The efficacy of vitamins for reducing or preventing depression symptoms in healthy individuals: natural remedy or placebo?

Over-the-counter vitamins have become increasingly popular as a natural remedy for reducing or preventing depression symptoms and enhancing the emotional well-being of healthy individuals in the general population. This placebo-controlled, single-blind trial evaluated the effect of vitamins on depression symptoms experienced by a nonclinical sample of participants. One hundred and fourteen healthy young adults were randomly assigned to multivitamin, B-complex vitamin, placebo vitamin, or no-treatment control conditions. At the end of a 6-week regimen, participants administered vitamins reported significant reductions in depression symptoms as measured by the Beck Depression Inventory compared to those who received no treatment. There was no difference between the multivitamin, the B-vitamin, and the placebo. The effect of each of the vitamin regimens on depression symptoms was partially mediated by response expectancies. The results do not support the efficacy of vitamins as a natural remedy for reducing or preventing depression symptoms among healthy people in the general population.     

Which symptoms matter? Self-report and observer discrepancies in repressors and high-anxious women with metastatic breast cancer

Clinicians working with cancer patients listen to them, observe their behavior, and monitor their physiology. How do we proceed when these indicators do not align? Under self-relevant stress, non-cancer repressors respond with high arousal but report low anxiety; the high-anxious report high anxiety but often have lower arousal. This study extends discrepancy research on repressors and the high-anxious to a metastatic breast cancer sample and examines physician rating of coping. Before and during a Trier Social Stress Test (TSST), we assessed affect, autonomic reactivity, and observers coded emotional expression from TSST videotapes. We compared non-extreme (N = 40), low-anxious (N = 16), high-anxious (N = 19), and repressors (N = 19). Despite reported low anxiety, repressors expressed significantly greater Tension or anxiety cues. Despite reported high anxiety, the high-anxious expressed significantly greater Hostile Affect rather than Tension. Physicians rated both groups as coping significantly better than others. Future research might productively study physician-patient interaction in these groups.     

Does psychological stress affect the outcome of in vitro fertilization?

BACKGROUND: The aim of the study was to investigate the effect of psychological stress before and during IVF treatment on the outcome of IVF, controlling for known physiological predictors. METHODS: This is a prospective, longitudinal study. A total of 166 women were studied during their first IVF treatment. They answered questionnaires concerning psychological and social factors on two occasions. Psychological well-being was measured by the Psychological General Well-Being (PGWB) index and psychological effects of infertility were assessed by 14 items. RESULTS: In the analysis of the psychological variables, no differences were found between pregnant and non-pregnant women. The total number of good quality embryos, the number of good quality embryos transferred, and the number of embryos transferred were significantly higher in the pregnant than in the non-pregnant group. In a multivariate analysis, the number of good quality embryos transferred was the only variable that was independently associated with pregnancy. CONCLUSIONS: We found no evidence that psychological stress had any influence on the outcome of IVF treatment. When counselling infertile couples, it might be possible to reduce the stress they experience during the treatment procedure by informing them of these findings.     

Are cause of subfertility and in vitro fertilization treatment risk factors for an earlier start of menopause?

OBJECTIVE: To study whether women diagnosed with unexplained subfertility reach the menopause transition and natural menopause earlier than women with tubal subfertility, in an in vitro fertilization (IVF)-treated population, and to examine the influence of the number of IVF cycles on the occurrence of an early menopause transition and natural menopause. DESIGN: This retrospective cohort study included 12 IVF clinics in the Netherlands. A nationwide retrospective cohort study was conducted among women whose first IVF cycle was stimulated with gonadotrophins in the Netherlands between 1983 and 1995 (n = 7,842). Most of the women were in their late 30s at the end of the follow-up period (range 24-55 y). The main outcome measures were the relative risk (RR) of having reached natural menopause and the risks (RR) of having entered the menopause transition or natural menopause according to the cause of subfertility and the number of IVF cycles. RESULTS: Women with unexplained subfertility did not have an increased risk of entering the menopause transition or natural menopause (adjusted RR = 0.5; 95% CI, 0.2-1.5; and RR = 0.8; 95% CI, 0.6-1.1). After a 5-year follow-up period, we found no increased risk for entering the menopause transition or natural menopause among women who had undergone six or more IVF cycles when compared with women who had undergone only one IVF cycle (adjusted RR = 0.4; 95% CI, 0.1-1.7; and RR = 0.9; 95% CI, 0.6-1.6). CONCLUSIONS: Underlying causes of unexplained subfertility do not predispose women to an early start of menopause. Although the number of IVF cycles was not associated with early menopause, longer follow-up is needed.     

Are somatic symptoms of depression better predictors of cardiac events than cognitive symptoms in coronary heart disease?

Several recent studies have found that somatic symptoms of depression predict cardiac events in patients with established coronary heart disease but cognitive symptoms of depression do not. However, other studies have not supported this finding, and the research in this area is complicated by methodological differences and inconsistencies in the classification of "cognitive" and "somatic" symptoms. In addition, somatic symptoms are more common than cognitive symptoms in cardiac patients and are often associated with more severe depression. These factors may confound the relationship between somatic symptoms and cardiac outcomes. Some reasons why somatic symptoms may be more common than cognitive symptoms in cardiac patients are considered, as well as whether somatic symptoms are likely to be symptoms of depression or of medical illness. Finally, some directions for future research are proposed.     

Are there any gender differences in frequency of self-reported somatic symptoms of depression?

BACKGROUND: The purpose of this study was to evaluate whether self-reported somatic symptoms of depression, as measured by the Beck Depression Inventory-II (BDI-II), are more frequent in women than in men with major depressive disorder. METHODS: A sample of 105 male and 105 female adult psychiatric outpatients diagnosed with major depressive disorder was classified according to endorsed changes in appetite, changes in sleeping pattern, and fatigue (i.e., "somatic depression") symptoms on the BDI-II. RESULTS: The female to male ratio of somatic symptoms was approximately 2:1. Subsequent analyses found that change in appetite robustly distinguished between women and men and that fatigue partially distinguished between women and men. LIMITATIONS: The sample was largely Caucasian and composed of patients with high rates of comorbidity who presented to a service known for specializing in cognitive therapy. CONCLUSIONS: In outpatients with major depressive disorder, the higher prevalence of "somatic depression" in women is largely attributable to changes in appetite.     

Do somatic complaints predict subsequent symptoms of depression?

BACKGROUND: Evidence suggests substantial comorbidity between symptoms of somatization and depression in clinical as well as nonclinical populations. However, as most existing research has been retrospective or cross-sectional in design, very little is known about the specific nature of this relationship. In particular, it is unclear whether somatic complaints may heighten the risk for the subsequent development of depressive symptoms. METHODS: We report findings on the link between symptoms of somatization (assessed using the SCL-90-R) and depression 5 years later (assessed using the CES-D) in an initially healthy cohort of community adults, based on prospective data from the RENO Diet-Heart Study. RESULTS: Gender-stratified multiple regression analyses revealed that baseline CES-D scores were the best predictors of subsequent depressive symptoms for men and women. Baseline scores on the SCL-90-R somatization subscale significantly predicted subsequent self-reported symptoms of depressed mood 5 years later, but only in women. However, somatic complaints were a somewhat less powerful predictor than income and age. CONCLUSIONS: Our findings suggest that somatic complaints may represent one, but not necessarily the most important, risk factor for the subsequent development of depressive symptoms in women in nonclinical populations. The results also highlight the importance of including social variables in studies on women's depression as well as conducting additional research to further examine predictors of depressive symptoms in men.     

Gender differences in adolescent depression: do symptoms differ for boys and girls?

BACKGROUND: Limited prior research suggests that depressed women are more likely to experience certain symptoms of depression than are depressed men. The purpose of this study was to examine whether such gender differences in depressive symptoms are present during adolescence. METHODS: The Childhood Version of the Schedule for Affective Disorders and Schizophrenia and the Beck Depression Inventory were administered to adolescents presenting for evaluation at an outpatient clinic (n=383; ages 11.9 to 20.0). RESULTS: Depressed girls and boys had similar symptom prevalence and severity ratings for most depressive symptoms. However, depressed girls had more guilt, body image dissatisfaction, self-blame, self-disappointment, feelings of failure, concentration problems, difficulty working, sadness/depressed mood, sleep problems, fatigue, and health worries than depressed boys on some comparisons. In contrast, depressed boys had higher clinician ratings of anhedonia, depressed morning mood, and morning fatigue. LIMITATIONS: Longitudinal research is needed to test whether such relatively gender-specific symptoms play different roles in the onset, maintenance, or remittance of depression for boys and girls. CONCLUSIONS: These findings indicate that, in general, the experience of depression is highly similar for adolescent girls and boys. However, some gender differences previously found among depressed adults appear to be present by adolescence, possibly suggesting somewhat distinct etiologies for depression among males and females.     

Genetic risk factors for major depression in men and women: similar or different heritabilities and same or partly distinct genes?

BACKGROUND: Although women are at consistently greater risk for major depression (MD) than men, it is unclear whether sex modifies the aetiological impact of genetic factors on MD. Is the heritability of MD different in men and women? Do the same genetic risk factors predispose to MD in the two sexes? METHODS: We obtained a lifetime history of MD by personal interview on two occasions from 6672 individual twins and 2974 complete twin pairs. Three diagnostic criteria of increasing narrowness were employed: DSM-III-R, DSM-III-R plus impairment and Washington University. To increase power by controlling for unreliability of assessment, we evaluated sex differences on genetic risk for MD using a structural equation measurement model. RESULTS: Using DSM-III-R criteria, but not the two narrower definitions, heritability of MD was significantly greater in women than in men. In the three diagnostic systems, the genetic correlation in liability to MD in men and women was estimated at between +0.50 and +0.65. These estimates differed significantly from unity for the two broader definitions. CONCLUSION: Using broad but not narrower definitions of illness, genetic factors play a greater role in the aetiology of MD in women than in men. The genes that influence risk for MD in the two sexes are correlated but are probably not entirely the same. These results raise the possibility that, in linkage and association studies, the impact of some loci on risk for MD will differ in men and women.     

Are measures of marital satisfaction valid for women with depressive symptoms? The examination of factor structure and measurement invariance of the Couple Satisfaction Index‐4 across depression levels in Portuguese women

Marital satisfaction (MS) is a key indicator of mental and physical health. Factor structure of MS measures in individuals with clinical levels of depression as well as their measurement invariance across groups with different levels of depressive symptoms were not yet explored. The lack of evidence of measurement invariance might compromise valid comparisons between individuals with elevated and minimal depressive symptoms in MS. This study examined the factor structure of the Couple Satisfaction Index‐4 (CSI‐4) among women with clinical levels of depression, tested the CSI‐4 measurement invariance across depression levels groups, and investigated CSI‐4 convergent and divergent validity. Participants were 891 heterosexual married/cohabiting women who were assigned into one of two groups based on assessment of their levels of depressive symptoms. Participants completed the CSI‐4 and self‐reported measures used to examine convergent and divergent validity. Support was found for the factor structure of the CSI‐4 for the total sample and both elevated depressive symptoms and minimal depressive symptoms groups. Subsequent multigroup confirmatory factor analyses supported the measurement invariance of the CSI‐4 across depression levels groups. The CSI‐4 revealed excellent values of internal consistency and convergent and divergent validity. Our findings suggest that CSI‐4 produces comparable response patterns across depression groups and thus meaningful comparisons between groups can be performed.     

Meta-analytic evidence for neuroimaging models of depression: State or trait?

Background

Major Depressive Disorder (MDD) is a leading cause of disease burden worldwide. With the rapid growth of neuroimaging research on relatively small samples, meta-analytic techniques are becoming increasingly important. Here, we aim to clarify the support in fMRI literature for three leading neurobiological models of MDD: limbic–cortical, cortico–striatal and the default mode network.

Methods

Searches of PubMed and Web of Knowledge, and manual searches, were undertaken in early 2011. Data from 34 case-control comparisons (n=1165) and 6 treatment studies (n=105) were analysed separately with two meta-analytic methods for imaging data: Activation Likelihood Estimation and Gaussian-Process Regression.

Results

There was broad support for limbic–cortical and cortico–striatal models in the case-control data. Evidence for the role of the default mode network was weaker. Treatment-sensitive regions were primarily in lateral frontal areas.

Limitations

In any meta-analysis, the increase in the statistical power of the inference comes with the risk of aggregating heterogeneous study pools. While we believe that this wide range of paradigms allows identification of key regions of dysfunction in MDD (regardless of task), we attempted to minimise such risks by employing GPR, which models such heterogeneity.

Conclusions

The focus of treatment effects in frontal areas indicates that dysregulation here may represent a biomarker of treatment response. Since the dysregulation in many subcortical regions in the case-control comparisons appeared insensitive to treatment, we propose that these act as trait vulnerability markers, or perhaps treatment insensitivity. Our findings allow these models of MDD to be applied to fMRI literature with some confidence.     

The impact of extroversion or menopause status on depressive symptoms among climacteric women in Taiwan: neuroticism as moderator or mediator?

OBJECTIVE: The study was designed to test whether neuroticism moderated the effect of extroversion and mediated the impact of menopause status on depressive symptoms among women in Taiwan during their menopausal transition. DESIGN: A sample of 197 women, aged 40 to 60 years, were recruited from the community. We used Ko's Depression Inventory, the Five-Factor Inventory-Chinese version, the Menopausal Symptoms Scale, and the Chinese version of the Modified Schedule of Affective Disorders and Schizophrenia-Lifetime to gather data. Moreover, each woman underwent a semistructured diagnostic interview in person to obtain her lifetime psychiatric history. RESULTS: The hierarchy regression analyses showed that the interaction between neuroticism and extroversion was statistically significant. Further analyses indicated that in the high neuroticism group, extroversion was negatively associated with depressive symptoms; however, in the low neuroticism group, extroversion was not correlated with depressive symptoms. Menopause status was correlated with depressive symptoms, but after adding neuroticism and extroversion, the main effect of menopause status became insignificant. Results of the Sobel test showed that depressive symptoms of women during the menopause transition largely represented neuroticism. CONCLUSIONS: The present study revealed that the lower levels of extroversion are associated with depression among all stages of menopausal women with high levels of neuroticism; moreover, all stages of menopausal women who have high levels of neuroticism are more vulnerable to depression. The results support that personality may play an important role in women's depression during the transition of menopausal status.     

Do polymorphic variants of chromosomes affect the outcome of in vitro fertilization and embryo transfer treatment?

BACKGROUND The aim of this study was to investigate the effect of chromosomal polymorphic variations on the outcome of IVF and embryo transfer (IVF-embryo transfer) treatment for infertile couples. METHODS During the period from October 2006 to December 2009, 1978 infertile couples who had received their first IVF-embryo transfer treatment cycle in our hospital were selected for this retrospective study, and the frequency of chromosomal polymorphic variations was calculated. From these, 1671 couples were selected and divided into three groups: 1402 couples with normal chromosomes (Group 1/control group), 82 couples with chromosomal polymorphic variations in only females (Group 2) and 187 couples with chromosomal polymorphic variations in only males (Group 3). The clinical pregnancy rates (CPR), early miscarriage rates and ongoing pregnancy rates after IVF-embryo transfer treatment were compared. RESULTS There were no statistically significant differences among the three groups in implantation rates (29.37% in the control group, 29.70% in Group 2 and 31.41% in Group 3, P > 0.05) and CPR (45.86, 46.34 and 51.87%, respectively, P > 0.05). Although there was a trend toward higher first trimester pregnancy loss rates in Group 3 (male chromosomal polymorphic variations), but not in Group 2, compared with normal karyotype couples (10.31 versus 6.84%), the difference did not reach significance (P > 0.05). CONCLUSIONS Chromosomal polymorphic variations appear to have no adverse effects on the outcome of IVF-embryo transfer treatment.     

Subtypes of postnatal depression? A comparison of women with recurrent and de novo postnatal depression

BackgroundIt has been suggested that there may be two groups of women with postnatal depression (PND) — one who have a history of depression and whose depression is etiologically similar to depression experienced at other times of life, and another who develop depression de novo in the postnatal period and whose depression is uniquely ‘postnatal’. The primary aim of this study was to clarify the role of negative attitudes (general and maternal-specific) for these proposed subtypes, whilst also considering the role of a range of other potentially relevant etiological factors.Methods157 postnatal women were classified into four groups: (i) ‘recurrent depression’, (ii) ‘de novo PND’, (iii) ‘prior (but not current) depression’, (iv) ‘healthy control’. Groups were compared on known vulnerability and situational risk factors for depression including negative attitudes (general and maternal-specific), personality style vulnerability, relationship insecurity, low social support, stressful life events and difficult infant behaviour. Hierarchical regressions were conducted to examine the role of general and maternal-specific negative attitudes in mediating the relationship between previous depression and PND.ResultsWomen with recurrent depression had more personality vulnerability and maternal-specific negative attitudes than women with de novo PND, but there were no differences in general negative attitudes or relationship insecurity. Non-depressed women with a history of prior depression were characterized by elevated general depression vulnerability but lower maternal-specific negative attitudes. General negative attitudes mediated the relationship between previous depression and PND.LimitationsAll participants had unsettled infants and the generalizability of results to general postpartum samples is not known.ConclusionsAlthough these results do not provide support for the proposed subtypes of PND, they highlight encouraging new avenues for cognitively based preventative interventions.