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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 -
International Journal of Molecular... Feb 2023Complex disorders, such as depression, remain a mystery for scientists. Although genetic factors are considered important for the prediction of one's vulnerability, it... (Review)
Review
Complex disorders, such as depression, remain a mystery for scientists. Although genetic factors are considered important for the prediction of one's vulnerability, it is hard to estimate the exact risk for a patient to develop depression, based only on one category of vulnerability criteria. Genetic factors also regulate drug metabolism, and when they are identified in a specific combination, may result in increased drug resistance. A proper understanding of the genetic basis of depression assists in the development of novel promising medications and effective disorder management schemes. This review aims to analyze the recent literature focusing on the correlation between specific genes and the occurrence of depression. Moreover, certain aspects targeting a high drug resistance identified among patients suffering from major depressive disorder were highlighted in this manuscript. An expected direction of future drug discovery campaigns was also discussed.
Topics: Humans; Depressive Disorder, Major; Depression; Drug Resistance
PubMed: 36769269
DOI: 10.3390/ijms24032946 -
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 -
Journal of Applied Gerontology : the... May 2023Solo agers may be vulnerable to social isolation and mental health sequelae, particularly if they lack close family or friendship ties. This study examined associations...
Solo agers may be vulnerable to social isolation and mental health sequelae, particularly if they lack close family or friendship ties. This study examined associations among indicators of solo aging, frequency of loneliness, and Major Depressive Disorder among adults aged 60+. Depressed participants were diagnosed by a geriatric psychiatrist and control participants were not depressed. We hypothesized that older adults with more indicators of solo aging (i.e., living alone, being unmarried, not having family or friends nearby) would be more often lonely and more likely to be depressed. In multivariate analyses controlling for health comorbidities and financial difficulty, each additional solo aging indicator significantly increased the likelihood of frequent loneliness, 95% CI OR [1.50, 2.80], and having a depression diagnosis 95% CI OR [1.04, 2.07]. Solo agers may be vulnerable to loneliness and depression, reinforcing the need for assessment and intervention for social isolation among older adults.
Topics: Humans; Aged; Loneliness; Depressive Disorder, Major; Depression; Social Isolation; Aging
PubMed: 36564863
DOI: 10.1177/07334648221146770 -
Ugeskrift For Laeger Nov 2017The gut microbiota is believed to affect a wide variety of mental disorders, including depression. The hypothesis involves bacterial signalling to the host through... (Review)
Review
The gut microbiota is believed to affect a wide variety of mental disorders, including depression. The hypothesis involves bacterial signalling to the host through metabolic, endocrinal, immunologic and neuronal pathways. Few studies of patients with depression have shown altered microbiota profiles and increased levels of systemic endotoxin, which can be detected by leucocytes and result in expression of cytokines. Studies performed so far have lacked statistical power and provide no causal explanation for the gut-brain hypothesis. Further research into the matter is certainly warranted.
Topics: Brain; Depression; Depressive Disorder; Dysbiosis; Gastrointestinal Microbiome; Humans
PubMed: 29208194
DOI: No ID Found -
Progress in Neuro-psychopharmacology &... Mar 2011Psychomotor retardation is a long established component of depression that can have significant clinical and therapeutic implications for treatment. Due to its negative... (Review)
Review
Psychomotor retardation is a long established component of depression that can have significant clinical and therapeutic implications for treatment. Due to its negative impact on overall function in depressed patients, we review its biological correlates, optimal methods of measurement, and relevance in the context of therapeutic interventions. The aim of the paper is to provide a synthesis of the literature on psychomotor retardation in depression with the goal of enhanced awareness for clinicians and researchers. Increased knowledge and understanding of psychomotor retardation in major depressive disorder may lead to further research and better informed diagnosis in regards to psychomotor retardation. Manifestations of psychomotor retardation include slowed speech, decreased movement, and impaired cognitive function. It is common in patients with melancholic depression and those with psychotic features. Biological correlates may include abnormalities in the basal ganglia and dopaminergic pathways. Neurophysiologic tools such as neuroimaging and transcranial magnetic stimulation may play a role in the study of this symptom in the future. At present, there are three objective scales to evaluate psychomotor retardation severity. Studies examining the impact of psychomotor retardation on clinical outcome have found differential results. However, available evidence suggests that depressed patients with psychomotor retardation may respond well to electroconvulsive therapy (ECT). Current literature regarding antidepressants is inconclusive, though tricyclic antidepressants may be considered for treatment of patients with psychomotor retardation. Future work examining this objective aspect of major depressive disorder (MDD) is essential. This could further elucidate the biological underpinnings of depression and optimize its treatment.
Topics: Antidepressive Agents, Tricyclic; Depression; Depressive Disorder, Major; Electroconvulsive Therapy; Female; Humans; Magnetic Resonance Imaging; Male; Psychiatric Status Rating Scales; Psychomotor Disorders; Transcranial Magnetic Stimulation
PubMed: 21044654
DOI: 10.1016/j.pnpbp.2010.10.019 -
Scientific Reports Feb 2023In recent years, postmortem brain studies have revealed that some molecular, cellular, and circuit changes associated with suicide, have an independent or additive...
In recent years, postmortem brain studies have revealed that some molecular, cellular, and circuit changes associated with suicide, have an independent or additive effect on depression. The aim of the present study is to identify potential phenotypic, tissue, and sex-specific novel targets and pathways to distinguish depression or suicide from major depressive disorder (MDD) comorbid with suicide. The mRNA expression profiling datasets from two previous independent postmortem brain studies of suicide and depression (GSE102556 and GSE101521) were retrieved from the GEO database. Machine learning analysis was used to differentiate three regrouped gene expression profiles, i.e., MDD with suicide, MDD without suicide, and suicide without depression. Weighted correlation network analysis (WGCNA) was further conducted to identify the key modules and hub genes significantly associated with each of these three sub-phenotypes. TissueEnrich approaches were used to find the essential brain tissues and the difference of tissue enriched genes between depression with or without suicide. Dysregulated gene expression cross two variables, including phenotypes and tissues, were determined by global analysis with Vegan. RRHO analysis was applied to examine the difference in global expression pattern between male and female groups. Using the optimized machine learning model, several ncRNAs and mRNAs with higher AUC and MeanDecreaseGini, including GCNT1P1 and AC092745.1, etc., were identified as potential molecular targets to distinguish suicide with, or without MDD and depression without suicide. WGCNA analysis identified some key modules significantly associated with these three phenotypes, and the gene biological functions of the key modules mainly relate to ncRNA and miRNA processing, as well as oxidoreductase and dehydrogenase activity. Hub genes such as RP11-349A22.5, C20orf196, MAPK8IP3 and RP11-697N18.2 were found in these key modules. TissueEnrich analysis showed that nucleus accumbens and subiculum were significantly changed among the 6 brain regions studied. Global analysis with Vegan and RRHO identified PRS26, ARNT and SYN3 as the most significantly differentially expressed genes across phenotype and tissues, and there was little overlap between the male and female groups. In this study, we have identified novel gene targets, as well as annotated functions of co-expression patterns and hub genes that are significantly distinctive between depression with suicide, depression without suicide, and suicide without depression. Moreover, global analysis across three phenotypes and tissues confirmed the evidence of sex difference in mood disorders.
Topics: Male; Female; Humans; Depressive Disorder, Major; Depression; Transcriptome; Brain; Suicide; Gene Regulatory Networks; Gene Expression Profiling
PubMed: 36781900
DOI: 10.1038/s41598-023-29101-1 -
Medicina (Kaunas, Lithuania) Dec 2023: This study investigated the differences in syntactic errors in older individuals with and without major depressive disorder and cognitive function disparities between...
: This study investigated the differences in syntactic errors in older individuals with and without major depressive disorder and cognitive function disparities between groups. We also explored the correlation between syntax scores and depression severity. : Forty-four participants, assessed for dementia with the Mini-Cog, completed the 15-item Geriatric Depression Scale (TGDS-15) and specific language tests. Following a single-anonymized procedure, clinical psychologists rated the tests and syntax scores. : The results showed that the depressive disorders group had lower syntax scores than the non-depressed group, primarily on specific subtests. Additionally, cognitive test scores were generally lower among the depressed group. A significant relationship between depression severity and syntax scores was observed (r = -0.426, 95% CI = -0.639, -0.143). : In conclusion, major depressive disorder is associated with reduced syntactic abilities, particularly in specific tests. However, the relatively modest sample size limited the sensitivity of this association. This study also considered the potential influence of cultural factors. Unique linguistic characteristics in the study's context were also addressed and considered as potential contributors to the observed findings.
Topics: Humans; Aged; Depressive Disorder, Major; Depression; Cognition Disorders; Neuropsychological Tests
PubMed: 38138236
DOI: 10.3390/medicina59122133 -
BMC Psychiatry Dec 2011Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety.
BACKGROUND
Depressive and anxiety symptoms often co-occur resulting in a debate about common and distinct features of depression and anxiety.
METHODS
An exploratory factor analysis (EFA) and a bifactor modelling approach were used to separate a general distress continuum from more specific sub-domains of depression and anxiety in an adolescent community sample (n = 1159, age 14). The Mood and Feelings Questionnaire and the Revised Children's Manifest Anxiety Scale were used.
RESULTS
A three-factor confirmatory factor analysis is reported which identified a) mood and social-cognitive symptoms of depression, b) worrying symptoms, and c) somatic and information-processing symptoms as distinct yet closely related constructs. Subsequent bifactor modelling supported a general distress factor which accounted for the communality of the depression and anxiety items. Specific factors for hopelessness-suicidal thoughts and restlessness-fatigue indicated distinct psychopathological constructs which account for unique information over and above the general distress factor. The general distress factor and the hopelessness-suicidal factor were more severe in females but the restlessness-fatigue factor worse in males. Measurement precision of the general distress factor was higher and spanned a wider range of the population than any of the three first-order factors.
CONCLUSIONS
The general distress factor provides the most reliable target for epidemiological analysis but specific factors may help to refine valid phenotype dimensions for aetiological research and assist in prognostic modelling of future psychiatric episodes.
Topics: Adolescent; Affect; Anxiety; Anxiety Disorders; Depression; Depressive Disorder; Factor Analysis, Statistical; Female; Humans; Male; Models, Psychological; Surveys and Questionnaires
PubMed: 22151586
DOI: 10.1186/1471-244X-11-191 -
Maturitas Oct 2014Late-life depression is highly prevalent worldwide. In addition to being a debilitating illness, it is a risk factor for excess morbidity and mortality. Older adults... (Review)
Review
Late-life depression is highly prevalent worldwide. In addition to being a debilitating illness, it is a risk factor for excess morbidity and mortality. Older adults with depression are at risk for dementia, coronary heart disease, stroke, cancer and suicide. Individuals with late-life depression often have significant medical comorbidity and, poor treatment adherence. Furthermore, psychosocial considerations such as gender, ethnicity, stigma and bereavement are necessary to understand the full context of late-life depression. The fact that most older adults seek treatment for depression in primary care settings led to the development of collaborative care interventions for depression. These interventions have consistently demonstrated clinically meaningful effectiveness in the treatment of late-life depression. We describe three pivotal studies detailing the management of depression in primary care settings in both high and low-income countries. Beyond effectively treating depression, collaborative care models address additional challenges associated with late-life depression. Although depression treatment interventions are effective compared to usual care, they exhibit relatively low remission rates and small to medium effect sizes. Several studies have demonstrated that depression prevention is possible and most effective in at-risk older adults. Given the relatively modest effects of treatment in averting years lived with disability, preventing late-life depression at the primary care level should be highly prioritized as a matter of health policy.
Topics: Aged; Cardiovascular Diseases; Comorbidity; Cooperative Behavior; Dementia; Depression; Depressive Disorder; Humans; Primary Health Care; Risk Factors
PubMed: 24996484
DOI: 10.1016/j.maturitas.2014.05.026