Subsyndromal Depressive Symptoms Research Articles

Psychosocial Impairment in Older Patients With Bipolar I Disorder.

The goal of this study was to assess psychosocial functioning in older patients with bipolar I disorder compared with healthy subjects and to identify the psychopathological factors associated with poor functioning in patients. We recruited 68 euthymic patients with bipolar I disorder from the outpatient unit and 89 healthy controls who were older than 50 years of age. In addition to clinical variables, we used other standardized measures, including the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Functional Assessment Short Test, and the Montreal Cognitive Assessment. Older patients with bipolar I disorder had poorer psychosocial functioning in general and in the domains of occupation, autonomy, and cognition than the healthy controls on the basis of previously defined Functional Assessment Short Test cutoff scores. We found that 35.3% (95% CI: 23%-47%) of the patients did not have clinically significant functional impairment, 38.2% (95% CI: 26%-50%) had mild impairment, and 26.5% (95% CI: 16%-37%) had moderate impairment. Depressive symptoms and impaired cognition were associated with poor overall functioning. The level of psychosocial functioning was heterogeneous among the patients. Subsyndromal depressive symptoms, even at low levels, and impaired cognition predicted poor functioning in euthymic middle-aged and older patients with bipolar I disorder.

PATHway: Intervention optimization of a prevention program for adolescents at–risk for depression in the primary care setting

With as many as 13% of adolescents diagnosed with depressive disorders each year, prevention of depressive disorders has become a key priority for the National Institute of Mental Health (NIMH). Currently, we have no widely available interventions to prevent these disorders. To address this need, we developed a multi-health system collaboration to develop and evaluate the primary care based technology “behavioral vaccine,” Competent Adulthood Transition with Cognitive-Behavioral Humanistic and Interpersonal Therapy (CATCH-IT). The full CATCH-IT program demonstrated evidence of efficacy in prevention of depressive episodes in clinical trials. However, CATCH-IT became larger and more complex across trials, creating issues with adherence and scalability.We will use a multiphase optimization strategy approach to optimize CATCH-IT. The theoretically grounded components of CATCH-IT include: behavioral activation, cognitive-behavioral therapy, interpersonal psychotherapy, and parent program. We will use a 4-factor (2x2x2x2) fully crossed factorial design with N = 16 cells (25 per cell, after allowing 15% dropout) to evaluate the contribution of each component. Eligible at-risk youth will be high school students 13 through 18 years old, with subsyndromal symptoms of depression. The study design will enable us to eliminate non-contributing components while preserving efficacy and to optimize CATCH-IT by strengthening tolerability and scalability by reducing resource use. By reducing resource use, we anticipate satisfaction and acceptability will also increase, preparing the way for an implementation trial.

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

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

67 Cognitive Reserve, Depressive Symptoms, and Functional Ability in Older Adults

Objective:Cognitive reserve has been linked to functional ability, and depression has been shown to be associated with more functional impairment in older adults. While cognitive reserve and depression are associated and have each been shown to impact functional impairment, the independent impact of cognitive reserve on functional ability after accounting for depressive symptoms has not been explored. For the purpose of this study, years of education served as a proxy for cognitive reserve, which is consistent with the literature. It was predicted that higher levels of education would be associated with better functional ability regardless of age and severity of depressive symptoms.Participants and Methods:Participants (ages 55 to 90) were drawn from the Alzheimer’s Disease Neuroimaging Initiative (N=3407); participants with major depression were not included. Subsyndromal depressive symptoms were measured using the Geriatric Depression Scale (GDS < 6) and functional impairment was assessed using the Functional Activities questionnaire. A three-stage hierarchical regression was conducted with functional ability as the dependent variable.Results:Age, entered at stage one of the regression model, was a significant predictor (F(1,1427) =49.75, p<.001) and accounted for 3.4% of the variance in functional ability. Adding depressive symptoms to the regression model led to a significant increase in variance explained (F(1,1426) = 64.57, p<.001), accounting for an additional 4.2% of the variance in functional ability. Adding years of education to the regression model explained an additional 1.4% of variance in functional ability and this increase in variance explained was significant (F(1,1425) = 22.53, p<.001).Conclusions:Cognitive reserve (operationalized as higher levels of education) was associated with higher functional ability even after accounting for age and depressive symptoms.

Comparison of childhood trauma between depressive disorders and personality disorders.

The relationship between childhood trauma with major depressive disorder (MDD) and personality disorders is complex. We explored the differences in the subjective reporting of childhood trauma to determine whether there were differences between those with a diagnosis of personality disorder and those with MDD. Adult patients with depressive symptoms were recruited from three adult psychiatry inpatient wards. Sixty inpatients fulfilled the study criteria and were requested to complete the childhood trauma questionnaire (CTQ). At discharge, diagnosis was determined and was allocated mainly to two groups: those with MDD and those with personality disorder. Those with MDD, dysthymia and subsyndromal depressive symptoms were included in the Depression Broad Definition (DBD) group (secondary analysis). Significantly higher subjective reporting of childhood trauma was observed in the personality disorder group compared with MDD in three CTQ domains. Similarly, significantly higher reporting of childhood trauma was observed in all five CTQ domains in those with a personality disorder compared with the DBD group. In conclusion, the presence of personality disorder was associated with greater subjective reporting of childhood trauma compared with those with MDD, and further research is required to explore the differences in objective experience of childhood trauma between the diagnoses using objective measures.

Differences in biobehavioral measures of cigarette smoking by depression symptomology

IntroductionResearch that explores the clinical relevance of subclinical depressive symptoms and smoking is primarily focused on smoking cessation. We examine whether depression symptoms vary across an array of biological (carbon monoxide boost), behavioral (FagerströmTest of Nicotine Dependence, cigarettes per day, smoking topography), and psychological smoking-related outcomes (Questionnaire on Smoking Urges, Withdrawal Symptoms Checklist) in non-treatment-seeking smokers. MethodsBaseline data were pooled from three research trials with identical procedures designed to assess individual smoking behavior using smokers preferred cigarette brands. Depression symptom level (asymptomatic, subsyndromal, syndromal) was defined using established Center for Epidemiological Depression Scale (CES-D) cutpoint criteria. Smokers were instructed to smoke as usual for one-week. At the beginning and end of the baseline period, nicotine dependence, smoking topography, CO boost, desire to smoke, anticipation of positive reinforcement, negative affect, and withdrawal were measured. ResultsOrdinary least squares linear regression models were used to test the association between depression symptom level and outcome measures adjusting for sex and education (N = 355). The results revealed no differences in topography measures, cigarettes per day and FTND. Smoking withdrawal and smoking urges were higher among both individuals with subsyndromal symptoms and syndromal depression symptoms compared to those who were asymptomatic. Individuals with subsyndromal depressive symptoms experienced higher smoke exposure and higher relief from negative affect. ConclusionIncreased smoke exposure, greater withdrawal symptoms and urges to smoke, and anticipation of negative affect relief among smokers with subsyndromal depression symptoms suggest that depression symptoms need not reach syndromal levels to alter smoking-related outcomes.

Augmenting neurocognitive remediation therapy to Preventive Cognitive Therapy for partially remitted depressed patients: protocol of a pragmatic multicentre randomised controlled trial

IntroductionMajor depressive disorder (MDD) affects 163 million people globally every year. Individuals who experience subsyndromal depressive symptoms during remission (ie, partial remission of MDD) are especially at risk for a...

Clinical Course in Patients With Melancholic and Nonmelancholic Bipolar Depression.

The aim of the current study was to compare the longitudinal clinical course of patients with a history of melancholic and nonmelancholic bipolar depression. Seventy-seven euthymic outpatients with bipolar disorder were categorized as melancholic or nonmelancholic through the clinician-rated Sydney Melancholia Prototype Index. Clinical course was assessed for a period longer than 48 months by time spent ill, density of affective episodes, severity and duration of depressive episodes, and time to depressive recurrence. The mean follow-up time was 69.05 months. Patients with melancholic depressions had more severe and longer depressive episodes during follow-up, whereas patients with nonmelancholic depressions had a shorter time to depressive recurrence and more subsyndromal depressive symptoms and affective instability. These findings highlight the heterogeneity inherent to the current construct of bipolar depression and position melancholia as an interesting target for comparison with nonmelancholic depressions in other external validators in the field of bipolar disorder.

Interim monitoring in sequential multiple assignment randomized trials.

A sequential multiple assignment randomized trial (SMART) facilitates the comparison of multiple adaptive treatment strategies (ATSs) simultaneously. Previous studies have established a framework to test the homogeneity of multiple ATSs by a global Wald test through inverse probability weighting. SMARTs are generally lengthier than classical clinical trials due to the sequential nature of treatment randomization in multiple stages. Thus, it would be beneficial to add interim analyses allowing for an early stop if overwhelming efficacy is observed. We introduce group sequential methods to SMARTs to facilitate interim monitoring based on the multivariate chi-square distribution. Simulation studies demonstrate that the proposed interim monitoring in SMART (IM-SMART) maintains the desired type I error and power with reduced expected sample size compared to the classical SMART. Finally, we illustrate our method by reanalyzing a SMART assessing the effects of cognitive behavioral and physical therapies in patients with knee osteoarthritis and comorbid subsyndromal depressivesymptoms.

Exploring the Impact of Flavonoid Interventions on Brain and Cognitive Function

Depression and high total plasma homocysteine (tHcy) are independently associated with cognitive impairment in older adults. We designed this study to determine if high tHcy is a mediator of cognitive performance in older adults with major depression.We recruited 358 community-dwelling older adults experiencing depressive symptoms, 236 (65.9%) of who met DSM-IV-TR criteria for major depression. Assessment included the Montgomery Asberg Depression Rating Scale (MADRS), fasting tHcy and the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery.Individuals with major depression and high tHcy had significantly worse immediate verbal and delayed visual recall. Non-depressed participants with high tHcy had lower MMSE, immediate and delayed recall scores than those with normal tHcy. The odds of cognitive inefficiency for those with high tHcy was nearly doubled for the MMSE (OR 1.9, 95%CI 1.1–3.3), immediate (OR 1.9, 95%CI 1.1–3.5) and delayed (OR 1.9, 95%CI 1.1–3.4) word recall after adjusting for age, gender, IHD and MADRS score.The presence of sub-syndromal depressive symptoms in our non-depressed group and exclusion of participants with established cognitive impairment may limit the generalizability of this study.Elevated tHcy was associated with weaker performance in tests of immediate and delayed memory and global cognitive performance when compared to those with normal tHcy independent of the presence of major depression or the severity of depressive symptoms. Homocysteine lowering B-vitamin supplementation may offer a potential therapeutic target to try and mitigate the often-disabling impact of cognitive deficits found in this population.

Mindfulness-based cognitive therapy versus psychoeducational intervention in bipolar outpatients: Results from a randomized controlled trial

IntroductionFew controlled trials have assessed the impact of Mindfulness Based Cognitive Therapy (MBCT) on symptoms and functioning in bipolar disorder (BD). This study aims to evaluate the effectiveness of MBCT adjunctive group treatment. Material and methodsRandomized, prospective, multicenter, single-blinded trial that included BP-outpatients with subthreshold depressive symptoms. Participants were randomly assigned to three arms: treatment as usual (TAU); TAU plus psychoeducation; and TAU plus MBCT. Primary outcome was change in Hamilton-D score; secondary endpoints were change in anxiety, hypo/mania symptoms and functional improvement. Patients were assessed at baseline (V1), 8 weeks (V2) and 6 months (V3). Main hypothesis was that adjunctive MBCT would improve depressive symptoms more than psychoeducation. ResultsEighty-four participants were recruited (MBCT=40, Psychoeducation=34, TAU=10). Depressive symptoms improved in the three arms between V1 and V2 (p<0.0001), and between V1 and V3 (p<0.0001), and did not change between V2 and V3. At V3 no significant differences between groups were found. There were no significant differences in other measures either. ConclusionsIn our BD population we did not find superiority of adjunctive MBCT over adjunctive Psychoeducation or TAU on subsyndromal depressive symptoms; neither on anxiety, hypo/mania, relapses, or functioning.

Effects of dietary interventions on depressive symptom profiles: results from the MooDFOOD depression prevention study.

Dietary interventions did not prevent depression onset nor reduced depressive symptoms in a large multi-center randomized controlled depression prevention study (MooDFOOD) involving overweight adults with subsyndromal depressive symptoms. We conducted follow-up analyses to investigate whether dietary interventions differ in their effects on depressive symptom profiles (mood/cognition; somatic; atypical, energy-related). Baseline, 3-, 6-, and 12-month follow-up data from MooDFOOD were used (n = 933). Participants received (1) placebo supplements, (2) food-related behavioral activation (F-BA) therapy with placebo supplements, (3) multi-nutrient supplements (omega-3 fatty acids and a multi-vitamin), or (4) F-BA therapy with multi-nutrient supplements. Depressive symptom profiles were based on the Inventory of Depressive Symptomatology. F-BA therapy was significantly associated with decreased severity of the somatic (B = -0.03, p = 0.014, d = -0.10) and energy-related (B = -0.08, p = 0.001, d = -0.13), but not with the mood/cognition symptom profile, whereas multi-nutrient supplementation was significantly associated with increased severity of the mood/cognition (B = 0.05, p = 0.022, d = 0.09) and the energy-related (B = 0.07, p = 0.002, d = 0.12) but not with the somatic symptom profile. Differentiating depressive symptom profiles indicated that food-related behavioral interventions are most beneficial to alleviate somatic symptoms and symptoms of the atypical, energy-related profile linked to an immuno-metabolic form of depression, although effect sizes were small. Multi-nutrient supplements are not indicated to reduce depressive symptom profiles. These findings show that attention to clinical heterogeneity in depression is of importance when studying dietary interventions.

Overweight and obese individuals with depressive symptoms from the MooDFOOD prevention trial: Role of sociodemographic, somatic health, and weight related factors

• Sociodemographics are not related to history of MDD in subsyndromal and obese people. • No difference in health claims among obese people with and without history of MDD. • In subclinical depression and obesity, anthropometrics are not related to lifetime MDD. Major depression disorder (MDD) 1 1 Abbreviations : BMI: Body mass index; MDD: Major depressive disorder; WHR: wait-to-hip-ratio and obesity are among the most common public health problems. The majority of epidemiological studies demonstrated a strong relationship between sociodemographic factors like age and socioeconomic status and depression. Also, a bidirectional link between depression and obesity is discussed. However, differences regarding sociodemographic factors and obesity between participants with and without lifetime MDD might occur, but potentially not in all individuals. This study intends to contribute to this discussion by investigating whether or not sociodemographic factors, chronic illness status, and overweight differ between individuals with and without lifetime MDD. In the MooDFOOD depression prevention trial, 1025 overweight or obese participants with subsyndromal symptoms of depression were recruited. Lifetime history of MDD, number of lifetime MDD episodes, sociodemographic data, and chronic illness were assessed via clinical interview, also standardized anthropometric measures (body mass index [BMI], waist-to-hip ratio [WHR]). A lifetime MDD diagnosis was present in 33.5% of the sample. Individuals with lifetime MDD and individuals who never suffered from MDD did not differ regarding sex, age, marital status, educational level, employment status, and income. Further, there were no significant differences in BMI, WHR, and number of chronic illnesses between participants with and without lifetime MDD. The cross-sectional nature of the data prohibited causal inferences. Sociodemographic variables, chronic illness status and anthropometric measures seem not to be related to the status of having suffered from MDD in the past vs. not having suffered from MDD in people who are currently overweight or obese.

Amyloid-Associated Depression—or Not?

In the current issue of Biological Psychiatry, Mackin et al. ( 1 Mackin R.S. Insel P.S. Landau S. Bickford D. Morin R. Rhodes E. et al. Late-life depression is associated with reduced cortical amyloid burden: Findings from the Alzheimer’s Disease Neuroimaging Initiative Depression Project. Biol Psychiatry. 2021; 89: 757-765 Abstract Full Text Full Text PDF PubMed Scopus (18) Google Scholar ) throw new light on the relationship between amyloid-β (Aβ) and depression in older individuals without dementia. But they may also compel us to throw some of our previous assumptions about this emerging field out the window. Early evidence for a link between late-life depression (LLD) and elevated Aβ pathogenesis came from postmortem studies of patients with dementia revealing an association between Aβ plaques and a history of major depression ( 2 Rapp M.A. Schnaider-Beeri M. Grossman H.T. Sano M. Perl D.P. Purohit D.P. et al. Increased hippocampal plaques and tangles in patients with Alzheimer disease with a lifetime history of major depression. Arch Gen Psychiatry. 2006; 63: 161-167 Crossref PubMed Scopus (294) Google Scholar ). The advent of positron emission tomography (PET) enabled the study of clinicopathologic associations in vivo and provided further support for Aβ pathogenesis as a possible mechanism underlying the connection between LLD and Alzheimer’s disease (AD). Elevated cortical Aβ deposition in older individuals with current or lifetime major depression has been observed in most PET studies ( 3 Kumar A. Kepe V. Barrio J.R. Siddarth P. Manoukian V. Elderkin-Thompson V. et al. Protein binding in patients with late-life depression. Arch Gen Psychiatry. 2011; 68: 1143-1150 Crossref PubMed Scopus (60) Google Scholar , 4 Wu K.Y. Hsiao I.T. Chen C.S. Chen C.H. Hsieh C.J. Wai Y.Y. et al. Increased brain amyloid deposition in patients with a lifetime history of major depression: Evidenced on 18F-florbetapir (AV-45/Amyvid) positron emission tomography. Eur J Nucl Med Mol Imaging. 2014; 41: 714-722 Crossref PubMed Scopus (76) Google Scholar ). Longitudinal cohort studies using PET imaging have also reported positive associations between Aβ pathology and subsyndromal depressive symptoms in cognitively normal older adults ( 5 Krell-Roesch J. Lowe V.J. Neureiter J. Pink A. Roberts R.O. Mielke M.M. et al. Depressive and anxiety symptoms and cortical amyloid deposition among cognitively normal elderly persons: The Mayo Clinic Study of Aging. Int Psychogeriatr. 2018; 30: 245-251 Crossref PubMed Scopus (34) Google Scholar , 6 Donovan N.J. Locascio J.J. Marshall G.A. Gatchel J. Hanseeuw B.J. Rentz D.M. et al. Longitudinal association of amyloid beta and anxious-depressive symptoms in cognitively normal older adults. Am J Psychiatry. 2018; 175: 530-537 Crossref PubMed Scopus (106) Google Scholar ). Of note, also in this issue of Biological Psychiatry, Xu et al. ( 7 Xu W. Feng W. Shen X.-N. Bi Y.-L. Ma Y.-H. Li J.-Q. et al. Amyloid pathologies modulate the associations of minimal depressive symptoms with cognitive impairments in older adults without dementia. Biol Psychiatry. 2021; 89: 766-775 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar ) corroborate these findings in older adults without dementia and use causal mediation analyses to explore the mediation effects of AD pathologies on cognition. These authors thus provide important new evidence that the influence of minimal depressive symptoms on cognition is partially mediated by Aβ pathology and that the causal relationship between depression and Aβ might be bidirectional. SEE CORRESPONDING ARTICLE ON PAGE 757 SEE CORRESPONDING ARTICLE ON PAGE 757 Late-Life Depression Is Associated With Reduced Cortical Amyloid Burden: Findings From the Alzheimer’s Disease Neuroimaging Initiative Depression ProjectBiological PsychiatryVol. 89Issue 8PreviewWe evaluated the role of cortical amyloid deposition as a factor contributing to memory dysfunction and increased risk of dementia associated with late-life depression (LLD). Full-Text PDF

Scoping Review of Geriatric Depression and Behavioral Activation

<h3>Introduction</h3> A substantial proportion of older adults will experience depression (including major depressive disorder and subsyndromal depressive symptoms), yet depression remains underdiagnosed and undertreated among older adults. Behavioral Activation is an effective, empirically-validated, first-line treatment for mild to moderate depression. Behavioral activation is a patient-centered intervention designed to decrease depressive behavior (e.g. social isolation, physical inactivity) and increase engagement in pleasurable activities (e.g. hobbies, family time). The objective of this scoping review is to evaluate the gaps in the literature and knowledge base regarding the implementation contexts, target populations, delivery modalities, assessment methods, and effectiveness of behavioral activation as a treatment for depression and/or anxiety among older adults, including both inpatient and outpatient settings. <h3>Methods</h3> We performed a scoping review and searched for peer-reviewed articles published from 1990 to 2020. The keywords and their combinations (e.g., depression, anxiety, elder(s), elderly, geriatric, older adult(s), age, aged, aging, behavio(u)ral activation) were used in search engines including the following but not limited to PubMed, PsycINFO, and Cochrane. Our search strategy identified 423 results; after removing duplicates, 232 results remained. Currently, we are evaluating the titles and abstracts using broad inclusion criteria to ensure that all relevant behavioral activation relevant to geriatric depression and/or anxiety are included. All types of studies and publications (e.g. randomized clinical trials, cohort studies, case controls, reviews, etc.) that focus on behavioral activation as an intervention or primary focus are being included in this comprehensive search. Studies have to include participants > 50 years old with either clinically diagnosed depression and/or anxiety at or above a pre-defined cut-point on a validated symptom scale (e.g., PHQ-9: >5 and GAD-7: >5). <h3>Results</h3> This scoping review will chart the landscape of literature relevant to behavioral activation for older adults with depression and/or anxiety. The literature will be reviewed in terms of study setting (e.g., community or outpatient settings, inpatient psychiatric units, assisted living facilities); study type (including randomized clinical trials, as well as observational studies, cohort studies, case controls, cross sectional, etc.); mode, frequency, and duration of intervention delivery; type and training of providers; assessment methods; and outcomes. Reviews will be examined for themes and consistency in synthesis of findings. Particular attention will be paid to identifying gaps in the literature where further work is needed to broaden the reach and impact of this promising intervention. <h3>Conclusions</h3> Scoping reviews represent a compelling method for evaluating existing literature and identifying gaps for future study. The present scoping review will synthesize the identified literature, in the hope of helping not only clinicians who work closely with older adults, but also researchers wishing to pursue studies in this area. Given a burgeoning older adult population and a paucity of geriatric mental health providers, clinical guidelines offering alternative nonpharmacologic therapy can be effective and cost-effective for clinicians and healthcare systems. Given the COVID-19 pandemic and the consequent escalation in social isolation among older adults, it is also hoped that this scoping review will identify promising avenues and methods for adapting behavioral activation in myriad ways—i.e., through implementation via telehealth platforms—to the older adult population. <h3>Funding</h3> Not applicable

The Effects of Gait Speed and Psychomotor Speed on Risk for Depression and Anxiety in Older Adults with Medical Comorbidities.

Gait speed and psychomotor speed slow with age and may predict neuropsychiatric disease such as depression and anxiety. We explored the relative predictive values of gait speed, psychomotor slowing, and a composite index of these two measures on time to new episode depression or anxiety in older adults at risk for these common psychiatric conditions. Randomized controlled prevention trial with 15-month follow-up. University-based late-life mental health research clinic. Two hundred thirteen individuals, age 60+ years, with subsyndromal symptoms of depression or anxiety and one of the following risk factors for these common conditions: mild cognitive impairment, knee osteoarthritis, or disabilities requiring home-based care. Participants in each of the risk factor groups were randomized to a depression-specific preventive intervention or usual care. Gait speed: 4-m walk test from the Short Physical Performance Battery. Psychomotor speed: Coding task of the Repeatable Battery for the Assessment of Neuropsychological Status. We created a composite index of slowing by determining whether participants exceeded established cut-offs for slow performance in both gait speed (≤0.8 m/s) and psychomotor speed (<7 on the coding task). Time to new onset syndromal depression/anxiety was measured using research diagnostic criteria. Fifty-four participants developed syndromal depression/anxiety (19.5%) over the course of 15 months. Participants with slowing in both areas were over twice as likely to experience new onset depression/anxiety (hazard ratio (HR) = 2.11; 95% confidence interval (CI) = 1.02-4.40, P = .046) compared to participants with no slowing in either area. Slowed gait (HR = 1.88; 95% CI = 0.992-3.55; P = .052) or slowed psychomotor speed (HR = 0.60; 95% CI = 0.14-2.58; P = .488) alone did not increase risk for depression/anxiety. Evaluating both gait and psychomotor speed in older adults with medical comorbidities and sub-syndromal depression may predict incident mental illness and inform prevention planning. Future research is needed to validate our observations and explore shared neurobiological mechanisms that explain this elevated risk.

Associations of Non-Alcoholic Beverages with Major Depressive Disorder History and Depressive Symptoms Clusters in a Sample of Overweight Adults.

Background: Meta-analysis of observational studies concluded that soft drinks may increase the risk of depression, while high consumption of coffee and tea may reduce the risk. Objectives were to explore the associations between the consumption of soft drinks, coffee or tea and: (1) a history of major depressive disorder (MDD) and (2) the severity of depressive symptoms clusters (mood, cognitive and somatic/vegetative symptoms). Methods: Cross-sectional and longitudinal analysis based on baseline and 12-month-follow-up data collected from four countries participating in the European MooDFOOD prevention trial. In total, 941 overweight adults with subsyndromal depressive symptoms aged 18 to 75 years were analyzed. History of MDD, depressive symptoms and beverages intake were assessed. Results: Sugar-sweetened soft drinks were positively related to MDD history rates whereas soft drinks with non-nutritive sweeteners were inversely related for the high vs. low categories of intake. Longitudinal analysis showed no significant associations between beverages and mood, cognitive and somatic/vegetative clusters. Conclusion: Our findings point toward a relationship between soft drinks and past MDD diagnoses depending on how they are sweetened while we found no association with coffee and tea. No significant effects were found between any studied beverages and the depressive symptoms clusters in a sample of overweight adults.

Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression

ObjectivesWe report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention...

Effects of food-related behavioral activation therapy on eating styles, diet quality and body weight change: Results from the MooDFOOD Randomized Clinical Trial

ObjectiveDepression and obesity are bi-directionally related, eating styles and diet quality are two important factors associated with both. It remains uncertain if and how these two factors can be modified. Therefore the current study aims to investigate whether food-related behavioral activation therapy (F-BA), targeting mood, dietary habits and food related behavior, can improve eating styles, and diet quality and reduce body weight in adults with overweight or obesity and subsyndromal depressive symptoms. MethodsData were derived from the MooDFOOD prevention trial, a 2x2 factorial RCT investigating the effect of nutritional strategies on prevention of depression. Changes in emotional, uncontrolled, and cognitive restrained eating (Three Factor Eating Questionnaire Revised), Mediterranean Diet Score (MDS), and body weight were analyzed among 1025 adults who either received F-BA or no intervention for 12 months. Intervention effect was tested by longitudinal analysis of covariance using mixed model analysis. ResultsThe F-BA group showed a small decrease in emotional (β=-5.68, p<.001) and uncontrolled eating (β=-4.05, p=.03), and increase in cognitive restrained eating (β=5.53, p<.01), compared to no F-BA. The effect of the F-BA therapy on emotional and uncontrolled eating was stronger in those with higher baseline depressive symptoms (IDS-SR). The F-BA did also lead to small improvements in MDS (β=1.95, p<.001), but not to change in body weight. ConclusionOur trial showed no reduction in bodyweight, but provides support for the possibility to improve both unhealthy eating styles and diet quality using an intervention targeting these specifically, although effects were small [Trial registration: clinicaltrials.gov NCT02529423].

The Moderating Role of Child Maltreatment in Treatment Efficacy for Adolescent Depression.

Adolescent girls are at heightened risk of depression, and because adolescent depression may initiate a negative developmental cascade, intervention early in adolescence has potential for altering a negative developmental trajectory. Identifying risk factors that impact response to intervention may inform decisions about the type of treatment to provide for adolescent girls with depression. Understanding moderators of outcomes in evidence-based treatment is critical to the delivery of timely and effective interventions. Matching patients effectively with optimal intervention will not only expedite the alleviation of patients' distress, but will also reduce unnecessary time and resources spent on less advantageous interventions. The current investigation examines the efficacy of Interpersonal Psychotherapy for Depressed Adolescents (IPT-A) in a racially and ethnically diverse sample of 120 low-income adolescent girls age 13-15 with and without histories of child maltreatment. Adolescent and parent report of depressive symptoms were assessed at the beginning and end of treatment and a diagnosis of subsyndromal symptoms of depression or depression were required for purposes of inclusion. Results indicated that among adolescent girls who had experienced two or more subtypes of maltreatment, IPT-A was found to be more efficacious than Enhanced Community Standard (ECS) treatment. Importantly, when the subtype of maltreatment experienced was further probed, among girls with a history of sexual abuse, we found preliminary evidence that IPT-A was significantly more effective than ECS in reducing depressive symptoms, and the effect size was large. Thus, if a history of maltreatment is present, especially including sexual abuse, specifically addressing the interpersonal context associated with depressive symptoms may be necessary.