Depression, depressive symptoms, and rate of hippocampal atrophy in a longitudinal cohort of older men and women

2015 ◽  
Vol 45 (9) ◽  
pp. 1931-1944 ◽  
Author(s):  
M. Elbejjani ◽  
R. Fuhrer ◽  
M. Abrahamowicz ◽  
B. Mazoyer ◽  
F. Crivello ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Age At Onset ◽  
Hippocampal Volume ◽  
Epidemiologic Studies ◽  
Linear Regression Models ◽  
Cerebral Magnetic Resonance Imaging ◽  
Unit Increase ◽  
History Of ◽  
Antidepressant Use ◽  
History Of Depression

BackgroundSeveral studies have reported smaller hippocampal volume (HcV) in depression patients; however, the temporality of the association remains unknown. One proposed hypothesis is that depression may cause HcV loss. This study evaluates whether previous depression and recent depressive symptoms are associated with HcV and HcV loss.MethodWe used a prospective cohort of older adults (n= 1328; age = 65–80 years) with two cerebral magnetic resonance imaging examinations at baseline and 4-year follow-up. Using multivariable linear regression models, we estimated, in stratified analyses by gender, the association between indicators of history of depression and its severity (age at onset, recurrence, hospitalization for depression), proximal depressive symptoms [Center for Epidemiologic Studies-Depression (CES-D) scale], baseline antidepressant use, and the outcomes: baseline HcV and annual percentage change in HcV.ResultsAt baseline, women with more depressive symptoms had smaller HcV [−0.05 cm3, 95% confidence interval (CI) −0.1 to −0.01 cm3per 10-unit increase in CES-D scores]. History of depression was associated with a 0.2% faster annual HcV loss in women (95% CI 0.01–0.36%). More baseline depressive symptoms and worsening of these symptoms were also associated with accelerated HcV loss in women. No associations were observed in men. Treatment for depression was associated with slower HcV loss in women and men.ConclusionsWhile only concomitant depressive symptoms were associated with HcV, both previous depression and more proximal depressive symptoms were associated with faster HcV loss in women.

Antidepressant use in Alzheimer's disease patients: results of the REAL.FR cohort

2009 ◽  
Vol 22 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Christophe Arbus ◽  
Virginie Gardette ◽  
Eric Bui ◽  
Christelle Cantet ◽  
Sandrine Andrieu ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Depressive Symptoms ◽  
Previous History ◽  
Natural Setting ◽  
Antidepressant Prescription ◽  
History Of ◽  
Antidepressant Use ◽  
Clinically Significant ◽  
History Of Depression

ABSTRACTBackground: Psychotropic medication is widely prescribed in clinical practice for the management of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). However, there have been few pharmaco-epidemiological studies or studies conducted in a natural setting on the real use of antidepressants in AD. The aim of this survey was to assess the prevalence of antidepressant use in AD and to identify the clinical factors associated with antidepressant prescription.Methods: REAL.FR is a four-year, prospective, multi-center study. Baseline data including demographic characteristics, clinical variables and drug intake were obtained. Depressive symptoms were determined using the Neuropsychiatric Inventory (NPI).Results: A total of 686 AD patients were included. Antidepressant treatment was prescribed for 34.8% of patients. Clinically significant depressive symptoms (NPI ≥ 4) were observed in 20.5% of the total population. Although depressed subjects were significantly more likely to be treated with antidepressants than non-depressed subjects (p<0.0001), only 60% of depressed subjects overall were prescribed an antidepressant. In multivariate analysis, clinically significant depressive symptoms were associated with antidepressant prescription although this result was only observed in subjects without a previous history of depression.Conclusions: The available data on antidepressant efficacy in BPSD other than depression (in particular, agitation, aggression and, occasionally, psychotic symptoms) do not influence prescription choices. Depressive symptoms may be taken more seriously in the absence of a previous history of depression, leading to increased antidepressant prescription rates in individuals presenting with depression for the first time.

scholarly journals Antidepressant treatment for primary care patients with depressive symptoms: Data from the diamond longitudinal cohort study

2020 ◽  
Vol 54 (4) ◽  
pp. 367-381
Author(s):  
Sandra K Davidson ◽  
Helena Romaniuk ◽  
Patty Chondros ◽  
Christopher Dowrick ◽  
Jane Pirkis ◽  
...  
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Antidepressant Treatment ◽  
Factors Associated ◽  
History Of ◽  
Primary Care Patients ◽  
General Practices ◽  
Antidepressant Use ◽  
History Of Depression

Background: In light of emerging evidence questioning the safety of antidepressants, it is timely to investigate the appropriateness of antidepressant prescribing. This study estimated the prevalence of possible over- and under-treatment with antidepressants among primary care attendees and investigated the factors associated with potentially inappropriate antidepressant use. Methods: In all, 789 adult primary care patients with depressive symptoms were recruited from 30 general practices in Victoria, Australia, in 2005 and followed up every 3 months in 2006 and annually from 2007 to 2011. For this study, we first assessed appropriateness of antidepressant use in 2007 at the 2-year follow-up to enable history of depression to be taken into account, providing 574 (73%) patients with five yearly assessments, resulting in a total of 2870 assessments. We estimated the prevalence of use of antidepressants according to the adapted National Institute for Health and Care Excellence guidelines and used regression analysis to identify factors associated with possible over- and under-treatment. Results: In 41% (243/586) of assessments where antidepressants were indicated according to adapted National Institute for Health and Care Excellence guidelines, patients reported not taking them. Conversely in a third (557/1711) of assessments where guideline criteria were unlikely to be met, participants reported antidepressant use. Being female and chronic physical illness were associated with antidepressant use where guideline criteria were not met, but no factors were associated with not taking antidepressants where guideline criteria were met. Conclusions: Much antidepressant treatment in general practice is for people with minimal or mild symptoms, while people with moderate or severe depressive symptoms may miss out. There is considerable scope for improving depression care through better allocation of antidepressant treatment.

Italian Bipolar II vs I patients have better individual functioning, in spite of overall similar illness severity

CNS Spectrums ◽  
2016 ◽  
Vol 22 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Bernardo Dell’Osso ◽  
Cristina Dobrea ◽  
Laura Cremaschi ◽  
Massimiliano Buoli ◽  
Shefali Miller ◽  
...  
Keyword(s):  
Stressful Life Events ◽  
Suicide Attempts ◽  
Age At Onset ◽  
Bipolar Disorders ◽  
Severe Illness ◽  
Text Revision ◽  
Duration Of Illness ◽  
Lifetime Number ◽  
History Of ◽  
Antidepressant Use

IntroductionBipolar disorders (BDs) comprise different variants of chronic, comorbid, and disabling conditions, with relevant suicide and suicide attempt rates. The hypothesis that BD types I (BDI) and II (BDII) represent more and less severe forms of illness, respectively, has been increasingly questioned over recent years, justifying additional investigation to better characterize related sociodemographic and clinical profiles.MethodsA sample of 217 outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR)–described BD (141 BDI, 76 BDII), without a current syndromal mood episode, was recruited, and sociodemographic and clinical characteristics of BDI and II patients were compared.ResultsBDII patients had significantly more favorable sociodemographics, in relation to occupational stability, cohabitation, and marital status. However, BDII compared with BDI patients had significantly longer duration of untreated illness, more frequent lifetime anxiety disorders comorbidity, longer most recent episode duration, higher rate of depressive first/most recent episode, and more current antidepressant use. In contrast, BDI compared with BDII patients had significantly more severe illness in terms of earlier age at onset; higher rate of elevated first/most recent episode, lifetime hospitalizations, and involuntary commitments; lower Global Assessment of Functioning score; and more current antipsychotic use. BDI and II patients had similar duration of illness, psychiatric family history, lifetime number of suicide attempts, current subthreshold symptoms, history of stressful life events, and overall psychiatric/medical comorbidity.ConclusionBDII compared with BDI patients had more favorable sociodemographic features, but a mixture of specific unfavorable illness characteristics, confirming that BDII is not just a milder form of BD and requires further investigation in the field.

Evaluating depression and suicidality in tetrabenazine users with Huntington disease

Neurology ◽  
2018 ◽  
Vol 91 (3) ◽  
pp. e202-e207 ◽  
Author(s):  
Jordan L. Schultz ◽  
Annie Killoran ◽  
Peg C. Nopoulos ◽  
Chloe C. Chabal ◽  
David J. Moser ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Huntington Disease ◽  
Cross Sectional Study ◽  
Cag Repeat ◽  
Cross Sectional ◽  
Increased Risk ◽  
History Of ◽  
Antidepressant Use ◽  
History Of Depression ◽  
Total Functional Capacity

ObjectiveTo determine whether tetrabenazine (TBZ) use is associated with an increased incidence of depression and/or suicidal ideation.MethodsIn this retrospective cross-sectional study of the Enroll-HD database, we used multiple logistic regression analyses to determine whether TBZ use is associated with an increased incidence of depression and/or suicidal ideation. For both dependent variables (depression and suicidality), separate analyses were conducted on (1) all participants, (2) only participants with a history of depression, and (3) only participants with no history of depression. Adjustments were made for CAG repeat length, total motor score, total functional capacity, Symbol Digit Modalities Test score, sex, disease duration, history of depression (when applicable), antipsychotic use, and antidepressant use.ResultsCompared to participants who were not using TBZ (n = 3,548), TBZ users (n = 543) did not have an increased risk of depression (odds ratio [OR] = 0.78, p = 0.064). Participants taking TBZ actually had a relatively lower risk of suicidality (OR = 0.61, p = 0.043). Among only participants with a history of depression, those using TBZ had a lower incidence of depression (OR = 0.71, p = 0.016) and suicidal ideation (OR = 0.57, p = 0.028) compared to those not using TBZ. Finally, among only participants with no history of depression, TBZ use was not associated with a higher incidence of depression (OR = 1.59, p = 0.18) or suicidality (OR = 1.43, p = 0.66) compared to those who were not using TBZ.ConclusionsTBZ use was not associated with an increased incidence of depression or suicidality. These findings suggest that TBZ may be safe to use in patients with Huntington disease who have a history of depression.

Abstract P543: Association Of Tanning Bed Use With Depression In A Preventive Medicine Cohort: The Cooper Center Longitudinal Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Katie Kinser ◽  
Beth B Wright ◽  
David Leonard ◽  
Laura F Defina
Keyword(s):  
Depressive Symptoms ◽  
Preventive Medicine ◽  
Personal History ◽  
Healthy Population ◽  
Cross Sectional ◽  
Tanning Beds ◽  
Increased Risk ◽  
Tanning Bed ◽  
History Of ◽  
History Of Depression

Importance: The use of tanning beds continues despite evidence of increased skin cancer risk among users. In the US, the prevalence of indoor tanning ranges from 35% of adults to 59% of college students. Objective: To investigate the association between depressive symptoms and tanning bed use. Design: Cross-sectional study. Setting: A preventive medicine clinic in Dallas, Texas. Participants: Between September 2013 and June 2019, a total of 11,823 generally healthy men and women presented for preventive medical examinations. Exposure: Self-reported tanning bed use. Main Outcome and Measures: Depressive symptoms as indicated by a score of greater than or equal to 10 on the Center for Epidemiologic Studies Depression (CES-D) Scale. Results: Fifteen percent of participants had used a tanning bed prior to their examination. For men, tanning bed use was associated with an increased risk of depressive symptoms (OR: 1.86; 95% CI:1.41-2.44). For women, the association between the use of tanning beds and depressive symptoms was significant in an unadjusted model, but was no longer significant after adjustment for confounders (OR: 1.26; 95% CI:0.99-1.61). However, the odds ratio was still in the direction of increased risk. Women with a personal history of depression were more likely to tan frequently and have higher CES-D scores than women with no personal history of depression ( p = .003). Conclusions and Relevance: In a generally healthy population, depressive symptoms were associated with the use of a tanning bed. This association was more evident in those with a history of depression, although remained true for those without a history of depression. As recurrent tanning bed use is known to contribute to the diagnosis of melanoma, it is critical to help patients identify other options to treat depression as well as to educate them on the risks of routine tanning bed use.

History of depression, depressive symptoms, and medial temporal lobe atrophy and the risk of Alzheimer disease

Neurology ◽  
2008 ◽  
Vol 70 (15) ◽  
pp. 1258-1264 ◽  
Author(s):  
M. I. Geerlings ◽  
T. den Heijer ◽  
P. J. Koudstaal ◽  
A. Hofman ◽  
M.M.B. Breteler
Keyword(s):  
Depressive Symptoms ◽  
Alzheimer Disease ◽  
Temporal Lobe ◽  
Medial Temporal Lobe ◽  
Medial Temporal Lobe Atrophy ◽  
History Of ◽  
History Of Depression ◽  
Lobe Atrophy

scholarly journals Acceptability and feasibility of two interventions in the MooDFOOD Trial: a food-related depression prevention randomised controlled trial in overweight adults with subsyndromal symptoms of depression

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e034025
Author(s):  
Matthew Owens ◽  
Edward Watkins ◽  
Mariska Bot ◽  
Ingeborg Annemarie Brouwer ◽  
Miquel Roca ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Depression Prevention ◽  
History Of ◽  
Randomised Controlled ◽  
Subsyndromal Symptoms ◽  
Overweight Adults ◽  
History Of Depression

ObjectivesWe report on the acceptability, feasibility, dose-response relationship and adherence of two nutritional strategies to improve mood (multinutrient supplements; food-related behavioural activation (F-BA)) studied in a randomised controlled depression prevention trial (the Multi‐country cOllaborative project on the rOle of Diet, Food‐related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Trial). We also assessed baseline determinants of adherence and assessed whether better adherence resulted in lower depressive symptoms.DesignRandomised controlled trial with a 2×2 factorial design conducted between 2015 and 2017.SettingGermany, the Netherlands, UK and Spain.ParticipantsCommunity sample of 1025 overweight adults with elevated depressive symptoms without a current episode of major depressive disorder. Main eligibility criteria included age (18–75 years), being overweight or obese, and having at least mild depressive symptoms, shown by a Patient Health Questionnaire Score of ≥5. A total of 76% of the sample was retained at the 12-month follow-up.InterventionsDaily nutritional supplements versus pill placebo or an F-BA therapy, delivered in individual and group sessions versus no behavioural intervention over a 1-year period.Primary and secondary outcome measuresPrimary outcome: self-reported acceptability of the interventions. Secondary outcomes: adherence and self-reported depressive symptoms.ResultsMost participants reported that the F-BA was acceptable (83.61%), feasible to do (65.91%) and would recommend it to a friend (84.57%). Individual F-BA sessions (88.10%) were significantly more often rated as positive than group F-BA sessions (70.17%) and supplements (28.59%). There were statistically significant reductions in depressive symptoms for those who both adhered to the F-BA intervention and had a history of depression (B=−0.08, SE=0.03, p=0.012) versus those who had no history of depression. Supplement intake had no effect on depressive symptoms irrespective of adherence.ConclusionsF-BA may have scope for development as a depression prevention intervention and public health strategy but further refinement and testing are needed.Trial registration numberNCT02529423.

Patterns of antidepressant use in patients with cancer: An analysis from SOAPP (E2Z02: Symptom Outcomes and Practice Patterns).

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 59-59
Author(s):  
Michael Fisch ◽  
Fengmin Zhao ◽  
Judith Manola ◽  
Andrew H. Miller ◽  
William F. Pirl ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Hormonal Treatment ◽  
Current Treatment ◽  
Case Finding ◽  
Logistic Regression Models ◽  
Depression Status ◽  
History Of ◽  
Antidepressant Use ◽  
Patient’S Perception ◽  
Type Of Institution

59 Background: Antidepressant (AD) use is common in outpatient oncology, but the pattern and determinants of prescribing for commonly used AD are unknown. Methods: 3,106 pts with cancer of the breast, prostate, colon/rectum, or lung were enrolled from multiple sites in a study of symptoms. Five depression case-finding methods were explored: 3 based on MDASI items reported by patients (1) sadness/depression>=4, (2) distress>=4, (3) interference with mood>=7 or enjoyment>=7; 2 based on clinician’s report (4) presence of psychological distress, (5) depression being listed as one of top 3 symptoms. AD use (excluding tricyclic antidepressants and psychostimulants) was examined by depression status. Logistic regression models were used to examine the effect of demographic and clinical characteristics on AD use. Results: Rates of depressive symptoms varied by casefinding method (1=29%, 2=28%, 3=14%, 4=24%, 5=11%); 47% (1,457) pts were defined as having depressive symptoms by at least one method. AD were prescribed in 25% of depressed pts compared to 14% of non-depressed pts. After adjusting for other covariates, factors associated with greater use of AD included depression (OR=1.7, p<0.01), family history of depression (OR=2.2, p<0.01), female sex (OR=1.8, P<0.01), younger age (OR=1.2, P=0.04), non-Hispanic White race (OR=2.0, p<0.01), prior chemo/immune/ hormonal treatment (OR=1.5, p<0.01), more concurrent medication use (OR=3.3, p<0.01), anxiolytics use (OR=2.0, p<0.01), sedative use (OR=2.1, p<0.01), receiving counseling (OR=1.6, p=0.04), patient’s perception of poor QOL (OR=1.3, p=0.02), duration of current treatment >1 year (OR=1.6, p<0.01), and being enrolled by a CCOP (OR=1.8, p=0.01). These significant associations remained regardless of the case-finding method used for depression. Conclusions: One-fourth of solid tumor pts with depressive symptoms are taking an AD. Antidepressant prescribing varies by type of institution, race/ethnicity, age, concomitant medication exposure and several other clinical factors. There is an opportunity to improve outcomes through quality improvement initiatives related to antidepressant prescribing.

Psychiatric Phenomena in Alzheimer's Disease. III: Disorders of Mood

1990 ◽  
Vol 157 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Alistair Burns ◽  
Robin Jacoby ◽  
Raymond Levy
Keyword(s):  
Alzheimer’S Disease ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Previous History ◽  
Ventricular Enlargement ◽  
Trained Observer ◽  
History Of ◽  
Interhemispheric Fissure ◽  
History Of Depression

Of 178 patients with AD, at least one depressive symptom was reported by 63%, 24% were rated as being depressed by a trained observer, and 43% were considered depressed by their relatives. Ten per cent had a previous history of depression. Elevated mood was rare, occurring in only six patients (3.5%). Subjects with depressive symptoms had less cognitive impairment and less ventricular enlargement on CT compared with those without symptoms. Widening of the interhemispheric fissure was associated with symptoms of mania but was inversely related to presence of depressive symptoms.

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