Search Results (55)

: Depression, commonly known as unipolar affective disorder, is one of the most prevalent mental illnesses in contemporary society, affecting individuals to varying degrees. Tea is one of the three major non-alcoholic beverages globally; it has a rich history of consumption and is associated with numerous health and nutritional benefits. This review systematically summarizes the antidepressant effects of various bioactive compounds found in tea, drawing upon research findings in the field of tea’s functional health. It elucidates the impact of tea’s bioactive components on the hypothalamic–pituitary–adrenal (HPA) axis, the nervous system, the immune system, intestinal microflora, and the monoaminergic system, among other physiological sites, to achieve antidepressant effects. These effects primarily involve enhancing neural signaling pathways, regulating neural signaling molecule levels, and reducing neuroinflammation. Tea may normalize the body’s nervous system by bolstering immune function, alleviating or eliminating cellular inflammation to maintain healthy homeostasis, or improving intestinal flora and mitigating stress to prevent or treat depressive disorders. Additionally, the potential social support derived from tea-drinking activities, such as cultural rituals and interpersonal communication, may contribute to its antidepressant effects. This review discusses and analyzes the current research status regarding the antidepressant effects of tea and highlights that tea and its active ingredients can be utilized to prevent and alleviate depression. Full article

Background: This study compares the short- and long-term effectiveness and safety of pramipexole augmentation (PA) and aripiprazole augmentation (AA) for unipolar treatment-resistant depression (TRD). Methods: Patients were recruited in a private out-patients clinic specializing in mood disorders. At intake and at each visit, depressive and (hypo)manic symptoms, clinical status, and level of functioning were evaluated with appropriate scales. The trend of outcomes was analyzed using mixed-effect linear regression models. Results: The study includes 81 patients with unipolar TRD treated with PA and 51 with AA. After 12 and 24 weeks of treatment with PA, the predicted response (64.1% and 76.2%) and remission rates (49.7% and 72.7%) were significantly higher than the predicted response (32.2% and 38.0%) and remission rates (18.9% and 28.1%) for AA. The improvement in psychosocial functioning was significantly greater and faster in PA than in AA. PA showed significant superiority over AA as a maintenance strategy (time spent ill and psychosocial functioning) up to 12 months. No difference in safety was found at each time point. Conclusions: PA could be an alternative option for the short- and long-term treatment of unipolar TRD, more effective than AA and similar in safety. These preliminary results need confirmation from randomized clinical trials. Full article

Increased immune–inflammatory activation has been repeatedly linked to etiopathogenesis and the progression of both major depressive disorder (MDD) and bipolar depression (BD). We explore the role of soluble intercellular cell adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in diagnostic differentiation and disorder progression in patients with MDD and BD. Serum levels of sICAM-1 and sVCAM-1 were measured in 137 patients (MDD = 93 and BD = 44) and compared with 73 healthy controls. The severity of psychopathology was assessed using the Hamilton Depression Rating Scale and Clinical Global Impression Scale. After adjustment for multiple confounders, we noticed significant downregulation of sVCAM-1 and upregulation of sICAM-1 levels in both patient groups. Decreased sVCAM-1 levels were detected in patients with acute episodes of BD when compared to MDD. Immune mediators were related to indicators of progression in both mood disorders. They also followed different post-treatment normalization patterns in MDD and BD and in relation to the stage of each disorder. Adhesion molecules could potentially be useful in discriminating between patients with MDD and BD and determining the possible progression of the disorders. Future nosological methods should include time-dependent pathoplasticity and biological correlates, at least for affective disorders. Full article

Background and Objectives: One of the most significant psychiatric problems in women is depression related to the perinatal period. Our study aims to determine the frequency and course of depressive symptomatology in the perinatal period with particular reference to objective rate and outcome of postpartum depression. Materials and Methods: One hundred and eighty-eight pregnant/postnatal women were included in a prospective, longitudinal, observational study during which the depressive symptomatology was estimated at the third trimester of pregnancy, and the first, sixth, and twelfth month‚ postpartum. All participants completed a semi-structured sociodemographic questionnaire constructed for research purposes, the Edinburgh Postnatal Depression Scale, Toronto Alexithymia Scale, Beck Anxiety Inventory, and The Mood Disorder Questionnaire at each time point. Postpartum depression diagnosis was confirmed by a trained and certified psychiatrist with long-standing experience. For a better understanding of the trajectory of depressive symptomatology and genuine postpartum depression, we classified depression into those with new-onset and those left over from the previous observation period. Results: In general, 48.9% of participants in the study were depressed at some point during the investigation. A total of 10.6% of women were depressed in the third trimester. The highest percentage of new-onset depression (25%) was in the first month after giving birth and was maintained for up to six months, after which the appearance was sporadic. Most of the postpartum depression resolved in the period from the first month to the sixth month after childbirth (20.7%). The episodes mainly had characteristics of unipolar depression. Conclusions: Our results imply that a new onset of depression is most intensive during the first six months, and after that, it is sporadic. Further studies are needed to explore whether all depressive symptomatology in the postnatal period is the same, or perhaps postpartum depression, classified in this way, has specific characteristics, etiology, and consequently different treatment and preventive options. Full article

Unipolar (UD) and bipolar depression (BDD) show a high degree of similarity in clinical presentations, which complicates the differential diagnosis of these disorders. The aim of this study was to investigate the serum levels of interleukin 6 (IL-6), C-reactive protein (CRP), albumin (Alb), and zinc (Zn) in patients with UD, BDD, and healthy controls (HC). A total of 211 samples were collected: 131 patient samples (65 UD and 68 BDD) and 80 HC. The Montgomery–Asberg Depression Rating Scale (MADRS), along with the Hamilton Depression Rating Scale (HAMD-17), were administered to patient groups to evaluate symptoms. A cross-sectional study was performed to analyse the serum levels of IL-6, CRP, albumin, and zinc. The concentration of CRP was determined using the immunoturbidimetry method, zinc using the colorimetric method, and albumin using the colorimetric method with bromocresol green on the Alinity c device. IL-6 cytokine concentration in serum samples was ascertained using a commercial enzyme immunoassay, ELISA. We found no significant differences in serum concentrations of zinc, albumin, CRP, and IL-6 between the groups of patients with unipolar and bipolar depression. There was a significant statistical difference (p < 0.001) between serum levels of all investigated parameters in both groups of depressed patients in comparison with HC. Furthermore, correlations with specific items on HAMD-17; (namely, hypochondrias, work and activities, somatic symptoms-general, and weight loss) and on MADRS (concentration difficulties, lassitude) were observed in both patient groups. These findings confirm the presence of low-grade inflammation in depression, thus adding better insight into the inflammation hypothesis directed to explain the aetiology of depressive disorders. Our results do not indicate potential biomarkers for distinguishing between unipolar and bipolar depression. Full article

Objectives: Schizophrenia, unipolar depression, bipolar disorder, bipolar mania, and bipolar depression are a few of the severe psychiatric diseases that affect millions of individuals and their overall life quality. This study aimed to look at differences in TGA, TC, HDL, LDL, and FPG levels in people who were going through acute episodes of listed diseases. Materials and methods: A cross-sectional prospective study was carried out in Jordan between January and November of 2023, involving all patients with the aforementioned diseases who attended three psychiatric clinics. This study encompassed results from 1187 patients (women N = 675, 56.87%) who were classified into the following ranges: <25, 25–45, 45–65, and >65. Results: The average level of LDL was the highest in bipolar depression (112.442 ± 36.178 mg/dL) and the lowest in bipolar mania (111.25 ± 33.14 mg/dL). The average level of HDL was the highest in schizophrenia (58.755 ± 16.198 mg/dL) and the lowest in bipolar depression (45.584 ± 12.128 mg/dL). Both average levels of TC and TGA were the highest in patients with bipolar depression (188.403 ± 37.396 mg/dL and 149.685 ± 96.951 mg/dL, respectively) and the lowest in bipolar mania (164.790 ± 40.488 mg/dL and 100.679 ± 54.337 mg/dL, respectively). The average level of FPG was the highest in unipolar depression (94.00 ± 21.453 mg/dL) and the lowest in bipolar mania (89.492 ± 14.700 mg/dL). Conclusions: The results confirmed that lipid and glucose abnormalities were more common in people with schizophrenia and mood disorders (unipolar and bipolar). Full article

Background: This meta-analysis aimed to determine the efficacy and safety of antidiabetic agents in the treatment of major depressive disorder and bipolar depression. Methods: Randomized controlled trials (RCTs) of antidiabetic agents in major depressive disorder or bipolar depression were searched in three electronic databases and three clinical trial registry websites from their inception up to October 2023. The differences in changes in the depression rating scale scores from baseline to endpoint or pre-defined sessions, response rate, remission rate, rate of side effects and dropout rate between antidiabetic agents and placebo were meta-analyzed. Results: Six RCTs involving 399 participants were included in the final meta-analysis, which did not find that antidiabetics outperformed the placebo in reducing depressive symptoms. The standardized mean difference (SMD) in the depression scores from baseline to endpoint was 0.25 (95% CI −0.1, 0.61). However, a subgroup analysis found a significant difference between antidiabetics and placebos in reducing depressive symptoms in Middle Eastern populations, with an SMD of 0.89 (95% CI 0.44, 1.34). Conclusions: The current meta-analysis does not support the efficacy of antidiabetics being superior to the placebo in the treatment of unipolar and bipolar depression. However, a subgroup analysis indicates that patients from the Middle East may benefit from adding an antidiabetic medication to their ongoing medication(s) for their depression. Larger studies with good-quality study designs are warranted. Full article

Objectives: One of the current challenges in psychiatry is the search for answers on how to effectively manage drug-resistant depression. The occurrence of drug resistance in patients is an indication for the use of electroconvulsive therapy (ECT). This method is highly effective and usually results in relatively quick health improvement. Despite the knowledge of how ECT works, not all of the biological pathways activated during its use have been identified. Hence, based on the neuroinflammatory hypothesis of depression, we investigated the concentration of two opposite-acting adipokines (anti-inflammatory adiponectin and proinflammatory resistin) and BDNF in antidepressant-resistant patients undergoing ECT. Methods: The study group comprised 52 patients hospitalized due to episodes of depression in the course of unipolar and bipolar affective disorder. The serum concentration of adipokines and BDNF was determined before and after the therapeutic intervention using an ELISA method. In the analyses, we also included comparisons considering the type of depression, sex, and achieving remission. Results: Adiponectin, resistin, and BDNF concentrations change after ECT treatment. These changes are correlated with an improvement in the severity of depressive symptoms and are more or less pronounced depending on the type of depression. Conclusions: Although not all observed changes reach statistical significance, adipokines in particular remain exciting candidates for biomarkers in assessing the course of the disease and response to ECT treatment. Full article

This review article attempts to provide a comprehensive review of the recent progress in cerium oxide (CeO₂)-based resistive random-access memories (RRAMs). CeO₂ is considered the most promising candidate because of its multiple oxidation states (Ce³⁺ and Ce⁴⁺), remarkable resistive-switching (RS) uniformity in DC mode, gradual resistance transition, cycling endurance, long data-retention period, and utilization of the RS mechanism as a dielectric layer, thereby exhibiting potential for neuromorphic computing. In this context, a detailed study of the filamentary mechanisms and their types is required. Accordingly, extensive studies on unipolar, bipolar, and threshold memristive behaviors are reviewed in this work. Furthermore, electrode-based (both symmetric and asymmetric) engineering is focused for the memristor’s structures such as single-layer, bilayer (as an oxygen barrier layer), and doped switching-layer-based memristors have been proved to be unique CeO₂-based synaptic devices. Hence, neuromorphic applications comprising spike-based learning processes, potentiation and depression characteristics, potentiation motion and synaptic weight decay process, short-term plasticity, and long-term plasticity are intensively studied. More recently, because learning based on Pavlov’s dog experiment has been adopted as an advanced synoptic study, it is one of the primary topics of this review. Finally, CeO₂-based memristors are considered promising compared to previously reported memristors for advanced synaptic study in the future, particularly by utilizing high-dielectric-constant oxide memristors. Full article

This article discusses the development and preliminary validation of a self-report inventory of the patient’s perception of, and affective reaction to, their therapist during a psychotherapy session. First, we wrote a pool of 131 items, reviewed them based on subject matter experts’ review, and then collected validation data from a clinical sample of adult patients in individual therapy (N = 701). We used exploratory factor analysis and item response theory graded response models to select items, confirmatory factor analysis (CFA) to test the factor structure, and k-fold cross-validation to verify model robustness. Multi-group CFA examined measurement invariance across patients with different diagnoses (unipolar depression, bipolar disorder, and neither of these). Three factors produced short scales retaining the strongest items. The in-Session Patient Affective Reactions Questionnaire (SPARQ) has a two-factor structure, yielding a four-item Negative affect scale and a four-item Positive affect scale. The Relationship In-Session Questionnaire (RISQ) is composed of four items from the third factor with dichotomized responses. Both scales showed excellent psychometric properties and evidence of metric invariance across the three diagnostic groups: unipolar depression, bipolar disorder, and neither of these. The SPARQ and the RISQ scale can be used in clinical or research settings, with particular value for capturing the patient’s perspectives about their therapist and session-level emotional processes. Full article

Modern technology frequently uses wearable sensors to monitor many aspects of human behavior. Since continuous records of heart rate and activity levels are typically gathered, the data generated by these devices have a lot of promise beyond counting the number of daily steps or calories expended. Due to the patient’s inability to obtain the necessary information to understand their conditions and detect illness, such as depression, objectively, methods for evaluating various mental disorders, such as the Montgomery–Asberg depression rating scale (MADRS) and observations, currently require a significant amount of effort on the part of specialists. In this study, a novel dataset was provided, comprising sensor data gathered from depressed patients. The dataset included 32 healthy controls and 23 unipolar and bipolar depressive patients with motor activity recordings. Along with the sensor data collected over several days of continuous measurement for each patient, some demographic information was also offered. The result of the experiment showed that less than 70 of the 100 epochs of the model’s training were completed. The Cohen Kappa score did not even pass 0.1 in the validation set, due to an imbalance in the class distribution, whereas in the second experiment, the majority of scores peaked in about 20 epochs, but because training continued during each epoch, it took much longer for the loss to decline before it fell below 0.1. In the second experiment, the model soon reached an accuracy of 0.991, which is as expected given the outcome of the UMAP dimensionality reduction. In the last experiment, UMAP and neural networks worked together to produce the best outcomes. They used a variety of machine learning classification algorithms, including the nearest neighbors, linear kernel SVM, Gaussian process, and random forest. This paper used the UMAP unsupervised machine learning dimensionality reduction without the neural network and showed a slightly lower score (QDA). By considering the ratings of the patient’s depressive symptoms that were completed by medical specialists, it is possible to better understand the relationship between depression and motor activity. Full article

Bipolar depression remains a clinical challenge with a quarter of patients failing to respond to initial conventional treatments. Although ketamine has been extensively studied in unipolar depression, its role in bipolar disorder remains inconclusive. The aim of our scoping review was to comprehensively synthesize the current clinical literature around ketamine use in bipolar depression. A total of 10 clinical studies (5 randomized controlled trials and 5 open label studies) were selected. The preliminary evidence, albeit weak, suggests that ketamine is a promising treatment and calls for further interest from the research community. Overall, ketamine treatment appeared to be tolerable with minimal risk for manic/hypomanic switching and showed some effectiveness across parameters of depression and suicidality. Moreover, ketamine is a potential treatment agent in patients with treatment-resistant bipolar depression with promising data extracted from extant controlled trials and real-world effectiveness studies. Future studies are needed to identify ketamine’s role in acute and maintenance treatment phases of bipolar depression. Moreover, future researchers should study the recurrence prevention and anti-suicidal effects of ketamine in the treatment of bipolar depression. Full article

Transcranial magnetic stimulation (TMS) has become a promising strategy for bipolar disorder (BD). This study reviews neuroimaging findings, indicating functional, structural, and metabolic brain changes associated with TMS in BD. Web of Science, Embase, Medline, and Google Scholar were searched without any restrictions for studies investigating neuroimaging biomarkers, through structural magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), magnetic resonance spectroscopy (MRS), positron emission tomography (PET), and single photon emission computed tomography (SPECT), in association with response to TMS in patients with BD. Eleven studies were included (fMRI = 4, MRI = 1, PET = 3, SPECT = 2, and MRS = 1). Important fMRI predictors of response to repetitive TMS (rTMS) included higher connectivity of emotion regulation and executive control regions. Prominent MRI predictors included lower ventromedial prefrontal cortex connectivity and lower superior frontal and caudal middle frontal volumes. SPECT studies found hypoconnectivity of the uncus/parahippocampal cortex and right thalamus in non-responders. The post-rTMS changes using fMRI mostly showed increased connectivity among the areas neighboring the coil. Increased blood perfusion was reported post-rTMS in PET and SPECT studies. Treatment response comparison between unipolar depression and BD revealed almost equal responses. Neuroimaging evidence suggests various correlates of response to rTMS in BD, which needs to be further replicated in future studies. Full article

Around 700,000 people die from suicide each year in the world. Approximately 90% of suicides have a history of mental illness, and more than two-thirds occur during a major depressive episode. Specific therapeutic options to manage the suicidal crisis are limited and measures to prevent acting out also remain limited. Drugs shown to reduce the risk of suicide (antidepressants, lithium, or clozapine) necessitate a long delay of onset. To date, no treatment is indicated for the treatment of suicidality. Ketamine, a glutamate NMDA receptor antagonist, is a fast-acting antidepressant with significant effects on suicidal ideation in the short term, while its effects on suicidal acts still need to be demonstrated. In the present article, we reviewed the literature on preclinical studies in order to identify the potential anti-suicidal pharmacological targets of ketamine. Impulsive–aggressive traits are one of the vulnerability factors common to suicide in patients with unipolar and bipolar depression. Preclinical studies in rodent models with impulsivity, aggressiveness, and anhedonia may help to analyze, at least in part, suicide neurobiology, as well as the beneficial effects of ketamine/esketamine on reducing suicidal ideations and preventing suicidal acts. The present review focuses on disruptions in the serotonergic system (5-HT_B receptor, MAO-A enzyme), neuroinflammation, and/or the HPA axis in rodent models with an impulsive/aggressive phenotype, because these traits are critical risk factors for suicide in humans. Ketamine can modulate these endophenotypes of suicide in human as well as in animal models. The main pharmacological properties of ketamine are then summarized. Finally, numerous questions arose regarding the mechanisms by which ketamine may prevent an impulsive–aggressive phenotype in rodents and suicidal ideations in humans. Animal models of anxiety/depression are important tools to better understand the pathophysiology of depressed patients, and in helping develop novel and fast antidepressant drugs with anti-suicidal properties and clinical utility. Full article

Background: Pramipexole is a dopamine full agonist approved for the treatment of Parkinson’s disease and restless legs syndrome. Its high affinity for the D3 receptor and neuroprotective, antioxidant, and anti-inflammatory activity provides a rationale for the treatment of depression. In this paper, we review studies on the effectiveness and safety of antidepressant pramipexole augmentation in treatment-resistant depression. Methods: This comprehensive systematic review and meta-analysis of observational studies on pramipexole–antidepressant augmentation included patients with resistant unipolar and bipolar depression. The primary outcome measure was the treatment response, measured at the study endpoint. Results: We identified 8 studies including 281 patients overall, 57% women and 39.5% with bipolar disorder and 60.5% with major depressive disorder. The mean follow-up duration was 27.3 weeks (range 8–69). The pooled estimate of treatment response was 62.5%, without significant differences between unipolar and bipolar depression. Safety was good, with nausea and somnolence the most frequent side effects. Conclusions: The findings of this systematic review, needing further confirmation, show that off-label use of pramipexole as augmentation of antidepressant treatment could be a useful and safe strategy for unipolar and bipolar treatment-resistant depression. Full article