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Anales Del Sistema Sanitario de Navarra Apr 2019
Topics: Depression; Depressive Disorder; Humans
PubMed: 30936571
DOI: 10.23938/ASSN.0591 -
Revista Chilena de Pediatria 2017Health supervision is a privileged opportunity to walk along with the new families during their transition to parenthood. This period is challenging for both mother and... (Review)
Review
Health supervision is a privileged opportunity to walk along with the new families during their transition to parenthood. This period is challenging for both mother and father, and there is the potential danger that demand surpasses the existing resources of the family. This imbalance may lead to mothers and fathers to develop depressive symptomatology. Postpartum depression may affect one to two out of ten men, and maternal depression is a major risk factor for developing it. The postpartum depression in the father impact all the family members, being the child development, the bonding, and the child´s mental health which can be disturb at a short, medium and long term. Therefore, it seems to be relevant to think about screening for post partum depression not only in mothers but also fathers, and give a first step to broaden the gaze from the dyad to the triad. The health supervision is a unique opportunity to be able to carry out this screening; however, the validation of a postpartum screening test for Chilean fathers is a pending task.
Topics: Depression, Postpartum; Depressive Disorder; Father-Child Relations; Fathers; Female; Humans; Infant; Infant, Newborn; Male; Object Attachment
PubMed: 29546941
DOI: 10.4067/S0370-41062017000500002 -
Zeitschrift Fur Kinder- Und... Nov 2019Depressive symptoms have long been associated with abnormalities in neural processing of reward. However, no review has yet consolidated evidence of such deficits in... (Review)
Review
Depressive symptoms have long been associated with abnormalities in neural processing of reward. However, no review has yet consolidated evidence of such deficits in adolescent depression, integrating findings across neuroimaging modalities, such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG). The current review found consistent evidence of reduced striatal responses in anticipation and upon receipt of rewards, and blunted feedback-related negativity (FRN) potentials associated with depression in adolescence, consistent with the adult literature. Furthermore, while these occurred in currently depressed adolescents, they were also found to be predictive of the onset of depressive symptoms in longitudinal studies with community-based adolescent samples. This paper makes recommendations for future work to continue to elucidate this relationship, a greater understanding of which may lead to more targeted and efficacious treatments for depression in adolescence.
Topics: Adolescent; Depression; Depressive Disorder; Electroencephalography; Humans; Magnetic Resonance Imaging; Neuroimaging; Reward
PubMed: 30957688
DOI: 10.1024/1422-4917/a000663 -
Annual Review of Psychology Jan 2020Depression remains one of the most prevalent psychiatric disorders, with many patients not responding adequately to available treatments. Chronic or early-life stress is... (Review)
Review
Depression remains one of the most prevalent psychiatric disorders, with many patients not responding adequately to available treatments. Chronic or early-life stress is one of the key risk factors for depression. In addition, a growing body of data implicates chronic inflammation as a major player in depression pathogenesis. More recently, the gut microbiota has emerged as an important regulator of brain and behavior and also has been linked to depression. However, how this holy trinity of risk factors interact to maintain physiological homeostasis in the brain and body is not fully understood. In this review, we integrate the available data from animal and human studies on these three factors in the etiology and progression of depression. We also focus on the processes by which this microbiota-immune-stress matrix may influence centrally mediated events and on possible therapeutic interventions to correct imbalances in this triune.
Topics: Animals; Depressive Disorder; Gastrointestinal Microbiome; Humans; Inflammation; Stress, Psychological
PubMed: 31567042
DOI: 10.1146/annurev-psych-122216-011613 -
The New England Journal of Medicine Sep 2014
Review
Topics: Age Factors; Aged; Antidepressive Agents; Depressive Disorder; Female; Humans; Practice Guidelines as Topic; Psychotherapy; Selective Serotonin Reuptake Inhibitors
PubMed: 25251617
DOI: 10.1056/NEJMcp1402180 -
Acta Psychiatrica Scandinavica May 2018To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose...
OBJECTIVE
To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose new models that reflect their complex relationship.
METHOD
A systematic review following PRISMA guidelines. A total of 2210 articles were identified from EMBASE, PsychInfo and MEDLINE, and further two articles were hand-searched from references. Twenty-seven met inclusion criteria and were included in the review.
RESULTS
In schizophrenia, primary evidence suggests symptoms of low mood, suicidal ideation and pessimism have more specificity for depression whereas alogia and blunted affect may have more specificity as negative symptoms. Anhedonia, anergia and avolition may be common to both.
CONCLUSION
It may be possible to further distinguish depressive features from negative symptoms in schizophrenia when detailed phenomenology is considered. However, in a proposed dimensional model, these two domains continue to share certain phenomena, highlighting their close relationship.
Topics: Comorbidity; Depressive Disorder; Humans; Schizophrenia
PubMed: 29532909
DOI: 10.1111/acps.12873 -
Australasian Psychiatry : Bulletin of... Jun 2020An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of... (Review)
Review
OBJECTIVE
An incorrect false positive diagnosis of melancholia can lead to inappropriate treatment and illness prolongation. This paper therefore seeks to introduce the concept of 'pseudo-melancholia' to capture such instances and provide clinical examples of contributing at-risk scenarios.
METHODS
The author draws on clinical experience to provide exemplars of circumstances most risking a false positive diagnosis of melancholia.
RESULTS
Pseudo-melancholia can result from invalid measures of melancholia and from several functional and organic conditions presenting with suggested melancholic features.
CONCLUSIONS
Recognising high-risk pseudo-melancholia scenarios has the potential to advance a change in diagnostic formulation, provide a more diagnosis-specific intervention and so avert a secondary diagnosis of 'treatment resistant depression'.
Topics: Depressive Disorder; Depressive Disorder, Treatment-Resistant; Diagnosis, Differential; Diagnostic Errors; Humans
PubMed: 32157900
DOI: 10.1177/1039856220908167 -
JAMA Psychiatry Nov 2022Treatment-resistant depression (TRD) is common in older adults. Bilateral repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex for... (Randomized Controlled Trial)
Randomized Controlled Trial
Effectiveness of Standard Sequential Bilateral Repetitive Transcranial Magnetic Stimulation vs Bilateral Theta Burst Stimulation in Older Adults With Depression: The FOUR-D Randomized Noninferiority Clinical Trial.
IMPORTANCE
Treatment-resistant depression (TRD) is common in older adults. Bilateral repetitive transcranial magnetic stimulation (rTMS) of the dorsolateral prefrontal cortex for 48 minutes has demonstrated efficacy in TRD. Theta burst stimulation (TBS), a newer form of rTMS, can also be delivered bilaterally using left intermittent TBS and right continuous TBS for only 4 minutes.
OBJECTIVE
To establish the effectiveness and tolerability of TBS compared with standard rTMS in older adults with TRD.
DESIGN, SETTING, AND PARTICIPANTS
In this randomized noninferiority trial with open treatment and blinded assessors, recruitment occurred between December 2016 and March 2020. The trial was conducted at the Centre for Addiction and Mental Health in Toronto, Ontario, Canada and included outpatients 60 years and older with a diagnosis of depression, moderate severity, and nonresponse to 1 or more antidepressant trial of adequate dosage and duration or intolerance of 2 or more trials.
INTERVENTIONS
Participants were randomized to receive a course of 4 to 6 weeks of either bilateral standard rTMS or TBS.
MAIN OUTCOMES AND MEASURES
The primary outcome measure was change in Montgomery-Åsberg Depression Rating Scale; secondary outcome measures included the 17-item Hamilton Rating Scale for Depression, Quick Inventory of Depressive Symptomatology (16-item) (self-report), and dropout rates. A noninferiority margin of 2.75 points was used for the primary outcome. All participants who attained the primary completion point of 4 weeks were analyzed.
RESULTS
A total of 87 participants (mean [SD] age, 67.1 [6.7] years; 47 [54.0%] female) were randomized to standard bilateral rTMS and 85 (mean [SD] age, 66.3 [5.3] years; 45 [52.9%] female) to TBS, of whom 85 (98%) and 79 (93%) were assessed for the primary outcome, respectively, whereas tolerability was assessed in all randomized participants. In the rTMS group, 4 (4.6%) were American Indian, reported other, or preferred not to answer; 5 (5.8%) were Asian; and 78 (89.7%) were White. In the TBS group, 6 (7.1%) were Asian, 2 (2.4%) were Black or reported other, and 77 (90.3%) were White. Mean (SD) Montgomery-Åsberg Depression Rating Scale total scores improved from 25.6 (4.0) to 17.3 (8.9) for rTMS and 25.7 (4.7) to 15.8 (9.1) for TBS (adjusted difference, 1.55; lower 95% CI -0.67), establishing noninferiority for TBS. The all-cause dropout rates were relatively similar between groups (rTMS: 2 of 87 [2.3%]; TBS: 6 of 85 [7.1%]; P = .14; χ2 = 2.2).
CONCLUSIONS AND RELEVANCE
In older adults with TRD, bilateral TBS compared with standard bilateral rTMS achieved noninferior reduction in depression symptoms. Both treatments had low and similar dropout rates. Using TBS rather than rTMS could increase access to treatment several-fold for older adults with TRD.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT02998580.
Topics: Female; Humans; Aged; Male; Transcranial Magnetic Stimulation; Depression; Depressive Disorder, Major; Prefrontal Cortex; Depressive Disorder, Treatment-Resistant; Ontario; Treatment Outcome
PubMed: 36129719
DOI: 10.1001/jamapsychiatry.2022.2862 -
Lancet (London, England) May 2019
Topics: Antidepressive Agents; Depressive Disorder; History, 19th Century; History, 20th Century; History, 21st Century; Humans
PubMed: 31226037
DOI: 10.1016/S0140-6736(19)31151-1 -
The Psychiatric Clinics of North America Mar 2018This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of... (Review)
Review
This article covers current research on the relationship between depression and cognitive impairment in older adults. First, it approaches the clinical assessment of late-life depression and comorbid cognitive impairment. Cognitive risk factors for suicide are discussed. Research is then provided on neuropsychological changes associated with depression, discussing subjective cognitive impairment, mild cognitive impairment, and dementia profiles. Additionally, literature regarding neuroimaging and biomarker findings in depressed older adults is presented. Finally, therapeutic models for treatment of late-life depression are also discussed, including psychotherapy models, holistic treatments, pharmacologic approaches, and brain-stimulation therapies.
Topics: Aged; Aging; Comorbidity; Depressive Disorder; Humans; Neurocognitive Disorders; Psychotherapy
PubMed: 29412840
DOI: 10.1016/j.psc.2017.10.009