MedicalResearch.com Interview with:
Turhan Canli, Ph.D.
Associate Professor, Psychology and Radiology
Director, SCAN (Social, Cognitive, and Affective Neuroscience) Center
Senior Fellow, Center for Medical Humanities, Compassionate Care, and Bioethics Stony Brook University Stony Brook, NY 11794
Medical Research: What is the background for this study? What are the main findings?
Response: I was struck by two aspects of major depression treatment.
First, that today's drug treatments are not much different from those used decades ago, with no real progress in treatment effectiveness. In severe cases of major depression, antidepressants may give some symptom relief, but for less severe cases, the effectiveness of antidepressants is not clinically relevant.
Second, recurrence rates remain stubbornly high: patients with diagnosed MDD have a lifetime recurrency rate of 50%. We are not treating depression; at best, we reduce symptoms.
MedicalResearch.com Interview with:
Dr. Marcus Povitz MD
Department of Community Health Sciences
University of Calgary, Calgary, Alberta, Canada
Adjunct Professor and Clinical Fellow
Western University Department of Medicine,
Western University, London, Ontario, Canada
Medical Research: What is the background for this study? What are the main findings?
Dr. Povitz: Both depression and obstructive sleep apnea are important causes of illness and have overlapping symptoms. Both feature poor quality sleep, difficulty with concentration and memory as well as daytime sleepiness or fatigue. Previous research showed that depression is common in individuals with sleep apnea, but studies investigating the effect of treating sleep apnea on depressive symptoms have had conflicting results. Our study combined the results of all randomized controlled trials of participants who were treated for sleep apnea with CPAP or mandibular advancement devices where symptoms of depression were measured both before and after treatment. We found that in studies of individuals without a lot of symptoms of depression there was still a small improvement in these symptoms after treatment with CPAP or mandibular advancement device. In 2 studies of individuals with more symptoms of depression there was a large improvement in symptoms of depression.
MedicalResearch.com Interview with:
Dr. Sunni Mumford PhD
Earl Stadtman Investigator in the DESPR Epidemiology Branch
Eunice Kennedy Shriver National Institute of Health and Human Development
Medical Research: What are the main findings of the study?
Dr. Mumford: Depressive symptoms in healthy women who don’t have diagnosed clinical depression isn’t related to reproductive hormone levels, like estrogen, or impaired ovulation.
Medical Research: What was most surprising about the results?
Dr. Mumford: Earlier research indicates that changes in estrogen may be associated with depression, for instance during the menopausal transition. Our study identified significant associations between estrogen and depressive symptoms in models that didn’t account for confounding factors, but this relationship was completed eliminated when adjustments were made for common confounding factors like age, race, BMI, and also stress level in these premenopausal women. Another interesting finding was that a score describing mood-related menstrual symptoms indicated that such symptoms are highest in the premenstrual phase, but remain lower throughout the rest of women’s cycles. This tells us that altered mood symptoms are most frequent prior to menstruation.
MedicalResearch.com Interview with:
Professor Pranas Serpytis
Vilnius University Hospital Santariskiu Clinic
Vilnius, Lithuania
Medical Research: What are the main findings of the study?
Professor Serpytis: The main findings of the study were that women are more likely to develop anxiety and depression after acute myocardial infarction. In our study depression was assessed by HADS scale: no depression (0-7 score), possible depression (8-10 score), definite depression (11+ score). The mean score of assessing depression were 6.87 (± 4.6) among men and 8.66 (± 3.7) among women (p <.05). Cardiovascular disease risk factors such as smoking increases patients anxiety levels, and low physical activity is associated with an increased risk to suffer from depression.
MedicalResearch.com Interview with:
Karl Ole Köhler, Research assistant
Department of Clinical Medicine
The Department of General Psychiatry
Aarhus University
Medical Research: What are the main findings of the study?
Response: We found that anti-inflammatory drugs and ordinary analgesics, which mainly are used against physical disorders, may have treatment effects against depression when used in combination with antidepressants. Thereby, our results furthermore support the hypothesis regarding a comorbidity between inflammatory diseases and depression, i.e. a connection between somatic and mental disorders.
MedicalResearch.com Interview with:
Dr. Philippe Courtet MD PhD
Centre Hospitalier Régional Universitaire de Montpellier, Institut National de la Santé et de la Récherche Médicale ,
Université Montpellier, Montpellier, France
Fondation Fondamental, Créteil, France
Medical Research: What are the main findings of the study?
Dr. Courtet: Depressed outpatients who are beginning the treatment with a SSRI at higher dose than recommended present an increased risk (x2) of worsening of suicidal ideation during the first 6 weeks of treatment.
This is consistent with the study by Miller et al published in the same journal few weeks ago, reporting a double risk of suicide attempt in young subjects (<24 yrs) who are begun an SSRI at higher dose than recommended.
Our results showed that the increased suicide risk with the high dose of SSRI is not restricted to youngsters and is independent of the severity of the depression.
MedicalResearch.com Interview with:
Sean Clouston Ph.D.
Assistant Professor
Core Faculty, Program in Public Health
Department of Preventive Medicine
Stony Brook University Health Sciences Center
Stony Brook, NY 11794
Medical Research: What is the background for this study:
Dr. Clouston: A number of epidemiological studies have found that suicide rates have decreased rapidly with the widespread distribution of SSRI antidepressants. Our group has found that proliferation of preventive medicine has, with regard to other causes of death, tended to occur unequally. We hypothesized that if SSRI antidepressants prevent suicide by treating depression, then suicide might also be susceptible to such inequality. Our study used mortality data to show that decreases in suicide were concentrated in regions with higher socioeconomic status.
Medical Research: What are the main findings of the study?
Dr. Clouston We used the best available data from the US and found that socioeconomic inequalities have increased dramatically in conjunction with the proliferation of SSRI antidepressants.
MedicalResearch.com Interview with
Dr Golam Khandaker
Clinical Lecturer, Department of Psychiatry
University of Cambridge
Medical Research: What are the main findings of the study?
Dr. Khandaker: The study shows low grade systemic inflammation may have a role in the pathogenesis of depression and psychotic disorders. Low grade systemic inflammation may also be a common cause for chronic physical and psychiatric illnesses.
The study shows that higher serum levels of the circulating inflammatory marker, interleukin 6 (IL-6), in childhood is associated with nearly two-fold increased risk of developing depression and psychotic disorder in young adulthood. This association persisted after taking into account effects of age, sex, social class, ethnicity, body mass index, maternal depression, and past psychological and behavioural problem in the participant.
We studied a sample of 4,500 individuals from the Avon Longitudinal Study of Parents and Children birth cohort, taking blood samples at age 9 and following up at age 18, to see if they had experienced episodes of depression or . We excluded children with an infection at the time of blood test at age 9 years.
Sandip M. Prasad MD
Assistant Professor
Medical University of South Carolina, Charleston, SC and
Scott E. Eggener, MD
Associate Professor of Surgery
Co-Director, Prostate Cancer Program
Director of Translational and Outcomes Research, Section of Urology
University of Chicago Medical Center, Chicago, IL;
Medical Research: What are the main findings of the study?
Answer: Depressed men with a diagnosis of intermediate- or high-risk prostate cancer have worse overall outcomes than those without baseline depression and are less likely to undergo definitive therapy. The difference in overall survival between men with and without a depression diagnosis was independent of prostate cancer treatment type.
MedicalResearch.com: Interview with
Dr. Amit J.Shah MD
Assistant Research Professor
Assistant Professor, Department of Epidemiology
Emory, Rollins School of Public Health
MedicalResearch: What are the main findings of the study?
Dr. Shah: We discovered that in a group of patients who were undergoing heart evaluation with coronary angiography, symptoms of depression predicted increased risk of coronary artery disease and death in women aged 55 years or less. This relationship was stronger in these women than older women, as well as in men aged 55 years or less. Over 1 in 4 women aged 55 years or less had moderate to severe depression, which was higher than any other group; these women had over twice the risk of having heart disease or dying over the next 3 years compared to those with none or mild depression.
MedicalResearch.com Interview with:
Monika Waszczuk
1+3 PhD Student
MRC SGDP Research Centre
Institute of Psychiatry, King's College London
DeCrespigny Park London UK
MedicalResearch: What are the main findings of the study?
Answer: Little is known about the genetic influences on the relationship between depression and anxiety disorders across development. We used two population-based prospective longitudinal twin and sibling studies to investigate phenotypic associations between the symptoms of these disorders, and tested genetic structures underlying these symptoms across three developmental stages: childhood, adolescence and early adulthood.
We found that depression and anxiety disorder symptoms are largely distinct in childhood and are influenced by largely independent genetic factors. Depression and anxiety symptoms become more associated and shared most of their genetic etiology from adolescence. An overarching internalizing genetic factor influencing depression and all anxiety subscales emerged in early adulthood. These results provide preliminary evidence for different phenotypic and genetic structures of internalizing disorder symptoms in childhood, adolescence and young adulthood, with depression and anxiety becoming more associated from adolescence.
MedicalResearch.com Interview with:
Dr. Jeffery C. Huffman, M.D.
Harvard Medical School
Department of Psychiatry
Massachusetts General Hospital, Boston
MedicalResearch.com: What are the main findings of the study?
Dr. Huffman: Depression and anxiety in cardiac patients are associated with adverse cardiac outcomes. We completed a very low-intensity care management intervention to identify depression and anxiety disorders during a cardiac admission and then to assist in the monitoring and management of the condition over the next 24 weeks. There have been other care management trials in cardiac patients, but ours was the first to co-manage depression and anxiety, the first to initiate treatment in the hospital, the first to take a broad population of cardiac patients rather than a single diagnosis, and the first to use such a low-resource strategy with only a single part-time social worker to coordinate care.
We found that the care management intervention was associated with significant improvements in mental health treatment, mental health related quality of life, depression, and function at 24 weeks compared to enhanced treatment as usual. We did not find differences in anxiety, adherence, or cardiac readmissions.
MedicalResearch.com Interview with:
Dr. Chuan-Ming Li MD, PhD
Statistician (Health/Medicine)
Division of Scientific Programs
The National Institute on Deafness and Other Communication Disorders
MedicalResearch.com: What are the main findings of the study?
Dr. Chuan-Ming Li: We used data on adults 18 years or older from the National Health and Nutrition Examination Survey for the study and found that prevalence of moderate to severe depression was 4.9 percent for individuals who reported excellent hearing, 7.1 percent for those with good hearing and 11.4 percent for participants who reported having a little hearing trouble or greater hearing impairment (HI). Depression rates were higher in women than in men. The prevalence of depression increased as hearing impairment became worse, except among participants who were deaf. There was no association between self-reported HI and depression among people ages 70 years and older; however, an association between moderate HI measured by pure-tone threshold hearing exams and depression was found in women aged 70 years and older but not in men.
MedicalResearch.com Interview with:
Steven A. Safren, Ph.D., ABPP
Professor of Psychology, Harvard Medical School
Director, Behavioral Medicine, Department of Psychiatry
Massachusetts General Hospital,
Boston, MA 02114
MedicalResearch.com: What are the main findings of the study?
Dr. Safren: The main findings of the study are that, in patients with uncontrolled type 2 diabetes and depression, a type of psychological treatment, cognitive behavioral therapy (CBT) that addressed both self-care and depression, resulted in improvements in both depressed mood, self-care, and glucose control. This was a randomized controlled trial, and this cognitive-behavioral treatment worked better than lifestyle adherence and nutrition counseling alone; and the effects were sustained over 8 months.
MedicalResearch.com Interview with:
Dr Peter de Jonge
Interdisciplinary Center for Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Netherlands
MedicalResearch.com: What are the main findings of the study?
Dr. de Jonge: The main findings were that depression and impulse control disorders, in particular binge eating and bulimia were associated with diabetes.
MedicalResearch.com Interview with:
Alize J. Ferrari
University of Queensland
School of Population Health
Herston, Queensland, Australia
MedicalResearch.com: What are the main findings of the study?
Answer: In our paper recently published in PloS Medicine, we report findings from the Global Burden of Disease Study 2010 for depression. We found that depression (defined as major depressive disorder and dysthymia) accounted fr 8% of the non fatal burden in 2010, making it the second leading cause of disability worldwide. Burden due to depression increased by 35% between 1990 and 2010, although this increase was entirely driven by population growth and ageing. Burden occurred across the entire lifespan, was higher in females compared to males, and there were differences between world regions.When depression was considered a risk factor for other health outcomes it explained 46% of the burden allocated to suicide and 3% of the burden allocated ischemic heart disease.
MedicalResearch.com Interview with:
Richard L. Kravitz, MD, MSPH
Professor and Co-vice Chair (Research)
Interim Director, UC Center Sacramento
Co-Editor in Chief, Journal of General Internal Medicine
MedicalResearch.com: What is the background for your study?
Dr. Kravitz: Depression in the United States is both undertreated and overtreated. As the de facto mental health care system for many, primary care is at the nexus of this problem. Up to 30% of patients with major depression in primary care go undiagnosed. At the same time, partly as a result of marketing, lots of patients who don’t need meds are started on antidepressants. So we were interested in finding ways to get more truly depressed patients into treatment without overtreating patients who don’t need it.
MedicalResearch.com Interview with:
Jannique van Uffelen, PhD, MSc (epidemiology),
MSc (human movement sciences), BHealth
Senior Research Fellow Active Ageing
INSTITUTE OF SPORT, EXERCISE & ACTIVE LIVING (ISEAL)
VICTORIA UNIVERSITY
MedicalResearch.com: What are the main findings of the study?
Answer: We examined the link between sitting-time and physical activity with current and future depressive symptoms in 8,950 mid aged women, who participated in the Australian Longitudinal Study on Women’s Health.
Both high sitting-time and low physical activity levels were associated with higher risk of current depressive symptoms, and in combination, the risk further increased. Compared with women sitting ≤4 hours/day and meeting the physical activity recommendations of at least 150 minutes of moderate intensity activity per week, women who sat >7 hrs/day and who did no physical activity were three times as likely to have depressive symptoms. However, only lack of physical activity was associated with increased risk of future depressive symptoms, irrespective of sitting-time. Women who did no physical activity were 26% more likely to have future depressive symptoms than women meeting physical activity recommendations.
John Hart, M.D.
Medical Science Director at the Center for BrainHealth
Jane and Bud Smith Distinguished Chair
Cecil Green Distinguished Chair
The University of Texas at Dallas
MedicalResearch.com: What are the main findings of the study?
Dr. Hart: Football players often sustain numerous concussive and subconcussive impacts—head impacts that do not elicit neurologic symptoms that may lead to white matter damage. We evaluated a population of retired NFL players in order to study the relationship between white matter integrity and the manifestation of depressive symptoms. We identified, for the first time, a correlation between depression and white matter abnormalities in former players with a remote history of concussion using diffusion tensor imaging (DTI).
Our data demonstrated a significant association between white matter integrity, as measured by DTI Fractional Anisotropy (FA), and the presence as well as severity of depressive symptoms in retired NFL athletes with a history of concussive or subconcussive impacts. We also found that dysfunction of the anterior aspect of the corpus callosum (forceps minor) and its projections to the frontal lobe can identify those with depression with 100% sensitivity and 95% specificity.
In Spain, 5-year survival following breast cancer diagnosis is more than 83%. Around 66% suffer fatigue following treatment. A Spanish research establishes the factors associated with tiredness in cancer survivors to improve their quality of life and rehabilitation. "Cancer-related fatigue is the symptom that most limits quality of life and is...
For Immediate Release – August 3, 2011 – (Toronto) – Twenty-five percent of people who were hospitalized for depression were readmitted or visited an emergency room again for depression within 30 days of discharge, according to a new study by the Centre for Addiction and Mental Health (CAMH). The results...