Exploring female mice interstrain differences relevant for models of depression

Depression is an extremely heterogeneous disorder. Diverse molecular mechanisms have been suggested to underlie its etiology. To understand the molecular mechanisms responsible for this complex disorder, researchers have been using animal models extensively, namely mice from various genetic backgrounds and harboring distinct genetic modifications. The use of numerous mouse models has contributed to enrich our knowledge on depression. However, accumulating data also revealed that the intrinsic characteristics of each mouse strain might influence the experimental outcomes, which may justify some conflicting evidence reported in the literature. To further understand the impact of the genetic background, we performed a multimodal comparative study encompassing the most relevant parameters commonly addressed in depression, in three of the most widely used mouse strains: Balb/c, C57BL/6, and CD-1. Moreover, female mice were selected for this study taken into account the higher prevalence of depression in women and the fewer animal studies using this gender. Our results show that Balb/c mice have a more pronounced anxious-like behavior than CD-1 and C57BL/6 mice, whereas C57BL/6 animals present the strongest depressive-like trait. Furthermore, C57BL/6 mice display the highest rate of proliferating cells and brain-derived neurotrophic factor (Bdnf) expression levels in the hippocampus, while hippocampal dentate granular neurons of Balb/c mice show smaller dendritic lengths and fewer ramifications. Of notice, the expression levels of inducible nitric oxide synthase (iNos) predict 39.5% of the depressive-like behavior index, which suggests a key role of hippocampal iNOS in depression. Overall, this study reveals important interstrain differences in several behavioral dimensions and molecular and cellular parameters that should be considered when preparing and analyzing experiments addressing depression using mouse models. It further contributes to the literature by revealing the predictive value of hippocampal iNos expression levels in depressive-like behavior, irrespectively of the mouse strain.

Postpartum depression in Recife - Brazil: prevalence and association with bio-socio-demographic factors

OBJECTIVE:To use a semi-structured interview to detect depression in postpartum women according to the criteria proposed by the DSM in child health care clinics in the city of Recife, together with the proper association of this disorder to bio-socio-demographic data. METHODS: The study used a cross-section method and contained a convenience sample of 400 women that were between 2 and 26 weeks of postpartum in child health care clinics. A bio-socio-demographic questionnaire and the Portuguese version of the Structured Clinical Interview for DSM-IV Axis I Disorders were used. RESULTS: Twenty nine of the mothers (7.2%) were diagnosed as suffering from postpartum depression. Women with a past history of psychiatric disorders, a family history of psychiatric disorder and some sort of clinical complication presented a higher prevalence of depression. The same happened to those with a past history of spontaneous abortion, those who had a transpelvic birth and those over 8 weeks of puerperium. CONCLUSION: The rate of postpartum depression in this sample, 7.2%, was lower than that reported by other Brazilian studies. It probably occurred because the other researchers used screening scales to assess this estimate instead of a clinical interview.

Long-term prognosis of geriatric major depression in relation to cognition and white matter integrity: follow up of two cases

INTRODUCTION: The geriatric depression (GD) represents one of the most frequent psychiatric disorders in outpatient services specialized in old-age treatment. OBJECTIVE: The course of two illustrative cases of GD is discussed, highlighting its clinical picture after antidepressant treatment and underlining variables related to disease prognosis, treatment effectiveness and conversion to major cognitive disorders such as vascular dementia (VD). METHODS: The cognitive performance, depressive symptoms, autonomy and brain structural measurements as white matter hyperintensities (WMH) and hippocampal size, and microstructural integrity of WM with diffusion tensor imaging were followed during four years. RESULTS: Case 1, with a severe degree of WMH, was associated with worsening cognition and increasing functional disability. Case 2, with mild WMH, an improvement of cognitive functioning could be seen. CONCLUSIONS: The existence of different subtypes of GD, as presented in this report, points a pathophysiological heterogeneity of GD, and suggests a possible continuum vascular depression (VaDp) and vascular cognitive impairment (VCI).

The impact of depression on survival of Parkinson's disease patients: a five-year study

OBJECTIVE: The aim of this study is to evaluate the survival rate in a cohort of Parkinson's disease patients with and without depression. METHODS: A total of 53 Parkinson's disease subjects were followed up from 2003-2008 and 21 were diagnosed as depressed. Mean time of follow up was 3.8 (SD 95% = 1.5) years for all the sample and there was no significant difference in mean time of follow up between depressed and nondepressed Parkinson's disease patients. Survival curves rates were fitted using the Kaplan-Meier method. In order to compare survival probabilities according to the selected covariables the Log-Rank test was used. Multivariate analysis with Cox regression was performed aiming at estimating the effect of predictive covariables on the survival. RESULTS: The cumulative global survival of this sample was 83% with nine deaths at the end of the study - five in the depressed and four in the nondepressed group, and 55.6% died in the first year of observation, and none died at the fourth and fifth year of follow up. CONCLUSION: Our finding point toward incremental death risk in depressed Parkinson's disease patients.

Forensic neuropsychological assessment: clinical case of depression and working incapacity

Issues related to mental health in relation to court matters have increasingly required the participation of the psychologist. We present the use of forensic neuropsychological assessment in a case of retirement reversal. Incapacity was attested due to disability resulting from depression of a 35-year-old attorney, and the case was forwarded from the courts to the Forensic Psychiatry and Psychology Unit at the USP Clinical Hospital. A clinical interview and application of cognitive tests was conducted. Despite the depression, significant cognitive losses that would prevent return to his professional assignments were not detected. The neuropsychological assessment has been shown to be an important tool in the forensic context, as it assists with diagnostic value for clarification of functional aspects in the various psychopathological areas in terms of disabilities or potentialities.

Assessing cardiorespiratory capacity in older adults with major depression and Alzheimer disease

ABSTRACT Objective To assess cardiorespiratory capacity through subjective and objective tests in older adults diagnosed with major depression (MDD), Alzheimer disease (AD) and healthy older adults. Methods Fifty seven subjects (72 ± 7.9 years) were divided into three groups: MDD (n = 20), AD (n = 17) and Healthy (n = 20). The subjects answered Hamilton Scale (HAM-D), Mini-Mental State Examination (MMSE), Veterans Specific Activity Questionnaire (VSAQ) and 2-minute Step test. Results MDD and AD showed lower scores than healthy group for Nomogram VSAQ (p < 0.001) and 2-minute Step (p = 0.009; p = 0.008, respectively). Adjusted for age and educational level, no differences among groups were observed for Step (MDD, p = 0.097; AD, p = 0.102). AD group did not present differences to healthy group for Step, when adjusting for MMSE (p = 0.261). Conclusions Despite the lower cardiorespiratory fitness of elderly patients with DM and DA have been found in both evaluations, the results should be viewed with caution, since the tests showed low correlation and different risk classifications of functional loss. In addition, age, level educational and cognitive performance are variables that can influence the performance objective evaluation.

Breastfeeding and depression: a systematic review of the literature

Background: Research has separately indicated associations between pregnancy depression and breastfeeding, breastfeeding and postpartum depression, and pregnancy and postpartum depression. This paper aimed to provide a systematic literature review on breastfeeding and depression, considering both pregnancy and postpartum depression. Methods: An electronic search in three databases was performed using the keywords: “breast feeding”, “bottle feeding”, “depression”, “pregnancy”, and “postpartum”. Two investigators independently evaluated the titles and abstracts in a first stage and the full-text in a second stage review. Papers not addressing the association among breastfeeding and pregnancy or postpartum depression, non-original research and research focused on the effect of antidepressants were excluded. 48 studies were selected and included. Data were independently extracted. Results: Pregnancy depression predicts a shorter breastfeeding duration, but not breastfeeding intention or initiation. Breastfeeding duration is associated with postpartum depression in almost all studies. Postpartum depression predicts and is predicted by breastfeeding cessation in several studies. Pregnancy and postpartum depression are associated with shorter breastfeeding duration. Breastfeeding may mediate the association between pregnancy and postpartum depression. Pregnancy depression predicts shorter breastfeeding duration and that may increase depressive symptoms during postpartum. Limitations: The selected keywords may have led to the exclusion of relevant references. Conclusions: Although strong empirical evidence regarding the associations among breastfeeding and pregnancy or postpartum depression was separately provided, further research, such as prospective studies, is needed to clarify the association among these three variables. Help for depressed pregnant women should be delivered to enhance both breastfeeding and postpartum psychological adjustment.

Sleep during the third trimester of pregnancy: the role of depression and anxiety

Depression has been associated with sleep disturbances in pregnancy; however, no previous research has controlled the possible confounding effect of anxiety on this association. This study aims to analyze the effect of depression on sleep during the third trimester of pregnancy controlling for anxiety. The sample was composed by 143 depressed (n = 77) and non-depressed (n = 66) pregnant women who completed measures of depression, anxiety, and sleep. Differences between groups in sleep controlling for anxiety were found. Depressed pregnant women present higher number of nocturnal awakenings and spent more hours trying falling asleep during the night and the entire 24 h period. Present findings point out the effect of depression on sleep in late pregnancy, after controlling for anxiety.

Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression

Background. This prospective cohort study explored the effects of prenatal and postpartum depression on breastfeeding and the effect of breastfeeding on postpartum depression. Method. The Edinburgh Postpartum Depression Scale (EPDS) was administered to 145 women at the first, second and third trimester, and at the neonatal period and 3 months postpartum. Self-report exclusive breastfeeding since birth was collected at birth and at 3, 6 and 12 months postpartum. Data analyses were performed using repeated-measures ANOVAs and logistic and multiple linear regressions. Results. Depression scores at the third trimester, but not at 3 months postpartum, were the best predictors of exclusive breastfeeding duration (β =−0.30, t=−2.08, p<0.05). A significant decrease in depression scores was seen from childbirth to 3 months postpartum in women who maintained exclusive breastfeeding for53 months (F1,65 =3.73, p<0.10, ηp 2 =0.05). Conclusions. These findings suggest that screening for depression symptoms during pregnancy can help to identify women at risk for early cessation of exclusive breastfeeding, and that exclusive breastfeeding may help to reduce symptoms of depression from childbirth to 3 months postpartum.

Screening for depression and anxiety disorders from pregnancy to postpartum with the EPDS and STAI

The Edinburgh Postnatal Depression Scale (EPDS) and the State Anxiety Inventory (STAI-S) are widely used self-report measures that still need to be further validated for the perinatal period. The aim of this study was to examine the screening performance of the EPDS and the STAI-S in detecting depressive and anxiety disorders at pregnancy and postpartum. Women screening positive on EPDS (EPDS ≥ 9) or STAI-S (STAI-S ≥ 45) during pregnancy (n = 90), as well as matched controls (n = 58) were selected from a larger study. At 3 months postpartum, 99 of these women were reassessed. At a second stage, women were administered a clinical interview to establish a DSM-IV-TR diagnosis. Receiver operator characteristics (ROC) analysis yielded areas under the curve higher than .80 and .70 for EPDS and STAI-S, respectively. EPDS and STAI-S optimal cut-offs were found to be lower at postpartum (EDPS = 7; STAI-S = 34) than during pregnancy (EPDS = 9; STAI-S = 40). EPDS and STAI-S are reasonably valid screening tools during pregnancy and the postpartum.

Breastfeeding and postpartum depression: state of the art review

Objective: To review the literature on the association between breastfeeding and postpartum depression. Sources: A review of literature found on MEDLINE/ PubMed database. Summary of findings: The literature consistently shows that breastfeeding provides a wide range of benefits for both the child and the mother. The psychological benefits for the mother are still in need of further research. Some studies point out that pregnancy depression is one of the factors that may contribute to breastfeeding failure. Others studies also suggest an association between breastfeeding and postpartum depression; the direction of this association is still unclear. Breastfeeding can promote hormonal processes that protect mothers against postpartum depression by attenuating cortisol response to stress. It can also reduce the risk of postpartum depression, by helping the regulation of sleep and wake patterns for mother and child, improving mother’s self efficacy and her emotional involvement with the child, reducing the child’s temperamental difficulties, and promoting a better interaction between mother and child. Conclusions: Studies demonstrate that breastfeeding can protect mothers from postpartum depression, and are starting to clarify which biological and psychological processes may explain this protection. However, there are still equivocal results in the literature that may be explained by the methodological limitations presented by some studies.

Mother’s depression at childbirth does not contribute to the effects of antenatal depression on neonate’s behavioral development

Background: Maternal depression is a worldwide phenomenon that has been linked to adverse developmental outcomes in neonates. Aims: To study the effect of antenatal depression (during the third trimester of pregnancy) on neonate behavior, preference, and habituation to both the mother and a stranger’s face/voice. To analyze mother’s depression at childbirth as a potential mediator or moderator of the relationship between antenatal depression and neonate behavioral development. Method: A sample of 110 pregnant women was divided in 2 groups according to their scores on the Edinburgh Postnatal Depression Scale during pregnancy (EPDS; ≥10, depressed; <10, non-depressed). In the first 5 days after birth, neonatal performance on the Neonatal Behavioral Assessment Scale (NBAS) and in the ‘Preference and habituation to the mother’s face/voice versus stranger’ paradigm was assessed; each mother filled out an EPDS. Results: Neonates of depressed pregnant women, achieved lower scores on the NBASs (regulation of state, range of state, and habituation); did not show a visual/auditory preference for the mother’s face/voice; required more trials to become habituated to the mother’s face/voice; and showed a higher visual/auditory preference for the stranger’s face/voice after habituation compared to neonates of non-depressed pregnant women. Depression at childbirth does not contribute to the effect of antenatal depression on neonatal behavioral development. Conclusion: Depression even before childbirth compromises the neonatal behavioral development. Depression is a relevant issue and should be addressed as a routine part of prenatal health care.

Anxiety and depression symptoms in women and men from early pregnancy to 3-months postpartum: parity differences and effects

This study aimed to investigate both anxiety and depression symptoms from early pregnancy to 3-months postpartum, comparing women and men and first and second-time parents. Methods: A sample of 260 Portuguese couples (N=520), first or second-time parents, recruited in an Obstetrics Out-patients Unit, filled in the State-Anxiety Inventory (STAI-S) and the Edinburgh Post-Natal Depression Scale (EPDS) at the 1st, 2nd and 3rd pregnancy trimesters, childbirth, and 3-months postpartum. Results: A decrease in anxiety and depression symptoms from early pregnancy to 3-months postpartum was found in both women and men, as well as in first and second-time parents. Men presented less anxiety and depression symptoms than women, but the same pattern of symptoms over time. Second-time parents showed more anxiety and depression symptoms than first-time parents and a different pattern of symptoms over time: an increase in anxiety and depression symptoms from the 3rd trimester to childbirth was observed in first-time parents versus a decrease in second-time parents. Limitations: The voluntary nature of the participation may have lead to a selection bias; women and men who agreed to participate could be those who presented fewer anxiety and depression symptoms. Moreover, the use of self-report symptom measures does not give us the level of possible disorder in participants. Conclusions: Anxiety and depression symptoms diminish from pregnancy to the postpartum period in all parents. Patterns of anxiety and depression symptoms from early pregnancy to 3-months postpartum are similar in women and men, but somewhat different in first and second time parents. Second-time parents should also be considered while studying and intervening during pregnancy and the postpartum.