Letter to editor: Low Birth Weight And Adult Depression: Eliciting Their Association

Theories supporting fetal origins of adult health and disease are nowadays widely accepted regarding some psychiatric conditions. However, whether genetic or environmental factors disrupting fetal growth might constitute a rick factor for depressive and/or anxious psychopathology remains still controversial.

Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.

Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression. Comment in The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.Destroy user interface controlEfficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis--results to be interpreted with caution.

Depression-like behavior is dependent on age in male SAMP8 mice

Aging is associated with an increased risk of depression in humans. To elucidate the underlying mechanisms of depression and its dependence on aging, here we study signs of depression in male SAMP8 mice. For this purpose, we used the forced swimming test (FST). The total floating time in the FST was greater in SAMP8 than in SAMR1 mice at 9 months of age; however, this difference was not observed in 12-month-old mice, when both strains are considered elderly. Of the two strains, only the SAMP8 animals responded to imipramine treatment. We also applied the dexamethasone suppression test (DST) and studied changes in the dopamine and serotonin (5-HT) uptake systems, the 5-HT2a/2c receptor density in the cortex, and levels of TPH2. The DST showed a significant difference between SAMR1 and SAMP8 mice at old age. SAMP8 exhibits an increase in 5-HT transporter density, with slight changes in 5-HT2a/2c receptor density. In conclusion, SAMP8 mice presented depression-like behavior that is dependent on senescence process, because it differs from SAMR1, senescence resistant strain.

Exploratory Factor Analysis of the contents and styles of irrational thoughts assessed by "The Attitudes and Beliefs Inventory"

The factor structure of a back translated Spanish version (Lega, Caballo and Ellis, 2002) of the Attitudes and Beliefs Inventory (ABI) (Burgess, 1990) is analyzed in a sample of 250 university students.The Spanish version of the ABI is a 48-items self-report inventory using a 5-point Likert scale that assesses rational and irrational attitudes and beliefs. 24-items cover two dimensions of irrationality: a) areas of content (3 subscales), and b) styles of thinking (4 subscales).An Exploratory Factor Analysis (Parallel Analysis with Unweighted Least Squares method and Promin rotation) was performed with the FACTOR 9.20 software (Lorenzo-Seva and Ferrando, 2013).The results reproduced the main four styles of irrational thinking in relation with the three specific contents of irrational beliefs. However, two factors showed a complex configuration with important cross-loadings of different items in content and style. More analyses are needed to review the specific content and style of such items.

Terapia sistémica de pareja en la depresión: un estudio de caso único

En este estudio de caso único se presenta el tratamiento de una mujer diagnosticada de depresión mayor con terapia sistémica de pareja. Esta modalidad de terapia supone la inclusión de la pareja en todas las sesiones de tratamiento, en las que se trabaja con ambos de forma conjunta. A medida que avanza la terapia se van explicitando los significados relacionales de los síntomas y las dificultades de relación, y se trabaja de forma conjunta para remediarlas. El proceso terapéutico se completó con 11 sesiones, la mayoría quincenales, y los resultados de la evaluación al terminar el tratamiento mostraron un descenso notable de los síntomas depresivos de la paciente (según el BDI-II) con respecto a la evaluación inicial. Asimismo, en la entrevista diagnóstica post-tratamiento no cumplía tampoco los criterios de depresión mayor. En cuanto a la pareja, ambos percibieron la relación como más armónica (según el DAS). Dentro de las limitaciones propias de los estudios de caso único, este trabajo permite ilustrar las potencialidades del enfoque sistémico en el tratamiento de la depresión.

A Spanish version of the athens insomnia scale

Objectives To develop and validate a Spanish version of the Athens Insomnia Scale (AIS). Methods The AIS is designed to assess sleep difficulty and comprises eight items: the first five refer to the sleep disturbance and the last three to the daytime consequences. Either the full eight-item scale (AIS-8) or the brief form (AIS-5) can be administered. The adaptation used a backtranslation design. The validation process was based on a sample of 323 participants (undergraduates, community sample and psychiatric outpatients), which completed the AIS and other questionnaires: anxiety (BAI), depression (BDI) and psychological well-being (GHQ-12) scales. Results The internal consistency coefficients for both versions were above 0.80. The study of dimensionality revealed a single factor with high loadings and a percentage of explained variance above 50% in both versions. Test-retest reliability was above 0.70 (AIS-5) and over 0.80 (AIS-8) at a one-month interval. The correlation between the AIS and the previously mentioned scales was for both the AIS-5 and the AIS-8 above 0.40 and 0.50, respectively.

Psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory - Adult Form

One of the goals of psychological assessment focuses on the adaptation of its instruments to different populations. The objective of this study is to establish the psychometric properties and dimensional structure of the Spanish version of the Coping Responses Inventory- Adult Form (CRI-Adult, Moos, 1993). The following criteria were analyzed: a) descriptive statistics; b) internal consistency reliability (Cronbach"s alpha, and intercorrelations between scales); c) test-retest reliability (4-week interval); d) dimensionality of CRI-Adult (exploratory factor analysis); e) construct validity (confirmatory factor analysis); f) convergent criterion validity (correlations between CRI-Adult and Coping Strategies Indicator, CSI, Amirkhan, 1990), and g) predictive criterion validity (correlations between CRI-Adult, and SCL-90-R, Derogatis, 1983). The results, obtained with 800 adults from Barcelona and surrounding area (334 men and 466 women, aged between 18 to 76 years) indicate that the Spanish version of CRIAdult has satisfactory psychometric properties that allow using this test with guarantee.

Subtypes of adolescents with substance use disorders and psychiatric comorbidity using cluster and discriminant analysis of MMPI-A profiles

The main aim of this study was to replicate and extend previous results on subtypes of adolescents with substance use disorders (SUD), according to their Minnesota Multiphasic Personality Inventory for adolescents (MMPI-A) profiles. Sixty patients with SUD and psychiatric comorbidity (41.7% male, mean age = 15.9 years old) completed the MMPI-A, the Teen Addiction Severity Index (T-ASI), the Child Behaviour Checklist (CBCL), and were interviewed in order to determine DSMIV diagnoses and level of substance use. Mean MMPI-A personality profile showed moderate peaks in Psychopathic Deviate, Depression and Hysteria scales. Hierarchical cluster analysis revealed four profiles (acting-out, 35% of the sample; disorganized-conflictive, 15%; normative-impulsive, 15%; and deceptive-concealed, 35%). External correlates were found between cluster 1, CBCL externalizing symptoms at a clinical level and conduct disorders, and between cluster 2 and mixed CBCL internalized/externalized symptoms at a clinical level. Discriminant analysis showed that Depression, Psychopathic Deviate and Psychasthenia MMPI-A scales correctly classified 90% of the patients into the clusters obtained.

Identification-commitment inventory (ICI-Model): confirmatory factor analysis and construct validity

The aim of this study is to confirm the factorial structure of the Identification-Commitment Inventory (ICI) developed within the frame of the Human System Audit (HSA) (Quijano et al. in Revist Psicol Soc Apl 10(2):27-61, 2000; Pap Psicól Revist Col Of Psicó 29:92-106, 2008). Commitment and identification are understood by the HSA at an individual level as part of the quality of human processes and resources in an organization; and therefore as antecedents of important organizational outcomes, such as personnel turnover intentions, organizational citizenship behavior, etc. (Meyer et al. in J Org Behav 27:665-683, 2006). The theoretical integrative model which underlies ICI Quijano et al. (2000) was tested in a sample (N = 625) of workers in a Spanish public hospital. Confirmatory factor analysis through structural equation modeling was performed. Elliptical least square solution was chosen as estimator procedure on account of non-normal distribution of the variables. The results confirm the goodness of fit of an integrative model, which underlies the relation between Commitment and Identification, although each one is operatively different.

Efficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis.

Randomized, controlled trials have demonstrated efficacy for second-generation antipsychotics in the treatment of acute mania in bipolar disorder. Despite depression being considered the hallmark of bipolar disorder, there are no published systematic reviews or meta-analyses to evaluate the efficacy of modern atypical antipsychotics in bipolar depression. We systematically reviewed published or registered randomized, double-blind, placebo-controlled trials (RCTs) of modern antipsychotics in adult bipolar I and/or II depressive patients (DSM-IV criteria). Efficacy outcomes were assessed based on changes in the Montgomery-Asberg Depression Rating Scale (MADRS) during an 8-wk period. Data were combined through meta-analysis using risk ratio as an effect size with a 95% confidence interval (95% CI) and with a level of statistical significance of 5% (p<0.05). We identified five RCTs; four involved antipsychotic monotherapy and one addressed both monotherapy and combination with an antidepressant. The two quetiapine trials analysed the safety and efficacy of two doses: 300 and 600 mg/d. The only olanzapine trial assessed olanzapine monotherapy within a range of 5-20 mg/d and olanzapine-fluoxetine combination within a range of 5-20 mg/d and 6-12 mg/d, respectively. The two aripiprazole placebo-controlled trials assessed doses of 5-30 mg/d. Quetiapine and olanzapine trials (3/5, 60%) demonstrated superiority over placebo (p<0.001). Only 2/5 (40%) (both aripiprazole trials) failed in the primary efficacy measure after the first 6 wk. Some modern antipsychotics (quetiapine and olanzapine) have demonstrated efficacy in bipolar depressive patients from week 1 onwards. Rapid onset of action seems to be a common feature of atypical antipsychotics in bipolar depression. Comment in The following popper user interface control may not be accessible. Tab to the next button to revert the control to an accessible version.Destroy user interface controlEfficacy of modern antipsychotics in placebo-controlled trials in bipolar depression: a meta-analysis--results to be interpreted with caution.

Dimensional structure of the Brief Symptom Inventory with Spanish College students.

The Brief Symptom Inventory is designed to assess symptoms of psychological disorders in adolescents and adults. The dimensional structure of the inventory, using exploratory and confirmatory factor analyses, was examined with a cross-sectional design in a Spanish sample of college students (N = 1,033, aged between 18 and 30 years old). Two hypotheses were tested: the original distribution of the items in nine factors, and the unidimensionality of the inventory. According to the results, a nine-factor structure seemed to be confirmed, although the strong intercorrelations found among the subscales indicated that these were measuring closely related constructs. The importance of cultural influences when assessing psychological symptoms and the need to develop national and sex norms for instruments that assess psychopathology, are also discussed.

Cost-effectiveness of a community pharmacist intervention in patients with depression: a randomized controlled trial (PRODEFAR study)

Background: Non-adherence to antidepressants generates higher costs for the treatment of depression. Little is known about the cost-effectiveness of pharmacist's interventions aimed at improving adherence to antidepressants. The study aimed to evaluate the cost-effectiveness of a community pharmacist intervention in comparison with usual care in depressed patients initiating treatment with antidepressants in primary care. Methods: Patients were recruited by general practitioners and randomized to community pharmacist intervention (87) that received an educational intervention and usual care (92). Adherence to antidepressants, clinical symptoms, Quality-Adjusted Life-Years (QALYs), use of healthcare services and productivity losses were measured at baseline, 3 and 6 months. Results: There were no significant differences between groups in costs or effects. From a societal perspective, the incremental cost-effectiveness ratio (ICER) for the community pharmacist intervention compared with usual care was 1,866 for extra adherent patient and 9,872 per extra QALY. In terms of remission of depressive symptoms, the usual care dominated the community pharmacist intervention. If willingness to pay (WTP) is 30,000 per extra adherent patient, remission of symptoms or QALYs, the probability of the community pharmacist intervention being cost-effective was 0.71, 0.46 and 0.75, respectively (societal perspective). From a healthcare perspective, the probability of the community pharmacist intervention being cost-effective in terms of adherence, QALYs and remission was of 0.71, 0.76 and 0.46, respectively, if WTP is 30,000. Conclusion: A brief community pharmacist intervention addressed to depressed patients initiating antidepressant treatment showed a probability of being cost-effective of 0.71 and 0.75 in terms of improvement of adherence and QALYs, respectively, when compared to usual care. Regular implementation of the community pharmacist intervention is not recommended.

Evaluation of a pharmacist intervention on patients initiating pharmacological treatment for depression: a randomized controlled superiority trial

Major depression is associated with high burden, disability and costs. Non-adherence limits the effectiveness of antidepressants. Community pharmacists (CP) are in a privileged position to help patients cope with antidepressant treatment. The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment. Newly diagnosed primary care patients were randomised to usual care (UC) (92) or pharmacist intervention (87). Patients were followed up at 6 months and evaluated three times (Baseline, and at 3 and 6 months). Outcome measurements included clinical severity of depression (PHQ-9), health-related quality of life (HRQOL) (Euroqol-5D) and satisfaction with pharmacy care. Adherence was continuously registered from the computerised pharmacy records. Non-adherence was defined as refilling less than 80% of doses or having a medication-free gap of more than 1 month. Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant. Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses. No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service. The results of our study indicate that a brief intervention in community pharmacies does not improve depressed patients' adherence or clinical symptoms. This intervention helped patients to improve their HRQOL, which is an overall measure of patient status.

Synaptic depression and slow oscillatory activity in a biophysical network model of the cerebral cortex

Short-term synaptic depression (STD) is a form of synaptic plasticity that has a large impact on network computations. Experimental results suggest that STD is modulated by cortical activity, decreasing with activity in the network and increasing during silent states. Here, we explored different activity-modulation protocols in a biophysical network model for which the model displayed less STD when the network was active than when it was silent, in agreement with experimental results. Furthermore, we studied how trains of synaptic potentials had lesser decay during periods of activity (UP states) than during silent periods (DOWN states), providing new experimental predictions. We next tackled the inverse question of what is the impact of modifying STD parameters on the emergent activity of the network, a question difficult to answer experimentally. We found that synaptic depression of cortical connections had a critical role to determine the regime of rhythmic cortical activity. While low STD resulted in an emergent rhythmic activity with short UP states and long DOWN states, increasing STD resulted in longer and more frequent UP states interleaved with short silent periods. A still higher synaptic depression set the network into a non-oscillatory firing regime where DOWN states no longer occurred. The speed of propagation of UP states along the network was not found to be modulated by STD during the oscillatory regime; it remained relatively stable over a range of values of STD. Overall, we found that the mutual interactions between synaptic depression and ongoing network activity are critical to determine the mechanisms that modulate cortical emergent patterns.

Implicación de la ansiedad y la depresión en los trastronos de alimentación de jovenes con obesidad

Objectives: the goals of the present study were: 1) to compare the levels of anxiety, depression, and eating disorders in young patients assisted at a children"s hospital for obesity; 2) to determine whether anxiety and depression explain the symptoms of the eating disorders; and 3) to know which of these symptoms better discriminate the young people with different degrees of obesity. Materials and method: Descriptive, cross-sectional study with a sample comprised by 281 youngsters (56% girls) aged 11-17 years. The BMI percentiles were calculated by using the WHO growth tables. Two study groups were created: severe obesity and overweight/light-moderate obesity. The following questionnaires were used: Eating Disorders Inventory-2 (EDI-2), depression questionnaire (DQ), and Status-Trait Anxiety Questionnaire (STAI). Results: The youngsters with obesity showed more psychological problems than youngsters with overweight/ light-moderate obesity, 12% had anxiety, and 11% depression. In both groups, the behaviours related with eating disorders were partially explained by the presence of symptoms of anxiety and depression. Dissatisfaction with the body and high anxiety trait increased the risk for perpetuating the obesity and were the two symptoms that better discriminated the patients with or without severe obesity. Conclusion: Obesity prevention programmes should include body dissatisfaction and the anxiety trait into the assessment and management protocols, and prevent anxiety getting fixed as a personality trait.