Comparison of Prevalence and Risk Factors of PTSS Between Chinese Patients With Depression and Non-depressed Controls During COVID-19 Outbreak

Background: COVID-19 pandemic is a traumatic event all over the world, and may lead to post-traumatic stress symptom (PTSS) in different population who are under the threat of novel corona virus. Therefore, the aim of our study was to compare the prevalence and risk factors of PTSS between Chinese patients with depression and non-depressed controls during the COVID-19 outbreak.Methods: 437 depressed patients and 2,940 non-depressed controls were enrolled in this cross-sectional study between February 14 and May 9, 2020.The Impact of Events Scale-Revised (IES-R), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS) and Pittsburgh Sleep Quality Index (PSQI) were used to evaluate the psychological status of all the participants.Results: The prevalence of PTSS (IES-R ≥ 33) in depressed patients (45.08%) was higher than that in non-depressed controls (5.31%). Patients with depression were 16 times more likely to suffer from PTSS than those without depression. Correlation analyses showed that the IES-R total score was positively correlated with SDS, SAS, and PSQI scores in both depressed and non-depressed groups (Bonferroni corrected all p < 0.001). Multiple linear regression analysis showed that SAS score, and PSQI score were independently associated with IES-R total score in both depression and non-depression groups. In depressed patients, education level and duration of media exposure to COVID-19 were positively associated with PTSS, while in the non-depressed group, subjects who were married, in the 31–50 year group or with higher SDS score were more likely to develop PTSS.Conclusions: These results indicate that the prevalence rate of PTSS in patients with depression is very higher than that in subjects without depression. PTSS are associated with a number of socio-demographic and clinical variables.

Effect of Kangaroo Mother Care on Maternal Anxiety and Depression States at the Neonatal ICU: A Prospective Cohort Study

Objectives. To determine the effect of kangaroo mother care (KMC) on anxiety and depression of mothers of low-birth-weight neonates during the immediate newborn period. Method. Eligible participants were mothers of low-birth-weight infants (birth weight ≤2500 grams) admitted at a tertiary hospital's neonatal intensive care unit. Mothers were instructed on providing KMC daily to their infants during the study period (first seven days of life). Main Outcome Measure(s). The primary study outcome was the effect of KMC in improving maternal anxiety and depression scores in the immediate postpartum period using the locally validated Hospital Anxiety and Depression Scale-Pilipino (HADS/HADS-P). Results. A total of 171 mothers were enrolled in the study. Only 79 mothers provided KMC, and the rest (92) did not provide KMC. The anxiety and depression scores improved significantly from day 1 to 7 postpartum in both groups (p<0.05). Frequency of mothers categorized as having severe anxiety significantly decreased over time whether they provided KMC or not (KMC: 40.5%, 13.9%, 7.6% at Day 1 and 7 postpartum and day of discharge; No KMC: 35.9% and 27.2% at Day 1 and Day 7 postpartum). There was a significant reduction in the percentage of mothers categorized in the depressed group from Day 1 to Day 7 postpartum, among those who rendered KMC compared with those who did not (KMC: 7.6%, 2.5%, 0% at Day 1 and 7 postpartum and at the day of discharge vs. No KMC: 7.6% and 10.9% at Day 1 and 7 postpartum). There were no significant differences in the anxiety and depression scores at any period between mothers who rendered KMC > 6 hours and KMC ≤ 6 hours/day. Conclusion. Anxiety and depression scores significantly decreased over time in both mothers who rendered and did not render KMC to their infants. However, there was a significant reduction in the percentage of mothers categorized as having severe depression over time among those who rendered KMC compared to those who did not. Other factors aside from KMC may affect the maternal anxiety and depression states, such as instability of the infant.

The Influence of Depression on Biased Diagnosis of Premenstrual Syndrome and Premenstrual Dysphoric Disorder by the PSST Inventory

The diagnosis of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) poses a challenge for clinicians due to the overdiagnosis of retrospective methods and overlapping symptoms with depression. The present study utilized an Item Response Theory analysis to examine the predictive utility of the Premenstrual Symptom Screening Tool (PSST) in women with and without depression. Two hundred and fifteen women aged 20–35 completed the PSST, a daily symptom calendar, SCID-I, and CES-D for two consecutive menstrual cycles. PSST items: fatigue, depressed mood, feeling overwhelmed, anxiety/tension, and decreased interest in everyday activities were the best predictors of PMS. Unlike the daily symptom ratings, the PSST over-diagnosed PMS/PMDD in the depressed group but not in the group of women without PMS/PMDD. While diagnosing premenstrual disorders, clinicians should be aware that a retrospective diagnosis with PSST can be more sensitive to mood disorders and cycle phases than a prospective diagnosis with a daily symptoms calendar.

Words and Faces on Left and Right: Perceptual Asymmetries as a Marker for SSRI Responsiveness

<p>Vulnerability to depression has been associated with greater relative right hemisphere frontal activity, as measured by EEG recordings of alpha activity. However, there is much heterogeneity in the patterns of hemispheric asymmetries in people at risk for depression. These different patterns of hemispheric asymmetries may be related to whether an individual responds to Selective Serotonin Reuptake Inhibitor (SSRI) medication. Response to SSRIs is associated with a pattern of overall relative LH activity, whereas non-response to SSRIs is associated with a pattern of overall relative RH activity. Very little is known about how these asymmetries in neural activity relate to asymmetries in cognition. The current study investigated hemispheric differences in the processing of emotional faces and words, in individuals not vulnerable to depression (a Never Depressed group) and in individuals vulnerable to depression (a Previously Depressed group). In the chimeric faces task, the Previously Depressed group had a significantly larger left hemispatial bias compared to the Never Depressed group. This may reflect relatively greater posterior RH activity/arousal in the Previously Depressed group. No differences were found between SSRI Responders and Non-responders in the chimeric faces task. In the divided visual field task, hemispheric differences in the processing of emotional words were found between the SSRI Responders and SSRI Non-responders. In contrast to SSRI Responders and Never Depressed controls, SSRI Non-responders showed a relative advantage for negative over positive words when they were presented to their LVF/RH; and an advantage for negative words presented to their LVF/RH compared to their RVF/LH. Additionally, they were more sensitive to perceiving the valence of a word that was presented to their LVF/RH. This suggests that their RH semantic systems may differ from that of SSRI Responders and Never Depressed controls. Genetic, hormonal and cognitive factors are discussed in relation to these patterns of hemispheric asymmetries and responsiveness to SSRI medication.</p>

Words and Faces on Left and Right: Perceptual Asymmetries as a Marker for SSRI Responsiveness

<p>Vulnerability to depression has been associated with greater relative right hemisphere frontal activity, as measured by EEG recordings of alpha activity. However, there is much heterogeneity in the patterns of hemispheric asymmetries in people at risk for depression. These different patterns of hemispheric asymmetries may be related to whether an individual responds to Selective Serotonin Reuptake Inhibitor (SSRI) medication. Response to SSRIs is associated with a pattern of overall relative LH activity, whereas non-response to SSRIs is associated with a pattern of overall relative RH activity. Very little is known about how these asymmetries in neural activity relate to asymmetries in cognition. The current study investigated hemispheric differences in the processing of emotional faces and words, in individuals not vulnerable to depression (a Never Depressed group) and in individuals vulnerable to depression (a Previously Depressed group). In the chimeric faces task, the Previously Depressed group had a significantly larger left hemispatial bias compared to the Never Depressed group. This may reflect relatively greater posterior RH activity/arousal in the Previously Depressed group. No differences were found between SSRI Responders and Non-responders in the chimeric faces task. In the divided visual field task, hemispheric differences in the processing of emotional words were found between the SSRI Responders and SSRI Non-responders. In contrast to SSRI Responders and Never Depressed controls, SSRI Non-responders showed a relative advantage for negative over positive words when they were presented to their LVF/RH; and an advantage for negative words presented to their LVF/RH compared to their RVF/LH. Additionally, they were more sensitive to perceiving the valence of a word that was presented to their LVF/RH. This suggests that their RH semantic systems may differ from that of SSRI Responders and Never Depressed controls. Genetic, hormonal and cognitive factors are discussed in relation to these patterns of hemispheric asymmetries and responsiveness to SSRI medication.</p>

Comparison of Maternal Self-Efficacy and Infant Care Behavior Between Mothers with and Without Depression: A Case-Control Study

Background: Postpartum depression (PPD) affects various dimensions of women's lives. The present study aimed to compare infant care behavior and maternal self-efficacy between depressed and non-depressed mothers. Objectives: This case-control study was conducted among 80 (n = 40 per group) postpartum women. Methods: A socio-demographic characteristics form, Edinburgh Postnatal Depression Scale (EPDS), Maternal Self-efficacy Questionnaire (MSQ), and Infant Care Behavior questionnaire were used for data collection. Independent t-test was run for data analysis. The mean score of maternal self-efficacy in the depressed group was 29.3 (3.6), and it was 33.0 (3.3) in the non-depressed group, which was significantly higher in the non-depressed group compared to the depressed group based on independent t-test results (adjusted mean difference: -3.7; 95% Confidence Interval: -2.2 to 5.3; P < 0.001). Results: The mean score of infant care behavior was 72.2 (5.2) in the depressed group and 73.0 (9.0) in the non-depressed group, indicating no significant differences between the two groups according to independent t-test (P = 0.627). Conclusions: Depressed women were less self-efficient; thus, given the central role of mothers, some strategies should be adopted to minimize mothers' postpartum physical and mental problems and promote their self-efficacy and infant care behaviors.

Maternal Serotonin Reuptake Inhibitor Antidepressants Have Acute Effects on Fetal Heart Rate Variability in Late Gestation

Background: Prenatal exposure to serotonin reuptake inhibitor (SRI) antidepressants increases risk for adverse neurodevelopmental outcomes, yet little is known about whether effects are present before birth. In relation to maternal SRI pharmacokinetics, this study investigated chronic and acute effects of prenatal SRI exposure on third-trimester fetal heart rate variability (HRV), while evaluating confounding effects of maternal depressed mood.Methods: At 36-weeks' gestation, cardiotocograph measures of fetal HR and HRV were obtained from 148 pregnant women [four groups: SRI-Depressed (n = 31), SRI-Non-Depressed (n = 18), Depressed (unmedicated; n = 42), and Control (n = 57)] before, and ~5-h after, typical SRI dose. Maternal plasma drug concentrations were quantified at baseline (pre-dose) and four time-points post-dose. Mixed effects modeling investigated group differences between baseline/pre-dose and post-dose fetal HR outcomes. Post hoc analyses investigated sex differences and dose-dependent SRI effects.Results: Maternal SRI plasma concentrations were lowest during the baseline/pre-dose fetal assessment (trough) and increased to a peak at the post-dose assessment; concentration-time curves varied widely between individuals. No group differences in fetal HR or HRV were observed at baseline/pre-dose; however, following maternal SRI dose, short-term HRV decreased in both SRI-exposed fetal groups. In the SRI-Depressed group, these post-dose decreases were displayed by male fetuses, but not females. Further, episodes of high HRV decreased post-dose relative to baseline, but only among SRI-Non-Depressed group fetuses. Higher maternal SRI doses also predicted a greater number of fetal HR decelerations. Fetuses exposed to unmedicated maternal depressed mood did not differ from Controls.Conclusions: Prenatal SRI exposure had acute post-dose effects on fetal HRV in late gestation, which differed depending on maternal mood response to SRI pharmacotherapy. Importantly, fetal SRI effects were sex-specific among mothers with persistent depressive symptoms, as only male fetuses displayed acute HRV decreases. At trough (pre-dose), chronic fetal SRI effects were not identified; however, concurrent changes in maternal SRI plasma levels suggest that fetal drug exposure is inconsistent. Acute SRI-related changes in fetal HRV may reflect a pharmacologic mechanism, a transient impairment in autonomic functioning, or an early adaption to altered serotonergic signaling, which may differ between males and females. Replication is needed to determine significance with postnatal development.

Lurasidone in the long-term treatment of Japanese patients with bipolar I disorder: a 52 week open label study

Background The current study evaluated the long-term (52 week) safety and impact on symptom measures of lurasidone (with or without lithium or valproate) for the treatment of bipolar I disorder in Japanese patients. Methods Bipolar patients for this open-label flexibly dosed lurasidone (20–120 mg/day) study were recruited from those with a recent/current depressive episode who completed an initial 6 week, double-blind, placebo-controlled, lurasidone study (depressed group), and those with a recent/current manic, hypomanic, or mixed episode (non-depressed group) who agreed to enroll directly into the long-term study. Measures of adverse events and safety included treatment-emergent adverse events, vital signs, body weight, ECG, laboratory tests, and measures of suicidality and extrapyramidal symptoms. Symptom measures included Montgomery Åsberg Depression Rating Scale (MADRS) and Young Mania Rating Scale (YMRS). Results The most common adverse events associated with lurasidone were akathisia (30.7%), nasopharyngitis (26.6%), nausea (12.1%), and somnolence (12.1%). Minimal changes in lipids and measures of glycemic control occurred. Mean change in body weight was + 1.0 kg in the non-depressed group and − 0.8 kg in the depressed group. MADRS total scores declined by a mean (SD) of 2.0 (14.7) points from long-term baseline to endpoint in the depressed group who had received placebo in the prior 6 week trial. The depressed group that had received lurasidone during the prior 6 week study maintained their depressive symptom improvements. For the non-depressed group, YMRS total scores decreased over time. Limitations No control group was included, treatment was open-label, and 49.7% of patients completed the 52 week study. Conclusions Long-term treatment with lurasidone 20–120 mg/day for Japanese patients with bipolar disorder maintained improvements in depressive symptoms for depressed patients who were treated in a prior 6 week trial and led to improvements in manic symptoms among a newly recruited subgroup of patients with a recent/current manic, hypomanic, or mixed episode. Few changes in weight or metabolic parameters were evident. Clinical trial registration: JapicCTI-132319, clinicaltrials.gov—NCT01986114.

Genetic Biomarkers in Association with Depressive Disorder in UAE Residents: A Pilot Case Study

Objectives: We sought to explore the expression of genes associated with depressive disorder in patients with depression compared to control patients. A large body of research in the area of genetics has shown familial aggregation for depressive disorders. The purpose of this study was to identify genetic risk factors in developing depression, particularly among the population residing in the UAE. Methods: We investigated five associated genes (PPARGC1A,CAMKMT,HSD11B1,SLC6A4,and MAOA) previously linked to depression and anxiety in other populations. The study was carried out in Al Ain, although participants were from different nationalities. Blood samples were collected over a period of seven months, and lab work was carried out over a period of two months from September 1, 2018 to May 30, 2019. We screened the prevalence of the PPARGC1A,CAMKMT,HSD11B1,SLC6A4, and MAOA in 29 patients with depressive disorder and 30 controls using the quantitative real-time polymerase chain reaction method. Results: The expression of the PPARGC1A gene, studied for the first time in the UAE population. The independent t-test was used to check the significance of difference between the expression levels of target genes where the control was set at a reference level of 1.0. PPARGC1A gene is lower among the depressed group which showed mean difference: 0.4 and p-value: 0.02, indicating a strong association with depression. No significant difference was found in the genes’ expression of CAMKMT with p-value 0.150, MAOA p-value 0.070, SLC6A4 p-value 0.750, and HSD11B1 p-value 0.100 in two groups in comparison with (p < 0.050). Conclusions: These results open several possibilities for further research to study the role of this gene as a protective factor against developing depression.

Detection of Minor and Major Depression through Voice as a Biomarker Using Machine Learning

Both minor and major depression have high prevalence and are important causes of social burden worldwide; however, there is still no objective indicator to detect minor depression. This study aimed to examine if voice could be used as a biomarker to detect minor and major depression. Ninety-three subjects were classified into three groups: the not depressed group (n = 33), the minor depressive episode group (n = 26), and the major depressive episode group (n = 34), based on current depressive status as a dimension. Twenty-one voice features were extracted from semi-structured interview recordings. A three-group comparison was performed through analysis of variance. Seven voice indicators showed differences between the three groups, even after adjusting for age, BMI, and drugs taken for non-psychiatric disorders. Among the machine learning methods, the best performance was obtained using the multi-layer processing method, and an AUC of 65.9%, sensitivity of 65.6%, and specificity of 66.2% were shown. This study further revealed voice differences in depressive episodes and confirmed that not depressed groups and participants with minor and major depression could be accurately distinguished through machine learning. Although this study is limited by a small sample size, it is the first study on voice change in minor depression and suggests the possibility of detecting minor depression through voice.