Abstract Background Behavioural inhibition and more specifically harm avoidance temperament dimension (HA) has been found to be associated with depression. Temperament and Character Inventory (TCI) ...by Cloninger et al. is the most widely used instrument in the assessment of temperament. The aims of the present study were to explore 1) if current or future depressive symptoms in non-clinical adult sample can be explained by TCI temperament dimensions, and 2) if recovery from major depression (MDD) during the acute phase of treatment is predictable by TCI temperament dimensions. Method Literature search from eight databases. Systematic review and meta-analysis. Results High HA was associated with current depressive symptoms in 11/12 studies and with depressive trait in 3/4 studies. In MDD studies, a consistent negative change in HA was found during treatment and this change was even more clearly associated with treatment response. Limitations The studies with general population samples were heterogeneous in methodology. Most of the intervention studies were of case–control design. Conclusions HA is indisputably associated with the risk and treatment response in depression.
There are numerous instruments for screening for depression. A feasible screen is good at both recognising and predicting depression.
To study the ability of the Depression Scale and its items to ...recognise and predict a depressive episode.
A sample of patients attending primary care was examined in 1991-992 and again 7 years later. The accuracy of the Depression Scale at baseline and at follow-up was tested against the Short Form of the Composite International Diagnostic Interview (CIDI-SF) diagnosis of depression at follow-up. The sensitivity and specificity of the Depression Scale and its items were assessed.
Both baseline and follow-up Depression Scale scores were consistent with the CIDI-SF diagnoses. It was possible to find single items efficient at both recognising and predicting depression.
The Depression Scale is a useful screening instrument for depression, with both diagnostic and predictive validity.
Abstract Objective The objective of this study was to examine how the outcomes of a structured diagnostic interview for depression are related to the results of a self-report scale in alexithymic and ...nonalexithymic groups. Materials and Methods Subjects ( N =389) recruited from primary care and psychiatric care completed the Depression Scale (DEPS) and the 20-item Toronto Alexithymia Scale. Major depression was diagnosed using the Composite International Diagnostic Interview–Short-Form by telephone. Results In the group without major depression, the DEPS scores of the alexithymic subjects were significantly higher than those of the nonalexithymic subjects. In the group with major depression, the ideal cutoff points of the DEPS, assessed by receiver operating characteristic analyses, were essentially higher for the alexithymic patients. Conclusions Alexithymic subjects without major depression may be rated as depressive if the only criterion is the score on a self-report scale. Furthermore, alexithymic patients may require higher cutoff points in a self-report depression scale.
Genes that regulate the serotonin signalling system are potential targets for research in the aetiology of mood disorders and also in the treatment response of serotonin reuptake inhibitors. In this ...study, we evaluated the association of seven serotonin signal transduction-linked single nucleotide polymorphisms HTR1A (rs6295), HTR2A (rs6313, rs6311 and rs7997012), HTR6 (rs1805054), TPH1 (rs1800532) and TPH2 (rs1386494) with major depressive disorder and/or treatment outcome with serotonin reuptake inhibitors. Patients who met the criteria for major depressive disorder were treated for 6 weeks with fluoxetine, paroxetine or citalopram. The treatment response was evaluated with the Montgomery-Asberg Depression Rating Scale, and according to predefined response criteria, the patients were divided into responders, nonresponders, remitters and nonremitters. Altogether, 86 patients completed the entire study according to the study protocol. We had also a control population (N = 395) of healthy blood donors. None of the seven single nucleotide polymorphisms was associated with major depressive disorder or with treatment response in our study population of Finnish individuals.
The relationship between life satisfaction and alexithymia was studied in a sample of 229 patients as a part of a naturalistic follow-up study of depression in Finnish primary health care. The ...measures were the abbreviated Life Satisfaction Scale and the 20-item Toronto Alexithymia Scale. Depression was assessed by telephone with the short form of the Composite International Diagnostic Interview. Of all subjects, 19.2% were alexithymic, and 9.2% were depressed. Alexithymia was negatively associated with life satisfaction even when depression and other confounding factors were controlled for. Alexithymia is a risk factor for life dissatisfaction in primary-care patients.
Abstract The functional val108/158met polymorphism of the COMT gene (rs4680) was evaluated in major depressive disorder (MDD), and in the treatment response to antidepressants in MDD. We could not ...demonstrate any significant difference in the distribution of this COMT single-nucleotide polymorphism (SNP) in the treatment response to selective serotonin reuptake inhibitors or between patients with MDD and control subjects.
The association between the tryptophan hydroxylase 1 (
TPH1) 218A/C polymorphism and (1) severity of major depressive disorder (MDD) and (2) response to treatment was studied. There were three study ...populations, the first consisting of 119 treatment-resistant MDD inpatients treated with electro-convulsive therapy (ECT), and the second of 98 MDD open care patients treated with selective serotonin reuptake inhibitors (SSRI). In addition, there was a control population of 395 healthy blood donors. The first aim of the study was to compare the genotypes of the patient with those of the healthy controls and between patient populations. The second aim was to compare the genotypes of MDD patients achieving remission with basic SSRI treatment (MADRS
<
8) with the genotypes of non-responders to ECT (defined as MADRS
>
15).
TPH1 218A/C polymorphism was associated with the risk of MDD. CC genotype was significantly more common in patients (including both ECT and SSRI treated patients) than in controls (38.2% and 26.8% respectively;
p
=
0.008), and its frequency was significantly higher in more severe forms of depression, i.e. in ECT treated patients compared with SSRI treated patients (42.0% and 33.7%,
p
=
0.026). CC genotype was also associated with lower probability of achieving remission. It was significantly more frequent among ECT non-responders than among SSRI remitters (53.1% and 23.3%,
p
=
0.049). In this Finnish population
TPH1 218A/C polymorphism was associated with the risk of MDD and treatment response; CC genotype was associated with the increased risk of MDD and lower probability of responding treatment. Further studies with larger samples will be required to confirm the results.
Background. There is a need for a simple depression questionnaire also capable of assessing the severity of depression. The Depression Scale (DEPS), has been a very popular self-rating depression ...questionnaire in Finland for >15 years. Objective. Our aim was to examine whether the DEPS has the ability to differentiate clearly defined levels of depression in primary care patients. Methods. Primary care patients aged 18–64 years completed a postal questionnaire including the DEPS. All screen-positive subjects and every 10th screen-negative subject were invited for interview using the Present State Examination (PSE) as the gold standard. Complete DEPS score was available for 410 patients. Descriptive statistics of the DEPS in the six diagnostic PSE classes were computed. Four of the PSE classes were selected for further analyses of depression severity. Receiver Operating Characteristic curves, sensitivity, specificity, ideal cut-off points and area under the curve were calculated. The ability of the DEPS to differentiate levels of functioning was also evaluated. Results. The DEPS identified three groups of patients: those with no psychiatric symptoms, those with some depressive symptoms and those with clinical depression. The margins between the levels were thin: the ideal cut-off point for clinical depression was 11/12 and for any level of depression 9/10. The DEPS was also able to differentiate three levels of functioning. Conclusions. The DEPS has some ability to identify severity of depression in primary care patients. Further research with larger unscreened material is called for.
The role of a functional polymorphism in the transcriptional control region of serotonin transporter gene (5-HTTLPR, SERTPR) has been studied intensively in major depression and in the response to ...selective serotonin inhibitors (SSRIs) in major depression. The findings have been contradictory, although majority of the studies indicate that the short allele is associated with poor response to SSRIs in major depression. In the present study, we evaluated the association of 5-HTTLPR with treatment response to SSRI medication in Finnish Caucasian MDD patients. A secondary purpose was to study the possible association of this particular polymorphism with major depressive disorder. The aim of the study was to replicate the previous findings in this area. Primary outcomes of the treatment were remission, defined by an exit score of seven or less, and response, defined by a reduction of at least 50% on the MADRS. We had also a control population of 375 healthy blood donors, as a secondary objective was to evaluate the possible association of this particular polymorphism with major depressive disorder. Twenty-nine of the 85 (34.1%) patients reached the remission and 58.8% achieved the predefined response criteria. The l/l genotype of 5-HTTLPR was presented in 51.7% of those patients who achieved remission vs. 25.0% in the non-remitters (
P
= 0.03). The result remained statistically significant after adjusting for age, gender, medication and MADRS points at the study entry. However, the small sample size limits the reliability of this result.
In major depression, one of the candidate genes possibly affecting the risk and severity of symptoms has been found to be tryptophan hydroxylase (TPH1). Variation in treatment response to ...antidepressive agents according to TPH1 genotype has also been found in several studies. However, the relationship between temperament and TPH1 genotype in major depression is poorly understood, as only one study has been published so far. There are no earlier studies on the interaction between temperament traits, antidepressive medication response and TPH1 genotype. This interaction was studied in 97 subjects with major depression treated for six weeks with selective serotonine reuptake inhibitors.
Temperament dimensions Harm Avoidance (HA), Novelty Seeking (NS), Reward Dependence (RD) and Persistence (P) scores at baseline (1) and endpoint (2) were rated with the Temperament and Character Inventory (TCI) and compared between TPH1 A218C genotypes. Multivariate analysis of co-variance (MANCOVA) was used to analyze the interaction between the TPH1 genotype, treatment response and the different temperament dimensions at baseline and endpoint. In the analysis model, treatment response was used as a covariate and TPH1 genotype as a factor. A post hoc analysis for an interaction between remission status and TPH1 A218C genotype at endpoint HA level was also performed.
The number of TPH1 A-alleles was associated with increasing levels in NS1 and NS2 scores and decreasing levels in HA1 and HA2 scores between TPH1 A218C genotypes. In the MANCOVA model, TPH1 genotype and treatment response had an interactive effect on both HA1 and HA2 scores, and to a lesser degree on NS2 scores. Additionally, an interaction between remission status and TPH1 A218C genotype was found to be associated with endpoint HA score, with a more marked effect of the interaction between CC genotype and remission status compared to A-allele carriers.
Our results suggest that in acute depression TPH1 A218C polymorphism and specifically the CC genotype together with the information on remission or treatment response differentiates between different temperament profiles and their changes.
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