Depressive and anxiety disorders are severe and disabling conditions that result in substantial cost and global societal burden. Accurate and efficient identification is thus vital to proper ...diagnosis and treatment of these disorders. The Inventory of Depression and Anxiety Symptoms (IDAS) is a reliable and well-validated measure that provides dimensional assessment of both mood and anxiety disorder symptoms. The current study examined the clinical utility of the IDAS by establishing diagnostic cutoff scores and severity ranges using a large mixed sample (N = 5,750). Results indicated that the IDAS scales are good to excellent predictors of their associated Structured Clinical Interview for DSM-IV diagnoses. These findings were replicated using Diagnostic and Statistical Manual of Mental Disorders–Fifth edition (DSM-5) criteria assessed via the Mini-International Neuropsychiatric Interview. We provide three cutoff scores for each scale that can be used differentially depending on the goal of their use: screening, efficiency, or diagnosis confirmation. The identified severity ranges allow users to characterize individuals as mild, moderate, or severe, providing clinical information beyond diagnostic status. Finally, the 10-item IDAS Dysphoria scale and 20-item General Depression scale demonstrate strong ability to predict internalizing diagnoses and may represent an efficient way to screen for the presence of internalizing psychopathology.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
•The response trajectory was a logarithmic curve, suggesting that the depressive symptoms scores improved immediately in the first weeks, then gradually leveled off, and continued to be sustained ...afterward.•When separately examining active rTMS arms and sham rTMS arms, both response trajectories exhibited similar logarithmic curves. This implies that the sustained affect-effects of rTMS could not be explained only by a placebo effect.•The subgroup analyses show distinct response trajectories across different rTMS protocols. The 1-week stimulation group exhibited an inverted-U shaped curve, while the 4-week stimulation group showed a logarithmic curve.•The first two months of antidepressant outcome may be positively associated with rTMS protocols of higher pulse/session and total pulses
The depression response trajectory after a course of repetitive transcranial magnetic stimulation(rTMS) remains understudied. We searched for blinded randomized controlled trials(RCTs) that examined conventional rTMS over left dorsolateral prefrontal cortex(DLPFC) for major depressive episodes(MDE). The effect size was calculated as the difference in depression improvement, between active and sham rTMS. We conducted a random-effects dose-response meta-analysis to model the response trajectory from the beginning of rTMS to the post-treatment follow-up phase. The area under curve (AUC) of the first 8-week response trajectory was calculated to compare antidepressant efficacy between different rTMS protocols. We included 40 RCTs(n = 2012). The best-fitting trajectory model exhibited a logarithmic curve(X2=17.7, P < 0.001), showing a gradual ascent with tapering off around the 3–4th week mark and maintaining until week 16. The maximum effect size was 6.1(95 %CI: 1.25–10.96) at week 16. The subgroup analyses showed distinct trajectories across different rTMS protocols. Besides, the comparisons of AUC showed that conventional rTMS protocols with more pulse/session group or more total pulses were associated with greater efficacy than those with fewer pulse/session or fewer total pulses, respectively. A course of conventional left DLPFC rTMS could lead to both acute antidepressant effects and sustained after-effects, which were modeled by different rTMS protocols in MDE.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ
Associating a neutral conditioned stimulus (CS) with the absence of a biologically significant unconditioned stimulus (US) confers conditioned inhibitory properties upon the CS, referred to as ...conditioned inhibition. Conditioned inhibition and conditioned excitation, an association of a CS with the presence of the US, are fundamental components of associative learning. While the neural substrates of conditioned excitation are well established, those of conditioned inhibition remain poorly understood. Recent research has shed light on the lateral habenula (LHb) engagement in conditioned inhibition, along with the midbrain dopaminergic neurons. This article reviews behavioral tasks conducted to assess conditioned inhibition and how experimental LHb manipulations affect performance in these tasks. These results underscore the critical role of the LHb in conditioned inhibition. Intriguingly, stress increases LHb reactivity and impairs performances in tasks consisting of a component of conditioned inhibition in animals. Dysfunction of the LHb is observed in patients with depression. The ability of an organism to perform conditioned inhibition is closely linked to altered neuronal activity in the LHb, which has implications for mental disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
The high global prevalence of depression, together with the recent acceleration of remote care owing to the COVID-19 pandemic, has prompted increased interest in the efficacy of digital interventions ...for the treatment of depression. We provide a summary of the latest evidence base for digital interventions in the treatment of depression based on the largest study sample to date. A systematic literature search identified 83 studies (N = 15,530) that randomly allocated participants to a digital intervention for depression versus an active or inactive control condition. Overall heterogeneity was very high (I2 = 84%). Using a random-effects multilevel metaregression model, we found a significant medium overall effect size of digital interventions compared with all control conditions (g = .52). Subgroup analyses revealed significant differences between interventions and different control conditions (WLC: g = .70; attention: g = .36; TAU: g = .31), significantly higher effect sizes in interventions that involved human therapeutic guidance (g = .63) compared with self-help interventions (g = .34), and significantly lower effect sizes for effectiveness trials (g = .30) compared with efficacy trials (g = .59). We found no significant difference in outcomes between smartphone-based apps and computer- and Internet-based interventions and no significant difference between human-guided digital interventions and face-to-face psychotherapy for depression, although the number of studies in both comparisons was low. Findings from the current meta-analysis provide evidence for the efficacy and effectiveness of digital interventions for the treatment of depression for a variety of populations. However, reported effect sizes may be exaggerated because of publication bias, and compliance with digital interventions outside of highly controlled settings remains a significant challenge.
Public Significance StatementThis meta-analysis demonstrates the efficacy of digital interventions in the treatment of depression for a variety of populations. Additionally, it highlights that digital interventions may have a valuable role to play in routine care, most notably when accompanied by human guidance. However, compliance with digital interventions remains a major challenge, with little more than 50% of participants completing the full intervention on average.
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Major Depression Disorder (MDD), a complex mental health disorder, poses significant challenges in accurate diagnosis. In addressing the issue of gradient vanishing in the classification of MDD using ...current data-driven electroencephalogram (EEG) data, this study introduces a TanhReLU-based Convolutional Neural Network (CNN). By integrating the TanhReLU activation function, which combines the characteristics of the hyperbolic tangent (Tanh) and rectified linear unit (ReLU) activations, the model aims to improve performance in identifying patterns associated with MDD while alleviating the issue of model overfitting and gradient vanishing. Experimental results demonstrate promising outcomes in the task of MDD classification upon the publicly available EEG data, suggesting potential clinical applications.
Abstract Background Depression severity is assessed in numerous research disciplines, ranging from the social sciences to genetics, and used as a dependent variable, predictor, covariate, or to ...enroll participants. The routine practice is to assess depression severity with one particular depression scale, and draw conclusions about depression in general, relying on the assumption that scales are interchangeable measures of depression. The present paper investigates to which degree 7 common depression scales differ in their item content and generalizability. Methods A content analysis is carried out to determine symptom overlap among the 7 scales via the Jaccard index (0=no overlap, 1=full overlap). Per scale, rates of idiosyncratic symptoms, and rates of specific vs. compound symptoms, are computed. Results The 7 instruments encompass 52 disparate symptoms. Mean overlap among all scales is low (0.36), mean overlap of each scale with all others ranges from 0.27–0.40, overlap among individual scales from 0.26–0.61. Symptoms feature across a mean of 3 scales, 40% of the symptoms appear in only a single scale, 12% across all instruments. Scales differ regarding their rates of idiosyncratic symptoms (0%–33%) and compound symptoms (22%–90%). Limitations Future studies analyzing more and different scales will be required to obtain a better estimate of the number of depression symptoms; the present content analysis was carried out conservatively and likely underestimates heterogeneity across the 7 scales. Conclusion The substantial heterogeneity of the depressive syndrome and low overlap among scales may lead to research results idiosyncratic to particular scales used, posing a threat to the replicability and generalizability of depression research. Implications and future research opportunities are discussed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract Background The symptoms for Major Depression (MD) defined in the DSM-5 differ markedly from symptoms assessed in common rating scales, and the empirical question about core depression ...symptoms is unresolved. Here we conceptualize depression as a complex dynamic system of interacting symptoms to examine what symptoms are most central to driving depressive processes. Methods We constructed a network of 28 depression symptoms assessed via the Inventory of Depressive Symptomatology (IDS-30) in 3,463 depressed outpatients from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. We estimated the centrality of all IDS-30 symptoms, and compared the centrality of DSM and non-DSM symptoms; centrality reflects the connectedness of each symptom with all other symptoms. Results A network with 28 intertwined symptoms emerged, and symptoms differed substantially in their centrality values. Both DSM symptoms (e.g., sad mood) and non-DSM symptoms (e.g., anxiety) were among the most central symptoms, and DSM criteria were not more central than non-DSM symptoms. Limitations Many subjects enrolled in STAR*D reported comorbid medical and psychiatric conditions which may have affected symptom presentation. Conclusion The network perspective neither supports the standard psychometric notion that depression symptoms are equivalent indicators of MD, nor the common assumption that DSM symptoms of depression are of higher clinical relevance than non-DSM depression symptoms. The findings suggest the value of research focusing on especially central symptoms to increase the accuracy of predicting outcomes such as the course of illness, probability of relapse, and treatment response.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
People who report frequently using cognitive reappraisal to decrease the impact of potentially upsetting situations report better affective functioning than people who report using cognitive ...reappraisal less frequently. However, most work linking everyday reappraisal use to affective outcomes has been correlational, making causal inference difficult. In this study, we examined whether 2 weeks of daily practice of reappraising negatively valenced personally relevant events would improve affective functioning compared with a wait-list control. Data were collected between 2021 and 2022 from a sample mainly comprised of females (82%) and who identified as Asian (35%) or White/Caucasian (40%). Our planned analyses indicated that reappraisal decreased depressive symptoms and perceived stress as well as increased life satisfaction both immediately and 4 weeks postintervention. Reductions in depressive symptoms and perceived stress were mediated by increases in reappraisal self-efficacy. These findings support the causal efficacy of brief reappraisal training. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Positive autobiographical memories (AMs) have the potential to repair low mood, but previously depressed individuals have difficulty leveraging their positive AMs for emotion regulation purposes. We ...examined whether previously depressed individuals benefit from guided, deliberate recollection of preselected AMs to counteract low mood in daily life, utilizing individuals’ smartphones to facilitate recollection. Sixty participants enrolled in 2020 were randomly allocated to retrieval of positive or everyday activity AMs and completed ecological momentary assessment of emotional experience for 3 weeks. Participants first created a pool of six memories for the digital AM diary. This was followed by a training week with two recollection tasks daily and a 2-week follow-up period where the diary could be used spontaneously. The positive condition experienced a greater increase in feelings of happiness and a greater decrease in feelings of sadness from pre- to post-AM recollection. While participants in the positive condition used the AM technique more frequently overall during the 2-week follow-up, the effect of condition was moderated by changes in feelings of sadness. The more participants experienced an emotional benefit during the training week, the more they used it spontaneously. Emotional vividness of untrained positive AMs at the 2-week follow-up differed depending on whether they were assessed before or after the first pandemic lockdown. Residual depressive symptoms decreased in both conditions over the study course, while mental well-being remained unchanged. Strengthening positive, self-affirming AMs in daily life may provide a tool to support regulation of transient low mood in those remitted from depression. (PsycInfo Database Record (c) 2024 APA, all rights reserved) (Source: journal abstract)
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CEKLJ, FFLJ, NUK, ODKLJ, PEFLJ, UPUK
Serotonin-Dopamine antagonists (SDA) have been evaluated as monotherapy and augmentation therapy for major depression (MDD) Despite evidence of efficacy for both, adverse events with SDA are ...considerably greater than for monotherapy. In this randomized clinical trial, low doses of pipamperone, an SDA approved in the EU, were used to treat major depression. We were in efficacy across treatments and the relative safety of pipamperone compared to previous treatments with SDA.
In this study, patients with MDD (n = 555; 535 received treatment) were randomized to low dose pipamperone plus placebo, citalopram plus placebo, or pipamperone plus citalopram in a 10-week efficacy study. Adverse events and clinician efficacy ratings with MADRS were examined.
The study was completed by 383 participants, with the most common reason for drop out being withdrawal of consent. All three arms showed treatment-related changes with no significant differences between treatments (all effect sizes from larger than d = 1.48, largest = 1.77: pipamperone plus citalopram). Drop-outs due to adverse events were 4 % with pipamperone monotherapy, compared to 3 % with citalopram alone. There were no differences in weight gain across the treatments and EPS was reported by one case and tremor was reported by two cases with combined treatment arm. Nausea was more common with citalopram monotherapy (16 % vs 9 % for pipamperone).
These data suggest that low doses of pipamperone have a substantially better safety profile than previous SDA medications used to treat MDD and that pipamperone has potential to be an efficacious treatment for MD, as monotherapy or combination therapy.
This trial was registered on clinicaltrials.gov: (NCT01312922).
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ
