Physical Activity,Gender Difference,and Depressive Symptoms

Objective

To investigate the roles of physical activity (exercise) and sociodemographic factors in depressive symptoms among men and women in the United States.

Data Source

2011 U.S. Behavioral Risk Factor Surveillance System (BRFSS).

Study Design

Patient Health Questionnaire Depression Scale (PHQ-8) scores are aggregated and divided into five categories. An ordered switching probability model with binary endogenous physical activity is developed to accommodate ordinality of depression categories and ameliorate statistical biases due to endogeneity of physical activity.

Principal Findings

Average treatment effects suggest physical activity ameliorates depressive symptoms among mildly and moderately depressed individuals, most notably among mildly depressed women. Gender differences exist in the roles of sociodemographic factors, with age, income, race, education, employment status, and recent mental health condition playing differentiated roles in affecting depressive symptoms.

Conclusions

Regular physical activity reduces depressive symptoms among both men and women with mild to moderate depression, notably among women.     

奥氮平与利培酮治疗精神分裂症抑郁症状的比较研究

目的:对照比较奥氮平与利培酮对精神分裂症抑郁症状的疗效。方法:66例精神分裂症伴抑郁症状的患者随机分为奥氮平组和利培酮组,各33例,均治疗8周,分别于治疗前和治疗后2、4、6、8周以阳性与阴性症状量表(PANSS)及汉密尔顿抑郁量表(HAMD)评定临床疗效;以治疗中出现的症状量表(TESS)评定不良反应,并体格检查及实验室检查,记录不良事件的发生。结果:治疗后两组患者PANSS和HAMD评分均显著下降,奥氮平组优于利培酮组,两组发生不良反应率无显著差异。结论:奥氮平治疗精神分裂症抑郁症状疗效优于利培酮疗效。     

盐城市小学生抑郁症状及相关行为研究

目的：了解盐城市小学生抑郁症状发生现况,探讨相关的影响因素。方法采用儿童抑郁量表(CDI)及自编问卷对盐城市2362名小学生进行抑郁症状及其行为生活方式等情况调查。结果盐城市小学生的抑郁症状总体检出率为10.7%,其中男生12.0%,女生10.1%,男生高于女生。多因素 Logistic 分析结果显示,男性、睡眠质量差、不是每天吃早餐、课外学习时间≥2 h/d、每次电脑游戏≥2 h 以及不锻炼是抑郁症状发生的危险因素,OR 值分别为1.34,2.04,4.05,1.65,1.90,1.45。结论合理安排小学生课外学习时间、增加体育锻炼、加强心理疏导以及避免沉溺电脑游戏是避免和预防小学生抑郁症状发生的有效途径。     

帕罗西汀治疗脑卒中后抑郁症的临床疗效和安全性分析

目的：探讨帕罗西汀治疗脑卒中后抑郁症的临床疗效和安全性。方法选取2010年9月—2012年3月于徐州市电力医院就诊的73例脑卒中后抑郁症患者,随机分为对照组34例和治疗组39例。对照组给予常规神经系统药物及对症支持治疗,治疗组在对照组基础上给予帕罗西汀治疗,比较两组患者的临床疗效及治疗前后的神经功能缺损（NIHSS）评分、抑郁自评量表（SDS）评分、生活质量评定量表（ADL）评分、汉密尔顿抑郁量表（HAMD）评分。结果治疗组总有效率（92.3%）高于对照组（70.6%）,治疗后 SDS、NIHSS、HAMD 评分低于对照组,ADL评分高于对照组,躯体功能、生理功能、社会功能、物质生活得分均高于对照组,差异均有统计学意义（P ＜0.05）。结论帕罗西汀治疗脑卒中后抑郁症具有显著疗效,可明显改善患者焦虑、抑郁情绪,安全性高。     

SOD2 genetic polymorphism (rs4880) has no impact on 6‐month response to antidepressant treatment and inflammatory biomarkers in depressed patients

Two thirds of patients suffering from a major depressive episode (MDE) do not reach a complete response with antidepressant drugs. This lack of response is due to several factors, including genetic determinants. Since major depressive disorder is associated with inflammatory and oxidative stress abnormalities, the metabolism of superoxide anions might be involved in non‐response to antidepressant drugs. Superoxide anions are metabolized by manganese‐dependent superoxide dismutase (SOD2) in the mitochondria. A functional genetic polymorphism (SOD2, rs4880), responsible of a 40% reduction in enzyme activity, is associated with anti‐inflammatory response of rosuvastatin. We investigated the association of ala‐allele of SOD2 rs4880 and both antidepressant efficacy and inflammatory parameters in patients treated for a MDE with antidepressant drugs. The Hamilton Depression Rating Scale (HDRS) score and levels of plasma CRP and inflammatory cytokines were assessed at baseline, one month (M1), 3 months (M3) and 6 months (M6) after antidepressant treatment. They were compared according to SOD2 genetic polymorphism. Of the 484 patients studied, 361 (74.6%) carried the ala‐allele (Ala group), 123 (25.4%) of them had Val/Val genotype (Val/Val group). No significant difference was observed between the Ala and Val/Val groups neither for baseline clinical characteristics, nor for HDRS scores, response/remission rates, plasma CRP and cytokine levels throughout the study. The rs4880 SOD2 genetic polymorphism was not associated with the clinical response and cytokines levels after antidepressant treatment. These data suggest that SOD2 is not a major genetic determinant of antidepressant response. Other genes of the oxidative stress pathways should be explored in further studies.     

喹硫平与丙戊酸钠缓释片在双相情感障碍躁狂发作治疗中的疗效比较

目的 对比分析喹硫平与丙戊酸钠缓释片在双相情感障碍躁狂发作治疗中的临床疗效。方法 52例双相情感障碍躁狂发作患者,采用随机数字表法分为A组和B组,每组26例。A组患者采用喹硫平治疗, B组患者采用丙戊酸钠缓释片治疗。比较两组患者临床疗效及贝克-拉范森躁狂量表(BRMS)评分降低1/2时间、治疗前后炎症因子水平、不良反应发生情况。结果 A组患者总有效率为96.15%,与B组的92.31%比较差异无统计学意义(χ^2=0.354, P=0.552>0.05)。A组患者BRMS评分降低1/2时间为(2.32±0.57)周,短于B组的(3.87±0.67)周,差异具有统计学意义(t=8.985, P=0.000<0.05)。治疗前,两组患者白细胞介素-1(IL-1)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)水平比较差异无统计学意义(P>0.05);治疗后,两组患者IL-1、TNF-α水平低于本组治疗前, IL-10水平高于本组治疗前,且A组患者IL-1、TNF-α水平低于B组, IL-10水平高于B组,差异具有统计学意义(P<0.05)。A组患者不良反应发生率为3.85%,低于B组的30.77%,差异具有统计学意义(χ^2=6.584, P=0.010<0.05)。结论 喹硫平与丙戊酸钠缓释片治疗双相情感障碍躁狂发作疗效相当,但喹硫平的起效时间更快,能够显著改善炎症因子水平,且不良反应更少,这对于控制病情发展具有更高的临床应用价值。     

Body-image dissatisfaction is strongly associated with chronic dysphoria

Background

Individual depressive symptoms may contribute to the risk of chronic depression. This study aimed to explore which symptoms predict chronic dysphoria, a hallmark of depression.

Methods

1057 participants from the population-based Young Finns study were examined for four times during a 16-year period. Those with a modified Beck’s Depression Inventory score in the upper third at all four screenings were considered to have chronic dysphoria (n=135). Participants with only one high depression score formed the reference group of transient dysphoria (n=179). Individual items of the Inventory were analyzed in terms of their association with dysphoria status and chronicity, controlling for potential confounding factors, such as personality assessed using the Temperament and Character Inventory.

Results

Body-image dissatisfaction was strongly associated with chronically elevated dysphoria (Bonferroni-corrected p=0.006). The degree of body-image dissatisfaction was associated with the probability for chronic dysphoria in a dose–response manner, with the estimated probability ranging from 0.01 to 0.60 as a function of item response. The association remained after adjustments for a wide range of personality characteristics.

Limitations

The study relied on self-reports of mood and personality, and lacked information on external opinion on participants appearances. The requirement of full time-series data may have resulted in attrition-related bias.

Conclusions

Body-image dissatisfaction was a strong predictor of chronic depression characterized by dysphoria. This finding suggests that dysfunctional attitude towards oneself might represent a potentially important target for cognitive therapies and preventive interventions.     

DSM-5 mixed specifier for manic episodes: Evaluating the effect of depressive features on severity and treatment outcome using asenapine clinical trial data

Background

To describe the frequency of mixed specifier as proposed in DSM-5 in bipolar I patients with manic episodes, and to evaluate the effect of mixed specifier on symptom severity and treatment outcome.

Methods

This post-hoc analysis used proxies for DSM-5 mixed features specifier by using MADRS or PANSS items.

Results

Of the 960 patients analysed, 34%, 18% and 4.3% of patients, respectively, had ≥3 depressive features with mild (score ≥1 for MADRS items and ≥2 for PANSS item), moderate (score ≥2 MADRS, ≥3 PANSS) and severe (score ≥3 MADRS, ≥4 PANSS) symptoms. In patients with ≥3 depressive features and independent of treatment: MADRS remission (score ≤12) rate decreased with increasing severity (61–43%) and YMRS remission (score ≤12) was similar for mild and moderate patients (36–37%), but higher for severe (54%). In asenapine-treated patients, the MADRS remission rate was stable regardless of baseline depressive symptom severity (range 64–67%), whereas remission decreased with increasing severity with olanzapine (63–38%) and placebo (49–25%). Reduction in YMRS was significantly greater for asenapine compared with placebo at day 2 across the 3 severity cut-offs and continued to decrease throughout the treatment period. The difference between olanzapine and placebo was statistically significant in mild and moderate patients.

Limitations

Results are from post-hoc analyses.

Conclusions

These analyses support the validity of proposed DSM-5 criteria. They confirm that depressive features are frequent in bipolar patients with manic episodes. With increasing baseline severity of depressive features, treatment outcome was poorer with olanzapine and placebo, but remained stable with asenapine.