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Objective To investigate the relevance of brain-derived neurotrophic factor (BDNF) gene polymorphisms and the effects of citalopram antidepressant.Methods The subjects comprised 280 patients according to the diagnostic and statistical manual of mental disorders in the fourth edition (DSM-Ⅳ) criterion for major depressive disorder (MDD).Severity of depression were assessed by 17 Hamilton depression scale (HAMD) at the baseline and 1,2,4,6 weekend.Citalopram were selected for treatment.Polymerase chain reaction (PCR) and DNA sequencing analysis were used to detect the genotype of SNPs rs7124442 and rs6265 of BDNF.SPSS17.0 software was used for statistical analysis.Results (1) There were 280 patients (242 responders and 38 nonresponders;175 remissioners and 105 nonremissioners) accomplished 6 weeks of treatment.No association was found between the polymorphisms and antidepressant drug response or remission (the reduction rate of HAMD score ≥ 50％ was defined as response,conversely,defined as nonresponse;HAMD score more than 7 was named as remission,in contrast,named as nonremission) (P＞0.05).(2) Repeated measures analysis of variance was adopted to compare the change of HAMD scores among the genotypes at different time points.There was a significant difference in rs6265 polymorphism between the GA +AA genotype (the scores of HAMD at 2,4,6 weeks were(9.98±4.97),(8.02±4.50),(5.83±3.49) respectively) and the GG genotype groups (the scores of HAMD at 2,4,6 weeks were(11.90±6.55),(9.34± 4.71),(7.07±4.28) respectively) (P=0.031).Conclusion The results suggest that BDNF rs6265 polymorphisms in part determine the antidepressant response to citalopram.
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O transtorno depressivo maior (TDM) é uma preocupação de Saúde Pública global, com alta prevalência entre os pacientes que procuram serviços médicos na atenção primária. Para 2020, se estima que estará entre as maiores causas de incapacidade no mundo e, mesmo assim, segue sendo subdiagnosticada ou subtratada, o que compromete a evolução clínica dos indivíduos acometidos. A etiologia do TDM é multifatorial, envolvendo mecanismos alostáticos, o que predispõe para o surgimento de outras condições clínicas crônicas e degenerativas, como diabetes melitus, infarto agudo do miocárdio, acidente vascular cerebral e demência de Alzheimer. Dessa forma, este artigo, voltado para generalistas versa sobre a importância do seu papel na redução do impacto da morbimortalidade e na melhoria da qualidade de vida dos pacientes com depressão, através de dados práticos para o diagnóstico e manejo da doença.
Major Depressive Disorder (MDD) is a global public health concern, with high prevalence among patients seeking medical services in primary care. In 2020, it is estimated to be among the leading causes of disability worldwide, and still remains underdiagnosed or undertreated, which compromises the clinical outcome of affected individuals. The etiology of MDD is multifactorial, involving alostatic mechanisms, which predisposes to the appearance of other clinical and chronic degenerative conditions such as Diabetes Mellitus, Acute Myocardial Infarction, Stroke and Alzheimer's dementia. This article for primary care, talks about the importance of their role in reducing the impact of morbidity and mortality and improving the quality of life of patients with depression through day to day data for the diagnosis and management of the disease.
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Objective To explore the impact of the variable number of tandem repeats of monoamine oxidase A gene (MAOA-uVNTR) on the intensity of brain activation during the recognition of facial expression in patients with depression and healthy controls.Methods 28 cases of depression,as well as 33 healthy controls who were matched in gender, age and years of education were divided into different genotypes with the methods of polymerase chain reaction (PCR) amplification and 1.5% agarose gel electrophoresis separation.61 cases were scanned to compare the intensity of brain activation in the recognition of happy, sad and neutral facial expression.Results In healthy controls,cases with high-activity genotype showed increased activation in left cuneus,left inferior frontal gyrus, right medial frontal gyrus and left inferior parietal lobule in comparision with carriers of low-activity genotype.In the depressed, compared with patients with low-activity genotype, cases with high-activity genotype decreased activation in bilateral putamen, left postcentral gyrus, left fusiform gyrus, right superior temporal gyrus and right thalamus.Conclusion Healthy controls with high-activity genotype shows the trend of priority for the identification of negative emotion,this genotype may be one of the risk factors for normal people suffering from depression.Patients with high-activity genotype is associated with the inhibitory of positive emotional state, this may attribute partly to the emotional symptoms in such kind of patients more serious.
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Objective To explore the impact of the variable number of tandem repeats of monoamine oxidase A gene (MAOA-uVNTR) on the concentration of gray matter in patients with major depressive disorders.Methods 56 cases of depression, as well as 37 healthy controls who were matched in gender, age and years of education were divided into low-activity genotype (3R or 3R/4R), and high-activity genotype (4R) with the methods of polymerase chain reaction (PCR) amplification and 1.5％ agarose gel electrophoresis separation. 93 cases all were performaned structural magnetic resonance imaging scanning. Results ① The difference of genotype and allele frequency between the depression group and the healthy group was not statistically significant(P＞0.05 ). ②Compared with the healthy,the concentration of gray matter( GMC ) of bilateral caudate nucleus (K = 11/68, Z =3.76/4.76 ), bilateral thalamus ( K = 21/181, Z = 3.26/3.63 ) and right hypothalamus ( K = 38/12, Z = 4.20/3.60) reduced significantly in depressed patients. ③ In patients with depression, cases with the high-activity genotype showed reduced GMC bilateral caudate nucleus (K = 17/33, Z = 3.23/4.36 ), left putamen ( K = 16, Z =3.42 ) and right hypothalamus( K = 12, Z = 3.62 ) in comparision with patients with low-activity genotype. In highactivity genotype group,compared with the healthy,patients with depression had reduced GMC in left caudate nucleus ( K = 11, Z = 4.13 ), bilateral thalamus ( K = 13/14, Z = 3.53/3.23 ) and left parahippocampal gyrus ( K = 13,Z = 4.04). Conclusion High-activity genotype may be an important factor contributing to the structural abnormalitily of the limbic-striatum-globus pallidus-thalamus loop.
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Objective Describe the prevalence of depressive disorders (mood disorders with current depressive episode) among individuals treated in general hospitals in Beijing. Methods 2877 outpatients and 2925 inpatients ≥15 years of age from 50 general hospitals (selected by stratified random sampling) were screened by trained psychiatric nurses using a depression screening instrument and then the gold standard diagnosis of all subjects screened positive and 10% of those screened negative was determined by a trained psychiatrist who used a semi-structured interview schedule based on American psychiatric diagnostic criteria (DSM-IV). Results The adjusted point prevalence, one-year prevalence, and lifetime prevalence of any type of depressive disorder were 5.23%, 5.72% and 8.22%, respectively; corresponding prevalences of major depressive disorder were 2.94%, 3.46%, and 5.32%, respectively. Conclusions The prevalence of depressive disorders among patients in general hospitals in Beijing is not significantly higher than in the general population in China.