Brain-derived Neurotrophic Factor and High Sensitive C-reactive Protein in Bipolar Depression and Unipolar Depression: The Practical Usage as a Discriminatory Tool

Objective@#Brain-derived neurotrophic factor (BDNF) and high sensitive C-reactive protein (hs-CRP) have been reported to play roles in depression and bipolar disorder (BD). However, the probable discriminatory properties of these biologic markers are less investigated. We aimed to assess the serum BDNF and hs-CRP levels among Iranian patients with major depressive disorder (MDD) and BD during a depressive episode and investigate the optimum cut-off point for differential diagnosis of BD and MDD. @*Methods@#We recruited 30 patients with MDD, 30 with BD in depressive mood and 30 healthy comparators. Blood sample was taken from each participant to measure BDNF and hs-CRP levels. We also used receiver operating characteristic (ROC) curve analysis to find an optimal cut-off point for differentiating MDD from BD according to pre-defined variables. @*Results@#The mean age of total study population was 37.3 ± 5.0 years (males: 49%). BDNF was significantly lower in patients with BD, followed by MDD subjects and healthy controls 541.0 ± 601.0 pg/ml vs. 809.5 ± 433.3 pg/ml vs. 1,482.1 ± 519.8, respectively, p ＜ 0.001). The area under curve of ROC curve analysis for BD versus MDD was 0.704 (95% confidence interval: 0.564−0.844, p = 0.007). We also found that the BDNF cut-off value of 504 could appropriately distinguished BD from MDD (sensitivity: 73%, specificity: 70%). No significant association were identified in terms of hs-CRP levels. @*Conclusion@#Patients suffering from BD had lowest BDNF levels compared to MDD or healthy adults and this biomarker could play a practical role differentiating MDD from BD. Several studies are required confirming our outcomes.

Predictive factors of delay in contact with a psychiatrist in depressive disorders: a sample of Iranian patients

The different duration of delay to first contact with a psychiatrist in depressive disordered patients has been observed in western and non western cultures. This study aimed to examine the duration and predictive factors of delay in contact with a psychiatrist in depressive patients in Isfahan city of Iran. In This cross sectional study 156 depressive patients were recruited from various outpatient clinics in Isfahan city between January 2013 and February 2013. We used the Anderson Socio-Behavioral Model [ASBM] for examine the role of various factors influencing delay in help seeking. In this models there were three categories variables [predisposing, enabling and need factors]. Quintile regression model was used to study the predictors. The median duration between symptom onset and first contact with a psychiatrist was 1 year. In the first step [predisposing model], age at onset of depressive symptoms and never married were negative predictors for delay, but widowed or divorced statues was positive predictors for delay. In the enabling model past contact with health provider was positively associated with duration of delay. In the need model, neither variable had a significant effect on duration of delay. In the full model, younger age at onset, widowed or divorced statues and past contact with health provider increased duration of delay. More delay of help seeking by children and adolescence and probability of maladaptive coping style such as substance use and complicating of situation need to earlier diagnosis of depression in young group and earlier treatment for decrease DALLY for MDD, Therefore we suggest the mental health awareness programs for adolescent in school, and more ever for the influenced roles of parent and other family members and teachers on teen and young person's life, the education for families and teachers on adolescent mental health problems can be effective. First help seeking contact with non-psychiatric medical professionals enhance the delay of contact with a psychiatrist. Appropriate training of non-psychiatric medical professionals and developing a referral system would lead to better provision of mental health care

association of contraceptive methods and depression

None of the contraceptive methods are fully side-effect free. One of the side effects that commonly causes discontinuation is mood changes and depression. The present study aimed to compare the depression between contraceptive methods including low-dose estrogen [LD] combined pills, condom and intrauterine devices [IUD]. In a cross-sectional study, 216 women were selected through systematic random sampling from 10 health care center sin Isfahan in 2011. Beck Depression Inventory II was used and individual productivity characteristics were asked. Validity and reliability of Beck depression inventory have been repeatedly confirmed in Iran. Content validity the productivity characteristics questionnaire was confirmed and its reliability was measured through Cronbach's alpha correlation coefficient [calculated as 0.71]. ANOVA, covariance analysis and logistic regression were used to analyze the data. Depression was observed in 47.8% of participants; however, there was no difference between mean score of depression in the users of three contraceptive methods. The findings of this study showed that depression is not correlated with family planning type and fear of depression should not be an obstacle to choose between these methods. Depression is a multifactor issue. This study showed that type of family planning method in itself cannot be the cause of depression and family planners and consultants should consider this.

association of depression and preterm labor

There are situations in every woman's life that impressively affect her whole life. Pregnancy is one of those situations. Pregnancy period is usually accompanied with positive emotions for the women and their families. Sometimes depression during pregnancy disturbs daily activities, acceptance of new roles, pregnant woman´s life responsibilities and pregnancy consequences. The goal of this study was to investigate the association between depression during pregnancy and preterm labor consequences and some personal characteristics. This was a cohort study in which the data were collected through cross-sectional method. Primarily, 10 health care centers in Isfahan were randomly selected. The subjects included 378 pregnant women selected based on the number of the pregnant women under the coverage of each health center. The data collection tool was a questionnaire which was filled in two phases. The first phase was during pregnancy and included both personal characteristics and Beck Depression Inventory II and the second phase was after delivery and included the subjects' pregnancy age at the time of delivery. Content validity and Cranach's alpha were employed for validity and reliability of the questionnaires, respectively. Prevalence of depression in the population studied was 26.7%. The results showed that there were significant association between depression during pregnancy and preterm labor [p < 0.001], the education of pregnant women [p < 0.001] and their spouses' education [p = 0.001], the pregnant women's occupation [p = 0.04] and their spouses' occupation [p = 0.009]. There was no significant association between depression during pregnancy and the women' age of pregnancy. The findings of the study showed a relationship between depression during pregnancy and preterm labor. Therefore, mental health counselors and programmers are suggested to have some educational programs about psychiatric health for midwives and the personnel who provide health care services for pregnant women.

Psychometric properties and diagnostic accuracy of the edinburgh postnatal depression scale in a sample of Iranian women

Edinburgh Postnatal Depression Scale [EPDS] has been used as a reliable screening tool for postpartum depression in many countries. This study aimed to assess the psychometric properties and diagnostic accuracy of the EPDS in a sample of Iranian women. Using stratified sampling 262 postpartum women [2 weeks-3 months after delivery] were selected from urban and rural health center in the city of Isfahan. They were interviewed using EPDS and Hamilton depression rating scale [HDRS]. Data were assessed using factor analysis, diagnosis analysis of receiver operating characteristic [ROC] curve, Cronbach's alpha and Pearson correlation coefficient. The age of then participants ranged 18-45 years [26.6 +/- 5.1]. Based on a cut-off point of >13 for HDRS, 18.3% of the participants. The overall reliability [Cronbach's alpha] of EPDS was 0.79. There was a significant correlation [r2=0.60, P value<0.01] between EPDS and HDRS. Two factor analysis showed that anhedonia and depression were two explanatory factors. At a cut-off point12 the sensitivity of the questionnaire was 78% [95% CI: 73%-83%] and its specificity was 75% [95% CI: 72%-78%]. The Persian version of the EPDS showed appropriate psychometric properties diagnostic accuracy index. It can be used by health system professionals for detection, assessment and treatment for mothers with post partum depression

Effect of add-on [self management and behavior modification] education on severity of COPD

Chronic Obstructive Pulmonary Disease [COPD] is a chronic and plenty disease and one of the important causes of morbidity and mortality in the world with restrict available medical treatments. The objective of this study was to assess whether psycho-educational plans [self management and behavior modification] administered in primary care have beneficial effects on symptoms of patients with COPD. Material and The study was a prospective, unblinded, randomized controlled trial of usual care vs. usual care plus structured education on the use of 8 sessions of "self management and behavior modification" group education: a simple educational package on life style modification and assumption of special behaviors in different situations of disease. The study was conducted in two educational hospitals [Khorshid and Alzahra] in Isfahan, Iran. Participants were 42 patients with COPD randomized into control or intervention groups. The primary outcome measure was change in severity of COPD symptoms that measured with "Clinical COPD Questionnaire" [CCQ]. The data were analyzed with SPSS software and statistic examination called Ancova- Repeated measure and Mancova-Repeated measure. Self management and behavior modification education were associated with significant higher decrease in mean score of CCQ in symptom, functional state and mental state domains but had no effect on change in mean score of CCQ-Total. Mean score of CCQ in symptom, functional state and mental state domains was lower in the intervention group but there was no difference in mean score of CCQ-Total due to "self-management and behavior modification" plans

study of factor structure of the mood disorder questionnaire in a sample of Iranian pregnant women

The Mood Disorder Questionnaire [MDQ] has been developed as a self-reporting, brief, and easy-to-use screening instrument to improve identification of bipolar mood disorders. The goals of the present study were to examine the prevalence of this disorder and interrelationship of its symptoms by factor analysis of MDQ in a group of pregnant women in Iran. One thousand and eight hundred and ninety eight pregnant women in their third trimester were recruited to take part in a cross-sectional study. Trained local health workers administered MDQ for them. A principal component factor analysis was used to determine factors for relevant items of MDQ questions. The mean age of the participants was 25.4 +/- 5.1 years. About 3.9% of participants met the MDQ diagnostic criteria for bipolar mood disorder, and 19.6% scored positively for at least one Mood Disorder Questionnaire item and also had moderate to severe psychosocial impairment [second sample]. The first factor analysis on the whole sample revealed elevated mood, increased self-confidence and energy, increased social activity and disinhibited sexual behavior as significant. Irritability, talkativeness, insomnia, racing thoughts, distractibility, risky behavior and overspending were determined as important by the second factor analysis. Self-reporting of hypomanic symptoms by Iranian pregnant women revealed a relatively high prevalence rate of Bipolar Spectrum Disorders. Study analysis also showed there were two independent factors: an energized-activity factor and an elevated mood-thought racing factor