Patterns of negative affective biases associated with depressive symptoms and during remission in large community-based sample

Background: Major Depressive Disorder (MDD) is associated with negative affective cognitive biases. Differences on population level however remain unclear, including whether they normalise with remission. This study investigated associations between affective cognition and MDD within a large community-based sample.Methods: Participants from Generation Scotland (N=1,179) completed three affective tasks: (i) Bristol Emotion Recognition Task (BERT), (ii) Face Affective Go/No-go (FAGN), and (iii) Cambridge Gambling Task (CGT). After exclusions, individuals were classified as MDD-current (n=43), MDD-remitted (n=282), or non-MDD controls (n=784). Main analyses tested for hypothesised associations between affective bias summary measures and depressive symptoms, and for differences in affective biases between MDD-remitted versus non-MDD subjects. Exploratory analyses examined responses per task condition in more detail.Results: We found an association between greater depressive symptom severity and lower risk adjustment (CGT win, standardised coefficient =-0.02, p=0.03). This was attenuated when non-affective cognition (g) was accounted for, or when restricting analysis to those not currently taking antidepressant medication. Main analysis revealed no further clear evidence of affective biases, neither for MDD-remitted individuals. Exploratory analyses however suggested more subtle negative biases associated with depressive symptoms.Conclusions: Individuals with high depressive ratings were less likely to bet more despite increasingly favourable win conditions, which may indicate lower reward motivation, but could also be explained by lower non-affective cognitive functioning. Overall, results from this community-based sample showed limited evidence for overarching cognitive affective differences in MDD, though subtle negative biases related to current symptom severity suggested by exploratory analyses across the whole sample.

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Relationship between depressive symptom severity and amygdala volume in a large community-based sample

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2018.12.005 ◽

2019 ◽

Vol 283 ◽

pp. 77-82 ◽

Cited By ~ 1

Author(s):

Shivani Daftary ◽

Erin Van Enkevort ◽

Alexandra Kulikova ◽

Michael Legacy ◽

E. Sherwood Brown

Keyword(s):

Depressive Symptom ◽

Symptom Severity ◽

Community Based ◽

Large Community ◽

Depressive Symptom Severity ◽

Amygdala Volume

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The contribution of depressive ‘disorder characteristics’ to determinations of prognosis for adults with depression: an individual patient data meta-analysis

Psychological Medicine ◽

10.1017/s0033291721001367 ◽

2021 ◽

pp. 1-14

Author(s):

Joshua E. J. Buckman ◽

Rob Saunders ◽

Zachary D. Cohen ◽

Phoebe Barnett ◽

Katherine Clarke ◽

...

Keyword(s):

Primary Care ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Panic Disorder ◽

Symptom Severity ◽

Individual Patient Data ◽

Antidepressant Treatment ◽

Patient Data ◽

History Of ◽

Depressive Symptom Severity

Abstract Background This study aimed to investigate general factors associated with prognosis regardless of the type of treatment received, for adults with depression in primary care. Methods We searched Medline, Embase, PsycINFO and Cochrane Central (inception to 12/01/2020) for RCTs that included the most commonly used comprehensive measure of depressive and anxiety disorder symptoms and diagnoses, in primary care depression RCTs (the Revised Clinical Interview Schedule: CIS-R). Two-stage random-effects meta-analyses were conducted. Results Twelve (n = 6024) of thirteen eligible studies (n = 6175) provided individual patient data. There was a 31% (95%CI: 25 to 37) difference in depressive symptoms at 3–4 months per standard deviation increase in baseline depressive symptoms. Four additional factors: the duration of anxiety; duration of depression; comorbid panic disorder; and a history of antidepressant treatment were also independently associated with poorer prognosis. There was evidence that the difference in prognosis when these factors were combined could be of clinical importance. Adding these variables improved the amount of variance explained in 3–4 month depressive symptoms from 16% using depressive symptom severity alone to 27%. Risk of bias (assessed with QUIPS) was low in all studies and quality (assessed with GRADE) was high. Sensitivity analyses did not alter our conclusions. Conclusions When adults seek treatment for depression clinicians should routinely assess for the duration of anxiety, duration of depression, comorbid panic disorder, and a history of antidepressant treatment alongside depressive symptom severity. This could provide clinicians and patients with useful and desired information to elucidate prognosis and aid the clinical management of depression.

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A randomized trial of aerobic exercise for major depression: examining neural indicators of reward and cognitive control as predictors and treatment targets

Psychological Medicine ◽

10.1017/s0033291720002573 ◽

2020 ◽

pp. 1-11 ◽

Cited By ~ 1

Author(s):

C. J. Brush ◽

Greg Hajcak ◽

Anthony J. Bocchine ◽

Andrew A. Ude ◽

Kristina M. Muniz ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Major Depression ◽

Cognitive Control ◽

Aerobic Exercise ◽

Symptom Severity ◽

Reward Processing ◽

Symptom Reduction ◽

Depressive Symptom Severity ◽

Pre Treatment

Abstract Background Aerobic exercise has demonstrated antidepressant efficacy among adults with major depression. There is a poor understanding of the neural mechanisms associated with these effects. Deficits in reward processing and cognitive control may be two candidate targets and predictors of treatment outcome to exercise in depression. Methods Sixty-six young adults aged 20.23 years (s.d. = 2.39) with major depression were randomized to 8 weeks of moderate-intensity aerobic exercise (n = 35) or light stretching (n = 31). Depressive symptoms were assessed across the intervention to track symptom reduction. Reward processing [reward positivity (RewP)] and cognitive control [error-related negativity (ERN)] were assessed before and after the intervention using event-related brain potentials. Results Compared to stretching, aerobic exercise resulted in greater symptom reduction (gs = 0.66). Aerobic exercise had no impact on the RewP (gav = 0.08) or ERN (gav = 0.21). In the aerobic exercise group, individuals with a larger pre-treatment RewP [odds ratio (OR) = 1.45] and increased baseline depressive symptom severity (OR = 1.18) were more likely to respond to an aerobic exercise program. Pre-treatment ERN did not predict response (OR = 0.74). Conclusions Aerobic exercise is effective in alleviating depressive symptoms in adults with major depression, particularly for those with increased depressive symptom severity and a larger RewP at baseline. Although aerobic exercise did not modify the RewP or ERN, there is preliminary support for the utility of the RewP in predicting who is most likely to respond to exercise as a treatment for depression.

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Protective effect of sex on chronic stress- and depressive behavior-induced vascular dysfunction in BALB/cJ mice

Journal of Applied Physiology ◽

10.1152/japplphysiol.00537.2014 ◽

2014 ◽

Vol 117 (9) ◽

pp. 959-970 ◽

Cited By ~ 24

Author(s):

Shyla C. Stanley ◽

Steven D. Brooks ◽

Joshua T. Butcher ◽

Alexandre C. d'Audiffret ◽

Stephanie J. Frisbee ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Chronic Stress ◽

Symptom Severity ◽

Plasma Cortisol ◽

Depressive Disorders ◽

Subsequent Development ◽

Female Rats ◽

Mild Stress ◽

Depressive Symptom Severity

The presence of chronic, unresolvable stresses leads to negative health outcomes, including development of clinical depression/depressive disorders, with outcome severity being correlated with depressive symptom severity. One of the major outcomes associated with chronic stress and depression is the development of cardiovascular disease (CVD) and an elevated CVD risk profile. However, in epidemiological research, sex disparities are evident, with premenopausal women suffering from depressive symptoms more acutely than men, but also demonstrating a relative protection from the onset of CVD. Given this, we investigated the differential effect of sex on conduit artery and resistance arteriolar function in male and female mice following 8 wk of an unpredictable chronic mild stress (UCMS) protocol. In males, plasma cortisol and depressive symptom severity (e.g., coat status, anhedonia, delayed grooming) were elevated by UCMS. Endothelium-dependent dilation to methacholine/acetylcholine was impaired in conduit arteries and skeletal muscle arterioles, suggesting a severe loss of nitric oxide bioavailability and increased production of thromboxane A2 vs. prostaglandin I2 associated with elevated reactive oxygen species (ROS) and an increased level of systemic inflammation. Endothelium-independent dilation was intact. In females, depressive symptoms and plasma cortisol increases were more severe than in males, although alterations to vascular reactivity were blunted, including the effects of elevated ROS and inflammation on dilator responses. These results suggest that compared with males, female rats are more susceptible to chronic stress in terms of the severity of depressive behaviors, but that the subsequent development of vasculopathy is blunted owing to an improved ability to tolerate elevated ROS and systemic inflammatory stress.

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Blunted medial prefrontal cortico-limbic reward-related effective connectivity and depression

Brain ◽

10.1093/brain/awaa106 ◽

2020 ◽

Vol 143 (6) ◽

pp. 1946-1956 ◽

Cited By ~ 3

Author(s):

Samuel Rupprechter ◽

Liana Romaniuk ◽

Peggy Series ◽

Yoriko Hirose ◽

Emma Hawkins ◽

...

Keyword(s):

Prefrontal Cortex ◽

Basal Ganglia ◽

Medial Prefrontal Cortex ◽

Symptom Severity ◽

Effective Connectivity ◽

Reward Learning ◽

Community Based ◽

Major Depressive ◽

Mood Symptoms ◽

Depressive Symptom Severity

Abstract Major depressive disorder is a leading cause of disability and significant mortality, yet mechanistic understanding remains limited. Over the past decade evidence has accumulated from case-control studies that depressive illness is associated with blunted reward activation in the basal ganglia and other regions such as the medial prefrontal cortex. However it is unclear whether this finding can be replicated in a large number of subjects. The functional anatomy of the medial prefrontal cortex and basal ganglia has been extensively studied and the former has excitatory glutamatergic projections to the latter. Reduced effect of glutamatergic projections from the prefrontal cortex to the nucleus accumbens has been argued to underlie motivational disorders such as depression, and many prominent theories of major depressive disorder propose a role for abnormal cortico-limbic connectivity. However, it is unclear whether there is abnormal reward-linked effective connectivity between the medial prefrontal cortex and basal ganglia related to depression. While resting state connectivity abnormalities have been frequently reported in depression, it has not been possible to directly link these findings to reward-learning studies. Here, we tested two main hypotheses. First, mood symptoms are associated with blunted striatal reward prediction error signals in a large community-based sample of recovered and currently ill patients, similar to reports from a number of studies. Second, event-related directed medial prefrontal cortex to basal ganglia effective connectivity is abnormally increased or decreased related to the severity of mood symptoms. Using a Research Domain Criteria approach, data were acquired from a large community-based sample of subjects who participated in a probabilistic reward learning task during event-related functional MRI. Computational modelling of behaviour, model-free and model-based functional MRI, and effective connectivity dynamic causal modelling analyses were used to test hypotheses. Increased depressive symptom severity was related to decreased reward signals in areas which included the nucleus accumbens in 475 participants. Decreased reward-related effective connectivity from the medial prefrontal cortex to striatum was associated with increased depressive symptom severity in 165 participants. Decreased striatal activity may have been due to decreased cortical to striatal connectivity consistent with glutamatergic and cortical-limbic related theories of depression and resulted in reduced direct pathway basal ganglia output. Further study of basal ganglia pathophysiology is required to better understand these abnormalities in patients with depressive symptoms and syndromes.

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Absenteeism and associated labour costs according to depressive symptom severity in the German general population: why preventive strategies matter

International Archives of Occupational and Environmental Health ◽

10.1007/s00420-021-01788-7 ◽

2021 ◽

Author(s):

Roland Eßl-Maurer ◽

Maria Flamm ◽

Katharina Hösl ◽

Jürgen Osterbrink ◽

Antje van der Zee-Neuen

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Sick Leave ◽

Symptom Severity ◽

Health Condition ◽

Economic Consequences ◽

Cross Sectional ◽

Men And Women ◽

Labour Costs ◽

Depressive Symptom Severity

Abstract Purpose Depression is a highly prevalent mental health condition with substantial individual, societal and economic consequences. This study focussed on the association of depressive symptom severity with absenteeism duration and employer labour costs. Methods Using cross-sectional data from the German Health Update 2014/2015, multivariable zero-inflated Poisson regression (ZIP) models explored the association of depressive symptom severity (8-item depression patient health questionnaire—PHQ-8), with absenteeism weeks during 12 months in men and women working full- or part-time. The predicted sick leave weeks were multiplied by mean average labour costs. Results The sample consisted of 12,405 persons with an average sick leave of 1.89 weeks (SD 4.26). Fifty-four % were women and 57% were between 40 and 59 years of age. In men and women, mild, moderate, moderately severe and severe depressive symptoms were associated with a significant factor increase in sick leave weeks compared to persons with no or minimal symptoms. Labour costs increased with increasing symptom severity from € 1468.22 for men with no or minimal depressive symptoms to € 7190.25 for men with severe depressive symptoms and from € 1045.82 to € 4306.30 in women, respectively. Conclusion The present results indicate that increasing depressive symptom severity is associated with increasing absenteeism and employer costs. They emphasize the need for implementation, realignment or extension of professional work-site health promotion programmes aiming at the improvement and maintenance of employee health and the reduction of labour costs associated with depression-related sick leave.

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The bipolarity of affect and depressive symptoms

10.31219/osf.io/ft3za ◽

2018 ◽

Author(s):

Egon Dejonckheere ◽

Merijn Mestdagh ◽

Marlies Houben ◽

Yasemin Erbas ◽

Madeline Pe ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Negative Affect ◽

Symptom Severity ◽

Depressive Symptomatology ◽

Emotional Experience ◽

Well Being ◽

Positive And Negative Affect ◽

Sampling Studies ◽

Depressive Symptom Severity

People differ in the extent to which they experience positive (PA) and negative affect (NA) rather independently or as bipolar opposites. Here, we examine the proposition that the nature of the relation between positive and negative affect in a person’s emotional experience is indicative of psychological well-being, in particular the experience of depressive symptoms, typically characterized by diminished positive affect (anhedonia) and increased negative affect (depressed mood). In three experience sampling studies, we examine how positive and negative affective states are related within people’s emotional experience in daily life and how the degree of bipolarity of this relation is associated with depressive symptom severity. In Study 1 and 2, we show both concurrently and longitudinally that a stronger bipolar PA-NA relationship is associated with, and in fact is predicted by, higher depressive symptom severity, even after controlling for mean levels of positive and negative affect. In Study 3, we replicate these findings in a daily diary design, with the two conceptually related main symptoms of depression, sadness and anhedonia, as specific manifestations of high NA and low PA, respectively. Across studies, additional analyses indicate these results are robust across different timescales and various PA and NA operationalizations and that affective bipolarity shows particular specificity towards depressive symptomatology, in comparison with anxiety symptoms. Together, these findings demonstrate that depressive symptoms involve stronger bipolarity between positive and negative affect, reflecting reduced emotional complexity and flexibility.

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Longitudinal brain changes in MDD during emotional encoding: effects of presence and persistence of symptomatology

Psychological Medicine ◽

10.1017/s0033291719001259 ◽

2019 ◽

Vol 50 (8) ◽

pp. 1316-1326 ◽

Cited By ~ 2

Author(s):

Hui Ai ◽

Esther M. Opmeer ◽

Jan-Bernard C. Marsman ◽

Dick J. Veltman ◽

Nic J. A. van der Wee ◽

...

Keyword(s):

Depressive Symptoms ◽

Symptom Severity ◽

Recognition Task ◽

Brain Activation ◽

Emotional Memory ◽

Symptomatic Improvement ◽

Memory Formation ◽

State Dependency ◽

State Dependent ◽

Over Time

AbstractBackgroundThe importance of the hippocampus and amygdala for disrupted emotional memory formation in depression is well-recognized, but it remains unclear whether functional abnormalities are state-dependent and whether they are affected by the persistence of depressive symptoms.MethodsThirty-nine patients with major depressive disorder and 28 healthy controls were included from the longitudinal functional magnetic resonance imaging (fMRI) sub-study of the Netherlands Study of Depression and Anxiety. Participants performed an emotional word-encoding and -recognition task during fMRI at baseline and 2-year follow-up measurement. At baseline, all patients were in a depressed state. We investigated state-dependency by relating changes in brain activation over time to changes in symptom severity. Furthermore, the effect of time spent with depressive symptoms in the 2-year interval was investigated.ResultsSymptom change was linearly associated with higher activation over time of the left anterior hippocampus extending to the amygdala during positive and negative word-encoding. Especially during positive word encoding, this effect was driven by symptomatic improvement. There was no effect of time spent with depression in the 2-year interval on change in brain activation. Results were independent of medication- and psychotherapy-use.ConclusionUsing a longitudinal within-subjects design, we showed that hippocampal–amygdalar activation during emotional memory formation is related to depressive symptom severity but not persistence (i.e. time spent with depression or ‘load’), suggesting functional activation patterns in depression are not subject to functional ‘scarring’ although this hypothesis awaits future replication.

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CAREGIVER DEPRESSIVE SYMPTOM SEVERITY AMONG OLDER ADULTS WITH COGNITIVE VULNERABILITY

Innovation in Aging ◽

10.1093/geroni/igz038.1416 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S385-S386

Author(s):

Richard H Fortinsky ◽

Dorothy Wakefield

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Depressive Symptom ◽

Symptom Severity ◽

Cognitive Vulnerability ◽

Family Members ◽

Depression Scale ◽

Cognitive Status ◽

Cognitive Symptom ◽

Depressive Symptom Severity

Abstract While caregivers of older adults with dementia often report considerable levels of depressive symptoms, much less is known about depressive symptoms among family members of older adults with depression or recent delirium. As part of an ongoing randomized clinical trial testing an in-home multidisciplinary team intervention for older adults with cognitive vulnerability due to dementia, depression, and/or delirium (care recipients, or CR) and their caregivers, in this presentation we report baseline data from the first 211 dyads enrolled in the trial to determine how caregiver depressive symptom severity is related to: CR diagnoses; CR cognitive impairment severity; and CR depressive symptom severity. CR diagnostic groups: Depression Only (n=49); Dementia Only (n=61); Depression and Dementia Only (n=47); Delirium Plus (n=54). Depressive symptom severity was measured using the Center for Epidemiologic Studies Depression Scale; CR cognitive symptom severity was measured using the Telephone Interview for Cognitive Status. Among CR, 57% were female, mean/sd age=77/6.9, 93% White; among caregivers, 64% were female, mean/sd age=66/13.7, 91% White, 55% spouses, 25% daughters, 9% sons. In multivariate linear regression models, which included covariates caregiver gender, relationship to CR, and number of hours/week providing care, we found that caregiver depressive symptom severity was less severe among caregivers of CR with Dementia Only compared to CR with Depression Only (b=-3.32; p=0.06); not associated with CR cognitive symptom severity; and significantly associated with CR depressive symptom severity (b=0.14; p<0.01). We conclude that family members of older adults with depression deserve greater attention to address their own depressive symptoms.

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Peer Relationships and Depressive Symptoms Among Adolescents: Results From the German BELLA Study

Frontiers in Psychology ◽

10.3389/fpsyg.2021.767922 ◽

2022 ◽

Vol 12 ◽

Author(s):

Adekunle Adedeji ◽

Christiane Otto ◽

Anne Kaman ◽

Franziska Reiss ◽

Janine Devine ◽

...

Keyword(s):

Depressive Symptoms ◽

Depressive Symptom ◽

Peer Relationships ◽

Symptom Severity ◽

Regression Models ◽

Peer Acceptance ◽

Linear Regression Models ◽

Bella Study ◽

Depressive Symptom Severity

Background: Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of peer relationships as a predictor of depressive symptom severity of adolescents in Germany.Method: Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14–17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships.Result: The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents’ peer relationships (F(1,444) = 125.65, p < 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in R2 = 0.05; Change in F = 27.01, p < 0.001). The gender-specific analysis shows different trends for boys and girls.Conclusion: The quality of peer relationships is a significant predictor of adolescents’ depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany’s adolescent population.

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