 1 January 1995, and who had a first psychiatric hospital admission between 1995 and 2015 (n = 24 559). Predictors included diagnoses, surgeries, prescribed medications and demographic information. The outcome was suicide death recorded in the Danish Cause of Death Registry. For men, prescriptions for anxiolytics and drugs used in addictive disorders interacted with other characteristics in the risk profiles (e.g. alcohol-related disorders, hypnotics and sedatives) that led to higher risk of postdischarge suicide. In women, there was interaction between recurrent major depression and other characteristics (e.g. poisoning, low income) that led to increased risk of suicide. Random forests identified important suicide predictors: alcohol-related disorders and nicotine dependence in men and poisoning in women. Our findings suggest that accurate prediction of suicide during the high-risk period immediately after psychiatric hospital discharge may require a complex evaluation of multiple factors for men and women.

A Pilot Study Differentiating Recurrent Major Depression from Bipolar Disorder Cycling on the Depressive Pole [Retraction

[This retracts the article DOI: 10.2147/NDT.S14353.].

The Role of Affective Temperament and Character Traits in Predicting Suicidality in Depressed Patients

espanolEl objetivo de este estudio fue evaluar la relacion de los temperamentos afectivos y los rasgos de personalidad con los intentos de suicidio en pacientes que sufren depresion. Un total de 251 pacientes diagnosticados de trastorno depresivo recurrente o episodio de depresion mayor se dividio en dos grupos, uno con intentos de suicidio previos (n = 168) y otro sin estas tentativas (n = 83), a los que se aplico un cuestionario sociodemografico, TEMPS-A, y un cuestionario de personalidad, VP+2-70. En todos los temperamentos que no eran los hipertimicos las puntuaciones mas altas se dieron predominantemente en el grupo de pacientes con tentativas de suicidio previas. El modelo que incluye temperamentos afectivos y rasgos de personalidad clasifico adecuadamente al 72.5% de los casos. Solo el temperamento depresivo aparecio como predictor positivo significativo con valencia negativa cercana a la significacion estadistica. El diseno transversal limita nuestra capacidad para sacar conclusiones sobre la causalidad ademas de que no se controlo el estado afectivo actual de los pacientes. Sin embargo, los resultados destacan aun mas la importancia del temperamento afectivo como herramienta de deteccion del riesgo de suicidio en pacientes deprimidos. EnglishThe purpose of this study was to assess the relationship of affective temperaments and personality traits with suicide attempts in patients suffering from depression. A total of 251 patients diagnosed with recurrent depressive disorder or major depression episode were divided in groups with previous suicide attempts (n = 168) and without such attempts (n = 83) and given a sociodemographic questionnaire, TEMPS-A, and a personality questionnaire, VP+2-70. In all temperaments other than hyperthymic, higher scores were predominant in the group of patients with previous suicide attempts. The model including affective temperaments and personality traits successfully classified 72.5% of cases. Only depressive temperament was found to be a significant positive predictor with negative valence close to statistical significance. The cross-sectional design limits our ability to draw conclusions about causality and current affective status of the patients was not controlled for. However, our findings further prove the importance of affective temperament as a screening tool for suicide risk in depressed patients.

T26. VISUO-TACTILE TRANSFER AND AUDIO-VISUAL INTEGRATION IMPAIRMENT AS A NEW VULNERABILITY MARKER IN CHILDREN-AT-RISK OF SCHIZOPHRENIA, BIPOLAR DISORDER OR RECURRENT DEPRESSIVE DISORDER

BackgroundMajor psychiatric disorders (MPD) such as schizophrenia, bipolar disorder and recurrent major depression have shared neurodevelopmental vulnerability due to early neuronal and sensory defect as revealed by sensory and cognitive endophenotypes observed in our cohorts (e.g. Gagné et al., Schizophr. Res., 2019). There is considerable evidence that a harmonious self-development - known to be disrupted in MPDs - requires a synchronized multisensory perception and an adequate integration of sensory afferences (e.g. tactile, visual, auditory and proprio / interoception) with cognition. Early impairment in intermodal transfer (IMT) and multisensory integration (MSI) may jeopardize a stable and unified self’s and world’s representation and then would undermine self-development and represent a risk factor for MPD. IMT is the capability to transfer a percept coming exclusively from a sensory modality (e.g. tactile) to another modality (e.g. visual). MSI is the ability to integrate sensory inputs from different modalities (e.g. visual and auditory) to have a better information processing. This study shows that impairment in IMT/MSI may be a vulnerability marker in children genetically at-risk.MethodsSample: Forty-four offspring (21 girls) of patients suffering from a MPD and thus genetically at-risk for MPD (GatR) aged from 9–15 years old (mean age = 12.06) were recruited from the cohort study INTERCEPT through the HoPE program of the CIUSSS de la Capitale-Nationale. Twenty-five controls (19 girls) with no family history of MPD and no DSM-V disorder aged from 9–15 years old (mean age = 12.87) were recruited using advertisements or control bank.IMT Task:Each condition has 12 trials and the shapes are hidden from sight during palpation.- T-T condition: The subject has to palpate a 3D target shape for 10s and must then recognize it by touch from among a distractor.- Condition T-V: The subject has to palpate a 3D target shape for 10s and must then recognize it visually from among a distractor.- V-T Condition: A 3D target shape is presented visually for 10s and the subject must then recognize it by touch from among a distractor.MSI Task: - Simple reaction time (RT) task comprising 80 trials with unimodal stimuli (Auditory OR Visual) and 40 trials with AV (Auditory and Visual simultaneously) multimodal stimuli presented randomly.- The Race model calculates the expected response probability for each RT knowing that AV RT could not be shorter than the shorter unimodal RT, if the sensory modalities are indeed separated channels (no MSI).- RTs shorter than those predicted by the Race model (best unimodal RT) are presumed to show multisensory facilitation which reflects MSI. The percentage of AV facilitation (AV – Race) is calculated for each reaction time.ResultsIMT task: When compared to controls, GatR were impaired in the three conditions (T-T: 9.77 vs. 10.32, T-V: 9.89 vs. 9.96, V-T: 9,11 vs. 9.92) with significant impairments both for T-T (t(60.53) = 2.18, p = 0.017) and V-T (t (57.28) = 2.33, p = 0.012) conditions.MSI task: GatR showed a deficit in MSI for almost all RT ranges (except for a peak at 185 ms), while control participants showed MSI facilitation for ranges from 150 to 200 ms.DiscussionDevelopmentally genetically high-risk children would show significant impairments both in IMT and MSI that might enter into the group of indicators of brain dysfunctions, or risk endophenotypes, that both children at risk and adult patients carry (Paccalet et al., Schizophr. Res., 2016; Maziade, New Eng J Medicine, 2017). In addition, the two tasks would be valid and sensitive to the early sensory alterations in self-development. Finally, the battery is brief, user-friendly and playful for children.

O7.2. MENTAL HEALTH AND SOMATIC STATUS OF YOUNG CHILDREN (0–6 YEARS) BORN TO PARENTS WITH SEVERE MENTAL ILLNESSES - A NATIONWIDE DANISH REGISTER STUDY

BackgroundChildren born to parents with severe mental illness like schizophrenia, bipolar disorder or recurrent major depression have been shown to have a higher risk, not only for developing a mental illness themselves in adulthood (Rasic) but also in childhood and adolescence. Less is known about the offspring’s somatic health and very early development processes. Increasing knowledge demonstrate the importance of the very early years of life from birth to age 6 for a healthy and natural brain development and for good life outcomes in general. Thus, more knowledge is needed about this vulnerable period in life, especially for children, who are born with a familial high risk for severe mental illness in order to develop relevant interventions for these children.MethodsWe used Danish registries to evaluate the incidence and the frequencies of early (i.e. age 0–6 years) psychiatric diagnoses of a nationwide cohort of children born to parents with severe mental illness. Further we calculated the frequencies of somatic health problems and compared them to population-based controls.ResultsWe found increased ORs for children in all three FHR-groups for having received any diagnosis of a mental disorder before age 7 (e.g.: mother depressed, N=1223): OR:2.82 (CI:2.65–2.99), mother bipolar (N=98): OR: 3.06 (CI 2.50–3.76), mother schizophrenia (N=574): OR 5.23 (CI: 4.80–5.69), and similar although a bit smaller ORs if it was the father, who had a diagnosis. Especially ORs for attachment disorder and anxiety were increased but also ORs for eating disorders and sleep disorders were found to be significantly higher than for controls. Odd ratios for somatic disorders were marginally increased for all disorders and also for intoxications and injuries.DiscussionOur results document that children born to parents with severe mental illnesses are vulnerable from the beginning of life, mainly in terms of their mental health but to some extent also in terms of somatic health. Parents who have a severe mental disorder may need extra support in the parenting role to ensure good health for the child.

Alcohol Use Disorder and the Persistence/Recurrence of Major Depression: Le trouble de l'usage de l'alcool et la persistance/récurrence de la dépression majeure.

This study aims to determine the role of alcohol use disorder and other potential risk factors on persistence/recurrence of major depression in a Canadian population sample. Data were drawn from the National Population Health Survey (1994/1995 to 2010/2011), a prospective epidemiologic survey of individuals 12 years and older, living in 10 Canadian provinces (N = 17,276). Participants were reinterviewed every 2 years for 9 cycles. This study population was a cohort of individuals who at baseline met the diagnosis of a major depressive episode (MDE) in the previous 12 months (n = 908). After the 6-year (cycle 4) and 16-year (cycle 9) follow-up period, 124 of 718 participants and 79 of 461 participants met the criteria for MDE, respectively. Persistence or recurrence of major depression was defined as meeting a diagnosis of MDE after 6 years and 16 years. Modified Poisson regression models were used to assess the role of alcohol dependence and other risk factors on the persistence/recurrence of major depression using Stata 14. Alcohol use disorder was significantly correlated with a 6-year (odds ratio [OR]: 3.03; 95% confidence interval [CI], 1.68 to 5.48; P < .0001) and 16-year (OR, 3.17; 95% CI, 1.15 to 8.77, P = 0.003) persistence/recurrence of major depression. Other factors associated with the persistence/recurrence of major depression include female sex, childhood traumatic events, chronic pain restricting activities, daily smoking, and low self-esteem. Comorbid alcohol use disorder was found to be a strong risk factor for the persistence or recurrence of major depression.