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Neurobiology of Disease Apr 2022Postpartum depression (PPD) is the most common psychiatric complication associated with pregnancy and childbirth with debilitating symptoms that negatively impact the... (Review)
Review
Postpartum depression (PPD) is the most common psychiatric complication associated with pregnancy and childbirth with debilitating symptoms that negatively impact the quality of life of the mother as well as inflict potentially long-lasting developmental impairments to the child. Much of the theoretical pathophysiology put forth to explain the emergence of PPD overlaps with that of major depressive disorder (MDD) and, although not conventionally described in such terms, can be seen as neurodegenerative in nature. Framing the disorder from the perspective of the well-established inflammatory theory of depression, symptoms are thought to be driven by dysregulation, and subsequent hyperactivation of the body's immune response to stress. Compounded by physiological stressors such as drastic fluctuations in hormone signaling, physical and psychosocial stressors placed upon new mothers lay bare a number of significant vulnerabilities, or points of potential failure, in systems critical for maintaining healthy brain function. The inability to compensate or properly adapt to meet the changing demands placed upon these systems has the potential to damage neurons, hinder neuronal growth and repair, and disrupt neuronal circuit integrity such that essential functional outputs like mood and cognition are altered. The impact of this deterioration in brain function, which includes depressive symptoms, extends to the child who relies on the mother for critical life-sustaining care as well as important cognitive stimulation, accentuating the need for further research.
Topics: Child; Depression; Depression, Postpartum; Depressive Disorder, Major; Female; Humans; Pregnancy; Quality of Life; Risk Factors
PubMed: 35104645
DOI: 10.1016/j.nbd.2022.105646 -
JAMA Network Open Aug 2023Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line pharmacological treatment for adolescent depression with moderate or higher levels of symptom... (Clinical Trial)
Clinical Trial
Measures of Connectivity and Dorsolateral Prefrontal Cortex Volumes and Depressive Symptoms Following Treatment With Selective Serotonin Reuptake Inhibitors in Adolescents.
IMPORTANCE
Selective serotonin reuptake inhibitors (SSRIs) are considered a first-line pharmacological treatment for adolescent depression with moderate or higher levels of symptom severity. Thus, it is important to understand neurobiological changes related to SSRIs during the course of treatment for adolescents with depression.
OBJECTIVE
To examine neurobiological changes associated with SSRI treatment in adolescents with major depressive disorder (MDD) by measuring longitudinal changes in volume and resting-state functional connectivity (rsFC) in the dorsolateral prefrontal cortex (DLPFC), a core region of cognitive control.
DESIGN, SETTING, AND PARTICIPANTS
This cohort study was conducted with an open-label design. Adolescents with MDD and healthy controls were recruited at the Seoul National University Hospital (Seoul, South Korea). Adolescents with MDD were treated with escitalopram for 8 weeks. Data analysis was conducted between April 2021 and February 2022.
MAIN OUTCOMES AND MEASURES
Depressive symptoms were assessed using the Children's Depression Rating Scale-Revised. The outcome measure was defined as the change in Children's Depression Rating Scale-Revised scores from week 0 (before treatment) to week 8 (after treatment) or upon termination. Participants completed structural and resting-state functional magnetic resonance imaging (rsfMRI) assessments before (week 0) and after (week 8) SSRI treatment. Repeated measures analysis of variance and liner mixed model analyses were used to examine the longitudinal associations of SSRI treatment with DLPFC volume and rsFC between responders who showed at least a 40% decrease in depressive symptoms and nonresponders who did not.
RESULTS
Ninety-five adolescents with MDD and 57 healthy controls were initially recruited. The final analyses of volume included 36 responders (mean [SD] age, 15.0 [1.6] years; 25 girls [69.4%]) and 26 nonresponders (mean [SD] age, 15.3 [1.5] years; 19 girls [73.1%]). Analyses of rsFC included 33 responders (mean [SD] age, 15.2 [1.5] years; 21 girls [63.6%]) and 26 nonresponders (mean [SD] age, 15.3 [1.5] years; 19 girls [73.1%]). The longitudinal associations of SSRI treatment were more evident in responders than in nonresponders. Responders showed significantly increased right DLPFC volume, decreased bilateral DLPFC rsFC with the superior frontal gyri, and decreased left DLPFC rsFC with the ventromedial PFC after treatment compared with before treatment. Furthermore, increased right DLPFC volume was correlated with decreased rsFC between the right DLPFC and superior frontal gyri after SSRI treatment.
CONCLUSIONS AND RELEVANCE
The preliminary results of this cohort study suggest that the DLPFC volumetric and rsFC changes may serve as potential neurobiological treatment markers that are associated with symptom improvement in adolescents with MDD.
Topics: Adolescent; Child; Female; Humans; Cohort Studies; Depression; Depressive Disorder, Major; Dorsolateral Prefrontal Cortex; Selective Serotonin Reuptake Inhibitors
PubMed: 37540512
DOI: 10.1001/jamanetworkopen.2023.27331 -
International Journal of Environmental... Feb 2023Voice-based depression detection methods have been studied worldwide as an objective and easy method to detect depression. Conventional studies estimate the presence or...
Voice-based depression detection methods have been studied worldwide as an objective and easy method to detect depression. Conventional studies estimate the presence or severity of depression. However, an estimation of symptoms is a necessary technique not only to treat depression, but also to relieve patients' distress. Hence, we studied a method for clustering symptoms from HAM-D scores of depressed patients and by estimating patients in different symptom groups based on acoustic features of their speech. We could separate different symptom groups with an accuracy of 79%. The results suggest that voice from speech can estimate the symptoms associated with depression.
Topics: Humans; Depression; Depressive Disorder, Major; Voice; Speech; Acoustics
PubMed: 36900976
DOI: 10.3390/ijerph20053965 -
Scientific Reports Jun 2021Eveningness, a preference for later sleep and rise times, has been associated with a number of negative outcomes in terms of both physical and mental health. A large... (Meta-Analysis)
Meta-Analysis
Eveningness, a preference for later sleep and rise times, has been associated with a number of negative outcomes in terms of both physical and mental health. A large body of evidence links eveningness to Major Depressive Disorder (MDD). However, to date, evidence quantifying this association is limited. The current meta-analysis included 43 effect sizes from a total 27,996 participants. Using a random-effects model it was demonstrated that eveningness is associated with a small effect size (Fisher's Z = - 2.4, 95% CI [- 0.27. - 0.21], p < 0.001). Substantial heterogeneity between studies was observed, with meta-regression analyses demonstrating a significant effect of mean age on the association between diurnal preference and depression. There was also evidence of potential publication bias as assessed by visual inspection of funnel plots and Egger's test. The association between diurnal preference and depression is small in magnitude and heterogenous. A better understanding of the mechanistic underpinnings linking diurnal preference to depression and suitably powered prospective studies that allow causal inference are required.
Topics: Circadian Rhythm; Depression; Depressive Disorder, Major; Female; Humans; Male; Photoperiod; Publication Bias; Regression Analysis; Sex Factors; Sleep
PubMed: 34099766
DOI: 10.1038/s41598-021-91205-3 -
Psychiatry Research Apr 2021While depression is a leading cause of disability, prior investigations of depression have been limited by studying correlates in isolation. A data-driven approach was...
While depression is a leading cause of disability, prior investigations of depression have been limited by studying correlates in isolation. A data-driven approach was applied to identify out-of-sample predictors of current depression from adults (N = 217) sampled on a continuum of no depression to clinical levels. The current study used elastic net regularized regression and predictors from sociodemographic, self-report, polygenic scores, resting electroencephalography, pupillometry, actigraphy, and cognitive tasks to classify individuals into currently depressed (MDE), psychiatric control (PC), and no current psychopathology (NP) groups, as well as predicting symptom severity and lifetime MDE. Cross-validated models explained 20.6% of the out-of-fold deviance for the classification of MDEs versus PC, 33.2% of the deviance for MDE versus NP, but -0.6% of the deviance between PC and NP. Additionally, predictors accounted for 25.7% of the out-of-fold variance in anhedonia severity, 65.7% of the variance in depression severity, and 12.9% of the deviance in lifetime depression (yes/no). Self-referent processing, anhedonia, and psychosocial functioning emerged as important differentiators of MDE and PC groups. Findings highlight the advantages of using psychiatric control groups to isolate factors specific to depression.
Topics: Adult; Anhedonia; Depression; Depressive Disorder, Major; Humans
PubMed: 33647705
DOI: 10.1016/j.psychres.2021.113805 -
Social Psychiatry and Psychiatric... Jul 2021While the association between income and depression is well established, less explored is the relation between wealth and depression, particularly among low-income... (Observational Study)
Observational Study
PURPOSE
While the association between income and depression is well established, less explored is the relation between wealth and depression, particularly among low-income adults. We studied the relation between two types of assets-savings and home ownership-and probable depression to understand how access to different assets may shape depression among low-income US adults.
METHODS
Study sample We conducted a serial cross-sectional, observational study with 12,019 adults with low-income in the United States using National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2016. Measures We measured probable major depressive disorder (MDD) with impairment using the Patient Health Questionnaire-9. Low savings was defined as having $5000 or less in family savings. Statistical analysis We estimated adjusted and unadjusted prevalence, odds ratios, and predicted probability of probable MDD across asset groups.
RESULTS
Of low-income US adults, 5.4% had probable MDD with impairment, 85.9% had low savings, and 54.9% rented their home. Persons with low savings had 2.34 (95% CI 1.44-3.79) times the odds of having probable MDD relative to those with high savings. Home owners had 2.14 (95% CI 1.20-3.86) and home renters had 3.65 (95% CI 1.45-9.20) times the odds of having probable MDD if they had low savings relative to high savings.
CONCLUSION
Family savings and home ownership are associated with lower burden of depression among low-income adults in the US.
Topics: Adult; Cross-Sectional Studies; Depression; Depressive Disorder, Major; Humans; Nutrition Surveys; Ownership; United States
PubMed: 33175205
DOI: 10.1007/s00127-020-01973-y -
PloS One 2022This research investigates whether thinking about the consequences of a problem being resolved can improve social problem-solving in clinical depression. We also explore...
This research investigates whether thinking about the consequences of a problem being resolved can improve social problem-solving in clinical depression. We also explore whether impaired social problem solving is related to inhibitory control. Thirty-six depressed and 43 non-depressed participants were presented with six social problems and were asked to generate consequences for the problems being resolved or remaining unresolved. Participants were then asked to solve the problems and recall all the consequences initially generated. Participants also completed the Emotional Stroop and Flanker tasks. We found that whilst depressed participants were impaired at social problem-solving after generating unresolved consequences, they were successful at generating solutions for problems for which they previously generated resolved consequences. Depressed participants were also impaired on the Stroop task, providing support for an impaired inhibitory control account of social problem-solving. These findings advance our understanding of the mechanisms underpinning social problem-solving in depression and may contribute to the development of new therapeutic interventions to improve social-problem solving in depression.
Topics: Depression; Depressive Disorder, Major; Emotions; Humans; Problem Solving; Social Problems
PubMed: 35771846
DOI: 10.1371/journal.pone.0270661 -
The Psychiatric Clinics of North America Jun 2023Major depressive disorder is characterized by depressed mood and/or anhedonia with neurovegetative symptoms and neurocognitive changes affecting an individual's... (Review)
Review
Major depressive disorder is characterized by depressed mood and/or anhedonia with neurovegetative symptoms and neurocognitive changes affecting an individual's functioning in multiple aspects of life. Treatment outcomes with commonly used antidepressants remain suboptimal. Treatment-resistant depression (TRD) should be considered after inadequate improvement with two or more antidepressant treatments of adequate dose and duration. TRD has been associated with increased disease burden including higher associated costs (both socially and financially) affecting both the individual and society. Additional research is needed to better understand the long-term burden of TRD to both the individual and society.
Topics: Humans; Depression; Depressive Disorder, Major; Antidepressive Agents; Depressive Disorder, Treatment-Resistant; Treatment Outcome
PubMed: 37149341
DOI: 10.1016/j.psc.2023.02.001 -
Psychological Medicine Jan 2023A recent hypothesis postulates the existence of an 'immune-metabolic depression' (IMD) dimension characterized by metabolic dysregulations. Combining data on...
BACKGROUND
A recent hypothesis postulates the existence of an 'immune-metabolic depression' (IMD) dimension characterized by metabolic dysregulations. Combining data on metabolomics and depressive symptoms, we aimed to identify depressions associated with an increased risk of adverse metabolic alterations.
METHOD
Clustering data were from 1094 individuals with major depressive disorder in the last 6 months and measures of 149 metabolites from a H-NMR platform and 30 depressive symptoms (IDS-SR30). Canonical correlation analyses (CCA) were used to identify main independent metabolite-symptom axes of variance. Then, for the replication, we examined the association of the identified dimensions with metabolites from the same platform and cardiometabolic diseases in an independent population-based cohort ( = 6572).
RESULTS
CCA identified an overall depression dimension and a dimension resembling IMD, in which symptoms such as sleeping too much, increased appetite, and low energy level had higher relative loading. In the independent sample, the overall depression dimension was associated with lower cardiometabolic risk, such as (i.e. per s.d.) HOMA-1B -0.06 (95% CI -0.09 - -0.04), and visceral adipose tissue -0.10 cm (95% CI -0.14 - -0.07). In contrast, the IMD dimension was associated with well-known cardiometabolic diseases such as higher visceral adipose tissue 0.08 cm (95% CI 0.04-0.12), HOMA-1B 0.06 (95% CI 0.04-0.09), and lower HDL-cholesterol levels -0.03 mmol/L (95% CI -0.05 - -0.01).
CONCLUSIONS
Combining metabolomics and clinical symptoms we identified a replicable depression dimension associated with adverse metabolic alterations, in line with the IMD hypothesis. Patients with IMD may be at higher cardiometabolic risk and may benefit from specific treatment targeting underlying metabolic dysregulations.
Topics: Humans; Depression; Depressive Disorder, Major; Metabolomics; Cardiovascular Diseases; Body Mass Index
PubMed: 34078486
DOI: 10.1017/S0033291721001471 -
General Hospital Psychiatry 2023Perinatal depression and anxiety are the most common complications in the perinatal period and disproportionately affect those experiencing economic marginalization....
OBJECTIVE
Perinatal depression and anxiety are the most common complications in the perinatal period and disproportionately affect those experiencing economic marginalization. Fewer than 15% of individuals at risk for perinatal depression are referred for preventative counseling. The goal of this study was to elicit patient and perinatal care professionals' perspectives on how to increase the reach of interventions to prevent perinatal depression and anxiety among economically marginalized individuals.
METHODS
We conducted qualitative interviews with perinatal individuals with lived experience of perinatal depression and/or anxiety who were experiencing economic marginalization (n = 12) and perinatal care professionals and paraprofessionals (e.g., obstetrician/gynecologists, midwives, doulas; n = 12) serving this population. Three study team members engaged a "a coding consensus, co-occurrence, and comparison," approach to code interviews.
RESULTS
Perinatal individuals and professionals identified prevention intervention delivery approaches and content to facilitate equitable reach for individuals who are economically marginalized. Factors influential included availability of mental health counselors, facilitation of prevention interventions by a trusted professional, digital health options, and options for mental health intervention delivery approaches. Content that was perceived as increasing equitable intervention reach included emphasizing stigma reduction, using cultural humility and inclusive materials, and content personalization.
CONCLUSIONS
Leveraging varied options for mental health intervention delivery approaches and content could reach perinatal individuals experiencing economic marginalization and address resource considerations associated with preventative interventions.
Topics: Pregnancy; Female; Humans; Depression; Depressive Disorder; Anxiety; Anxiety Disorders; Mental Health
PubMed: 37862962
DOI: 10.1016/j.genhosppsych.2023.10.003