scholarly journals The Tryptophan Catabolite or Kynurenine Pathway’s Role in Major Depression

2022 ◽  
Author(s):  
Abbas F. Almulla ◽  
Michael Maes
Keyword(s):  
Immune Response ◽  
Major Depression ◽  
Immune Activation ◽  
Nitrosative Stress ◽  
Picolinic Acid ◽  
Xanthurenic Acid ◽  
Response System ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
The Impact

Kynurenine or tryptophan catabolite (TRYCAT) pathway contributes to the pathophysiology of major depression disorder (MDD) and major depressive episodes (MDE) in bipolar disorder and suicidal behaviors. The consequences of the overactivation of this pathway large reduced tryptophan (TRP) levels in peripheral blood and the CNS and increased levels of neurotoxic TRYCATs including kynurenine (KYN), 3-hydroxy kynurenine (3HK), quinolinic acid (QA), xanthurenic acid (XA), and picolinic acid (PA). However, other TRYCATs are protective, such as kynurenic acid (KA) and anthranilic acid (AA). Inflammation and cell-mediated immune activation along with oxidative and nitrosative stress (O&NS) may stimulate the first and rate-limiting enzyme of this pathway, namely indoleamine-2,3-dioxygenase (IDO). Therefore, during depression, balancing neuroprotective versus neurotoxic TRYCATs and balancing activation of the immune response system (IRS) versus the compensatory immune response system is crucial for achieving better treatment outcomes. Furthermore, targeting the causes of TRYCAT pathway activation (immune activation and O&NS) is probably the most effective strategy to treat depression. In the present review, we aim to provide a comprehensive explanation of the impact of TRYCATs in terms of pathophysiology and treatment of MDD and MDE.

scholarly journals Psychotherapy for subclinical depression: meta-analysis

2014 ◽  
Vol 205 (4) ◽  
pp. 268-274 ◽  
Author(s):  
Pim Cuijpers ◽  
Sander L. Koole ◽  
Annemiek van Dijke ◽  
Miquel Roca ◽  
Juan Li ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Depressive Disorder ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Subclinical Depression

BackgroundThere is controversy about whether psychotherapies are effective in the treatment of subclinical depression, defined by clinically relevant depressive symptoms in the absence of a major depressive disorder.AimsTo examine whether psychotherapies are effective in reducing depressive symptoms, reduce the risk of developing major depressive disorder and have comparable effects to psychological treatment of major depression.MethodWe conducted a meta-analysis of 18 studies comparing a psychological treatment of subclinical depression with a control group.ResultsThe target groups, therapies and characteristics of the included studies differed considerably from each other, and the quality of many studies was not optimal. Psychotherapies did have a small to moderate effect on depressive symptoms against care as usual at the post-test assessment (g = 0.35, 95% CI 0.23–0.47; NNT = 5, 95% CI 4–8) and significantly reduced the incidence of major depressive episodes at 6 months (RR = 0.61) and possibly at 12 months (RR = 0.74). The effects were significantly smaller than those of psychotherapy for major depressive disorder and could be accounted for by non-specific effects of treatment.ConclusionsPsychotherapy may be effective in the treatment of subclinical depression and reduce the incidence of major depression, but more high-quality research is needed.

Work stress as a risk factor for major depressive episode(s)

2004 ◽  
Vol 35 (6) ◽  
pp. 865-871 ◽  
Author(s):  
JIANLI WANG
Keyword(s):  
Multivariate Analysis ◽  
Risk Factor ◽  
Major Depression ◽  
Work Stress ◽  
Depressive Episode ◽  
Major Depressive Episode ◽  
Working Population ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background. Major depression is a prevalent mental disorder in the general population, with a multi-factorial etiology. However, work stress as a risk factor for major depression has not been well studied.Method. Using a longitudinal study design, this analysis investigated the association between the levels of work stress and major depressive episode(s) in the Canadian working population, aged 18 to 64 years. Data from the longitudinal cohort of the Canadian National Population Health Survey (NPHS) were used (n=6663). The NPHS participants who did not have major depressive episodes (MDE) at baseline (1994–1995 NPHS) were classified into four groups by the quartile values of the baseline work stress scores. The proportion of MDE of each group was calculated using the 1996–1997 NPHS data.Results. The first three quartile groups had a similar risk of MDE. Those who had a work stress score above the 75th percentile had an elevated risk of MDE (7·1%). Using the 75th percentile as a cut-off, work stress was significantly associated with the risk of MDE in multivariate analysis (odds ratio=2·35, 95% confidence interval 1·54–3·77). Other factors associated with MDE in multivariate analysis included educational level, number of chronic medical illnesses and child and adulthood traumatic events. There was no evidence of effect modification between work stress and selected sociodemographic, clinical and psychosocial variables.Conclusions. Work stress is an independent risk factor for the development of MDE in the working population. Strategies to improve working environment are needed to keep workers mentally healthy and productive.

Comorbidity of Mood Disorders: A Longitudinal Prospective Study

1996 ◽  
Vol 168 (S30) ◽  
pp. 31-37 ◽  
Author(s):  
Jules Angst
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Panic Disorder ◽  
Generalised Anxiety Disorder ◽  
Major Depressive ◽  
Recurrent Brief Depression ◽  
Cannabis Consumption ◽  
Major Depressive Episodes ◽  
Depressive Episodes

From the Zurich cohort study (n=591), the association of major depressive episodes and recurrent brief depression (RBD) with other psychiatric disorders is presented cross-sectionally at age 28 and 30 years, and over ten years (age 20 to 30 years). Longitudinally, the odds ratios of major depression are highest with dysthymia (4.4), generalised anxiety disorder (4.4), panic disorder (2.7), hypomania and agoraphobia (2.6), and social phobia (2.4). There is a significant association with cannabis consumption and smoking. Follow-up data over nine years are available for 41 patients with a major depressive disorder (MDD) and 62 with RBD: approximately 20% of MDD patients did not receive a diagnosis during follow-up. Major depression reoccurred in 32%, became bipolar in 24%, or developed into RBD in 24%. RBD remitted in 41 %, reoccurred in 35%, turned into major depression in 22%, and became bipolar in only 7%. Longitudinally, MDD and RBD show a symmetrical diagnostic change in a quarter of the cases. There is no substantial development of MDD or RBD into minor depression or generalised anxiety disorder. Thirteen per cent of those with RBD later developed panic disorder.

scholarly journals Depression in women infected with HIV

2006 ◽  
Vol 28 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Valéria Antakly de Mello ◽  
André Malbergier
Keyword(s):  
Major Depression ◽  
Hiv Infection ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Asymptomatic Group ◽  
Dsm Iv ◽  
Women With Hiv ◽  
Major Depressive Episodes ◽  
Depressive Episodes

OBJETIVE:The number of women with HIV infection has been on the rise in recent years, making studies of the psychiatric aspects of this condition very important. The aim of this study was to evaluate the prevalence of major depression in women with HIV infection. METHOD: A total of 120 women were studied, 60 symptomatic (with AIDS symptoms) and 60 asymptomatic (without AIDS symptoms). Sociodemographic data were collected, and depressive disorders were identified. The instruments used to evaluate the depressive disorders were the SCID, DSM-IV, 17-item Hamilton depression scale, Hamilton depression scale for nonsomatic symptoms and the Beck depression scale. RESULTS: The prevalence of major depression was 25.8% and was higher in the symptomatic group than in the asymptomatic group (p = 0.002). CONCLUSIONS: The prevalence of major depressive episodes in women with HIV infection is high, and women with AIDS-related symptoms are more often depressed than are those who have never presented such symptoms.

Novel Therapeutics for Depression:L-methylfolate as a Trimonoamine Modulator and Antidepressant-Augmenting Agent

CNS Spectrums ◽  
2007 ◽  
Vol 12 (10) ◽  
pp. 739-744 ◽  
Author(s):  
Stephen M. Stahl
Keyword(s):  
Folic Acid ◽  
High Risk ◽  
Major Depression ◽  
Mechanism Of Action ◽  
Folate Deficiency ◽  
Major Depressive ◽  
Antidepressant Effects ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
Putative Mechanism

Folate deficiency may increase the risk of depression and reduce the action of antidepressants. Individuals with an inherited polymorphism that reduces the efficiency of folate formation may be at high risk for folate deficiency and for major depression. Antidepressant effects have been reported when antidepressants are augmented with folic acid, folinic acid, or the centrally active L-methylfolate (known formally as (6(S)-5-methyltetrahydrofolate [MTHF]), particularly in depressed patients with folate deficiency whose major depressive episodes have failed to respond to antidepressants. The putative mechanism of action of MTHF as an augmenting agent to antidepressants is that it acts as a trimonoamine modulator (TMM), enhancing the synthesis of the three monoamines: dopamine (DA), norepinephrine (NE), and serotonin (5-HT), resulting in a boost to the efficacy of antidepressants.

The impact of generalized anxiety disorder and stressful life events on risk for major depressive episodes

2006 ◽  
Vol 36 (6) ◽  
pp. 789-795 ◽  
Author(s):  
JOHN M. HETTEMA ◽  
JONATHAN W. KUHN ◽  
CAROL A. PRESCOTT ◽  
KENNETH S. KENDLER
Keyword(s):  
Anxiety Disorder ◽  
Life Events ◽  
Generalized Anxiety Disorder ◽  
Stressful Life Events ◽  
Stressful Life ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
The Impact

Background. Both generalized anxiety disorder (GAD) and stressful life events (SLEs) are established risk factors for major depressive disorder, but no studies exist that examine the interrelationship of their impact on depressive onsets. In this study, we sought to analyze the joint effects of prior history of GAD and recent SLEs on risk for major depressive episodes, comparing these in men and women.Method. In a population-based sample of 8068 adult twins, Cox proportional hazard models were used to predict onsets of major depression from reported prior GAD and last-year SLEs rated on long-term contextual threat.Results. For all levels of threat, prior GAD increases risk for depression, with a monotonic relationship between threat level and risk. While females without prior GAD consistently show higher depressive risk than males, this is no longer the case in subjects with prior GAD who have experienced SLEs. Rather, males appear to be more vulnerable to the depressogenic effects of both prior GAD and SLEs.Conclusion. The effects of prior GAD and SLEs jointly increase the risk of depression in both sexes, but disproportionately so in males.

scholarly journals Determining the “IMPACT” of therapeutics for depression requires an adaptive trial design

2018 ◽  
Keyword(s):  
Trial Design ◽  
Treatment Options ◽  
Pharmacological Therapy ◽  
Treatment Modalities ◽  
Major Depressive ◽  
Adaptive Trial Design ◽  
Major Depressive Episodes ◽  
Depressive Episodes ◽  
The Impact ◽  
Adaptive Trial

A large proportion of adolescents suffering from moderate-to-severe major depression respond to psychological and pharmacological therapy, and the range of effective treatment modalities is increasing. Now, Ian Goodyer and Paul Wilkinson have compiled a Practitioner Review that compares the various treatment options available and assesses their effectiveness for adolescents affected by major depressive episodes.

scholarly journals Major Depression and its Association with Long-Term Medical Conditions

2002 ◽  
Vol 47 (2) ◽  
pp. 149-152 ◽  
Author(s):  
Lisa M Gagnon ◽  
Scott B Pat ten
Keyword(s):  
Major Depression ◽  
Depressive Disorders ◽  
Short Form ◽  
Community Sample ◽  
Self Report ◽  
Medical Conditions ◽  
Cross Sectional ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objective: To replicate previously re ported as sociations between major depressive episodes (MDEs) and long-term medical conditions in a Canadian community sample. Methods: A sample of 2542 house hold residents was selected using random digit dialing (RDD). Data were collected by tele phone in ter view. The Composite International Diagnostic In ter view (CIDI)-Short Form for major depression (CIDI-SFMD) was used to identify MDEs occurring in the previous 12 months. Long-term medical conditions were identified by self-report. Results: The prevalence of MDE was elevated in those subjects who re ported 1 or more long-term medical conditions. The association was not due to con founding by age, sex, social support, or stressful recent life events. Conclusion: This study replicates a previously re ported as sociation between depressive disorders and long-term medical conditions. These cross-sectional associations suggest that medical conditions may increase the risk of major depression or that major depression may in crease the risk of medical conditions. Alternatively, comorbid medical conditions may influence the duration of depressive episodes, or vice versa. These explanations are not mutually exclusive.

scholarly journals Comorbidity of Major Depression and Migraine — A Canadian Population-Based Study

2005 ◽  
Vol 50 (13) ◽  
pp. 832-837 ◽  
Author(s):  
Carmen V Molgat ◽  
Scott B Patten
Keyword(s):  
Major Depression ◽  
General Population ◽  
Chronic Conditions ◽  
Large Scale ◽  
Short Form ◽  
Large Fraction ◽  
Strong Association ◽  
Medical Conditions ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Objective: To estimate the prevalence of major depressive episodes (MDEs) in patients with migraine and to compare the strength of association with that of other long-term medical conditions. Methods: This study used a large-scale probability sample (over 130 000 sample) from the Canadian Community Health Survey (CCHS), a cross-sectional survey conducted by Statistics Canada. The CCHS screened for a broad set of medical conditions. Major depression was evaluated with the Composite International Diagnostic Interview Short Form for Major Depression, and the diagnosis of migraine was self-reported. The annual prevalence of major depression was calculated in the general population, in subjects with migraine, and in those with chronic conditions other than migraine. Results: The prevalence of major depression in subjects reporting migraine was higher than that in the general population or in subjects with other chronic medical conditions (17.6%, compared with 7.4% and 7.8%, respectively). Conclusions: There is a strong association between major depression and migraine. The migraine–MDE association may account for a large fraction of the chronic condition–MDE association. The association between migraines and MDE differs from that of other chronic conditions, as the association persists into older age groups.

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