Neuroendocrine Challenges in the Diagnosis of Depressive Disorders

1989 ◽  
Vol 154 (S4) ◽  
pp. 73-76 ◽  
Author(s):  
J. J. López-Ibor ◽  
J. Saiz-Ruiz ◽  
L. Moral Iglesias
Keyword(s):  
Suicidal Behaviour ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Indoleacetic Acid ◽  
Spinal Fluid ◽  
Melancholic Depression ◽  
Low Concentration ◽  
Depressed Patients

An important topic in the neurobiology of the affective disorders relates to changes in the metabolism of neurotransmitters. Since the early 1960s, the ‘serotonergic’ hypothesis (Coppen et al, 1972) has been supported by findings such as a low concentration of 5-hydroxy-indoleacetic acid (5-HIAA) in the cerebro-spinal fluid (CSF) of patients with melancholic depression and/or suicidal behaviour (Banki & Arato, 1983; Åsberg et al, 1984; Banki et al, 1984; López-Ibor, Jr et al, 1985; Korpi et al, 1986) as well as the efficacy of serotonin precursors, when combined with MAOIs, in the treatment of depressed patients (Coppen et al, 1963; Glassman & Platman, 1969; Ayuso et al, 1971; López-Ibor, Jr et al, 1976).

Antidepressant responses in direct comparisons of melancholic and non-melancholic depression

2020 ◽  
Vol 34 (12) ◽  
pp. 1335-1341 ◽  
Author(s):  
Juan Undurraga ◽  
Gustavo H Vázquez ◽  
Leonardo Tondo ◽  
Ross J Baldessarini
Keyword(s):  
Systematic Review ◽  
Depressive Disorders ◽  
Antidepressant Treatment ◽  
Placebo Treatment ◽  
Melancholic Depression ◽  
Diagnostic Categories ◽  
Depressed Patients ◽  
Meta Analyses ◽  
Norepinephrine Reuptake ◽  
Biological Differentiation

Background: Efforts to develop less heterogeneous, more clinically useful diagnostic categories for depressive disorders include renewed interest in the concept of melancholia (Mel). However, clinical or biological differentiation of Mel from other (nonMel) episodes of depression has been questioned, and it remains unclear whether pharmacological responses proposed to be characteristic of Mel are supported by available research. Methods: We carried out a systematic review seeking treatment trials reports comparing Mel and nonMel depressed subjects for meta-analyses of their differences in responses (a) to antidepressants overall, (b) to tricyclic (TCAs) or serotonin-enhancing agents (serotonin reuptake inhibitors/serotonin–norepinephrine reuptake inhibitors) and (c) with placebo treatment. Results: We identified 25 trials in 16 reports comparing 2597 Mel with 5016 nonMel subjects. Overall, responses to antidepressant treatment did not differ between Mel (39.4%) and nonMel (42.2%) subjects. However, all subjects responded better to TCAs (50.6%) than SRIs (30.0%; p<0.0001). Mel subjects also responded less well with placebo, but also were significantly more severely depressed at intake. Conclusions: Antidepressant responses were similar in Mel and nonMel depressed patients. Mel subjects responded 25% less with placebo but were more severely depressed initially, and there was preferential response to TCAs in both Mel and nonMel subjects. The findings provide little support for proposed differences in responses to particular treatments among Mel versus nonMel depressed patients, and underscore the need to match for illness severity in making such comparisons.

scholarly journals Targeting the CCL2-CCR2 axis in depressive disorders

2021 ◽  
Author(s):  
Katarzyna Curzytek ◽  
Monika Leśkiewicz
Keyword(s):  
Nervous System ◽  
Immune System ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Brain Diseases ◽  
Receptor System ◽  
Proinflammatory Mediators ◽  
Pathological Conditions ◽  
The Central Nervous System ◽  
Abnormal Brain

AbstractSince affective disorders are considered to be underlain by the immune system malfunction, an important role in their pathophysiology is assigned to the proinflammatory mediators. Recently, chemokines, the group of chemotactic cytokines, have become a focus for basic and clinical scientists in the context of the development and treatment of brain diseases. Among them, chemokine CCL2 and its main receptor CCR2 have become candidate mediators of abnormal brain-immune system dialogue in depression. Besides the chemotactic activity, the CCL2-CCR2 axis is involved in various neurobiological processes, neurogenesis, neurotransmission, neuroinflammation, neurodegeneration, as well as neuroregeneration. Given the range of immunomodulatory possibilities that the CCL2-CCR2 pair can exert on the nervous system, its proinflammatory properties were initially thought to be a major contributor to the development of depressive disorders. However, further research suggests that the malfunctions of the nervous system are rather associated with impaired homeostatic properties manifested by the CCL2-CCR2 dyad dysfunctions. This review aims to present literature data on the action of the CCL2-CCR2 axis in the central nervous system under physiological and pathological conditions, as well as the contribution of this ligand-receptor system to the processes underlying affective disorders. Additionally, this article draws attention to the importance of the CCL2-CRR2 pathway as a potential pharmacological target with antidepressant potential.

scholarly journals Baseline characteristics of depressive disorders in Thai outpatients: findings from the Thai Study of Affective Disorders

2014 ◽  
pp. 217 ◽  
Author(s):  
Tinakon Wongpakaran ◽  
Nahathai Wongpakaran ◽  
Manee Pinyopornpanish ◽  
Usaree Srisutasanavong ◽  
Peeraphon Lueboonthavatchai ◽  
...  
Keyword(s):  
Affective Disorders ◽  
Depressive Disorders ◽  
Baseline Characteristics

scholarly journals DYNAMICS OF THE PREVALENCE OF AFFECTIVE AND NEUROTIC DISORDERS ON THE EXAMPLE OF THE POLTAVA REGION FOR 2014-2018

2019 ◽  
Vol 72 (5) ◽  
pp. 1122-1125
Author(s):  
Oleksandr Havlovskyi
Keyword(s):  
Mental Health ◽  
Mood Disorders ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
World Population ◽  
Neurotic Disorders ◽  
Life Problems ◽  
The World ◽  
Somatic Disorders ◽  
And Behavior

Introduction: Recently, the situation regarding the mental health of the world population has a tendency to deteriorate and is one of the most serious problems, which faced all countries of the world and in particular the European region (ER), since at one or another period of life problems of mental health arise at least in every fourth person of the ER, and Ukraine is no exception. ATO in Ukraine was started in 2014. We investigated the level of hospitalized mental morbidity in the residents of the city of Poltava since 2014. The aim: To study hospitalized mental morbidity of the population of the Poltava region since 2014. Materials and methods: Studied the incidence and prevalence of depressive disorders in Poltava and Poltava regions according to the new WHO classification. ICD-11. According to the report form 10 “Report on the Disease of Persons with Mental Disorders and Behavior”, the following classes of depression were studied: F30-39 Mood Disorders (Affective Disorders, F40-48 - Neurotic and Somatic Disorders, F43.0 - Severe Stress and Compliance). Review: Affective disorders are a set of psychiatric disorders, also called mood disorders. The main types of affective disorders are depression, bipolar disorder, and anxiety disorder. Symptoms vary by individual and can range from mild to severe. Conclusions: The rate of growth of morbidity of affective disorder has decreased, compared with 2014, by -14% and neurotic disorders has increased 3,2%.

scholarly journals Cognitive impairments in patients with treatment resistant epilepsy and complex rehabilitation

2021 ◽  
Vol 8 (2) ◽  
pp. 123-129
Author(s):  
Volodymyr Korostiy ◽  
Iryna Blazhina
Keyword(s):  
Quality Of Life ◽  
Cognitive Decline ◽  
Cognitive Training ◽  
Affective Disorders ◽  
Depressive Disorders ◽  
Cognitive Impairments ◽  
Control Group ◽  
Quality Of Life Scale ◽  
Patients With Epilepsy

Background. The study of features of comorbid pathology in patients with epilepsy is of particular interest due to the high prevalence of this pathology and a significant impact on the quality of life of patients and their social adaptation. Aim. The aim of the research was to detect versatile cognitive impairments and affective disorders in epilepsy, and to study the results of cognitive training and psychoeducation. Materials and methods. The theoretical analysis of modern scientific researches in the field of cognitive and affective impairments during epilepsy was carried out. We studied the features of clinical and psychopathological manifestations in patients, suffering from epilepsy. The study covered 146patients (85 men and 61 women) who were in inpatient care. The following psychodiagnostic techniques were used: the MOCA test, the Toronto Cognitive Assessment (TorCA), the MiniMult test, the Münsterberg test, the quality of life scale, the Hamilton scale of depression and anxiety. Results. This publication offers the results of a study of cognitive and affective disorders the quality of life in patients who suffer from epilepsy and the results of online cognitive training and psychoeducation. We found cognitive decline in 88% of patients with epilepsy and improvement of cognitive functions by methods of non-pharmacological correction. Conclusions. Affective and cognitive disorders significantly affects the quality of life of patients, their ability to work and socialization. The conducted research showed that compared to the control group of healthy persons, patients with epilepsy showed improvement in their cognitive decline, anxiety and depressive disorders. Cognitive online training appeared to be effective for the patients with epilepsy.

Basic mechanisms of, and treatment targets for, depressive disorders

2020 ◽  
pp. 779-788
Author(s):  
Marcela Pereira ◽  
Roberto Andreatini ◽  
Per Svenningsson
Keyword(s):  
Major Depressive Disorder ◽  
Immune System ◽  
Depressive Disorder ◽  
Affective Disorders ◽  
Sleep Disturbances ◽  
Depressive Disorders ◽  
Signs And Symptoms ◽  
Molecular Pathways ◽  
Therapy Targets ◽  
Gene Environment

The diagnosis of major depressive disorder (MDD) relies on the presence of a certain number of signs and symptoms, including feelings of guilt, hopelessness, dysphoria, cognitive dysfunction, persistent sleep, and appetite abnormalities. These signs and symptoms overlap with other conditions such as anxiety, bipolar, and seasonal affective disorders. This chapter provides an overview of the basic neurobiological mechanisms underlying MDD and its treatment. There are several alterations in the molecular pathways and neuronal networks associated with MDD. The chapter focuses here on: gene × environment interactions, dysfunctional brain circuitries, neurotransmitter alterations, maladaptation in neurotrophins and neuroplasticity, hypothalamus–pituitary–adrenal (HPA) axis dysfunction, abnormal immune system responses, circadian arrhythmicity, and sleep disturbances. The chapter briefly describes the mechanisms of actions for approved antidepressant therapies and also discusses recent insights into the pathophysiology of MDD and future possible therapy targets.

Neurocognitive functioning predicts suicidal behaviour in young people with affective disorders

2021 ◽  
Vol 281 ◽  
pp. 289-296
Author(s):  
Catherine M. McHugh ◽  
Frank Iorfino ◽  
Jacob J Crouse ◽  
Ashleigh Tickell ◽  
Alissa Nichles ◽  
...  
Keyword(s):  
Young People ◽  
Suicidal Behaviour ◽  
Affective Disorders ◽  
Neurocognitive Functioning

scholarly journals Systematic review and meta-analysis of the relationship between sleep disorders and suicidal behaviour in patients with depression

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xiaofen Wang ◽  
Sixiang Cheng ◽  
Huilan Xu
Keyword(s):  
Suicidal Ideation ◽  
Suicide Attempt ◽  
Sleep Disorders ◽  
Suicidal Behaviour ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Assessment Development ◽  
Depressed Patients ◽  
Completed Suicide

Abstract Background The potential link between sleep disorders and suicidal behaviour has been the subject of several reviews. We performed this meta-analysis to estimate the overall association between sleep disorders and suicidal behaviour and to identify a more specific relationship in patients with depression. Methods A systematic search strategy was developed across the electronic databases PubMed, EMBASE and the Cochrane Library from inception to January 1, 2019 for studies that reported a relationship between sleep disorders and suicidal behaviour in depressed patients. The odds ratio (OR) and corresponding 95% confidence interval (CI) were used to measure the outcomes. Heterogeneity was evaluated by Cochran’s Q test and the I2 statistic. The Newcastle-Ottawa Scale (NOS) was adopted to evaluate the methodological quality of each of the included studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of the evidence. We calculated the overall association between sleep disorders and suicidal behaviour and estimated more specific categories, including insomnia, nightmares, hypersomnia, suicidal ideation, suicide attempt, and completed suicide. Results A total of 18 studies were included in this study. Overall, sleep disorders were closely related to suicidal behaviour in patients with depression (OR = 2.45 95% CI: 1.33 4.52). The relatively increased risks of sleep disorders with suicidal ideation, suicide attempt and completed suicide ranged from 1.24 (95% CI: 1.00 1.53) to 2.41 (95% CI: 1.45 4.02). Nightmares were found to be highly correlated with the risk of suicidal behaviour (OR = 4.47 95% CI: 2.00 9.97), followed by insomnia (OR = 2.29 95% CI: 1.69 3.10). The certainty of the evidence was rated as very low for the overall outcome and the major depression subgroup and was rated as low for the depression subgroup. Conclusions This meta-analysis supports the finding that sleep disorders, particularly nightmares and insomnia, increase the risk of suicidal behaviour in depressed patients. Considering that all included studies were observational, the quality of the evidence is rated as very low. More well-designed studies are needed to confirm our findings and to better explain the mechanisms by which sleep disorders aggravate suicidal behaviour in depressed patients.

Depression in Adults with Intellectual Disability. Part 2: A Pilot Study

1997 ◽  
Vol 31 (2) ◽  
pp. 243-251 ◽  
Author(s):  
Julian P. Davis ◽  
Fiona K. Judd ◽  
Helen Herrman
Keyword(s):  
Intellectual Disability ◽  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Patient Group ◽  
Depressive Disorders ◽  
Psychiatric Evaluation ◽  
Depressed Patients ◽  
Standard Assessment ◽  
Core Measure ◽  
Dsm Iv

Objectives: To identify adults with intellectual disability (ID) with a depressive disorder referred to a tertiary consultation clinic for psychiatric assessment; to investigate common presenting features of depression in adults with ID; to assess the utility of visual analogue scale (VAS) measures of emotion/behaviour, the CORE measure of psychomotor disturbance, and substitutive diagnostic criteria in the assessment of depressive disorders in this patient group. Method: Over a 6-month period 47 patients were seen for psychiatric evaluation. Patients in whom a diagnosis of depression was made were further assessed using: VAS measures of depression, irritability, verbal aggression, physical aggression, temper outbursts, regressed behaviour; CORE measure of psychomotor disturbance; and substitutive diagnostic criteria designed by the authors. Results: Ten patients were found to have a depressive disorder. Substitutive criteria resulted in a greater rate of diagnosis than standard DSM-IV criteria. The VAS measure of irritability was highly scored for all 10 depressed patients. All 10 depressed patients were assigned to the melancholic subgroup according to CORE score. Conclusions: Standard assessment measures and diagnostic criteria may require modification to enhance their utility in this patient group. Melancholic features require further investigation.

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