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BMC Psychiatry Dec 2023Insomnia symptoms in patients with major depressive disorder (MDD) are common and deleterious. Childhood trauma, personality traits, interpersonal distress, and social...
BACKGROUND
Insomnia symptoms in patients with major depressive disorder (MDD) are common and deleterious. Childhood trauma, personality traits, interpersonal distress, and social support contribute to insomnia, but how they interact to affect insomnia remains uncertain.
METHODS
A total of 791 patients with MDD completed the Insomnia Severity Index, Eysenck Personality Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, Childhood Trauma Questionnaire, Social Support Rating Scale and Hamilton Depression Scale-17. This study utilized network analyses to identify the central symptoms of insomnia and their associations with psychosocial factors.
RESULTS
Worrying about sleep was identified as the central symptom in the insomnia network, insomnia and associated personality network, insomnia and associated interpersonal disturbance network, insomnia and associated childhood trauma network, insomnia and associated social support network, and the integrated network of insomnia symptoms and associated psychosocial factors. In the networks of insomnia symptoms and individual psychosocial factors, most psychosocial factors (other than childhood trauma) were directly or indirectly related to insomnia symptoms; however, neuroticism was the only factor directly associated with insomnia symptoms before and after controlling for covariates. In the final integrated network of insomnia symptoms and psychosocial factors, neuroticism was a bridge node and mediated the relationships of social support and interpersonal disturbances with insomnia symptoms, which is clearly presented in the shortest pathways.
CONCLUSIONS
Worrying about sleep and neuroticism were prominent in the integrated network of insomnia symptoms and associated psychosocial factors, and the edge between them connected psychosocial factors and insomnia symptoms in MDD patients.
Topics: Humans; Depression; Sleep Initiation and Maintenance Disorders; Depressive Disorder, Major; Personality
PubMed: 38104061
DOI: 10.1186/s12888-023-05454-9 -
International Review of Psychiatry... 2020The delineation of anxiety and depression as well as the relation between anxiety and depression are still subject of debate. Many patients suffering from depression... (Review)
Review
The delineation of anxiety and depression as well as the relation between anxiety and depression are still subject of debate. Many patients suffering from depression also suffer from anxiety, and many patients with anxiety suffer or will suffer from depression. The co-occurrence or co-morbidity is higher than what could be expected based on their respective prevalences, and even pushed some authors to call it cothymia. This epidemiological and clinical reality results in many conceptual hesitations. We first will summarize how the different (versions of the) classification systems do not seem to have been successful in their attempts to delineate the blurred line between depression and anxiety, before questioning whether a dialogue with a more phenomenological or psychopathological approach could be helpful in understanding the articulation between both affective phenomena, as well as in bridging neurobiological research and clinical practice.
Topics: Anxiety; Anxiety Disorders; Comorbidity; Depression; Depressive Disorder; Humans; Psychopathology
PubMed: 32436448
DOI: 10.1080/09540261.2020.1764509 -
American Journal of Psychotherapy Mar 2020Family-based interpersonal psychotherapy (FB-IPT) is an evidence-based psychosocial intervention for depression in preadolescents (ages 8-12 years). Adapted from... (Review)
Review
Family-based interpersonal psychotherapy (FB-IPT) is an evidence-based psychosocial intervention for depression in preadolescents (ages 8-12 years). Adapted from interpersonal psychotherapy for adolescents with depression and modified for younger children, this therapy includes structured dyadic sessions with preadolescents and their parents, guidance for parents in supporting their children and decreasing negative parent-child interactions, and a focus on preadolescents' comorbid anxiety and peer relationships. This article reviews the conceptual foundations and risk factors related to preadolescent depression and the rationale for focusing on improving preadolescents' interpersonal relationships to decrease depressive symptoms and risk for depression during adolescence. The structure and goals for the initial, middle, and termination phases of FB-IPT are described, as well as the specific communication and problem-solving strategies presented to preadolescents and parents. Last, research on the efficacy of FB-IPT is summarized, as are future directions for implementing this promising psychosocial intervention for preadolescent depression in community settings.
Topics: Anxiety; Child; Depression; Depressive Disorder; Family Therapy; Humans; Interpersonal Psychotherapy; Interpersonal Relations; Peer Group
PubMed: 32050785
DOI: 10.1176/appi.psychotherapy.20190028 -
Journal of Affective Disorders Apr 2023Depression is a common mental illness that afflicts over 300 million individuals worldwide. Despite a variety of therapeutic options available, a significant number of... (Review)
Review
BACKGROUND & RATIONALE
Depression is a common mental illness that afflicts over 300 million individuals worldwide. Despite a variety of therapeutic options available, a significant number of depressed patients fail to respond to treatment. Current guidelines for treating depression suggest that supplementation of essential nutrients may be an appropriate adjunctive to treatment, but research investigating full dietary interventions for depressed patients is scarce.
STUDY OBJECTIVE
The primary aim of this study was to systematically review published scientific literature investigating full dietary interventions as treatment for individuals with a diagnosis of depression. In doing so, we assessed existing evidence for recommendation of a dietary intervention and reviewed theory of how diet may be important in this context.
METHODS
A systematic search was conducted using OVID to search Medline, PsychINFO, and EMBASE, and PubMed for relevant publications. Only studies including full dietary interventions for patients with Major Depressive Episode, Major Depressive Disorder, Persistent Depressive Disorder, Seasonal Affective Disorder, or Dysthymia, as diagnosed using criteria defined in the chapter of "Depressive Disorders" in the DSM, were included.
RESULTS
Only five studies met the inclusion criteria for this review. All five studies included in this review reported improvements in mood following dietary intervention as compared to the comparison group. However, heterogeneity in both the dietary intervention and the outcome(s) measured made it difficult to compare these studies against each other and to generalize them to larger populations.
CONCLUSION
The findings of this review provide preliminary evidence for the positive impact of dietary interventions in the treatment of depressed patients. However, the mechanism by which particular diets induce positive changes in mood, be it through anti-inflammatory mechanisms or via weight loss in overweight patients, is unclear. Future research investigating the impact of dietary interventions on a large-scale is warranted and needed.
Topics: Humans; Depression; Depressive Disorder, Major; Diet; Overweight; Seasonal Affective Disorder
PubMed: 36738997
DOI: 10.1016/j.jad.2023.01.094 -
Journal of Geriatric Oncology Sep 2019The increasing number of older adults living with cancer will inevitably include vulnerable subgroups who experience a range of depressive symptoms throughout the care... (Review)
Review
The increasing number of older adults living with cancer will inevitably include vulnerable subgroups who experience a range of depressive symptoms throughout the care continuum. It is well established that depression can lead to decreased quality of life, poor treatment adherence, increased length of hospital stay and health service utilization, and in severe cases, suicide. Thus, clinicians working in oncology must be able to identify, conceptualize, and treat (or connect to services) the mental health concerns of their older patients. This brief review describes the unique etiologies, features, and treatments for depressive syndromes among older adults in the oncology setting, drawing on the literature and prevailing depression management guidelines from both psycho-oncology and geriatric depression research.
Topics: Adjustment Disorders; Aged; Antidepressive Agents; Cognitive Behavioral Therapy; Depression; Depressive Disorder; Depressive Disorder, Major; Geriatric Psychiatry; Humans; Neoplasms; Patient Health Questionnaire; Problem Solving; Psychiatric Status Rating Scales; Psycho-Oncology; Psychotherapy
PubMed: 30797709
DOI: 10.1016/j.jgo.2019.02.005 -
Zhurnal Nevrologii I Psikhiatrii Imeni... 2021To compare socio-demographic and clinical characteristics in men and women with depression.
OBJECTIVE
To compare socio-demographic and clinical characteristics in men and women with depression.
MATERIAL AND METHODS
We studied 388 patients with unipolar depression, 74 men and 314 women. The survey was carried out using the clinical-psychopathological method and psychometric scales for depression.
RESULTS AND CONCLUSION
Gender differences are identified for several parameters. Women are older, more often had comorbid somatic and organic disorders; men have personality disorders and chronic depression. The severity of depression in women was higher due to symptoms such as reported sadness, anxiety, reduced sleep and appetite, concentration difficulties, and suicidal thoughts. Apparent sadness did not significantly differ in men and women. Anhedonia was more pronounced in men.
Topics: Anhedonia; Anxiety; Anxiety Disorders; Depression; Depressive Disorder; Female; Humans; Male
PubMed: 34481430
DOI: 10.17116/jnevro202112108113 -
International Journal of Psychiatry in... Mar 2023In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in... (Review)
Review
PURPOSE
In diagnostic systems (e.g., DSM-5, ICD-10), depression is defined categorically. However, the concept of subthreshold depression (SD) has gained increasing interest in recent years. The purpose of the present paper was to review, based on a scoping review, the relevant papers in this field published between October 2011 and September 2020.
MATERIALS AND METHODS
Of the 1,160 papers identified, 64 records could be included in further analysis. The scoping review was conducted using both electronic and manual methods.
RESULTS
The main result of the analysis is that the operationalisation criteria used are highly heterogeneous, which also leads to very heterogenous epidemiological data.
CONCLUSIONS
Clear conclusions are not possible scrutinising the reported results. Most definitions seem to be arbitrary, with considerable overlap (e.g., between SD and minor depression). The review also revealed that the impact of SD on quality of life and related parameters appear to be in the range of the respective impact of major depression (MD) and therapeutic approaches might be helpful for SD and also for the prevention of conversion from SD to MD. Keeping the presented difficulties in mind, a proposal for the definition of SD is made in the present paper in order to facilitate the discussion leading to more homogeneous criteria.
Topics: Humans; Depression; Quality of Life; Depressive Disorder, Major; Diagnostic and Statistical Manual of Mental Disorders; International Classification of Diseases
PubMed: 35736807
DOI: 10.1080/13651501.2022.2087530 -
Current Opinion in Psychiatry Sep 2021Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence... (Review)
Review
PURPOSE OF REVIEW
Depression is a prevalent comorbidity in cancer that significantly increases the risk for numerous negative health outcomes. This review updates the current evidence base for management of depression in cancer, highlighting new research directions based on the inflammatory hypothesis of depression.
RECENT FINDINGS
Research on pharmacotherapy and psychotherapy for depression in cancer has shown mixed efficacy partly because of methodological issues arising from the phenomenology of depression in cancer. After decades of stagnancy, more recent high-quality clinical trials are beginning to provide an evidence base to guide treatment. Inflammatory cytokine-associated depression is a subtype of depression that may have particular relevance in cancer, opening new avenues to explore therapeutic targets and biobehavioral impacts of interventions, which may improve cancer outcomes.
SUMMARY
The continuum of severity in cancer-related depression is important to consider in management approaches. Choice of treatment should be personalized to the patient and their symptom profile as there is currently insufficient evidence to recommend any particular medication or psychotherapy over another. Psychological interventions should be considered first line for mild-to-moderate depression, and pharmacological treatment added for more severe depression, which can be optimally delivered within a collaborative care model.
VIDEO ABSTRACT
http://links.lww.com/YCO/A62.
Topics: Antidepressive Agents; Antineoplastic Agents; Combined Modality Therapy; Comorbidity; Depression; Depressive Disorder; Humans; Neoplasms; Psychotherapy
PubMed: 34224469
DOI: 10.1097/YCO.0000000000000727 -
The World Journal of Biological... Nov 2023Melancholia is a severe form of depression that is typified by greater genetic and biological influence, distinct symptomatology, and preferential response to physical... (Review)
Review
OBJECTIVES
Melancholia is a severe form of depression that is typified by greater genetic and biological influence, distinct symptomatology, and preferential response to physical treatment. This paper sought to broadly overview potential biomarkers of melancholia to benefit differential diagnosis, clinical responses and treatment outcomes. Given nuances in distinguishing melancholia as its own condition from other depressive disorder, we emphasised studies directly comparing melancholic to non-melancholic depression.
METHODS
A comprehensive literature search was conducted. Key studies were identified and summarised qualitatively.
RESULTS
105 studies in total were identified. These studies covered a wide variety of biomarkers, and largely fell into three domains: endocrinological (especially cortisol levels, particularly in response to the dexamethasone suppression test), neurological, and immunological (particularly inflammatory markers). Less extensive evidence also exists for metabolic, genetic, and cardiovascular markers.
CONCLUSIONS
Definitive conclusions were predominantly limited due to substantial heterogeneity in how included studies defined melancholia. Furthermore, this heterogeneity could be responsible for the between- and within-group variability observed in the candidate biomarkers that were examined. Therefore, clarifying these definitional parameters may help identify underlying patterns in biomarker expression to improve diagnostic and therapeutic precision for the depressive disorders.
Topics: Humans; Depression; Depressive Disorder; Diagnosis, Differential; Biomarkers
PubMed: 37259772
DOI: 10.1080/15622975.2023.2219725 -
European Neuropsychopharmacology : the... Apr 2022Currently, only a limited number of interventions can rapidly relieve depressive symptomatology in patients with major depressive disorder or bipolar disorder... (Review)
Review
Currently, only a limited number of interventions can rapidly relieve depressive symptomatology in patients with major depressive disorder or bipolar disorder experiencing extreme distress. Such crises, especially when suicide attempt or ideation is involved, are a major risk factor of suicide. Ketamine, a N-methyl-d-aspartate glutamate receptor antagonist, and its enantiomer esketamine rapidly reduce depressive symptoms in depressed patients with current suicidal ideation. Recently, esketamine has been approved for use in patients with depression at risk of suicide and for psychiatric emergency by major medical agencies in the United States and Europe, whereas ketamine is increasingly used off-label. However, there is currently limited guidance on why, when, and how to use these drugs in patients with depression to treat a crisis. In this review article, we provide a succinct overview of the cellular and molecular mechanisms of action of ketamine and esketamine, and of the functional brain changes following their administration. We also summarize the major clinical studies on ketamine and esketamine efficacy in patients experiencing a crisis (generally, suicidal ideation), and propose a profile of patients who can benefit most from such drugs, on the basis of neurobiological and clinical observations. Finally, we describe the administration mode, the efficacy and tolerability profiles, the side effect management, possible concomitant treatments and the issue of deprescribing.
Topics: Antidepressive Agents; Depression; Depressive Disorder, Major; Humans; Ketamine; Suicidal Ideation
PubMed: 35219097
DOI: 10.1016/j.euroneuro.2022.02.004