A Study of Remitted and Treatment-Resistant Depression Using MMPI and Including Pessimism and Optimism Scales

Background

The psychological aspects of treatment-resistant and remitted depression are not well documented.

Methods

We administered the Minnesota Multiphasic Personality Inventory (MMPI) to patients with treatment-resistant depression (n = 34), remitted depression (n = 25), acute depression (n = 21), and healthy controls (n = 64). Pessimism and optimism were also evaluated by MMPI.

Results

ANOVA and post-hoc tests demonstrated that patients with treatment-resistant and acute depression showed similarly high scores for frequent scale (F), hypochondriasis, depression, conversion hysteria, psychopathic device, paranoia, psychasthenia and schizophrenia on the MMPI compared with normal controls. Patients with treatment-resistant depression, but not acute depression registered high on the scale for cannot say answer. Using Student''s t-test, patients with remitted depression registered higher on depression and social introversion scales, compared with normal controls. For pessimism and optimism, patients with treatment-resistant depression demonstrated similar changes to acutely depressed patients. Remitted depression patients showed lower optimism than normal controls by Student''s t-test, even though these patients were deemed recovered from depression using HAM-D.

Conclusions

The patients with remitted depression and treatment-resistant depression showed subtle alterations on the MMPI, which may explain the hidden psychological features in these cohorts.     

抑郁症与自杀

自杀是一种社会现象也是医学问题,自杀意念是抑郁症主要症状之一,抑郁症与自杀之间存在密切的关系,抑郁症患者甚至视自杀为一种解脱。本文从社会文化的角度探讨抑郁症病惠自杀的原因与特征,旨在有效识别抑郁症患者的自杀倾向,及早防护,降低抑郁症患者自杀率,同时丰富我国抑郁症研究的医学社会学内容。     

Environment-dependent inbreeding depression: its ecological and evolutionary significance

Inbreeding depression is a major evolutionary and ecological force that influences population dynamics and the evolution of inbreeding-avoidance traits such as mating systems and dispersal. There is now compelling evidence that inbreeding depression is environment-dependent. Here, we discuss ecological and evolutionary consequences of environment-dependent inbreeding depression. The environmental dependence of inbreeding depression may be caused by environment-dependent phenotypic expression, environment-dependent dominance, and environment-dependent natural selection. The existence of environment-dependent inbreeding depression challenges classical models of inbreeding as caused by unconditionally deleterious alleles, and suggests that balancing selection may shape inbreeding depression in natural populations; loci associated with inbreeding depression in some environments may even contribute to adaptation to others. Environment-dependent inbreeding depression also has important, often neglected, ecological and evolutionary consequences: it can influence the demography of marginal or colonizing populations and alter adaptive optima of mating systems, dispersal, and their associated traits. Incorporating the environmental dependence of inbreeding depression into theoretical models and empirical studies is necessary for understanding the genetic and ecological basis of inbreeding depression and its consequences in natural populations.     

糖尿病性勃起功能障碍与抑郁症的共病研究

目的:观察糖尿病性勃起功能障碍(diabetic erectile dysfunction,DMED)和抑郁症的共病情况,分析相关的影响因素,探讨抑郁症对DMED的影响。方法:将500例糖尿病男性患者进行勃起障碍评估和抑郁评分,将筛选出的DMED患者分为抑郁症组和无抑郁症组,记录患者的年龄、病程、血压、血糖、糖化血红蛋白、血脂、C肽、睾酮(T)、催乳素(PRL)及雌二醇(E2)等信息。DMED并发抑郁症的相关危险因素分析采用logistic回归分析。结果:DMED和抑郁症的共病率为73%,DMED患者的抑郁量表指数高。单因素logistic回归显示年龄、病程、体质量指数(BMI)、血糖、糖化血红蛋白、血脂、激素水平是DMED并发抑郁症的影响因素;多因素logistic回归分析表明年龄、病程、睾酮水平是DMED并发抑郁症的影响因素。结论:DMED患者和抑郁症的共病率较高,年龄、病程和睾酮水平可能是DMED和抑郁症共同的影响因素。     

Population-based retrospective study to investigate preexisting and new depression diagnosis among head and neck cancer patients

This study aimed to estimate the pre-cancer prevalence and post-cancer incidence of depression in older adult head and neck cancer patients. Using SEER-Medicare files, cancer was identified from SEER data and depression diagnosis was identified using Medicare claims. Of 3533 head and neck cancer patients, 10.6% were diagnosed with depression during the two years prior to cancer diagnosis, and an additional 8.9% developed depression in the year following cancer diagnosis. This study supports the critical need of screening for depression throughout cancer diagnosis and treatment, as well as a preventative approach in depression development in the older head and neck cancer patient population.     

The detection and treatment of depression in the physically ill

Depression and chronic physical illness are in reciprocal relationship with one another: not only do many chronic illnesses cause higher rates of depression, but depression has been shown to antedate some chronic physical illnesses. Depression associated with physical illness is less well detected than depression occurring on its own, and various ways of improving both the detection and treatment of depression accompanying physical illness are described. This paper is in four parts, the first dealing with the evidence for depression having a special relationship with physical disorders, the second dealing with detection of depression in physically ill patients, the third with the treatment of depression, and the fourth describing the advantages of treating depression among physically ill patients.     

Depression and diabetes in India: perspectives and recommendations

Diabet. Med. 29, e308-e311 (2012) ABSTRACT: As diabetes prevalence shifts from affluent to lower-income groups in India, focus on depression in diabetes will become essential. This paper describes four perspectives through which depression and diabetes should be understood in the Indian context. We consider (1) how rapid socio-economic and demographic changes contribute to increased co-occurring diabetes and depression; (2) how social, cultural and economic factors in the Indian context contribute to depression and therefore play an important role in diabetes care; (3) biological and behavioural pathways between depression and diabetes; and (4) the role of health systems in depression, diabetes and their overlap. We conclude with recommendations for future research and policy on this topic in India.     

Artery balloon angioplasty and depression symptoms

Peripheral arterial occlusive disease (PAOD) as a chronic disease is associated with physical, psychological and social distress for elderly patients and their families. The study has three main aims: 1. to evaluate the occurrence and the relevance of depression symptoms in patients with PAOD, 2. to evaluate the effect of age and Fontaine stage of PAOD on relevance of depression in patients with PAOD, and 3. to evaluate the effect of artery balloon angioplasty (ABA) on occurence and relevance of depression symptoms. The study was prospective and longitudinal. Dates were obtained during year 2006. The total number of subjects with PAOD was 42 (28 males, 14 females). Thirty subjects with PAOD (20 male, 10 female) treated by ABA filled in Zung's scale 3-6 months after ABA (61%). The mean age of all subjects was 65.4 years (aged 45-79). The evaluation of occurrence and relevance of depression was performed with Czech version of Zung self-rating depression scale (ZSRS). The mean Zung self-rating depression score (ZSRDS) certifies the presence of signs of minimum or mildly depression in patients with PAOD. The results proved statistically significant dependence of depression on age and on Fontaine stage of PAOD. Also, the results proved that artery balloon angioplasty has a highly positive effect on occurrence and relevance of depression symptoms. The results had shown the existence of the association between PAOD, depression and ABA.     

Inbreeding depression and mixed mating in Leptosiphon jepsonii: a comparison of three populations

BACKGROUND AND AIMS: Inbreeding depression is thought to play a central role in the evolution and maintenance of cross-fertilization. Theory indicates that inbreeding depression can be purged with self-fertilization, resulting in positive feedback for the selection of selfing. Variation among populations of Leptosiphon jepsonii in the timing and rate of self-fertilization provides an opportunity to study the evolution of inbreeding depression and mating systems. In addition, the hypothesis that differences in inbreeding depression for male and female fitness can stabilize mixed mating in L. jepsonii is tested. METHODS: In a growth room experiment, inbreeding depression was measured in three populations with mean outcrossing rates ranging from 0.06 to 0.69. The performance of selfed and outcrossed progeny is compared at five life history stages. To distinguish between self-incompatibility and early inbreeding depression, aborted seeds and unfertilized ovules were counted in selfed and outcrossed fruits. In one population, pollen and ovule production was quantified to estimate inbreeding depression for male and female fitness. KEY RESULTS: Both prezygotic barriers and inbreeding depression limited self seed set in the most outcrossing population. Cumulative inbreeding depression ranged from 0.297 to 0.501, with the lowest value found in the most selfing population. Significant inbreeding depression for early life stages was found only in the more outcrossing populations. Inbreeding depression was not significant for pollen or ovule production. CONCLUSIONS: The results provide modest support for the hypothesized relationship between inbreeding depression and mating systems. The absence of early inbreeding depression in the more selfing populations is consistent with theory on purging. Differences in male and female expression of inbreeding depression do not appear to stabilize mixed mating in L. jepsonii. The current estimates of inbreeding depression for L. jepsonii differ from those of previous studies, underscoring the effects of environmental variation on its expression.     

Omega-3 fatty acids and perinatal depression: a review of the literature and recommendations for future research

INTRODUCTION: Perinatal depression refers to major depression in the context of pregnancy and postpartum. In consideration of its prevalence and consequences, the treatment and prevention of perinatal depression should be important public health priorities. Omega-3 fatty acids are attractive for consideration in perinatal women, due to known health benefits for the mother and baby. Antidepressant medications may pose risks in utero and in breastfeeding. METHODS: MEDLINE and manual searches were conducted. RESULTS: Epidemiological and preclinical data support a role of omega-3 fatty acids in perinatal depression. Two studies failed to support a role of omega-3 fatty acids for postpartum depression prophylaxis, although one included a small sample, and the other utilized a low dosage. Two pilot studies suggest good tolerability and potential efficacy in the acute treatment of perinatal depression. CONCLUSIONS: Further research studies are warranted to determine the role of omega-3 fatty acids in the treatment of perinatal depression.     

Shared genetic loci between depression and cardiometabolic traits

Epidemiological and clinical studies have found associations between depression and cardiovascular disease risk factors, and coronary artery disease patients with depression have worse prognosis. The genetic relationship between depression and these cardiovascular phenotypes is not known. We here investigated overlap at the genome-wide level and in individual loci between depression, coronary artery disease and cardiovascular risk factors. We used the bivariate causal mixture model (MiXeR) to quantify genome-wide polygenic overlap and the conditional/conjunctional false discovery rate (pleioFDR) method to identify shared loci, based on genome-wide association study summary statistics on depression (n = 450,619), coronary artery disease (n = 502,713) and nine cardiovascular risk factors (n = 204,402–776,078). Genetic loci were functionally annotated using FUnctional Mapping and Annotation (FUMA). Of 13.9K variants influencing depression, 9.5K (SD 1.0K) were shared with body-mass index. Of 4.4K variants influencing systolic blood pressure, 2K were shared with depression. ConjFDR identified 79 unique loci associated with depression and coronary artery disease or cardiovascular risk factors. Six genomic loci were associated jointly with depression and coronary artery disease, 69 with blood pressure, 49 with lipids, 9 with type 2 diabetes and 8 with c-reactive protein at conjFDR < 0.05. Loci associated with increased risk for depression were also associated with increased risk of coronary artery disease and higher total cholesterol, low-density lipoprotein and c-reactive protein levels, while there was a mixed pattern of effect direction for the other risk factors. Functional analyses of the shared loci implicated metabolism of alpha-linolenic acid pathway for type 2 diabetes. Our results showed polygenic overlap between depression, coronary artery disease and several cardiovascular risk factors and suggest molecular mechanisms underlying the association between depression and increased cardiovascular disease risk.     

The prevalence and pulmonary consequences of anxiety and depressive disorders in patients with asthma

The aim of this study was to determine the prevalence of anxiety and depression symptoms in outpatients with treated asthma and to determine the influence of anxiety and depression symptoms on lung function and asthma symptoms. The study was conducted in the pulmonary clinic of the Department of Pulmonary Diseases, Osijek University Hospital Centre, on 200 outpatients with asthma, aged 18-50 years, of which there were 65.5% women and 35.5% men. Each patient underwent a clinical examination with an extensive anamnesis and lung auscultation. The lung function was tested by spirometry. Demographic data and data on general and socioeconomic characteristics were evaluated using a questionnaire created internally for the purposes of this research, psychological status was assessed by HAD questionnaire, and Q test was used as a measure of asthma control. Based on the HAD questionnaire, 44.5% of asthma patients met the criteria for anxiety, and 24.5% of asthma patients met the criteria for depression. There was no significant correlation between asthma symptoms and the degree of anxiety or depression, while the pulmonary function of asthma patients negatively correlated with the degree of anxiety and depression. Pulmonary function in asthma patients with symptoms of anxiety and depression was significantly poorer than in asthma patients without anxiety and/or depression symptoms. The results show that among asthma patients there are large number of those who have symptoms of anxiety and depression. Asthma patients with symptoms of anxiety and depression have poorer lung function than patients with only asthma symptoms, however there is no significant correlation between the lung function and symptoms of asthma. We have confirmed that patients with anxiety symptoms visit general practitioners or EMS significantly more when compared to patients with depression symptoms.     

Susto, Coraje, and Abuse: Depression and Beliefs About Diabetes

Mexican immigrants in the US often incorporate folk beliefs into diabetes etiologies but little is known about the relationship between such beliefs and depression. This study examines the relationship of diabetes beliefs and depression among 404 first- and second-generation Mexican immigrants seeking diabetes care in safety-net clinics in Chicago and San Francisco. We used multivariate linear regression to compare the association of depression with beliefs that susto (fright), coraje (anger), and/or interpersonal abuse cause diabetes, adjusting for gender, age, income, education, diabetes duration, co-morbidities, language preference, and acculturation. We incorporated the belief that abuse causes diabetes based on previous ethnographic research. Individuals reporting belief that abuse contributes to diabetes were significantly more likely to report symptoms of depression before (β?=?1.37; p?相似文献   

Depression screening and patient outcomes in cancer: a systematic review

Background

Several practice guidelines recommend screening for depression in cancer care, but no systematic reviews have examined whether there is evidence that depression screening benefits cancer patients. The objective was to evaluate the potential benefits of depression screening in cancer patients by assessing the (1) accuracy of depression screening tools; (2) effectiveness of depression treatment; and (3) effect of depression screening, either alone or in the context of comprehensive depression care, on depression outcomes.

Methods

Data sources were CINAHL, Cochrane, EMBASE, ISI, MEDLINE, PsycINFO and SCOPUS databases through January 24, 2011; manual journal searches; reference lists; citation tracking; trial registry reviews. Articles on cancer patients were included if they (1) compared a depression screening instrument to a valid criterion for major depressive disorder (MDD); (2) compared depression treatment with placebo or usual care in a randomized controlled trial (RCT); (3) assessed the effect of screening on depression outcomes in a RCT.

Results

There were 19 studies of screening accuracy, 1 MDD treatment RCT, but no RCTs that investigated effects of screening on depression outcomes. Screening accuracy studies generally had small sample sizes (median = 17 depression cases) and used exploratory methods to set sample-specific cutoff scores that varied substantially across studies. A nurse-delivered intervention for MDD reduced depressive symptoms moderately (effect size = 0.37).

Conclusions

The one treatment study reviewed reported modest improvement in depressive symptoms, but no evidence was found on whether or not depression screening in cancer patients, either alone or in the context of optimal depression care, improves depression outcomes compared to usual care. Depression screening in cancer should be evaluated in a RCT in which all patients identified as depressed, either through screening or via physician recognition and referral in a control group, have access to comprehensive depression care.     

Temporal relationship between neurotransmitter release and ion flux during spreading depression and anoxia

Brain ion homeostasis is severely perturbed during spreading depression of Leao and during anoxia. The ionic composition of the extracellular space changes abruptly and approaches the intracellular concentrations owing to an increase in cell permeability. In spreading depression, synchronous transmitter efflux caused by a depolarization of the presynaptic terminals has been implicated as a possible mechanism that would explain the concomitant movement of ions. Anoxia, having many features in common with spreading depression, may follow the same mechanism. We have measured the concentrations of extracellular potassium with ion-selective microelectrodes and dopamine by in vivo voltammetry with carbon fiber microelectrodes during spreading depression and anoxia to compare the temporal relationship between the release of dopamine and ion movements in the striatum. There is a pronounced release of dopamine during both spreading depression and anoxia. In spreading depression, the sharp increase of potassium concentration that follows an initial smaller and slower increase of potassium is accompanied by the release of dopamine. In anoxia, the dopamine release clearly precedes the fast rise of extracellular potassium concentration. We conclude that in striatum, there is a pronounced dopamine release during spreading depression and anoxia, but that the relationships between ionic changes and transmitter release for these two phenomena are different and probably reflect different mechanisms.     

Effects of depression on physical health and mortality in the elderly. Longitudinal results of the LASA research

This longitudinal study examines the physical health consequences of depression among 3107 older persons (55-85 years). Major depression was defined according to DSM-III criteria in a psychiatric interview. Minor depression was defined by a Center for Epidemiologic Studies Depression score > or = 16. Health consequences were assessed by 3-year change in self-reported functional status, 3-year change in performance on objective tests, and risk of death over 4.5 years. At baseline, 12.8% of the older persons had minor depression and 2.0% major depression. Minor depression was associated with a significantly greater decline in functional status and performance and, only in men but not in women, with an increased risk of death. Major depression also increases decline in functional status and the risk of death (irrespective of sex), but was not associated with decline in physical performance. These results show that late-life depression has strong unfavorable physical health consequences. The consequences of minor depression are comparable with those of major depression.     

基于肠道菌群代谢和免疫炎症分析中药缓解抑郁症的研究现状

抑郁症是以连续而长期的心情低落为主要临床特征的一类最常见的精神疾病。肠道菌群的变化可导致肠道炎症,进而影响外周与中枢神经系统炎症。现代研究表明抑郁症的发生发展与肠道菌群的改变密切相关,肠道菌群已成为缓解抑郁症的关键靶点。在一定程度上中药能够调节肠道菌群及其代谢产物,修复肠道屏障,降低全身炎症水平,从而缓解抑郁症。本综述以肠道菌群为切入点,通过分析肠道菌群的代谢、免疫炎症与抑郁症发生发展的关系以及中药在调节肠道菌群缓解抑郁症方面的研究,总结中药通过影响肠道菌群的代谢,降低炎症水平,缓解抑郁症的作用和机制,以期为中药缓解抑郁症及相关药物的研发提供新思路。

     

The association between mild geriatric depression and reproductive history--a Darwinian approach

The well described trend of population ageing results in a dramatic increase in the number of elderly, reporting symptoms of depression, the most common mood disorder today. Various intrinsic and extrinsic factors are discussed to be responsible for this increase of mood disorders. In the present study the association patterns between mild geriatric depression and the individual reproductive history are analyzed. 264 subjects, 167 females and 97 males, ageing between 60 and 95 years (mean 72.3, SD 8.1 yrs) were enrolled in the present study. The prevalence of depression was tested by mean of the geriatric depression scale (GDS), additionally reproductive history was documented. It turned out, that with increasing number of offspring the depression score decreased. Childless women exhibited the highest prevalence of mild depression and the highest mean depression score. These association patterns between reproductive history and depressive disorders during old age were discussed by means of Darwinian psychiatry. A low number of offspring or childlessness and a lack of social networks for support are new in the evolutionary history of Homo sapiens. Mild geriatric depression may be interpreted as a result of a mismatch or dysregulation because the recent social environment of elderly is completely different from that in which Homo sapiens evolved. The occurrence of geriatric depression may be an adaptation to this new situation.     

Depression and type 2 diabetes: cortisol pathway implication and investigational needs

Depression and type 2 diabetes (T2D) are clinically associated and the causes of the association are still under investigation. We aimed at identifying what is known about the stress response and cortisol pathway and the clinical association of depression and T2D, and at hypothesizing the link of the association. In this review, we report independent studies on stress response, cortisol pathway, depression, T2D, and independent studies on stress and cortisol pathway in depression, and in T2D. We focus and integrate the stress and cortisol pathway hypothesis to explain the clinical association of depression and T2D. We hypothesize that the corticotropin-releasing hormone receptors are one of the missing linking factor of the cortisol pathway underlying the clinical association of depression and T2D. We state what studies are still needed to confirm or rule out our hypothesis.