Depression Treatment: [Depressive Symptoms in Primary Caregivers of Patients Diagnosed With Paranoid Schizophrenia Attending at a Psychiatric Office of a General Hospital in Lima, Peru].

[Depressive symptoms in primary caregivers of patients diagnosed with paranoid schizophrenia attending at a psychiatric office of a general hospital in Lima, Peru].

Filed under: Depression Treatment

Vertex. 2012 Mar-Apr; 23(102): 92-7
Arévalo-Flores M, Krüger-Malpartida H, Vega-Dienstmaier J

Objective: To determine the prevalence of depressive symptoms in caregivers of patients attending at a psychiatric office of a general hospital with diagnosis of paranoid schizophrenia and to estimate the correlation between the severity of schizophrenia and depressive symptoms in the primary caregiver. Methods: The Zung Depression Scale (ZDS) and the Depressive Psychopathology Scale (DPS) were administered to caregivers and the severity of schizophrenia was assessed using the scale of Clinical Global Impression (CGI). Results: We evaluated 61 patient-caregiver pairs. Between the patients; 63.9% were male and 88.5% were single. Of the caregivers; 77.05% were women, 47.5% married, and 42.6% were the mothers of the patients. The prevalence of probable clinic depression was 3.3% and 14.8% according to the DPS (= 25.5) and the ZDS (= 56.25). It was find correlation between the caregiver score in the ZDS and the CGI of the patient (rho = 0.317, p = 0.0013). The female caregivers had higher scores in ZDS than male caregivers (49.65 ± 8.9 vs. 42.59 ± 7.15, p = 0.009). Conclusions: Patients were mostly male and single; most caregivers were married, women and mothers of patients. Depressive symptoms (according ZDS) in caregivers were higher in female and were correlated with the severity of the patient’s illness.
HubMed – depression

Sensitivity, specificity, and predictive power of the “Brief Risk-resilience Index for SCreening,” a brief pan-diagnostic web screen for emotional health.

Filed under: Depression Treatment

Brain Behav. 2012 Sep; 2(5): 576-89
Williams LM, Cooper NJ, Wisniewski SR, Gatt JM, Koslow SH, Kulkarni J, Devarney S, Gordon E, John Rush A

Few standardized tools are available for time-efficient screening of emotional health status across diagnostic categories, especially in primary care. We evaluated the 45-question Brief Risk-resilience Index for SCreening (BRISC) and the 15-question mini-BRISC in identifying poor emotional health and coping capacity across a range of diagnostic groups – compared with a detailed clinical assessment – in a large sample of adult outpatients. Participants 18-60 years of age (n = 1079) recruited from 12 medical research and clinical sites completed the computerized assessments. Three index scores were derived from the full BRISC and the mini-BRISC: one for risk (negativity-positivity bias) and two for coping (resilience and social capacity). Summed answers were converted to standardized z-scores. BRISC scores were compared with detailed health assessment and diagnostic interview (for current psychiatric, psychological, and neurological conditions) by clinicians at each site according to diagnostic criteria. Clinicians were blinded to BRISC scores. Clinical assessment stratified participants as having “clinical” (n = 435) or “healthy” (n = 644) diagnostic status. Receiver operating characteristic analyses showed that a z-score threshold of -1.57 on the full BRISC index of emotional health provided an optimal classification of “clinical” versus “healthy” status (sensitivity: 81.2%, specificity: 92.7%, positive predictive power: 80.2%, and negative predictive power: 93.1%). Comparable findings were revealed for the mini-BRISC. Negativity-positivity bias index scores contributed the most to prediction. The negativity-positivity index of emotional health was most sensitive to classifying major depressive disorder (100%), posttraumatic stress disorder (95.8%), and panic disorder (88.7%). The BRISC and mini-BRISC both offer a brief, clinically useful screen to identify individuals at risk of disorders characterized by poor emotion regulation, from those with good emotional health and coping.
HubMed – depression

Gene expression profiles associated with depression in patients with chronic hepatitis C (CH-C).

Filed under: Depression Treatment

Brain Behav. 2012 Sep; 2(5): 525-31
Birerdinc A, Afendy A, Stepanova M, Younossi I, Baranova A, Younossi ZM

The standard treatment for CH-C, pegylated interferon-? and ribavirin (PEG-IFN + RBV), is associated with depression. Recent studies have proposed a new role for cytokines in the pathogenesis of depression. We aimed to assess differential gene expression related to depression in CH-C patients treated with PEG-IFN + RBV. We included 67 CH-C patients being treated with PEG-IFN+RBV. Of the entire study cohort, 22% had pre-existing depression, while another 37% developed new depression in course of the treatment. Pretreatment blood samples were collected into PAXgene™ RNA tubes, the RNAs extracted from peripheral blood mononuclear cells (PBMCs) were used for one step RT-PCR to profile 160 mRNAs. Differentially expressed genes were separated into up- and down-regulated genes according to presence or absence of depression at baseline (pre-existing depression) or following the initiation of treatment (treatment-related depression). The mRNA expression profile associated with any depression and with treatment-related depression included four and six genes, respectively. Our data demonstrate a significant down-regulation of TGF-?1 and the shift of Th1-Th2 cytokine balance in the depression associated with IFN-based treatment of HCV infection. We propose that TGF-?1 plays an important role in the imbalance of Th1/Th2 in patients with CH-C and depression. With further validation, TGF-?1 and other components of Th1/Th2 regulation pathway may provide a future marker for CH-C patients predisposed to depression.
HubMed – depression

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