Journal of Affective Disorders Reports最新文献

Background

The neuroinflammatory hypothesis of Major Depressive Disorder (MDD) postulates that dysregulated cytokine production is implicated in the etiopathology of the disorder. This study aimed to determine baseline levels of Interleukin-8 (IL-8), an inflammatory cytokine, in MDD and identify possible changes in response to antidepressant drug therapy.

Methods

Two independent groups of MDD patients who met study criteria were enrolled; one group was treated with Escitalopram and the other with Quetiapine for twelve weeks. There was a healthy control (HC) group. In the Escitalopram group 30 patients completed the baseline visit and in the Quetiapine group 43 patients. Plasma concentrations of IL-8 were measured at baseline, week eight, and week 12 of treatment. IL-8 levels were correlated with depression severity at baseline and week 12. The sample size for IL-8 analysis was 17 study completers in the Escitalopram study, 21 study completers in the Quetiapine study, and 19 HCs. We used the Student's t-test and the Pearson Correlation Coefficient for statistical analyses.

Results

MDD patients exhibited elevated IL-8 levels at baseline compared to healthy controls (p = 0.007). However, IL-8 levels did not show a significant reduction after 12 weeks of treatment and were not significantly correlated with depression severity at either baseline or week 12 of treatment. However, there was a notable downtrend in IL-8 levels after treatment in both groups though not statistically significant.

Limitations

Study limitations include sample size variations and power, and study length. No formal assessment was conducted to rule out Axis II diagnoses.

Conclusions

These findings underscore the relationship between IL-8 and MDD, suggesting that IL-8 may play a role in the pathophysiology of MDD, but its relationship with antidepressant treatment requires a prolonged period of treatment. This study suggests a role for IL-8 in MDD as a pro-inflammatory biomarker, while the lack of immediate normalization post-treatment indicates the need for further exploration of delayed effects of antidepressant therapy on immune markers and IL-8′s relationship with the mechanism of action of specific pharmacotherapies used in MDD.

Introduction

Eating disorders include a variety of symptoms related to concerns about body shape, weight, and food consumption, frequently manifesting as behaviors like restrictive eating, binge eating, and purging. Body surveillance and body shame have consistently been associated with the severity of these psychopathologies, while self-compassion has been suggested as a protective factor against these conditions. This study aims to test the hypothesis that there is a relationship between higher body surveillance and increased eating disorder symptoms, and to investigate whether self-compassion and body shame may act as mediators of this relationship.

Methods

Questionnaires were administered to 386 emerging adults (M = 26.11; DS=4.29) to assess Body Surveillance, Self-compassion, Body Shame, and Eating disorders symptoms.

Results

Body Surveillance is negatively linked with Self-Compassion, while positively correlated with Body Shame and Eating Disorders. Furthermore, negative correlations were found between Self-Compassion, Body Shame, and Eating Disorders. Moreover, there was a positive correlation between Body Shame and Eating Disorders. In addition, a statistically significant indirect association was found from Body Surveillance to Eating disorders symptoms by Body Shame, and from Self-compassion to Eating disorders symptoms by Body Shame.

Conclusion

These results suggest that maladaptive eating patterns may be associated with Body Surveillance and Body Shame, while Self-compassion may serve as a protective factor against these maladaptive attitudes. The implications for clinicians are thoroughly discussed.

Background

The affective temperaments are defined as the fundamental predisposition from which normal affective states originate or as the constitutional core of personality. Recently, researchers have started considering the role of affective temperament on the clinical expression of affective disorders. The aim of the study is to learn more about the role of affective temperaments on irritability, anxiety and depression symptoms.

Methods

748 subjects belonging to Italian population were included. Data were collected through an online survey including IDAS and TEMPS-A questionnaire. Two correlation analysis were performed to assess sex differences in the affective patterns. A linear regression analysis was performed to assess how age, sex and temperamental dimensions could play a role as predictors of depression, anxiety and irritability symptoms.

Results

The correlation analysis shows that "Cyclothymic," "Depressive," "Irritable", and "Anxious" temperaments, in both genders, positively correlate with Anxiety, Depression, and Irritability. Hyperthymic temperament, instead, negatively correlates with Depression in men and with both Anxiety and Depression in women. Linear regression show that Cyclothymic, depressive and anxious temperaments are significant predictors of anxiety symptoms while depressive and cyclothymic temperaments are predictors of depressive symptoms. The irritability was found to be a significant predictor of depression and anxiety disorders. The results of the linear regression analysis show that the Cyclothymic and Irritable temperaments significantly predicted “Irritability”. Finally, female sex was found to be a predictor of anxiety (β = 0.090, t = 2.906, p = <0.004)

Conclusion

The present study confirms the role of affective temperaments as possible risk factors in psychopathological manifestations. Further studies would be necessary in order to investigate the mechanisms of these observed associations.

Background

Bipolar disorder (BD) is a serious chronic disease with a high frequency of suicide attempts (SA) and suicides. There are few long-term studies concerning characteristics of SA in BD, especially what characterizes early from late SA.

Methods

A long-term study of 51 BD patients (DSM-IV) with SA were collected from lithium dispensaries in northern Sweden. Patients were divided into early SA (the first five years) after age of onset (AOO) or late SA.

Results

Patients with early SA were younger (p = 0.036), met BD earlier (p = 0.005), had less repeated depressions before SA (p = 0.002), often performed SA at first episode (p < 0.001) and before initiating of lithium (p = 0.002). Before first SA they had, fewer but more frequent episodes/year (p < 0.001), fewer depressive (p < 0.001) but more frequent depressive episodes/year (p < 0.001), lower frequency of hypomanic (p = 0.016) or manic episodes (p = 0.006). They had a higher frequency of episodes/year off (p = 0.047) and on (p = 0.042) lithium. Twenty percent of all patients performed SA at first episode, 47 % early SA and 65 % first ten years after AOO.

Early SA was associated with a family history of first- and/or second-degree relative of affective disorder (AD) (p = 0.005), first-degree relative of AD (p = 0.031) and first-degree relative of BD (p = 0.049). All patients with early SA had a family history of AD.

Conclusions

Patients with early SA have a more severe form of BD. Family history of AD among first- and/or second-degree relatives is significantly associated with especially early SA which implies a special psychiatric treatment and care for this BD group.

Background

This cross-sectional online survey aims to investigate the impact of Primary Sjögren's Syndrome (pSS) on mental health by measuring anxiety, depressive symptoms and health-related quality of life (HR-QoL) in the Italian context.

Methods

Participants diagnosed with pSS were recruited via the National Association of Sjögren's Syndrome Patients (A.N.I.Ma.S.S.), composed by members across Italy, and completed an online survey using the LimeSurvey platform. Data collected encompassed demographic, clinical information (e.g., age, gender, disease duration), diagnostic details (suspecting and diagnosing specialists), and mental health assessments (HADS for depressive and anxiety symptoms, SF-36 for HR-QoL). Descriptive analyses were conducted, including frequencies for binary variables, mean and standard deviations for interval-level variables, alongside correlation assessments between clinical scales.

Results

The study included 216 women with pSS who completed the survey (average age: 54 years). Mental health symptoms evaluated by the HADS subscales revealed a clinical level of anxiety in 50 % and depression in 41 % of the respondents Patients with pSS had a low score in all eight domains of the SF-36.

Limitations

The study has limitations, including its focus on female pSS patients due to limited male participants, potential biases in self-reported survey data, and the lack of certain demographic and clinical variables.

Conclusion

Our results emphasize the critical role of emotional distress in the progression of pSS, highlighting the need for its proper management. This insight contributes to the development of a rational therapeutic approach to pSS patients useful for all the healthcare professionals, pharmaceutical industry, and drug regulatory organizations.

Introduction

Post-traumatic stress symptoms (PTSS) have been shown to negatively impact treatment outcomes in outpatient settings, but few have investigated in acute settings, such as partial hospital programs (PHP). The present study examined how PTSS may influence treatment outcomes– depression, anxiety, overall functioning– among patients attending a PHP.

Methods

1298 (Female n = 728) adults underwent standard transdiagnostic treatment at a PHP in which patients attend the day-long program for approximately 2 weeks for stabilization primarily focused on mood and anxiety symptoms. We utilized previously validated questionnaires to measure PTSD severity (PCL-5), anxiety (GAD-7), depression (PHQ-9), and overall functioning (WSAS). Linear regression analyses were conducted to determine the degree of improved symptoms and functioning across three trauma groups: patients with no trauma history, patients with trauma exposure, and patients who had severe PTSS.

Results

Patients in the PTSS group were more likely to endorse higher depression and anxiety symptoms, as well as functional impairment at admission. Severe PTSS, not trauma exposure, predicted less improvement of depression, anxiety, and overall functioning at discharge.

Limitations

Due to the nature of the private hospital, results may not generalize to a wider clinical population. Further, we were unable to test any potential mechanisms because the current naturalistic treatment study relied on a deidentified clinical database that was not designed with these research questions.

Conclusions

Severe PTSS above and beyond anxiety and depression symptoms potentially serve as predictors of treatment outcomes in acute psychiatric settings such as PHPs, further emphasizing the need for enhanced trauma-informed care.

Background

Intravenous esketamine treatment (EKIT) has been proposed to have greater efficacy than its racemic counterpart for the management of treatment-resistant depression and suicidal ideation; however, few studies have been documented this regard. We evaluated the clinical evolution of treatment-resistant major depressive disorder (MDD) and bipolar affective disorder (BAD) with or without suicidal ideation in patients who received EKIT, based on real-world data.

Methods

This study included patients with treatment-resistant MDD/BAD primary diagnosed by their own psychiatrists and prescribed EKIT. In the Cetamine Clinic, primary and follow-up measurements used Patient Health Questionnaire (PHQ-9). The study analyzed 263 patients with baseline PHQ-9 > 4 who received at least two infusions of EKIT.

Results

After the EKIT induction phase, PHQ-9 score reduced from 20.5 ± 4.6 to 9.8 ± 7.0 (p < 0.001; Cohen's d = 1.47). Based on the final PHQ-9 score, 26.2 %, 32.7 %, 19.4 %, and 21.7 % of the patients achieved remission (PHQ-9 ≤ 4), had a good-response (PHQ-9 reduction >50 %), had a mild-response (PHQ-9 reduction 25–50 %) and failed, respectively. Among 92 patients at high risk of suicide at baseline (PHQ-9 item-9=3), 84 % became low-risk after EKIT.

Limitations

The retrospective design of the study, diagnosis of treatment-resistant MDD/BAD by the concerned psychiatrists, and lack of washout for any medication possibly contributed to a heterogeneous study population. However, these characteristics were attributed to the real-world design. Monitoring was exclusively conducted using the PHQ-9 and long-term follow-up was not performed.

Conclusion

Our findings demonstrated a robust overall response regarding depression after EKIT; moreover, a substantial proportion of the participants demonstrated a mild response. A notable response concerning suicide was observed after EKIT.

Mindfulness-based interventions (MBIs) have been shown to be effective in treating psychological disturbances such as depression and anxiety. However the neural mechanisms underpinning MBIs, remain unclear. While studies employing functional magnetic resonance imaging (fMRI) and electroencephalography have advanced our understanding of neural correlates influenced by mindfulness, these modalities have notable limitations that restrict their applicability across various demographics. This study explored the feasibility of functional near-infrared spectroscopy (fNIRS) as a viable alternative for assessing neurocognitive changes induced by MBIs. To do this, fNIRS data was collected from 19 university students during a modified flanker task, before and after a week-long, app-based mindfulness intervention. Post intervention, participants improved their ability to inhibit pre-potent responses to stimuli after a rule change. While no significant pre-post changes in cortical activation of the DLPFC were observed, participants who performed better (i.e., better response accuracy) required less modulation from the DLPFC. These results continue to establish the use of fNIRS as an effective tool for understanding neurocognitive underpinnings of mindfulness. As a less invasive, cost-efficient modality, fNIRS shows promise in expanding neuroscientific investigation into understudied samples that may not be well suited for traditional methods such as fMRI. Ultimately, this could lead to more effective mindfulness interventions that have already shown promise in treating a range of physical and psychological disorders.

The Mini-International Neuropsychiatric Interview (MINI) is a widely used structured diagnostic interview that assesses common mental health disorders in the DSM-5 and ICD-10. Using data from the 2004 Pelotas Birth Cohort Study, we highlight that the criteria for manic episodes in the MINI is not coded according to DSM-5 or ICD-10 criteria. The implications of this are discussed

Ninety percent of people with depression also report suffering from additional cognitive disorders. However, despite the high prevalence, the effectiveness of cognitive training methods for mental illnesses has not yet been extensively researched.

In our study, ninety-six adult patients with depressive symptoms were randomly assigned to one of two intervention groups or a passive control group. Ultimately, 48 patients successfully completed the training and assessments. The first intervention group completed computer-based cognitive training (three times a week for 20 min). The second intervention group practiced different memory strategies three times a week, in addition to completing the same computer-based cognitive training as the first intervention group.

All groups demonstrated several improvements in cognitive performance and experienced benefits in everyday life over time. However, we found neither a significant group effect nor a significant time × group interaction effect for any of the measures. Despite this, on a descriptive level, the intervention groups showed improvements across all five cognitive test performance outcomes (especially attention and working memory) and displayed better scores in the post intervention assessment of the self-reported personal variables (well-being, emotional regulation and depressive symptoms). Approximately 50 % of the subjects in each group did not complete the training or the post intervention assessment and were excluded. We worked closely with healthcare professionals, therapists and doctors and were thus able to gather not only research results but also valuable experience in dealing with patients with depressive symptoms who are undergoing cognitive training. Our findings and experiences may have implications for optimizing the reintegration of people with depressive symptoms.