Browsing by Subject "depression"

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    ItemOpen Access
    Adapting culturally appropriate mental health screening tools for use among conflict-affected and other vulnerable adolescents in Nigeria
    (Global Mental Health, 2019) Kaiser, BN; Ticao, C; Anoje, C; Minto, J; Boglosa, J; Kohrt, BA
    BackgroundThe Boko Haram insurgency has brought turmoil and instability to Nigeria, generating a large number of internally displaced people and adding to the country's 17.5 million orphans and vulnerable children. Recently, steps have been taken to improve the mental healthcare infrastructure in Nigeria, including revamping national policies and initiating training of primary care providers in mental healthcare. In order for these efforts to succeed, they require means for community-based detection and linkage to care. A major gap preventing such efforts is the shortage of culturally appropriate, valid screening tools for identifying emotional and behavioral disorders among adolescents. In particular, studies have not conducted simultaneous validation of screening tools in multiple languages, to support screening and detection efforts in linguistically diverse populations. We aim to culturally adapt screening tools for emotional and behavioral disorders for use among adolescents in Nigeria, in order to facilitate future validation studies.MethodsWe used a rigorous mixed-method process to culturally adapt the Depression Self Rating Scale, Child PTSD Symptom Scale, and Disruptive Behavior Disorders Rating Scale. We employed expert translations, focus group discussions (N = 24), and piloting with cognitive interviewing (N = 24) to achieve semantic, content, technical, and criterion equivalence of screening tool items.ResultsWe identified and adapted items that were conceptually difficult for adolescents to understand, conceptually non-equivalent across languages, considered unacceptable to discuss, or stigmatizing. Findings regarding problematic items largely align with existing literature regarding cross-cultural adaptation.ConclusionsCulturally adapting screening tools represents a vital first step toward improving community case detection.
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    Delineating the maladaptive pathways of child maltreatment: A mediated moderation analysis of the roles of self-perception and social support
    (2010) Appleyard, Karen; Yang, Chongming; Runyan, Desmond K
    The current study investigated concurrent and longitudinal mediated and mediated moderation pathways among maltreatment, self-perception (i.e., loneliness and self-esteem), social support, and internalizing and externalizing behavior problems. For both genders, early childhood maltreatment (i.e., ages 0-6) was related directly to internalizing and externalizing behavior problems at age 6, and later maltreatment (i.e., ages 6-8) was directly related to internalizing and externalizing behavior problems at age 8. Results of concurrent mediation and mediated moderation indicated that early maltreatment was significantly related to internalizing and externalizing behavior problems at age 6 indirectly both through age 6 loneliness and self-esteem for boys and through age 6 loneliness for girls. Significant moderation of the pathway from early maltreatment to self-esteem, and for boys, significant mediated moderation to emotional and behavioral problems were found, such that the mediated effect through self-esteem varied across levels of social support, though in an unexpected direction. No significant longitudinal mediation or mediated moderation was found, however, between the age 6 mediators and moderator and internalizing or externalizing problems at age 8. The roles of the hypothesized mediating and moderating mechanisms are discussed, with implications for designing intervention and prevention programs.
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    Do comorbid self-reported depression and anxiety influence outcomes following surgery for cervical spondylotic myelopathy?
    (Journal of neurosurgery. Spine, 2023-03) Chan, Andrew K; Shaffrey, Christopher I; Park, Christine; Gottfried, Oren N; Than, Khoi D; Bisson, Erica F; Bydon, Mohamad; Asher, Anthony L; Coric, Domagoj; Potts, Eric A; Foley, Kevin T; Wang, Michael Y; Fu, Kai-Ming; Virk, Michael S; Knightly, John J; Meyer, Scott; Park, Paul; Upadhyaya, Cheerag D; Shaffrey, Mark E; Buchholz, Avery L; Tumialán, Luis M; Turner, Jay D; Michalopoulos, Giorgos D; Sherrod, Brandon A; Agarwal, Nitin; Chou, Dean; Haid, Regis W; Mummaneni, Praveen V

    Objective

    Depression and anxiety are associated with inferior outcomes following spine surgery. In this study, the authors examined whether patients with cervical spondylotic myelopathy (CSM) who have both self-reported depression (SRD) and self-reported anxiety (SRA) have worse postoperative patient-reported outcomes (PROs) compared with patients who have only one or none of these comorbidities.

    Methods

    This study is a retrospective analysis of prospectively collected data from the Quality Outcomes Database CSM cohort. Comparisons were made among patients who reported the following: 1) either SRD or SRA, 2) both SRD and SRA, or 3) neither comorbidity at baseline. PROs at 3, 12, and 24 months (scores for the visual analog scale [VAS] for neck pain and arm pain, Neck Disability Index [NDI], modified Japanese Orthopaedic Association [mJOA] scale, EQ-5D, EuroQol VAS [EQ-VAS], and North American Spine Society [NASS] patient satisfaction index) and achievement of respective PRO minimal clinically important differences (MCIDs) were compared.

    Results

    Of the 1141 included patients, 199 (17.4%) had either SRD or SRA alone, 132 (11.6%) had both SRD and SRA, and 810 (71.0%) had neither. Preoperatively, patients with either SRD or SRA alone had worse scores for VAS neck pain (5.6 ± 3.1 vs 5.1 ± 3.3, p = 0.03), NDI (41.0 ± 19.3 vs 36.8 ± 20.8, p = 0.007), EQ-VAS (57.0 ± 21.0 vs 60.7 ± 21.7, p = 0.03), and EQ-5D (0.53 ± 0.23 vs 0.58 ± 0.21, p = 0.008) than patients without such disorders. Postoperatively, in multivariable adjusted analyses, baseline SRD or SRA alone was associated with inferior improvement in the VAS neck pain score and a lower rate of achieving the MCID for VAS neck pain score at 3 and 12 months, but not at 24 months. At 24 months, patients with SRD or SRA alone experienced less change in EQ-5D scores and were less likely to meet the MCID for EQ-5D than patients without SRD or SRA. Furthermore, patient self-reporting of both psychological comorbidities did not impact PROs at all measured time points compared with self-reporting of only one psychological comorbidity alone. Each cohort (SRD or SRA alone, both SRD and SRA, and neither SRD nor SRA) experienced significant improvements in mean PROs at all measured time points compared with baseline (p < 0.05).

    Conclusions

    Approximately 12% of patients who underwent surgery for CSM presented with both SRD and SRA, and 29% presented with at least one symptom. The presence of either SRD or SRA was independently associated with inferior scores for 3- and 12-month neck pain following surgery, but this difference was not significant at 24 months. However, at long-term follow-up, patients with SRD or SRA experienced lower quality of life than patients without SRD or SRA. The comorbid presence of both depression and anxiety was not associated with worse patient outcomes than either diagnosis alone.
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    Does comorbid depression and anxiety portend poor long-term outcomes following surgery for lumbar spondylolisthesis? Five-year analysis of the Quality Outcomes Database.
    (Journal of neurosurgery. Spine, 2024-09) DiDomenico, Joseph; Farber, S Harrison; Virk, Michael S; Godzik, Jakub; Johnson, Sarah E; Bydon, Mohamad; Mummaneni, Praveen V; Bisson, Erica F; Glassman, Steven D; Chan, Andrew K; Chou, Dean; Fu, Kai-Ming; Shaffrey, Christopher I; Asher, Anthony L; Coric, Domagoj; Potts, Eric A; Foley, Kevin T; Wang, Michael Y; Knightly, John J; Park, Paul; Shaffrey, Mark E; Slotkin, Jonathan R; Haid, Regis W; Uribe, Juan S; Turner, Jay D

    Objective

    Depression and anxiety are associated with poor outcomes following spine surgery. However, the influence of these conditions on achieving a minimal clinically important difference (MCID) following lumbar spine surgery, as well as the potential compounding effects of comorbid depression and anxiety, is not well understood. This study explores the impact of comorbid depression and anxiety on long-term clinical outcomes following surgical treatment for degenerative lumbar spondylolisthesis.

    Methods

    This study was a retrospective analysis of the multicenter, prospectively collected Quality Outcomes Database (QOD). Patients with surgically treated grade 1 lumbar spondylolisthesis from 12 centers were included. Preoperative baseline characteristics and comorbidities were recorded, including self-reported depression and/or anxiety. Pre- and postoperative patient-reported outcomes (PROs) were recorded: the numeric rating scale (NRS) score for back pain (NRS-BP), NRS score for leg pain (NRS-LP), Oswestry Disability Index (ODI), and EQ-5D. Patients were grouped into 3 cohorts: no self-reported depression or anxiety (non-SRD/A), self-reported depression or anxiety (SRD/A), or presence of both comorbidities (SRD+A). Changes in PROs over time, satisfaction rates, and rates of MCID were compared. A multivariable regression analysis was performed to establish independent associations.

    Results

    Of the 608 patients, there were 452 (74.3%) with non-SRD/A, 81 (13.3%) with SRD/A, and 75 (12.3%) with SRD+A. Overall, 91.8% and 80.4% of patients had ≥ 24 and ≥ 60 months of follow-up, respectively. Baseline PROs were universally inferior for the SRD+A cohort. However, at 60-month follow-up, changes in all PROs were greatest for the SRD+A cohort, resulting in nonsignificant differences in absolute NRS-BP, NRS-LP, ODI, and EQ-5D across the 3 groups. MCID was achieved for the SRD+A cohort at similar rates to the non-SRD/A cohort. All groups achieved > 80% satisfaction rates with surgery without significant differences across the cohorts (p = 0.79). On multivariable regression, comorbid depression and anxiety were associated with worse baseline PROs, but they had no impact on 60-month PROs or 60-month achievement of MCIDs.

    Conclusions

    Despite lower baseline PROs, patients with comorbid depression and anxiety achieved comparable rates of MCID and satisfaction after surgery for lumbar spondylolisthesis to those without either condition. This quality-of-life benefit was durable at 5-year follow-up. These data suggest that patients with self-reported comorbid depression and anxiety should not be excluded from consideration of surgical intervention and often substantially benefit from surgery.
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    Emotion Regulation and the Experience of Future Negative Mood: The Importance of Assessing Social Support.
    (Frontiers in Psychology, 2018-01) d'Arbeloff, Tracy C; Freedy, Katherine R; Knodt, Annchen R; Radtke, Spenser R; Brigidi, Bartholomew D; Hariri, Ahmad R
    Emotion regulation refers to the use of various strategies, such as cognitive reappraisal and expressive suppression, to help manage our negative experiences, emotions, and thoughts. Although such emotion regulation often occurs within broader social dynamics and interactions, little is known about how social contexts interact with specific regulation strategies to shape the experience of negative emotions. Using data from 544 young adult university students, we provide initial evidence that habitual use of cognitive reappraisal is associated with lower future experience of depression and anxiety primarily through higher perceived social support (PSS). In contrast, expressive suppression is associated with higher future depression and anxiety primarily through lower PSS. These patterns are consistent with the importance of interpersonal influences on emotion regulation and suggest that assessment of social support can help elucidate the mechanisms of successfully regulating negative mood.
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    Forty-five good things: a prospective pilot study of the Three Good Things well-being intervention in the USA for healthcare worker emotional exhaustion, depression, work-life balance and happiness.
    (BMJ open, 2019-03-20) Sexton, J Bryan; Adair, Kathryn C
    OBJECTIVES:High rates of healthcare worker (HCW) burn-out have led many to label it an 'epidemic' urgently requiring interventions. This prospective pilot study examined the efficacy, feasibility and evaluation of the 'Three Good Things' (3GT) intervention for HCWs, and added burn-out and work-life balance to the set of well-being metrics. METHODS:228 HCWs participated in a prospective, repeated measures study of a web-based 15-day long 3GT intervention. Assessments were collected at baseline and 1, 6 and 12-month post-intervention. The primary measure of efficacy was a derivative of the emotional exhaustion subscale of the Maslach Burnout Inventory. The secondary measures were validated instruments assessing depression symptoms, subjective happiness, and work-life balance. Paired samples t-tests and Cohen's d effect sizes for correlated samples were used to examine the efficacy of the intervention. RESULTS:3GT participants exhibited significant improvements from baseline in emotional exhaustion, depression symptoms and happiness at 1 month, 6 months and 12 months, and in work-life balance at 1 month and 6 months (effect sizes 0.16-0.52). Exploratory subgroup analyses of participants meeting 'concerning' criteria at baseline revealed even larger effects at all assessment points (0.55-1.57). Attrition rates were similar to prior 3GT interventions. CONCLUSION:3GT appears a promising low-cost and brief intervention for improving HCW well-being. ETHICS AND DISSEMINATION:This study is approved by the Institutional Review Board of Duke University Health System (Pro00063703). All participants are required to give their informed consent prior to any study procedure.
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    Implementing and feasibility testing depression screening using the electronic medical record for patients with type 2 diabetes admitted to the hospital.
    (Nursing open, 2019-01) Joseph, Letha M; Berry, Diane C; Jessup, Ann; Davison, Jean; J Schneider, Brian; I Twersky, Jack

    Aim

    Is it feasible to implement a programme to screen for depression in patients admitted to the hospital for diabetes complications and use the electronic medical record to notify providers of their patient's depression score and give suggestions for medication and counselling?

    Design

    A feasibility study was conducted with patients hospitalized with diabetes and depression in the Durham Veterans Affairs Medical Center, Durham, North Carolina, United States.

    Methods

    Patients with type 2 diabetes were screened for depression. The healthcare provider was notified via the electronic medical record about the patients' depression scores. The provider discussed options for management of depression with the patient and initiated treatment.

    Results

    The process of screening for depression at admission, notifying the provider by way of electronic medical record that the patient screened positive for depression with suggestions for medication and counseling was feasible and acceptable to providers and patients.
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    Invisible partners in care: Snapshot of well-being among caregivers receiving comprehensive support from Veterans Affairs.
    (Health science reports, 2019-03) Miller, Katherine EM; Lindquist, Jennifer H; Olsen, Maren K; Smith, Valerie; Voils, Corrine I; Oddone, Eugene Z; Sperber, Nina R; Shepherd-Banigan, Megan; Wieland, G Darryl; Henius, Jennifer; Kabat, Margaret; Van Houtven, Courtney Harold

    Background and aims

    Since May 2011, over 23 000 caregivers of Veterans seriously injured on or after September 11, 2001 have enrolled in the Program of Comprehensive Assistance for Family Caregivers (PCAFC). PCAFC provides caregivers training, a stipend, and access to health care. The aim of this study is to describe the characteristics of caregivers in PCAFC and examine associations between caregiver characteristics and caregiver well-being outcomes.

    Methods

    We sent a web survey invitation to 10 000 PCAFC caregivers enrolled as of September 2015. Using linear and logistic regressions, we examine associations between PCAFC caregiver characteristics and caregiver outcomes: perceived financial strain, depressive symptoms (Center for Epidemiologic Studies Depression Scale [CESD-10]), perceived quality of Veteran's Veterans Health Administration (VHA) care, and self-reported caregiver health.

    Results

    We had complete survey data for 899 respondents. Since becoming a caregiver, approximately 50% of respondents reported reducing or stopping work. Mean time spent providing care was 3.8 years (median 3, IQR 1-5) with an average of 4.9 weekdays (median 5, IQR 5-5) and 1.9 weekend days (median 2, IQR 2-2). The mean CESD-10 score was 8.2 (median 7, 4-12), at the cutoff for screening positive for depressive symptoms. A longer duration of caregiving was associated with having 0.08 increase in rating of financial strain (95% CI, 0.02-0.14). Caregiver rating of the Veteran's health status as "fair" or better was a strong predictor of better caregiver outcomes, ie, self-reported caregiver health. However, higher levels of education were associated with worse caregiver outcomes, ie, lower global satisfaction with VHA care, higher CESD-10 score, and higher rating of financial strain.

    Conclusions

    Higher depressive symptoms among longer duration caregivers, coupled with high rates of reductions in hours worked, suggest interventions are needed to address the long-term emotional and financial needs of these caregivers of post-9/11 Veterans and identify subpopulations at risk for worse outcomes.
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    It's Not the Genes OR the Environment, It's the Genes AND the Environment!
    (Journal of the American Heart Association, 2021-09-02) Williams, Redford B
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    Polygenic Risk Score Effectively Predicts Depression Onset in Alzheimer's Disease Based on Major Depressive Disorder Risk Variants.
    (Frontiers in neuroscience, 2022-01) Upadhya, Suraj; Liu, Hongliang; Luo, Sheng; Lutz, Michael W; Chiba-Falek, Ornit

    Introduction

    Depression is a common, though heterogenous, comorbidity in late-onset Alzheimer's Disease (LOAD) patients. In addition, individuals with depression are at greater risk to develop LOAD. In previous work, we demonstrated shared genetic etiology between depression and LOAD. Collectively, these previous studies suggested interactions between depression and LOAD. However, the underpinning genetic heterogeneity of depression co-occurrence with LOAD, and the various genetic etiologies predisposing depression in LOAD, are largely unknown.

    Methods

    Major Depressive Disorder (MDD) genome-wide association study (GWAS) summary statistics were used to create polygenic risk scores (PRS). The Religious Orders Society and Rush Memory and Aging Project (ROSMAP, n = 1,708) and National Alzheimer's Coordinating Center (NACC, n = 10,256) datasets served as discovery and validation cohorts, respectively, to assess the PRS performance in predicting depression onset in LOAD patients.

    Results

    The PRS showed marginal results in standalone models for predicting depression onset in both ROSMAP (AUC = 0.540) and NACC (AUC = 0.527). Full models, with baseline age, sex, education, and APOEε4 allele count, showed improved prediction of depression onset (ROSMAP AUC: 0.606, NACC AUC: 0.581). In time-to-event analysis, standalone PRS models showed significant effects in ROSMAP (P = 0.0051), but not in NACC cohort. Full models showed significant performance in predicting depression in LOAD for both datasets (P < 0.001 for all).

    Conclusion

    This study provided new insights into the genetic factors contributing to depression onset in LOAD and advanced our knowledge of the genetics underlying the heterogeneity of depression in LOAD. The developed PRS accurately predicted LOAD patients with depressive symptoms, thus, has clinical implications including, diagnosis of LOAD patients at high-risk to develop depression for early anti-depressant treatment.
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    Proceedings of the Seventh Annual Deep Brain Stimulation Think Tank: Advances in Neurophysiology, Adaptive DBS, Virtual Reality, Neuroethics and Technology.
    (Frontiers in human neuroscience, 2020-01) Ramirez-Zamora, Adolfo; Giordano, James; Gunduz, Aysegul; Alcantara, Jose; Cagle, Jackson N; Cernera, Stephanie; Difuntorum, Parker; Eisinger, Robert S; Gomez, Julieth; Long, Sarah; Parks, Brandon; Wong, Joshua K; Chiu, Shannon; Patel, Bhavana; Grill, Warren M; Walker, Harrison C; Little, Simon J; Gilron, Ro'ee; Tinkhauser, Gerd; Thevathasan, Wesley; Sinclair, Nicholas C; Lozano, Andres M; Foltynie, Thomas; Fasano, Alfonso; Sheth, Sameer A; Scangos, Katherine; Sanger, Terence D; Miller, Jonathan; Brumback, Audrey C; Rajasethupathy, Priya; McIntyre, Cameron; Schlachter, Leslie; Suthana, Nanthia; Kubu, Cynthia; Sankary, Lauren R; Herrera-Ferrá, Karen; Goetz, Steven; Cheeran, Binith; Steinke, G Karl; Hess, Christopher; Almeida, Leonardo; Deeb, Wissam; Foote, Kelly D; Okun, Michael S
    The Seventh Annual Deep Brain Stimulation (DBS) Think Tank held on September 8th of 2019 addressed the most current: (1) use and utility of complex neurophysiological signals for development of adaptive neurostimulation to improve clinical outcomes; (2) Advancements in recent neuromodulation techniques to treat neuropsychiatric disorders; (3) New developments in optogenetics and DBS; (4) The use of augmented Virtual reality (VR) and neuromodulation; (5) commercially available technologies; and (6) ethical issues arising in and from research and use of DBS. These advances serve as both "markers of progress" and challenges and opportunities for ongoing address, engagement, and deliberation as we move to improve the functional capabilities and translational value of DBS. It is in this light that these proceedings are presented to inform the field and initiate ongoing discourse. As consistent with the intent, and spirit of this, and prior DBS Think Tanks, the overarching goal is to continue to develop multidisciplinary collaborations to rapidly advance the field and ultimately improve patient outcomes.
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    Psychometric and Clinical Evaluation of the Clinician (VQIDS-C5) and Self-Report (VQIDS-SR5) Versions of the Very Quick Inventory of Depressive Symptoms.
    (Neuropsychiatric disease and treatment, 2022-01) Rush, A John; Madia, Nancy D; Carmody, Thomas; Trivedi, Madhukar H

    Purpose

    Evaluate the psychometric properties of the 5-item Very Quick Inventory of Depressive Symptomatology self-report and clinician-rated versions (VQIDS-SR5/VQIDS-C5), compare their relative performance, create crosswalks between their total scores and other accepted depressive symptom ratings, and define clinically relevant depressive symptom severity thresholds and categorical outcomes for both versions.

    Patients and methods

    The Sequenced Treatment Alternatives to Relieve Depression trial obtained baseline and exit 17-item Hamilton Rating Scale for Depression (HRSD17) and 30-item Inventory of Depressive Symptomatology - Clinician-rated scores, and baseline and visit-wise QIDS-SR16 and QIDS-C16 ratings from the first treatment step (citalopram). The VQIDS-C5 and the VQIDS-SR5 items (sad mood, self-outlook, involvement, fatigue, psychomotor slowing) (each rated 0-3), extracted from the corresponding 16-item ratings, were selected to best reflect the 6-item HRSD (HRSD6) (exclusive of anxiety). Classical Test Theory (CTT) and Item-Response Theory (IRT) analyses assessed psychometric features. IRT analyses produced total score crosswalks between the VQIDS5, QIDS-C16, QIDS-SR16 and HRSD6. Clinically relevant VQIDS symptom severity thresholds and treatment outcomes were estimated based on cross-walks from the parent QIDS16 ratings.

    Results

    Both VQIDS versions were unifactorial with acceptable internal consistencies (Cronbach's alphas >0.80), item-total correlations (0.57-0.74) by CCT, and strong IRT item performance. Based on QIDS16 severity thresholds (none 0-5; mild 6-10; moderate 11-15; severe 16-20; and very severe 21-27), comparable thresholds were 0-2; 3-5; 6-9; 9-12; and >12 for VQIDS-C5, and 0-2; 2-5; 6-8; 9-12; and >12 for VQIDS-SR5. Kappa values were acceptable in comparing categories of outcomes (eg, no benefit, remission, etc) based on VQIDS and corresponding QIDS categories.

    Conclusion

    The VQIDS-C5 and VQIDS-SR5 assess selected core depressive symptoms with psychometrically acceptable properties. Theelf-report and clinician-rated versions provide virtually identical information, symptom severity thresholds and symptom change categories. Both are as sensitive to change as the corresponding QIDS16, making them suitable for use in busy practices.
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    Revising a Self-Regulation Phenotype for Depression Through Individual Differences in Macroscale Brain Organization.
    (Current directions in psychological science, 2023-08) Strauman, Timothy J; Hariri, Ahmad R
    Self-regulation denotes the processes by which people initiate, maintain, and control their own thoughts, behaviors, or emotions to produce a desired outcome or avoid an undesired outcome. Self-regulation brings the influence of distal factors such as biology, temperament, and socialization history onto cognition, motivation, and behavior. Dysfunction in self-regulation represents a contributory causal factor for psychopathology. Accordingly, we previously proposed a risk phenotype model for depression drawing from regulatory focus theory and traditional task-based fMRI studies. In this article, we revise and expand our risk phenotype model using insights from new methodologies allowing quantification of individual differences in task-free macroscale brain organization. We offer a set of hypotheses as examples of how examination of intrinsic macroscale brain organization can extend and enrich investigations of self-regulation and depression. In doing so, we hope to promote a useful heuristic for model development and for identifying transdiagnostic risk phenotypes in psychopathology.
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    Revisiting the monoamine hypothesis of depression: a new perspective.
    (Perspect Medicin Chem, 2014) Goldberg, Joel S; Bell, Clifton E; Pollard, David A
    As the incidence of depression increases, depression continues to inflict additional suffering to individuals and societies and better therapies are needed. Based on magnetic resonance spectroscopy and laboratory findings, gamma aminobutyric acid (GABA) may be intimately involved in the pathophysiology of depression. The isoelectric point of GABA (pI = 7.3) closely approximates the pH of cerebral spinal fluid (CSF). This may not be a trivial observation as it may explain preliminary spectrophotometric, enzymatic, and HPLC data that monoamine oxidase (MAO) deaminates GABA. Although MAO is known to deaminate substrates such as catecholamines, indoleamines, and long chain aliphatic amines all of which contain a lipophilic moiety, there is very good evidence to predict that a low concentration of a very lipophilic microspecies of GABA is present when GABA pI = pH as in the CSF. Inhibiting deamination of this microspecies of GABA could explain the well-established successful treatment of refractory depression with MAO inhibitors (MAOI) when other antidepressants that target exclusively levels of monoamines fail. If further experimental work can confirm these preliminary findings, physicians may consider revisiting the use of MAOI for the treatment of non-intractable depression because the potential benefits of increasing GABA as well as the monoamines may outweigh the risks associated with MAOI therapy.
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    Self-system therapy for distress associated with persistent low back pain: A randomized clinical trial.
    (Psychother Res, 2016-07) Waters, Sandra J; Strauman, Timothy J; McKee, Daphne C; Campbell, Lisa C; Shelby, Rebecca A; Dixon, Kim E; Fras, Anne Marie; Keefe, Francis J
    OBJECTIVE: Persistent low back pain (PLBP) is associated with vulnerability to depression. PLBP frequently requires major changes in occupation and lifestyle, which can lead to a sense of failing to attain one's personal goals (self-discrepancy). METHOD: We conducted a clinical trial to examine the efficacy of self-system therapy (SST), a brief structured therapy for depression based on self-discrepancy theory. A total of 101 patients with PLBP and clinically significant depressive symptoms were randomized either to SST, pain education, or standard care. RESULTS: Patients receiving SST showed significantly greater improvement in depressive symptoms. Reduction in self-discrepancy predicted reduction in depressive symptoms only within the SST condition. CONCLUSIONS: Findings support the utility of SST for individuals facing persistent pain and associated depression.
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    Serotonin is a Common Thread Linking Different Classes of Antidepressants.
    (Res Sq, 2023-03-28) Witt, Colby E; Mena, Sergio; Holmes, Jordan; Hersey, Melinda; Buchanan, Anna Marie; Parke, Brenna; Saylor, Rachel; Honan, Lauren E; Berger, Shane N; Lumbreras, Sara; Nijhout, Frederik H; Reed, Michael C; Best, Janet; Fadel, James; Schloss, Patrick; Lau, Thorsten; Hashemi, Parastoo
    Depression pathology remains elusive. The monoamine hypothesis has placed much focus on serotonin, but due to the variable clinical efficacy of monoamine reuptake inhibitors, the community is looking for alternative therapies such as ketamine (synaptic plasticity and neurogenesis theory of antidepressant action). There is evidence that different classes of antidepressants may affect serotonin levels; a notion we test here. We measure hippocampal serotonin in mice with voltammetry and study the effects of acute challenges of antidepressants. We find that pseudo-equivalent doses of these drugs similarly raise ambient serotonin levels, despite their differing pharmacodynamics because of differences in Uptake 1 and 2, rapid SERT trafficking and modulation of serotonin by histamine. These antidepressants have different pharmacodynamics but have strikingly similar effects on extracellular serotonin. Our findings suggest that serotonin is a common thread that links clinically effective antidepressants, synergizing different theories of depression (synaptic plasticity, neurogenesis and the monoamine hypothesis).
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    The association between cognitive function and subsequent depression: a systematic review and meta-analysis.
    (Psychol Med, 2017-01) Scult, MA; Paulli, AR; Mazure, ES; Moffitt, TE; Hariri, AR; Strauman, TJ
    Despite a growing interest in understanding the cognitive deficits associated with major depressive disorder (MDD), it is largely unknown whether such deficits exist before disorder onset or how they might influence the severity of subsequent illness. The purpose of the present study was to conduct a systematic review and meta-analysis of longitudinal datasets to determine whether cognitive function acts as a predictor of later MDD diagnosis or change in depression symptoms. Eligible studies included longitudinal designs with baseline measures of cognitive functioning, and later unipolar MDD diagnosis or symptom assessment. The systematic review identified 29 publications, representing 34 unique samples, and 121 749 participants, that met the inclusion/exclusion criteria. Quantitative meta-analysis demonstrated that higher cognitive function was associated with decreased levels of subsequent depression (r = -0.088, 95% confidence interval. -0.121 to -0.054, p < 0.001). However, sensitivity analyses revealed that this association is likely driven by concurrent depression symptoms at the time of cognitive assessment. Our review and meta-analysis indicate that the association between lower cognitive function and later depression is confounded by the presence of contemporaneous depression symptoms at the time of cognitive assessment. Thus, cognitive deficits predicting MDD likely represent deleterious effects of subclinical depression symptoms on performance rather than premorbid risk factors for disorder.
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    The effects of depression and use of antidepressive medicines during pregnancy on the methylation status of the IGF2 imprinted control regions in the offspring.
    (Clinical epigenetics, 2011-10-26) Soubry, A; Murphy, Sk; Huang, Z; Murtha, A; Schildkraut, Jm; Jirtle, Rl; Wang, F; Kurtzberg, J; Demark-Wahnefried, W; Forman, Mr; Hoyo, C
    In utero exposures to environmental factors may result in persistent epigenetic modifications affecting normal development and susceptibility to chronic diseases in later life. We explored the relationship between exposure of the growing fetus to maternal depression or antidepressants and DNA methylation at two differentially methylated regions (DMRs) of the imprinted Insulin-like Growth Factor 2 (IGF2) gene. Aberrant DNA methylation at the IGF2 and neighboring H19 DMRs has been associated with deregulated IGF2 expression, childhood cancers and several chronic diseases during adulthood. Our study population is comprised of pregnant mothers and their newborns (n = 436), as part of the Newborn Epigenetics Study (NEST). A standardized questionnaire was completed and medical record data were abstracted to ascertain maternal depression and antidepressive drug use. DMR methylation levels in umbilical cord blood leukocytes were quantified using pyrosequencing. From the 436 newborns, laboratory data were obtained for 356 individuals at the IGF2 DMRs, and for 411 individuals at the H19 DMRs; about half of each group was African American or Caucasian. While overall no association between depression and methylation profiles was found, we observed a significant hypermethylation of the H19 DMRs in newborns of African American (n = 177) but not Caucasian (n = 168) mothers who reported the use of antidepressive drugs during pregnancy (β = +6.89, p = 0.01). Of note, our data reveal a race-independent association between smoking during pregnancy and methylation at the IGF2 DMR (+3.05%, p = 0.01). In conclusion, our findings suggest a race-dependent response related to maternal use of antidepressants at one of the IGF2 DMRs in the offspring.
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    Understanding Our Own Biology: The Relevance of Auto-Biological Attributions for Mental Health
    (Clinical Psychology: Science and Practice, 2017-03-01) MacDuffie, KE; Strauman, TJ
    As knowledge of the neurobiological basis of psychopathology has advanced, public perceptions have shifted toward conceptualizing mental disorders as disorders of biology. However, little is known about how patients respond to biological information about their own disorders. We refer to such information as auto-biological—describing our own biological systems as a component of our identity. Drawing on research from attribution theory, we explore the potential for auto-biological information to shape how patients view themselves in relation to their disorders. We propose an attributional framework for presenting auto-biological information in a way that encourages agency, rather than destiny. We argue that this framework has the potential to change expectations and improve outcomes in the treatment of psychiatric disorders.