Serum plasminogen activator inhibitor-1 levels in patients with major depressive disorder vs. healthy controls: a systematic review and meta-analysis

Abstract Introduction Major depressive disorder (MDD) is a severe mental health condition that affects millions of people worldwide. Etiologically, several factors may play a role in its development. Previous studies have reported elevated plasminogen activator inhibitor-1 (PAI-1) levels in patients with depression, suggesting that PAI-1 levels might be linked to the etiology of MDD. Methods We systematically searched the following online databases: MEDLINE, Scopus, and Web of Science up to September 10, 2020, to identify studies in which PAI-1 levels were reported in subjects with MDD. Subsequently we used RevMan 5.3 to perform a meta-analysis of data extracted from the included studies using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and PICO criteria for the search and analysis. Results Six studies that reported mean ± standard deviation (SD) were included in the analysis, with a total of 507 MDD patients and 3,453 controls. The overall standardized mean difference (SMD) was 0.27 (95% confidence interval [95% CI] 0.01-0.53). PAI-1 serum levels were 0.27 SDs higher in MDD patients than in controls. The test for overall effect was significant (z = 2.04, p = 0.04). Substantial heterogeneity was detected among the studies, demonstrated by the inconsistency test (I2 = 72%) and the chi-square test (χ2 = 18.32; p = 0.003). Conclusion This systematic review and meta-analysis showed that MDD might be related to elevated PAI-1 levels. We propose larger prospective clinical studies to further investigate this clinical correlation and validate the clinical significance of these observations.

Increased insulin resistance due to long COVID is associated with depressive symptoms and partly predicted by the inflammatory response during acute infection

Objective: Some months after the remission of acute COVID-19, some individuals show depressive symptoms, which are predicted by increased peak body temperature (PBT) and decreased blood oxygen saturation (SpO2). The present study aimed to examine data on whether long COVID is associated with increased insulin resistance (IR) in association with neuroimmune and oxidative (NIO) processes during the acute infectious and long COVID phases. Methods: This case-control, retrospective cohort study used the Homeostasis Model Assessment 2 (HOMA2) calculator© to compute β-cell function (HOMA2%B) and insulin sensitivity (HOMA2%S) and resistance (HOMA2-IR) and administered the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAMD) to 86 patients with long COVID and 39 controls. Results: Long COVID (3-4 months after the acute infection) is accompanied by increased HOMA2-IR, fasting blood glucose (FBG), and insulin levels; 33.7% of the patients vs. 0% of the controls had HOMA2-IR values > 1.8, suggesting IR. Increased IR was predicted by PBT during acute infection and associated with depressive symptoms above and beyond the effects of NIO pathways (nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing protein 3 [NLRP3] inflammasome, myeloperoxidase [MPO], protein oxidation). There were no significant associations between increased IR and the activated NIO pathways during long COVID. Conclusion: Long COVID is associated with new-onset IR, which may contribute to onset of depressive symptoms due to long COVID by enhancing overall neurotoxicity.

Updated Understanding of the Glial-Vascular Unit in Central Nervous System Disorders / 神经科学通报·英文版

The concept of the glial-vascular unit (GVU) was raised recently to emphasize the close associations between brain cells and cerebral vessels, and their coordinated reactions to diverse neurological insults from a "glio-centric" view. GVU is a multicellular structure composed of glial cells, perivascular cells, and perivascular space. Each component is closely linked, collectively forming the GVU. The central roles of glial and perivascular cells and their multi-level interconnections in the GVU under normal conditions and in central nervous system (CNS) disorders have not been elucidated in detail. Here, we comprehensively review the intensive interactions between glial cells and perivascular cells in the niche of perivascular space, which take part in the modulation of cerebral blood flow and angiogenesis, formation of the blood-brain barrier, and clearance of neurotoxic wastes. Next, we discuss dysfunctions of the GVU in various neurological diseases, including ischemic stroke, spinal cord injury, Alzheimer's disease, and major depression disorder. In addition, we highlight the possible therapies targeting the GVU, which may have potential clinical applications.

Manejo farmacológico del episodio depresivo bipolar en adolescentes: actualización bibliográfica / Pharmacological management of bipolar depressive episode in adolescents: bibliographic update

El manejo farmacológico del episodio depresivo en contexto del trastorno bipolar constituye un desafío para el clínico tanto en psiquiatría adultos como infantoadolescente. El presente trabajo tiene por objetivo actualizar y sintetizar la evidencia disponible respecto al manejo farmacológico para la depresión bipolar en población pediátrica. Metodología: Se realizó una búsqueda de las publicaciones de los últimos 5 años en bases de datos. Resultados: La evidencia muestra como primera línea el uso de antipsicóticos de segunda generación por sobre los estabilizadores del ánimo en este grupo etario; demostrando lurasidona y lanzapina/fluoxetina eficacia similares. Lurasidona es una opción con mejor perfil de seguridad por asociarse a menos efectos adversos y mejor adherencia. El uso de antidepresivos debe considerarse dentro de los pasos iniciales del manejo, asociado a un antipsicótico de segunda generación. Conclusiones: Se destaca la importancia de la sospecha, evaluación y diagnóstico adecuado para guiar la decisión de manejo integral. A pesar de los riesgos y consideraciones existentes, es importante considerar el uso en primera línea de antipsicóticos de segunda generación y de antidepresivos en el manejo de un cuadro depresivo en contexto de la enfermedad bipolar. La escasez de estudios en el tratamiento farmacológico de la depresión bipolar en general y especialmente en población pediátrica limita la generalización y extrapolación de los resultados a la realidad local.

The pharmacological management of the depressive episode in the context of bipolar disorder constitutes a challenge for the clinician both in adult and child-adolescent population. The objective of this paper is to update and synthesize the available evidence regarding the pharmacological management of bipolar depression in the pediatric population. Methodology: A search of the publications of the last 5 years in databases was carried out. Results: The evidence shows the use of second generation antipsychotics over mood stabilizers as the first line in this age group; demonstrating similar efficacy. Results: The evidence shows the use of second generation antipsychotics over mood stabilizers as the first line in this age group; demonstrating similar efficacy lurasidone and lanzapine/fluoxetine. Lurasidone is an option with a better safety profile as it is associated with fewer adverse effects and better adherence. The use of antidepressants should be considered within the initial steps of management, associated with a second generation antipsychotic. Conclusions: The importance of suspicion, evaluation and adequate diagnosis to guide the decision of comprehensive management is highlighted. Despite the existing risks and considerations, it is important to consider the first-line use of second-generation antipsychotics and antidepressants in the management of a depressive episode in the context of bipolar illness. The scarcity of studies on the pharmacological treatment of bipolar depression in general and especially in the pediatric population limits the generalization and extrapolation of the results to the local reality.

Sleep hygiene practices in patients with major depression with comorbid insomnia, primary insomnia, and good sleepers / Prácticas de higiene de sueño en pacientes con depresión mayor con insomnio comórbido, insomnio primario y buenos durmientes

Abstract Introduction Inadequate sleep hygiene (SH) is considered factor contributing to insomnia. However, the practice of SH by depressed patients with comorbid insomnia has not been explored. Objective We aimed to compare the practice of SH between patients with major depression, comorbid insomnia, primary insomnia, and good sleepers. Method One hundred and eighty-two adult individuals participated: 62 outpatients with major depressive disorder with comorbid insomnia (MDD), 56 outpatients with primary insomnia (PI), and 64 good sleepers (GS). All participants were assessed with a structured psychiatric interview, an insomnia interview, the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Sleep Hygiene Practice Scale. We compared the practice of SH as a whole and by domains between the groups and the relation between SH practice, insomnia, and sleep quality. Results Patients with PI and MDD showed a significantly worse practice of global SH. In the comparison by SH domains, MDD and PI groups had significantly worse scores than GS in all domains. Individuals with MDD showed a significantly worse practice of sleep schedule and arousal related behaviors than PI group. Although, SH practice was significantly related with insomnia and sleep quality in the whole sample, this association remained significant only in the PI. The arousal-related behaviors domain was the main predictor of insomnia and sleep quality. Discussion and conclusion Although patients with insomnia comorbid with MDD or with PI have a worse SH practice than GS, only arousal-related behaviors and drinking/eating habits contribute significantly to insomnia severity and sleep quality.

Resumen Introducción Una inadecuada higiene de sueño (HS) se considera como un factor que contribuye al insomnio, incluido el insomnio comórbido con trastornos mentales. Sin embargo, no se ha estudiado la práctica de HS en pacientes con depresión e insomnio comórbido. Objetivo Comparar la práctica de HS entre pacientes con depresión mayor con insomnio comórbido, insomnio primario y buenos durmientes. Método Participaron 182 individuos: 62 pacientes ambulatorios con trastorno depresivo mayor con insomnio comórbido (TDM), 56 pacientes con insomnio primario (IP) y 64 buenos durmientes (BD). A todos se les realizó una entrevista psiquiátrica estructurada, una entrevista sobre insomnio, el Índice de Calidad de Sueño de Pittsburgh, el Índice de Severidad de Insomnio y la Escala de Prácticas de Higiene de Sueño. Comparamos la práctica de HS tanto global como por dominios entre los grupos, y la relación entre la práctica de HS, el insomnio y la calidad de sueño. Resultados Los pacientes con IP y con TDM mostraron una práctica global de la HS significativamente peor. En la comparación por dominios, los grupos con TDM e IP alcanzaron peores calificaciones que los BD en todos. La práctica de HS se relacionó significativamente con el insomnio y calidad de sueño en la muestra total, sin embargo, solamente en el grupo con IP se mantuvo significativa. El dominio de conductas relacionadas con el alertamiento fue el principal predictor de insomnio y calidad de sueño. Discusión y conclusión Aunque los pacientes con insomnio comórbido con TDM o con IP tienen peores hábitos de HS que los BD, solamente las conductas relacionadas con el alertamiento y los hábitos de alimentación contribuyen significativamente a la gravedad del insomnio y calidad de sueño.

Depresión mayor en ancianos de 85 y más años. Su asociación con demencia / Major depression in the elderly aged 85 and over. Its association with dementia

Depression is considered the most frequent mental illness; it is a cause of disability and constitutes a modifiable risk factor for the future development of dementia. The objective of tis study was to determine the frequency of major depression in elderly aged 85 and over and its possible association with dementia and with sociodemographic and clinical aspects. A descriptive cross-sectional study was carried out in 202 elderly who were treated in the protocolized consultation ¨The care of cognitive disorders in the elderly ¨, of the Hermanos Ameijeiras hospital, during the period between February 2016 and May 2016. 2020. 55.9% of the elderly were women and 64.9% were between 85 and 89 years old. A significant association was found between major depression and having comorbidity (p = 0.001), being a smoker (p = 0.003) and being a drinker (p <0.001). Major depression and dementia were diagnosed in 12.9% of the elderly, with no significant relationship (p = 0.731). The frequency of major depression in elderly aged 85 and over who were treated in a care consultation for cognitive disorders in the elderly is considered high. An association was identified between factors that deteriorated health and the presence of major depression, but not between it and dementia.

La depresión es considerada la enfermedad mental más frecuente, es causa de discapacidad y constituye un factor de riesgo modificable para el futuro desarrollo de demencia. El objetivo de este estudio fue determinar la frecuencia de depresión mayor en ancianos de 85 y más años de edad y su posible asociación con demencia, con aspectos sociodemográficos y clínicos. Se realizó un estudio descriptivo transversal, en 202 ancianos que fueron atendidos en la consulta protocolizada para la atención de los trastornos cognitivos en el anciano, del hospital Hermanos Ameijeiras, durante el periodo comprendido entre febrero de 2016 y mayo de 2020. El 26% de los ancianos estudiados presentaba depresión mayor. Se encontró asociación significativa entre la depresión mayor y tener comorbilidad (p = 0,001), ser fumador (p = 0,003) y ser bebedor (p < 0,001). En el 12,9% de los ancianos se diagnosticó depresión mayor y demencia, sin relación significativa (p = 0,731). La frecuencia de depresión mayor en ancianos de 85 y más años que fueron atendidos en consulta de atención a los trastornos cognitivos en el anciano se considera alta. Se identificó asociación entre factores que deterioraron la salud y presencia de depresión mayor, no así entre esta y demencia.

Absence of an association between serum interleukin-6 and brain-derived neurotrophic factor in drug-naïve first-episode major depression

ABSTRACT Peripheral and central cytokine interleukin-6 (IL-6) levels play an important role in the pathophysiology of major depression (MD). We investigated the association between serum levels of IL-6 and brain-derived neurotrophic factor (BDNF) in drug-naïve, first-episode patients with MD. This study included 28 patients (male/female: 11/17; mean [standard deviation] age, 46.7 [11.9] years) who met the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for MD without any physical diseases. We evaluated the severity of depression using the Hamilton Rating Scale for Depression. No associations were found between serum levels of IL-6 and BDNF (r=-0.102, P =0.605). These results suggest that IL-6 does not influence BDNF and vice versa, but both act in a peripheral manner.

Lowered serum cesium levels in schizophrenia: association with immune-inflammatory biomarkers and cognitive impairments

Objectives: A previous study has shown that schizophrenia (SCZ) is accompanied by lowered levels of trace/metal elements, including cesium. However, it is not clear whether changes in cesium, rubidium, and rhenium are associated with activated immune-inflammatory pathways, cognitive impairments, and the symptomatology of SCZ. Methods: This study measured cesium, rubidium, and rhenium, cognitive impairments (using the Brief Assessment of Cognition in Schizophrenia [BACS]), and the levels of cytokines/chemokines interleukin (IL)-1β, tumor necrosis factor (TNF)-α, and eotaxin (CCL11) in 120 patients with SCZ and 54 healthy controls. Severity of illness was assessed using the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Negative Symptoms (SANS), the Fibromyalgia and Chronic Fatigue Syndrome Rating (FF) Scale, and the Hamilton Depression Rating Scale (HAM-D). Results: Serum cesium was significantly lower in patients with SCZ as compared with controls. Further, serum cesium was significantly and inversely associated with CCL11 and TNF-α, but not IL-1β, in patients with SCZ; significant inverse associations were also noted between serum cesium levels and BPRS, FF, HAM-D, and SANS scores. Finally, cesium was positively correlated with neurocognitive probe results including the Tower of London, Symbol Coding, Controlled Word Association, Category Instances, Digit Sequencing Task, and List Learning tests. Conclusion: The results suggest that lowered serum cesium levels may play a role in the pathophysiology of SCZ, contributing to specific symptom domains including negative, depressive and fatigue symptoms, neurocognitive impairments (spatial working, episodic, and semantic memory and executive functions), and neuroimmune pathways.

Treatment of major depression disorder and bilateral angle-closure glaucoma comorbidity： a case report / 四川精神卫生

The purpose of this study is to describe the principles in selection and application of antidepressants in patients with depression complicating glaucoma or at high risk of glaucoma. With the aim of providing a partial reference for relevant issues， this paper elaborated a case of major depression after glaucoma surgery receiving 6 weeks of treatment with escitalopram oxalate and sulpiride achieved significant improvement in depressive and psychotic symptoms without triggering or exacerbating glaucoma.

Depresión en San Carlos de Bariloche: estudio epidemiológico sobre prevalencia y uso de los servicios de salud mental / Depression in San Carlos de Bariloche: Epidemiological study of prevalence and use of mental health services

RESUMEN INTRODUCCIÓN pocos estudios han evaluado la prevalencia de depresión mayor (DM) en Argentina, y las estimaciones son muy disímiles. El objetivo de la presente investigación fue estimar la prevalencia de DM, la utilización de los servicios de salud y la relación con aspectos sociodemográficos en personas de 18-64 años de San Carlos de Bariloche, Argentina. MÉTODOS se utilizó la Escala de Depresión del Centro de Estudios Epidemiológicos (CESD-R) para evaluar DM en una muestra de 299 personas en 2017 La encuesta comprendió, además, preguntas sociodemográficas y consultó si la persona había visitado a un profesional y recibido tratamiento por problemas de depresión. RESULTADOS la prevalencia de DM fue 5,7% (IC95%: 3,3-8,9). La tasa fue mayor en los estratos de menor nivel socioeconómico. Solamente un 47,1% de los casos de DM habían visitado a un médico por problemas emocionales, nervios o salud mental, con una tasa menor en los estratos de menor nivel socioeconómico. Se encontró mayor prevalencia de DM entre los desempleados y las personas que no trabajaban ni buscaban trabajo. El consumo perjudicial de alcohol o dependencia alcohólica fue más frecuente en individuos con DM (17,6%) que entre aquellos que no la padecían (6,9%). DISCUSIÓN la prevalencia de DM encontrada es similar a la registrada a nivel nacional. Se destaca la importante brecha entre atención y tratamiento. Es necesario fomentar políticas de Salud Pública para acceder a instancias terapéuticas adecuadas con el fin de mejorar la calidad de vida de las personas.

ABSTRACT INTRODUCTION few studies have evaluated major depression (MD) prevalence in Argentina, and estimates are very variable. The goal of this research was to estimate prevalence of MD, health services utilization and relationship with socio-demographic factors in 18- to 64-year-old people from San Carlos de Bariloche. METHODS the Center for Epidemiologic Studies Depression Scale Revised (CESD-R) was used to assess MD in a sample of 299 people in 2017. The questionnaire also inquired about socio-demographic aspects, and asked if people had visited a health care provider and received treatment for depression. RESULTS MD prevalence was 5.7% (CI95%: 3.3-8.9). The rate was higher in lower socio-economic strata. Only 47.1% of MD cases had visited a health care provider for emotional, nervous or mental health problems, with lower rates in lower socio-economic strata. There was a higher risk of MD among unemployed people and those who were neither working nor seeking for a job. Risky alcohol consumption or dependency was more common among MD cases (17.6%) than among non-MD cases (6.9%). DISCUSSION the MD prevalence found is similar to that reported nationwide. The study highlights an important gap between service use and treatment. It is necessary to promote public health policies to provide adequate therapeutic resources with the purpose of improving the quality of life.

Review of brain mechanism of abnormal semantic processing in major depression disorder / 上海交通大学学报（医学版）

Major depression disorder (MDD) is a serious mental illness with high disability rate and high recurrence rate, accompanied by cognitive impairment including language processing. This article reviews neurophysiological evidences of abnormal semantic processing in MDD patients in recent years. Electrophysiological data indicates that abnormal semantic processing in the patients begins in the early stages of perceptual processing and persists in subsequent cognitive processing stages with hemispheric lateralization. Brain imaging studies show that the patients have abnormal activation levels in the medial prefrontal cortex and inferior frontal gyrus. The current research paradigms cannot separate semantic processing from other cognitive processes, and more research is needed.

Study of suicides in Mangalore region of South Karnataka, India

Background: To evaluate the various causes of suicides and mental illness of different age groups which enables the patients to commit suicide in both sexes.Methods: The data of suicides was collected from medical records of the different Hospital in Mangalore region of South Karnataka.Results: Total 32 cases of suicides in adults were studied at Mangalore city and district as a whole. The history of suicide was 6(18.7%) was alcoholic, 4(12.5%) were drug addicted (dependent), 5(15.6%) were HIV infected, 3(9.37%) had infertility 4(12.5%) had loss of job, 2(6.25%) had sudden loss of property, 8(25%) had failure in love affair. The clinical manifestations of suicides were (8.25%) had major depression 5(15.6%) had multiple personality disorder. 11(34.3%) were schizophrenic, 6(18.7%) had mood disorders, 2(6.25%) were epileptic.Conclusions: This study of suicides of young adults will be quite helpful to psychiatrist and medico-social workers to take preventive measures to prevents such suicides because suicide is not only social problem, but it is due to abnormal mental state too.

Depresión en el embarazo / Depression in Pregnancy

RESUMEN Introducción: La depresión es la morbilidad psiquiátrica más común en el embarazo, y llega a afectar a más del 13% de las gestantes. Su diagnóstico se basa en los criterios establecidos por el DSM-V y la aplicación de escalas validadas como la Escala de Depresión Posnatal de Edimburgo; sin embargo, entre los profesionales de la salud aún existen errores y falencias en el reconocimiento, el diagnóstico y el tratamiento de la depresión durante el embarazo, lo que propicia las diferentes consecuencias y repercusiones para la gestación misma o el feto. Objetivo: Presentar una revisión de tema acerca de la depresión en el embarazo, sus factores de riesgo, las características clínicas, las complicaciones y el tratamiento. Métodos: Se utilizaron las bases de datos PubMed y LILACS para la búsqueda de manuscritos; de 223 artículos, 55 cumplían los criterios de inclusión. Resultados: En Sudamérica se registra una prevalencia de aproximadamente el 29%. Los factores de riesgo con mayor significación son el abuso sexual, la edad temprana al embarazo y la violencia intrafamiliar. Por ello, el diagnóstico temprano favorece la disminución en las conductas de riesgo, los trastornos del neurodesarrollo fetal y los resultados obstétricos. Conclusiones: La depresión en el embarazo es una afección frecuente; no obstante, se presenta subregistro por la atribución de los síntomas a la gestación misma. Se recomienda el uso de antidepresivos como los inhibidores de la recaptación de serotonina, especialmente la fluoxetina, que no sea ha relacionado con teratogenicidad, además de la implementación de tratamiento no farmacológico como psicoterapia, mindfulness y ejercicio aeróbico. La sensibilización del personal de salud permitirá el diagnóstico y el tratamiento adecuados de esta enfermedad.

ABSTRACT Introduction: Depression is the most common psychiatric morbidity in pregnancy, affecting more than 13% of pregnant women. Its diagnosis is based on the criteria established by the DSM-5 and the application of validated scales such as the Edinburgh Postnatal Depression Scale. However, there are still errors and shortcomings among healthcare professionals in the recognition, diagnosis and treatment of depression during pregnancy, with the resulting consequences and repercussions on the gestation itself or the foetus. Objective: To present a review of depression in pregnancy, its risk factors, clinical characteristics, complications and treatment. Methods: The PubMed and LILACS databases were used to search for manuscripts. Of the 223 articles found, 55 fulfilled the inclusion criteria. Results: The prevalence of depression in pregnancy in South America is approximately 29% and the most significant risk factors are sexual abuse, pregnancy at an early age and intrafamily violence. Therefore, early diagnosis favours a reduction in risk behaviour, foetal neurodevelopmental disorders and obstetric outcomes. Conclusions: Depression in pregnancy is common condition but is underreported as its symptoms are often attributed to the pregnancy itself. The use of selective serotonin reuptake inhibitor antidepressants, particularly fluoxetine, which has not been associated with teratogenicity, is recommended, in addition to the implementation of non-pharmacological treatment such as psychotherapy, mindfulness and aerobic exercise. Educating healthcare professionals will facilitate the correct diagnosis and treatment of this condition.

Comparing the effects of depression, anxiety, and comorbidity on quality-of-life, adverse outcomes, and medical expenditure in Chinese patients with acute coronary syndrome / 中华医学杂志(英文版)

Background:@#Depression and anxiety have been correlated with elevated risks for quality-of-life (QOL), adverse outcomes, and medical expenditure in patients with acute coronary syndrome (ACS). However, the relevant data are lacking for Chinese ACS populations, especially regarding different effects of major depression, anxiety, and comorbidity. The objective of this study was to evaluate the dynamic changes of depression and/or anxiety over 12 months and examine the effects of depression, anxiety, and comorbidity on QOL, adverse outcomes, and medical expenditure in Chinese patients with ACS.@*Methods:@#For this prospective longitudinal study, a total of 647 patients with ACS were recruited from North China between January 2013 and June 2015. Among them, 531 patients (82.1%) completed 12-month follow-ups. Logistic regression model was utilized for analyzing the association of baseline major depression, anxiety, and comorbidity with 12-month all-cause mortality, cardiovascular events, QOL, and health expenditure.@*Results:@#During a follow-up period of 12 months, 7.3% experienced non-fatal myocardial infarction (MI) and 35.8% cardiac rehospitalization. Baseline comorbidity, rather than major depression/anxiety, strongly predicted poor 12-month QOL as measured by short-form health survey-12 (odds ratio [OR]: 1.77, 95% confidence interval [CI]: 1.22–2.52, P = 0.003). Regarding 12-month non-fatal MI and cardiac re-hospitalization, baseline anxiety (OR: 2.83, 95% CI: 1.33–5.89, P < 0.01; OR: 4.47, 95% CI: 1.50–13.00, P < 0.01), major depression (OR: 2.58, 95% CI: 1.02–6.15, P < 0.05; OR: 5.22, 95% CI: 1.42–17.57, P < 0.03), and comorbidity (OR: 6.33, 95% CI: 2.96–13.79, P < 0.0001, OR: 14.08, 95% CI: 4.99–41.66, P < 0.0001) were all independent predictors, and comorbidity had the highest predictive value. Number of re-hospitalization stay, admission frequency within 12 months and medical expenditure within 2 months were the highest in patients with ACS with comorbidity.@*Conclusions:@#Major depression and anxiety may predict 12-month non-fatal MI and cardiac re-hospitalization. However, comorbidity has the highest predictive value with greater medical expenditure and worse QOL in Chinese patients with ACS. And depression with comorbid anxiety may be a new target of mood status in patients with ACS.

Immune inflammation and major depression disorder / 中华行为医学与脑科学杂志

In recent years,the research direction of the pathogenesis of depression has gradually ex-panded from classical neurotransmitter disorders and neuroendocrine disorders theory to the related fields of immuno-inflammatory response and researchers believe that depression is a psycho-neuro-immune disorder disease. Because many patients with chronic inflammation,cancer and autoimmune diseases are easy to suffer depression,it confirms that the occurrence of depression may be related to the adverse effects of immune in-flammation in the brain. A large number of clinical and experimental studies have shown that the role of im-mune inflammation in depression is mainly due to the release of inflammatory factors from immune cells through the blood-brain barrier,activation or intensification of brain immune cell response,or changes in the structure and function of neuroendocrine axis,neurotransmitters,emotional regulation-related brain regions, leading to the occurrence and development of depression. The purpose of this review is to summarize the pos-sible mechanisms and links of immune inflammation in depression in recent years,and to provide ideas and methods for the research and treatment of depression.

Cognitive impairment in patients with recurrent major depression disorder / 中华行为医学与脑科学杂志

Objective To explore the psychological process of cognitive impairment in patients with recurrent major depression disorder (MDD). Methods Patients with first-episode (n=30) and recurrent MDD (n=68) in the outpatient department of the First Affiliated Hospital of Zhengzhou University from Sep-tember 2016 to December 2017 were collected and healthy controls(n=30) were collected at the same time. According to HAMD-24 score,the group with recurrent attacks was further divided into recurrent attacks-on-set period (n=35) and recurrent attacks-remission period (n=33). All subjects were tested for cognitive function by MATRICS Consensus Cognitive Battery( MCCB). Results (1) In terms of cognitive function assessment,the scores of information processing speed ( 41. 27 ± 8. 44, 37. 00 ± 11. 68), working memory (40. 53±10. 33,41. 26±9. 37),attention/alertness ( 40. 50± 7. 25,39. 58± 8. 23),word learning ( 38. 83± 8. 39,38. 84±9. 57),visual memory(39. 30±14. 03,37. 57±10. 42),reasoning and problem solving(37. 80± 9. 55,38. 78±8. 66),and social cognition (34. 63± 9. 66) in the first-episode group and the recurrent group were lower than those in the control group ( information processing speed ( 48. 23±7. 63),working memory (50. 57±7. 84),attention/alertness (51. 63±7. 41),word learning (45. 57±9. 55),visual memory (50. 57± 8. 42),reasoning and problem solving (50. 03±9. 87) and social cognition (47. 90±19. 01)) (F=12. 818, 12. 173,26. 166,6. 004,15. 085,18. 331,10. 218,P<0. 05); (2) In working memory and social cognition, the difference was statistically significant in the first-episode group,repeated attacks-episodes(working mem-ory:37. 89±9. 15,social cognition:28. 48± 8. 35) and recurrent group-remission( working memory:44. 85± 8. 32,social cognition:40. 44 ± 11. 36, P=0. 010,0. 001). Further comparisons revealed that the score of working memory in repeated attacks-episodes was lower than that in recurrent group-remission (P=0. 003). the score of social cognition in the first-episode group was higher than that in the recurrent-attack period group (P=0. 038). The score of social cognition in the recurrent group-remission was higher than that in re-current-attack period group (P<0. 01). Conclusion There is cognitive impairment in the first episode and the recurrence MDD. The impairment in the recurrent episode is more serious than that in the first episode of depression. The impairment of social cognitive in the recurrent attacks-episodes is more serious than that in the first-episode of depression.

Action of ketamine and endocannabinoid system in rapid anti-depression therapy / 上海交通大学学报（医学版）

Major depression disorder (MDD) is a common but serious affective disorder in modern society. Suicide idea and suicide behaviour induced by MDD during its later stage put a heavy burden on society and family. Anti-depression drugs lack efficiency in treating a portion of MDD patients. This is referred to as treatment resistant depression (TRD). A study reported the rapid onset and long lasting anti-depression effect of ketamine, which also come into effect in TRD patients. △9-Tetrahydrocannabinol is the active substance of marijuana, which also exerts rapid anti-depression effect via targeting at brain cannabinoid receptors. The two central nerve system stimulants belonging to the tightly controlled psychoactive substances have obvious adverse effects. This article summarizes the action of ketamine and endocannabinoid system in rapid anti-depression therapy in recent researches.

Action of ketamine and endocannabinoid system in rapid anti-depression therapy / 上海交通大学学报（医学版）

Major depression disorder (MDD) is a common but serious affective disorder in modern society. Suicide idea and suicide behaviour induced by MDD during its later stage put a heavy burden on society and family. Anti-depression drugs lack efficiency in treating a portion of MDD patients. This is referred to as treatment resistant depression (TRD). A study reported the rapid onset and long lasting anti-depression effect of ketamine, which also come into effect in TRD patients. Δ9-Tetrahydrocannabinol is the active substance of marijuana, which also exerts rapid anti-depression effect via targeting at brain cannabinoid receptors. The two central nerve system stimulants belonging to the tightly controlled psychoactive substances have obvious adverse effects. This article summarizes the action of ketamine and endocannabinoid system in rapid anti-depression therapy in recent researches.

Impact of resilience on the improvement of depressive symptoms after cognitive therapies for depression in a sample of young adults / Impacto da resiliência na melhora dos sintomas depressivos após terapias cognitivas para depressão em uma amostra de adultos jovens

Abstract Introduction Few studies have evaluated positive measures for therapeutic response. Thus, the objective of this study was to assess the effects of resilience on severity of depressive and anxious symptoms after brief cognitive psychotherapy for depression. Methods This was a clinical follow-up study nested in a randomized clinical trial of cognitive therapies. The Resilience Scale was applied at baseline. The Hamilton Anxiety Rating Scale (HARS) and the Hamilton Depression Rating Scale (HDRS) were used at baseline, post-intervention, and at six-month follow-up. Results Sixty-one patients were assessed at baseline, post-intervention and at six-month follow-up. Resilience scores were significantly different between baseline and post-intervention assessments (p<0.001), as well as at baseline and at six-month follow-up (p<0.001). We observed a weak negative correlation between baseline resilience scores and HDRS scores at post-intervention (r=-0.295, p=0.015) and at six-month follow-up (r=-0.354, p=0.005). Furthermore, we observed a weak negative correlation between resilience scores and HARS scores at post-intervention (r=-0.292, p=0.016). Conclusion Subjects with higher resilience scores at baseline showed a lower severity of symptoms at post-intervention and at six-month follow-up.

Resumo Introdução Poucos estudos têm avaliado medidas positivas de resposta terapêutica. Assim, o objetivo deste estudo foi verificar os efeitos da resiliência na severidade dos sintomas depressivos e ansiosos após psicoterapia cognitiva breve para depressão. Métodos Trata-se de um estudo de intervenção clínica aninhado a um ensaio clínico com dois diferentes modelos de terapia cognitiva. A Resilience Scale foi aplicada no baseline, enquanto que a Hamilton Anxiety Rating Scale e a Hamilton Depression Rating Scale foram utilizadas no baseline, após a intervenção e no acompanhamento de seis meses. Resultados Sessenta e um pacientes foram avaliados no baseline, no pós-intervenção e no acompanhamento de seis meses. Os escores de resiliência foram significativamente diferentes entre as avaliações de baseline e pós-intervenção (p<0,001), bem como no baseline vs. acompanhamento de seis meses (p<0,001). Observamos uma correlação negativa fraca entre os escores de resiliência no baseline e os escores de sintomas depressivos no pós-intervenção (r=-0,295; p=0,015) e em seis meses de acompanhamento (r=-0,354; p=0,005). Além disso, observamos uma correlação negativa fraca entre os escores de resiliência e sintomas ansiosos no pós-intervenção (r=-0,292; p=0,016). Conclusão Indivíduos com maiores escores de resiliência na avaliação pré-tratamento apresentaram uma menor severidade de sintomas no pós-intervenção e no acompanhamento de seis meses.

Pro-inflammatory Cytokines, Biomarkers, Genetics and the Immune System: A Mechanistic Approach of Depression and Psoriasis / Citocinas proinflamatorias, biomarcadores, genética y sistema inmunológico: un enfoque mecanicista de la depresión y la psoriasis

ABSTRACT Objective: To highlight the inflammatory and immunological mechanisms involved in depression and psoriasis. Methods: A comprehensive literature search was performed in various databases, in total 145 studies were selected. Results: Depression and psoriasis have an association. Immune mechanisms -the actions of tumor necrosis factor-a, interleukin 1 (IL-1), IL-2, IL-10, IL-22, IL-17, interferon-7, IL-1ß, prostaglandin E2, C-reactive protein, IL-6, and IL-8 etc.-, and some genetic changes are involved. Conclusions: A possible bidirectional relationship of psoriasis and major depression exists; i.e. the depression leads to psoriasis, and psoriasis leads to depression. We recommend more studies in the future to get a deeper and better understanding about this relationship.

RESUMEN Objetivo: Poner de relieve los mecanismos inflamatorios e inmunológicos involucrados en la depresión y la psoriasis. Métodos: Se realizó en varias bases de datos una búsqueda bibliográfica completa; en total se incluyeron 145 estudios. Resultados: Hay asociación entre depresión y psoriasis y están involucrados mecanismos inmunitarios -las acciones del factor de necrosis tumoral alfa, las interleucinas (IL) 1, 2, 10, 22 y 17, el interferón gamma, la IL-1ß, la prostaglandina E2, la proteína C reactiva, la IL-6 y la IL-8, etc. - y algunos cambios genéticos. Conclusiones: Hay una posible relación bidireccional entre psoriasis y depresión, es decir, la depresión lleva a psoriasis y la psoriasis lleva a depresión. Se recomiendan más estudios en el futuro para obtener una comprensión más profunda y mejor sobre esta relación.