The Relationship between Alexithymia and General Symptoms of Patients with Depressive Disorders

Objective

Depression has been associated with alexithymic features. However, few studies have investigated the differences in the general symptoms of patients with depressive disorders according to the presence of alexithymia. Thus, the aim of this study was to evaluate the relationship between alexithymia and symptoms experienced by patients with clinically diagnosed depressive disorders.

Methods

A chart review of patients who were evaluated using the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20) and Symptom Checklist 90-Revised (SCL-90-R) at the same time between the years 2003 and 2007 was conducted. A total of 104 patients with depressive disorders were included and divided into two groups: alexithymia (n=52) and non-alexithymia (n=52). A direct comparison between the two groups was carried out. Regression analysis was also carried out for the TAS-20 total and subset scores in order to model the relationship between alexithymia and symptoms.

Results

The presence of alexithymia was confirmed in 50% of the patients with depressive disorders, and the symptoms of depressive patients with alexithymia were more severe than those of their non-alexithymic counterparts on all 9 symptom domains of the SCL-90-R. Furthermore, regression analysis revealed that the presence of alexithymia was positively associated with depression, phobic anxiety, and psychoticism but inversely associated with anxiety.

Conclusion

These results suggest that the clinical features of depression are partially dependent on the presence of alexithymia. Alexithymic patients with depressive disorders are likely to show more severe depressive, psychotic, and phobic symptoms. In other words, clinicians should suspect the presence of alexithymic tendencies if these symptoms coexist in patients with depressive disorders and address their difficulties in effective communication.     

Alexithymia and Stress Response Patterns among Patients with Depressive Disorders in Korea

Objective

Alexithymic characteristics may represent cognitive and affective mediators between stressors and stress responses among those with depressive disorders. This study evaluated how alexithymic characteristics, as measured by the Korean version of the Toronto Alexithymia Scale-20 (TAS-20K), could be related to stress response patterns, as measured by the Stress Response Inventory (SRI), within a sample composed of individuals diagnosed with depressive disorders.

Methods

Participants comprised a cross section of patients diagnosed with depressive disorders (n=98). Data on demographic and psychosocial factors (i.e., sex, age, and level of education), clinical profiles {i.e., primary and comorbid psychiatric conditions meeting the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria at the time of the evaluation}, duration of illness, medications, and Clinical Global Impression (CGI) scores, and the results of psychological assessments (TAS-20K, SRI) were analyzed.

Results

Patients having depressive disorders with alexithymia obtained significantly higher scores in terms of all seven subscales of the SRI, as compared to those without alexithymia, a logistic regression model was used to assess possible predictors for the presence of alexithymia in patients with depressive disorders, including the seven subscales of the SRI, gender, age, and duration of illness. We found that aggressive and somatizing responses to stress were significantly associated with the presence of alexithymia among patients with depression.

Conclusion

These findings suggest that patients having depression with alexithymia were more susceptible to stress than those without alexithymia. Clinicians might improve their treatment of depression by identifying the clinical predictors for alexithymia and by helping those individuals demonstrating such symptoms in coping with emotionally stressful situations.     

Reliability and Validity of the 20-Item Toronto Alexithymia Scale in Korean Adolescents

Objective

Adolescence is a period of developing emotional regulation. However, alexithymia has rarely been examined during this period. The objective of this study is to examine the factor structure and internal consistency of the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K) in normal adolescents in South Korea.

Methods

The TAS-20K was administered to a sample of 290 adolescents aged from 12 to 16 years old. Internal reliability, test-retest reliability, and factorial validity were evaluated.

Results

The three factors of the TAS-20K were confirmed by confirmatory factor analysis. The internal consistency, measured using Cronbach''s alpha coefficient was acceptable for difficulty in identifying feelings, good for difficulty in describing feelings, and acceptable for externally oriented thinking.

Conclusion

Our study indicates that the TAS-20K is an appropriate instrument to assess alexithymia in Korean adolescents.     

The TAS-20 more likely measures negative affects rather than alexithymia itself in patients with major depression,panic disorder,eating disorders and substance use disorders

Background

This study evaluates whether the difference in Toronto Alexithymia Scale-20 item (TAS-20) between patients with major depression (MD), panic disorder (PD), eating disorders (ED), and substance use disorders (SUD) and healthy controls persisted after controlling for the severity of anxiety and depression.

Methods

Thirty-eight patients with MD, 58 with PD, 52 with ED, and 30 with SUD and 78 healthy controls (C) completed the TAS-20, the Hamilton Rating Scale for Anxiety (Ham-A), the Hamilton Rating Scale for Depression (Ham-D).

Results

The differences in TAS-20 scores observed between patient groups, regardless of the type of their disorders, and controls disappeared after controlling for the effect of anxiety and depression severity. In contrast, the differences in severity of anxiety and depression between patients and controls were still present, after excluding the effect of alexithymic levels.

Conclusions

Our data suggest that alexithymic levels, as measured by the TAS-20, are modulated by the severity of symptoms, supporting the view that alexithymia can represent a state phenomenon in patients with MD, PD, ED and SUD, because the TAS-20 seems overly sensitive to a general distress syndrome, and it is more likely to measure negative affects rather than alexithymia itself.     

Comorbid Depressive Disorders in ADHD: The Role of ADHD Severity,Subtypes and Familial Psychiatric Disorders

Objective

To evaluate the presence of Major Depressive Disorder (MDD) and Dysthymic Disorder (DD) in a sample of Italian children with Attention Deficit Hyperactivity Disorder (ADHD) and to explore specific features of comorbid depressive disorders in ADHD.

Methods

Three hundred and sixty-six consecutive, drug-naïve Caucasian Italian outpatients with ADHD were recruited and comorbid disorders were evaluated using DSM-IV-TR criteria. To evaluate ADHD severity, parents of all children filled out the ADHD Rating Scale. Thirty-seven children with comorbid MDD or DD were compared with 118 children with comorbid conduct disorder and 122 without comorbidity for age, sex, IQ level, family psychiatric history, and ADHD subtypes and severity.

Results

42 of the ADHD children displayed comorbid depressive disorders: 16 exhibited MDD, 21 DD, and 5 both MDD and DD. The frequency of hyperactive-impulsive subtypes was significantly lower in ADHD children with depressive disorders, than in those without any comorbidity. ADHD children with depressive disorders showed a higher number of familial psychiatric disorders and higher score in the Inattentive scale of the ADHD Rating Scale, than children without any comorbidity. No differences were found for age, sex and IQ level between the three groups.

Conclusion

Consistent with previous studies in other countries, depressive disorders affect a significant proportion of ADHD children in Italy. Patient assessment and subsequent treatment should take into consideration the possible presence of this comorbidity, which could specifically increase the severity of ADHD attention problems.     

Alexithymia in the medically ill. Analysis of 1190 patients in gastroenterology,cardiology, oncology and dermatology

Objective

To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria.

Method

Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis.

Results

Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%).

Conclusions

The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.     

Effects of inpatient psychotherapy on the stability of alexithymia characteristics

Background

Although alexithymia is associated with several psychiatric disorders, there has been little research into the effects of psychodynamic psychotherapies on this condition. Here, the influence of inpatient multimodal psychodynamic psychotherapy on alexithymia and symptom load was evaluated in a large sample of patients.

Methods

Alexithymia [measured with the Toronto Alexithymia Scale (TAS)-26] and psychological stress and depression [measured with the Symptom Checklist 90 Revised (SCL-90-R)] were evaluated at admission and after inpatient multimodal psychotherapy in patients with various psychosomatic and psychiatric disorders admitted to this unit between 2002 and 2005. Patients undergoing both short-term (up to 4 weeks) and long-term treatment (8-12 weeks) were studied. Analyses of covariance were used to analyse the data on depression (SCL-90-R) and psychological stress (SCL-90-R), and correlations between admission and discharge scores for the TAS-26 were computed to evaluate mean and relative stability of alexithymia.

Results

Data on 397 of the 568 patients admitted were analysed. Psychological stress and depression (SCL-90-R) decreased significantly during the study across all diagnostic groups. The TAS-26 total score also decreased significantly, showing that there was no mean stability of alexithymic characteristics. However, the significance of decrease was lost when psychological stress and depression were controlled for. Highly significant correlations between TAS-26 sores before and after treatment reflected high relative stability of alexithymia.

Conclusions

During inpatient multimodal psychodynamic treatment, the symptom load and alexithymia in our patients decreased. The high relative stability of alexithymia shown supports the view that alexithymia is a relative stable personality trait.     

Depressed REM Sleep Behavior Disorder Patients Are Less Likely to Recall Enacted Dreams than Non-Depressed Ones

Objective

REM sleep behavior disorder (RBD) is associated with psychiatric symptoms, such as anxiety and alexithymia. However, only a few studies on the relationship between depression and RBD have been published. In this study, we investigated the occurrence of depression and associated factors in patients with RBD.

Methods

In total 94 patients (mean age: 61.9±12.7 years, male: 70.2%) diagnosed as RBD were examined using detailed clinical histories, the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), and nocturnal polysomnography (PSG).

Results

The mean BDI score of all patients was 12.4±10.3 and 44.7% of RBD patients showed depressed mood (BDI >11 points). Depressed RBD patients were less able to recall enacted dreams than were non-depressed patients (61.9% vs. 86.5%, p=0.008). Logistic regression analysis showed that failure to recall enacted dreams was significantly associated with depression, after controlling for confounding variables including the respiratory disturbance index and a history of psychiatric disorders (odds ratio=0.323, p=0.041).

Conclusion

In this study, 44.7% of RBD patients were found to suffer from depressed mood. And, depression was found to be associated with reduced ability to recall enacted dreams. We suggest that routine evaluation of depression be performed in RBD patients, particularly when failure to recall enacted dreams is evident. We speculate that such failure may be associated with emotional dysregulation or neurodegeneration.     

Suicidal Behaviour in Mood Disorders—Who,When, and Why?

Objective:

About one-half to two-thirds of all suicides are by people who suffer from mood disorders; preventing suicides among those who suffer from them is thus central for suicide prevention. Understanding factors underlying suicide risk is necessary for rational preventive decisions.

Method:

The literature on risk factors for completed and attempted suicide among subjects with depressive and bipolar disorders (BDs) was reviewed.

Results:

Lifetime risk of completed suicide among psychiatric patients with mood disorders is likely between 5% and 6%, with BDs, and possibly somewhat higher risk than patients with major depressive disorder. Longitudinal and psychological autopsy studies indicate suicidal acts usually take place during major depressive episodes (MDEs) or mixed illness episodes. Incidence of suicide attempts is about 20- to 40-fold, compared with euthymia, during these episodes, and duration of these high-risk states is therefore an important determinant of overall risk. Substance use and cluster B personality disorders also markedly increase risk of suicidal acts during mood episodes. Other major risk factors include hopelessness and presence of impulsive–aggressive traits. Both childhood adversity and recent adverse life events are likely to increase risk of suicide attempts, and suicidal acts are predicted by poor perceived social support. Understanding suicidal thinking and decision making is necessary for advancing treatment and prevention.

Conclusion:

Among subjects with mood disorders, suicidal acts usually occur during MDEs or mixed episodes concurrent with comorbid disorders. Nevertheless, illness factors can only in part explain suicidal behaviour. Illness factors, difficulty controlling impulsive and aggressive responses, plus predisposing early exposures and life situations result in a process of suicidal thinking, planning, and acts.     

There Is No Difference in IQ between Suicide and Non-Suicide Psychiatric Patients: A Retrospective Case-Control Study

Objective

The goal of this study was to examine the association between IQ and suicide in psychiatric patients.

Methods

We conducted a nested case-control study using data obtained from psychiatric patients affiliated with a general hospital in Seoul, Korea. In a one-to-two ratio the psychiatric patients who died of suicide (Suicide Group; n=35) were matched to those who didn''t (Non-suicide Group; n=70) by age, gender, psychiatric diagnosis and approximate time of first treatment. IQ was measured using the Korean version of the Wechsler Adult Intelligence Scale-Revised.

Results

There were no significant differences in any type of IQ between suicide patients and non-suicide patients. Logistic regression showed no evidence of an association between IQ and suicide.

Conclusion

These results do not support the existence of an association between IQ and suicide.     

Korean Self-Report Version of the Yale-Brown Obsessive-Compulsive Scale: Factor Structure,Reliability, and Validity

Objective

Although several self-report versions of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have been developed and used widely, few psychometric studies have established the construct validity of this measure. Therefore, we developed Korean self-report version of the Y-BOCS and evaluated its factor structure, reliability, and validity.

Methods

A non-clinical student sample (n=206) and a clinical OCD sample (n=199) completed the Korean self-report version and other measures of obsessive-compulsive disorder (OCD), depression, and anxiety.

Results

Consistent with the originally proposed structure, confirmatory factor analyses supported a factor structure comprised of Obsessions and Compulsions factors in the Korean self-report version. Two subscale scores and the total score of the Korean self-report version showed good internal consistency and convergent validity, but relatively poor discriminant validity. Applying a cutoff score of 16, 84% of OCD patients and 93% of the non-clinical sample were classified correctly.

Conclusion

Korean self-report version of the Y-BOCS is a psychometrically sound and valid measure for assessing OCD symptoms as compared with the clinician-administered version. The originally proposed division of OCD severity into obsessions and compulsions appears accurate in the Korean self-report version. The cutoff score for the Korean self-report version needs adjustment based on further researches.     

Type 1 diabetes is associated with alexithymia in nondepressed, non-mentally ill diabetic patients: A case-control study

Objective

Alexithymia refers to difficulty in identifying and expressing emotions, and it is a characteristic common to several psychiatric and medical conditions, including autoimmune disorders. Type 1 diabetes (T1D) is an autoimmune disorder with increased psychiatric comorbidity. Previously reported associations between alexithymia and T1D may have been confounded by the presence of depression. The central aim of this study was to examine alexithymia levels in psychiatrically uncomplicated T1D outpatients with that of nondiabetic controls.

Methods

Ninety-six T1D patients without any DSM-IV Axis I diagnoses and 105 age- and sex-matched healthy controls entered the study. Alexithymia and depressive symptoms were assessed with the Toronto Alexithymia Scale (TAS-20) and the Beck Depression Inventory (BDI-21), respectively. Multivariate regression models were used to evaluate the association of alexithymia with the presence of diabetes, duration of diabetes, diabetes control, parameters of treatment intensification, and diabetic complications.

Results

T1D was positively associated with the TAS-20 “identifying feelings” (β coefficient=2.64, P=.003) and “externally oriented thinking” (β coefficient=1.73, P=.011) subscales. The prevalence of overall alexithymia (TAS-20 total score, ≥60) was 22.2% in T1D patients and 7.6% in the controls (OR, 4.6; 95% CI, 1.7-12.8). TAS-20 scores were positively associated with diabetes duration and negatively with treatment intensification parameters.

Conclusions

Alexithymia is higher in psychiatrically uncomplicated T1D patients than in healthy controls even after adjustment for confounding depressive symptoms; it is greater with longer diabetes duration and is associated with some reduced parameters of treatment intensification but not with worse outcome in terms of glycemic control or somatic complications.     

Impact of White Matter Lesions on Depression in the Patients with Alzheimer's Disease

Objective

Comorbid depression is common in patients with Alzheimer''s disease (AD). An increase in white matter lesions (WMLs) has been associated with depression in both elderly individuals with normal cognition and patients with Alzheimer''s disease. We investigated whether the severity and location of WMLs influence the association between WMLs and comorbid depression in AD.

Methods

We enrolled 93 AD patients from Seoul National University Bundang Hospital. We administered both the Mini International Neuropsychiatric Inventory (MINI) and the Korean version of the Consortium to Establish a Registry for Alzheimer''s Disease Assessment Packet (CERAD-K) clinical and neuropsychological battery. Subjects also underwent brain magnetic resonance imaging (MRI). We diagnosed AD according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer''s Disease and Related Disorders Association. We diagnosed depressive disorders according to the DSM-IV diagnostic criteria, and evaluated the severity of depressive symptoms using the Korean version of the Geriatric Depression Scale (GDS-K). We quantified the WML volumes from the brain MRI using a fully automated segmentation algorithm.

Results

The log of the WML volume in the frontal lobe was significantly associated with depressive disorders (odds ratio=1.905, 95% CI=1.027-3.533, p=0.041), but not with the severity of depressive symptoms as measured by the GDS-K.

Conclusion

The WML volume in the frontal lobe conferred a risk of comorbid depressive disorders in AD, which implies that comorbid depression in AD may be attributed to vascular causes.     

Standardization of the Korean Version of the Posttraumatic Embitterment Disorder Self-Rating Scale

Objective

Embitterment is a persistent feeling of being let down or insulted, feeling like a "loser", or feeling revengeful but helpless. In South Korea, social injustice experienced during rapid industrial development and protracted unemployment during the Asian economic crisis may lead to strong feelings of embitterment. North Korean defectors and victims of industrial disasters may also experience humiliation and feelings of injustice. Posttraumatic Embitterment Disorder (PTED) is a recent conceptualization of a new psychiatric disorder. This study tested the reliability and validation of the Korean version of the PTED Scale.

Methods

Subjects aged 18 years or older were recruited from a psychiatric outpatient clinic. All subjects were diagnosed with a depressive disorder. Subjects completed the Korean version of the PTED Scale, the Patient Health Questionnaire (PHQ-9) and the Patient Health Questionnaire (PHQ-15) at baseline and two weeks later.

Results

Approximately 15.4% of subjects could be categorized as having PTED. The test-retest reliability of the PTED Scale was good (r=0.76) and the internal consistency was very high (Cronbach''s alpha=0.962). Positive correlations were found between the PTED Scale, the PHQ-9 and the PHQ-15, indicating substantial convergent validity of the PTED Scale.

Conclusion

The Korean version of the PTED Scale is a reliable and valid measurement of embitterment in Korean adults as an emotional reaction to a negative life event.     

The Relationships between Early Trauma,Dissociation, and Alexithymia in Alcohol Addiction

Objective

Addiction is often considered a dissociative behavior that is related to alexithymia and developmental trauma. The study aims were to explore the relationships between early trauma, alexithymia, and dissociation.

Methods

A total of 117 (males=60; females=57) alcohol-addicted individuals and 117 healthy individuals (males=60; females=57) were administered a series of self-report questionnaires that assess traumatic experiences, alexithymia, and pathological dissociation.

Results

Correlation analyses indicated significant correlations between alexithymia, dissociation, and trauma and a significant difference between the target and control groups, with higher alexithymia and dissociation scores in the target group.

Conclusion

These findings suggest that trauma, alexithymia, and dissociation are predictors of alcohol addiction.     

Psychometric Properties of the 20-Item Toronto Alexithymia Scale in a Group of Italian Younger Adolescents

Objective

Alexithymia is a personality construct that inhibits and interferes with normal affect regulating abilities. The purpose of our study was to assess psychometric properties of TAS-20 in younger adolescents.

Methods

Data were collected from 508 younger adolescents (48.8% male and 51.2% female) with a mean age of 12.56 years (DS=0.50, range: 12-13 years). We administered the following scales: 20-Item-Toronto Alexithymia Scale.

Results

The confirmatory factor analysis performed on the second random subsample showed reasonable goodness-of-fit for the oblique bi-factorial model: [chi]² (32, n=254)=54.22; p=0.008; χ²/df=1.69; NNFI=0.92; CFI=0.95; SRMR=0.05; RMSEA=0.05; 90% confidence interval=0.027-0.078.

Conclusion

Based on the outcomes of our research we support the idea of evaluating adolescents for alexithymia.     

How Childhood Maltreatment Is Related to Suicidality,Bipolarity and Central Serotonergic Activity in Patients with Major Depressive Disorder: A Cross-Sectional Pilot Study

Objective

The aims of this study were to determine whether childhood maltreatment contributes to the occurrence of major depressive disorder (MDD) with bipolarity, and whether there is a relationship between central serotonergic activity, as assessed using loudness dependence of auditory evoked potentials (LDAEP), and childhood maltreatment.

Methods

Thirty-five MDD patients were stratified according to the presence or absence of childhood trauma into two subgroups, childhood trauma (CT) and no childhood trauma (NCT), using the Korean version of the Childhood Trauma Questionnaire (K-CTQ). The CT group was subjected to further analysis. Several psychometric ratings were also applied. In addition, auditory processing for the loudness dependence of auditory evoked potentials (LDAEP), which was used as a marker of serotonergic activity, was measured before beginning medication.

Results

There was a significant difference in total Korean Bipolar Spectrum Disorder Scale score between the CT and NCT groups (t=-2.14, p=0.04). The total K-CTQ score was positively correlated with the total Beck Scale for Suicidal Ideation (BSS) score (r=0.36, p=0.036). In particular, emotional abuse was positively correlated with the total Barratt Impulsiveness Scale (r=0.38, p=0.026), BSS (r=0.38, p=0.025), and Hamilton Depression Rating Scale (HAMD) (r=0.36, p=0.035) scores. There was also a positive correlation between LDAEP and total Hypomania Personality Scale (r=0.49, p=0.02) and HAMD (r=0.58, p=0.004) scores within CT group.

Conclusion

The findings of this study support that there is a relationship between childhood maltreatment and bipolarity in patients with MDD.     

Subjective Cognitive Complaints and Functional Disability in Patients With Borderline Personality Disorder and Their Nonaffected First-Degree Relatives

Objective:

To examine the contributions of subjective cognitive complaints to functional disability in patients with borderline personality disorder (BPD) and their nonaffected relatives.

Method:

Patients with BPD (n = 26), their first-degree biological relatives (n = 17), and nonpsychiatric control subjects (n = 31) completed a self-report measure of cognitive difficulties and rated the severity of their functional disability on the World Health Organization Disability Assessment Schedule 2.0.

Results:

After accounting for group differences in age and severity of depressive symptoms, patients and relatives endorsed more inattention and memory problems than control subjects. Whereas probands reported greater disability than relatives and control subjects across all functional domains, relatives described more difficulties than control subjects in managing multiple life activities, including domestic activities and occupational and academic functioning, and participating in society. For both probands and relatives, inattention and memory problems were linked primarily to difficulties with life activities, independent of depression and other comorbid psychiatric disorders.

Conclusions:

Problems with inattention and forgetfulness may lead to difficulties carrying out activities of daily living and occupational or academic problems in patients with BPD, as well as their nonaffected first-degree relatives.     

Can the Loudness Dependence of Auditory Evoked Potentials and Suicidality Be Used to Differentiate between Depressive Patients with and without Bipolarity

Objective

This study aimed to test the hypothesis that the loudness dependence of auditory evoked potentials (LDAEP) can be used to predict the presence of bipolarity in patients with major depressive episodes.

Methods

A cohort of 61 patients who met the criteria for major depressive disorder (MDD) following diagnosis using Axis I of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders-text revision, and who had no history of hypomanic or manic episodes was included in this study. The patients were stratified into two subgroups based on whether or not they achieved a positive score for the Korean versions of the Mood Disorder Questionnaire (K-MDQ). The LDAEP was evaluated by measuring the auditory event-related potentials before beginning medication with serotonergic agents.

Results

The Barratt Impulsiveness Scale (BIS) score was also higher for the positive screening group (81.24±11.87) than for the negative screening group (73.30±14.92; p=0.039, independent t-test). However, the LDAEP, Beck Depression Inventory, Hamilton Depression Rating Scale, Beck Hopelessness Scale (BHS), and Hamilton Anxiety Scale scores did not differ significantly between them. When binary logistic regression analysis was carried, the relationship between the positive or negative subgroups for K-MDQ and BIS or Beck Scale for Suicidal Ideation (BSS) score was also significant (respectively, p=0.017, p=0.038).

Conclusion

We found that LDAEP was not significantly different between depressive patients with and without bipolarity. However, our study has revealed the difference between two subgroups based on whether or not they achieved a positive score for the K-MDQ in BIS or BSS score.     

Genetic Role of BDNF Val66Met and 5-HTTLPR Polymorphisms on Depressive Disorder

Objective

We investigated possible association between depressive disorders and BDNF Val66Met and 5-HTTLPR. Brain derived neurotrophic factor (BDNF) gene and serotonin transporter (SLC6A4) gene are promising candidate genes for depressive disorders. It has been suggested that BDNF promotes the survival and differentiation of serotonergic neurons and that serotonergic transmission exerts powerful control over BDNF gene expression.

Methods

Final analyses were performed on 186 patients with depressive disorders and 1032 controls. Val66Met polymorphism of BDNF gene and 5-HTTLPR polymorphism of serotonin transporter gene were genotyped and allele and genotypic associations on the diagnosis of depression and age at onset of depression were analyzed.

Results

The 5-HTTLPR was positively associated with depressive affected status in the total sample and in females (p=0.038 for allelewise, p=0.015 for genotype-wise associations), but, not in males. The BDNF Val66Met showed no association with depression. BDNF Val66Met and 5-HTTLPR alone were not associated with age at onset of depression. Additional analysis on the interaction between BDNF Val66Met and 5-HTTLPR found a significant association with age at onset of depression in the entire patient group. This association was also found in the female but not in the male patient group. None of the positive results survived Bonferroni correction for multiple testing.

Conclusion

This result suggested that BDNF Val66Met and 5-HTTLPR may contribute to depressive disorders in a complex way and that the genetic effect could differ by gender. Further studies with large number of patients will be necessary.