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Schizophrenia Bulletin Mar 2017The presence of depression in schizophrenia has been a challenge to the Kraepelinian dichotomy, with various attempts to save the fundamental distinction including... (Review)
Review
The presence of depression in schizophrenia has been a challenge to the Kraepelinian dichotomy, with various attempts to save the fundamental distinction including evoking and refining diagnoses such as schizoaffective disorder. But the tectonic plates are shifting. Here we put forward a summary of recent evidence regarding the prevalence, importance, possible aetiological pathways and treatment challenges that recognizing depression in schizophrenia bring. Taken together we propose that depression is more than comorbidity and that increased effective therapeutic attention to mood symptoms will be needed to improve outcomes and to support prevention.
Topics: Comorbidity; Depressive Disorder; Humans; Psychotic Disorders; Schizophrenia
PubMed: 27421793
DOI: 10.1093/schbul/sbw097 -
Ugeskrift For Laeger Oct 2017The aim of this study was to examine what we know about the general practitioners' ability to diagnose and treat depression. Some studies suggest that clinicians might... (Review)
Review
The aim of this study was to examine what we know about the general practitioners' ability to diagnose and treat depression. Some studies suggest that clinicians might have considerable difficulty identifying depressions correctly, but that diagnostics become more accurate with increased severity of the disease. Several studies suggest that patients diagnosed with depression are undertreated, and some studies suggest that patients might receive antidepressants, even though they do not fulfil the International Classification of Diseases 10 criterion for depression.
Topics: Clinical Competence; Depressive Disorder; Diagnostic Errors; General Practitioners; Humans
PubMed: 28992842
DOI: No ID Found -
International Journal of Molecular... Sep 2023Brain-derived neurotrophic factor (BDNF) has been studied as a biomarker of major depressive disorder (MDD). Besides diagnostic biomarkers, clinically useful biomarkers... (Review)
Review
Brain-derived neurotrophic factor (BDNF) has been studied as a biomarker of major depressive disorder (MDD). Besides diagnostic biomarkers, clinically useful biomarkers can inform response to treatment. We aimed to review all studies that sought to relate BDNF baseline levels, or BDNF polymorphisms, with response to treatment in MDD. In order to achieve this, we performed a systematic review of studies that explored the relation of BDNF with both pharmacological and non-pharmacological treatment. Finally, we reviewed the evidence that relates peripheral levels of BDNF and BDNF polymorphisms with the development and management of treatment-resistant depression.
Topics: Humans; Depressive Disorder, Major; Brain-Derived Neurotrophic Factor; Biomarkers; Depressive Disorder, Treatment-Resistant; Polymorphism, Genetic
PubMed: 37834258
DOI: 10.3390/ijms241914810 -
Journal of Psychiatry & Neuroscience :... Sep 2021Rumination, a tendency to focus on negative self-related thoughts, is a central symptom of depression. Studying the self-related aspect of such symptoms is challenging...
BACKGROUND
Rumination, a tendency to focus on negative self-related thoughts, is a central symptom of depression. Studying the self-related aspect of such symptoms is challenging because of the need to distinguish self effects from the emotional content of task stimuli. This study employed an emotionally neutral self-related paradigm to investigate possible altered self-processing in depression and its link to rumination.
METHODS
People with major depressive disorder ( = 25) and controls ( = 25) underwent task-based electro-encephalogram recording. We studied late event-related potentials, along with low-frequency oscillatory power. We compared electroencephalogram metrics between groups and correlated them with depressive symptoms and reported rumination.
RESULTS
Participants with major depressive disorder displayed a difference in late positive potentials across frontocentral electrodes between self-related and non-self-related conditions. We found no such difference in controls. The magnitude of this difference was positively correlated with depressive symptoms and reported rumination. Participants with major depressive disorder also had elevated theta oscillation power at central electrodes in self-related conditions, a finding that we did not see in controls.
LIMITATIONS
Patients with major depressive disorder were medicated at the time of the study. The group studied was primarily female, so the observed effects may have been sex-specific.
CONCLUSION
Rumination appears to be linked to altered self-related processing in depression, independent of stimuli-related emotional confounds. This connection between self-related processing and depression may point to a self disorder as a core component of depression.
Topics: Adult; Brain; Depressive Disorder, Major; Emotions; Female; Humans; Male; Rumination, Cognitive
PubMed: 34548386
DOI: 10.1503/jpn.210052 -
Neuropsychobiology 2020Electroconvulsive therapy (ECT) is still one of the most potent treatments in the acute phase of major depressive disorder (MDD) and particularly applied in patients... (Review)
Review
BACKGROUND/AIMS/METHODS
Electroconvulsive therapy (ECT) is still one of the most potent treatments in the acute phase of major depressive disorder (MDD) and particularly applied in patients considered treatment resistant. However, despite the frequent and widespread use of ECT for >70 years, the exact neurobiological mechanisms underlying its efficacy remain unclear. The present review aims to describe differential antidepressant and cognitive effects of ECT as well as effects on markers of neural activity and connectivity, neurochemistry, and inflammation that might underlie the treatment response and remission.
RESULTS
Region- specific changes in brain function and volume along with changes in concentrations of neurotransmitters and neuroinflammatory cytokines might serve as potential biomarkers for ECT outcomes.
CONCLUSIONS
However, as current data is not consistent, future longitudinal investigations should combine modalities such as MRI, MR spectroscopy, and peripheral physiological measures to gain a deeper insight into interconnected time- and modality-specific changes in response to ECT.
Topics: Depressive Disorder, Major; Electroconvulsive Therapy; Humans; Outcome Assessment, Health Care
PubMed: 32344410
DOI: 10.1159/000505553 -
Psychiatrike = Psychiatriki Dec 2021Major depressive disorder is a serious mental health disorder of high prevalence and the leading cause of disability worldwide. While there are several classes of... (Review)
Review
Major depressive disorder is a serious mental health disorder of high prevalence and the leading cause of disability worldwide. While there are several classes of therapeutic agents with proven antidepressant efficacy, only about 40-60% of patients respond to initial antidepressant monotherapy, and 30-40% of patients may even show resistance to treatment even under optimal antidepressant pharmacotherapy. Despite the existence of international guidelines, there are still no clear and widely accepted treatment algorithms, no established predictive biomarkers of response to treatment, while the management treatment- resistant depression is usually based on clinical experience. The present article offers a brief narrative review of studies published so far on the predictive quality of various blood-based peripheral biomarkers with respect to response to pharmacological, stimulation or behavioral treatment in patients with treatment-resistant depression. To summarize the results, there does not yet appear to be any specific biomarker that has sufficient discriminative predictive validity and can be used in the routine clinical practice of treating resistant depression. Many factors are likely to account for the above-mentioned research findings, including the wide variety of treatment protocols and the non-uniformly accepted definition of resistant depression used by the various studies, the small number of patients with treatment-resistant depression included, and the existence of different pathophysiological phenotypes of the disorder. The ineffective treatment of major depressive disorder requires an immediate improvement of our therapeutic approach by establishing clinically useful and easily accessible predictive biomarkers of response with high accuracy. The discovery of new and better clinical characterization of known biomarkers in the treatment of treatment-resistant depression could support a better staging and classification of the disorder, the development of personalized treatment algorithms for specific patient subgroups, the achievement of higher rates of stable remission, and the development of new precision drugs with minimal side effects.
Topics: Antidepressive Agents; Depression; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Humans; Prognosis
PubMed: 34990379
DOI: 10.22365/jpsych.2021.049 -
The Psychiatric Clinics of North America Sep 2018Transcranial magnetic stimulation has emerged as a treatment option for treatment-resistant depression. While existing data largely support efficacy of transcranial... (Review)
Review
Transcranial magnetic stimulation has emerged as a treatment option for treatment-resistant depression. While existing data largely support efficacy of transcranial magnetic stimulation for major depressive disorder, ongoing research aims to optimize treatment parameters and identify biomarkers of treatment response. In this article, the authors describe data from controlled trials and ongoing efforts to enhance transcranial magnetic stimulation outcomes for major depressive disorder. Findings from preliminary research aimed at identifying neuroimaging and neurophysiological biomarkers of transcranial magnetic stimulation effects are discussed.
Topics: Brain; Depressive Disorder, Major; Depressive Disorder, Treatment-Resistant; Electroencephalography; Humans; Nerve Net; Neuroimaging; Transcranial Magnetic Stimulation
PubMed: 30098655
DOI: 10.1016/j.psc.2018.04.006 -
Journal of the American Academy of... Jan 2019We conducted meta-analyses to assess risk for anxiety disorders among offspring of parents with anxiety disorders, and to establish whether there is evidence of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We conducted meta-analyses to assess risk for anxiety disorders among offspring of parents with anxiety disorders, and to establish whether there is evidence of specificity of risk for anxiety disorders as opposed to depression in offspring, and whether particular parent anxiety disorders confer risks for particular child anxiety disorders. We also examined whether risk was moderated by offspring age, gender, temperament, and the presence of depressive disorders in parents.
METHOD
We searched PsycINFO, PubMed, and Web of Science in June, 2016, and July, 2017 (PROSPERO CRD42016048814). Study inclusion criteria were as follows: published in peer-reviewed journals; contained at least one group of parents with anxiety disorders and at least one comparison group of parents who did not have anxiety disorders; reported rates of anxiety disorders in offspring; and used validated diagnostic tools to ascertain diagnoses. We used random and mixed-effects models and evaluated study quality.
RESULTS
We included 25 studies (7,285 offspring). Where parents had an anxiety disorder, offspring were significantly more likely to have anxiety (risk ratio [RR] = 1.76, 95% CI = 1.58-1.96) and depressive disorders (RR = 1.31, 95% CI = 1.13-1.52) than offspring of parents without anxiety disorders. Parent panic disorder and generalized anxiety disorder appeared to confer particular risk. Risk was greater for offspring anxiety than for depressive disorders (RR = 2.50, 95% CI = 1.50-4.16), and specifically for offspring generalized anxiety disorder, separation anxiety disorder and specific phobia, but there was no evidence that children of parents with particular anxiety disorders were at increased risk for the same particular anxiety disorders. Moderation analyses were possible only for offspring age, sex, and parental depressive disorder; none were significant.
CONCLUSION
Parent anxiety disorders pose specific risks of anxiety disorders to offspring. However, there is limited support for transmission of the same particular anxiety disorder. These results support the potential for targeted prevention of anxiety disorders.
Topics: Adolescent; Adult; Anxiety Disorders; Child; Child of Impaired Parents; Child, Preschool; Depressive Disorder; Humans; Young Adult
PubMed: 30577938
DOI: 10.1016/j.jaac.2018.07.898 -
Journal of Abnormal Psychology Jul 2016Dysfunctional reward processing has long been considered an important feature of major depressive disorder (MDD). However, depression is a heterogeneous construct and...
Dysfunctional reward processing has long been considered an important feature of major depressive disorder (MDD). However, depression is a heterogeneous construct and the nature of this heterogeneity may contribute to some of the inconsistent empirical findings on reward dysfunction in MDD. The current study examined 1 source of heterogeneity, melancholic symptoms, and its association with reward processing. In individuals with MDD (N = 141) and MDD-free controls (N = 113), electroencephalogram (EEG) alpha asymmetry was measured during a behavioral reward task that probed reward anticipation. Melancholic depression was measured both categorically (Diagnostic and Statistical Manual of Mental Disorders [DSM] diagnosis) and dimensionally (Hamilton Endogenomorphy Scale [HES]). Results showed that a dimensional (and not categorical) definition of melancholia predicted reward processing, with higher melancholic symptoms predicting reduced reward anticipation. Importantly, the effects of melancholic symptoms on reduced reward anticipation remained above and beyond overall depression severity. These results suggest that dysfunctional reward processing may only be associated with melancholic symptoms, not depression in general. (PsycINFO Database Record
Topics: Adult; Anticipation, Psychological; Cerebral Cortex; Depressive Disorder; Electroencephalography; Female; Humans; Male; Reward
PubMed: 27175986
DOI: 10.1037/abn0000172 -
Journal of Affective Disorders Mar 2016Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and... (Review)
Review
Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and associated with high social dysfunction, only recently its underpinning biological pathways have been explored, while multiple and concomitant risk factors have been identified (e.g. psychosocial stress). Peripartum depression usually has its onset during the third trimester of pregnancy or in the postpartum, being one of the most common medical complications in new mothers. Purpose of the present review is to summarize the state of art of biological biomarkers involved in the pathogenesis of perinatal depression, in view of the fact that suboptimal prenatal milieu can induce permanent damage in subsequent offspring life and have a negative impact on mother-child relationship. Furthermore, parents' biological changes due to medical/psychiatric disorders or stress exposure could influence offspring life: a concept known as 'intergenerational transmission', acting by variations into gametes and the gestational uterine environment. Given the evidence that perinatal mental disorders involve risks for the mother and offspring, the search for reliable biomarkers in high-risk mothers actually represents a medical priority to prevent perinatal depression.
Topics: Biomarkers; Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Pregnancy
PubMed: 26802316
DOI: 10.1016/j.jad.2016.01.027