In Patients with Major Depressive Disorders, Depression, Stress Axis Activity and Problem Solving Skills as a Proxy of Executive Functions Are Unrelated

2017 ◽  
Author(s):  
Serge Brand
Keyword(s):  
Problem Solving ◽  
Executive Functions ◽  
Depressive Disorders ◽  
Stress Axis ◽  
Major Depressive ◽  
Problem Solving Skills ◽  
Major Depressive Disorders

In patients with major depressive disorders, depression, stress axis activity and problem solving skills as a proxy of executive functions are unrelated

2017 ◽  
Vol 41 (S1) ◽  
pp. S524-S524
Author(s):  
S. Brand ◽  
M. Hatzinger ◽  
U.M. Hemmeter ◽  
D. Sadeghi Bahmani ◽  
E. Holsboer-Trachsler
Keyword(s):  
Problem Solving ◽  
Depressive Disorders ◽  
Cortisol Secretion ◽  
Transfer Performance ◽  
Major Depressive ◽  
Problem Solving Skills ◽  
Symptoms Of Depression ◽  
Cognitive Information ◽  
Major Depressive Disorders ◽  
Over Time

IntroductionMajor depressive disorders (MDD) are among the most prevalent psychiatric disorders worldwide. While there is abundant literature showing that an increased cortisol secretion, understood as a proxy of the deteriorated hypothalamus-pituitary-adrenocortical axis activity (HPA AA), and poor cognitive performance are tightly related, less is known as regards to the HPA AA and higher cognitive information processes such as problem solving.AimsInvestigating the association between cortisol secretion and problem solving performance among patients with MDD.MethodsFifteen inpatients with MDD (HDRS > 24; mean age: 59 years; 80% females) underwent a pharmacologic HPA AA challenge both at baseline and six weeks later to assess the cortisol secretion. They were treated with standard antidepressants at therapeutic dosages. Further, they learned how to solve the Tower-of-Hanoi problem-solving task (ToH-PS-T) and how to apply the problem solving strategy to other tasks (transfer). Testing occurred both at baseline and six weeks later. Outcome variables were symptoms of depression, cortisol secretion and the performance to transfer the acquired ToH-PS-T.ResultsBoth symptoms of depression and cortisol secretion decreased over time, and transfer performance increased over time. Neither at baseline nor six weeks later, symptoms of depression, transfer performance and cortisol secretion were statistically related.ConclusionsThe pattern of results suggests that cortisol secretion as a proxy of physiological stress regulation, symptoms of depression, and higher order cognitive performances seem unrelated. Given that cognitive information processing performance substantively increased regardless from depression and cortisol secretion, problem-solving skills need to be focused separately.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The Role of HPA Axis and Allopregnanolone on the Neurobiology of Major Depressive Disorders and PTSD

2021 ◽  
Vol 22 (11) ◽  
pp. 5495
Author(s):  
Felipe Borges Almeida ◽  
Graziano Pinna ◽  
Helena Maria Tannhauser Barros
Keyword(s):  
Hpa Axis ◽  
Depressive Disorders ◽  
Post Traumatic Stress ◽  
Major Depressive ◽  
Physiological Adaptations ◽  
Suppression Test ◽  
Post Traumatic ◽  
Major Depressive Disorders ◽  
Cortisol Release

Under stressful conditions, the hypothalamic-pituitary-adrenal (HPA) axis acts to promote transitory physiological adaptations that are often resolved after the stressful stimulus is no longer present. In addition to corticosteroids (e.g., cortisol), the neurosteroid allopregnanolone (3α,5α-tetrahydroprogesterone, 3α-hydroxy-5α-pregnan-20-one) participates in negative feedback mechanisms that restore homeostasis. Chronic, repeated exposure to stress impairs the responsivity of the HPA axis and dampens allopregnanolone levels, participating in the etiopathology of psychiatric disorders, such as major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). MDD and PTSD patients present abnormalities in the HPA axis regulation, such as altered cortisol levels or failure to suppress cortisol release in the dexamethasone suppression test. Herein, we review the neurophysiological role of allopregnanolone both as a potent and positive GABAergic neuromodulator but also in its capacity of inhibiting the HPA axis. The allopregnanolone function in the mechanisms that recapitulate stress-induced pathophysiology, including MDD and PTSD, and its potential as both a treatment target and as a biomarker for these disorders is discussed.

scholarly journals Development of a Nomogram for Predicting Depression in the Elderly Using Patient Health Questionnaire-9 among a Nationwide Sample of Korean Elderly

2021 ◽  
Vol 11 (7) ◽  
pp. 645
Author(s):  
Haewon Byeon
Keyword(s):  
Depressive Disorders ◽  
The Elderly ◽  
Subjective Health ◽  
Moderate Intensity ◽  
Subjective Health Status ◽  
Major Depressive ◽  
Moderate Intensity Physical Activity ◽  
Patient Health ◽  
Intensity Physical Activity ◽  
Major Depressive Disorders

This cross-sectional study developed a nomogram that could allow medical professionals in the primary care setting to easily and visually confirm high-risk groups of depression. This study analyzed 4011 elderly people (≥60 years old) who completed a health survey, blood pressure, physical measurement, blood test, and a standardized depression screening test. A major depressive disorder was measured using the Korean version of the Patient Health Questionnaire (PHQ-9). This study built a model for predicting major depressive disorders using logistic regression analysis to understand the relationship of each variable with major depressive disorders. In the result, the prevalence of depression measured by PHQ-9 was 6.8%. The results of multiple logistic regression analysis revealed that the major depressive disorder of the elderly living alone was significantly (p < 0.05) related to monthly mean household income, the mean frequency of having breakfast per week for the past year, moderate-intensity physical activity, subjective level of stress awareness, and subjective health status. The results of this study implied that it would be necessary to continuously monitor these complex risk factors such as household income, skipping breakfast, moderate-intensity physical activity, subjective stress, and subjective health status to prevent depression among older adults living in the community.

scholarly journals Systematic review and meta-analysis of the prevalence of depressive symptoms, dysthymia and major depressive disorders among homeless people

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040061
Author(s):  
Getinet Ayano ◽  
Asmare Belete ◽  
Bereket Duko ◽  
Light Tsegay ◽  
Berihun Assefa Dachew
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Random Effect ◽  
Homeless People ◽  
Sensitivity Analyses ◽  
Prevalence Rates ◽  
Major Depressive ◽  
Major Depressive Disorders

ObjectivesTo assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.DesignSystematic review and meta-analysis.Data sourcesDatabases including PubMed, Scopus and Web of Science were systematically searched up to February 2020 to identify relevant studies that have reported data on the prevalence of depressive symptoms, dysthymia and MDDs among homeless people.Eligibility criteriaOriginal epidemiological studies written in English that addressed the prevalence of depressive problems among homeless people.Data extraction and synthesisA random-effect meta-analysis was performed to pool the prevalence estimated from individual studies. Subgroup and sensitivity analyses were employed to compare the prevalence across the groups as well as to identify the source of heterogeneities. The Joanna Briggs Institute’s quality assessment checklist was used to measure the study quality. Cochran’s Q and the I2 test were used to assess heterogeneity between the studies.ResultsForty publications, including 17 215 participants, were included in the final analysis. This meta-analysis demonstrated considerably higher prevalence rates of depressive symptoms 46.72% (95% CI 37.77% to 55.90%), dysthymia 8.25% (95% CI 4.79% to 11.86%), as well as MDDs 26.24% (95% CI 21.02% to 32.22%) among homeless people. Our subgroup analysis showed that the prevalence of depressive symptoms was high among younger homeless people (<25 years of age), whereas the prevalence of MDD was high among older homeless people (>50 years of age) when compared with adults (25–50 years).ConclusionThis review showed that nearly half, one-fourth and one-tenth of homeless people are suffering from depressive symptoms, dysthymia and MDDs, respectively, which are notably higher than the reported prevalence rates in the general population. The findings suggest the need for appropriate mental health prevention and treatment strategies for this population group.

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