Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta‐analysis

Background: A large number of studies have shown that psychological treatments have significant effects on depression. Although several studies have examined the relative effects of psychological and combined treatments, this has not been studied satisfactorily in recent statistical meta‐analyses. Method: We conducted a meta‐analysis of randomized studies in which a psychological treatment was compared to a combined treatment consisting of the same psychological treatment with a pharmacological therapy. For each of these studies we calculated the effect size indicating the difference between the psychological and the combined treatment. Results: All inclusion criteria were met by 18 studies, with a total of 1,838 subjects. The mean effect size indicating the difference between psychological and combined treatment was 0.35 (95% CI: 0.24～0.45; P<0.001), with low heterogeneity. Subgroup analyses indicated that the difference between psychological and combined treatments was significantly smaller in studies in which cognitive behavior therapy was examined. We also found a trend (P<0.1) indicating that the difference between psychological and combined treatment was somewhat larger in studies aimed at specific populations (older adults, chronic depression, HIV patients) than in studies with adults, and in studies in which Trycyclic antidepressants or SSRIs were examined, compared to studies in which a medication protocol or another antidepressant was used. At follow‐up, no difference between psychological and combined treatments was found. Conclusion: We conclude that combined treatment is more effective than psychological treatment alone. However, it is not clear whether this difference is relevant from a clinical perspective. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.     

Self-reported reactive and regulative temperament in early adolescence: relations to internalizing and externalizing problem behavior and "Big Three" personality factors

The present study examined the relations between self-reported reactive and regulative temperament factors and psychopathological symptoms and personality traits in a group of non-clinical youths aged 9-13 years (N=208). Results showed that the reactive temperament factor of negative affectivity was positively associated with internalizing and externalizing symptoms, whereas the regulative temperament factor of effortful control was negatively related to such symptoms. Further analyses provided some support for the notion that in particular the combination of high negative affectivity and low effortful control was associated with high symptom levels. Results also revealed specific relations between lower-order temperament traits and internalizing and externalizing symptoms. That is, fear and (low) attention control appeared to be more clearly associated with internalizing symptoms, whereas anger/frustration and (low) activation and inhibitory control were more convincingly linked to externalizing symptoms. Finally, relations with the "Big Three" personality traits were as anticipated, with high positive correlations between negative affectivity and extraversion/surgency and their Eysenckian counterparts of neuroticism and extraversion, respectively.     

An allosteric model of circadian KaiC phosphorylation

In a recent series of ground-breaking experiments, Nakajima et al. [Nakajima M, Imai K, Ito H, Nishiwaki T, Murayama Y, Iwasaki H, Oyama T, Kondo T (2005) Science 308:414-415] showed that the three cyanobacterial clock proteins KaiA, KaiB, and KaiC are sufficient in vitro to generate circadian phosphorylation of KaiC. Here, we present a mathematical model of the Kai system. At its heart is the assumption that KaiC can exist in two conformational states, one favoring phosphorylation and the other dephosphorylation. Each individual KaiC hexamer then has a propensity to be phosphorylated in a cyclic manner. To generate macroscopic oscillations, however, the phosphorylation cycles of the different hexamers must be synchronized. We propose a novel synchronization mechanism based on differential affinity: KaiA stimulates KaiC phosphorylation, but the limited supply of KaiA dimers binds preferentially to those KaiC hexamers that are falling behind in the oscillation. KaiB sequesters KaiA and stabilizes the dephosphorylating KaiC state. We show that our model can reproduce a wide range of published data, including the observed insensitivity of the oscillation period to variations in temperature, and that it makes nontrivial predictions about the effects of varying the concentrations of the Kai proteins.     

Actions taken to cope with depressed mood: the role of personality traits

It is still largely unknown which actions people take to improve their mood when they feel they are getting depressed. Using the five-factor model of personality, we explore coping actions in a population of older adults in residential homes in relation to personality traits. A total of 350 non-cognitively impaired inhabitants of residential homes in the Netherlands participated in this study (mean age 85 years). They indicated which of 22 actions to cope with depression they had used in the past three months, and which of these they considered to be helpful in reducing depression. Other measures included the NEO-FFI, CES-D and MINI. Almost 60% of all subjects had used one or more actions to reduce depression in the past three months, and almost 90% considered one or more actions to be helpful in reducing depression. People scoring high on neuroticism had used more coping actions, including relaxing, eating chocolate, praying, seeking professional help, engaging in more pleasant activities, and talking to friends and relatives. People scoring high on openness considered many of the actions to be helpful. We conclude that actions taken to cope with depression and their helpfulness differ considerably for subjects with differing personality traits.     

Assessment of acute reperfused myocardial infarction with delayed enhancement 64-MDCT

OBJECTIVE: The purpose of this study was to evaluate the utility of delayed enhancement 64-MDCT in the assessment of myocardial infarct size in a porcine model of acute reperfused myocardial infarction. CT can be used for noninvasive assessment of coronary artery stenosis, but to our knowledge, evaluation of myocardial viability in the subacute phase of acute myocardial infarction has not been validated. We performed delayed enhancement imaging on six domestic swine 5 days after reperfused acute myocardial infarction and assessed the relation between delayed enhancement patterns in vivo and the extent of viable and nonviable myocardium at postmortem histochemical analysis. CONCLUSION: Delayed enhancement imaging with 64-MDCT can be used for accurate assessment of the size of reperfused acute myocardial infarcts.     

Depression and body mass index, a u-shaped association

Background  

Results of studies concerning the association between obesity and depression are conflicting. Some find a positive association, some a negative association and some find no association at all. Most studies, however, examine a linear association between Body Mass Index (BMI) and depression. The present study investigates if a nonlinear (U-shaped) trend is preferable over a linear trend to describe the relationship between BMI and depression, which means that both underweight and obesity are associated with depression.     

Exposure–Response Analysis of Osimertinib in EGFR Mutation Positive Non-Small Cell Lung Cancer Patients in a Real-Life Setting

Pharmaceutical Research - Osimertinib, an irreversible inhibitor of the epidermal growth factor receptor (EGFR) is an important drug in the treatment of EGFR-mutation positive non-small cell lung...