Lab Test for Depression?
Although there isn't currently a laboratory test that can be used to detect depression, researchers say it may eventually become a reality.
In an attempt to design such a test, Dr. George Papakostas and his team gave 36 people with depression and 43 people without a blood test which looked at nine different biomarkers which have been associated with depression. These biomarkers appear to be an indicator of inflammation in the brain, according to Papakostas.
They found that 91% of the time the test accurately identified depression and about 81% of the time it correctly identified those without depression.
According to Papakostas, more research is needed to confirm his findings.
When asked about the cost of such a test, he indicated that it would probably be similar to other routine blood tests that are currently performed.
A test which could be used to diagnose depression would be helpful, said Papakostas, because it would help doctors who are less experienced with diagnosing depression in making a correct diagnosis. It would also help patients who might otherwise be reluctant to accept a diagnosis without some sort of outside validation.
The article appeared in a recent issue of the journal Molecular Psychiatry.
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Child Abuse May Cause Later Depression By Affecting Brain Development
New research appears to show that the stress of child abuse shrinks an important area of the brain called the hippocampus, which has been associated with memory, learning and emotional regulation.
This finding is important because it may explain why abused children often go on to have later psychiatric disorders, such as depression.
Almost 200 young adults in the Boston area who were not taking medications or abusing drugs or alcohol were involved in the study.
The study participants were interviewed about any mistreatment they may have suffered as children, such as physical, emotional or sexual abuse. They were also asked about any neglect, verbal abuse or significant separations or losses that they might have experienced.
The researchers found that about 16% of the group had endured significant levels of abuse, having experienced three or more types of mistreatment. And, this same group had higher than average rates of mental illness. Depression was twice as common in this group and post-traumatic stress disorder (PTSD) was about three times as common.
They researchers next used magnetic resonance imaging to examine a region of the brain called the hippocampus. Shrinkage in this area has previously been associated with depression and other mental illness.
What they found was that in those who had suffered abuse as children, three key areas of this region had shrinkage. And, this shrinkage existed regardless of whether the individuals had any signs of mental illness, which would seem to indicate that the shrinkage preceded the mental illness in those who had it.
The good news, however, according to lead author Martin H. Teicher, is that the changes in the hippocampus can be modified. Activities such as vigorous exercise and mental stimulation can undo them.
The study was published in Proceedings of the National Academy of Sciences on February 12, 2012.
Exercise Can Help Depression in Those With Chronic Illness
If you have a chronic illness and are battling depression, exercise may be just what you need to lift your mood, according to University of Alabama, Birmingham researchers.
For the study, Matthew Herring and his team examined 90 previous studies of 10,500 sedentary patients with chronic illness. Each study included people who had been randomly assigned to either an exercise group or a non-exercise group. In addition, the study participants had had their depression levels measured both before and after exercise.
The researchers found that those who engaged in exercise - which included such as activities as jogging, cycling and resistance training - had a 22% reduction in their depression symptoms. Those who exercised either at least 150 minutes at a moderate intensity or at least 75 minutes at a vigorous intensity had even greater improvements. The patients who received the greatest benefit from exercise were those who had mild to moderate depression and for whom exercise improved their ability to function.
Based upon these results, Herring suggests that exercise can be recommended as a potential low-risk treatment for depression in those suffering from chronic illness.
The article was published in January 23, 2012 issue of Archives of General Medicine.
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Free Depression Screening
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Working Too Many Hours Can Make You Depressed
Newly published research indicates that working too many overtime hours could make you more prone to developing depression.
The study, which included about 2,000 British government employees, found that those who worked 11 or more hours per day were more than twice as likely to develop depression as those who worked a normal seven or eight hour day.
The authors noted that because the study included only civil servants it is not possible to determine from the data whether this same effect would apply for blue collar jobs.
It is not known how long work hours might influence depression risk, but factors such as work-family conflict, difficulty in relaxing after hours and chronically high levels of stress hormones could play a role.
The study was published online on Jan. 25, 2012 in the journal PLoS ONE
DSM-V: Proposed Changes in Depression Criteria Too Broad?
The American Psychiatric Association is in the process of revising its Diagnostic and Statistical Manual of Mental Disorders (DSM) , a handbook used by clinicians when making diagnoses of conditions such as depression, and some believe it may be going too far.
A new report by researchers at Columbia and New York universities argues that the newly proposed definition of depression, which includes grief after the loss of a loved one under the umbrella of depression, is opening the door for false-positive diagnosis of depression and the unnecessary treatment of people who are simply going through the normal process of grieving.
Other experts, however, argue that clinical depression can and often does occur as a result of grief. These proponents of the proposed changes feel that changing the criteria for a depression diagnosis will aid these people in getting the help that they need.
The 5th edition of the DSM, which is the first major update the manual has undergone since 1994, is due to be published in May 2013.
If you would like to learn more about the proposed changes, please visit http://www.dsm5.org/.
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Antidepressants Increase Risk for Nursing Home Falls in Patients With Dementia
Nursing home patients with dementia who were taking a class of antidepressants called serotonin reuptake inhibitors - which includes such drugs as Prozac, Paxil, Lexapro, Zoloft and Celexa - were three times more likely to experience a fall than other dementia patients, according to a new study out of the Netherlands.
Falls are a problem for patients with dementia, said the study authors, because about one-third of these falls will result in an injury.
The effect of SSRIs was examined because depression is very common in dementia patients and SSRIs are the most commonly prescribed antidepressant type in this population.
Lead author Carolyn Shanty Sterke and her team found that the increased risk for falls was present even at low doses and increased proportionately as the dose rose.
Concurrent use of antidepressants with certain other drugs, such as hyponotics or sedatives, increased the risk even more.
Sterke says that doctors should be careful about prescribing SSRIs to older patients with dementia and suggests that they should develop new treatment protocols that take into account the risk of falls.
The study was published online in the British Journal of Clinical Pharmacology on January 18, 2012.
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Low Vitamin D Associated With Depression
According to a study conducted by UT Southwestern Medical Center psychiatrists, low levels of vitamin D have been linked with depression.
When the researchers looked at the results gathered from 12,600 participants in the Cooper Center Longitudinal Study between 2006 and 2010, they found that low levels of vitamin D were associated with depressive symptoms, especially in those with a history of depression. High vitamin D levels, however, were associated with a significantly decreased risk for current depression.
The study did not attempt to assess whether vitamin D supplementation would reduce depression symptoms.
Nor is it known exactly what the relationship is between vitamin D and depression. It could be that low vitamin D levels trigger depression or that depression in some way lowers vitamin D levels.
"Our findings suggest that screening for vitamin D levels in depressed patients - and perhaps screening for depression in people with low vitamin D levels - might be useful," said senior author Dr. E. Sherwood Brown, "but we don't have enough information yet to recommend going out and taking supplements."
Vitamin D is a fat-soluble vitamin that is produced by natural processes within the body when ultraviolet radiation from the sun hits the skin. It can be obtained in the diet by eating foods such as cod liver oil, salmon, mackerel, tuna, sardines and vitamin D fortified milk. The current recommended dietary allowance for vitamin D is 600 IU for persons between the ages of one and 70.
The study was published in Mayo Clinic Proceedings.
Race, Ethnicity Influence Depression Treatment in the Elderly
According to a study out of Rutgers University, significant differences exist in the diagnosis and treatment of depression in older patients, with the differences being divided along racial and ethnic lines.
In particular, the researchers found that African Americans were less likely to be diagnosed with depression than their non-Hispanic white counterparts. And, when they were diagnosed, they were less likely to receive treatment.
Lead author Ayse Akincigil, an assistant professor in Rutgers' School of Social Work, and her team gathered data for the study from the U.S. Medicare Current Beneficiary Survey, 2001-2005, looking at 33,708 Medicare beneficiaries. When they examined rates of depression diagnosis, they found that 7.2% of Hispanics, 6.4% of non-Hispanic whites, 4.2% of African Americans and 3.8% of all others had received a depression diagnosis.
Hispanics and African Americans, however, were less likely to receive treatment for their depression.
Akincigil suggests that these differences may arise because of cultural differences in how various racial or ethnic groups seek help. For example, she says that African Americans may be more likely to turn to a pastor or lay counselor for support. They may also feel more stigma or shame associated with depression or turn to more dysfunctional means of coping with the illness due to income restraints.
Akincigil also notes that whites tend to have higher incomes and live in neighborhoods where mental health professionals are more likely to be located, possibly making it easier for them to access professional care.
Due to the diverse makeup of the Hispanic community, it is more difficult to draw conclusions about why they might be undertreated.
The study authors suggest that ethnic minorities could be better served if universal depression screening and access to treatment for low-income and minority neighborhoods was ensured. Increased reimbursement of case management services for depression treatment might also be helpful, they add.
The study appears online ahead of print on the American Journal of Public Health website. It will appear in print February 2012.
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Deep Brain Stimulation Offers Long-Term Results
In its first placebo-controlled study, deep brain stimulation has shown that it can provide long-term relief from depression that has failed to respond to other types of therapy.
Unfortunately it is not a quick or easy fix. It requires the surgical implantation of electrodes deep in the brain and recovery can be quite slow. In fact, some the patients studied did not respond until after a year or more of stimulation.
However, out of the twelve patients who reached the two-year point using the device, all but one experienced either a complete remission of symptoms or had only mild symptoms.
Also encouraging was the fact that bipolar disorder patients in the study responded just as well as those with major depressive disorder.
It should be noted, however, that deep brain stimulation is not a cure for depression. The effects only continue as long as the stimulation is applied. Still, for those who have found no relief elsewhere, it may be a worthwhile option to pursue.
At the present time larger placebo-controlled phase-3 clinical trials are being carried out in multiple centers in North America and Europe by two different manufacturers of the device, but those results will not be available for several years.
The study was conducted by neurologist Helen Mayberg at Emory University in Atlanta, Georgia.