Journal of affective disorders
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Correlational studies investigating neurohormonal-cytokine modulation by antidepressants suggest, among others, variations in cytokines balances as state markers of different biological subtypes of major depressive disorder (MDD) and response predictors to specific treatments. Objective of the study was to investigate cytokines modulation by duloxetine, a relatively newer SNRI with "clean" dual serotonin/norepinephrine mechanism. ⋯ In accordance to early clinical response, duloxetine treatment could divide depressed patients into at least 2 subgroups characterized by clinical and laboratory differentiated behavior, suggesting different neurobiological background within depressive syndrome differentially sensitive to different drug components: pro-serotonergic effect and increase in Th1 cytokines in ENR vs. pro-noradrenergic effect and decrease in Th1 cytokines in ER.
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The study endeavoured to gauge the impact of the current economic crisis on the mental health of the Greek population. Particularly, it explored changes in the prevalence rates of major depression between 2008 and 2011, and its link to financial hardship. Furthermore, the study also identified potential predictors of major depression in 2011. ⋯ The impact of the economic crisis on the mental health of the population is pervasive. Services and clinicians should focus on the primary prevention of major depression as well as on its timely recognition and treatment.
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Review Multicenter Study
Posttraumatic stress disorder, depression, and health-related quality of life in patients with bipolar disorder: review and new data from a multi-site community clinic sample.
Evidence suggests that patients with bipolar disorder have an elevated risk for comorbid posttraumatic stress disorder (PTSD) compared to those without a bipolar diagnosis. Although bipolar disorder is associated with decreased health-related quality of life (HRQOL), it is unclear whether comorbid PTSD interacts to affect HRQOL. ⋯ Depressive symptoms may explain the association between PTSD and mental HRQOL. Clinicians working with these patients will want to emphasize treatment of depression as important towards improving HRQOL for this group.
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Melancholia is positioned as either a more severe expression of clinical depression or as a separate entity. Support for the latter view emerges from differential causal factors and treatment responsiveness but has not been convincingly demonstrated in terms of differential clinical features. We pursue its prototypic clinical pattern to determine if this advances its delineation. ⋯ The clinician-rated SMPI differentiated melancholic and non-melancholic depressed subjects at a higher level of confidence than the self-report SMPI, and with a highly acceptable level of discrimination. The measure is recommended for further testing of its intrinsic and applied properties.
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Comparative Study
Independent versus substance-induced major depressive disorders in first-admission patients with substance use disorders: an exploratory study.
Clinical differences between independent and substance-induced (S-I) major depressive disorders (MDDs) in patients with substance use disorders (SUDs) are insufficiently studied. ⋯ Independent MDDs were more severe and had different qualities compared with S-I MDDs, suggesting important treatment implications. Longitudinal studies including larger samples and carefully addressing the association between SUD subtypes and MDD subtypes are needed to substantiate our findings.