Common Antidepressant Sertraline Does Not Improve Depression in Chronic Kidney Disease Patients

MedicalResearch.com Interview with:

Dr. Susan Hedayati MD University of Texas Southwestern Dallas, Texas

Dr. Hedayati

Dr. Susan Hedayati MD
Yin Quan-Yuen Distinguished Professorship in Nephrology
University of Texas Southwestern
Dallas, Texas

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We previously showed that Major Depression is associated with a significantly higher risk of death, dialysis initiation, and hospitalization among patients with Chronic Kidney Disease (CKD). Now we show that a common antidepressant medication, a selective serotonin reuptake inhibitors (SSRI), sertraline, does not improve depression in this patient population, a chronically ill group that is not only at significantly increased risk for developing depression but also its serious complications.

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Migraines More Frequent With Increased Anxiety and Depression

MedicalResearch.com Interview with:

“Headache.” by Avenue G is licensed under CC BY 2.0

“Headache.” by Avenue G

Fu-Chi Yang, M.D., Ph.D.Assistant Professor
Department of Neurology,
Tri-Service General Hospital
National Defense Medical Center
Taipei, Taiwan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Migraineurs are likely to suffer from comorbid depression and anxiety. Furthermore, increased migraine frequency is associated with an increased risk of mood/anxiety disorders. It is not distinguished by grouping frequency of migraine attacks, whether it is associated with severity scores of depression and anxiety. Thus, we evaluated the relationship between severity of depression/anxiety and migraine frequency

We mainly found that the severity of depression (BDI and HADS-depression scores) and anxiety (HADS anxiety score) were related to migraine frequency, after adjusting confounding factors.

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Alzheimer’s: Antidepressants Increase Risk of Head and Traumatic Brain Injuries

MedicalResearch.com Interview with:

Heidi Taipale, PhD Pharm Senior Researcher School of Pharmacy, University of Eastern Finland; and Department of Clinical Neuroscience Karolinska Institutet 

Dr. Taipale

Heidi Taipale, PhD Pharm
Senior Researcher
School of Pharmacy, University of Eastern Finland; and
Department of Clinical Neuroscience
Karolinska Institutet 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Antidepressant use among older persons has been associated with an increased risk of falling and fall-related events, such as hip fractures, in previous studies. Our previous study identified risk of hip fractures in antidepressant among persons with Alzheimer’s disease. As falling is the main causal factor for head traumas and traumatic brain injuries among older persons, we hypothesized that antidepressant use could also be associated with these injuries.

We utilized a nationwide cohort of 70,718 persons newly diagnosed with Alzheimer’s disease, identified from the Finnish registers. The risk of head injuries and traumatic brain injuries was compared between persons initiating antidepressant use and comparison persons of the same age, gender and time since they received diagnoses of Alzheimer’s disease but not using antidepressants. We found a 40-percent increased risk of head injuries and 30-percent increased risk of traumatic brain injuries associated with antidepressant use. Antidepressant use was associated with a higher risk of head injuries especially at the beginning of use – during the first 30 days – but the risk persisted even longer, up to two years. The association was also confirmed in a study design comparing time periods within the same person, thus eliminating selective factors. Continue reading

Brain Imaging Confirms Boys and Girls Experience Depression Differently

MedicalResearch.com Interview with:

Jie-Yu Chuang PhD Department of Psychiatry University of Cambridge Cambridge, United Kingdom

Dr. Jie-Yu Chuang

Jie-Yu Chuang PhD
Department of Psychiatry
University of Cambridge
Cambridge, United Kingdom 

MedicalResearch.com: What is the background for this study?

Response: Men and women appear to suffer from depression differently, and this is particularly striking in adolescents. By 15 years of age, girls are twice as likely to suffer from depression as boys. There are various possible reasons for this, including body image issues, hormonal fluctuations and genetic factors, where girls are more at risk of inheriting depression. However, differences between the sexes don’t just involve the risk of experiencing depression. Men are more liable to suffer from persistent depression, whereas in women depression tends to be more episodic. Compared with women, depressed men are also more likely to suffer serious consequences from their depression, such as substance abuse and suicide. Despite this, so far, most researchers have focused on depression in women, likely because it is more common. As a result, we’d like to make people more aware of the sex difference issue in depression.

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Study Helps Explains Why Dopamine Drugs Not Effective For Depression

MedicalResearch.com Interview with:

Robb B. Rutledge, PhD Max Planck University College London Centre for Computational Psychiatry  and Ageing Research University College London London, England

Dr. Rutledge

Robb B. Rutledge, PhD
Max Planck University College London Centre for Computational Psychiatry
and Ageing Research
University College London
London, England

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depression is associated with deficits in how the brain responds to rewards, something the neurotransmitter dopamine is strongly implicated in.

Dopamine represents what is called a reward prediction error, the difference between experienced and predicted reward. This error signal is used for learning. For example, if the outcome of a decision is better than expected, you can update your expectations using this error signal and you should expect more next time. Previous research has shown that depression reduces these signals in the brain when people are learning about the world around them. We designed a task where participants did not have to learn anything during the experiment and we found that in this situation reward prediction error signals were not affected by depression. The signals we measured in the ventral striatum, a brain area with a lot of input from the dopamine neurons, looked the same in depressed and non-depressed individuals. We also found that the emotional impacts of reward prediction errors were similar in depressed and non-depressed individuals when we eliminated the need for learning during the task in both the lab and using a smartphone experiment with 1833 participants.

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New Simultaneous Antidepressant and Benzodiazepine Use Relatively Common

MedicalResearch.com Interview with:

Greta A Bushnell, MSPH Doctoral Candidate, Department of Epidemiology UNC, Gillings School of Global Public Health

Greta Bushnell

Greta A Bushnell, MSPH
Doctoral Candidate, Department of Epidemiology
UNC, Gillings School of Global Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Patients with depression may be co-prescribed a benzodiazepine at antidepressant initiation for a short period for a variety of reasons. Reasons include reducing concurrent anxiety and insomnia, reducing depression severity more quickly, and improved antidepressant continuation. However, there are concerns with benzodiazepines including dependency. As such, benzodiazepines are usually recommended for only short-term treatment.

Prior to our study, little was known about a) how often new simultaneous antidepressant and benzodiazepine prescribing occurred among patients initiating antidepressant treatment for depression or b) whether new simultaneous users became long-term benzodiazepine users.

In a large commercial insurance database, we identified adults aged 18-64 years with depression who initiated an antidepressant from 2001 to 2014. We found that 11% of adults simultaneously initiated benzodiazepine treatment, which increased from 6% in 2001 to a peak at 12% in 2012. We observed similar antidepressant treatment length at six months in simultaneous new users and among patients initiating antidepressants only. The majority of simultaneous new users had only one benzodiazepine prescription fill before benzodiazepine discontinuation; however, 12% were identified as long-term benzodiazepine users.

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Pain and Depression in ESRD- End Stage Renal Disease

MedicalResearch.com Interview with:
Kathy Aebel-Groesch, MSW,LCSW
Manager, Social Work Services
DaVita Inc.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Chronic pain and depression can impact quality of life and adherence to treatment regimen among patients with end-stage renal disease (ESRD). Previous research has demonstrated that patients with ESRD experience pain and depression more frequently than the general population. From 2016, CMS has required that all eligible ESRD patients are evaluated regularly for pain and depressive symptoms.

We assessed pain and depression symptom scores among patients of a large dialysis organization (LDO) over the period Mar-Oct 2016. Pain was assessed monthly by LDO nurses using the Wong-Baker pain scale (0-10). Depression screenings were conducted biannually by LDO social workers using the PHQ-2 (scale 0-6) and excluded patients with existing diagnosis of depression or bipolar disorder, cognitive impairment or language barrier, and those who were hospitalized or refused screening.

A total of 688,346 pain responses from 160,626 individual patients and 223,421 depression screening responses from 158,172 patients were considered. A score of 0 (no pain) was reported for 83.5% of pain responses and 65.7% of patients had a 0 score in all pain assessments. A score of 10 (most severe pain) was reported at least once during the study period by 3.0% of patients. Patients with a pain score of 10 were more frequently female (55%) and patients on peritoneal dialysis were less likely to have a pain score of 10 than those on other modalities. A depression score of 0 (patient answered “Not at all” to both “Little interest or pleasure in doing things” and “Feeling down, depressed, or hopeless”) was reported for 69.1% of all responses and 62.6% of patients had a 0 score in all assessments; 1.8% of patients had at least one score of 6 (patient responded “Nearly every day” to both questions) and 9.7% had at least one score of 3 or more. Patients with a score of 0 were more likely to be male vs. female, HHD vs. PD or ICHD, ≥ age 70 years.

The majority of ESRD patients did not report pain symptoms and, among those not excluded from screening due to an existing diagnosis of depression or other reason, the majority did not report symptoms of depression. However, routine assessment of pain and depression enables the timely identification of new or increased symptoms, thus allowing earlier implementation of interventions that may improve patient experience. The LDO has since revised its depression screening policy to remove diagnosis of depression from exclusion criteria and to administer the PHQ-9 to patients with a PHQ-2 score ≥ 3.

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Acupuncture Therapy and Incidence of Depression After Stroke

MedicalResearch.com Interview with:
Chung-Yen Lu, MD, PhD

Assistant Professor
Department of Sport and Health Management, Da-Yeh University, Changhua, Taiwan; Department of Chinese Medicine, Taipei Hospital, Ministry of Health and Welfare,
New Taipei, Taiwan 

MedicalResearch.com: What is the background for this study?

Response: Post-stroke depression is a common mood complication of patients with stroke and may deteriorate motor function and cognitive function. Acupuncture therapy is an alternative and supplementary medical care often used worldwide. Previous studies have reported that acupuncture therapy for post-stroke depression may involve multiple therapeuticeffects including treating neurological disorders and physical disabilities following stroke, which are predictors of post-stroke depression. However, population-based evaluations on the association between acupuncture treatment and prevention of post-stroke depression are rare.  Continue reading

Microvascular Disease Linked To Late-Life Depression

MedicalResearch.com Interview with:

Miranda T. Schram PhD Associate professor Department of Medicine Maastrich

Dr. Schram

Miranda T. Schram PhD
Associate professor
Department of Medicine
Maastrich

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Late-life depression, also called vascular depression, is highly prevalent, recurrent and difficult to treat. Anti-depressants only relieve symptoms in about 50% of the patients. So we urgently need new treatment targets for this disease.

In this study we found that microvascular dysfunction, irrespective if you measure this by biomarkers in the blood or in the brain, is associated with an increased risk for depression. Moreover, we found evidence from longitudinal studies that microvascular dysfunction, at least of the brain, may actually be a cause of depression. To investigate this, we undertook a meta-analyses of data from over 40,000 individuals of whom over 9,000 had a depression.

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LATUDA Phase 3 Study Demonstrates Improvement in Pediatric and Adolescent Bipolar Depression

MedicalResearch.com Interview with:

Antony Loebel, M.D. Executive Vice President and Chief Medical Officer Sunovion, Head of Global Clinical Development Sumitomo Dainippon Pharma Group

Dr. Loebel

Antony Loebel, M.D.
Executive Vice President and Chief Medical Officer
Sunovion, Head of Global Clinical Development
Sumitomo Dainippon Pharma Group

MedicalResearch.com: What is the background for this study? What are the main findings?

In the six-week, randomized, double-blind, placebo-controlled study, 347 children and adolescents (10 to 17 years of age) with bipolar depression received once-daily LATUDA flexibly dosed (20-80 mg/day) or placebo.The Phase 3 clinical study met its primary endpoint, showing statistically significant and clinically meaningful improvement in symptoms compared to placebo. LATUDA was generally well tolerated, with minimal effects on weight and metabolic parameters.

The primary efficacy endpoint was change from baseline to week 6 on the Children Depression Rating Scale, Revised (CDRS-R) total score. LATUDA was associated with statistically significant and clinically meaningful improvement in bipolar depression symptoms compared to placebo, based on CDRS-R total score (-21.0 vs. -15.3; effect size = 0.45; p<0.0001) and CGI-BP-S score for depression (-1.49 vs. -1.05; effect size = 0.44; p<0.001).

LATUDA also demonstrated statistically significant improvement on secondary efficacy endpoints.

The most common treatment-emergent adverse events reported for LATUDA compared to placebo were nausea (16% vs. 5.8%), somnolence (9.1% vs. 4.7%), weight gain (6.9% vs. 1.7%), vomiting (6.3% vs. 3.5%), dizziness (5.7% vs. 4.7%) and insomnia (5.1% vs. 2.3%). LATUDA was associated with no increases in fasting glucose or lipids, and minimal increase in mean weight vs. placebo (+0.74 kg vs. +0.44 kg).

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Depressive Symptoms Not Found To Increase Risk of Dementia

MedicalResearch.com Interview with:

Archana Singh-Manoux, PhD Research Professor (Directeur de Recherche) Epidemiology of ageing & age-related diseases INSERM U1018, France Honorary Professor University College London, UK

Dr. Archana Singh-Manoux

Archana Singh-Manoux, PhD
Research Professor (Directeur de Recherche)
Epidemiology of ageing & age-related diseases
INSERM  France
Honorary Professor
University College London, UK 

MedicalResearch.com: What is the background for this study?

Response: Depressive symptoms are common in dementia patients. Previous studies, based on older adults, show depressive symptoms in late life to be associated with an increased risk of dementia. These studies do not allow conclusions to be drawn on the causal nature of the association between depressive symptoms and dementia.

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Vagus Nerve Stimulation Improved Treatment-Resistant Depression

MedicalResearch.com Interview with:

Scott T. Aaronson, M.D Psychiatrist, The Retreat at Sheppard Pratt Director of Clinical Research Sheppard Pratt Health System Baltimore, MD

Dr. Aaronson

Scott T. Aaronson, M.D
Psychiatrist, The Retreat at Sheppard Pratt
Director of Clinical Research
Sheppard Pratt Health System
Baltimore, MD

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is the largest ever conducted on patients with severe, chronic depression, a group typically ignored by clinical research in psychiatry. We looked at individuals who, on average, had received 8 unsuccessful treatment interventions in the past. These individuals were split into two groups and examined over five years. One group was given proven anti-depressant treatments (medications, psychotherapy, and/or electroconvulsive therapy (ECT)), and one group was given both anti-depressant treatments and VNS Therapy—an implantable, pacemaker-like device that stimulates the vagus nerve, which regulates mood in the brain.
• The study found that 67.9% of the VNS therapy group responded to treatment, compared to 40.9% of patients receiving treatment as usual. Importantly, the VNS therapy group reported responses earlier in treatment, and responses were sustained longer than those receiving treatment as usual.
• VNS therapy improved treatment effect in individuals whether they had unipolar or bipolar disorder, and whether or not they had responded to ECT in the past.

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Singing Enhances Mother-Infant Bond Even When Mom Has PostPartum Depression

MedicalResearch.com Interview with:

Shannon K. de l’Etoile, Ph.D., MT-BC Associate Dean of Graduate Studies Professor, Music Therapy University of Miami Phillip and Patricia Frost School of Music Coral Gables, FL

Dr. de l’Etoile

Shannon K. de l’Etoile, Ph.D., MT-BC
Associate Dean of Graduate Studies
Professor, Music Therapy
University of Miami
Phillip and Patricia Frost School of Music
Coral Gables, FL

MedicalResearch.com: What is the background for this study?

Response: Infant-directed (ID) singing allows infants to have emotionally-synchronized interactions with caregivers, during which they gain valuable experience in self-regulation. Maternal depression can disrupt mother-infant interaction, thus hindering infants’ efforts at self-regulation and possibly contributing to a depressed interaction style that can generalize to infant interaction with strangers. Additionally, maternal depression can alter the acoustic parameters of ID singing, such that mothers may not modify musical elements (i.e., tempo and key), to accommodate infant state.

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Antidepressants Have Variable Effects On Symptom Clusters

MedicalResearch.com Interview with:

Adam Chekroud PhD Candidate Human Neuroscience Lab

Adam Chekroud

Adam Chekroud
PhD Candidate
Human Neuroscience Lab
Department of Psychology
Yale University

MedicalResearch.com: What is the background for this study?

Response: We know that depression includes a wide range of symptoms, from low mood and feeling worthless, to problems sleeping, slowed thinking, and suicidal ideation.

We wanted to know whether antidepressants work well in treating all of these symptoms, or whether they are primarily effective on certain kinds of symptoms.

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Self-Guided Internet Based Cognitive Behavioral Therapy Shows Promise For Depression

MedicalResearch.com Interview with:
Eirini Karyotaki, MSc

Department of Clinical Psychology and EMGO Institute for Health and Care Research
Vrije Universiteit Amsterdam
Amsterdam, the Netherlands

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depression is broadly acknowledged as a major health issue associated with a great risk of mortality and morbidity. Nevertheless, help-seeking rates are low among individuals with depression. Some of the barriers that impede help seeking are the limited availability of trained clinicians, the fear of stigmatisation and the cost of treatment. Self-guided Internet based Cognitive behavioural therapy (iCBT) has the potential to overcome many of these treatment barriers. However, recent randomised controlled trials (RCTs) have produced mixed evidence regarding the effects of self-guided iCBT in treating adults with depressive symptoms.

To gain more insight in the effectiveness of self-guided iCBT, an Individual Participant Data meta-analysis was performed. 3876 individual participant data across 13 RCTs were collected and analysed.

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Paternal Depression Linked To Not Being in Relationship With Mother

MedicalResearch.com Interview with:
Lisa Underwood, PhD
Research Fellow| Centre for Longitudinal Research
Growing Up in New Zealand | Who are Today’s Dads?
School of Population Health, Faculty of Medical & Health Sciences
University of Auckland  Auckland

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is part of the contemporary, longitudinal study Growing Up in New Zealand, which is tracking the development of more than 6000 children born in 2009 and 2010.

In previous reports we investigated antenatal and postnatal depression symptoms among the mothers of our cohort children. In this study we looked at the partners of those mothers to explore whether men and women have different risks for depression in each perinatal period.

Our main findings were that expectant fathers were at risk if they felt stressed or were in poor health. Elevated depression symptoms following their child’s birth, were also linked to social and relationship problems.

The strongest predictor of postnatal paternal depression was no longer being in a relationship with the child’s mother.

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Oxytocin During Labor Linked to Increased Risk of Postpartum Depression

MedicalResearch.com Interview with:

Kristina M. Deligiannidis, MD Associate Professor, Center for Psychiatric Neuroscience The Feinstein Institute for Medical Research Director, Women’s Behavioral Health, Zucker Hillside Hospital Northwell Health Associate Professor, Psychiatry and Obstetrics & Gynecology Hofstra Northwell School of Medicine

Dr. Kristina Deligiannidis

Kristina M. Deligiannidis, MD
Associate Professor
Center for Psychiatric Neuroscience
The Feinstein Institute for Medical Research
Director, Women’s Behavioral Health
Zucker Hillside Hospital Northwell Health
Associate Professor
Psychiatry and Obstetrics & Gynecology
Hofstra Northwell School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Because of effects on social behavior, including maternal behavior, oxytocin has often been seen as a potential mediator of postpartum depression and anxiety.

The original objective of our study was to examine the relationship between the use of synthetic oxytocin during and after labor and the development of depressive and anxiety disorders within the first year postpartum. We hypothesized that women exposed to synthetic oxytocin before or during labor would have a reduced risk of postpartum depressive and anxiety disorders compared with those without any exposure. Our findings told the opposite story.

We found that peripartum synthetic oxytocin exposure was associated with an increase in risk for the development of postpartum depression and anxiety.

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More Hip Fractures in Elderly on Antidepressants

MedicalResearch.com Interview with:

Sanna Torvinen-Kiiskinen MSc (Pharm.), PhD student, Kuopio Research Centre of Geriatric Care and School of Pharmacy University of Eastern Finland

Sanna Torvinen-Kiiskinen

Sanna Torvinen-Kiiskinen
MSc (Pharm.), PhD student,
Kuopio Research Centre of Geriatric Care and School of Pharmacy
University of Eastern Finland

MedicalResearch.com: What is the background for this study?

Response: Antidepressants are widely used among elderly persons, especially persons with Alzheimer’s disease. They are used not only for treatment for major depression, but for treatment of anxiety, insomnia and chronic pain as well as behavioral symptoms caused by dementia.

However, antidepressants, as well as other psychotropic drugs, may cause sedation, confusion, orthostatic hypotension and hyponatremia, which increase the risk of falling and fractures. Because of changes in pharmacodynamics and pharmacokinetics due to aging, older persons are at the higher risk of those adverse events.

The aim of our study was to investigate whether antidepressant use is associated with an increased risk of hip fracture among community-dwelling persons with and without Alzheimer’s disease.

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Strong SSRIs Linked To Increase Risk of Intracranial Hemorrhage

MedicalResearch.com Interview with:
Christel Renoux, MD, PhD
Assistant Professor, Dept. of Neurology & Neurosurgery
McGill University
Centre For Clinical Epidemiology
Jewish General Hospital – Lady Davis Research Institute
Montreal  Canada

MedicalResearch.com: What is the background for this study?

Response: Selective serotonin reuptake inhibitors (SSRIs) increase the risk for abnormal bleeding, in particular, gastrointestinal tract bleeding. Previous studies also suggested an increased risk for intracranial hemorrhage (ICH) in patients treated with SSRIs compared to non users. However, even if this risk exists, the comparison with a non-treated group may exaggerate the strength of a potential association and the comparison with a group of patients treated with other antidepressants may help better delineate the risk. The potential bleeding effect of antidepressants is linked to the strength of serotonin inhibition reuptake, and antidepressants that are strong inhibitors of serotonin reuptake have been associated with the risk for gastrointestinal or abnormal bleeding compared with weak inhibitors but the risk of ICH is unclear.

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Is Depression in Mild Cognitive Impairment a Precursor to Dementia?

MedicalResearch.com Interview with:
Zahinoor Ismail MD FRCPC

Clinical Associate Professor,
Hotchkiss Brain Institute
University of Calgary

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depression and depressive symptoms are common in mild cognitive impairment (MCI). Evidence suggests that depression in MCI increases the likelihood of progression from MCI to dementia, compared to non-depressed people with MCI. In the newer construct of mild behavioural impairment (MBI), which describes the relationship between later life onset of sustained and impactful neuropsychiatric symptoms and the risk of cognitive decline and dementia, depression is an important subdomain (in addition to apathy, impulse control, social cognition and psychotic symptoms). Thus, depression and depressive symptoms are a significant risk factor for cognitive, behavioural and functional outcomes in older adults who have at most mild cognitive impairment. As the importance of neuropsychiatric symptoms in older adults emerges, good prevalence estimates are required to inform clinicians and researchers as well as public health policy and decision makers.

We performed a systematic review and meta-analysis to determine the best estimate of prevalence of depression in  mild cognitive impairment. We included 57 studies, representing 20,892 participants in the analysis. While we determined that the omnibus prevalence estimate was 32%, there was significant heterogeneity in this sample based on setting. In community samples, the rate was 25%, but in clinical samples this was higher at 40%. Additionally, different case ascertainment methods for depression (self report, clinician administered or caregiver report) and different MCI criteria didn’t change the prevalence estimates.

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Hearing Loss Linked To Increased Depression and Dementia Risk

MedicalResearch.com Interview with:

Dr-Frank-Lin.jpg

Dr. Lin

Frank Robert Lin, M.D., Ph.D.
Associate Professor of Geriatric Medicine, Head and Neck Surgery
Johns Hopkins Medicine

MedicalResearch.com Editor’s note: Dr. Lin discussed his research during Cochlear’s Global Research Symposium, which brought together international experts from the audiology community.

MedicalResearch.com: Is there a link between hearing loss and the risk of developing dementia?

Response: In the last few years, we have investigated the link between hearing loss and dementia in large studies of older adults who have been followed for many years. In these studies, we and others have found that those with greater hearing loss have a higher risk of developing dementia even after we account for factors like age, education, medical comorbidities, etc. We think this is because there are some pathways through which hearing loss can directly affect our thinking and memory abilities

MedicalResearch.com: Is there an association between hearing loss and cognitive decline or premature death?

Response: There is a link between hearing loss and accelerated cognitive decline. There is also external research that links hearing loss and premature death (Friburg 2014, Contrera 2015). Hearing loss can also increase a person’s chance of using medical and social services

MedicalResearch.com: How is hearing loss linked to increased social isolation and depression in the elderly?

Response: Older people with hearing loss are at a greater risk of social isolation due to their difficulty communicating with people. These individuals may be less likely to go out, particularly to settings where listening can be difficult (e.g., restaurants), and even if they do go out, they may feel isolated from the conversation and not able to engage with others.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that we’re increasingly understanding that hearing loss can detrimentally impact our thinking and memory abilities, risk of dementia, and our ability to remain engaged with others. Ongoing research is now studying to what extent our current hearing loss therapies can reduce and mitigate these risks and promote healthy aging.

MedicalResearch.com: Is there anything else you would like to add?

Response: Readers should know that hearing loss is a growing public health issue. It has been estimated that by 2050 1.2 billion people will suffer from hearing loss, underscoring the need for us to address it and recognize the burden of hearing loss on wider health. To learn more visit,www.linresearch.org and www.nas.edu/hearing

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Cochlear’s Global Research Symposium October 2016

Disclosure:  Symposium supported by Cochlear Limited (ASX: COH), together with Macquarie University and the Australian Hearing Hub

www.cochlear.com

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on MedicalResearch.com

Childhood Depression and Antidepressants Associated With Weight Gain

MedicalResearch.com Interview with:

Lisa Bailey-Davis, DEd, RD Assistant Professor, Department of Epidemiology and Health Services Research Associate Director, Obesity Institute Geisinger Health Systems Danville, PA 17822

Lisa Bailey-Davis

Lisa Bailey-Davis, DEd, RD
Assistant Professor, Department of Epidemiology and Health Services Research
Associate Director, Obesity Institute
Geisinger Health Systems
Danville, PA 17822

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: National data from CDC suggest that 3.1% of 12-17 year olds self-reported using an antidepressant in 2005-2010, however we examined electronic health record orders at a large health system and found that antidepressants are ordered more frequently. Antidepressants were ordered for 7.2% of 13 year olds and 16.6% of 18 year olds in our population-representative data.

Five or more cumulative months of antidepressant use was strongly associated with increased body mass index, particularly among older youths. At age 18 years, youth treated with 12 or more months of antidepressants were likely to be 2.1 kg heavier than youth without antidepressants. Depression diagnosis, independent, of antidepressants was also associated with higher body mass index. At age 12 years, youth with at least 1 depression diagnosis had a higher average BMI than youth without such diagnosis.

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Use of Marijuana At Young Age Linked To Functional Brain Abnormalities and Lower IQ

MedicalResearch.com Interview with:

Elizabeth Osuch, M.D. Associate Professor; Rea Chair Department of Psychiatry FEMAP--London Health Sciences Centre London, ON

Dr. Elizabeth Osuch

Elizabeth Osuch, M.D.
Associate Professor; Rea Chair
Department of Psychiatry
FEMAP–London Health Sciences Centre
London, ON   

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: As a researcher and psychiatrist doing clinical work in youth aged 16-25 with mood and anxiety disorders I often see patients who are depressed and believe that using marijuana (MJ) improves their mood.  Yet they remain depressed.  This was the clinical inspiration for this brain imaging study, where we investigated emerging adults with Major Depressive Disorder (MDD).  Subject groups included patients with MDD who did and did not use MJ frequently.  Our results showed that the MDD+MJ group did not have significantly less depression than the MDD alone group, and the brain abnormalities found in MDD were not corrected by MJ use in the MDD+MJ group.  In fact, some of the brain differences were worse with the addition of MJ, while others were just different.

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Efficacy of Lurasidone in treatment of MDD-MF

MedicalResearch.com Interview with:
Antony Loebel, M.D. Executive Vice President and Chief Medical Officer, Sunovion, Head of Global Clinical Development for Sumitomo Dainippon Pharma GroupAntony Loebel, M.D.
Executive Vice President and Chief Medical Officer
Sunovion
Head of Global Clinical Development
Sumitomo Dainippon Pharma Group

MedicalResearch.com: What is the background for this study?

Response: Early predictors of subsequent clinical response are important in the treatment of depression, since 6-10 weeks of treatment are often required before full antidepressant response may occur. Early identification of patients who are unlikely to eventually achieve a response permits clinicians to intervene early to adjust the dose of medication, or switch to an alternative therapy.

Multiple studies in major depressive disorder (MDD, unipolar) have reported that early improvement at 2 weeks is significantly predictive of treatment response at 6-8 weeks.The most common early improvement criterion is a 20-25% reduction in the Hamilton Depression Rating Scale (HAM-D) or the Montgomery-Asberg Depression Rating Scale (MADRS) scores1-6.

Major depressive disorder with mixed features (MDD-MF) has recently been recognized as a diagnostic subtype in DSM-5. No research we are aware of has examined the predictive value of early improvement in patients diagnosed with MDD-MF.

The aim of the current post-hoc analysis was to evaluate the value of early improvement in the MADRS or the Clinical Global Impressions, Severity (CGI-S) scale as predictors of response to lurasidone in patients with MDD-MF.

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Depression Common in Lung Cancer and Linked To Mortality

MedicalResearch.com Interview with:

Donald R. Sullivan, M.D., M.A. Assistant Professor, Division of Pulmonary & Critical Care Medicine Oregon Health & Science University Investigator, VA Portland Health Care System

Dr. Donald Sullivan

Donald R. Sullivan, M.D., M.A.
Assistant Professor, Division of Pulmonary & Critical Care Medicine
Oregon Health & Science University
Investigator, VA Portland Health Care System

MedicalResearch.com: What is the background for this study?

Response: There is an inextricably link between physical and mental health, and all too often clinicians focus solely on the physical components of disease. A life-threatening diagnosis such as cancer often evokes significant psychological distress and lung cancer patients are at significantly risk. Up to 44% of lung cancer patients experience depression symptoms and 5-13% major depressive disorder, higher than most other cancers. Previous studies have demonstrated the development of depression or depression symptoms at lung cancer diagnosis can increase patient mortality, but there is a paucity of research exploring how longitudinal changes in depression symptoms impact patient outcomes.
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Nighttime Hot Flashes With Sleep Disruption Linked To Depressive Symptoms During Menopause

MedicalResearch.com Interview with:

Hadine Joffe, MD, MSc Associate Professor of Psychiatry, Harvard Medical School Vice Chair for Psychiatry Research Director of Division of Women's Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute www.brighamwharp.org

Dr. Hadine Joffe

Hadine Joffe, MD, MSc
Associate Professor of Psychiatry, Harvard Medical School
Vice Chair for Psychiatry Research
Director of Division of Women’s Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital
Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute
www.brighamwharp.org

MedicalResearch.com: What is the background for this study?

Response: We conducted this study to advance our understanding about causes of mood disturbance in the menopause transition that are specifically related to menopause. We used an experimental model to dissect out the contributions of hot flashes and sleep disturbance from contribution of changing levels of estrogen because hot flashes, sleep problems, and estrogen fluctuations co-occur and are difficult to distinguish from one another. Understanding whether hot flashes and/or sleep disturbance are causally related to mood disturbance will help us identify who is at risk for mood changes during the menopause transition. This is incredibly important now that we are finding effective non-hormonal treatments for hot flashes and sleep disruption.

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Depressive disorders are the most frequent neuropsychiatric complication of TBI

MedicalResearch.com Interview with:

Ricardo E. Jorge MD Professor of Psychiatry and Behavioral Sciences Director Houston Translational Research Center for TBI and Stress Disorders Senior Scientist Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry Michael E DeBakey VA Medical Center Baylor College of Medicine

Dr. Ricardo Jorge

Ricardo E. Jorge  MD
Professor of Psychiatry and Behavioral Sciences
Director Houston Translational Research Center for TBI and Stress Disorders
Senior Scientist  Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry
Michael E DeBakey VA Medical Center
Baylor College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depressive disorders affect between one-third and one-half of patients with traumatic brain injury. Once established, these disorders are difficult to treat and frequently follow a chronic and refractory course.

Depression has a deleterious effect on TBI outcomes, particularly affecting the community reintegration of TBI patients.

In this randomized clinical trial that included 94 adult patients with TBI, the hazards for developing depression for participants receiving placebo were about 4 times the hazards of participants receiving sertraline treatment.

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Sertraline May Prevent Depression Following Traumatic Brain Injury

MedicalResearch.com Interview with:

Ricardo E. Jorge MD Professor of Psychiatry and Behavioral Sciences Director Houston Translational Research Center for TBI and Stress Disorders Senior Scientist Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry Michael E DeBakey VA Medical Center Baylor College of Medicine

Dr. Ricardo Jorge

Ricardo E. Jorge MD
Professor of Psychiatry and Behavioral Sciences
Director Houston Translational Research Center for TBI and Stress Disorders
Senior Scientist Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry
Michael E DeBakey VA Medical Center
Baylor College of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Depressive disorders affect between one-third and one-half of patients with traumatic brain injury (TBI). Once established, these disorders are difficult to treat and frequently follow a chronic and refractory course.

Depression has a deleterious effect on TBI outcomes, particularly affecting the community reintegration of TBI patients. In this randomized clinical trial that included 94 adult patients with TBI, the hazards for developing depression for participants receiving placebo were about 4 times the hazards of participants receiving sertraline treatment.

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Collaborative Care is Effective and Cost-Effective For Adolescent Depression

MedicalResearch.com Interview with:

Laura P. Richardson, MD, MPH Interim Chief | Division of Adolescent Medicine Director | UW Leadership Education in Adolescent Health (LEAH) Program Professor | UW Department of Pediatrics Seattle Children's | University of Washington

Dr. Laura Richardson

Laura P. Richardson, MD, MPH
Interim Chief | Division of Adolescent Medicine
Director | UW Leadership Education in Adolescent Health (LEAH) Program
Professor | UW Department of Pediatrics
Seattle Children’s | University of Washington

MedicalResearch.com: What is the background for this study?

Response: Adolescent depression is one of the most common mental health conditions during adolescence. Up to one in five adolescents experience an episode of major depression by age 18. Depressed youth are at greater risk of suicide, dropping out of school and poor long-term health. Treatments, including medications and psychotherapy, have been proven to be effective but most depressed teens don’t receive any treatment.

Two years ago, we showed that the Reaching Out to Adolescents in Distress (ROAD) collaborative care model (a.k.a. Reach Out 4 Teens) designed to increase support and the delivery of evidence-based treatments in primary care was effective in treating depression in teens, significantly improving outcomes. We ran a randomized clinical trial at nine of Group Health’s primary care clinics and reported effectiveness results in JAMA.

The current paper represents the next step in this work, examining the cost-effectiveness of collaborative care for adolescent depression in our intervention sample of 101 adolescents with depression, ages 13-17 years.

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Standardized Clinical Interview Evaluates Depression in Diabetes Patients

MedicalResearch.com Interview with:

Dr Cathy E. Lloyd Professor of Health Studies School of Health, Wellbeing and Social Care Faculty of Wellbeing, Education and Language Studies The Open University Milton Keynes

Prof. Cathy Lloyd

Dr Cathy E. Lloyd
Professor of Health Studies
School of Health, Wellbeing and Social Care
Faculty of Wellbeing, Education and Language Studies
The Open University
Milton Keynes UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We know from earlier epidemiological research that people with diabetes have an increased risk of developing depression and other mental health problems compared to those without diabetes. However the impact of this and what treatment and care should be provided is still unclear, in particular in countries other than the US or the UK.
Our study aims to redress that imbalance, collecting data on diabetes and depression in 16 countries across the globe.

Ours is the first study to measure depressive symptoms but also use a standardised clinical interview to diagnose depression according to ICD criteria.

Overall 10.6% received a diagnosis of Major Depressive Disorder (MDD), however prevalence rates differed widely between countries with 1% diagnosed with MDD in Uganda and nearly 30% in Bangladesh. Twenty-five percent reported subthreshold levels (PHQ-9 score 5 -9) of depression. Those with MDD were significantly more likely to be female and living in an urban rather than rural location (p<0.001). Age and duration of diabetes did not significantly differ between those with and without MDD. Multi-variable analyses demonstrated that while controlling for country, a diagnosis of MDD was significantly associated with female sex, lower education, taking insulin, less exercise, higher levels of diabetes-related distress and a previous diagnosis of MDD. A negligible proportion of those with either MDD or subthreshold levels of depression had a diagnosis or any treatment for their depression recorded in their medical records.

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HIV Patients With Depression Have Greater Risk of Myocardial Infarction

MedicalResearch.com Interview with:
Matthew S Freiberg, MD, MSc
Cardiovascular Medicine Division, Vanderbilt University School of Medicine
Tennessee Valley Geriatric Research Education and Clinical Center, Nashville  TN
Tasneem Khambaty, PhD
Department of Psychology, University of Miami, Coral Gables, Florida
Jesse C. Stewart, PhD
Department of Psychology, Indiana University–Purdue University , Indianapolis, Indianapolis

MedicalResearch.com: What is the background for this study?

Response: Due to highly effective antiretroviral therapy, people with HIV are living longer. Unfortunately, these HIV-infected individuals remain at a higher risk for other chronic diseases, with cardiovascular disease (CVD) being one of the leading cause of death in this population. In the general population, depressive disorders, such as major depressive disorder (MDD) and dysthymic disorder, are associated with increased risk of new-onset CVD. Given that roughly 24-40% of HIV-infected individuals have a depressive disorder, we examined whether MDD and dysthymic disorder are also associated with an increased risk of new-onset CVD in people with HIV.
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Behavioural Activation Therapy Offers Lower-Cost, Effective Treatment for Depression

MedicalResearch.com Interview with: David A Richards, PhD Professor of Mental Health Services Research and NIHR Senior Investigator University of Exeter Medical School University of Exeter St Luke's Campus Exeter United Kingdom MedicalResearch.com: What is the background for this study? Response: Depression is a common mental health disorder affecting around 350 million people worldwide. Untreated depression is expected to cost the global economy US$5.36 trillion between 2011 and 2030. Many patients request psychological therapy, but the best-evidenced therapy—cognitive behavioural therapy (CBT)—is complex and costly. A simpler therapy—behavioural activation (BA)—might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression. MedicalResearch.com: What are the main findings? Response: We found that behavioural activation, a simpler psychological treatment than CBT, can be delivered by junior mental health workers with less intensive and costly training, with no lesser effect than CBT. Effective psychological therapy for depression can be delivered without the need for costly and highly trained professionals MedicalResearch.com: What should readers take away from your report? Response: Our findings have substantial implications given the increasing global pressure for cost containment across health systems in high-income countries and the need to develop accessible, scalable interventions in low-income and middle-income countries. Such countries might choose to investigate the training and employment of junior workers over expensive groups of psychological professionals. Our results, therefore, offer hope to many societies, cultures, and communities worldwide, rich and poor, struggling with the effect of depression on the health of their people and economies. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: Research into these and other potential strengths of behavioural activation in the context of implementation science is necessary for the hope and promise offered by the COBRA trial to be fulfilled. Now that we have support for BA as a treatment that is clinically effective and cost-effective, we can shift our efforts to focus on what is necessary to produce sustainable large-scale behavioural activation implementation across diverse geographical and cultural settings. MedicalResearch.com: Is there anything else you would like to add? Response: Although many obstacles exist to successful dissemination in addition to training of Mental Health Workers, our findings suggest that health services globally could reduce the need for costly professional training and infrastructure, reduce waiting times, and increase access to psychological therapies. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: Lancet Cost and Outcome of Behavioural Activation versus Cognitive Behavioural Therapy for Depression (COBRA): a randomised, controlled, non-inferiority trial Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions. More Medical Research Interviews on MedicalResearch.com

Prof. David Richards

MedicalResearch.com Interview with:
Professor David A. Richards, PhD
Professor of Mental Health Services Research and NIHR Senior Investigator
University of Exeter Medical School
University of Exeter
St Luke’s Campus
Exeter United Kingdom

MedicalResearch.com: What is the background for this study?

Response: Depression is a common mental health disorder affecting around 350 million people worldwide. Untreated depression is expected to cost the global economy US$5.36 trillion between 2011 and 2030.

Many patients request psychological therapy, but the best-evidenced therapy—cognitive behavioural therapy (CBT)—is complex and costly. A simpler therapy—behavioural activation (BA)—might be as effective and cheaper than is CBT. We aimed to establish the clinical efficacy and cost-effectiveness of BA compared with CBT for adults with depression.

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Depression in Parents of Preterm Infants Can Persist With Ongoing Childcare Challenges

MedicalResearch.com Interview with:

Dr Carmen Pace MPsych (Clin Child) PhD AMACPA Clinical Psychologist and Research Fellow Murdoch Childrens Research Institute The Royal Children’s Hospital Flemington Rd Parkville, Victoria AU

Dr. Carmen Pace

Dr Carmen Pace MPsych (Clin Child) PhD AMACPA
Clinical Psychologist and Research Fellow
Murdoch Childrens Research Institute
The Royal Children’s Hospital
Flemington Rd Parkville, Victoria AUS

MedicalResearch.com: What is the background for this study?

Response: We know that mothers of very preterm infants (born prior to 32 weeks gestation) are at higher risk for psychological distress compared to mothers who have healthy full term infants. However, detailed longitudinal research looking at how symptoms evolve over the first weeks and months is limited, and fathers are largely neglected in the literature. We addressed these gaps by assessing symptoms of depression and anxiety in both mothers and fathers every two weeks for the first twelve weeks after birth, and again at six months.

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Depression More Common In Women (But Not Men) Who Experience Infertility

MedicalResearch.com Interview with:

Jessica Datta Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London

Jessica Datta

Jessica Datta
Department of Social & Environmental Health Research
London School of Hygiene & Tropical Medicine
London

MedicalResearch.com: What is the background for this study?

Response: The paper presents an analysis of data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 is a survey of more than 15,000 women and men aged 16-74 resident in Britain, conducted in 2010-2012, which includes a wide range of questions about sexual relationships and behaviour and reproductive history.

In this paper we analysed responses to the questions: ‘Have you ever had a time, lasting 12 months or longer, when you and a partner were trying for a pregnancy but it didn’t happen?’ and ‘Have you (or a partner) ever sought medical or professional help about infertility?’. As well as calculating the prevalence of experience of infertility and help seeking, we looked at associated factors e.g. education, employment, relationship status.

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Antidepressant Did Not Reduce Hospitalizations or Death in Heart Failure Patients

MedicalResearch.com Interview with:

Prof. Dr. med. Christiane E. Angermann, FESC, HFA Deutsches Zentrum für Herzinsuffizienz Würzburg Comprehensive Heart Failure Center (CHFC) Universitätsklinikum Würzburg Würzburg

Prof. Christiane Angermann

Prof. Dr. med. Christiane E. Angermann, FESC, HFA
Deutsches Zentrum für Herzinsuffizienz Würzburg
Comprehensive Heart Failure Center (CHFC)
Universitätsklinikum Würzburg
Würzburg

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous meta-analysis indicates that depression prevalence in patients with heart failure is much higher than in the general population, 10 percent to 40 percent, depending on disease severity. Depression has been shown to be an independent predictor of mortality and rehospitalization in patients with heart failure, with incidence rates increasing in parallel with depression severity. Furthermore, it is associated with poor quality of life and increased healthcare costs.

It would, against this background, seem desirable to treat the depression, and when planning the study we hypothesized that by doing so we might be able to improve depression and thus reduce mortality and morbidity of this population. Long-term efficacy and safety of selective serotonin reuptake inhibitors (SSRIs), which are widely used to treat depression and have proven efficacious in individuals with primary depression, is unknown for patients with heart failure and (comorbid) depression.

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DSM-V Classification May Not Capture Depression in African Americans

MedicalResearch.com Interview with:

Sirry Alang PhD Assistant professor of sociology and anthropology Lehigh University

Dr. Sirry Alang

Sirry Alang PhD
Assistant professor of sociology and anthropology
Lehigh University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Discrepancies exist between how some Black populations perceive depression and how depression is conceptualized within research and clinical settings. African Americans are exposed to a lot of stress from structural racism, yet, they perceive themselves to be resilient. The context of stress from discrimination and beliefs about depression inform how they express psychological distress. Depression is thought of as a weakness that is inconsistent with notions of strength in the community. Although depression was expressed through classic depressive symptoms such as feeling hopeless, loss of sleep, and losing interests in activities, symptom like anger, agitation, and the frantic need for human interaction were considered to be indicative of depression. Anger, agitation, and the frantic need for human interaction are not consistent with how depression is defined in the latest manual for psychiatric diagnosis- the DSM-V.

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Is Depression Genetic or Environmental?

As of now, little is known about the causes of depression. Whilst some scientists believe that there are genetic links to depression, many people who suffer from this condition do so due to past experiences, upbringing, or trauma. Perhaps you are related to somebody who has suffered or is suffering from depression – watching a loved one battle depression is never easy, but does this mean that you will also suffer from the condition? Studies show that a person with a family member who suffers from depression is five times more likely to suffer from the condition themselves, but is this hereditary, or are other factors involved?

About Depression:

Major depressive disorder or clinical depression is one of the most common forms of depression and also one of the most commonly suffered mental health conditions. The Stanford School of Medicine estimates that around ten percent of U.S.A. citizens will experience major depressive disorder at some point in their lives. Clinical depression is also more likely to be shared by siblings and children, putting those who are related to somebody with the condition at a higher risk of suffering from clinical depression themselves. If you know somebody who is battling depression, Smart Brain and Health offers depression treatment Los Angeles.

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Fluoxetine – Prozac – May Be Best Choice For Pediatric and Adolescent Depression

MedicalResearch.com Interview with:

Andrea Cipriani, MD PhD Associate Professor Department of Psychiatry University of Oxford Warneford Hospital Oxford UK

Dr. Andrea Cipriani

Andrea Cipriani, MD PhD
Associate Professor
Department of Psychiatry
University of Oxford
Warneford Hospital
Oxford UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Cipriani: Major depressive disorder is common in young people, with a prevalence of about 3% in school-age children (aged 6–12 years) and 6% in adolescents (aged 13–18 years). Compared with adults, children and adolescents with major depressive disorder are still underdiagnosed and undertreated, possibly because they tend to present with rather undifferentiated depressive symptoms—eg, irritability, aggressive behaviours, and school refusal. Consequences of depressive episodes in these patients include serious impairments in social functioning, and suicidal ideation and attempts. Our analysis represents the most comprehensive synthesis of data for currently available pharmacological treatments for children and adolescents with acute major depressive disorder (5620 participants, recruited in 34 trials).

Among all antidepressants, we found that only fluoxetine was significantly better than placebo. According to our results, fluoxetine should be considered the best evidence-based option among antidepressants when a pharmacological treatment is indicated for children and adolescents with moderate to severe depression. Other antidepressants do not seem to be suitable as routine treatment options.

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Epigenetic Changes Link Environmental Deprivation to Depression

MedicalResearch.com Interview with:
Dr. Johnna Swartz, PhD
Postdoctoral researcher in the lab of Ahmad Hariri
Duke postdoctoral researcher in the lab of Ahmad Hariri

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Swartz: Prior research has shown that low socioeconomic status is a risk factor for the development of depression. In this study, we examined whether this risk factor was associated with changes in an epigenetic tag near the gene coding for the serotonin transporter, which has previously been linked to depression. We found that adolescents growing up in families with lower socioeconomic status accumulated more of these tags over time, which may lead to decreased gene expression. Moreover, we found that more of these tags were associated with increased activity in the amygdala, a brain region that plays an important role in the stress response.

Finally, we found that adolescents with increased activity in the amygdala were more likely to develop depression symptoms a year later, particularly if they had a close relative with a history of depression. This is some of the first research to draw a link from an environmental risk factor to changes in depression symptoms through changes in epigenetic markers and brain function.

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Women of Color Discuss Unique Issues Surrounding PostPartum Depression

MedicalResearch.com Interview with:

Professor Robert H. Keefe PhD, LMSW, ACSW School of Social Work, University at Buffalo State University of New York, Buffalo, New York

Dr. Robert Keefe

Professor Robert H. Keefe PhD, LMSW, ACSW
School of Social Work, University at Buffalo
State University of New York, Buffalo, New York 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Keefe: The study focuses on recommendations mothers of color, who have histories of postpartum depression, would make to service providers that they believe would improve service effectiveness.  The study is timely inasmuch as the Patient Protection and Affordable Care Act mandates ongoing research to better understand and address differences in treatment needs among mothers from racial and ethnic groups and to develop culturally competent, evidence-based treatment approaches.

We were concerned that the research on postpartum depression relies heavily on White mothers, who have access to care, ongoing relationships with service providers, are married or otherwise coupled, and from middle-class backgrounds.  While the limited research on mothers of color notes their rates of postpartum depression are markedly higher than White mothers, it does little to address how their treatment needs differ from White mothers.

We undertook this study to get recommendations from the mothers and discovered that many of the issues that inhibit the mothers from accessing services are the very issues that lead mothers to have postpartum depression.  For example, many of the mothers report because they have poor-paying jobs, no health benefits, and limited transportation, they are unable to keep appointments despite wanting to do what is best for their newborn babies.  Furthermore, because they missed appointments, the service provider would terminate the mother from a service the mother needs, or worse contact Child Protective Services to report the mother for neglect.  The mothers were not at all neglectful.  They were all invested in their child’s wellbeing; but various life problems kept mounting up so that they and their babies were not receiving ongoing care.

Consequently, the recommendations these mothers make have little to do with psychotherapy.  In fact, most of the mothers reported they had no time to be depressed and that psychotherapy was a luxury they could not afford. Instead, the mothers wanted service systems in place that would allow them to receive the care they need so that they and their new-born babies could live happy and health lives.

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MRI Before Electroconvulsive Therapy May Help Predict Treatment Success for Depression

MedicalResearch.com Interview with:

Dipl.-Psych. R. Redlich Neuroimaging Group Klinik und Poliklinik für Psychiatrie und Psychotherapie Westfaelische Wilhelms-Universitaet Muenster

Dr. Redlich

Dipl.-Psych. R. Redlich
Neuroimaging Group
Klinik und Poliklinik für Psychiatrie und Psychotherapie
Westfaelische Wilhelms-Universitaet Muenster

MedicalResearch.com: What is the background for this study?

Response: Electroconvulsive therapy (ECT) is one of the most effective treatments for severe depression. The ability to advise psychiatrists and patients accurately regarding the chances of successful ECT is of considerable value, particularly since ECT is a demanding procedure and, despite having relatively few side effects, has a profound impact on patients. Therefore, the present study sought to predict ECT response in a psychiatric sample by using a combination of structural Magnetic Resonance Imaging data and machine-learning techniques.
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Worsening Depression in Older Adults May Be Early Indicator of Dementia

MedicalResearch.com Interview with:

Saira Saeed Mirza, MD, PhD Department of Epidemiology Erasmus MC, Rotterdam

Dr. Saira Saeed Mirza

Saira Saeed Mirza, MD, PhD
Department of Epidemiology
Erasmus MC, Rotterdam

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Mirza: Depressive symptoms appearing in late-life have been extensively studied for their relationship with dementia. They not only very frequently occur in demented patients, but also predict dementia. In this context, depressive symptoms have largely been assessed at a single time point only. However, depression is a disorder which remits and relapses, and symptoms do not remain same over the years. Given this pattern of disease progression, it is more important to study the course of depression over time in relation to long-term health outcomes such as dementia, rather than assessing it at a single time-point, which will neglect the course of depression. This is important as people follow different courses of depression, and different courses of depression might carry different risks of dementia.

When we studied the course of depressive symptoms over 11 years in community dwelling older adults in Rotterdam, and the subsequent risks of dementia, we observed that only those who had increasing or worsening depressive symptoms were at a higher risk of dementia. In this group of people, about one in five persons developed dementia. Interestingly, people suffering from high depressive symptoms at a single time point were not at a higher dementia risk than those without depressive symptoms.

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Exposure to SSRI’s During Pregnancy May Raise Risk of Adolescent Depression

MedicalResearch.com Interview with:

Heli Malm, MD, PhD Specialist in Obstetrics and Gynecology Teratology Information Service Helsinki University and Helsinki University Hospi

Dr. Heli Malm

Heli Malm, MD, PhD
Specialist in Obstetrics and Gynecology
Teratology Information Service
Helsinki University and Helsinki University Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Malm: Animal studies have demonstrated that exposure to SSRIs during early brain development can result in depression-like behavior in adolescence. Today 6% of pregnant women in the US and 4% in Finland are on selective serotonin reuptake inhibitors (SSRIs) at some stage of pregnancy. SSRIs pass the placenta but no prior studies have followed children beyond childhood to monitor the development of depressive disorders, which typically emerge after puberty onset. Results on autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorders (ADHD) have been conflicting.

The study material is based on national register data from Finland. We investigated offspring psychiatric diagnoses, including depression, anxiety, ASD, and ADHD, of nearly 16,000 mothers who had used SSRIs during pregnancy between 1996 and 2010. Children in this cohort ranged in age from 0 to 15 years old. Because maternal psychiatric illness can affect offspring neurodevelopment in the absence of SSRIs, primary comparisons were made between offspring of the SSRI group and offspring of mothers with a psychiatric disorder diagnosis but no antidepressant use.

Children exposed to SSRIs during gestation were diagnosed with depression at an increasing rate after age 12, reaching a cumulative incidence of 8.2% by age 15, compared to 1.9% in the group of children exposed to maternal psychiatric illness but no antidepressants. Rates of anxiety, autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD) diagnoses did not differ significantly between the two groups.

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Slow Sparse Ketamine Infusions Show Promise For Resistant Depression

MedicalResearch.com Interview with:
Theodore Henderson, MD, PhD
Neuroluminance Ketamine Infusion Centers

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Henderson: Depression is a widespread problem. Psychotropic medications or therapy are the standard treatments, but they are often disappointing. Some studies have shown that the response rate to antidepressant medications is only 12-17% better than placebo response rate. Newer non-pharmacetical treatments, like transcranial magnetic stimulation, appear to have only a 50% response rate at best. The seminal study by Berman and colleagues in 2000 showed that sub-anesthetic dose infusions of the anesthetic, ketamine, produced a rapid antidepressant response. Many clinics across the United States focus on these rapid effects.

Our clinic has been treating patients with treatment-resistant depression (defined as failing five or more antidepressants) for over three years. Our response rate is 80% based on multiple depression rating scales. We report here on 100 of the over 300 patients in our clinic who agreed to share their data in a research study. We treated patients with ketamine infusions no more frequently than once per week, unlike the clinical studies and many other ketamine clinics. We found our patients did equally well or better and received fewer treatments.

The neurobiology of ketamine and its mechanism of action hold the key. Ketamine is a potent activator of the growth factor, brain derived neurotrophic factor (BDNF). This growth factor reverses the damage that depression causes to the brain – loss of synapses, dearborization of dendrites, and neuronal death. Ketamine’s ability to activate BDNF over time is responsible for a persistent antidepressant effect upon the brain.

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Meta-analysis Reassesses Omega 3 Fatty Acids in Major Depressive Disorders

MedicalResearch.com Interview with:

Dr. Roel JT Mocking Program for Mood Disorders Department of Psychiatry Academic Medical Center University of Amsterdam, The Netherlands

Dr. RJT Mocking

Dr. Roel JT Mocking
Program for Mood Disorders
Department of Psychiatry
Academic Medical Center
University of Amsterdam, The Netherlands 

MedicalResearch.com: What is the background for this study?

Response: Omega-3 polyunsaturated fatty acid supplementation (popularly referred to as fish oil) is being promoted as (add-on) treatment for depression. Thus far, many studies have been performed that tested the effects of omega-3 fatty acids in depression. In order to overcome differences between these results of individual studies, a meta-analysis can be performed. A meta-analysis pools the results of all individual studies, and thereby provides a more definitive conclusion regarding the effect of omega-3 fatty acids in depression. Moreover, using the differences between the individual studies, a meta-analysis can point to factors that are associated with a better effect of the supplementation, for example supplementation dose or duration.

There have been meta-analyses performed previously, but they seemed to contain several inconsistencies. For example, they accidentally included the same study two or three times, which results in errors. In addition, these meta-analyses did not only include studies performed in patients with the psychiatric disorder “major depressive episode”, but also subjects from the general population with less severe depressive complaints. This makes it more difficult to interpret the results. Therefore, we performed a meta-analysis that included only studies performed in patients with major depressive disorder, and corrected errors from earlier meta-analyses.

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Older Adults with Chronically High Depressive Symptoms May Be At Higher Risk of Dementia

MedicalResearch.com Interview with:
Allison R. Kaup, PhD
Assistant Adjunct Professor, UCSF Department of Psychiatry
Clinical Research Psychologist / Clinical Neuropsychologist and
Kristine Yaffe MD
Professor of Psychiatry, Neurology and Epidemiology
Chief of Geriatric Psychiatry and Director of the Memory Evaluation Clinic

San Francisco VA Medical Center 

MedicalResearch.com: What is the background for this study?

Response: Previous research has shown that older adults with depression are more likely to develop dementia.  But, most studies have only examined an older adult’s depressive symptoms at one point in time.  This is an important limitation because we know that depressive symptoms change over time and that older adults show different patterns of depressive symptoms over time.  For the present study, older adults were followed for several years.  We assessed what patterns of depressive symptoms they tended to have during the early years of the study, and then investigated whether these different patterns were associated with who developed dementia during the later years of the study.

MedicalResearch.com: What are the main findings?

Response: Older adults in this study tended to show one of 3 different patterns of depressive symptoms.  Most tended to have few, if any, symptoms over time.  Some tended to have a moderate level of depressive symptoms at the beginning of the study, which increased over time.  And others tended to have a high level of depressive symptoms at the beginning of the study, which increased over time.

We found that older adults with the high-and-increasing depressive symptoms pattern were almost twice as likely to develop dementia than those with minimal symptoms, even when accounting for other important factors.  While older adults with the moderate-and-increasing depressive symptom pattern were also somewhat more likely to develop dementia, this association was not as strong and did not hold up in our statistical models when we accounted for what individuals’ cognitive functioning was like during the early years of the study.

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Autism Spectrum Disorders Linked To Depression in Adults

MedicalResearch.com Interview with:

Dr. Rebecca A. Charlton PhD Senior Lecturer in Psychology; Undergraduate Admissions Tutor Department of Psychology Goldsmiths, University of London New Cross London, UK

Dr. Rebecca Charlton

Dr. Rebecca A. Charlton PhD
Senior Lecturer in Psychology; Undergraduate Admissions Tutor
Department of Psychology
Goldsmiths, University of London
New Cross London, UK

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Charlton: Although Autism Spectrum Disorders are classified as developmental disorders, they last throughout life. Autism Spectrum Disorders were first identified in the 1940s, but it was only from the 1960s onwards that awareness of the condition began to increase. Initial research into Autism focused on the area of greatest need, i.e. childhood and education. Only now that those individuals first diagnosed with Autism are reaching old age are studies able to examine what happens in late-life. Although there are an increasing number of older adults with a diagnosis of Autism Spectrum Disorders, it is often difficult to identify individuals willing to participate in research. One alternative is to explore Autism traits in the general population, this is known as the Broad Autism Phenotype (BAP). These BAP traits occur in relatives of those with Autism and in the general population. By examining the BAP in community-dwelling older adults, we can begin to understand whether these traits confer additional risk to in ageing.

MedicalResearch.com: What did you do in the study? What are the main findings?
Dr. Charlton: Adults aged over 60 years old were recruited to take part in the study. They completed questionnaires reporting on presences of  Broad Autism Phenotype traits, executive functions (the ability to plan and organise behaviour), mood (depression and anxiety), and social support.

Of the 66 individuals who participated, 20 individuals reported significant BAP traits – classified as the  Broad Autism Phenotype group. Individuals in the BAP group reported more problems with executive functions, higher rates of depression and anxiety, and less social support than those in the non-BAP group. Further analyses demonstrated that having  Broad Autism Phenotype traits was the factor that most explained presence of depression and anxiety symptoms among these older adults.

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Study Examines Trajectory of Moderate or Severe Depression

MedicalResearch.com Interview with:

Katherine L. Musliner, PhD National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark The Lundbeck Foundation Initiative for Integrative Psychiatric Research Department of Mental Health The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

Dr. Katherine Musliner

Katherine L. Musliner, PhD
National Centre for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
The Lundbeck Foundation Initiative for Integrative Psychiatric Research
Department of Mental Health
The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is great variation among patients with depression in terms of long-term illness course. This variation may be indicative of underlying differences in the cause of the illness, and from a practical perspective, it also has implications for treatment and allocation of public health resources. Our goal was to identify different trajectories of depression course by examining inpatient and outpatient contacts for depression at psychiatric treatment facilities in Denmark (where healthcare is free) during the 10-year period following patients’ initial depression diagnosis.

We found that the majority of patients (77% in our sample) followed a trajectory characterized by a brief period of contact with the psychiatric treatment system and no contact for depression during the remainder of the 10-year follow up period. Patients with more prolonged contact either had a drawn out initial period of contact lasting as long as five years (13%), left depression treatment for several years only to return with a depression diagnosis years later (7%) or exhibited a chronic course (3%).

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Depression Can Recur After Opioids Initiated For Non-Cancer Pain

MedicalResearch.com Interview with:

Dr-Jeffrey-ScherrerJeffrey F. Scherrer, PhD
Associate Professor
Research Director
Department of Family and Community Medicine
Saint Louis University School of Medicine
St. Louis, MO 63104 

Medical Research: What is the background for this study? What are the main findings?

Dr. Scherrer: We initiated a series of studies on chronic opioid use and risk of depression about 3 years ago and obtained an NIH R21 to study prescription opioid use and risk of new onset depression, depression recurrence and transition to treatment resistant depression.  The rationale comes partly from clinical observations of the research team (I am not a clinician, just a epidemiologist).  We also observed the large field demonstrating patients with depression are more likely to get opioids for pain, take them longer and develop abuse.  We wanted to switch the direction of effect to determine if the reverse exists.  After publishing two papers demonstrating longer use of opioid was associated with increasing risk of depression, our next step was to look at recurrence among patients with a recent history of depression.

Medical Research: What should clinicians and patients take away from your report?

Dr. Scherrer: Our main recommendation is clinicians should repeatedly screen patients for depression.  While screening at time of starting opioids is common, repeated screening is worth consideration.  Patients with depression who may experience temporary euphoria should not expect opioids to cure depression and they may increase risk for worsening mood and or recurrence after long term use.

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Driving Cessation Contributes to Health Problems and Depression in Elderly

MedicalResearch.com Interview with:

Stanford Chihuri

Stanford Chihuri

Stanford Chihuri MPH
Center for Injury Epidemiology and Prevention
Department of Anesthesiology
Columbia University Medical Center
New York City, New York 

Medical Research: What is the background for this study? What are the main findings?

Response: For many older adults, driving is instrumental to their daily living and is a strong indicator of self-control, personal freedom and independence. This study assesses and synthesizes evidence in the research literature on the impact of driving cessation on subsequent health and well-being of older adults. The main findings are that driving cessation in older adults appears to contribute to a variety of health problems, particularly depression.

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