Subclinical Depression Research Articles

Black Racial Identity, Perceived Support, and Mental Health Within Dyadic Relationships

Black racial identity (BRI), particularly centrality and private regard, have been linked to mental health and are often theorized to reflect trait-like and situational influences. We estimated the strength of trait and dyadic relationships (a type of situation) for BRI and its links to subclinical anxiety and depression. Black university students ( N = 110) rated their BRI, mental health, and perceived support when with or thinking about three relationship partners (e.g., mothers, friends). Variance components analyses estimated the strength of trait and dyadic effects. All constructs had significant trait and dyadic components. Participants with higher trait private regard and centrality reported better mental health than those with lower BRI. Additionally, BRI varied depending upon which partner was rated (dyadic effects). When a participant experienced high private regard or centrality with a partner, the participant had low subclinical depression and anxiety in that relationship. When a participant had high BRI and mental health when with a partner, the participant saw the partner as highly supportive. Findings suggest the importance of supportive others for adaptive BRI.

Associations Between Severity of Depression, Lifestyle Patterns, and Personal Factors Related to Health Behavior: Secondary Data Analysis From a Randomized Controlled Trial.

BackgroundDepression is a prevalent condition that has a significant impact on psychosocial functioning and quality of life. The onset and persistence of depression have been linked to a variety of biological and psychosocial variables. Many of these variables are associated with specific lifestyle characteristics, such as physical activity, diet, and sleep patterns. Some psychosocial determinants have an impact on people’ health-related behavior change. These include personal factors such as sense of coherence, patient activation, health literacy, self-efficacy, and procrastination. This study aims to analyze the association between the severity of depression, lifestyle patterns, and personal factors related to health behavior. It also aims to analyze whether personal factors moderate the relationship between lifestyles and depression.MethodsThis study is a secondary data analysis (SDA) of baseline data collected at the start of a randomized controlled trial (RCT). A sample of 226 patients with subclinical, mild, or moderate depression from primary healthcare centers in two sites in Spain (Zaragoza and Mallorca) was used, and descriptive, bivariate, multivariate, and moderation analyses were performed. Depression was the primary outcome, measured by Beck II Self-Applied Depression Inventory. Lifestyle variables such as physical exercise, adherence to Mediterranean diet and sleep quality, social support, and personal factors such as self-efficacy, patient activation in their own health, sense of coherence, health literacy, and procrastination were considered secondary outcomes.ResultsLow sense of coherence (β = −0.172; p < 0.001), poor sleep quality (β = 0.179; p = 0.008), low patient activation (β = −0.119; p = 0.019), and sedentarism (more minutes seated per day; β = 0.003; p = 0.025) are predictors of having more depressive symptoms. Moderation analyses were not significant.DiscussionLifestyle and personal factors are related to depressive symptomatology. Our findings reveal that sense of coherence, patient’s activation level, sedentarism, and sleep quality are associated with depression. Further research is needed regarding adherence to Mediterranean diet, minutes walking per week and the interrelationship between lifestyles, personal factors, and depression.

Adverse Childhood Experiences and (New Onset) Late-Life Depression, A Case Report.

<h3>Introduction</h3> Childhood abuse has been strongly related to late-life depression and its comorbidities. About one-third of later-onset disorders have been linked to childhood abuse. Individuals who experienced childhood abuse may be able to maintain psychological wellbeing throughout middle age but may be disturbed in later life. Older adults may recall old traumas when reflecting on their lives, and memory of their past traumas may function as new stressors. We report the case of a 72-year-old Black male who presented with suicidal ideation and other symptoms of a depressive episode. His history was significant for extensive childhood trauma. His depressive symptoms ensued after reflecting and ruminating on traumatic childhood experiences. <h3>Methods</h3> We reviewed current literature describing relationship between adverse childhood experiences and depression in late life. No written consent was obtained from the patient as there is no patient identifiable data included in this case report. <i>Case summary:</i> Patient is a 72-year-old black male with no known past psychiatric history, and past medical history of hypertension, diabetes, and dyslipidemia. Two weeks before presentation, he became irritable, and occasionally expressed suicidal ideation. He presented because of changes in behavior, outbursts, and aggression. He reported "miserable" and depressed mood, poor appetite, and fatigue in context of ruminating on traumatic childhood experiences. He endorsed reduced concentration, sleep problems, and anhedonia. He described frequent emotional and physical abuses by his father, from childhood until adolescence. He did most of the house chores while his younger siblings ate, and he ate what was left over. He also reported being treated unequally and unfairly by his paternal aunts. He believed this was due to his darker skin color compared to his siblings. He coped with the psychological effects of the childhood abuse most of his life until few weeks before presentation. He found himself ruminating more on these past experiences which made him depressed. He refused meals for 2-3 days and expressed suicidal thoughts prior to presentation. On examination, he exhibited psychomotor retardation. His affect was flat and constricted. Mini-mental State Exam score was 28 out of 30. Blood glucose was 33 mg/dL. CT head showed mild cerebral atrophy and mild periventricular white matter disease. Patient was admitted to telemetry for treatment of hypoglycemia. Psychiatry was consulted for evaluation of depressed mood, and aggression. Once medically stable, he continued to endorse depressive symptoms in context of rumination on childhood experiences. He met DSM-5 criteria for Major depressive disorder, single episode, severe. He was commenced on Mirtazapine 7.5 mg po at bedtime and was to follow-up in our clinic. However, he was lost to follow-up. When contacted, he declined further care. <h3>Results</h3> Our patient had significant childhood trauma. Major depressive disorder due to another medical condition was plausible on account of his past medical history. We also considered delirium, however patient continued to ruminate on childhood experiences after he was medically stable. It is unclear if our patient had undiagnosed chronic subclinical depression, hence it would be helpful to explore his core cultural beliefs and attitude toward mental health treatment. Our patient was going through life transitions like retirement and isolation related to the covid-19 pandemic. These psychosocial stressors may have precipitated a depressive episode or compounded his ruminations on his adverse childhood experiences. We also considered the possibility of prodromal neurocognitive disorder given findings on his brain imaging. Although his MMSE was noncontributory, continuous follow-up and further workup was needed. Despite the limitations and complexity of our case report, we postulate a strong link between our patient's major depressive episode and his adverse childhood experiences. While it is important to consider other differential diagnoses when assessing older adults with depression, it is helpful to screen for adverse childhood experiences. The ACE questionnaire is a reliable and valid measure of childhood adversity. Our case report corroborates findings shown in studies relating adverse childhood experience with new onset late-life depression and other disorders. <h3>Conclusions</h3> Our case report corroborates findings shown in studies relating adverse childhood experience with new onset late-life depression. We hope this article will increase awareness of the relationship between adverse childhood experiences and late-life depression and the need to screen older adults with depression for this important stressor. <h3>This research was funded by</h3> We did not receive any funding for this case report.

Brain Functional Network and Amino Acid Metabolism Association in Females with Subclinical Depression

This study aimed to investigate the association between complex brain functional networks and the metabolites in urine in subclinical depression. Electroencephalography (EEG) signals were recorded from 78 female college students, including 40 with subclinical depression (ScD) and 38 healthy controls (HC). The phase delay index was utilized to construct functional connectivity networks and quantify the topological properties of brain networks using graph theory. Meanwhile, the urine of all participants was collected for non-targeted LC-MS metabolic analysis to screen differential metabolites. The global efficiency was significantly increased in the α-2, β-1, and β-2 bands, while the characteristic path length of β-1 and β-2 and the clustering coefficient of β-2 were decreased in the ScD group. The severity of depression was negatively correlated with the level of cortisone (p = 0.016, r = −0.40). The metabolic pathways, including phenylalanine metabolism, phenylalanine tyrosine tryptophan biosynthesis, and nitrogen metabolism, were disturbed in the ScD group. The three metabolic pathways were negatively correlated (p = 0.014, r = −0.493) with the global efficiency of the brain network of the β-2 band, whereas they were positively correlated (p = 0.014, r = 0.493) with the characteristic path length of the β-2 band. They were mainly associated with low levels of L-phenylalanine, and the highest correlation sparsity was 0.11. The disturbance of phenylalanine metabolism and the phenylalanine, tryptophan, tyrosine biosynthesis pathways cause depressive symptoms and changes in functional brain networks. The decrease in the L-phenylalanine level may be related to the randomization trend of the β-1 frequency brain functional network.

Mindfulness intervention improves executive functions of depressed individuals and their neural mechanism

<p indent="0mm">By 2030, depression is expected to become a global economic burden due to its serious effect on people’s physical and mental health. According to LeMoult and Gotlib’s cognitive theory of depression, individuals with depression have executive function defects, which lead to negative cognitive processing bias and increased use of non-adaptive emotional regulation strategies such as rumination. According to Beevers’ dual processing theory of cognitive vulnerability to depression, individuals with depression use more negative automatic processing and less reflective processing, which results in bad mood cycles. This review suggests that executive functions are closely related to reflective processing and that the improvement of executive functions provides depressed individuals with more cognitive resources for such processing. This is because the improvement of executive functions reduces the bias of negative cognitive processing and the negative automatic processing mentioned in the dual processing theory of cognitive vulnerability to depression. The decentralized mechanism of mindfulness can effectively improve executive functions, trigger reflective processing, particularly in depressed individuals, correct negative automatic thinking, and alleviate depressive symptoms. Depressive individuals have defects in working memory, cognitive flexibility, and response inhibition and maintain cognitive processing biases consistent with depressive mood. Therefore, executive function defects may be an important cognitive dispositional factor for individuals with depression. Mindfulness interventions can alleviate depressive symptoms and negative cognitive processing biases by improving executive functions. This review compared two studies published in <italic>Nature Reviews Neuroscience</italic> on the cognitive neural mechanisms of mindfulness and depression respectively, and then suggested that the intrinsic functional connectivity of the prefrontal cortex, anterior cingulate cortex, amygdala, default mode network, and frontal limbic system is an important neural mechanism for mindfulness intervention’s effect on the executive function defects of depressed individuals. Specifically, mindfulness intervention can activate the anterior cingulate gyrus in depressed individuals and enhance the functional connection between the prefrontal lobe and anterior cingulate gyrus, which is the neural mechanism of attentional control in mindfulness intervention. Improvements in attentional control are conducive to the inhibition of depressed individuals’ responses to negative stimuli. Mindfulness interventions can effectively reduce the activation of the amygdala in depressed individuals and enhance the functional connection between the prefrontal cortex and amygdala, which is the neural mechanism for emotional regulation in depressed individuals. This can reduce attentional bias to negative stimuli and the feeling of negative emotions. Mindfulness interventions can also effectively reduce the activation level of the default mode network in depressed individuals and enhance the control of the central executive network, which is the neural mechanism that aids mindfulness in improving meta-awareness. Improvements in meta-awareness help depressed individuals reduce negative self-reference processing and rumination. Future research should first explore the interactions between the three components of executive functions in individuals with depression. The executive functions that are the most effective predictors of depression should also be explored. Next, the aspect of mindfulness intervention that has the largest effect on the executive functions of individuals with depression should be clarified, specifically, which executive functions of mindfulness intervention has the most obvious effect on depressed individuals—whether “Awareness” or “Acceptance” is the core component of the effectiveness of mindfulness interventions on individuals with depression. This should be proved by randomized dismantling trial. Finally, mindfulness intervention programs should be developed to improve the efficacy of depression treatment. “Acceptance” may be a key component of the effectiveness of mindfulness interventions for individuals with depression. Morita therapy can be integrated into the daily practice of mindfulness to improve individuals’ acceptance of negative events. Cognitive impairment in individuals with subclinical depression is not very severe. Thus, cognitive training can first improve the cognitive functions of individuals with subclinical depression; then, mindfulness interventions that increase the acceptance can consolidate cognitive functions and relieve depressive symptoms.

Hippocampal Subfields and White Matter Connectivity in Patients with Subclinical Geriatric Depression.

Despite an abundance of research related to the functional and structural changes of the brain in patients with geriatric depression, knowledge related to early alterations such as decreased white matter connectivity and their association with cognitive decline remains lacking. We aimed to investigate early alterations in hippocampal microstructure and identify their associations with memory function in geriatric patients with subclinical depression. Nineteen participants with subclinical geriatric depression and 19 healthy controls aged ≥65 years exhibiting general cognitive function within the normal range were included in the study and underwent assessments of verbal memory. Hippocampal subfield volumes were determined based on T1-weighted magnetization-prepared rapid gradient echo (T1-MPRAGE) images, while group tractography and connectometry analyses were conducted using diffusion tensor images. Our findings indicated that the volumes of whole bilateral hippocampus, cornus ammonis (CA) 1, molecular layer, left subiculum, CA3, hippocampal tail, right CA4, and granule cell/molecular layers of the dentate gyrus (GC-ML-DG) were significantly smaller in the subclinical depression group than in the control group. In the subclinical depression group, verbal learning was positively correlated with the volumes of the CA1, GC-ML-DG, molecular layer, and whole hippocampus in the right hemisphere. The fractional anisotropy of the bilateral fornix was also significantly lower in the subclinical depression group and exhibited a positive correlation with verbal learning and recall in both groups. Our results suggest that hippocampal microstructure is disrupted and associated with memory in patients with subclinical depression.

IsiXhosa Translation of the Patient Health Questionnaire (PHQ-9): A Pilot Study of Psychometric Properties [Stage 1

Depression is a debilitating illness, and stigma associated with it often prevents people from seeking support. Easy-to-administer and culturally-specific diagnostic tools can allow for early screening for depression in primary care clinics, especially in resource-limited settings. In this pilot study, we will produce the first open-access isiXhosa-language version of the nine-item Patient Health Questionnaire (PHQ-9), a well-validated measure of depression incidence and severity, using a transcultural translation framework. We will validate this isiXhosa PHQ-9 in a small sample of adolescents living with HIV in Cape Town, South Africa who speak isiXhosa at home. Participants have previously completed the ASEBA Youth Self Report (YSR) form, and responses from the YSR will be used as a gold standard to validate the isiXhosa PHQ-9. If validated through this Registered Report, this isiXhosa PHQ-9 may be an invaluable culturally-specific tool for clinicians serving Xhosa people in identifying clinical or sub-clinical depression.

Impact of endothelial inflammation on depression in patients with cerebral microangiopathy: a prospective study

Epidemiological studies demonstrate a strong relationship between depression and cerebral microangiopathy (CM) associated with arterial hypertension (AH) and cerebral atherosclerosis, but the pathogenetic mechanisms underlying this relationship are not fully understood.Objective: to evaluate the relationship between the level of peripheral markers of endothelial inflammation and depression severity in patients with CM.Patients and methods. The level of peripheral markers of endothelial inflammation was assessed by enzyme immunoassay, and the severity of depression was assessed using the HADS scale in 262 patients with CM. All patients had correction of hypotensive, antiplatelet, anticoagulant, lipid-lowering, hypoglycemic therapy. Observation of the patients lasted 3 months with an assessment of the follow-up clinical and laboratory parameters. Results and discussion. Comparative analysis shown that in the group of patients with clinically significant depression (n=146) C-reactive protein (CRP) level was составил 6.11 mg/l, monocytic chemoatactic factor-1 (МСР-1) – 2.02 ng/ml, which differed significantly from the group f patients with subclinical depression (n=116): CRP – 2.03 mg/l, МСР-1 – 0.66 ng/ml (р&lt;0.05). Correlation analysis showed a direct strong significant linear relationship between the depression severity and the level of CRP (correlation coefficient r=0.85, p&gt;&lt;0.05). A similar significant correlation was found between the depression severity and the MCP-1 level – a direct strong linear relationship (r=0.8, p&gt;&lt;0.05). The odds ratio assessment revealed that increased peripheral markers of endothelial inflammation are associated with clinically significant depression. The use of drugs aimed at correcting the main cardiovascular risk factors contributed to a significant normalization of the levels of peripheral markers of inflammation (p&gt;&lt;0.05), accompanied by a reduction in depressive symptoms in patients with CM without the use of specific antidepressant therapy. Conclusion. The study revealed a relationship between altered levels of peripheral markers of inflammation and the severity of depression in patients with CM associated with hypertension and cerebral atherosclerosis. The normalization of the peripheral markers of endothelial inflammation contributed to the restoration of the emotional background. Keywords: endothelial inflammation; inflammatory markers; depression; cerebral microangiopathy&gt;˂0.05). Correlation analysis showed a direct strong significant linear relationship between the depression severity and the level of CRP (correlation coefficient r=0.85, p˂0.05). A similar significant correlation was found between the depression severity and the MCP-1 level – a direct strong linear relationship (r=0.8, p˂0.05). The odds ratio assessment revealed that increased peripheral markers of endothelial inflammation are associated with clinically significant depression. The use of drugs aimed at correcting the main cardiovascular risk factors contributed to a significant normalization of the levels of peripheral markers of inflammation (p˂0.05), accompanied by a reduction in depressive symptoms in patients with CM without the use of specific antidepressant therapy.Conclusion. The study revealed a relationship between altered levels of peripheral markers of inflammation and the severity of depression in patients with CM associated with hypertension and cerebral atherosclerosis. The normalization of the peripheral markers of endothelial inflammation contributed to the restoration of the emotional background.

It's not always binary: Connecting the continuum of caregiver depression with child adjustment in children who are high risk for maltreatment

BackgroundYoung children living with a depressed parent are at risk for developing social, behavioral, and emotional problems. The purpose of this study was to evaluate whether an increase in subclinical caregiver depression scores was associated with increases in internalizing and externalizing behavior in children who are at high risk for maltreatment. MethodsThe 1019 U.S.-based dyads consisted of predominantly single (45.53%) and Black/African American (53.29%) caregivers and high-risk 4-year-olds from the LONGSCAN study. Multivariate regression analyzes were used to evaluate the relationship between caregiver Center for Epidemiological Studies-Depression (CES-D) scores, above and below the at-risk for depression CES-D score, and preschooler internalizing, externalizing, and total problem behaviors, measured with the Child Behavior Checklist (CBCL). ResultsCaregiver CES-D score increases, above and below the at-risk for depression score, were significantly associated (p < 0.05) with increased child internalizing, externalizing, and total problem behaviors. After adjusting for covariates, among dyads whose caregivers had subclinical (CES-D < 16) scores, a one-unit score increase was significantly associated with a 0.43 increase (p = 0.00) in children's CBCL internalizing score. LimitationsThese findings are restricted to preschool children who are at risk for maltreatment, limiting generalizability. ConclusionsLow and moderate levels of caregiver depressive symptomatology were associated with a negative influence on preschoolers' adjustment. Practitioners should consider that the link between caregiver depression and child wellbeing may lie on a continuum. With consideration of the full continuum of symptoms, early intervention and anticipatory guidance may decrease the impact of depression on the caregiver, child, and system.

Positive psychotherapy based on “belief in divine goodness” for subclinical depression in Iran: treatment development, feasibility, and preliminary results

ABSTRACT Implementing positive psychotherapy in various cultures is challenging. This study assessed the clinical outcomes of a positive psychotherapy protocol based on “belief in divine goodness”, using a multiple-baseline design. We used a modified form of Seligman’s protocol on three Iranian adults with subclinical depression. Four new techniques were also added to the protocol to enhance the concept of happiness and life satisfaction, based on the dominant religious culture in Iran. The participants showed lower levels of depression but higher happiness, life satisfaction, pleasure, engagement and meaning in their lives compared to their status at the baseline. The new protocol may have psychotherapeutic benefits for use in subjects with subclinical depression. Future studies with larger sample sizes are warranted to assess the true effects of this protocol compared to those achieved by standard positive psychotherapy.

Temporal and Spatial Dynamics of EEG Features in Female College Students with Subclinical Depression.

Synchronization of the dynamic processes in structural networks connect the brain across a wide range of temporal and spatial scales, creating a dynamic and complex functional network. Microstate and omega complexity are two reference-free electroencephalography (EEG) measures that can represent the temporal and spatial complexities of EEG data. Few studies have focused on potential brain spatiotemporal dynamics in the early stages of depression to use as an early screening feature for depression. Thus, this study aimed to explore large-scale brain network dynamics of individuals both with and without subclinical depression, from the perspective of temporal and spatial dimensions and to input them as features into a machine learning framework for the automatic diagnosis of early-stage depression. To achieve this, spatio–temporal dynamics of rest-state EEG signals in female college students (n = 40) with and without (n = 38) subclinical depression were analyzed using EEG microstate and omega complexity analysis. Then, based on differential features of EEGs between the two groups, a support vector machine was utilized to compare performances of spatio–temporal features and single features in the classification of early depression. Microstate results showed that the occurrence rate of microstate class B was significantly higher in the group with subclinical depression when compared with the group without. Moreover, the duration and contribution of microstate class C in the subclinical group were both significantly lower than in the group without subclinical depression. Omega complexity results showed that the global omega complexity of β-2 and γ band was significantly lower for the subclinical depression group compared with the other group (p < 0.05). In addition, the anterior and posterior regional omega complexities were lower for the subclinical depression group compared to the comparison group in α-1, β-2 and γ bands. It was found that AUC of 81% for the differential indicators of EEG microstates and omega complexity was deemed better than a single index for predicting subclinical depression. Thus, since temporal and spatial complexity of EEG signals were manifestly altered in female college students with subclinical depression, it is possible that this characteristic could be adopted as an early auxiliary diagnostic indicator of depression.

Trajectories of Symptom Change in School-Based Prevention Programs for Adolescent Girls with Subclinical Depression

Effectiveness research on depression prevention usually compares pre- to post-intervention outcomes across groups, but this aggregation across individuals may mask heterogeneity in symptom change trajectories. Hence, this study aimed to identify subgroups of adolescents with unique trajectories of change in a school-based depression prevention trial. It was also examined how trajectory membership was associated with the intervention conditions, depressive symptoms at 12-month follow-up, and baseline predictors. Hundred-ninety adolescent girls (Mage = 13.34; range = 11–16 years) with subclinical depression at screening (M = 57 days before pre-test) were allocated to four conditions: a face-to-face, group-based program (OVK), a computerized, individual program (SPARX), OVK and SPARX combined, and a monitoring control condition. Growth Mixture Modeling was used to identify the distinct trajectories during the intervention period using weekly depressive symptom assessments from pre-test to post-test. Analyses revealed three trajectories of change in the full sample: Moderate-Declining (62.1% of the sample), High-Persistent (31.1%), and Deteriorating-Declining (6.8%) trajectories. Trajectories were unrelated to the intervention conditions and the High-Persistent trajectory had worse outcomes at follow-up. Several baseline factors (depression severity, age, acceptance, rumination, catastrophizing, and self-efficacy) enabled discrimination between trajectories. It is concluded that information about likely trajectory membership may enable (school) clinicians to predict an individual’s intervention response and timely adjust and tailor intervention strategies as needed.

The Italian consensus conference on psychological therapies for anxiety and depressive disorders: findings and recommendations.

A Consensus Conference of clinicians, researchers, public health specialists and users was convened in Italy to review efficacy, effectiveness, treatment appropriateness and access to care for anxiety and depression, and to consider the role of psychological therapies. Expert opinion was sought concerning identification of people requiring psychological therapies according to levels of symptom severity matched to corresponding levels of treatment intensity, suitability of psychological therapies for subclinical anxiety or depression, definition of a minimum level of information on evidence-based psychotherapies to be provided by university medical and psychology courses, initiatives to raise awareness among potential users and decision makers on the role and effectiveness of psychological therapies in healthcare. The expert jury concluded that a number of psychological therapy models endorsed by most authoritative guidelines are supported by research showing their effectiveness at least equal to the drugs used in common mental disorders (CMDs). Such therapies are under-represented in the Italian public health system, leading many people to resort to the private sector, resulting in unacceptable wealth discrimination. The difficulty of accessing psychological treatments often entails the use of drug therapies in cases where they are not indicated. Starting from these assumptions, the experts recommended the promotion of better and timely recognition of anxiety and depressive disorders and their classification in terms of symptom intensity and functional impairment, differentiating subthreshold mood swings from clinical forms, to foster outcome studies of psychotherapies in CMDs in Italy, to introduce a stepped care model structured according to levels of intensity of treatment, based on wellbeing support strategies in nonmedical contexts for subthreshold situations, self-help, support and psychoeducation as frontline interventions in mild clinical forms, evidence-based psychotherapies in moderate and severe forms, with the option of combining psychological treatment and appropriate drug therapy in the most severe cases.

노인 아임상 우울군에서 편도체 세부영역 부피의 특징

Objectives The purpose of this study was to identify the volumetric alterations of the amygdala and their association with geriatric subclinical depression. Method Eighteen and 19 subjects aged 65 and above were recruited for the subclinical depression and the control group, respectively. Subclinical depression was defined by a cut-off value of 8 points on the Short Geriatric Depression Scale and no diagnosis of clinical psychiatric disorders. Participants of both groups must have normal cognitive functions assessed using Mini-Mental Status Examination. T1-weighted magnetic resonance images were acquired using 3T magnetic resonance imaging scanner. Volumes of bilateral amygdala and their nuclei, and lateralization indexes were determined using FreeSurfer(version 7.1.1). Statistical methods of Mann-Whitney U test, and Analysis of Covariance were used. Results Volumes of the left and right amygdala were smaller in the geriatric subclinical depression group compared to the control group(p≤0.048). There were significant volume reductions in left lateral nucleus, left anterior amygdaloid area, right lateral nucleus, right basal nucleus, right accessory basal nucleus, right anterior amygdaloid area, right cortical nucleus and right paralaminar nucleus(p≤0.034). Conclusion Various regions of amygdala nuclei which are known to be associated with emotional processing were smaller in size in the group of geriatric subclinical depression. Further studies are warranted to identify the neurophysiological factors that provoke the amygdala volume reduction in geriatric subclinical depression.

A Hidden Link between Subclinical Hypothyroidism and Depression: A literature Review

The association between Subclinical hypothyroidism and Depression is recognised. It is found that patients with Thyroid disorders are more prone to develop depressive symptoms and depression may be accompanied by various subtle thyroid abnormalities. The most commonly documented abnormalities are elevated T4 levels, Low T3, elevated rT3, a blunted TSH response to TSH, Positive anti thyroid autoantibodies and elevated CSF TRH concentrations. It is also found that thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressants. It is found out that Depression is associated with changes in Hypothalamic-pituitary axis as thyroid hormones act on the central nervous system. Mild thyroid dysfunction causes depression in younger patients (&lt;60 years old) diagnosed by depressive scale. It was found that differences in age group may cause depressive episodes. Depressive episodes such as anxiety and the risk of committing suicide are considerable factors that differ according to the age of the individuals.SCH was found to be associated with depression in the younger adults (&lt;60 years old). The only difference between SCH and normal thyroid function is TSH.In depressive disorder and subclinical hypothyroidism sex differences have also been recognised. Association between subclinical hypothyroidism and Depression is assessed by various depressive scores such as Beck Depression Inventory and Hamilton depression rating scale. As Subclinical hypothyroidism is associated with low mood, Serum levels of TSH, FT3, FT4 and Hamilton depression, treatment with Levothyroxine showed significant decrease is TSH levels and Hamilton scores were decreased. Since the prevalence of depressive symptoms in hypothyroidism is high TSH cut-off levels is used,TSH cut off value for hypothyroidism is based on associated symptoms,TSH cut-off value is 2.5 MIU/L is optima

A Hidden Link between Subclinical Hypothyroidism and Depression: A literature Review

The association between Subclinical hypothyroidism and Depression is recognised. It is found that patients with Thyroid disorders are more prone to develop depressive symptoms and depression may be accompanied by various subtle thyroid abnormalities. The most commonly documented abnormalities are elevated T4 levels, Low T3, elevated rT3, a blunted TSH response to TSH, Positive anti thyroid autoantibodies and elevated CSF TRH concentrations. It is also found that thyroid hormone supplements appear to accelerate and enhance the clinical response to antidepressants. It is found out that Depression is associated with changes in Hypothalamic-pituitary axis as thyroid hormones act on the central nervous system. Mild thyroid dysfunction causes depression in younger patients (&lt;60 years old) diagnosed by depressive scale. It was found that differences in age group may cause depressive episodes. Depressive episodes such as anxiety and the risk of committing suicide are considerable factors that differ according to the age of the individuals.SCH was found to be associated with depression in the younger adults (&lt;60 years old). The only difference between SCH and normal thyroid function is TSH.In depressive disorder and subclinical hypothyroidism sex differences have also been recognised. Association between subclinical hypothyroidism and Depression is assessed by various depressive scores such as Beck Depression Inventory and Hamilton depression rating scale. As Subclinical hypothyroidism is associated with low mood, Serum levels of TSH, FT3, FT4 and Hamilton depression, treatment with Levothyroxine showed significant decrease is TSH levels and Hamilton scores were decreased. Since the prevalence of depressive symptoms in hypothyroidism is high TSH cut-off levels is used,TSH cut off value for hypothyroidism is based on associated symptoms,TSH cut-off value is 2.5 MIU/L is optimal

Lyfas, A Smartphone-Based Subclinical Depression Tracker

Background: Subclinical traces of depression are difficult to diagnose; although, it influences other mental faculties. Lyfas is a smartphone-based ubiquitous and non-invasive biomedical application that captures Heart Rate Variability (HRV) and its associated Cardiovascular biomarkers (CVb), which might help detect such traces as mind and body are intertwined through autonomic modulation. Aim: Using Lyfas, an attempt has been made to (i) screen Subclinical depression states in adults by assessing the CVb scores, and (ii) analyze the psychophysiological effects of Subclinical depression on other mental faculties for establishing a correlation. Methods: The paper presents a retrospective observational study of 86 adults, comprised of 52 males and 36 females who took the Lyfas test. Lyfas findings are validated by an established questionnaire-based instrument under the supervision of a senior psychiatrist. Results: The study found that 77% of the subjects (84% females and 72% males) showed traces of Subclinical depression, further validated by a senior psychiatrist through a series of consultations. ‘Insomnia’ (males 36% and females 71%) and ‘Negative thoughts’ (males 36% and females 46%) were the two correlated high-rank effects of the Subclinical depression in the sample. Conclusion: The paper proposes that Lyfas can detect the traces of Subclinical depression in adults by capturing and interpreting CVb scores that surrogate for the Cardiac Autonomic Modulation (CAM) and provide the snapshot of the mind-body state of homeostasis.

Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms

BackgroundLittle is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults. MethodsA total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education. ResultsFour distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol. LimitationsThere is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment. ConclusionChildhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep.

Emerging Role of Flavonoids as the Treatment of Depression.

Depression is one of the most frequently observed psychological disorders, affecting thoughts, feelings, behavior and a sense of well-being in person. As per the WHO, it is projected to be the primitive cause of various other diseases by 2030. Clinically, depression is treated by various types of synthetic medicines that have several limitations such as side-effects, slow-onset action, poor remission and response rates due to complicated pathophysiology involved with depression. Further, clinically, patients cannot be given the treatment unless it affects adversely the job or family. In addition, synthetic drugs are usually single targeted drugs. Unlike synthetic medicaments, there are many plants that have flavonoids and producing action on multiple molecular targets and exhibit anti-depressant action by affecting multiple neuronal transmissions or pathways such as noradrenergic, serotonergic, GABAnergic and dopaminergic; inhibition of monoamine oxidase and tropomyosin receptor kinase B; simultaneous increase in nerve growth and brain-derived neurotrophic factors. Such herbal drugs with flavonoids are likely to be useful in patients with sub-clinical depression. This review is an attempt to analyze pre-clinical studies, structural activity relationship and characteristics of reported isolated flavonoids, which may be considered for clinical trials for the development of therapeutically useful antidepressant.

P007 The Frequency of Anxiety and Depression in Patients With Inflammatory Bowel Diseases in the Moscow Clinical Scientific Center.

Anxiety and depression occur in a significant number of patients with inflammatory bowel diseases (IBD). The prevalence of anxiety and / or depression is 13-44.4% in patients with IBD compared to 4.4% among the world population. To identify the frequency of anxiety and depression in patients with inflammatory bowel diseases in the Moscow Clinical Scientific Center named after A. S. Loginov. A questionnaire was conducted on the Hospital Anxiety and Depression Scale (HADS) questionnaire for 370 patients with moderate to severe UC during the period of exacerbation of the disease. Of the 370 patients with UC, 283 (76.48%) had clinical and subclinical signs of anxiety and depression. Subclinical depression was noted in 76 (26.8%), clinically pronounced depression - 11 (3.4%), signs of anxiety had higher indicators-subclinical anxiety was found in 172 (60.8%) of the surveyed patients, pronounced clinical anxiety - in 24 (8.4%) patients with UC. Statistically significant correlations of average strength between the indicators of adherence according to the Morisky - Green questionnaire with scores on the HADS scale, both for anxiety and depression (p < 0.001, r - 0.6299) were revealed Among patients with anxiety and depression, the ratio of patients with high adherence to therapy (HAT) and low adherence to therapy (LAT) was 204 (55,1%) 79 (21,4%), accordingly. When comparing the degree of adherence depending on the presence of anxiety and depression, we found that HAT was associated with anxiety and depression in patients with UC (OR = 0.024; 95% CI 0.003-0.186; p < 0.001). The prevalence of anxiety and/or depression is 77% in patients with IBD during an exacerbation in the Moscow Clinical Scientific Center named after A. S. Loginov.