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Revista Brasileira de Psiquiatria (Sao... Aug 2016Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in... (Review)
Review
OBJECTIVE:
Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in MDD is essential for improving therapeutic strategies and predicting response to interventions. This systematic review discusses recent findings regarding cortical alterations in depressed patients during emotional or cognitive tasks, as measured by electroencephalography (EEG).
METHODS:
A search of the MEDLINE/PubMed and Cochrane databases was carried out using the keywords EEG and depression, confined to article title.
RESULTS:
The studies identified reveal the frontal cortex as an important brain structure involved in the complex neural processes associated with MDD. Findings point to disorganization of right-hemisphere activity and deficient cognitive processing in MDD. Depressed individuals tend to ruminate on negative information and respond with a pattern of relatively higher right frontal activity to emotional stimuli associated with withdrawal and isolation.
CONCLUSION:
Patients with MDD may have altered dynamic patterns of activity in several neuroanatomical structures, especially in prefrontal and limbic areas involved in affective regulation. Identification of these alterations might help predict the response of patients to different interventions more effectively and thus maximize the effects both of pharmacotherapeutic and of psychotherapeutic strategies.
Topics: Brain; Brain Mapping; Cerebral Cortex; Cognition; Depressive Disorder, Major; Electroencephalography; Emotions; Humans
PubMed: 27508396
DOI: 10.1590/1516-4446-2015-1834 -
Journal of Neural Transmission (Vienna,... Jun 2019Major depressive disorder (MDD) is primarily hinged on the presence of either low mood and/or anhedonia to previously pleasurable events for a minimum of 2 weeks. Other...
Major depressive disorder (MDD) is primarily hinged on the presence of either low mood and/or anhedonia to previously pleasurable events for a minimum of 2 weeks. Other clinical features that characterize MDD include disturbances in sleep, appetite, concentration and thoughts. The combination of any/both of the primary MDD symptoms as well as any four of the other clinical features has been referred to as MDD. The challenge for replicating gene association findings with phenotypes of MDD as well as its treatment outcome is putatively due to stratification of MDD patients. Likelihood for replication of gene association findings is hypothesized with specificity in symptoms profile (homogenous clusters of symptom/individual symptoms) evaluated. The current review elucidates the genetic factors that have been associated with insomnia symptom of MDD phenotype, insomnia symptom as a constellation of neuro-vegetative cluster of MDD symptom, insomnia symptom of MDD as an individual entity and insomnia feature of treatment outcome. Homozygous CC genotype of 3111T/C, GSK3B-AT/TT genotype of rs33458 and haplotype of TPH1 218A/C were associated with insomnia symptom of MDD. Insomnia symptom of MDD was not resolved in patients with the A/A genotype of HTR2A-rs6311 when treated with SSRI. Homozygous short (SS) genotype-HTTLPR, GG genotype of HTR2A-rs6311 and CC genotype of HTR2A-rs6313 were associated with AD treatment-induced insomnia, while val/met genotype of BDNF-rs6265 and the TT genotype of GSK-3beta-rs5443 reduced it. Dearth of association studies may remain the bane for the identification of robust genetic endophenotypes in line with findings for genotypes of HTR2A-rs6311.
Topics: Antidepressive Agents; Depressive Disorder, Major; Endophenotypes; Humans; Sleep Initiation and Maintenance Disorders
PubMed: 31111219
DOI: 10.1007/s00702-019-02014-y -
BMC Psychiatry Oct 2012Subthreshold depressive disorders (minor and subthrehold depression) have been defined in a wide range of forms, varying on the number of symptoms and duration required.... (Review)
Review
BACKGROUND
Subthreshold depressive disorders (minor and subthrehold depression) have been defined in a wide range of forms, varying on the number of symptoms and duration required. Disability associated with these conditions has also been reported. Our aim was to review the different definitions and to determine factors associated with these conditions in order to clarify the nosological implications of these disorders.
METHODS
A Medline search was conducted of the published literature between January 2001 and September 2011. Bibliographies of the retrieved papers were also analysed.
RESULTS
There is a wide heterogeneity in the definition and diagnostic criteria of minor and subthreshold depression. Minor depression was defined according to DSM-IV criteria. Regarding subthreshold depression, also called subclinical depression or subsyndromal symptomatic depression, between 2 and 5 depressive symptoms were required for the diagnosis, and a minimum duration of 2 weeks. Significant impairment associated with subthreshold depressive conditions, as well as comorbidity with other mental disorders, has been described.
CONCLUSIONS
Depression as a disorder is better explained as a spectrum rather than as a collection of discrete categories. Minor and subthreshold depression are common conditions and patients falling below the diagnostic threshold experience significant difficulties in functioning and a negative impact on their quality of life. Current diagnostic systems need to reexamine the thresholds for depressive disorders and distinguish them from ordinary feelings of sadness.
Topics: Depressive Disorder; Diagnosis, Differential; Diagnostic and Statistical Manual of Mental Disorders; Humans; Prevalence
PubMed: 23110575
DOI: 10.1186/1471-244X-12-181 -
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 -
The American Journal of Geriatric... Mar 2015To determine the efficacy of psychotherapy in late-life depression and to determine the effect of the type of control group on the magnitude of psychotherapy effects. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To determine the efficacy of psychotherapy in late-life depression and to determine the effect of the type of control group on the magnitude of psychotherapy effects.
DESIGN
A systematic review and meta-analysis of randomized controlled psychotherapy trials for late-life depression.
SETTING
Outpatient clinics or in subjects' home.
PARTICIPANTS
Subjects aged 55 years or older with acute-phase depressive disorder.
MEASUREMENTS
Change in depressive symptoms was measured with validated scales. Standardized mean differences (SMD) were calculated for each therapy-control contrast, as meta-analytic summaries for contrasts using a similar control, and for all contrasts combined.
RESULTS
The search identified 27 trials with 37 therapy-control contrasts and 2,245 subjects. Trials utilized five types of control groups (waitlist, treatment-as-usual, attention, supportive therapy, placebo). In the combined contrasts, psychotherapy was effective (SMD: 0.73; 95% confidence interval [CI]: 0.51, 0.95; z=6.42, p<0.00001). The SMD varied widely (from 0.05 to 1.36) and significantly (χ2=35.67, df=4, p<0.00001) between subgroups by type of control. In five trials that compared psychotherapy with supportive therapy, the SMD was 0.39 (95% CI: 0.16, 0.61; z=3.37, p<0.0007; I2=0%). The SMD was 0.11 within the waitlist controls and 1.10 within the supportive therapy subgroup.
CONCLUSIONS
Psychotherapy is effective for late-life depression, but the magnitude of the effect varies widely with the type of control group. Supportive therapy appears to best control for the nonspecific elements of psychotherapy and is associated with considerable change itself, but few trials have utilized it as a control.
Topics: Aging; Depressive Disorder; Humans; Late Onset Disorders; Psychotherapy
PubMed: 24856580
DOI: 10.1016/j.jagp.2014.04.003 -
Multiple Sclerosis and Related Disorders Jan 2016Depression and anxiety are common in persons with multiple sclerosis (MS), and adversely affect fatigue, medication adherence, and quality of life. Though effective... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Depression and anxiety are common in persons with multiple sclerosis (MS), and adversely affect fatigue, medication adherence, and quality of life. Though effective treatments for depression and anxiety exist in the general population, their applicability in the MS population has not been definitively established.
OBJECTIVE
To determine the overall effect of psychological and pharmacological treatments for depression or anxiety in persons with MS.
METHODS
We searched the Medline, EMBASE, PsycINFO, PsycARTICLES Full Text, Cochrane Central Register of Controlled Trials, CINAHL, Web of Science, and Scopus databases using systematic review methodology from database inception until March 25, 2015. Two independent reviewers screened abstracts, extracted data, and assessed risk of bias and strength of evidence. We included controlled clinical trials reporting on the effect of pharmacological or psychological interventions for depression or anxiety in a sample of persons with MS. We calculated standardized mean differences (SMD) and pooled using random effects meta-analysis.
RESULTS
Of 1753 abstracts screened, 21 articles reporting on 13 unique clinical trials met the inclusion criteria. Depression severity improved in nine psychological trials of depression treatment (N=307; SMD: -0.45 (95%CI: -0.74, -0.16)). The severity of depression also improved in three pharmacological trials of depression treatment (SMD: -0.63 (N=165; 95%CI: -1.07, -0.20)). For anxiety, only a single trial examined psychological therapy for injection phobia and reported no statistically significant improvement.
CONCLUSION
Pharmacological and psychological treatments for depression were effective in reducing depressive symptoms in MS. The data are insufficient to determine the effectiveness of treatments for anxiety.
Topics: Adolescent; Adult; Aged; Anxiety Disorders; Clinical Trials as Topic; Cognitive Behavioral Therapy; Depressive Disorder; Humans; Middle Aged; Multiple Sclerosis; Psychotherapy; Quality of Life; Severity of Illness Index; Treatment Outcome; Young Adult
PubMed: 26856938
DOI: 10.1016/j.msard.2015.10.004 -
Journal of Affective Disorders Aug 2018The purpose of this meta-analytic study was to determine the pooled prevalence estimates of anxiety and depressive disorders among children and adolescents with... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this meta-analytic study was to determine the pooled prevalence estimates of anxiety and depressive disorders among children and adolescents with intellectual disabilities (ID) and to assess the extent to which these pooled prevalence rates differed according to studies' characteristics.
METHOD
A systematic literature search was performed in nine databases and 21 studies, published between 1975 and 2015, met the inclusion criteria.
RESULTS
The resulting pooled prevalence estimates of combined subtypes of anxiety and depressive disorders were respectively (a) 5.4% and 2.8% across samples; (b) 1.2% and 0.03% among children; and (c) 7.9% and 1.4% among adolescents. Pooled prevalence estimates for specific subtypes of anxiety disorders ranged from (a) 0.2% to 11.5% across samples; (b) 0.7% to 17.6% among children; and (c) 0.6% to 19.8% among adolescents. Pooled prevalence estimates of dysthymic disorder and major depressive disorder were respectively (a) 3.4% and 2.5% across samples; (b) 2.1% and 3.2% among children; and (c) 6.9% and 5.7% among adolescents. Finally, subgroup analyses showed significant variations in the pooled prevalence estimates of combined subtypes of anxiety disorders, obsessive-compulsive disorder, and generalized anxiety disorder; and combined subtypes of depressive disorders.
LIMITATIONS
The present findings of this meta-analysis should be interpreted with caution given several limitations related to the characteristics of the populations, diagnostic method and sampling method.
CONCLUSION
Findings provide recommendations for future studies investigating psychological disorders among youth with ID, as well as how clinicians and policy makers can improve diagnostic practices and support for youth with ID.
Topics: Adolescent; Anxiety Disorders; Child; Child, Preschool; Depressive Disorder, Major; Dysthymic Disorder; Female; Humans; Infant; Infant, Newborn; Intellectual Disability; Male; Obsessive-Compulsive Disorder; Prevalence; Young Adult
PubMed: 29751238
DOI: 10.1016/j.jad.2018.04.029 -
International Journal of Geriatric... Nov 2007To gain more insight into the association between severity of Alzheimer's Disease (AD) and prevalence of comborbid depression. (Review)
Review
OBJECTIVES
To gain more insight into the association between severity of Alzheimer's Disease (AD) and prevalence of comborbid depression.
METHODS
A systematic literature review based on the Cochrane methodology was performed. PubMed, PsychINFO and EMBASE databases were searched for existing studies that fulfilled predefined inclusion criteria. The studies were divided into: (1) those that analysed the association between severity of AD and prevalence of depressive symptoms ('continuous' approach) and (2) those that investigated the association between severity of AD and diagnosed depression ('categorical' approach). The quality of existing studies was rated and the results were synthesized with a best evidence synthesis.
RESULTS
Twenty-four studies fulfilled the inclusion criteria. Nineteen reported results for a continuous approach and seven for a categorical approach. Three of the four high quality studies within the continuous approach did not find a significant association between severity of AD and prevalence of depressive symptoms. None of the three high quality studies using the categorical approach found a significant association between the severity of AD and the prevalence of diagnosed depression.
CONCLUSIONS
There is evidence for a lack of association between the severity of AD and the prevalence of comorbid depressive symptoms or diagnosed depression. Until new studies contradict this conclusion, prevention and intervention strategies for comorbid depression in AD should be aimed at all patients irrespective their disease severity.
Topics: Alzheimer Disease; Depression; Depressive Disorder; Evidence-Based Medicine; Humans; Prevalence
PubMed: 17457960
DOI: 10.1002/gps.1809 -
Revista Brasileira de Psiquiatria (Sao... 2015To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD). (Review)
Review
OBJECTIVE
To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).
METHODS
We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors "rumination" and "bipolar disorder" and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.
RESULTS
Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.
CONCLUSIONS
Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.
Topics: Adult; Affect; Anxiety Disorders; Bipolar Disorder; Child; Cognition; Depressive Disorder; Feeding and Eating Disorders of Childhood; Female; Humans; Male; Psychiatric Status Rating Scales
PubMed: 26176599
DOI: 10.1590/1516-4446-2014-1556 -
Eye (London, England) Dec 2016AimTo evaluate the association of dry eye disease (DED) with depression and anxiety.Patients and methodsWe conducted a systematic review and meta-analysis of studies... (Meta-Analysis)
Meta-Analysis Review
AimTo evaluate the association of dry eye disease (DED) with depression and anxiety.Patients and methodsWe conducted a systematic review and meta-analysis of studies that reported the prevalence, incidence and/or severity grading of depression and/or anxiety in DED patients and healthy controls. We searched MEDLINE, EMBASE, PsycINFO, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform for relevant studies.ResultsTwenty-two eligible studies consisted of 2 980 026 patients were analyzed. DED was associated with an increased prevalence of depression (summary odds ratio (OR)=2.92, 95% CI: 2.13-4.01, P<0.00001) and anxiety (OR=2.80, 95% CI: 2.61-3.02, P<0.00001). The depression score (standardized mean difference (SMD)=0.81, 95% CI: 0.48-1.15, P<0.00001) and anxiety score (SMD=0.37, 95% CI: 0.10-0.64, P=0.007) were higher in DED patients than in controls. Subgroup analyses revealed that the prevalence and severity of depression are greatest in primary Sjogren's syndrome patients. No study reported the incidence.ConclusionDepression and anxiety are more prevalent in DED patients than in controls. Among patients with DED, those suffering from primary Sjogren's syndrome have higher prevalence and severity of depression.
Topics: Anxiety Disorders; Case-Control Studies; Depressive Disorder; Dry Eye Syndromes; Eye Pain; Humans; Prevalence
PubMed: 27518547
DOI: 10.1038/eye.2016.186