Depression

A study of more than 1,100 brain scans has concluded that clinical depression can be categorized into four unique subtypes defined by distinct patterns of abnormal connectivity in the brain. These subtypes are associated with different symptom profiles and probably differ in their response to different treatments.

https://www.eurekalert.org/pub_releases/2016-12/wcm-ncf120816.php

Drysdale, A. T., Grosenick, L., Downar, J., Dunlop, K., Mansouri, F., Meng, Y., … Liston, C. (2017). Resting-state connectivity biomarkers define neurophysiological subtypes of depression. Nat Med, 23(1), 28–38. Retrieved from http://dx.doi.org/10.1038/nm.4246

A large, long-running European study, involving 3,428 male patients aged 45-74 years, has found that depression is a major risk factor for cardiovascular disease. The risk is almost as great as that due to high cholesterol levels or obesity.

https://www.eurekalert.org/pub_releases/2017-01/hzm--dah011317.php

Ladwig, KH. et al. (2016): Room for depressed and exhausted mood as a risk predictor for all-cause and cardiovascular mortality beyond the contribution of the classical somatic risk factors in men. Atherosclerosis, doi: 10.1016/j.atherosclerosis.2016.12.003

A new meta-analysis supports the link between intake of EPA and DHA omega-3 fatty acids, and reduction in major depressive disorder (MDD).

The meta-analysis only included studies in adult patients with MDD assessed using standardized clinical interviews, and excluded studies that specifically studied perinatal/perimenopausal or comorbid MDD, in order to get a more homogenous population. Studies not applying a randomized placebo-controlled trial design were also excluded. This criteria resulted in 13 studies with a total of 1233 participants (out of an original pool of 1955 studies).

The analysis of these studies showed a benefit for these omega-3 acids that was comparable to effects reported in meta-analyses of antidepressants. The effect was greater in studies supplementing higher doses of EPA and performed in patients already on antidepressants.

http://www.eurekalert.org/pub_releases/2016-03/g-nss031716.php

Mocking, R. J. T., Harmsen, I., Assies, J., Koeter, M. W. J., Ruhe, H. G., & Schene, A. H. (2016). Meta-analysis and meta-regression of omega-3 polyunsaturated fatty acid supplementation for major depressive disorder. Transl Psychiatry, 6, e756. Retrieved from http://dx.doi.org/10.1038/tp.2016.29

A small study involving 22 students with depression and 30 mentally healthy students had positive results from a program that combines mental training through meditation and physical training through aerobic exercise. After eight weeks, those with depression showed a nearly 40% reduction in depressive symptoms, and said they did not spend as much time worrying about negative situations taking place in their lives as they did before the study began. There were also changes in brain activity that may reflect better cognitive control.

Interestingly, those in the control group also reported fewer depressive symptoms.

The program involved two sessions a week, with each one having 30 minutes of focused attention meditation followed by 30 minutes of aerobic exercise. They were told that if their thoughts drifted to the past or the future they should refocus on their breathing - enabling those with depression to accept moment-to-moment changes in attention.

http://www.eurekalert.org/pub_releases/2016-02/ru-eam021016.php

Alderman, B. L., Olson, R. L., Brush, C. J., & Shors, T. J. (2016). MAP training: combining meditation and aerobic exercise reduces depression and rumination while enhancing synchronized brain activity. Transl Psychiatry, 6, e726. Retrieved from http://dx.doi.org/10.1038/tp.2015.225

A number of studies have pointed to a link between depression and type 2 diabetes, but a new study indicates that this is not as straightforward as it seemed. The large Canadian study involving 2,525 adults aged 40-69 has found that it is not depression alone that increases the risk of developing diabetes, but depression in conjunction with metabolic risk factors such as obesity, high blood pressure and unhealthy cholesterol levels,.

The study found that those with metabolic symptoms but not depression were around four times more likely to develop diabetes than normally healthy people, while those with both depression and metabolic risk factors were more than six times more likely to develop diabetes. The combined effect of depression and metabolic symptoms was greater than the sum of the individual effects. But those with depression alone had no more risk than normally healthy people.

There are probably two main causes for this effect. One is that, as evidence shows, people suffering from depression are less likely to adhere to medical advice aimed at tackling metabolic symptoms. This makes the metabolic symptoms worse, which can exacerbate the symptoms of depression, and so it goes, in a horrible negative cycle.

The second reason is that some forms of depression are associated with changes in the body's metabolic systems which can lead to weight gain, high blood pressure and problems with glucose metabolism. Some antidepressant medications can also cause weight gain.

http://www.eurekalert.org/pub_releases/2016-04/mu-hdm041216.php

Schmitz, N., Deschenes, S. S., Burns, R. J., Smith, K. J., Lesage, A., Strychar, I., … Wang, J. L. (2016). Depression and risk of type 2 diabetes: the potential role of metabolic factors. Mol Psychiatry. Retrieved from http://dx.doi.org/10.1038/mp.2016.7

Depression is a known risk factor for cardiovascular disease, but a large study suggests that effectively and promptly treating depression can reduce a patient's heart risks to the same level as those who never had short-term depression.

The study involved 7,550 patients who completed at least two depression questionnaires over the course of one to two years.

The study was presented at the 2016 American College of Cardiology Scientific Sessions.

http://www.eurekalert.org/pub_releases/2016-04/imc-ids032916.php

A 10-year French study of 7,313 older adults (65+), of whom nearly 30% of the women and 15% of the men had high levels of depressive symptoms, has found that repeated occurrences of depression produced increasing risk of heart disease or stroke. Those who had high levels of depressive symptoms on one, two, three, or four occasions during the study had 15%, 32%, 52%, and 75% greater risk, respectively, of experiencing heart disease or stroke events.

http://www.eurekalert.org/pub_releases/2016-02/ags-foa020116.php

Péquignot, R., Dufouil, C., Prugger, C., Pérès, K., Artero, S., Tzourio, C., & Empana, J.-P. (2016). High Level of Depressive Symptoms at Repeated Study Visits and Risk of Coronary Heart Disease and Stroke over 10 Years in Older Adults: The Three-City Study. Journal of the American Geriatrics Society, 64(1), 118–125. http://doi.org/10.1111/jgs.13872

A review of 200 studies on depression and inflammation has concluded that depression and inflammation fuel one another, with inflammation playing a key role in the development of depression in some people, and depression priming greater physiological responses to stress.

Moreover, depression that is caused by chronic inflammation is resistant to traditional therapy methods. However, it is more responsive to activities such as yoga, meditation, omega-3 fatty acids, NSAIDS and exercise.

The review indicates that treatment for depression needs to consider its pathway. The researcher suggests that chronic inflammation is most common in individuals who have experienced stress in their lives, including lower socio-economic status or those who experienced abuse or neglect as children. Other contributing factors are a high-fat diet and high body mass index.

If inflammation is a significant factor, it needs to be treated in tandem with the depression.

http://www.eurekalert.org/pub_releases/2015-12/ru-icf121815.php

Kiecolt-Glaser, J. K., Derry, H. M., & Fagundes, C. P. (2015). Inflammation: Depression Fans the Flames and Feasts on the Heat. American Journal of Psychiatry, 172(11), 1075–1091. http://doi.org/10.1176/appi.ajp.2015.15020152

Previous research has indicated that about a quarter of older adults who become mildly depressed will go on to become seriously depressed within a year or two. A study comparing problem-solving therapy for primary care — a seven-step approach delivered by non-mental-health professionals to help patients resolve difficulties and thus improve coping skills and confidence — with a program of dietary coaching (same number of sessions and hours), has found that elderly adults with mild symptoms of depression responded equally well to both treatments.

The study involved 244 participants, of whom 90 were African-American. Only 9% of people in each intervention went on to experience an episode of major depression, and they all had a similar reduction in depressive symptoms over the two-year study period. Both approaches were equally successful among black and white participants.

The benefit of both programs is assumed to lie in the way they give people greater perceived control over their lives.

http://www.eurekalert.org/pub_releases/2014-03/uops-lic032014.php