High
risk for psychopathology in the offspring of
parents with bipolar disorder
Bipolar
disorder is a debilitating highly familial
psychiatric disorder. A study has assessed the
risk of psychopathology in offspring of parents
with bipolar disorder compared to off spring of
healthy control parents. Offspring of bipolar
parents had higher risks for many severe
psychiatric disorders and high levels of
psychosocial and educational
dysfunction................................
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Effectiveness
of transcranial magnetic stimulation in patients
with drug-resistant major depression
Repetitive
transcranial magnetic stimulation (rTMS) has
been most commonly used in depression usually in
drug-resistant patients. A recent study
investigated the use of high frequency TMS in
drug-resistant depressed patients. It confirmed
that TMS may be a useful and safe treatment in
drug-resistant depression with 11/18 patients
responding to the highest intensity stimulation
compared to 1/16 in the sham
group...................................Click
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Efficacy
of milnacipran in patients with Taijin Kyofusho
notably on insight and stress coping
Taijin
Kyofusho is a phobia specific to Japan which
resembles social anxiety disorder with fear of
offending others as a central feature. A open
study has been conducted on the effects of the
SNRI, milnacipran, in patients suffering from
Taijin Kyofusho focusing on insight and stress
coping strategies.
Milnacipran was administered to 16 patients for
12 weeks. Of the 10 patients who completed the
study, 70% were responders (scoring 2 or less on
CGI). There was a significant improvement in
Taijin Kyofusho offensive anxiety scores as well
as insight and emotional
coping................................
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Increased
risk of major depression in women with
incontinence
Urinary
incontinence and major depression are two
conditions associated with social stigma,
functional impairment and decreased quality of
life which are more prevalent in women. To
better understand the relationship between
depression and urinary incontinence, a study
evaluated the prevalence of comorbid major
depression urinary incontinence in women in the
general
population............................................
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Tryptophan
hydroxylase 2 haplotype linked to major
depression and suicide attempts
Tryptophan
hydroxylase (TPH), the rate-limiting enzyme for
brain serotonin biosynthesis, is encoded by the
TPH2 gene. The TPH2 haplotype has been suggested
to be associated with depression. The role of
the TPH2 haplotype in the pathogenesis of
suicide and major depression has recently been
studied. In addition, the relationship with
an intermediate phenotype for suicidality and
depression, CSF 5-HIAA levels, was
investigated........
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Antidepressant
efficacy of milnacipran in Korean depressed
patients
Some
studies have suggested that depression may have
different characteristics in different cultures,
such as between Korea and western countries. The
serotonin and noradrenaline reuptake inhibitor
(SNRI), milnacipran, is effective in treating
major depression in patients in Western
countries as well as in Japan. A study compared
the efficacy and safety of milnacipran and the
selective serotonin reuptake inhibitor (SSRI),
fluoxetine, in the treatment of major depression
in a population of Korean
patients...........................................
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Providing
therapy for major depression to low-income
minority women is
cost-effective
In
the USA, ethnic minorities have less access to
care for depression. A recent study evaluated
the cost-effectiveness of pharmacotherapy or
cognitive behavior therapy (CBT) for major
depression compared with community referral in
low-income minority women.The results indicate
that providing pharmacotherapy or CBT to
low-income minority women is cost-effective for
the public health care system
..........................................
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Increased
risk of suicide attempts in adults taking
paroxetine
Increased
risk of suicidalilty following the use of
certain antidepressants has been demonstrated in
children and adolescents. It is still unclear
whether a similar risk exists in adult patients.
Unpublished, and previously unavailable, data
for paroxetine have been included in a recent
analysis. A pooled analysis carried out on 16
double blind, parallel design studies including
unpublished and previously unavailable data
suggests that the use of paroxetine is
associated with an increased risk of suicide
attempts in adults
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Genetic
overlap between pathological gambling and major
depression in men
Co-occurrence
of pathological gambling and major depression is
frequent. Estimation of relative genetic and
environmental contributions between pathological
gambling and major depression was the objective
of a study. 7869 subjects from the Vietnam Era
Twin (VET) Registry were interviewed in a recent
study to compare the influence of genetic and
environmental factors. Genetic factors were
found to contributed to 66% of the variance in
pathological gambling and 41% of the variance in
major depression
...........................................
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Association
of continued lithium treatment with reduced
suicide risk
Individuals
with bipolar disorder and unipolar depressive
disorder are known to have an increased risk of
suicide. Despite the well established
mood-stabilizing properties of lithium, it is
less clear whether treatment with lithium may
prevent suicide. A recent Danish population
study compared the rates of suicide in patients
who purchased lithium with the general
population
...........................................
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Triiodothyronine
augmentation of selective serotonin reuptake
inhibitors (SSRIs) in SSRI-resistant subjects
with major depressive disorder
Several
studies have shown the efficacy of
triiodothyronine (T3) for augmenting the
efficacy of tricyclic antidepressants (TCAs) in
treatment-resistant subjects with major
depressive disorder (MDD). Few studies,
generally with a small number of patients,
however, have focused on whether T3 was
efficacious in combination
with
selective
serotonin reuptake inhibitors (SSRIs). The
efficacy of T3 augmentation of SSRIs was
assessed in patients with MDD resistant to SSRI
treatment as well as patients with
SSRI-resistant melancholic and atypical MDD..
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The
public believe antidepressants to be harmful
Several
surveys have found negative public attitudes
towards antidepressants in contrast to positive
perceptions of health professionals. In spite of
efforts at public education negative attitudes
continue to prevail. An Australian study has
examined the factors associated with these
negative
attitudes.........................................
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Reversal
of enhanced noradrenaline levels in melancholia
by electroconvulsive
therapy
Increased
plasma noradrenaline levels increases mortality
in chronic heart failure patients. Depression
also increases the risk of mortality in these
patients. To determine whether the
depression-induced risk was related to increased
circulating noradrenaline, cerebrospinal fluid
and plasma noradrenaline were measured in
depressed patients and controls, before and
after electroconvulsive
therapy.........................................
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Decreased
density of pyramidal neurons in the
orbitofrontal cortex of elderly subjects with
depression
Neuroimaging
studies have suggested that elderly depressed
patients may have reduced in the volume of
prefrontal cortex and orbitofrontal cortex
(ORB). Postmortem autopsy samples from elderly
depressed and age-matched control were the
subject of a detail neuroanatomical study.
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Association
of paternal postnatal depression with increased
risk of behavioural problems in the child
Early
maternal influences are important in the
development of the offspring, and depression in
mothers can lead to disturbances in children's
later behaviour and cognition. A recent study
examined the effects of paternal depression
after childbirth on children's early behavioural
and emotional.
........................................
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High
suicide risk in the hospitalized very
elderly
A
recent study involving1,684,205 persons examined
the influence of hospitalization with medical
illnesses on suicide risk in the very old (80
and over) compared with that in the old (65 to
79) and middle-aged (52-64)
people.......................................
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Depressed
patients who suffer from pain take longer to
achieve remission than those who do not
It
has been suggested that in patients treated for
depression who also suffer from pain respond
less well to antidepressants. A study has tested
the hypothesis that in patients with recurrent
depression, the presence of pain at baseline
would predict a delayed time to remission
following
treatment...................................Click
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Similar
pattern of symptom response for a selective
serotonin and a selective noradrenaline
antidepressant
Similary
rates of antidepressant response have been found
for selective 5-HT and selective NA
reuptake inhibitors. However, it is not known
whether the same symptoms respond to both types
of agents. A study recently examined symptom
response pattrerns in two studies comparing, the
selective 5-HT reuptake inhibitor, fluoxetine,
and the selective NA reuptake inhibitor,
reboxetine.......................................
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Early
identification of patients at high risk for
depression after mild brain
injury
18%
of patients with mild traumatic brain injury
develop a psychiatric illness within 1 year and
depression is the most frequent. A study has
investigated factors that can be used to
identify patients at risk of developing
depression following mild traumatic brain
injury.....................................
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Sensitivity
of the serotonin transporter gene to the
depressogenic effects of stressful life
events
The
variability with which stress can lead to
depression is thought to be influenced by the
polymorphism of certain genes. A recent study
investigated the possible responsibility of the
functional length polymorphism in the promoter
of the serotonin transporter gene for this
different differential response to
stress.................................Click
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Effect
of direct-to-consumer advertising on patients'
request for antidepressants
Direct-to-consumer
(DTC) advertising of prescription drugs can lead
to overprescribing but it can also help to
promote efficacious treatments and encourage
patients to seek care. A study has investigated
the effects on physician prescribing, of
DTC-stimulated requests for antidepressants by
depressed
patients.....................................
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Changes
in brain function indicate susceptibility to
antidepressant side effects
Several
studies have compared changes in brain function
with clinical response to antidepressants. A
recent study, explored the relationship between
antidepressant-induced side effects and changes
in electroencephalographic brain
activity...................................
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Association
between negative self-schemas and onset of
depression
Beck's
cognitive theory of depression states that
negative self-beliefs can induce a
susceptibility to depression. A new study
examined whether non-depressed pregnant women
with negative self-schemas were at a greater
risk of onset of
depression...............................Click
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Positive
association between the dopamine D4 receptor
gene (DRD4) and mood disorders
The
dopamine D4 receptor gene (DRD4) has been
suggested to be a candidate gene for depression.
A meta-analysis was conducted to re-evaluate the
role of the DRD4 gene 48-base-pair-repeat
polymorphism in unipolar and bipolar
depression...................................
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Efficacy
of deep brain stimulation in
treatment-refractory major depression
About
20% of depressed people do not respond to
standard treatments. Functional neuroimaging
studies have shown that the subgenual cingulate
(Cg25) region has a critical role in modulating
negative mood states, and is metabolically
overactive in patients with treatment-resistant
depression. Investigators studied the effect of
a chronic stimulation of Cg25 in six patients
with severe refractory depression in an attempt
to decrease this high activity and improve their
depression.................................
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Association
between history of depression and high risk of
Alzheimer's disease in men
Depression
is common in patients with dementia or
Alzheimer's disease. There is controversy about
a possible causal relationship. A study examined
the relationship between premorbid symptoms of
depression and the development of dementia and
AD over a period of 14 years in 1357 subjects.
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Increased
tryptophan hydroxylase in the dorsal raphe
nucleus of depressed suicide victims
Serotonin
(5-HT) neurotransmission including key receptors
and transporters is reduced in suicide victims.
In contrast a higher density and number of DRN
neurons in the dorsal raphe nucleus have been
observed. Tryptophan hydroxylase is the
rate-limiting enzyme in the synthesis of 5-HT,
and alterations in TPH could explain decreased
neurotransmission in spite of an increased
number of neurons. A recent study has measured
serotonin synthesis, in the dorsal and median
raphe nucleus of depressed suicides and
controls...................................
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Drop
of suicide rates with increased use of SSRIs and
new non-SSRIs
Although
1 million suicides occur annually worldwide and
mood disorders are the most common psychiatric
illnesses associated with suicide, the
relationship between antidepressant use and the
rate of suicide is not clearly known. The
association between the volume of pharmacy
prescriptions of antidepressants and suicide
rate has been analysed across the United
States...............................
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Association
of selective serotonin reuptake inhibitors with
neonatal withdrawal syndrome
Abrupt
discontinuation of treatment with
antidepressants frequently provokes withdrawal
syndromes. A database study analysed a large
series of reports of neonatal withdrawal
symptoms including convulsions, irritability,
abnormal crying, and tremor to investigate a
relationship with SSRI and to determine
differences between
antidepressants............................Click
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Efficacy
and tolerability of St John's wort in moderate
to severe depression
Although
the efficacy of Hypericum extract (St John's
wort)
has
been demonstrated in mild to moderate
depression, its efficacy in more severe
depression has not been determined. A recent
study investigated the efficacy of the hypericum
extract, WS 5570, in comparison with paroxetine
in patients with moderate to severe
depression.................................
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Mutation
in serotonin synthesis enzyme linked to
increased risk of depression
Studies
in mice have shown a link between a tryptophan
hydroxylase gene (TPH2) mutation and a reduction
in 5-HT levels and responses to
antidepressants. Similar mutations in human TPH2
which may affect brain 5-HT homeostasis in
depression have been investigated in 300
subjects at risk of psychosocial and behavioral
disorders...........................Click
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Increasing
risk of depression through three generations
The
familial nature of major depression and the
increased risk in children of depressed parents
has been demonstrated repeatedly. No studies to
date, however, have gone beyond 2 generations. A
recent study investigated the familial
aggregation of psychiatric disorders by
investigating grandparents (generation 1), their
children (generation 2) and their grandchildren
(generation 3) who were aged an average of 12
years.............................
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Link
between low intelligence and suicide risk
An
association has been shown between bad
performance on cognition tests and enhanced risk
of depression and psychosis. The rare studies
that have examined the influence of the
intelligence level on suicide have produced
conflicting results. Recently a new study
investigated the association between
intelligence scores in men and subsequent
suicide................................
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Updated
January 2006