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Journal of Affective Disorders Apr 2017Major depressive disorder is a significant contributor to global disability and mortality. The mechanisms of depression are vast and not fully understood, and as a... (Review)
Review
BACKGROUND
Major depressive disorder is a significant contributor to global disability and mortality. The mechanisms of depression are vast and not fully understood, and as a result current treatment of depression is suboptimal. Aberrant sphingolipid metabolism has been observed in some cases of depression, specifically alterations in ceramide concentrations. The role of ceramides and other sphingolipids in depression is a novel concept. This review summarizes and evaluates the current state of evidence for a role of ceramides in depression pathophysiology and the potential for novel depression pharmacotherapies targeting ceramide metabolism.
METHODS
Medline, Embase, and PsycINFO databases were searched through October 2016 for English-language studies using combinations of the search terms: ceramide, depression, sphingolipid, and depressive symptoms.
RESULTS
Of the 489 articles screened, 14 were included in the qualitative synthesis of this review article. Pre-clinical and clinical evidence suggest that ceramide species may contribute to depression pathophysiology. In human studies, ceramides C18:0 and C20:0 are the species most strongly linked to depression. Evidence for altered ceramide metabolism in depression is present, but data for a causal role of ceramides in depression are lacking.
LIMITATIONS
This review was limited by potential reporting bias. Furthermore, a lack of specificity of which ceramides were altered in depression was common.
CONCLUSIONS
Pharmacotherapy targeting ceramide metabolism may be a novel treatment option for depression. A number of pharmacological targets exists for ceramide reduction and a number of currently approved medications inhibit ceramide production. More evidence, pre-clinical and clinical, is warranted to determine the extent and consistency of the role of ceramides in depression.
Topics: Ceramides; Depression; Depressive Disorder; Humans
PubMed: 28189963
DOI: 10.1016/j.jad.2017.02.008 -
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 -
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 -
Chemical Senses Jul 2016Previous studies on the relationship between olfaction and depression have revealed mixed results. In addition, few have focused on the reciprocity of this association.... (Review)
Review
Previous studies on the relationship between olfaction and depression have revealed mixed results. In addition, few have focused on the reciprocity of this association. The aim of this study is to combine depression and olfactory data in two separate patient populations to further understand their association. A systematic literature review was conducted using 3 online databases to identify studies correlating olfaction and depression in patients presenting with either primary depression or primary olfactory dysfunction. For the depressed population, weighted means and standard deviations for the Sniffin' Sticks Test and the 40-item Smell Identification Test were combined using 10 studies. For the olfactory dysfunction population, weighted means of Beck's Depression Inventory were combined using 3 studies. Independent t-tests were used to compare differences between groups. Comparing primary depressed patients with controls, depressed patients showed decreased scores in olfactory threshold (6.31±1.38 vs. 6.78±0.88, P = 0.0005), discrimination (12.05±1.44 vs. 12.66±1.36, P = 0.0073), identification (12.57±0.74 vs. 12.98±0.90, P < 0.0001), and 40-Item Smell Identification Test (35.31±1.91 vs. 37.41±1.45, P < 0.0001). In patients with primary olfactory dysfunction, Beck's Depression Inventory scores were significantly different between patients classified as normosmics, hyposmics and anosmics (5.21±4.73 vs. 10.93±9.25 vs. 14.15±5.39, P ≤ 0.0274 for all 3 comparisons). In conclusion, patients with depression have reduced olfactory performance when compared with the healthy controls and conversely, patients with olfactory dysfunction, have symptoms of depression that worsen with severity of smell loss.
Topics: Depressive Disorder; Humans; Olfaction Disorders; Sensory Thresholds; Smell
PubMed: 27170667
DOI: 10.1093/chemse/bjw061 -
Journal of Affective Disorders Jun 2023Individuals with a severe mental illness (SMI), such as bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SZ), have increased rates of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Individuals with a severe mental illness (SMI), such as bipolar disorder (BD), major depressive disorder (MDD), and schizophrenia (SZ), have increased rates of cardiovascular and cerebrovascular disease. Interestingly, it has been reported that retinal microvessels, a proxy cerebrovascular measure, non-invasively assessed via retinal imaging, predict future cardiovascular disease, with some studies also showing anomalous retinal microvascular caliber in SMI. Therefore, this review and meta-analysis evaluated whether retinal microvascular caliber differs between individuals with SMI vs controls and summarized current findings.
METHODS
A systematic literature search for retinal microvascular caliber and SMI was conducted in Embase and MEDLINE. Studies needed to be published in English before 2022 December 1st and examine retinal microvascular caliber in individuals diagnosed with a SMI. Finally, a meta-analysis of arteriolar and venular caliber in SMI case-controlled studies was also conducted.
RESULTS
The search yielded 65 unique articles, 11 were included in the review and 6 in the meta-analysis. The meta-analysis found that the SMI group had significantly wider venules than controls (SMD = 0.53; 95 % CI = 0.24, 0.81; p = 0.0004) but not arterioles (SMD = 0.07; 95 % CI = -0.29, 0.44; p = 0.70). Additionally, the systematic review found that poorer retinal microvascular health is associated with greater illness severity.
LIMITATIONS
Large heterogeneity of findings and small sample size.
CONCLUSION
This systematic review and meta-analysis found that SMI, specifically SZ, is associated with wider retinal venules. Retinal imaging, a fast, cost-effective, and non-invasive assay of cerebrovascular health, may provide insight into the pathophysiological processes of SMI. However, future longitudinal studies investigating these findings are warranted.
Topics: Humans; Bipolar Disorder; Depressive Disorder, Major; Schizophrenia; Retina; Cerebrovascular Disorders
PubMed: 36958491
DOI: 10.1016/j.jad.2023.03.040 -
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 -
The British Journal of Dermatology Sep 2017Vitiligo is a common depigmenting disorder with profound psychosocial impacts. Previous observational studies have suggested a link between vitiligo and psychiatric... (Meta-Analysis)
Meta-Analysis Review
Vitiligo is a common depigmenting disorder with profound psychosocial impacts. Previous observational studies have suggested a link between vitiligo and psychiatric morbidity, such as depression. However, variability in study design makes it difficult to quantify accurately the relationship between vitiligo and depression. We aimed to investigate the underlying prevalence and risk of depression among patients with vitiligo. A comprehensive search of MEDLINE, Embase and the Cochrane Library was conducted. Cross-sectional, case-control or cohort studies that assessed the prevalence of depression among patients with vitiligo or the relationship between vitiligo and depression were included. DerSimonian and Laird random-effects models were utilized to calculate the pooled prevalence and relative risks. Publication bias was evaluated by funnel plots and Egger's tests. Twenty-five studies with 2708 cases of vitiligo were included. Based on diagnostic codes, the pooled prevalence of depression among patients with vitiligo was 0·253 [95% confidence interval (CI) 0·16-0·34; P < 0·001)]. Using self-reported questionnaires, the pooled prevalence of depressive symptoms was 0·336 (95% CI 0·25-0·42; P < 0·001). The pooled odds ratio of depression among patients with vitiligo was 5·05 vs. controls (95% CI 2·21-11·51; P < 0·001). Moderate-to-high heterogeneity was observed between the studies. Patients with vitiligo were significantly more likely to suffer from depression. Clinical depression or depressive symptoms can be prevalent, with the actual prevalence differing depending on screening instruments or, possibly, geographical regions. Clinicians should actively evaluate patients with vitiligo for signs/symptoms of depression and provide appropriate referrals to manage their psychiatric symptoms accordingly.
Topics: Depressive Disorder; Early Diagnosis; Epidemiologic Methods; Humans; Vitiligo
PubMed: 27878819
DOI: 10.1111/bjd.15199 -
Harvard Review of Psychiatry 2018Pain comorbid with depression is frequently encountered in clinical settings and often leads to significant impaired functioning. Given the complexity of comorbidities,...
BACKGROUND
Pain comorbid with depression is frequently encountered in clinical settings and often leads to significant impaired functioning. Given the complexity of comorbidities, it is important to address both pain and depressive symptoms when evaluating treatment options.
AIM
To review studies addressing pain comorbid with depression, and to report the impact of current treatments.
METHOD
A systematic search of the literature databases was conducted according to predefined criteria. Two authors independently conducted a focused analysis of the full-text articles and reached a consensus on 28 articles to be included in this review.
RESULTS
Overall, studies suggested that pain and depression are highly intertwined and may co-exacerbate physical and psychological symptoms. These symptoms could lead to poor physical functional outcomes and longer duration of symptoms. An important biochemical basis for pain and depression focuses on serotonergic and norepinephrine systems, which is evident in the pain-ameliorating properties of serotonergic and norepinephrine antidepressants. Alternative pharmacotherapies such as ketamine and cannabinoids appear to be safe and effective options for improving depressive symptoms and ameliorating pain. In addition, cognitive-behavioral therapy may be a promising tool in the management of chronic pain and depression.
CONCLUSION
The majority of the literature indicates that patients with pain and depression experience reduced physical, mental, and social functioning as opposed to patients with only depression or only pain. In addition, ketamine, psychotropic, and cognitive-behavioral therapies present promising options for treating both pain and depression.
Topics: Chronic Pain; Comorbidity; Depressive Disorder; Humans
PubMed: 30407234
DOI: 10.1097/HRP.0000000000000198 -
Psychosomatics 2015Demoralization is a psychological response that is frequently observed in patients with cancer or advanced diseases. Depression and demoralization syndrome in patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Demoralization is a psychological response that is frequently observed in patients with cancer or advanced diseases. Depression and demoralization syndrome in patients with cancer are closely related to suicidal behavior.
OBJECTIVE
The purpose of this study was to explore the factors affecting demoralization of patients with cancer from a depression perspective, to assist with distinguishing patient emotions and provide appropriate intervention as early as possible, thereby enabling patients to receive proper care.
METHODS
A systematic review and meta-analysis was employed in this study. The databases included Cumulative Index for Nursing and Allied Health Literature, Cochrane, PubMed/ MEDLINE, PsycINFO, and Centre for European Policy Studies, and reference lists of articles. Experts in this field also were contacted. Based on inclusion criteria, 2 investigators selected the research and reviewed each study's quality according to the Newcastle-Ottawa Scale. Five correlational studies with 32 subjects were identified.
RESULTS
The countries of studies included Australia, Germany, Taiwan, and the United States. There was a statistically significant difference in depression between patients with cancer in the high-demoralization group and those of the low-demoralization group (odds ratio = 9.65, 95% CI: 6.99-13.33, Z = 15.002, p < 0.0001). Four studies regarded demoralization and depression as distinguishable.
CONCLUSIONS
The demoralization of patients with cancer was highly correlated with depression. Therefore, the suicide risk of demoralized patients without depression must also be assessed to prevent patients with high suicide risk from being neglected. If medical staff can perceive patient's demoralization issues earlier, they can more effectively prevent patients' depression from occurring, which benefits suicide prevention.
Topics: Attitude to Health; Australia; Depressive Disorder; Germany; Humans; Neoplasms; Stress, Psychological; Suicidal Ideation; Surveys and Questionnaires; Syndrome; Taiwan; United States
PubMed: 26411374
DOI: 10.1016/j.psym.2015.06.005 -
The Journal of Urology Sep 2013This systematic review focuses on the relationship between nocturia and depression/anxiety. Our objective is to provide an overview of current data on the epidemiology,... (Comparative Study)
Comparative Study Review
PURPOSE
This systematic review focuses on the relationship between nocturia and depression/anxiety. Our objective is to provide an overview of current data on the epidemiology, pathophysiology and patient management implications of the association between nocturia and depression/anxiety.
MATERIALS AND METHODS
We queried PubMed®, Web of Science® and Embase™ in July 2012 to identify abstracts, and original, review and editorial articles on nocturia and mood disorders, specifically depression and anxiety. The search was done using the key words "nocturia," "depression" and "anxiety." We complied with the Assessment of Multiple Systemic Reviews (AMSTAR) instrument. We retrieved a total of 500 records, including 95, 81 and 324 from PubMed, Web of Science and Embase, respectively.
RESULTS
Cross-sectional (level 3) data indicated that nocturia and depression/anxiety are strongly associated. One prospective study contended that depression leads to nocturia in a unidirectional relationship. Nocturia poses a greater risk for depression in men vs women. Results conflict on the effect of serotonin reuptake inhibitors on nocturia.
CONCLUSIONS
The results of this systematic review suggest a bidirectional association between depression and nocturia. The relationship between anxiety and nocturia is less clear. Practicing clinicians should consider administering a brief self-administered scale to assess for depression in patients with nocturia.
Topics: Adult; Age Distribution; Aged; Anxiety Disorders; Comorbidity; Cross-Sectional Studies; Depressive Disorder; Female; Humans; Incidence; Male; Middle Aged; Nocturia; Quality of Life; Risk Assessment; Severity of Illness Index; Sex Distribution; Stress, Psychological; Surveys and Questionnaires
PubMed: 23680309
DOI: 10.1016/j.juro.2013.03.126