Types Of Depressive Disorders Research Articles

Gender-age and clinical-dynamic aspects of the course of depressive disorders in obese patients

Obesity and depression are global health problems. According to WHO estimates, depression is experienced by 3.8% of the population, including 5.0% of adults (4.0% of men and 6.0% of women) and 5.7% of people over the age of 60. About 60.0% of the population of economically developed countries is overweight, 25.0–30.0% are suffering from obesity. Taking into account the great medical and social importance and the insufficient study of the peculiarities of the structure, clinical course, and management of depression in patients with abdominal obesity, the purpose of the study is to analyse and compare the structure, gender-age, and clinical-dynamic features of the course of depressive disorders in obese patients. 140 people were examined. Patients were divided into two clinical groups. The 1st group included 70 women with abdominal obesity and average BMI (34.6±1.42) kg/m2, the 2nd group – 70 men with abdominal obesity and average BMI (34.6±1.42) kg/m2. Examination of patients included: a detailed collection of complaints and anamnesis of patients; a questionnaire to identify depressive disorders according to Beck’s Depression Inventory; clinical and objective examination; measurement of anthropometric and physiological indicators; and laboratory and statistical research. The results of the study established that in young people (25–44 years old), depression was recorded 3.80 times (χ2=24.86, p=0.00001) more often in women than in men, while the number of depressive disorders at the age of 45–59 among men was 2.42 times (χ2=20.94, p=0.00001) more often than among women. The emotional type with an episodic and more severe course of depression prevailed in women, while physical manifestations of depression were characteristic of men. In particular, aggression, which was registered 2.00 times (χ2=4.54, p=0.00001) more often than in women. In order to effectively provide treatment to patients with abdominal obesity and depression, not only the course and type of depressive disorders but also the gender and age characteristics of the patients must be taken into account. Keywords: obesity, depression, gender-age characteristics, body mass index.

Depression in the Diabetic Patient

Depression is a common emotional state in humans, which is sometimes triggered by stressful events and certain physical and/or mental conditions that may occur and may increase the body's vulnerability to various types of depressive disorders, causing sometimes organic changes difficult to quantify and to treat. Depressive conditions are major clinical problems that occur throughout life and often require a specialized treatment, but the use of the antidepressant compounds is often endangered by the risk of formidable side effects, requiring to stop the treatment or to use medicine doses that cannot determine the desired therapeutic results. These are reasons for the impressive expansion of the research on the depression types, with emphasize on etiological and etiopathogenetical studies, allowing the discovery of compounds with good therapeutic potential and an appropriate pharmacological profile to reduce the side effects. Diabetes (diabetes mellitus) is a major public health problem, with increasing costs and frequency in recent years. Late diagnosis, inadequate treatment, lack of ongoing monitoring or ignorance of the disease can have serious consequences for the health of that individual, his family and his community. The mental state of a patient with diabetes is different from one moment to the next and varies with the stage of the disease and the appearance of various complications. The stress of chronic illness, the pressure to have a lifestyle and a diet according to medical recommendations, sadness, anger and even denial of the disease, are feelings experienced by patients with diabetes at least once in their lives.

Resting-state frontal, frontlateral, and parietal alpha asymmetry:A pilot study examining relations with depressive disorder type and severity.

The search for biomarkers has been central to efforts of improving clinical diagnosis and prognosis in psychopathology in the last decades. The main approach has been to validate biomarkers that could accurately discriminate between clinical diagnoses of very prevalent forms of psychopathology. One of the most popular electrophysiological markers proposed for discrimination in depressive disorders is the electroencephalography (EEG)-derived frontal alpha asymmetry. However, the validity, reliability and predictive value of this biomarker have been questioned in recent years, mainly due to conceptual and methodological heterogeneity. In the current non-experimental, correlational study we investigated relationship of resting-state EEG alpha asymmetry from multiple sites (frontal, frontolateral, and parietal) with different forms of depressive disorders (varying in type or severity), in a clinical sample. Results showed that alpha asymmetry in the parietal (P3-P4) was significantly higher than in the frontal (F3-F4) and frontolateral sites (F7-F8). However, we did not find significant relations between alpha asymmetry indices and our depressive disorder measures, except for a moderate positive association between frontolateral alpha asymmetry (eyes-closed only) and depressive disorder severity (determined through clinical structured interview). We also found no significant differences in alpha asymmetry between participants, depending on their depression type. Based on results, we propose the parietal and frontolateral asymmetry indices to form hypotheses that should not be abandoned in the depression markers research, but worth for further experimental research. Methodological and clinical implications of the current findings are discussed.

Depression: a new look at etiopathogenesis and treatment

Depression is considered a multifactorial disease, the trigger of which is unknown. Eye diseases and depressive disorders may have a common trigger - excessively constricted pupils (experimental data). The hypothesis of the occurrence of depression: in genetically predisposed individuals, long-term negative emotions cause - through cortico-nuclear pathways - excessive narrowing of the pupils. Narrowed pupils (reduction of light flux) through the optic-vegetative system trigger pathological biochemical processes in the body, which leads to deterioration of the mental and physical conditions of patients. It is proposed to investigate experimentally (taking into account the principle of "direct - feedback" in the optic-vegetative system), whether the terms of treatment of patients with postpartum depression will be shortened when dilating one pupil with atropine (simulation of Adi's syndrome) against the background of standard therapy. With a positive effect of treatment, the above method can be used for other types of depressive disorders

Депресивні розлади з переважанням апато-адинамічної чи тривожно-фобічної симптоматики: взаємозв’язок клінічних проявів та пошукової активності

Topicality. In today's world, depressive disorders (DD) are one of the most common mental disorders. DD causes disturbances in various areas of human mental activity, significantly affecting the quality of life, as well as impairing the ability to understand and properly assess the future. The need to develop new strategies for diagnosis and therapy. In addition to the main groups of symptoms in DD should pay attention to clinical and psychopathological syndromes: depressive, asthenic, apathetic, anxiety-phobic, somato-vegetative and hypochondriac. at DD and will need further research. The aim of the study. Explore the severity of apathic-adynamic or anxiety-phobic symptoms in DD, their nosological affiliation in relation to the level of MLO. Methods. We examined 66 patients of both sexes (36 women and 30 men) aged 18 to 40 years (24.4 ± 3.8) with different types of DD, diagnosed according to the criteria of the International Classification of 10 revisions. A clinical-psychopathological method (semi-structured clinical-diagnostic interview) was used to determine apatic-adynamic (AA) or anxiety-phobic (AF) variants of DD. According to the clinical picture, patients are divided into 2 groups: the first - patients with apatic-adynamic symptoms, the second - with anxiety-phobic symptoms. The PHQ-9 patient health questionnaire was used to assess the severity of depression. We used the Test of meaningful life orientation, Leontiev), adapted by D. Leontiev version of the test J. Crambo, L. Maholic "Purpose-in-Life Test". The article examines and analyzes the difference between depressive disorders (DD) and the leading anxiety-phobic and apathic-dynamic symptoms. Results. Significantly lower indicators were found in the scales of goal presence, interest in life, life satisfaction (effectiveness, self-realization) and the ability to control one's life in general in the presence of apatic-dynamic symptoms of DD compared to anxiety-phobic symptoms. The presence of a statistically significant difference indicates possible therapeutic targets in patients of these two groups.

Emotional sphere disorders in patients with cognitive impairments in depressive disorders

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinical-psychopathological and statistical. As a result of the study, the clinical and psychopathological features of affective disorders in different types of depressive disorders were identified: a predominance of apathy, emotional lability, hypothymia, anxiety, feelings of dissatisfaction, despair and anhedonia were identified in patients with RDD; a low mood, apathy, emotional coldness, hypothymia, ambivalence of emotions, dysphoria, dissatisfaction, feelings of sadness and annoyance were identified in patients with BAD; a feelings of despair, anxiety, dissatisfaction, hypothymia, fear, sadness, feelings of horror and fear, emotional lability, feelings of anger, hostility and shame and sensitivity were dominated in patients with PDR.

Characteristics of Executive Functions in Patients With Cognitive Impairments in the Presence of Depressive Disorders

Introduction. The urgency of the problem of affective pathology and, above all, depression, due to a number of factors: the growing prevalence of depression, reaching 10.0 % in the population, the high risk of chronic such conditions, their maladaptive impact on social functioning, efficiency and quality of life, the burden of economic costs etc. According to epidemiological indicators in Ukraine over the past 10 years, the incidence of affective disorders has increased by 6.13 %, and the prevalence – by 13.16 %. Impaired thinking and executive functions, decreased concentration and difficulty making decisions are key diagnostic signs of depression. Cognitive impairment (CI) has a cumulative effect on the functionality of patients with depression and is associated with a longer duration of depressive episodes, which indicates the need for its diagnosis and treatment. At the present stage, there are no systematic ideas about the specifics of disorders of executive functions in the presence of different types of depressive disorders (DD), which determines the relevance of the study in this direction. The aim of the study. Describe the executive functions in patients with CI in the presence of DD. Materials and methods. The study included 362 patients with CI in the presence of DD, which were stratified into three groups of comparisons by the mechanism of DD: 123 patients with recurrent depressive disorders (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). The predominant numbers (38.12 %) of patients with CI in the presence of DD were in adulthood (30-44 years). There were more young people (18-29 years) among patients with PDR (21.43 %, DC = 8.19) and among patients with BAD (31.21 %, DC = 9.82), and middle-aged people (45-59 years) (37.40 %, DC = 1.54) and the elderly (60-74 years) (17.07 %, DC = 4.78) – among patients with RDD. A set of research methods was used: clinical-psychopathological, psychodiagnostic and statistical. Results. Peculiarities of executive functions in patients with CI in the presence of DD were established: the moderate and severe disorders of visual-motor coordination (39.84 % and 19.51 %, respectively) and impaired visual-spatial functions (13.72 %), moderate and severe violations of executive functions (54.47 % and 13.01 %, respectively), moderate, severe and weak violations of the executive function of the lexical system (39.84 %, 32.52 % and 23.58 %, respectively) were present in patients with RDD; the moderate violations of verbal performance (58.54 %); moderate and severe violations of visual-motor coordination (41.13 % and 26.24 %, respectively), executive functions (65.96 % и 21.38 %, respectively), executive functions of the lexical system (47.52 % и 39,01 %, respectively) and verbal productivity (58.16 % and 21.28 % respectively) were found in BAD; absence and weak impairments of visual-motor coordination (45.92 % and 36.73 %, respectively), executive functions (23.47 % and 66.33 %, respectively), executive functions of the lexical system (31.63 % and 45.92 %, respectively) and verbal productivity (26.53 % and 58.16 %, respectively) were presented in patients with PDR. Conclusions. The study revealed the features of executive functions in patients with cognitive impairment in the presence of depressive disorders, which should be taken into account in the algorithm of their psychosocial rehabilitation.

Depression and suicidality among Egyptian renal transplant recipients

BackgroundHigh rates of depression and suicidality risk have been reported after renal transplantation. The study aims to estimate the prevalence of depressive disorders and suicidality risk among Egyptian renal transplant recipients and their demographic and clinical correlates.ResultsThe prevalence of depressive disorders among renal transplant recipients was (32.2%). Major depression (16.5%), adjustment disorder depressive type (9.13%) while dysthymic disorder occurred in (6.5%). Suicidality risk was present among 31.3% of the sample. Hopelessness was the commonest depressive symptoms within the depressed patients. There was a statistically significant association of depression and risk of suicidality, with age, educational attainment, employment, and the presence of side effects of medication. However, there was no significant correlation between depression or suicidality, with marital status, type of donor, duration of dialysis, and associated other medical illnesses. Despite there was no relation between gender and severity of depression, yet male recipients showed more pronounced suicidal risk.ConclusionsThe prevalence of depression and suicidality is quite high among post renal transplantation recipients (PRTRs). Early psychiatric evaluation and intervention together with regular long term follow-up from the multi-disciplinary team are necessary for recipients after renal transplant operation.

Peculiarities of the attention process at depressive disorders

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder, 141 patients with bipolar affective disorder and 98 people with prolonged depressive reaction. Peculiarities of the process of attention of patients with depressive disorders were the presence of a decrease in concentration, stability and switching of attention, decrease in work efficiency and working capacity. The peculiarities of the functioning of attention indicators were determined for various types of depressive disorders, which can use as diagnostic criteria in the differential diagnosis of cognitive impairment in depressive disorders. Key words: cognitive impairment, depressive disorders, persistence, concentration and switching of attention, recurrent depressive disorder, bipolar depressive disorder, prolonged depressive reaction

S178. SHOULD SCHIZOAFFECTIVE DISORDER DEPRESSED-TYPE BE DISTINCT FROM SCHIZOPHRENIA? ANALYSIS OF GENETIC LIABILITY AND LIFETIME CLINICAL CHARACTERISTICS

BackgroundSchizoaffective disorder depressed type (SAD) has been considered a distinct diagnostic entity since 1987, yet it is rarely recognised in clinical and research settings as it is considered analogous to schizophrenia with comorbid depression. However, these assumptions are often based on anecdotal evidence, as little research has attempted to examine differences between the two disorders. We aimed to establish the validity of SAD as a diagnosis, by investigating phenotypic and genotypic differences between schizophrenia and SAD.MethodsParticipants were from the Cardiff Cognition study and included if they met ICD-10 criteria for schizophrenia (n=713) or SAD (n=151). Diagnosis was determined via consensus assessment by trained researchers using lifetime symptom data from the SCAN interview alongside patient medical records. Polygenic risk scores were derived for schizophrenia and major depressive disorder using PRSice. Logistic regressions were used to measure the association between diagnosis and lifetime clinical characteristics across five categories: demographics, premorbid functioning, illness progression, psychosis, and depression. Sex and age at interview were included as covariates. Logistic regressions were used to measure the association between diagnosis and polygenic risk scores for schizophrenia and depression at a threshold of p<.05, covarying for sex and principal components.ResultsCompared to schizophrenia, SAD was significantly associated with female sex (OR= 3.19, 95% CI= 2.23 - 4.59, p=5.0x10-9), lower global assessment score in worst episode of depression (OR= 0.47, 95% CI= 0.37 – 0.59, p=5.0x10-9), higher global assessment score in worst episode of psychosis (OR= 1.44, 95% CI= 1.20 – 1.72, p= 6.8x10-4), a greater likelihood of an admission for depression (OR= 2.24, 95% CI= 1.48 – 3.40, p= 1.2x10-3), greater alcohol abuse or dependence (OR= 2.12, 95% CI= 1.41 – 3.20, p= 2.3x10-3), longer duration of depression (OR= 1.46, 95% CI= 1.19 - 1.84, p= 3.5x10-3), experiencing childhood abuse (OR= 2.07, 95% CI = 1.35 – 3.17, p= 3.9x10-3), a reduced likelihood of an involuntary admission for psychosis (OR= 0.40, 95% CI= 0.22 – 0.75, p= 0.01), depression onset occurring prior to psychosis onset (OR= 2.40, 95% CI= 1.37 – 4.43, p= 0.01), having a higher number of children (OR= 1.34, 95% CI= 1.08 – 1.67, p= 0.03), and better cognitive functioning (OR= 1.20, 95% CI= 1.04 – 1.40, p= 0.05).Depression polygenic risk score was higher in participants with SAD (OR= 1.33, 95% CI= 1.06 – 1.66, R2= 0.015, p= 0.01); schizophrenia polygenic risk score was not associated with diagnosis (OR= 0.94, 95% CI= 0.75 – 1.17, R2= 0.001, p= 0.58). Secondary analyses were conducted to investigate sex-specific effects. A significant difference in schizophrenia polygenic risk was observed between males and females, which indicated that males with SAD have lower schizophrenia polygenic risk scores than females with SAD (OR= 0.46, 95% CI= 0.28 – 0.74, R2= 0.143, p=1.5x10-3). Sex-specific effects were not observed for depression PRS or phenotypes.DiscussionOur results indicate a number of differences between individuals with schizophrenia and SAD. Primarily, the results demonstrate a greater burden of depression in those with SAD, both phenotypically and genotypically. Our results also suggest that the genetic contribution to SAD may differ between males and females. The findings indicate that schizophrenia research, particularly genetic research, needs to consider the impacts of sex-specific effects and comorbid depression before combining patient samples for analysis.

Schizoaffective Disorder Depressive Type in “The Yellow Wallpaper” by Charlotte Perkins Gilman

Presentation given at the 21th Annual Phi Kappa Phi Student Research and Fine Arts Conference

Depression among patients admitted to medical wards: comparison between a university hospital and regional hospital

Abstract Objective: We aimed to determine the prevalence of depression and to find factors associated with depression in admitted medical patients. The differences in the pattern of depression between a university hospital (UH) and a regional hospital (RH) were determined as well. Methods: This is a cross-sectional study. The Patient Health Questionnaire-9 (PHQ-9) was administered among hospitalized patients in medical wards. PHQ-9 could not differentiate between the type of depressive disorder that could be from medical conditions, adjustment disorder with depressed mood, major depressive disorder, or dysthymia. Results: A total of 343 patients (191 in UH, 152 in RH group) with age of 52.1 ± 16.9 years were included. Timing of interview was 4.3 ± 1.4 days after admission. The prevalence of depression (PHQ-9 score ≥ 9) was 12% (7.3% in UH vs 17.8% in RH, p &lt; 0.005). According to PHQ-9 scoring, the prevalence of moderate-to-severe depression was 3.8%. Mean PHQ-9 score in RH was significantly higher than in UH (p &lt; 0.001). Multiple baseline characteristics were analyzed by logistic regression and found no factors associated with depression. There was no difference in baseline characteristics of UH patients with depression compared to RH, except for universal health coverage plan. Conclusions: The prevalence of depression was 1 in 10 patients and was found to be more frequent and severe in RH than UH. All patients were at equal risk to develop depression during admission.

Depressive Disorder yang Dialami Tokoh Kayoko Numata dalam Drama Kazoku Game

The title of this research is “Depressive Disorder of Kayoko Numata’s Character in Kazoku Game Drama”. The research aims to provide psychological knowledge about psychiatric illness especially depressive disorder in the literature work. The research method used was descriptive analysis. There were three theories used in this research, they were the psychology literature theory by Wellek and Warren (2016), theory of depressive disorder by Fawcett (2013), and theory of how to overcome depressive disorder by Sharf (2010) as well as concept of depressive disorder by Holland (2015). The results obtained from this research are Kayoko Numata character suffered from psychiatric disease called depressive disorder with major type of depressive disorder or severe depression disorder in accordance with the symptoms shown, namely (1) dejected mood; (2) diminished interest in others or activities; (3) weight loss; (4) insomnia; (5) psychomotor agitation; (6) decreased ability to think and; (7) attempted suicide. Kayoko character showed seven of the nine major depressive disorder symptoms and has shown symptoms for more than two weeks. Depressive disorder in the Kayoko character was caused by his efforts in maintaining his marriage and his relationship with his children. Kayoko also had no major events during her life so she often thought of doing something that could change her life. How to overcome depressive disorder on the Kayoko character is with therapy, namely family therapy system and interpersonal therapy. The therapy helps Kayoko to be able to deal with and solve problems in her family, and to make her be more positive in facing the future.

Депрессия при болезни Паркинсона: аспекты психопатологической структуры и нозологической квалификации

Background: depression along with cognitive impairment is one of the most common non-motor psychopathological symptom of Parkinson's disease (PD), however, the problem of nosological differentiation and typology of affective disorders in PD is still unresolved. The goal: of this study is the investigation of psychopathological and nosological differentiation of depression in PD with the determination of the mode of association between affective and neurological disorders. Patients and methods : the research was conducted at the Clinic of Nervous Diseases named after A.Ya. Kozhevnikov of the I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University). 28 patients (22 women, 6 men; mean age 64.4±9.4 years) with verified diagnoses of depression and PD were enrolled in the study. For assessment of depression we used Hamilton Depression Scale (HADS-21), for assessment of cognitive functions were used a brief neuropsychological examination of the cognitive sphere (KNOKS) and a brief mental status assessment scale (MMSE). Neurological examination was provided with unified Parkinson's disease rating scale (UPDRS). Results: a clinical typology of depression in PD, considering the patterns of formation and the association between affective and neurological disorders, has been proposed. Two types of depressive disorders were identified, each of which included two clinical subtypes: (I) depression directly associated with the onset of PD, including (1) nosogenic and (2) organic subtypes; and (II) depressions manifesting independently of PD, including (3) reactive and (4) endogenous subtypes. In addition, a special group of endoform depressive states have been identified. Conclusion: as the result of this study, the clinical and nosological heterogeneity of depression in PD was established, psychopathological structure of depressive episodes and the pattern of interaction between affective disorder and PD were determined. These findings expand the possibility of differential diagnosis, the determination of an individual prognosis and selection of personalized therapy.

Psychophysical Characteristics of Patients with Depression and Anxious-Depressive Disorders

Psychophysical investigations were carried out on patients with depressive and anxious-depressive disorders, including ECG, EEG, speech signal recordings, and testing of visuomotor reactions. Patients showed deterioration in measures of variational cardiometry relative to healthy subjects regardless of the presence or absence of anxiety syndrome. EEG dynamics during cognitive tests and the variability of the correlation dimension of the speech signal changed specifically in patients with anxiety syndrome. Increases in the standard deviation of the correlation dimension of the speech signal may provide an indicator of the presence of a depressive disorder, changes in the speech signal depending on the type of depressive disorder.

Examining cognition across the bipolar/schizophrenia diagnostic spectrum.

Cognitive impairments are well-established features of schizophrenia, but there is ongoing debate about the nature and degree of cognitive impairment in patients with schizoaffective disorder and bipolar disorder. We hypothesized that there is a spectrum of increasing impairment from bipolar disorder to schizoaffective disorder bipolar type, to schizoaffective disorder depressive type and schizophrenia. We compared performance on the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery between participants with schizophrenia (n = 558), schizoaffective disorder depressive type (n = 112), schizoaffective disorder type (n = 76), bipolar disorder (n = 78) and healthy participants (n = 103) using analysis of covariance with post hoc comparisons. We conducted an ordinal logistic regression to examine whether cognitive impairments followed the hypothesized spectrum from bipolar disorder (least severe) to schizophrenia (most severe). In addition to categorical diagnoses, we addressed the influence of symptom domains, examining the association between cognition and mania, depression and psychosis. Cognitive impairments increased in severity from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia and schizoaffective disorder depressive type. Participants with schizophrenia and schizoaffective disorder depressive type showed equivalent performance (d = 0.07, p = 0.90). The results of the ordinal logistic regression were consistent with a spectrum of deficits from bipolar disorder to schizoaffective disorder bipolar type, to schizophrenia/schizoaffective disorder depressive type (odds ratio = 1.98, p < 0.001). In analyses of the associations between symptom dimensions and cognition, higher scores on the psychosis dimension were associated with poorer performance (B = 0.015, standard error = 0.002, p < 0.001). There were fewer participants with schizoaffective disorder and bipolar disorder than schizophrenia. Despite this, our analyses were robust to differences in group sizes, and we were able to detect differences between groups. Cognitive impairments represent a symptom dimension that cuts across traditional diagnostic boundaries.

Depressive Disorders: Update on Diagnosis, Etiology, and Treatment

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals. This review contains 6 table and 53 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress

Depressive Disorders: Update on Diagnosis, Etiology, and Treatment

This review discusses the changes in the diagnostic criteria for depressive disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), and recent findings exploring the etiology of and treatment strategies for these disorders. Depressive disorders are typically characterized by depression in the absence of a lifetime history of mania or hypomania. New developments in the DSM-5 include the recognition of new types of depressive disorders, such as disruptive mood dysregulation disorder, persistent depressive disorder, premenstrual dysphoric disorder, and the addition of catatonic features as a specifier for persistent depressive disorder. These diagnostic changes have important implications for the prognosis and treatment of this condition. A thorough understanding of both the clinical phenotype and the biosignature of these conditions is essential to provide individualized, long-term, effective treatments to affected individuals. This review contains 1 table and 52 references Key words: brain volumes, depressive disorders, DSM-5, hormones, inflammation, neuropeptides, somatic therapy, stress

Is knowledge “half the battle”? The role of depression literacy in help-seeking among a non-clinical sample of adults with currently untreated mental health problems

BackgroundsThe concept of mental health literacy suggests that higher literacy increases the likelihood of seeking treatment. However, previous studies mostly use vignettes, and do not investigate actual help-seeking behaviour. MethodsWe assessed depression literacy and type of mental illness in a convenience sample of 207 adults with currently untreated mental health problems from the general population. Our analysis sample comprised 152 adults (Mage = 52.12; 73.0% female) with a depressive disorder. Help-seeking behaviour was measured 3 and 6 months after the initial assessment. We conducted multiple logistic regression models to test whether depression literacy predicted help-seeking from mental health professionals, general practitioner, family and friends, or counselling, controlling for sociodemographic data, and depression severity. ResultsDepression literacy was lower in men and older participants, and higher in participants with prior treatment experience. Depression literacy was negatively linked to informal help-seeking (aOR = 0.33 [0.13; 0.84]) when included as a dichotomous predictor (i.e., ‘high’ versus ‘low’ literacy). LimitationsOur sample was small, thus we did not differentiate between types of depressive disorders in our analysis. ConclusionWe could not corroborate most postulated associations between depression literacy and help-seeking, except for the negative association with informal help. Our findings underline differences between previous vignette-based and community-based investigations of the help-seeking process for mental health problems. To explore underlying mechanisms, future research should investigate the role of intermediary variables and processes in the association between depression literacy and help-seeking, such as self-efficacy and symptom attribution, which might be more clinically relevant in help-seeking for depressive symptoms.

S189. CARVING A MORE SPECIFIC SUBTYPE OF SCHIZOPHRENIA FOR GENETIC STUDIES: SPORADIC SCHIZOAFFECTIVE BIPOLAR TYPE

BackgroundSchizophrenia is a heterogeneous group of disorders. The familial-sporadic distinction has been considered under a range of genetic models. Research supports a strong association of de novo copy mutations with sporadic schizophrenia. The aim of the study was to determine a more homogenous phenotype for genetic research via comparison of various clinical and socio-demographic variables in familial and sporadic schizophrenia.MethodsA cross-sectional observational design was used. This study included 384 participants with schizophrenia/schizoaffective disorder from an Afrikaner founder population in South Africa that previously participated in genetic research. A comprehensive data capturing sheet was completed from a pre-existing database that contains information obtained from the Diagnostic Interview for Genetic Studies, chronological clinical summary reports and additional sources of information. The study protocol was approved by the Research Ethics Committee from the Faculty of Health Sciences at the University of Pretoria. Logit models were fitted using the backward elimination procedure to investigate relationships where the dependent variable was binary. Odds ratio estimates were calculated for independent variables that were significant in the model. The Kruskal-Wallis test was conducted to compare the means of groups. For cases where there were significant differences a post-hoc test with a Bonferroni correction was done to determine which groups differ significantly.ResultsThere were 214 familial and 170 sporadic subjects. 279 had a diagnosis of schizophrenia, 66 schizoaffective, bipolar type and 39 schizoaffective disorder, depressive type. 242 were male and 142 female. The age at onset of the primary psychiatric diagnosis, season of birth, co-morbid diagnoses, symptomatology, suicidality history and marital status weren’t significantly different when considering the combined schizophrenia/schizoaffective disorder group and its relationship to familiality. Early deviant behaviour was however decreased in the sporadic group. These findings were replicated when analysing schizophrenia independently from schizoaffective disorder. The sporadic schizoaffective disorder, bipolar type did however have a significantly lower age at onset (mean 20.18 versus 25.07 years), 8.8 times more hallucinations, 6.6 times more odd behaviour before the age of 10 and were 2.8 times more likely to be single. The bipolar type also had 2.9 times more suicide attempts as opposed to ideation. This finding wasn’t statistically significant. The sporadic schizoaffective group overall was 2.2 times more likely to abuse substances. The depressive type didn’t differ significantly with regards to age at onset, season of birth, co-morbidities, early deviant behaviour, symptomatology, suicidality or marital status.DiscussionThe combined schizophrenia/schizoaffective group didn’t differ significantly, nor did schizophrenia and schizoaffective disorder depressive type when analysed independently. The sporadic schizoaffective bipolar type differed significantly on multiple important variables that suggest a poorer prognosis and increased disease severity. The sporadic schizoaffective bipolar type forms a more homogenous group, with genetic studies hinting at relatively specific genetic risk factors. Studies elucidating the genetic architecture of this group could prove invaluable in clarifying the aetiology of schizophrenia.