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International Journal of Molecular... Nov 2023Major depressive disorder (MDD) has a high prevalence and is a major contributor to the global burden of disease. This psychiatric disorder results from a complex... (Review)
Review
Major depressive disorder (MDD) has a high prevalence and is a major contributor to the global burden of disease. This psychiatric disorder results from a complex interaction between environmental and genetic factors. In recent years, the role of the gut microbiota in brain health has received particular attention, and compelling evidence has shown that patients suffering from depression have gut dysbiosis. Several studies have reported that gut dysbiosis-induced inflammation may cause and/or contribute to the development of depression through dysregulation of the gut-brain axis. Indeed, as a consequence of gut dysbiosis, neuroinflammatory alterations caused by microglial activation together with impairments in neuroplasticity may contribute to the development of depressive symptoms. The modulation of the gut microbiota has been recognized as a potential therapeutic strategy for the management of MMD. In this regard, physical exercise has been shown to positively change microbiota composition and diversity, and this can underlie, at least in part, its antidepressant effects. Given this, the present review will explore the relationship between physical exercise, gut microbiota and depression, with an emphasis on the potential of physical exercise as a non-invasive strategy for modulating the gut microbiota and, through this, regulating the gut-brain axis and alleviating MDD-related symptoms.
Topics: Humans; Gastrointestinal Microbiome; Depressive Disorder, Major; Dysbiosis; Inflammation; Exercise
PubMed: 38069198
DOI: 10.3390/ijms242316870 -
Ugeskrift For Laeger Apr 2022This narrative review addresses the challenges of how to identify and treat bipolar depression. Bipolar depression, i.e. depressive episode(s) as part of bipolar... (Review)
Review
This narrative review addresses the challenges of how to identify and treat bipolar depression. Bipolar depression, i.e. depressive episode(s) as part of bipolar disorder, can be differentiated from unipolar depression only through the previous course of illness. A correct diagnosis therefore may be delayed. The pharmacotherapy of bipolar depression differs from that of unipolar depression due to a high risk of recurrence of either hypomanic/manic or depressive episodes or mood instability. Therefore, long periods of specialized treatment will often be required. Both bipolar and unipolar depression will often benefit from adjunctive social and psychological interventions.
Topics: Bipolar Disorder; Depressive Disorder; Diagnostic and Statistical Manual of Mental Disorders; Humans
PubMed: 35410656
DOI: No ID Found -
Harvard Review of Psychiatry 2020Mobile technology is increasingly being used to enhance health and wellness, including in the assessment and treatment of psychiatric disorders. Such applications have... (Review)
Review
Mobile technology is increasingly being used to enhance health and wellness, including in the assessment and treatment of psychiatric disorders. Such applications have been referred to collectively as mHealth, and this article provides a comprehensive review and clinical perspective of research regarding mHealth in late-life mood and anxiety disorders. The novel data collection offered by mHealth has contributed to a broader understanding of psychopathology, to an increased diversity of psychological interventions, and to novel methods of assessment that may ultimately provide individually adaptive mental health care for this population. Older adults face challenges (e.g., transportation, mobility) that limit their ability to receive medical and mental health care services, and mHealth may improve the capacity to reach this population. Although several mobile interventions exist for health-related issues in older adults (e.g., balance, diabetes, medication management), mHealth targeting psychiatric disorders is limited and most often focuses on problems related to dementia, cognitive dysfunction, and memory loss. Given that depression and anxiety are two of the most common mental health concerns among this population, mHealth has strong potential for broad public health interventions that may improve effectiveness of mental health care via individualized assessments and treatments.
Topics: Aged; Anxiety Disorders; Depressive Disorder; Geriatrics; Humans; Mental Health; Mobile Applications; Telemedicine
PubMed: 32310834
DOI: 10.1097/HRP.0000000000000255 -
European Archives of Psychiatry and... Apr 2021
Topics: Antidepressive Agents; Depressive Disorder, Major; Humans; Ketamine; Precision Medicine
PubMed: 33666694
DOI: 10.1007/s00406-021-01249-9 -
Advances in Therapy Sep 2021Symptoms of anxiety and depression often coexist, and evidence suggests that this has a genetic basis, among other possible causes. However, the current classification... (Review)
Review
Symptoms of anxiety and depression often coexist, and evidence suggests that this has a genetic basis, among other possible causes. However, the current classification of comorbid generalised anxiety disorder (GAD) and depression (anxious depression) in the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition; DSM-5) does not fully reflect the high prevalence of anxiety symptoms in people with depression and the International Classification of Diseases (10th and 11th revisions) has tended to identify anxious depression with minor disorders seen in primary care. As a result, few dedicated therapeutic trials have been conducted in patients with anxious depression, and specific treatment guidelines and recommendations are lacking. Fortunately, there is considerable therapeutic overlap between anxiety and depression, such that many agents with antidepressant efficacy are also effective for symptoms of GAD. The initial treatment of a patient with depression and symptoms of anxiety should be with an agent that is approved for both major depressive disorder and GAD, such as a selective serotonin reuptake inhibitor. There is an obvious need for greater recognition of anxious depression in order to boost the volume of high-quality clinical data, which should translate over time into better, more specific treatment recommendations and improved outcomes.
Topics: Antidepressive Agents; Anxiety Disorders; Depression; Depressive Disorder, Major; Humans; Selective Serotonin Reuptake Inhibitors
PubMed: 34417993
DOI: 10.1007/s12325-021-01861-0 -
Topics in Antiviral Medicine 2022Depressive disorders are the most common psychiatric disorders among people with HIV. Depressive disorders cause great suffering and disability and, among people with...
Depressive disorders are the most common psychiatric disorders among people with HIV. Depressive disorders cause great suffering and disability and, among people with HIV, are associated with numerous negative HIV outcomes, including nonadherence to antiretroviral medication and increased morbidity and mortality. This article is focused on the detection, differential diagnosis, and management of depressive disorders among adults in HIV primary care settings in the United States. Because of the siloed nature of HIV primary health care and behavioral health care in the United States, this paper is geared toward clinicians who are not behavioral health specialists and who are working in HIV care settings that have limited access to behavioral health services and still seek to treat depressive disorders. In clinical settings that are fortunate enough to have well-integrated behavioral health services, HIV primary care clinicians may be able to depend on this specialist workforce, but these settings tend to be the exception and not the rule.
Topics: Adult; Humans; United States; HIV Infections; Anti-Retroviral Agents; Depressive Disorder
PubMed: 36346702
DOI: No ID Found -
Journal of Endocrinological... Nov 2021The close association among thyroid metabolism, mood disorders and behavior has long been known. The old and modern uses of thyroid hormones to modulate the expression... (Review)
Review
PURPOSE
The close association among thyroid metabolism, mood disorders and behavior has long been known. The old and modern uses of thyroid hormones to modulate the expression of depression and bipolar disorder and to improve clinical outcome when used in conjunction with psychotropic medications.
METHODS
A literature search was performed to identify studies investigating the effects of thyroid hormone treatment in patient s with mood disorders.
RESULTS
The successful modification of mood disorders with thyroid hormone underscores the association between endocrine and cerebral systems in these disorders. Thyroid hormones have a profound influence on behavior and appear to be capable of modulating the phenotypic expression of major mood disorders. In fact, there is evidence that triiodothyronine (LT3) may accelerate the antidepressant response to antidepressants, and studies suggest that LT3 also may augment the response to antidepressants in refractory depression. Add-on treatment with supraphysiologic doses of levothyroxine (LT4) has shown efficacy in open-label and in placebo-controlled studies, including in rapid cycling and prophylaxis-resistant bipolar disorder, and with acute refractory uni- or bipolar depression. Functional brain-imaging studies (PET) demonstrated that administration of supraphysiologic LT4 improves depressive symptoms in patients with bipolar depression by modulating cerebral activity in the anterior limbic network.
CONCLUSION
The add-on administration of supraphysiologic doses of LT4 is a promising strategy in patients with refractory bipolar and depressive mood disorders.
Topics: Antidepressive Agents; Bipolar Disorder; Depressive Disorder; Drug Interactions; Humans; Thyroid Diseases; Thyroid Hormones; Thyroxine
PubMed: 34129186
DOI: 10.1007/s40618-021-01600-w -
European Journal of Nuclear Medicine... May 2023Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive... (Review)
Review
Major depressive disorder is a growing and poorly understood pathology. Due to technical and ethical limitations, a significant proportion of the research on depressive disorders cannot be performed on patients, but needs to be investigated in animal paradigms. Over the years, animal studies have provided new insight in the mechanisms underlying depression. Several of these studies have used PET imaging for the non-invasive and longitudinal investigation of the brain physiology. This review summarises the findings of preclinical PET imaging in different experimental paradigms of depression and compares these findings with observations from human studies. Preclinical PET studies in animal models of depression can be divided into three main different approaches: (a) investigation of glucose metabolism as a biomarker for regional and network involvement, (b) evaluation of the availability of different neuroreceptor populations associated with depressive phenotypes, and (c) monitoring of the inflammatory response in phenotypes of depression. This review also assesses the relevance of the use of PET imaging techniques in animal paradigms for the understanding of specific aspects of the depressive-like phenotypes, in particular whether it might contribute to achieve a more detailed characterisation of the clinical depressive phenotypes for the development of new therapies for depression.
Topics: Animals; Humans; Depressive Disorder, Major; Positron-Emission Tomography; Models, Animal; Phenotype; Brain; Disease Models, Animal
PubMed: 36642759
DOI: 10.1007/s00259-022-06073-4 -
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 -
Cancer Medicine Aug 2021There is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed... (Observational Study)
Observational Study
BACKGROUND
There is limited data on the longitudinal trajectories of psychiatric disorders in children with cancer and risk factors for their persistence. The current study aimed to longitudinally assess the trajectories and risk factors for anxiety and depressive symptoms and disorders in children and adolescents with cancer.
METHODS
Children and adolescents with cancer and their parents completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Depression and Anxiety Module and were interviewed by the semi-structured Affective and Anxiety Modules of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS), at 4 time points, 1, 4, 7, and 12 months following the diagnosis of cancer.
RESULTS
Of the 99 patients enrolled, 48% met criteria for anxiety and/or depressive disorders at least once during the follow-up period. There was a significant decrease in PROMIS pediatric and parent anxiety and depression scores (all p's < 0.01) and in the rate of depressive disorders over time (p = 0.02), while rates of anxiety disorders remained stable. Anxiety PROMIS pediatric and parent scores at baseline, having brain tumors and being in the acute treatment phase significantly predicted the presences of anxiety disorders at endpoint.
CONCLUSIONS
Our results highlight the importance of screening for anxiety and disorders in children with cancer, especially among those with brain tumors and at the acute phase of treatment.
Topics: Adolescent; Adult; Anxiety Disorders; Child; Depression; Depressive Disorder; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Neoplasms; Psychiatric Status Rating Scales; Risk Factors; Young Adult
PubMed: 34309238
DOI: 10.1002/cam4.4100