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

2020 ◽  
pp. 1-11 ◽  
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.

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

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.

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

2014 ◽  
Vol 117 (9) ◽  
pp. 959-970 ◽  
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.

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

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.

scholarly journals The bipolarity of affect and depressive symptoms

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.

scholarly journals CAREGIVER DEPRESSIVE SYMPTOM SEVERITY AMONG OLDER ADULTS WITH COGNITIVE VULNERABILITY

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.

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2019 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2020 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 15 RCTs met inclusion criteria. The Dep-GP database will include the 6271 participants from the 13 studies that provided IPD. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

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

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.

scholarly journals What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database

2019 ◽  
Vol 4 ◽  
pp. 69
Author(s):  
Joshua E.J. Buckman ◽  
Rob Saunders ◽  
Zachary D. Cohen ◽  
Katherine Clarke ◽  
Gareth Ambler ◽  
...  
Keyword(s):  
Social Support ◽  
Depressive Symptom ◽  
Life Events ◽  
Symptom Severity ◽  
Individual Patient Data ◽  
Inclusion Criteria ◽  
Related Factors ◽  
History Of ◽  
Depressive Symptom Severity ◽  
Pre Treatment

Background: Pre-treatment severity is a key indicator of prognosis for those with depression. Knowledge is limited on how best to encompass severity of disorders. A number of non-severity related factors such as social support and life events are also indicators of prognosis. It is not clear whether this holds true after adjusting for pre-treatment severity as a) a depressive symptom scale score, and b) a broader construct encompassing symptom severity and related indicators: “disorder severity”. In order to investigate this, data from the individual participants of clinical trials which have measured a breadth of “disorder severity” related factors are needed. Aims: 1) To assess the association between outcomes for adults seeking treatment for depression and the severity of depression pre-treatment, considered both as i) depressive symptom severity only and ii) “disorder severity” which includes depressive symptom severity and comorbid anxiety, chronicity, history of depression, history of previous treatment, functional impairment and health-related quality of life. 2) To determine whether i) social support, ii) life events, iii) alcohol misuse, and iv) demographic factors (sex, age, ethnicity, marital status, employment status, level of educational attainment, and financial wellbeing) are prognostic indicators of outcomes, independent of baseline “disorder severity” and the type of treatment received. Methods: Databases were searched for randomised clinical trials (RCTs) that recruited adults seeking treatment for depression from their general practitioners and used the same diagnostic and screening instrument to measure severity at baseline – the Revised Clinical Interview Schedule; outcome measures could differ between studies. Chief investigators of all studies meeting inclusion criteria were contacted and individual patient data (IPD) were requested. Conclusions: In total 13 RCTs were found to meet inclusion criteria. The Dep-GP database was formed from the 6271 participants. This protocol outlines how these data will be analysed. Registration: PROSPERO CRD42019129512 (01/04/2019)

scholarly journals Protection from vascular dysfunction in female rats with chronic stress and depressive symptoms

2018 ◽  
Vol 314 (5) ◽  
pp. H1070-H1084 ◽  
Author(s):  
Steven D. Brooks ◽  
Stanley M. Hileman ◽  
Paul D. Chantler ◽  
Samantha A. Milde ◽  
Kent A. Lemaster ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptom ◽  
Chronic Stress ◽  
Symptom Severity ◽  
Vascular Reactivity ◽  
Vascular Dysfunction ◽  
Sex Hormone ◽  
Female Rats ◽  
Depressive Symptom Severity ◽  
Female Subjects

The increasing prevalence and severity of clinical depression are strongly correlated with vascular disease risk, creating a comorbid condition with poor outcomes but demonstrating a sexual disparity whereby female subjects are at lower risk than male subjects for subsequent cardiovascular events. To determine the potential mechanisms responsible for this protection against stress/depression-induced vasculopathy in female subjects, we exposed male, intact female, and ovariectomized (OVX) female lean Zucker rats to the unpredictable chronic mild stress (UCMS) model for 8 wk and determined depressive symptom severity, vascular reactivity in ex vivo aortic rings and middle cerebral arteries (MCA), and the profile of major metabolites regulating vascular tone. While all groups exhibited severe depressive behaviors from UCMS, severity was significantly greater in female rats than male or OVX female rats. In all groups, endothelium-dependent dilation was depressed in aortic rings and MCAs, although myogenic activation and vascular (MCA) stiffness were not impacted. Higher-resolution results from pharmacological and biochemical assays suggested that vasoactive metabolite profiles were better maintained in female rats with normal gonadal sex steroids than male or OVX female rats, despite increased depressive symptom severity (i.e., higher nitric oxide and prostacyclin and lower H2O2and thromboxane A2levels). These results suggest that female rats exhibit more severe depressive behaviors with UCMS but are partially protected from the vasculopathy that afflicts male rats and female rats lacking normal sex hormone profiles. Determining how female sex hormones afford partial vascular protection from chronic stress and depression is a necessary step for addressing the burden of these conditions on cardiovascular health.NEW & NOTEWORTHY This study used a translationally relevant model for chronic stress and elevated depressive symptoms to determine how these factors impact conduit and resistance arteriolar function in otherwise healthy rats. While chronic stress leads to an impaired vascular reactivity associated with elevated oxidant stress, inflammation, and reduced metabolite levels, we demonstrated partial protection from vascular dysfunction in female rats with normal sex hormone profiles compared with male or ovariectomized female rats.

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