scholarly journals Temporal Associations of Daily Changes in Sleep and Depression Core Symptoms in Patients Suffering From Major Depressive Disorder: Idiographic Time-Series Analysis

10.2196/17071 ◽  
2020 ◽  
Vol 7 (4) ◽  
pp. e17071
Author(s):  
Noah Lorenz ◽  
Christian Sander ◽  
Galina Ivanova ◽  
Ulrich Hegerl
Keyword(s):  
Time Series ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Total Sleep Time ◽  
Sleep Time ◽  
The Other ◽  
Series Data ◽  
Major Depressive ◽  
Time In Bed ◽  
Core Symptoms

Background There is a strong link between sleep and major depression; however, the causal relationship remains unclear. In particular, it is unknown whether changes in depression core symptoms precede or follow changes in sleep, and whether a longer or shorter sleep duration is related to improvements of depression core symptoms. Objective The aim of this study was to investigate temporal associations between sleep and depression in patients suffering from major depressive disorder using an idiographic research approach. Methods Time-series data of daily sleep assessments (time in bed and total sleep time) and self-rated depression core symptoms for an average of 173 days per patient were analyzed in 22 patients diagnosed with recurrent major depressive disorder using a vector autoregression model. Granger causality tests were conducted to test for possible causality. Impulse response analysis and forecast error variance decomposition were performed to quantify the temporal mutual impact of sleep and depression. Results Overall, 11 positive and 5 negative associations were identified between time in bed/total sleep time and depression core symptoms. Granger analysis showed that time in bed/total sleep time caused depression core symptoms in 9 associations, whereas this temporal order was reversed for the other 7 associations. Most of the variance (10%) concerning depression core symptoms could be explained by time in bed. Changes in sleep or depressive symptoms of 1 SD had the greatest impact on the other variable in the following 2 to 4 days. Conclusions Longer rather than shorter bedtimes were associated with more depression core symptoms. However, the temporal orders of the associations were heterogeneous.

The selective orexin-2 receptor antagonist seltorexant improves sleep: An exploratory double-blind, placebo controlled, crossover study in antidepressant-treated major depressive disorder patients with persistent insomnia

2019 ◽  
Vol 33 (2) ◽  
pp. 202-209 ◽  
Author(s):  
Sander Brooks ◽  
Gabriël E Jacobs ◽  
Peter de Boer ◽  
Justine M Kent ◽  
Luc Van Nueten ◽  
...  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Depressive Symptomatology ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Sleep Efficiency ◽  
Least Square ◽  
Self Report ◽  
Major Depressive ◽  
Double Blind

Background: Insomnia is common in patients with major depressive disorder. Although antidepressants improve mood, insomnia often persists as a result of physiological hyperarousal. The orexin-2 receptor is increasingly being recognized as a new target for the treatment of persistent insomnia in major depressive disorder . Aim: This exploratory study investigated the effects of seltorexant on objective sleep parameters and subjective depressive symptoms in antidepressant treated major depressive disorder patients with persistent insomnia. Methods: Twenty male and female patients received a single dose of 10, 20, 40 mg seltorexant and placebo with a washout period of seven days in a double-blind four-way crossover study. Effects on latency to persistent sleep, total sleep time and sleep efficiency were assessed with polysomnography. Subjective changes in mood were explored by the Quick Inventory of Depressive Symptomatology Self-Report. Safety was recorded and suicidal ideation and behavior were assessed with the Columbia Suicide Severity Rating Scale. Results: Latency to persistent sleep was significantly shorter for all doses of seltorexant compared to placebo. Placebo least square mean was 61.05 min with least square mean ratios treatment/placebo (80% confidence interval) of 0.32 (0.24–0.44), 0.15 (0.11–0.2) and 0.17 (0.12–0.23) 19.69, 9.2, 10.15 for 10, 20 and 40 mg seltorexant respectively, (all p<0.001). Total sleep time was significantly longer for all doses of seltorexant compared to placebo. Sleep efficiency was significantly improved. The Quick Inventory of Depressive Symptomatology Self-Report demonstrated a trend to mood-improvement for the 40 mg group. Conclusions: Seltorexant showed a statistically significant, dose-dependent decrease in latency to persistent sleep, and increase in total sleep time and sleep efficiency combined with a tendency toward subjectively improved mood.

The Effect of Desipramine upon Central Adrenergic Function in Depressed Patients

1982 ◽  
Vol 141 (4) ◽  
pp. 372-376 ◽  
Author(s):  
Ilana B. Glass ◽  
Stuart A. Checkley ◽  
Eric Shur ◽  
Sheila Dawling
Keyword(s):  
Growth Hormone ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Diagnostic Criteria ◽  
Statistical Significance ◽  
Adaptive Change ◽  
The Other ◽  
Major Depressive ◽  
Uptake Of Noradrenaline ◽  
Drug Free

SummaryEleven drug free patients meeting Research Diagnostic Criteria for Major Depressive Disorder have been treated with desipramine and given a clonidine infusion after 0, 1 and 3 weeks of treatment. The sedative and hypotensive effects of clonidine were significantly inhibited after three weeks of treatment with desipramine: a similar interaction was seen after one week of treatment although this just failed to reach statistical significance. The growth hormone (GH) response to clonidine was initially impaired, but increased significantly after one week of treatment. A significant reduction in the GH response occurred during the second and third weeks of treatment with desipramine. This last finding is interpreted as evidence of adaptive change of α2 adrenoceptors: the other changes can be explained by the known ability of desipramine to block the re-uptake of noradrenaline.

scholarly journals Core symptoms of major depressive disorder: relevance to diagnosis and treatment

2008 ◽  
Vol 10 (3) ◽  
pp. 271-277 ◽  
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Sleep Disturbance ◽  
Major Depressive Episode ◽  
Rating Scale ◽  
Symptom Clusters ◽  
Major Depressive ◽  
Associated Symptoms ◽  
Core Symptoms ◽  
Core Features

The construct of major depressive disorder makes no etiological assumptions about populations with diverse symptom clusters. "Depressed mood" and "loss of interest or pleasure in nearly all activities" are core features of major depressive episode, though a strong case can be made to pay increasing attention to symptoms of fatigue, sleep disturbance, anxiety, and neurocognitive and sexual dysfunction in the diagnosis and evaluation of treatment outcome. Mood, guilt, work, and interest, as well as psychic anxiety, are consistently identified across validated subscales of the Hamilton Depression Rating Scale as prevalent and sensitive to change with existing treatments. A major limitation of these antidepressant therapies is their narrow spectrum of action. While the core "mood and interest" symptoms have been the main focus of attention, the associated symptoms listed above are often unaffected or exacerbated by current treatments. Careful clinical evaluation should address all of these dimensions, recognizing that improvement may occur sooner in some symptoms (eg, mood) compared with others (eg, sleep disturbance).

scholarly journals Changes in genetic and environmental influences on the development of nicotine dependence and major depressive disorder from middle adolescence to early adulthood

2010 ◽  
Vol 22 (4) ◽  
pp. 831-848 ◽  
Author(s):  
Erin C. Tully ◽  
William G. Iacono ◽  
Matt McGue
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Nicotine Dependence ◽  
Community Sample ◽  
Early Adulthood ◽  
Environmental Influences ◽  
Subsequent Development ◽  
The Other ◽  
Major Depressive ◽  
Middle Adolescence

AbstractThis longitudinal study used a representative community sample of same-sex twins (485 monozygotic pairs, 271 dizygotic pairs) to study longitudinal changes in genetic and environmental influences on nicotine dependence (NicD) symptoms and major depressive disorder (MDD) symptoms and the longitudinal relationships between NicD and MDD symptoms at three relatively discrete ages spanning middle adolescence to early adulthood (ages 15, 18, and 21). Clinical interviews were used to assess NicD and MDD symptoms lifetime at age 15 and during the previous 3 years at the two subsequent assessments. Biometric models revealed similar patterns of findings for NicD and MDD. Heritability increased with age, particularly between ages 15 and 18. Shared environmental influences were small, and the proportion of variance attributed to shared environmental influences decreased with age. Nonshared environmental influences were moderate to large in magnitude and were entirely age specific. Both NicD and MDD symptoms showed considerable stability from age 15 to 21, and at each age those with one disorder showed elevated rates of the other. However, a cross-lagged model revealed no longitudinal predictive relationships between MDD symptoms and NicD symptoms after accounting for stability of symptoms within disorders. In summary, the transition between middle and late adolescence is a critical period for developmental shifts in the magnitudes of genetic and environmental influences on both MDD and NicD symptoms. Despite similarities in the development of genetic and environmental influences for the two phenotypes, the association between NicD and MDD reflects concurrent covariation rather than one phenotype being an antecedent influence on the subsequent development of the other.

scholarly journals Development of a Novel Web Camera-Based Contact-Free Major Depressive Disorder Screening System Using Autonomic Nervous Responses Induced by a Mental Task and Its Clinical Application

2021 ◽  
Vol 12 ◽  
Author(s):  
Batbayar Unursaikhan ◽  
Nobuaki Tanaka ◽  
Guanghao Sun ◽  
Sadao Watanabe ◽  
Masako Yoshii ◽  
...  
Keyword(s):  
Time Series ◽  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Rest Period ◽  
Percentage Change ◽  
Screening System ◽  
Mental Task ◽  
Major Depressive ◽  
Web Camera ◽  
Contact Free

BackgroundTo increase the consultation rate of potential major depressive disorder (MDD) patients, we developed a contact-type fingertip photoplethysmography-based MDD screening system. With the outbreak of SARS-CoV-2, we developed an alternative to contact-type fingertip photoplethysmography: a novel web camera-based contact-free MDD screening system (WCF-MSS) for non-contact measurement of autonomic transient responses induced by a mental task.MethodsThe WCF-MSS measures time-series interbeat intervals (IBI) by monitoring color tone changes in the facial region of interest induced by arterial pulsation using a web camera (1920 × 1080 pixels, 30 frames/s). Artifacts caused by body movements and head shakes are reduced. The WCF-MSS evaluates autonomic nervous activation from time-series IBI by calculating LF (0.04–0.15 Hz) components of heart rate variability (HRV) corresponding to sympathetic and parasympathetic nervous activity and HF (0.15–0.4 Hz) components equivalent to parasympathetic activities. The clinical test procedure comprises a pre-rest period (Pre-R; 140 s), mental task period (MT; 100 s), and post-rest period (Post-R; 120 s). The WCF-MSS uses logistic regression analysis to discriminate MDD patients from healthy volunteers via an optimal combination of four explanatory variables determined by a minimum redundancy maximum relevance algorithm: HF during MT (HFMT), the percentage change of LF from pre-rest to MT (%ΔLF(Pre–R⇒MT)), the percentage change of HF from pre-rest to MT (%ΔHF(Pre–R⇒MT)), and the percentage change of HF from MT to post-rest (%ΔHF(MT⇒Post–R)). To clinically test the WCF-MSS, 26 MDD patients (16 males and 10 females, 20–58 years) were recruited from BESLI Clinic in Tokyo, and 27 healthy volunteers (15 males and 12 females, 18–60 years) were recruited from Tokyo Metropolitan University and RICOH Company, Ltd. Electrocardiography was used to calculate HRV variables as references.ResultThe WCF-MSS achieved 73% sensitivity and 85% specificity on 5-fold cross-validation. IBI correlated significantly with IBI from reference electrocardiography (r = 0.97, p &lt; 0.0001). Logit scores and subjective self-rating depression scale scores correlated significantly (r = 0.43, p &lt; 0.05).ConclusionThe WCF-MSS seems a promising contact-free MDD screening apparatus. This method enables web camera built-in smartphones to be used as MDD screening systems.

scholarly journals The relevance of personality assessment in estimating the risk of onset and the outcome of major depressive disorder

2016 ◽  
Vol 89 (2) ◽  
pp. 212-215 ◽  
Author(s):  
Bogdan Nemes ◽  
Doina Cozman
Keyword(s):  
Major Depressive Disorder ◽  
Depressive Disorder ◽  
Personality Assessment ◽  
Harm Avoidance ◽  
The Other ◽  
Novelty Seeking ◽  
Major Depressive ◽  
Initial Development ◽  
Diagnostic Categories ◽  
Current State

The study of the relationship between the psychobiological model of temperament and character on one side and the development and evolution of major depressive disorder on the other side has drawn some attention in the past two decades, especially since a diagnosis model based on fewer diagnostic categories and a more phenomenological and person oriented approach seems to be supported other research and current state-of-the art therapeutic practices, which are based more on descriptive clinical data than on the current diagnostic categories.The aim of this paper was to review the latest developments in this area, but in the context of the initial development of the psychobiological model of temperament and character, i.e. as a tool for the comprehensive diagnosis of depressed individuals.Data published so far supports the following observations: (1) high harm avoidance and low self-directedness are risk factors for the development of major depressive disorder, but further research is needed to clearly establish the role of the other dimensions or their facets as predictors for the development of a depressive episode; (2) although some evidence has been obtained so far regarding the use of harm avoidance, novelty seeking, reward dependence and cooperativeness in predicting treatment response in major depressive disorder, further research is needed to clarify and/or to replicate these findings; and (3) data on temperament and character dimensions related to relapse in major depressive disorder are insufficient, although some evidence has been brought to support the hypothesis that high harm avoidance scores, and low self-directedness and novelty seeking scores might serve as predictors, further prospective studies need to be carried out to establish their utility in this respect.

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