Self-reported Depressive Symptom Severity Research Articles

Inferring Depression and Its Semantic Underpinnings from Simple Lexical Choices

Spatial demonstratives are highly frequent linguistic universals, with at least two contrastive expressions (proximal (“this”) vs. distal (“that”)) indicating physical, social, or functional proximity of the speaker to the referent object. Recent evidence based on the Demonstrative Choice Task (DCT), in which participants couple words with a spatial demonstrative with no context provided, suggests that demonstrative use is also indicative of experienced or emotional proximity to the self in an imagined mental space. As depression is characterized by increased and maladaptive focus on the self, the DCT may be a simple and reliable way to elicit behaviors that enable inference on the presence of severe depressive states and allow descriptions of the semantic characteristics of individual differences in such states. In two independent cross-sectional studies, including 775 and 879 participants, respectively, we showed that DCT-based classification models reliably capture semantic characteristics of experiential states that are predictive of self-reported depression symptom severity, as measured by PHQ-9. In both samples, DCT classifiers outperformed baseline models and replicated semantic patterns of negative affect previously observed to be associated with depression. This indicates that the paradigm captures semantic characteristics of the experiential states underlying depression symptoms and may be used to map individuals along a broad semantic space, potentially providing novel insights into individual differences in depressive states.

Effects of Cortisol Administration on Resting-State Functional Connectivity in Women with Depression

Previous resting-state functional connectivity (rsFC) research has identified several brain networks impacted by depression and cortisol, including default mode (DMN), frontoparietal (FPN), and salience networks (SN). In the present study, we examined the effects of cortisol administration on rsFC of these networks in individuals varying in depression history and severity. We collected resting-state fMRI scans and self-reported depression symptom severity for 74 women with and without a history of depression after cortisol and placebo administration using a double-blind, crossover design. We conducted seed-based rsFC analyses for DMN, FPN, and SN seeds to examine rsFC changes after cortisol vs. placebo administration in relation to depression history group and severity. Results revealed a main effect of depression group, with lower left amygdala (SN)-middle temporal gyrus connectivity in women with a history of depression. Cortisol administration increased insula (SN)-inferior frontal gyrus and superior temporal gyrus connectivity. We also found that greater depression severity was associated with increased PCC (DMN)-cerebellum connectivity after cortisol. These results did not survive Bonferroni correction for seed ROIs and should be interpreted with caution. Our findings indicate that acute cortisol elevation may normalize aberrant connectivity of DMN and SN regions, which could help inform clinical treatments for depression.

Depression is associated with reduced outcome sensitivity in a dual valence, magnitude learning task.

Learning from rewarded and punished choices is perturbed in depressed patients, suggesting that abnormal reinforcement learning may be a cognitive mechanism of the illness. However, previous studies have disagreed about whether this behavior is produced by alterations in the rate of learning or sensitivity to experienced outcomes. This previous work has generally assessed learning in response to binary outcomes of one valence, rather than to both rewarding and punishing continuous outcomes. A novel drifting reward and punishment magnitude reinforcement-learning task was administered to patients with current (n = 40) and remitted depression (n = 39), and healthy volunteers (n = 40) to capture potential differences in learning behavior. Standard questionnaires were administered to measure self-reported depressive symptom severity, trait and state anxiety and level of anhedonic symptoms. Our findings demonstrate that patients with current depression adjust their learning behaviors to a lesser degree in response to trial-by-trial variations in reward and loss magnitudes than the other groups. Computational modeling revealed that this behavioral signature of current depressive state is better accounted for by reduced reward and punishment sensitivity (all p < 0.031), rather than a change in learning rate (p = 0.708). However, between-group differences were not related to self-reported symptom severity or comorbid anxiety disorders in the current depression group. These findings suggest that current depression is associated with reduced outcome sensitivity rather than altered learning rate. Previous findings reported in this domain mainly from binary learning tasks seem to generalize to learning from continuous outcomes.

Depressed, stressed, and inflamed: C-reactive protein linked with depression symptoms in midlife women with both childhood and current life stress.

To determine whether the relationship between inflammatory factors and clinically significant depression symptoms is moderated by high exposure to adverse childhood experiences and current life stressors in a longitudinal community cohort of midlife women. Methods: Participants from the Penn Ovarian Ageing Study community cohort (age at baseline: M=45.3 [SD=3.8]) were included in analyses if they had a blood sample measuring basal inflammatory markers during at least one visit where depression symptom severity and current stressful life events were also assessed (N=142, average number of visits per participant=1.75 [SD=0.92]). Approximately annually over the course of 16years, participants self-reported depression symptom severity using the Centre for Epidemiologic Studies Depression (CESD) Scale, provided menstrual diaries to determine menopause stage, and contributed blood samples. Residual blood samples were assayed for interleukin (IL)-6, IL 1-beta (IL-1β), tumour necrosis factor alpha (TNF-α), and high sensitivity C-reactive protein (hsCRP). Early life stress was quantified using the Adverse Childhood Experiences questionnaire (low [0-1 experience(s)] versus high [≥ 2 experiences]). Current stressful life events were assessed using a structured interview (low [0-1 events] vs. high [≥ 2 events]). Generalised estimating equation models were used to model associations with the outcome of interest-clinically significant depression symptoms (CESD ≥16)-and risk factors: inflammatory marker levels (log transformed), adverse childhood experiences group, and current life stressors group. Covariates included menopause stage, age at study baseline, body mass index, race, and smoking status. We found a significant three-way interaction between log hsCRP levels, adverse childhood experiences group, and current life stressors group on likelihood of experiencing clinically significant depression symptoms (OR: 4.33; 95% CI: 1.22, 15.46; p=0.024) after adjusting for covariates. Solely for women with high adverse childhood experiences and with high current life stressors, higher hsCRP was associated with higher odds of having clinically significant depression symptoms (OR: 1.46; 95% CI 1.07, 1.98; p=0.016). This three-way interaction was not significant for IL-6, IL-1β, or TNF-α. For women in midlife with exposure to high adverse childhood experiences and multiple current life stressors, elevated levels of CRP were uniquely associated with clinically significant depression symptoms. Early life adversity and current life stressors represent identifiable individual risk factors whose negative impact may be curtailed with inventions to target inflammation in midlife women.

Multisystemic Resources Matter for Resilience to Depression: Learning From a Sample of Young South African Adults.

This article interrogates the continuing emphasis on personal sources of resilience; it also amends the inattention to the protective factors and processes (PFPs) that support the mental health resilience of African emerging adults. To that end, we report a study that explored which PFPs distinguished risk-exposed South African 18- to 29-year-olds with negligible depression symptoms from those who reported moderate to severe symptoms. Using an arts-based approach, young people volunteered the PFPs they had personally experienced as resilience-enabling. An inductive thematic analysis of visual and narrative data, generated by young people self-reporting high exposure to family and community adversity (n = 233; mean age: 24.63, SD: 2.43), revealed patterns in the PFPs relative to the severity of self-reported depression symptoms. Specifically, young people reporting negligible depression symptoms reported a range of PFPs associated with psychological, social, and ecological systems. In contrast, the PFPs identified by those reporting more serious depression symptoms were mostly restricted to personal strengths and informal relational supports. In the interests of youth mental health, the findings direct society's attention to the criticality of facilitating young people's access to a composite of resources rooted in personal, social, and ecological systems.

Abnormal neurophysiological sensitivity to rewards in depression is moderated by sex and age in middle adulthood

A candidate pathophysiological process in major depressive disorder is diminished neural reactivity to reward delivery, which is theorized to give rise to anhedonia. Reduced amplitude in the reward positivity (RewP), which captures initial reward evaluation, has been linked to current symptoms of depression among child, adolescent, and young adult samples. However, the developmental trajectory of this association is incomplete, with relatively few studies in middle and older adulthood. Further, emerging evidence in the literature also suggests that this association may be linked to female sex-specific processes, but no studies to date have directly contrasted the effect of sex on the depression-RewP association. The current study sought to address these gaps by testing how sex and age may moderate the depression-RewP association within a mature adult community sample. Symptoms of depression were evaluated using a survey and a clinical interview, and the RewP was elicited using a simple guessing task. There was a three-way interaction between depression symptom severity, age, and sex in predicting RewP amplitude. This was driven by younger (late 30’s to early 40’s) female-sexed people such that for this group, elevated symptoms of depression were associated with blunting of the RewP. This association tapered around age 50. This effect was specific to clinician-rated rather than self-reported depressive symptom severity. This pattern of effects suggests that among female-sexed people, developmental processes continue to shape the association between reward responsiveness and depression throughout middle adulthood.

Design and rationale of the REStoring mood after early life trauma with psychotherapy (RESET-psychotherapy) study: a multicenter randomized controlled trial on the efficacy of adjunctive trauma-focused therapy (TFT) versus treatment as usual (TAU) for adult patients with major depressive disorder (MDD) and childhood trauma

BackgroundMajor depressive disorder (MDD) is a common, recurrent mental disorder and a leading cause of disability worldwide. A large part of adult MDD patients report a history of childhood trauma (CT). Patients with MDD and CT are assumed to represent a clinically and neurobiologically distinct MDD subtype with an earlier onset, unfavorable disease course, stress systems’ dysregulations and brain alterations. Currently, there is no evidence-based treatment strategy for MDD that specifically targets CT. Given the central role of trauma in MDD patients with CT, trauma-focused therapy (TFT), adjunctive to treatment as usual (TAU), may be efficacious to alleviate depressive symptoms in this patient population.MethodsThe RESET-psychotherapy study is a 12-week, single-blind, randomized controlled trial testing the efficacy of TFT in 158 adults with moderate to severe MDD, as a ‘stand-alone’ depression diagnosis or superimposed on a persistent depressive disorder (PDD), and CT. TFT (6–10 sessions of Eye Movement Desensitization and Reprocessing and/or imagery rescripting) + TAU is compared to TAU only. Assessments, including a wide range of psychological/psychiatric and biological characteristics, take place before randomization (T0), during treatment (T1), at post-treatment (T2) and at 6-month follow-up (T3). Pre-post treatment stress-related biomarkers in hair (cortisol) and blood (epigenetics and inflammation) will be assessed to better understand working mechanisms of TFT. A subgroup of 60 participants will undergo structural and functional Magnetic Resonance Imaging (MRI) assessments to determine pre-post treatment brain activity. The primary outcome is self-reported depression symptom severity at post-treatment, measured with the 30-item Inventory of Depressive Symptomatology – Self Report (IDS-SR).DiscussionIf adjunctive TFT efficaciously alleviates depressive symptoms in MDD patients with CT, this novel treatment strategy could pave the way for a more personalized and targeted MDD treatment.Trial registrationClinicalTrials.gov, registered at 08–12-2021, number of identification: NCT05149352.

Anterior Insula Activation During Cardiac Interoception Relates to Depressive Symptom Severity in HIV-Positive and HIV-Negative Postmenopausal Women.

ABSTRACTObjectiveThis study aimed to determine whether subclinical symptoms of depression in postmenopausal women are associated with blood oxygen level–dependent (BOLD) activity within the anterior insula during cardiac interoceptive awareness and whether this association differs for persons living with the human immunodeficiency virus (PWH).MethodTwenty-three postmenopausal (mean [standard deviation] age = 56.5 [4.8] years) and 27 HIV-negative women (mean [standard deviation] age = 56.4 [8.0]) underwent functional magnetic resonance imaging while performing a heartbeat detection task. BOLD activation within the bilateral anterior insula based on the contrast of a heartbeat detection condition with and without a distracting tone was entered along with age, HIV status, and psychological stress into two multivariate regression models with self-reported depressive symptom severity as the outcome.ResultsDepressive symptoms did not vary by HIV status, nor was there a main effect or interaction for PWH on insula BOLD activation. Depressive symptoms were positively associated with psychological stress for the left (β = 0.310, t(49) = 2.352, p = .023) and right brain models (β = 0.296, t(49) = 2.265, p = .028) as well as the magnitude of BOLD activation in the left insula (β = 0.290, t(49) = 2.218, p = .032) and right insula (β = 0.318, t(49) = 2.453, p = .018), respectively. Exploratory analyses revealed that greater magnitude of BOLD activation attributed to exteroceptive noise (tone) was also correlated with self-reported distrust and preoccupation with interoceptive sensations.ConclusionsResults support an active interference model for interoceptive awareness wherein greater BOLD signal in the anterior insula in the presence of distracting exteroceptive stimuli may reflect greater prediction error, a feature of depression.

Visit-To-Visit Blood Pressure Variability and Subthreshold Depressive Symptoms in Older Adults

ObjectivesDepression is related to increased risk for dementia, possibly through links with cerebrovascular disease. Blood pressure variability is an emerging risk factor for cerebrovascular disease and dementia, but relationships with affective symptoms remain understudied. DesignRetrospective analysis of prospective cohort study. SettingAlzheimer's Disease Neuroimaging Initiative. Participants505 older adults without history of dementia or recent depression underwent three to four blood pressure measurements over 12 months and completed a self-report measure of depressive symptoms (Geriatric Depression Scale – 15 Item) at study baseline and 24-months follow-up. MeasurementsBlood pressure variability was calculated as variability independent of mean and maximum minus minimum. Regression models investigated relationships between blood pressure variability and severity of self-reported depressive symptoms at 24-months follow-up after controlling for several variables, including average blood pressure, antihypertensive use, antidepressant use, and baseline depressive symptom severity. ResultsElevated diastolic blood pressure variability was related to greater total depressive symptom score at follow-up (ß = .16 [95% CI 0.02, .30]; p = 0.03), with specific contribution from increased severity of symptoms of dysphoria (odds ratio = 1.35 [95% CI 1.07, 1.75]; p = 0.02). Blood pressure variability was not significantly related to other symptom subscales, including those reflecting life satisfaction or withdrawal. ConclusionsFindings suggest that elevated diastolic blood pressure variability is related to subthreshold depressive symptomatology in older adults without history of dementia or recent depression, independent of average blood pressure. Blood pressure variability may be an understudied vascular risk factor linked with depression and cognitive impairment, with potential therapeutic implications.

Supervised machine learning to predict reduced depression severity in people with epilepsy through epilepsy self-management intervention

ObjectiveTo develop a classifier that predicts reductions in depression severity in people with epilepsy after participation in an epilepsy self-management intervention. MethodsNinety-three people with epilepsy from three epilepsy self-management randomized controlled trials from the Managing Epilepsy Well (MWE) Network integrated research database met the inclusion criteria. Supervised machine learning algorithms were utilized to develop prediction models for changes in self-reported depression symptom severity. Features considered by the machine learning classifiers include age, gender, race, ethnicity, education, study type, baseline quality of life, and baseline depression symptom severity. The models were trained and evaluated on their ability to predict clinically meaningful improvement (i.e., a reduction of greater than three points on the nine-item Patient Health Questionnaire (PHQ-9)) between baseline and follow-up (<=12 weeks) depression scores. Models tested were a Multilayer Perceptron (ML), Random Forest (RF), Support Vector Machine (SVM), Logistic Regression with Stochastic Gradient Descent (SGD), K-nearest Neighbors (KNN), and Gradient Boosting (GB). A separate, outside dataset of 41 people with epilepsy was used in a validation exercise to examine the top-performing model’s generalizability and performance with external data. ResultsAll six classifiers performed better than our baseline mode classifier. Support Vector Machine had the best overall performance (average area under the curve [AUC] = 0.754, highest subpopulation AUC = 0.963). Our analysis of the SVM features revealed that higher baseline depression symptom severity, study type (i.e., intervention program goals), higher baseline quality of life, and race had the strongest influence on increasing the likelihood that a subject would experience a clinically meaningful improvement in depression scores. From the validation exercise, our top-performing SVM model performed similarly or better than the average SVM model with the outside dataset (average AUC = 0.887). SignificanceWe trained an SVM classifier that offers novel insight into subject-specific features that are important for predicting a clinically meaningful improvement in subjective depression scores after enrollment in a self-management program. We provide evidence for machine learning to select subjects that may benefit most from a self-management program and indicate important factors that self-management programs should collect to develop improved digital tools.

The relationship between text message sentiment and self-reported depression

BackgroundPersonal sensing has shown promise for detecting behavioral correlates of depression, but there is little work examining personal sensing of cognitive and affective states. Digital language, particularly through personal text messages, is one source that can measure these markers. MethodsWe correlated privacy-preserving sentiment analysis of text messages with self-reported depression symptom severity. We enrolled 219 U.S. adults in a 16 week longitudinal observational study. Participants installed a personal sensing app on their phones, which administered self-report PHQ-8 assessments of their depression severity, collected phone sensor data, and computed anonymized language sentiment scores from their text messages. We also trained machine learning models for predicting end-of-study self-reported depression status using on blocks of phone sensor and text features. ResultsIn correlation analyses, we find that degrees of depression, emotional, and personal pronoun language categories correlate most strongly with self-reported depression, validating prior literature. Our classification models which predict binary depression status achieve a leave-one-out AUC of 0.72 when only considering text features and 0.76 when combining text with other networked smartphone sensors. LimitationsParticipants were recruited from a panel that over-represented women, caucasians, and individuals with self-reported depression at baseline. As language use differs across demographic factors, generalizability beyond this population may be limited. The study period also coincided with the initial COVID-19 outbreak in the United States, which may have affected smartphone sensor data quality. ConclusionsEffective depression prediction through text message sentiment, especially when combined with other personal sensors, could enable comprehensive mental health monitoring and intervention.

Mantra meditation as adjunctive therapy in major depression: A randomized controlled trial

• Mantra meditation is an effective add-on treatment in major depression. • Mantra meditation is superior to progressive muscle relaxation. • After 6 months, mantra meditation mainly improved mood rather than cognitive symptoms. • Untapped potentials of mantra meditation warrant further research. To investigate the efficacy of add-on mantra meditation compared to progressive muscle relaxation in major depression. This study was a two-arm, single-site, raterblinded, randomized controlled trial involving 123 inpatients at a psychiatric hospital diagnosed with major depression according to DSM-IV criteria (January 2017 to June 2020). The treatment group practiced mantra meditation (MAM, N = 60); the comparator group practiced progressive muscle relaxation (PMR, N = 63). Both treatments were delivered via an introductory lesson followed by 30-minute group sessions twice weekly, adjunctively to usual treatment for depressive inpatients (TAU). The primary outcome measure was change in clinician-rated depression symptom severity, measured by the MADRS interview. The secondary outcome measure was self-reported depression severity, measured by the BDI-II questionnaire. Intentionto-treat was analyzed using linear mixed models. The TAU + MAM group had significantly greater improvements in MADRS score than the TAU + PMR group, both at the 3- month follow-up (between-group difference = 4.78, 95% CI = -8.32 – -1.42; d = 0.62) and at the 6-month follow-up (between-group difference = -6.24, 95% CI = -9.80 – -2.69; d = 0.79). Posttreatment, self-reported depression symptom severity was not significantly lower in the TAU + MAM group than in the TAU + PMR group. Exploratory analysis of the differences between primary and secondary outcomes showed that mantra meditation mainly improved mood rather than cognitive symptoms. In inpatients with major depression, adjunctive mantra meditation led to clinically relevant reduction in depressive symptom severity. Further research would build evidence for the untapped potentials of mantra meditation. ClinicalTrials.gov Identifier : NCT03004430

Anterior cingulate cortex in individuals with depressive symptoms: A structural MRI study

Several magnetic resonance imaging (MRI) studies have reported reduction in anterior cingulate cortex (ACC) volume in individuals with major depressive disorder (MDD). However, some MRI studies did not find significant ACC volumetric changes in MDD, and sample sizes were generally small. This cross-sectional structural MRI study examined the relationship between current depressive symptoms and ACC volume in a large community sample of 1803 adults. A series of multiple linear regression analyses were conducted to predict right and left ACC volumes using Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) scores, intracranial volume, age, sex, race/ethnicity, alcohol use, tobacco use, and psychotropic medications as predictor variables. Right ACC volume was significantly negatively associated with QIDS-SR scores, while no significant association was found between left ACC volume and QIDS-SR scores. In addition, there was a significant negative association between QIDS-SR scores and right but not left ACC volumes in males, and no significant association between QIDS-SR scores and right or left ACC volumes in females. These findings suggest that right ACC volume is reduced in people with greater self-reported depressive symptom severity, and that this association is only significant in men.

Efficacy of a short-term residential smoking cessation therapy versus standard outpatient group therapy (\u2018START-Study\u2019): study protocol of a randomized controlled trial

BackgroundIn Germany, evidence-based outpatient smoking cessation therapies are widely available. Long-term abstinence rates, however, are limited. Studies suggest that short-term residential therapy enables a higher level of environmental control, more intense contact and greater support among patients and from therapists, which could result in higher abstinence rates. The aim of the current START-study is to investigate the long-term efficacy of a short-term residential therapy exclusively for smoking cessation, conducted by a mobile team of expert therapists.MethodsA randomized controlled trial (RCT) is conducted to examine the efficacy of residential behavior therapeutic smoking cessation therapy compared to standard outpatient behavior therapeutic smoking cessation group therapy. Adult smokers consuming 10 or more cigarettes per day, who are willing to stop smoking, are randomized in a ratio of 1:1 between therapy groups. The primary endpoint is sustained abstinence for 6-month and 12-month periods. Secondary endpoints include smoking status after therapy, 7-day point abstinence after the 6-month and 12-month follow-ups, level of physical dependence, cost-effectiveness, use of nicotine replacement products, health-related quality of life, self-efficacy expectation for tobacco abstinence, motivational and volitional determinants of behavior change, self-reported depressive symptom severity, adverse events and possible side effects. Assessments will take place at baseline, post-therapy, and at 6-month and 12-month intervals after smoking cessation.DiscussionThere is a high demand for long-term effective smoking cessation therapies. This study represents the first prospective RCT to examine the long-term efficacy of a residential smoking cessation therapy program compared to standard outpatient group therapy as an active control condition. The residential therapeutic concept may serve as a new model to substantially enhance future cessation therapies and improve the understanding of therapeutic impact factors on tobacco abstinence. Utilizing a mobile team, the model could be applied efficiently to medical centers that do not have permanent and trained personnel for smoking cessation at their disposal.Trial registrationGerman Register for Clinical Trials (Deutsches Register für Klinische Studien), DRKS00013466. Retrospectively registered on 1 April 2019. https://www.drks.de/drks_web/navigate.do?navigationId=start.

Severity of self-reported depressive symptoms in a healthy sample is modulated by trait Harm Avoidance, not by 5-HTTLPR polymorphism

Background: The length of the serotonin transporter polymorphic region (5-HTTLPR) has been suggested to be associated with risk for developing depression, though with inconsistent evidence. Likewise, the personality trait Harm Avoidance (HA) has been linked to vulnerability for developing depression. However, no study has investigated whether there is an interaction effect between 5-HTTLPR and trait HA on depressive symptoms in healthy individuals.Methods: A total of 319 healthy individuals were included in this cross-sectional study. All participants were genotyped for the 5-HTTLPR polymorphism and completed self-reported measures of personality trait HA with the Temperament and Character Inventory (TCI), and of depression with the Major Depression Inventory (MDI). Linear regression analyses were used to test interaction effects between 5-HTTLPR and HA on MDI. Post hoc analyses were further performed to investigate main effects of HA and possible interaction effects between 5-HTTLPR and HA sub-scales on MDI.Results: No significant interaction effect between 5-HTTLPR and HA on MDI was found. A significant main effect of trait HA on MDI was found, indicating that personality trait HA is a viable vulnerability factor for even sub-clinical depressive symptoms.Conclusion: This study finds a strong significant relationship between HA and MDI. Moreover, the present study supports the line of research indicating that candidate gene-by-interactions does not increase vulnerability for developing depression even at a sub-clinical level.

B-37 Examining Self-Reported Depressive Symptoms: A SPECT Exploratory Analysis

Abstract Objective To examine regional cerebral blood flow (rCBF) differences between those with self-reported high and low levels of depressive symptoms. Method Participants were selected from a de-identified archival SPECT database. Depressive symptoms were determined by self-reported factors related to depression which included eight questions rated on a six point Likert scale. Groups were separated into highest and lowest 20% of ratings on this scale. Low reported depressive symptoms group (n = 2453,Mage = 42.85,SD = 18.35,male = 64%,Caucasian = 67%); high reported depressive symptoms group consisted (n = 2673,Mage = 38.52,SD = 13.44,male = 58%,Caucasian = 70%). Differences between groups were assessed across 17 brain regions at baseline. Results One-way ANCOVAs were conducted (p &lt; .001) controlling for age and gender across 17 brain regions. Significant differences were found between groups in the left cerebellum (F[1,5122] = 19.396,p &lt; .001),left frontal(F[1,5122] = 17.870,p &lt; .001),right frontal (F[1,5122] = 22.175,p &lt; .001),left motor sensory(F[1,5122] = 28.974,p &lt; .001),and right motor sensory(F[1,5122] = 31.534,p &lt; .001),such that the low depressive symptoms group exhibited higher rCBF in the left and right frontal and left and right motor sensory,whereas, the high depressive symptoms group exhibited higher rCBF in the left cerebellum. Conclusion Results indicate increased self-reported depressive symptomatology may be associated with decreased frontal lobe. The motor sensory region can result in deficits involving encoding or motor output showing slower motor/sensory processing in those with increased self-reported depressive symptoms. Research has shown increased activity in the cerebellum during sadness which may explain the higher rCBF in the depressed group. These findings demonstrate that neurological differences exist between varying degrees of self-reported depressive symptom severity. As a result, SPECT may be a useful objective measure to monitor and assess self-reported depressive severity throughout the course of treatment.

Variation in recognition of happy and sad facial expressions and self-reported depressive symptom severity: A prospective cohort study

ObjectiveCognitive theories suggest people with depression interpret self-referential social information negatively. However, it is unclear whether these biases precede or follow depression. We investigated whether facial expression recognition was associated with depressive symptoms cross-sectionally and longitudinally. MethodsProspective cohort study of people who had visited UK primary care in the past year reporting depressive symptoms (n = 509). Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9) at four time-points, 2 weeks apart. A computerised task assessed happy and sad facial expression recognition at three time-points (n = 505 at time 1). The unbiased hit rate measured ability to recognise emotions accounting for any general tendency to identify the emotion when it was not present. ResultsThe sample included the full range of depressive symptom severity, with 45% meeting diagnostic criteria for depression. There was no evidence that happy or sad unbiased hit rates were associated with concurrent or subsequent depressive symptoms. There was weak evidence that, for every additional face incorrectly classified as happy, concurrent PHQ-9 scores reduced by 0.05 of a point (95% CI = -0.10 to 0.002, p = 0.06 after adjustment for confounders). This association was strongest for more ambiguous facial expressions (interaction term p<0.001). LimitationsThis was an observational study with relatively short follow-up (6 weeks) and small changes in depressive symptoms and emotion recognition. Only 7% of invited patients consented to participate. ConclusionsReduced misclassifications of ambiguous faces as happy could be a state marker of depression, but was not associated with subsequent depressive symptoms. Future research should focus on the interpretation of ambiguous social information.

Human Safety and Pharmacokinetics Study of Orally Administered Icariin: Randomized, Double-Blind, Placebo-Controlled Trial

Preclinical literature suggests that icariin, a flavonoid found in Epimedium, may have potential for medical and psychiatric conditions. The objective of this study was to examine the safety, tolerability, and pharmacokinetics of orally administered icariin at doses of 100 to 1,680 mg/day in 24 healthy adult participants. Cognition, mood, and side effects were assessed over 5 days. Multiple blood samples were obtained over 24 hours to assess bioavailability and pharmacokinetics. Data were analyzed using a Wilcoxon signed rank test and Mann-Whitney U test. At all doses, either very low or undetectable blood levels of icariin were observed, demonstrating the low bioavailability of the oral formulation and preventing a determination of pharmacokinetic properties. No significant between-group differences were observed on side effect scales, either by self-report, or on cognitive assessments. A statistically significant, but not clinically significant, increase in self-reported depressive symptom severity was observed with icariin relative to placebo. Tolerability of icariin was good except at the highest dose. Two participants receiving 1,680 mg of icariin discontinued the study drug due to gastrointestinal symptoms. Bioavailability of oral icariin appears to be low at all doses tested. Although icariin appears generally to have a favorable tolerability profile, the highest doses may be associated with gastrointestinal distress. Different drug formulation and delivery method may be needed to assess the pharmacokinetic profile of icariin adequately.

The Relationship Between Prior Concussions and Depression Is Modified by Somatic Symptomatology in Retired NFL Athletes.

A positive relationship between sport-related concussion (SRC) history and depressive symptoms in retired National Football League (NFL) athletes has been observed, with self-rated physical functioning identified as a confounding factor. The authors examined the influence of somatic symptom endorsement on the relationship between SRC history and self-reported depressive symptom severity in retired NFL athletes. Forty-three former NFL athletes completed self-report inventories of depression (with the Beck Depression Inventory II) and somatic symptoms (with the adjusted Patient Health Questionnaire-15). A moderation analysis examined the influence of somatic symptoms on the relationship between SRC history and depressive symptom severity. SRC history and somatic symptoms accounted for a significant amount of depressive symptomology. SRC history was not significantly associated with depressive symptom severity at low levels of somatic symptoms but was significant at the mean and high levels. The effect of somatic symptoms on depressive symptoms was nearly twice that of SRC history. The relationship between SRC and depression is complex, and treatment of depression in retired athletes should address comorbid somatic symptoms.

Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial.

Although equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD. One hundred thirty-four adult (18-65) depressed outpatients who were treated with CT (n = 69) or IPT (n = 65) in a large open-label randomized controlled trial (parallel group design; computer-generated block randomization) were monitored across a 17-month follow-up phase. Mixed regression was used to determine the course of self-reported depressive symptom severity (Beck Depression Inventory II; BDI-II) after treatment termination, and to test whether CT and IPT differed throughout the follow-up phase. Analyses were conducted for the total sample (n = 134) and for the subsample of treatment responders (n = 85). Furthermore, for treatment responders, rates of relapse and sustained response were examined for self-reported (BDI-II) and clinician-rated (Longitudinal Interval Follow-up Evaluation; LIFE) depression using Cox regression. On average, the symptom reduction achieved during the 7-month treatment phase was maintained across follow-up (7-24 months) for CT and IPT, both in the total sample and in the responder sample. Two-thirds (67%) of the treatment responders did not relapse across the follow-up period on the BDI-II. Relapse rates assessed with the LIFE were somewhat lower. No differential effects between conditions were found. Patients who responded to IPT were no more likely to relapse following treatment termination than patients who responded to CT. Given that CT appears to have a prophylactic effect following successful treatment, our findings suggest that IPT might have a prophylactic effect as well.