Journal of Affective Disorders Reports最新文献

Background

Medical students are at high risk for mental disorders, and the COVID-19 pandemic might have exacerbated psychological distress. However, no data are available for the southern part of Italy. The SMS-ME (Sicilian Medical Students’ MEntal health) project aimed to estimate the prevalence of and predictors of depression, anxiety, stress, and suicidal ideation in a sample of Sicilian medical students.

Methods

A web-based cross-sectional survey was carried out from September 2022 to December 2022. The study protocol investigated sociodemographic factors and clinical data including Depression, Anxiety, Stress Scale-21 (DASS-21), and a specific question addressing suicidal ideation frequency over the last six months. Multivariate regression models were assessed to examine the association between symptoms and relevant predictors and then regressed their residuals with suicidal thought frequency.

Result

We collected 1,866 records (age=22.5, SD=3.4; 65.2 % females). One out of four students presented highly severe depression (25 %) and referred to the presence of some suicidal ideation in the six months preceding the interview (26.1 %). DASS-21 scores, especially depression (F(5, 1,828)=58.8, p = 6.59^–57), increasingly predicted the frequency of suicidal thoughts when above the sample's mean.

Limitations

The cross-sectional study design does not allow inferences on temporal relationships and the self-report strategy could be intrinsically biased by the person's feelings at the time of the interview.

Conclusions

High prevalence of anxiety and depressive symptoms and suicidal thoughts were observed among Sicilian medical students. The DASS-21 was a good predictor for suicidal ideation that Universities could use as a simple tool to assess the need for psychological healthcare in this population.

Introduction

Anhedonia is a core symptom in depressive episodes, predicting the occurrence of treatment resistance, suicidality, and poor responses to conventional treatments. Ketamine has shown potent antidepressant properties and appears to be a promising antianhedonic agent.

Methods

A systematic review and meta-analysis were performed for interventional studies published between 2013 and April 2023. Additionally, an active search was conducted on April 10, 2024. Sixteen studies, with an initial total sample of 1048 participants with treatment-resistant major depressive disorder (MDD) and bipolar depression (BD), were included in the meta-analysis. The ROBINS-I and ROB-2 tools assessed the risk of bias.

Results

Compared to baseline levels, ketamine showed a significant antianhedonic effect 24 h after the first infusion (MD -0.73, 95 % CI -0.93, -0.52, p < 0.01; Z= -7.07, Tau2= 0.0643, I²= 53 %, p = 0.02), for the general analysis considering the last infusion defined by each study protocol (MD -1.42, 95 % CI -1.79, -1.05, p < 0.01; Z= -7.46, Tau2= 0.6208, I² = 92 %, p < 0.01). Subanalysis revealed a significant effect for ketamine both in MDD patients (MD -1.13, 95 % CI -1.56, -0.70, p < 0.01; Z= -5.11, Tau2= 0.4116, I²= 88 %, p < 0.01) and those with BD (MD -1.21, 95 % CI -1.80, -0.62, p < 0.001; Z=-4.02, Tau2= 0.2142, I² = 66 %, p = 0.05).

Limitations

most included studies were non-randomized trials and post-hoc analyses. In addition, consistent heterogeneity was identified in the analysis.

Conclusion

The growing current evidence suggests that ketamine is a promising treatment for anhedonia.

Background

Current treatment of major depressive disorders still leave many patients with modest improvement. Attention Bias Modification (ABM) is an approach that may serve as an adjuvant therapy for subgroups of patients. We examined whether rumination, often found to be associated with a negative attentional bias, acts as a moderating variable in a computerized ABM procedure in participants with recurrent depression.

Methods

A total of 301 patients were randomized to receive either active - or sham ABM twice daily for 14 days. A regression-based moderator analysis was applied to evaluate whether baseline brooding, from the Rumination Response Scale (RRS-B), moderated the effect of ABM on Hamilton Depression Rating Scale (HDRS) and Beck Depression Inventory II (BDI-II).

Results

There was no significant interaction effect of ABM and RRS-B on HDRS or BDI-II at post-intervention or at 1 month follow-up. In addition, no correlation was found for pre-training attention bias and RRS-B.

Limitations

: Generalizability is limited to individuals with non-clinical symptom scores.

Conclusions

There was no moderator effect of brooding rumination on clinical depression scales in the largest clinical study on ABM to date.

Background

Emotion regulation (ER) plays an important role for mental health. However, there is limited research involving ER variability as a prerequisite for adaptive ER. The present study assessed the relations between two indicators of ER variability (between- and within-strategy), depressive symptoms, perceived ER effort and success, and age.

Methods

We implemented a three-week ambulatory assessment study during a nationwide lockdown in Germany during the Covid-19 pandemic (April 2020). The sample comprised 322 participants aged between 15 and 82 years (M = 28.8 years, SD = 14.0, 74.5 % female). Participants reported their daily use of ER strategies in the evening. The data were analysed with stepwise regression analyses.

Results

We found significant positive associations between within-strategy variability and depressive symptoms. Perceived ER effort was positively correlated to depressive symptoms, while perceived ER success was negatively associated with depressive symptoms. Between-strategy variability did not show a significant connection to depressive symptoms. Age was negatively associated with within-strategy variability.

Conclusions

The findings support that day-to-day ER variability, particularly within-strategy variability, is a significant correlate of depressive symptoms across a wide age range. Our results underscore the importance of considering situational context information when analyzing the adaptiveness of specific ER patterns.

Post-traumatic stress disorder (PTSD) is a mental disorder linked to neurochemical, hypothalamic-pituitary-adrenal (HPA)-axis dysregulations, inflammatory and pro-oxidant challenges in response to traumatic events. It is one of the leading causes of neurocognitive declines, hence prompting the need for a pharmacological intervention. However, the impact of diosgenin, a naturally occurring steroidal saponin with adaptogenic-like action, on PTSD-induced neuropsychiatric disturbances and its underlying mechanisms are unknown. In this study, we investigated the outcome of diosgenin treatment in a multimodal traumatic, single prolonged stress (SPS)-induced PTSD in mice. Following the SPS-induced 7 days of PTSD, mice (n = 9) were thereafter treated with diosgenin (25 and 50 mg/kg) or fluoxetine (10 mg/kg) orally from days 8–20 (14 days). Locomotory, cognitive-, depressive- and anxiety-like behaviors were investigated. We assayed for changes in adrenal weight, serum glucose and corticosterone concentrations. Neurochemical, inflammatory, oxido-nitrergic dysfunctions and monoamine oxidase-B and acetylcholinesterase activities, were measured in the striatum, prefrontal-cortex and hippocampus. The results revealed that the SPS challenge inhibited locomotor, spatial/non-spatial memory functions, increased anxiety and depressive-like features, which were reversed by diosgenin. Diosgenin reduced SPS-induced increased monoamine oxidase-B, acetylcholinesterase activities, TNF-α, IL-6, malondialdehyde and nitrite levels in the striatum, prefrontal-cortex and hippocampus. Antioxidants such as glutathione, superoxide-dismutase, and catalase levels in SPS-mice brains were increased by diosgenin. Moreover, diosgenin attenuated SPS-induced hyper-HPA-axis mediation of PTSD by decreasing serum corticosterone, glucose levels and adrenal gland hypertrophy. Herewith, we suggest that diosgenin convenes adaptogenic-like protection against mice exposed to PTSD by enhancing antioxidant machinery, neurochemical modulations, and inhibition of oxido-nitrergic, inflammatory, and HPA-axis dysfunctions.

Background

Individuals with major depressive disorder (MDD) hospitalized for a suicide attempt are at high risk for a repeated suicide attempt. Previous studies have identified immune alterations in MDD, but not the prospective association between immunological abnormalities and subsequent suicide behavior.

Methods

We enrolled 69 adults with MDD following hospitalization for a suicide attempt. Participants were assessed for co-occurring immunological disorders and on clinical measures. Participants had a blood sample drawn from which were measured cytokines, antibodies, and other markers of inflammation. Following hospital discharge, participants were assessed for six months. Cox proportional hazard models examined the relationships between baseline variables and a repeated suicide attempt.

Results

A total of 15 (24 %) of the 62 participants with at least one post-hospital visit had a suicide attempt in the follow-up period. These individuals had a significant alteration in a combined immune marker consisting of the cytokines, IL-1β, TNF-α, and IFN‐γ as well as IgG antibodies to Epstein Barr Virus (HR= 8.03, 95 % CI 1.73, 37.08, p=.008). A diagnosis of asthma was also associated with a repeated suicide attempt (HR= 3.10, 95 % CI 1.10, 8.79, p=.033). Suicidal intent, stressful events, and aspects of psychiatric history also predicted this outcome.

Limitations

The sample was relatively small limiting statistical power. Also, we focused on one specific high-risk group.

Conclusions

Persons with MDD and immunological abnormalities have an increased rate of repeated suicide attempts. Immunological measurements combined with clinical information may identify high risk individuals who would benefit from personalized interventions.

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.