Category Archives: J Affect Disord

Uric acid in major depressive and anxiety disorders.

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Uric acid in major depressive and anxiety disorders.

J Affect Disord. 2017 Sep 06;225:684-690

Authors: Black CN, Bot M, Scheffer PG, Snieder H, Penninx BWJH

Abstract
BACKGROUND: Uric acid has neuroprotective effects, owing to its antioxidant properties. Lowered antioxidant capacity, causing increased oxidative stress, may be involved in affective disorders and might be altered by antidepressants. This study investigated the association of plasma uric acid, the greatest contributor to blood antioxidant capacity, with major depressive disorder (MDD) and anxiety disorders.
METHODS: Data were from the Netherlands Study of Depression and Anxiety including patients with current (N = 1648), remitted (N = 609) MDD and/or anxiety disorders (of which N = 710 antidepressant users) and 618 controls. Diagnoses were established with the Composite International Diagnostic Interview. Symptom severity was assessed with the Inventory of Depressive Symptoms-Self Report, Beck Anxiety Inventory and Fear Questionnaire. Uric acid was measured in plasma. Analyses were adjusted for sociodemographic, health and lifestyle variables.
RESULTS: Plasma uric acid adjusted mean levels were lower in current MDD and/or anxiety disorder(s) (289μmol/l) compared to remitted disorders (298μmol/l, p < .001) and controls (299μmol/l, p < .001; Cohen’s d .10). This finding was independent of antidepressant use. Depressive (β-.05, p = .0012), anxiety (β-.04, p = .009) and phobic (β-.03, p = .036) symptom severity, and symptom duration (β-.04, p = .009) were negatively associated with uric acid.
LIMITATIONS: Limitations include the lack of data on dietary intake which could be a potential confounding factor. From these cross-sectional findings, the association between uric acid and psychopathology cannot be inferred to be causal.
CONCLUSION: This large scale study finds plasma uric acid levels are lower in current, but not remitted, MDD and/or anxiety disorders, according to a dose-response gradient. This suggests the involvement of decreased antioxidant status in affective disorders, and points to their potential as an avenue for treatment.

PMID: 28917195 [PubMed – as supplied by publisher]

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Positive affective functioning in anhedonic individuals’ daily life: Anything but flat and blunted.

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Positive affective functioning in anhedonic individuals’ daily life: Anything but flat and blunted.
J Affect Disord. 2017 Apr 21;218:437-445
Authors: Heininga VE, Van Roekel E, Ahles JJ, Oldehinkel AJ… Continue reading

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The ten-year course of depression in primary care and long-term effects of psychoeducation, psychiatric consultation and cognitive behavioral therapy.

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The ten-year course of depression in primary care and long-term effects of psychoeducation, psychiatric consultation and cognitive behavioral therapy.
J Affect Disord. 2017 Mar 30;217:174-182
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The relation between chronotype and treatment outcome with light therapy on a fixed time schedule.

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The relation between chronotype and treatment outcome with light therapy on a fixed time schedule.

J Affect Disord. 2016 May 24;202:87-90

Authors: Knapen SE, Gordijn MC, Meesters Y

Abstract
BACKGROUND: Seasonal affective disorder (SAD) is characterized by recurrent episodes of major depression in a seasonal pattern. The therapy of choice is light therapy (LT). It is suggested that LT should be administered relative to the chronotype of the patient, with the optimal timing earlier for morning than for evening types. This study aims to retrospectively investigate the relation between chronotype and the effect of LT on a fixed time in the morning in a population of SAD patients.
METHODS: Data from four different studies conducted at the University Center of Psychiatry in Groningen, the Netherlands was used. Data from 132 patients was used (103 women). Depression score was determined by a structured interview (SIGH-SAD) prior to LT and after LT. Prior to LT morningness/eveningness preference of the patient was determined by the ‘Morningness/Eveningness Questionnaire’ (MEQ). All patients received LT at 8:00 AM at the clinic, independent of chronotype.
RESULTS: Patients had an average MEQ score of 51.5±8.2. There was no significant relationship between MEQ score and therapy success as measured with the SIGH-SAD (F2,129=0.05, ns). When patients were divided by chronotype (ranging from definite morning to moderate evening) no significant relation between MEQ score and therapy success was found (F2,129=0.02, ns).
LIMITATIONS: Retrospective design.
CONCLUSIONS: The lack of a significant relationship between chronotype, as measured with the MEQ, and therapy success with LT at a fixed timepoint may indicate that the anti-depressive effect of morning light in SAD patients is not explained by a phase shift of the biological clock.

PMID: 27259079 [PubMed – as supplied by publisher]

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The identification of symptom-based subtypes of depression: A nationally representative cohort study.

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The identification of symptom-based subtypes of depression: A nationally representative cohort study.

J Affect Disord. 2015 Oct 25;190:395-406

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Low stability of diagnostic classifications of anxiety disorders over time: A six-year follow-up of the NESDA study.

Low stability of diagnostic classifications of anxiety disorders over time: A six-year follow-up of the NESDA study.

J Affect Disord. 2015 Oct 28;190:310-315

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Daily symptom ratings for studying premenstrual dysphoric disorder: A review.

Daily symptom ratings for studying premenstrual dysphoric disorder: A review.
J Affect Disord. 2015 Sep 14;189:43-53
Authors: Bosman RC, Jung SE, Miloserdov K, Schoevers RA, Aan Het Rot M
Abstract
BAC… Continue reading

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Predicting long-term depression outcome using a three-mode principal component model for depression heterogeneity.

Predicting long-term depression outcome using a three-mode principal component model for depression heterogeneity.
J Affect Disord. 2015 Sep 12;189:1-9
Authors: Monden R, Stegeman A, Conradi HJ, de Jonge P, Wardenaar… Continue reading

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The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms.

The association between cardiac rehabilitation and mortality risk for myocardial infarction patients with and without depressive symptoms.

J Affect Disord. 2015 Sep 2;188:278-283

Authors: Meurs M, Burger H, van Riezen J, Slaets JP, Rosmalen JG, van Melle JP, Roest AM, de Jonge P

Abstract
BACKGROUND: Post-myocardial infarction (MI) depression is associated with reduced adherence to cardiac rehabilitation (CR) and increased mortality risk. The present study investigated whether all-cause mortality reduction associated with CR is different for MI-patients with and without depressive symptoms.
METHODS: Data of 2198 post-MI patients from the Depression after Myocardial Infarction (DepreMI) study and Myocardial Infarction and Depression Intervention Trial (MIND-IT) was used. Depression was assessed at hospitalization, defined as a score≥10 on the Beck Depression Inventory (BDI). Participation in CR was assessed with a self-report questionnaire, 12 months post-MI. Cox regression was used to estimate hazard ratios (HR) for all-cause mortality, up till 10 years post-MI. Missing data was imputed, using multiple imputation.
RESULTS: 878 (52%) Patients attended CR, 517 (26%) patients had a BDI score ≥10, and 379 (18%) patients died during the follow-up period. Overall, CR was not associated with a lower mortality risk (HR: 0.83; 0.54-1.30; p=0.41), adjusted for age, sex, left ventricle ejection fraction, previous MI, and past or current heart failure. However, there was a significant interaction between depression and CR on mortality (HR: 0.49; 0.27-0.90; p=0.02). CR was significantly associated with reduced mortality in depressed patients (HR: 0.48; 0.28-0.84; p=0.01), but not in non-depressed patients (HR: 1.09; 0.63-1.89; p=0.74).
LIMITATIONS: Patients were not randomized to CR. We had no information about the specific reasons of clinicians to offer CR and about the patients’ motives to participate.
CONCLUSIONS: CR was associated with reduced mortality risk only for MI-patients with depression. Clinicians should therefore particularly encourage MI-patients with depression to participate in CR.

PMID: 26384014 [PubMed – as supplied by publisher]

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Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial.

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Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled…

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Personality and cognitive vulnerability in remitted recurrently depressed patients.

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Personality and cognitive vulnerability in remitted recurrently depressed patients.

J Affect Disord. 2015 Mar 1;173:97-104

Authors: van Rijsbergen GD, Kok GD, Elgersma HJ, Hollon SD, Bockting CL

Abstract
INTRODUCTION: Personality disorders (PDs) have been associated with a poor prognosis of Major Depressive Disorder (MDD). The aim of the current study was to examine cognitive vulnerability (i.e., dysfunctional beliefs, extremity of beliefs, cognitive reactivity, and rumination) that might contribute to this poor prognosis of patients with PD comorbidity.
METHODS: 309 outpatients with remitted recurrent MDD (SCID-I; HAM-D17 ≤ 10) were included within two comparable RCTs and were assessed at baseline with the Personality Diagnostic Questionnaire-4(+) (PDQ-4(+)), the Dysfunctional Attitude Scale Version-A (DAS-A), the Leiden Index of Depression Sensitivity (LEIDS), the Ruminative Response Scale (RRS), and the Inventory of Depressive Symptomatology-Self Report (IDS-SR).
RESULTS: We found an indication that the PD prevalence was 49.5% in this remitted recurrently depressed sample. Having a PD (and higher levels of personality pathology) was associated with dysfunctional beliefs, cognitive reactivity, and rumination. Extreme ‘black and white thinking’ on the DAS was not associated with personality pathology. Brooding was only associated with a Cluster C classification (t(308) = 4.03, p < .001) and with avoidant PD specifically (t(308) = 4.82, p < .001), while surprisingly not with obsessive-compulsive PD.
LIMITATIONS: PDs were assessed by questionnaire and the analyses were cross-sectional in nature.
CONCLUSION: Being the first study to examine cognitive reactivity and rumination in patients with PD and remitted MDD, we demonstrated that even after controlling for depressive symptomatology, dysfunctional beliefs, cognitive reactivity, and rumination were associated with personality pathology. Rumination might be a pathway to relapse for patients with avoidant PD. Replication of our findings concerning cognitive vulnerability and specific PDs is necessary.

PMID: 25462402 [PubMed – indexed for MEDLINE]

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Training mental health professionals in suicide practice guideline adherence: Cost-effectiveness analysis alongside a randomized controlled trial.

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Training mental health professionals in suicide practice guideline adherence: Cost-effectiveness analysis alongside a randomized controlled trial.

J Affect Disord. 2015 Jul 26;186:203-210

Authors: de Beurs DP, Bosmans JE, de Groot MH, de Keijser J, van Duijn E, de Winter RF, Kerkhof AJ

Abstract
BACKGROUND: There is a lack of information on the cost-effectiveness of suicide prevention interventions. The current study examines the cost-effectiveness of a multifaceted structured intervention aiming to improve adherence to the national suicide practice guideline in comparison with usual implementation.
METHODS: In the intervention condition, professionals of psychiatric departments were trained using an e-learning supported Train-the-Trainer program. Newly admitted suicidal patients were assessed as soon as their department was trained and at 3 months follow-up. The primary outcome was improvement in suicide ideation. Missing cost and effect data were imputed using multiple imputation. Cost-effectiveness planes were plotted, and cost-effectiveness acceptability curves were estimated.
RESULTS: For the total group of suicidal patients (n=566), no effect of the intervention on suicide ideation or costs was found. For a subgroup of depressed suicidal patients (n=154, intervention=75, control=79), mean level of suicide ideation decreased with 2.7 extra points in the intervention condition, but this was not statistically significant. For this subgroup, the intervention may be considered cost-effective in comparison with usual implementation if society is willing to pay≥€ 6100 per unit of effect on the suicide ideation scale extra.
LIMITATIONS: Considering the cost outcomes, we had almost no cases that were complete, and heavily relied on statistical techniques to impute the missing data. Also, diagnoses were not derived from structured clinical interviews.
CONCLUSIONS: We presented the first randomized trial (trial registration: The Netherlands Trial Register (NTR3092 www.trialregister.nl)) on cost-effectiveness of a suicide practice guideline implementation in mental health care. The intervention might be considered cost-effective for depressed suicidal patients if society is willing to make substantial investments.

PMID: 26247913 [PubMed – as supplied by publisher]

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Enduring effects of Preventive Cognitive Therapy in adults remitted from recurrent depression: A 10 year follow-up of a randomized controlled trial.

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Enduring effects of Preventive Cognitive Therapy in adults remitted from recurrent depression: A 10 year follow-up of a randomized controlled trial.
J Affect Disord. 2015 Jul 11;185:188-194
Authors: B… Continue reading

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Loneliness is associated with poor prognosis in late-life depression: Longitudinal analysis of the Netherlands study of depression in older persons.

Loneliness is associated with poor prognosis in late-life depression: Longitudinal analysis of the Netherlands study of depression in older persons.
J Affect Disord. 2015 Jun 25;185:1-7
Authors: Holvast F, Burger H, … Continue reading

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Cognitive reactivity, self-depressed associations, and the recurrence of depression.

Cognitive reactivity, self-depressed associations, and the recurrence of depression.
J Affect Disord. 2015 May 18;183:300-309
Authors: Elgersma HJ, de Jong PJ, van Rijsbergen GD, Kok GD, Burger H, van der Does W, Pen… Continue reading

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Methylation of NR3C1 and SLC6A4 and internalizing problems. The TRAILS study.

Methylation of NR3C1 and SLC6A4 and internalizing problems. The TRAILS study.

J Affect Disord. 2015 Apr 6;180:97-103

Authors: van der Knaap LJ, van Oort FV, Verhulst FC, Oldehinkel AJ, Riese H

Abstract
BACKGROUND: The relationship between early adverse life events and later internalizing problems could be mediated by DNA methylation. Adversity has been associated with higher methylation levels in the glucocorticoid receptor gene (NR3C1) and the serotonin transporter gene (SLC6A4) in adolescents. We investigated cross-sectional and prospective associations of NR3C1 and SLC6A4 methylation with adolescents׳ clinical diagnoses of internalizing disorders and internalizing symptom scores.
METHODS: In a population sample (mean age=16.2) we measured DNA methylation in three regions of NR3C1 (NR3C1_1, N=454; NR3C1_2, N=904; NR3C1_3, N=412) and one region of SLC6A4 (N=939) at baseline. Internalizing problems were operationalized as clinical DSM-IV diagnoses, assessed at 3 year follow-up with a diagnostic interview, and internalizing symptom scores, assessed with Self-Report questionnaires at baseline and follow-up.
RESULTS: Only NR3C1_1 methylation was positively associated with risk of lifetime internalizing disorders, and with symptom scores at follow-up. However, after accounting for baseline symptom scores there was only a tendency for association with internalizing symptom scores at follow-up. There was no association between SLC6A4 methylation and risk of lifetime internalizing disorders. SLC6A4 methylation and internalizing symptom scores showed a tendency for association, also after accounting for baseline symptom scores.
LIMITATIONS: There was no repeated measure of DNA methylation to study causality between methylation and internalizing problems. Gene expression data were not available.
CONCLUSIONS: Although the role of gene methylation in the development of internalizing problems remains unclear, our findings suggest that gene methylation, particularly of NR3C1, may be involved in the development of internalizing problems in adolescence.

PMID: 25889020 [PubMed – as supplied by publisher]

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Data-driven atypical profiles of depressive symptoms: Identification and validation in a large cohort.

Data-driven atypical profiles of depressive symptoms: Identification and validation in a large cohort.

J Affect Disord. 2015 Apr 3;180:36-43

Authors: Wanders RB, Wardenaar KJ, Penninx BW, Meijer RR, Jonge P

Abstract
BACKGROUND: Atypical response behavior on depression questionnaires may invalidate depression severity measurements. This study aimed to identify and investigate atypical profiles of depressive symptoms using a data-driven approach based on the item response theory (IRT).
METHODS: A large cohort of participants completed the Inventory of Depressive Symptomatology self-report (IDS-SR) at baseline (n=2329) and two-year follow-up (n=1971). Person-fit statistics were used to quantify how strongly each patient׳s observed symptom profile deviated from the expected profile given the group-based IRT model. Identified atypical profiles were investigated in terms of reported symptoms, external correlates and temporal consistency.
RESULTS: Compared to others, atypical responders (6.8%) showed different symptom profiles, with higher ‘mood reactivity’ and ‘suicidal ideation’ and lower levels of mild symptoms like ‘sad mood’. Atypical responding was associated with more medication use (especially tricyclic antidepressants: OR=1.5), less somatization (OR=0.8), anxiety severity (OR=0.8) and anxiety diagnoses (OR=0.8-0.9), and was shown relatively stable (29.0%) over time.
LIMITATIONS: This is a methodological proof-of-principal based on the IDS-SR in outpatients. Implementation studies are needed.
CONCLUSION: Person-fit statistics can be used to identify patients who report atypical patterns of depressive symptoms. In research and clinical practice, the extra diagnostic information provided by person-fit statistics could help determine if respondents׳ depression severity scores are interpretable or should be augmented with additional information.

PMID: 25881279 [PubMed – as supplied by publisher]

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Multiple risk factors predict recurrence of major depressive disorder in women.

Multiple risk factors predict recurrence of major depressive disorder in women.
J Affect Disord. 2015 Apr 2;180:52-61
Authors: van Loo HM, Aggen SH, Gardner CO, Kendler KS
Abstract
BACKGROUND: It is d… Continue reading

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Symptom-specific course trajectories and their determinants in primary care patients with Major Depressive Disorder: Evidence for two etiologically distinct prototypes.

Symptom-specific course trajectories and their determinants in primary care patients with Major Depressive Disorder: Evidence for two etiologically distinct prototypes.

J Affect Disord. 2015 Mar 26;179:38-46

Authors: Wardenaar KJ, Monden R, Conradi HJ, de Jonge P

Abstract
BACKGROUND: The course-heterogeneity of Major Depressive Disorder (MDD) hampers development of better prognostic models. Although latent class growth analyses (LCGA) have been used to explain course-heterogeneity, such analyses have failed to also account for symptom-heterogeneity of depressive symptoms. Therefore, the aim was to identify more specific data-driven subgroups based on patterns of course-trajectories on different depressive symptom domains.
METHODS: In primary care MDD patients (n=205), the presence of the MDD criterion symptoms was determined for each week during a year. Weekly ‘mood/cognition’ (MC) and ‘somatic’ (SOM) scores were computed and parallel processes-LCGA (PP-LCGA) was used to identify subgroups based on the course on these domains. The classes׳ associations with baseline predictors and 2-/3-year outcomes were investigated.
RESULTS: PP-LCGA identified four classes: quick recovery, persisting SOM, persisting MC, and persisting SOM+MC (chronic). Persisting SOM was specifically predicted by higher baseline somatic symptomatology and somatization, and was associated with more somatic depressive symptomatology at long-term follow-up. Persisting MC was specifically predicted by higher depressive severity, thinking insufficiencies, neuroticism, loneliness and lower self-esteem, and was associated with lower mental health related quality of life and more mood/cognitive depressive symptomatology at follow-up.
LIMITATIONS: The sample was small and contained only primary care MDD patients. The weekly depression assessments were collected retrospectively at 3-month intervals.
CONCLUSIONS: The results indicate that there are two specific prototypes of depression, characterized by either persisting MC or persisting SOM, which have different sets of associated prognostic factors and long-term outcomes, and could have different etiological mechanisms.

PMID: 25845748 [PubMed – as supplied by publisher]

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The effect of an e-learning supported Train-the-Trainer programme on implementation of suicide guidelines in mental health care.

The effect of an e-learning supported Train-the-Trainer programme on implementation of suicide guidelines in mental health care.
J Affect Disord. 2015 Jan 24;175C:446-453
Authors: de Beurs DP, de Groot MH, de Keijser… Continue reading

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