Exercise as a treatment for depression: An update

The traditional treatments for nonbipolar affective disorders have been pharmacological. Recently, a number of well-designed studies have demonstrated the efficacy of different nonpharmacological treatments for depression. Exercise has been among the more novel approaches to the treatment of depression, and the antidepressant effects of exercise have received considerable popular attention. The early research reports on the effects of exercise on depression suffer from conceptual confusion and methodological problems. An appraisal of recent research, however, provides grounds for cautious optimism regarding the potential therapeutic effects of exercise.     

Handedness: An alternative hypothesis

Handedness data collected during the Hawaii Family Study of Cognition were congruent with similar data from major published studies. Mixed-model segregation analysis did not detect a significant major gene or polygenes contributing to handedness and partitioned the total phenotypic variation into 10–20% genetic and 80–90% environmental components. No relationship between handedness and cognitive ability was detected, but significant relationships between birth stress and offspring handedness were found. There was a significant decline in the percentage of left-handed individuals grouped by advancing age. A hypothesis of handedness is proposed in which left-handedness results from a combination of genotype, birth experience, and maternal example.The results reported here were made possible by collaboration of a group of investigators (G. C. Ashton, R. C. Johnson, M. P. Mi, and M. N. Rashad at the University of Hawaii, and J. C. DeFries, G. E. McClearn, S. G. Vandenberg, and J. R. Wilson at the University of Colorado) supported by National Science Foundation Grant GB 34720 and National Institute of Child Health and Human Development Grant HD 06669.     

Anxiety and depression in juvenile diabetes: a critical review

A critical examination of the recent literature on anxiety and depression in juvenile diabetes is presented. The objectives of this review are: (1) to determine the general association of psychological factors, especially anxiety and depression, with diabetes, (2) to examine the specific association of anxiety and depression with metabolic control, and (3) to propose methodological changes that are needed to advance future research in this field. The major conclusions of this review support the notion of a general association of psychological disorders with juvenile diabetes. However, while anxiety and depression appear to play an important and complex role in determining adaptation to the disease, their relationship to metabolic control does not yet appear clear. Additional prospective and controlled studies as well as multivariate models of chronic disease are now necessary to more fully understand the etiology and impact of these disorders in the adolescent population.     

Postnatal undernutrition: An alternative method

Rat pups were undernourished from birth by placing them for 12 hr/day with a normal lactating mother and 12 hr/day with a nipple-ligated mother each day for 25 days. The method resulted in a marked delay in the body growth of the undernourished pups, especially during the first 2 weeks of life. Observations of the behavior of the mothers towards the underfed pups were made at different times of the day and compared to the behavior of the mothers suckling well-fed pups. The results show that (1) nipple-ligated mothers are able to provide adequate maternal care for undernourished pups, and (2) both ligated and nonligated mothers caring for underfed pups spend more time with those pups than mothers caring for well-fed pups.     

The cip battery: Identification of depression in a juvenile delinquent population

Delinquent adolescents (N = 32) aged 10-16 were given a battery of three psychometric measures to determine characteristics of depressive symptomatology. The CIP battery consisted of the Children's Depression Inventory the Nowicki-Strickland Locus of Control Scale, and the Piers-Harris Self-Concept Scale. On the three measures the delinquent adolescent sample showed evidence of reduced self-esteem, depressive symptomatology, and characteristically external locus of control orientation. Implications for identification and remediation using this battery are discussed.     

Complementary and alternative medicine for perinatal depression

INTRODUCTION: Perinatal Major Depressive Disorder (MDD) is common and poses particular treatment dilemmas. Complementary and Alternative Medicine (CAM) treatments are widely used, accessible, and understudied for well-defined psychiatric indications. Women are more likely than men to both suffer from MDD and use CAM. METHODS: A PubMed/Medline search was conducted to assess the evidence base for commonly utilized CAM treatments, MDD, and perinatal depression. RESULTS: Among CAM treatments, omega-3 fatty acids have received the most specific study in terms of epidemiological, preclinical, and clinical research for perinatal depression. Three randomized placebo-controlled trials have been conducted in which investigators assessed omega-3 fatty acids vs. placebo for perinatal depression, with conflicting results. CAM interventions that can be easily added to a treatment plan with little risk and general health benefits for most women include omega-3 fatty acids, exercise, and folate, although data are insufficient at this time to recommend any of these as monotherapy for perinatal depression. S-adenosyl-methionine (SAMe) and bright light therapy may be reasonable to consider based on the evidence in MDD. St. John's Wort requires further study with regard to safety in pregnancy, and drug interactions can be a potential problem. DISCUSSION: Further study is required to elucidate the role of CAM treatments for perinatal depression, and the clinical context of perinatal depression requires safe, effective, and accessible treatment options.     

Prostaglandins and aspirin: An alternative view

The hypothesis that the anti-inflammatory and anti-rheumatic actions of aspirin are due to an inhibition of prostaglandin synthetase activity is discussed critically.     

Measuring contraceptive values: An alternative approach

Previous assessments of individuals' values for various contraceptive consequences have employed one of four methodologies: free elicitation, direct ratings, multiple regression, or factor analysis. All four methodologies are flawed because they produce group rather than individual values, rely on rating scales, and fail to incorporate information regarding consequence trade-offs. Axiomatic conjoint measurement is proposed as an alternative methodology and used to determine individuals' values for a selected set of contraceptive consequences at two stages of the family-planning career.Preparation of this paper was supported in part by Grants HD-10802 and HD-14403 from the National Institute of Child Health and Human Development. Appreciation is due the Statistical Computing Facility of the University of California at Berkeley. Requests for reprints should be sent to the Publications Librarian, Center for Research on Judgment and Policy, Muenzinger Psychology Building, University of Colorado, Boulder, Colorado 80309-0344.     

Mechanism of chemical carcinogenesis: An alternative hypothesis

Ultimate carcinogens are usually very reactive electrophilic species and therefore of transient existence in the cell. Both because of the biological reactivity and the inherent danger in their reaction with DNA, direct interaction with the latter is prevented, especially in higher mammalian cells, by various cell defence mechanisms and, lastly, by a nuclear membrane monitoring system. Hence, reaction of chemical carcinogen with nuclear DNA is possible only when the cell is overwhelmed leading to cell death, or following a temporary breach of the nuclear membrane control points, but the DNA damage in the latter is totally reparable. Both situations are therefore of no consequence to chemical carcinogenesis. Instead, the excess electrical charge created by the physical presence of the electrophilic carcinogens is hypothesized to predispose the cell to irreversible genetic changes like cellular oncogene activation, or uncontrolled cell proliferation common to cancerous cells. These effects would be catalyzed by a Na+-H+ exchange-mediated intracellular alkalinization resulting from the cell's attempt to restore electrical neutrality by elevating the Na(+)-pump activity, fuelled by an increased Na+/H+ antiport.     

An effective and acceptable treatment alternative for chronic thumb- and finger-sucking

Evaluated treatment for thumb-sucking in a randomized trial. Study included 22 children, ages 4-11, who displayed chronic thumb-sucking. Treatment included aversive taste and a reward system. Significant results were obtained at posttest, with 12 cessations at 3-month follow-up and 20 at 1 year. Participating parents, pediatricians, and pediatric psychologists validated treatment acceptability. Results support the treatment as an alternative to common medical and dental advice about thumb-sucking. Directions for future research are discussed.     

Complex depression: The treatment of major depression and severe personality pathology

The intensive treatment of a patient presenting with major depression, chronic suicidal ideation, and a borderline personality disorder with narcissistic features is described as it developed over an 18-month treatment. The treatment approach is a transdiagnostic one with an emphasis on change in the patient's representation of self and others, identity and interpersonal functioning. The intended change is not only in the reduction of depression and suicidal ideation but also an improvement in interactions with others at work and intimate relations. The combination of rich clinical information from the therapist and independent research ratings of patient progress provide a complex picture of the treatment.     

Nicotine and cigarette smoking: An alternative hypothesis

A new hypothesis is presented to explain some aspects of human smoking behaviour. While acknowledging the importance of the nicotine self-titration phenomenon, changes in puffing intensity during the smoking of a single cigarette are related not to the control of nicotine uptake but to the modification of cigarette smoke composition prior to inhalation. It is suggested that nicotine, in addition to its central effects, has the local action of reducing the acute airway response to irritant components of cigarette smoke. The new hypothesis explains some of the 'anomalous' results of smoking behaviour research, and has implications both for cigarette design and for the recommendations made to smokers by statutory health agencies.     

Characterization of release-independent short-term depression in the juvenile rat hippocampus

Short-term depression strongly influences neuronal activity in cerebral circuits and contributes to low-pass temporal filtering of information. In this work, we show that synaptic depression evoked by stimulation of commissural–Schaffer collateral afferents at 10 Hz is associated with a reduction of the fibre volley. This depression of action potentials is also evident in the absence of extracellular Ca²⁺, which underlies its release-independent nature. In addition, this reduction of the excitability is independent of failures in action potential propagation since increasing the distance between the stimulus and recording electrodes does not alter this effect. Whole-cell recordings show that tetanic stimulation at supraminimal intensity induces action potential failures preceded by changes in the repolarization rate of the action potentials leading the membrane potential to hyperpolarized values. This activity-dependent hyperpolarization was blocked by ouabain, an indication of the important role of the Na⁺–K⁺-ATPase in this process. Then again, an alteration of the firing threshold was observed when action potentials were elicited either by somatic current injection or by synaptic stimulation, which indicates that this mechanism could alter the EPSP–spike coupling in these cells. The results suggest that these factors act together to reduce gradually the safety factor for action potential generation and to produce failures in action potential initiation; in fact, experiments made at twice the supraminimal intensity show a dramatic decrease in the rate of these failures. Taken together, the results suggest the existence of a release-independent component of short-term depression that is related to failures in action potential initiation.     

Bipolar depression: diagnostic and treatment considerations

Bipolar affective disorder is a recurrent, disabling, and potentially lethal illness that typically begins early in life. Although the disorder is defined by the manic and hypomanic episodes, for most people the depression episodes are the more virulent aspect of the illness. Specifically, the depressive episodes are more numerous, last longer, and are more difficult to treat than the manias, and depression is the principal cause of the illness's increased mortality due to suicide. For people with early-onset depression, predictors of subsequent bipolarity include a family history, psychotic features, and reverse neurovegetative features. Initial episodes of depression are commonly misdiagnosed, which often delays initiation of appropriate therapy and increases the likelihood of treatment with antidepressants alone. Unfortunately, the correct diagnosis is often not made until there has been a treatment-emergent affective switch. There are no treatments specifically approved for bipolar disorder in youth and, among antidepressants, only fluoxetine has received approved. When bipolarity is suspected, treatment with mood stabilizers, both conventional (i.e., lithium, valproate, and carbamazapine) and more recently classified (lamotrigine) and atypical antipsychotics should be prioritized. When antidepressants are indicated in combination with mood stabilizers, first choice options include bupropion and the selective serotonin reuptake inhibitors. Studies of adults indicate that several forms of focused psychotherapy may improve longer term outcomes.