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PubMed1982

The treatment of depression in general practice: a comparison of L-tryptophan, amitriptyline, and a combination of L-tryptophan and amitriptyline with placebo.

One hundred and fifteen patients from 5 general practices participated in a 12-week, double-blind study comparing L-tryptophan, amitriptyline, L-tryptophan-amitriptyline combination and placebo in the treatment of depression. Analysis of total score on the Hamilton Depression Scale and a global rating of depression showed that all 3 active treatments were more effective than placebo. Significantly more patients were withdrawn as treatment failures in the placebo group compared with the active treatment groups. Side-effects necessitated withdrawal of more patients from the amitriptyline group than from the other active treatment groups, but this difference was not significant. Plasma amitriptyline and nortriptyline levels were similar in the amitriptyline and combined treatment groups. Standard haematological and biochemical profiles did not alter significantly in any group, but mean heart rate was significantly increased in patients receiving amitriptyline. There was no change in free or total plasma tryptophan concentration with treatment or on remission of symptoms.

Adolescent↗
PubMed1999

Coincidence detection and changes of synaptic efficacy in spiny stellate neurons in rat barrel cortex.

Paired whole-cell voltage recordings were made from synaptically connected spiny stellate neurons in layer 4 of the barrel field in young (P14) rat somatosensory cortex. When postsynaptic action potentials (APs) followed each of 5 presynaptic APs in a 10- or 20-Hz train by less than 25 ms, subsequent unitary EPSP amplitudes were persistently reduced. Induction of long-term depression (LTD) depended on activation of group II metabotropic glutamate receptors, but not on NMDA or AMPA receptors. Reducing postsynaptic increases in intracellular calcium ([Ca2+]i) by intracellular loading with a fast- (BAPTA) or a slow- (EGTA) acting Ca2+ buffer blocked synaptic depression. Analysis of EPSP failures suggested mediation of LTD by a reduction in release probability. We propose a mechanism by which coincident activity results in long-lasting reduction of synaptic efficacy between synaptically connected neurons.

Animals↗
PubMed2002

Association study of the serotonin transporter promoter polymorphism and symptomatology and antidepressant response in major depressive disorders.

The serotonin transporter (5-HTT) is the site of primary action for the selective serotonin reuptake inhibitors (SSRIs). Previous Western reports have demonstrated that the lallele of the 5-HTT gene-linked polymorphic-region (5-HTTLPR) polymorphism is associated with better SSRI antidepressive effects than the s allele, however, another study of a Korean population has produced a contrasting finding. The present study tested the hypothesis that the 5-HTTLPR genetic polymorphism is associated with SSRI antidepressant response by evaluating total and cluster depressive symptoms for 121 Chinese patients diagnosed with major depression. Analysis of the results reveals that patients with the l/l genotype had a significantly better response to SSRI (fluoxetine) when compared with s allele carriers, as evaluated on the basis of total (P = 0.013), core (P = 0.011), and psychic-anxiety (P = 0.005) and somatic-anxiety (P = 0.002) Hamilton Depression Rating Scale-score percentage change. Our findings confirm reports that the l allele is associated with better SSRI response.

Adult↗
PubMed1987

Loss and depression. A controversial link.

Inconsistent findings in studies of loss and depression arise from methodological differences, lack of common definitions of depression and loss, and the failure to consider the interaction hypothesis: the effect of early loss on depression is partly conditional on the presence of a current loss. Data were collected from 744 university students. Only 15% of subjects without loss vs. 44% with both types of loss had Beck Depression Inventory scores indicative of moderate depression. Analysis of variance confirmed this strong interaction effect. These results provide empirical support for Freud's view that a recent loss can reactivate depressive feelings associated with earlier loss.

Adolescent↗
PubMed1987

Symptoms and diagnosis of depression in alcoholics.

We examined depressive symptoms, using the Beck Depression Inventory (BDI), in a group of 50 alcoholic patients, diagnosed according to DSM III criteria during active drinking, withdrawal (4 days after their last drink), and abstinence (24 days after their last drink). DSM III diagnoses of major depression were made in 16 (32%) of the patients. The diagnoses were made using the NIMH Diagnostic Interview Schedule (DIS) between the 10th and 24th day after the patients' last drink. Depressive symptoms decreased markedly as the patients progressed from active drinking to abstinence. Alcoholic patients having a diagnosis of major depression had higher BDI scores than those not having a diagnosis of major depression. Analysis of BDI items using a two-parameter logistic item response model confirmed that the BDI measured depressive symptoms in these alcoholics. We conclude that the BDI is valid for screening for depression in alcoholic patients.

Adult↗
PubMed1985

From clomipramine to mianserin: therapeutic relevance of interactions with serotonin uptake and storage, as studied in the blood platelet model.

Inhibition of active serotonin uptake into neurones and platelets is a common effect of tricyclic and related antidepressants, and has been regarded as one of the more important mechanisms of action of such drugs. However, as is shown in this survey, the antidepressants vary widely in their potency as inhibitors of platelet serotonin uptake, and they also differ in the type of inhibition kinetics, from purely competitive to mixed competitive/noncompetitive. The therapeutic relevance of this effect is discussed. Serotonin uptake inhibition seems to be one of several mechanisms for obtaining the required normalization of monoamine dysfunction in depression. Analysis of efflux from platelets preloaded with a moderate amount of 14C-serotonin provides information on the storage and compartmentation of serotonin in the platelets, and on the rate of efflux from the different compartments. When present during the preloading phase, some antidepressants seem to produce a relative increase in serotonin in the granular storage compartment when compared to the smaller cytoplasmic compartment. This effect is in some respects opposite to that exerted by reserpine, and possibly may be pharmacologically relevant.

Antidepressive Agents↗
PubMed2004

The SCL-90 and SCL-90R versions validated by item response models in a Danish community sample.

OBJECTIVE: To evaluate the internal validity of the subscales of the combined SCL-90 and SCL-90R, the SCL-92, by item response analyses as compared with several previously reported factor analyses of this questionnaire in the literature. METHOD: The SCL-92 questionnaire was mailed to an age- and gender-stratified random sample of Danish citizens. The sample comprised 2040 individuals. The internal structure of the nine factors of the SCL-92 questionnaire was evaluated by Mokken-Loevinger analysis and Rasch analysis. RESULTS: In total, 1153 persons or 58% returned the questionnaire fully completed. Mokken analysis found all scales apart from the psychoticism scale acceptable. The Rasch analysis found most of the subscales to be robust. Minor problems were seen for the scales of phobic anxiety, obsession-compulsion and depression. Analysis of the Global Severity Index showed that the Rasch model was rejected for the full 92-item scale, but not for a scale consisting of the 63 items from the non-psychotic subscales. Spearman correlations among the subscales were all positive (range 0.34-0.79) and so were correlations between each of the subscales and the Global Severity Index (range 0.55-0.91). CONCLUSION: In this sample from the Danish general population the non-psychotic subscales, i.e. the subscales covering psychological distress were observed to function well. In a general population sample, the 63 non-psychotic items primarily appear to reflect one broad dimension of distress.

Humans↗
PubMed2002

Regulation of the retinal bipolar cell mGluR6 pathway by calcineurin.

Glutamate produces a hyperpolarizing postsynaptic potential in ON bipolar cells by binding to the metabotropic receptor mGluR6 and subsequently closing a cation-selective channel. It has been proposed that Ca(2+) influx through the cation channel triggers a depression of the synaptic potential. Here we report that this Ca(2+)-mediated depression requires activation of calcineurin, a Ca(2+)/calmodulin-regulated phosphatase. We measured glutamate-evoked currents (I(glu)) with whole cell recordings of ON bipolar cells in light-adapted retinal slices. Depression of I(glu) by Ca(2+) was prevented by inhibitors of calcineurin or by tightly buffering Ca(2+) with bis-(o-aminophenoxy)-N,N,N',N'-tetraacetic acid (BAPTA). However, when cells were dialyzed with BAPTA and a Ca(2+)-independent form of calcineurin (CaN420), depression of I(glu) was restored. Similarly, CaN420 induced depression of I(glu) during continuous glutamate application, a protocol that ordinarily prevents depression. Analysis of changes in the amplitude of the cation-selective current (I(cat)) of cells that were dialyzed with high Ca(2+) (1 microM), or with BAPTA and CaN420, indicates that Ca(2+) depresses I(glu) by reducing I(cat) and that calcineurin acts via the same mechanism. Ca(2+)-mediated depression of I(glu) was not found to involve CaMKII, as inhibitors of CaMKII did not prevent this depression nor did they affect the sensitivity of the response to small changes in the concentration of mGluR6 agonist. Our data suggest that Ca(2+) and calcineurin may play an adaptive role at the synapse between photoreceptor and ON bipolar cells, closing postsynaptic cation channels that are opened by a drop in synaptic glutamate levels during prolonged photoreceptor illumination.

Animals↗
PubMed2002

Association analysis for serotonin transporter promoter polymorphism and auditory evoked potentials for major depression.

The serotonergic system has been implicated in the production of the N1 and P2 components of auditory evoked potentials (AEPs). Moreover, studies have indicated the influence of heritability in the genesis of these AEP components. The serotonin transporter is the major site of serotonin reuptake into the presynaptic neuron, and it has been determined that variants in the serotonin transporter gene-linked polymorphic region (5-HTTLPR) may affect gene transcription activity. The present study tested the hypothesis that the 5-HTTLPR genetic polymorphism is associated with the N1 and P2 components of AEPs in a sample of 127 Chinese patients (mean age: 41.6 years; male/female ratio: 58/69) diagnosed with major depression. Analysis of the results revealed a significantly shorter P2 latency for patients bearing the s/s genotype in comparison with l allele carriers, especially for the female patients (p = 0.004). The 5-HTTLPR polymorphism accounted for 3.4% of the variance in P2 latency. Our findings suggest a relationship between the 5-HTTLPR polymorphism and AEP P2 latency, and further studies of other genetic polymorphisms in the serotonergic system may help to predict this latency.

Adult↗
PubMed1993

Dawn simulation treatment of winter depression: a controlled study.

OBJECTIVE: This study sought to determine whether dawn simulation was superior to a shorter dimmer "placebo" dawn signal in treating winter depression. METHOD: In a randomized, parallel design, 22 patients with winter depression were treated with either 1 week of a 2-hour dawn simulation peaking at 250 lux or 1 week of a 30-minute dawn simulation peaking at 0.2 lux. The subjects were told that they would receive either a "gradual" dawn or a "rapid" dawn reaching an intensity that would be dimmer than standard bright light treatment. At the end of both the baseline week and the treatment week, subjects were assessed in a blind manner with the Hamilton Rating Scale for Depression. Analysis of covariance was used to compare the two dawn treatments. RESULTS: The 2-hour, 250-lux dawn simulation resulted in Hamilton depression scale scores that were significantly lower than scores after the 30-minute, 0.2-lux dawn simulation. CONCLUSIONS: This study indicates that dawn simulation is an effective treatment for winter depression.

Adult↗
PubMed2006

Familial aggregation of illness chronicity in recurrent, early-onset major depression pedigrees.

OBJECTIVE: The authors used a large sample collected for genetic studies to determine whether a chronic course of illness defines a familial clinical subtype in major depressive disorder. METHOD: A measure of lifetime chronicity of depressive symptoms (substantial mood symptoms most or all of the time) was tested for familial aggregation in 638 pedigrees from the Genetics of Recurrent Early-Onset Depression (GenRED) project. RESULTS: In subjects with chronic depression, the mean age at illness onset was lower and rates of attempted suicide, panic disorder, and substance abuse were higher than among those with nonchronic depression. Chronicity was assessed in 37.8% of affected first-degree relatives of probands with chronic depression and in 20.2% of relatives of probands with nonchronic depression. Analysis using the generalized estimating equation model yielded an odds ratio of 2.52 (SE=0.39, z=6.02, p<0.0001) for the likelihood of chronicity in a proband predicting chronicity in an affected relative. With stratification by proband age at illness onset, the odds ratio for chronicity in relatives by proband chronicity status was 6.17 (SE=2.09, z=5.35, p<0.0001) in families of probands whose illness onset was before age 13 and 1.92 (SE=0.34, z=3.72, p<0.0001) in families of probands whose illness started at age 13 or later. CONCLUSIONS: These findings suggest that chronicity of depressive symptoms is familial, especially in preadolescent-onset illness. Chronicity is also associated with other indicators of illness severity in recurrent, early-onset major depression. Further study using chronicity as a subtype in the genetic analysis of depressive illness is warranted. Refinement of the definition of chronicity in depressive illness may increase the power of such studies.

Adolescent↗
PubMedDate not supplied

The prevalence of distress in persons with human immunodeficiency virus infection.

The purpose of this study was to assess the prevalence of distress, anxiety, and depression in persons with human immunodeficiency virus (HIV) infection and determine the feasibility of screening in an urban HIV primary care setting. A convenience sample of 101 patients in the waiting room of an acquired immunodeficiency syndrome clinic completed two questionnaires, the Hospital Anxiety and Depression Scale (HADS) and the Distress Thermometer. The patient's demographic, medical, and psychiatric histories were obtained through chart review. The results of the Distress Thermometer revealed that 72.3% had a score of 5 or greater, demonstrating high distress. The results of the HADS revealed that 70.3% had high anxiety, with a score of 7 or greater. On the HADS depression questions, 45.5% had a score of 7 or greater, indicating depression. Analysis of the total HADS scores, including anxiety and depression, revealed that 53.5% had a score of greater than 15 and were experiencing significant distress. Patients with high viral loads were more likely to be distressed (P < 0.0005). Patients with high viral loads were also more likely to have higher anxiety or depression scores on the HADS. Patients who had CD4 counts higher than 500/mm(3) were less likely to be depressed. This study demonstrates a high prevalence of distress, anxiety, and depression among persons with HIV. The HADS and the Distress Thermometer showed a good correlation with each other (P < 0.0005), and these questionnaires can provide a simple and efficient method for rapid screening in an HIV clinic setting.

Adult↗
PubMed1979

Hostility and guilt in obsessive-compulsive neurosis.

The enquiry relates to the investigation of 30 cases of obsessive-compulsive neurosis with special reference to the phenomena of hostility and guilt as revealed through Foulds' Five Punitive Scales and the Thematic Apperception Test. Controls consisted of an equal number of subjects suffering from neurotic depression. Analysis reveals acting-out hostility and extrapunitive tendency in the experimental group. No significant difference was found in terms of guilt scores.

Female↗
PubMed1985

Hereditary differentiation of anxiety and affective neuroses.

One hundred and fifty anxiety neurotic and neurotic depressive twin probands were differentiated into three groups by means of discriminant analysis, 50 in each group. The groups were named: pure anxiety neurosis, mixed anxiety-depression, and pure neurotic depression. Analysis of concordance rates indicated that only pure anxiety neurosis seemed to be influenced by hereditary factors.

Anxiety Disorders↗
PubMed1988

Social dimensions of mental illness among rural elderly populations.

Despite growing concern with rural elderly populations, little attention has focused on their mental health, ways it may correlate with physical health, or how rural mental health patterns compare to urban. Popular wisdom contends that elderly people in general, and rural elderly persons in particular, are at increased risk for mental illness. This article examines these questions. A review of available literature suggests that elderly people may be at only slightly greater risk of mental illness than the population at large, though there are some indications that rates of depression may be somewhat higher among the elderly population. Much of this same literature implies that objective environmental conditions play a significant role in the incidence of depression. Analysis of data gathered in a statewide random poll (N = 743) indicates that while physical health tends to be poorer among rural populations, when health is held constant there is actually an inverse relationship between age and depression. Therefore, rural elderly persons are no more likely to be depressed than their urban counterparts despite harsher living conditions. Both conceptual and policy implications are discussed.

Adolescent↗
PubMed1992

MMPI-ER two-point codes of industrially injured Hispanic workers by DSM-III--R diagnosis.

The purpose of this study was to describe the MMPI-ER two-point codes of 492 Hispanic adults who had sustained work-related injuries and who had applied for workers' compensation benefits. More specifically, the focus was on whether there are unique MMPI two-point codes for Hispanic workers with three specific types of DSM-III--R diagnoses--adjustment disorder, anxiety disorder, and major depression. Analysis suggests that psychiatric condition or diagnosis may act as a moderator variable in Hispanic persons' MMPI performance, including MMPI two-point codes.

Accidents, Occupational↗
PubMed2003

[The effect of exercise program on health and depression in the elderly].

PURPOSE: The purpose of this research was to determine the effect of an exercise program on the health status and depression in the elderly. METHOD: The research design was a nonequivalent control group pre-post test design. The exercise program (experimental group) consisted of 22 elderly over a period exercising for 12 weeks, 3 days/week. The phone counselling about exercise and health(control group) was applied for 12 weeks for 10-15 minutes/day/week. To identify the health status SF-36 was utilized and the GDS was used for depression analysis. The data was collected from May 2001 to July 2001. RESULT: The effect of the exercise appeared significant in the subarea of health status (physical function, physical role, mental health, general health) and depression. The effect of the phone counselling was appeared significant in subarea of health status - bodily pain. The effect of the exercise and the phone counselling did not appear significant. CONCLUSION: The exercise designed for the elderly promotes health in the elderly and further evaluation about the effect on exercise and phone counselling is needed.

English Abstract↗
PubMed2004

The Association Between Spirituality and Depression in an Urban Clinic.

OBJECTIVE: To investigate the correlation between spiritual beliefs and depression in an urban population. METHOD: A convenience sample of adult patients of an urban primary care clinic completed a self-administered questionnaire consisting of the Zung Depression Scale and the Spiritual Involvement and Beliefs Scale (SIBS). RESULTS: Among 122 respondents, 99 (81%) reported that they consider themselves religious. Responses from the Zung Depression Scale found that 76 (62%) of the patients were depressed and 46 (38%) were not. The Pearson correlation coefficient between the Zung Depression Scale and the SIBS was -0.36 (p <.0001). Backward stepwise regression analysis revealed that SIBS score and physical health predicted the Zung Depression Scale score. Age, gender, ethnicity, religious affiliation, and income showed no significant association with depression. Analysis of individual SIBS items revealed that high spirituality scores on items in the domain of intrinsic beliefs, such as belief in a higher power (p <.01), the importance of prayer (p <.0001), and finding meaning in times of hardship (p <.05), were associated negatively with depression. Attendance of religious services had no significant association with depression. CONCLUSION: Appropriate encouragement of a patient's spiritual beliefs may be a helpful adjunct to treating depression.

Journal Article↗