Depression Treatment: Factors Associated With Suicidal Thoughts in a Large Community Study of Older Adults.

Factors associated with suicidal thoughts in a large community study of older adults.

Filed under: Depression Treatment

Br J Psychiatry. 2012 Dec; 201: 466-72
Almeida OP, Draper B, Snowdon J, Lautenschlager NT, Pirkis J, Byrne G, Sim M, Stocks N, Flicker L, Pfaff JJ

Thoughts about death and self-harm in old age have been commonly associated with the presence of depression, but other risk factors may also be important.To determine the independent association between suicidal ideation in later life and demographic, lifestyle, socioeconomic, psychiatric and medical factors.A cross-sectional study was conducted of a community-derived sample of 21 290 adults aged 60-101 years enrolled from Australian primary care practices. We considered that participants endorsing any of the four items of the Depressive Symptom Inventory -Suicidality Subscale were experiencing suicidal thoughts. We used standard procedures to collect demographic, lifestyle, psychosocial and clinical data. Anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale.The 2-week prevalence of suicidal ideation was 4.8%. Male gender, higher education, current smoking, living alone, poor social support, no religious practice, financial strain, childhood physical abuse, history of suicide in the family, past depression, current anxiety, depression or comorbid anxiety and depression, past suicide attempt, pain, poor self-perceived health and current use of antidepressants were independently associated with suicidal ideation. Poor social support was associated with a population attributable fraction of 38.0%, followed by history of depression (23.6%), concurrent anxiety and depression (19.7%), prevalent anxiety (15.1%), pain (13.7%) and no religious practice (11.4%).Prevalent and past mood disorders seem to be valid targets for indicated interventions designed to reduce suicidal thoughts and behaviour. However, our data indicate that social disconnectedness and stress account for a larger proportion of cases than mood disorders. Should these associations prove to be causal, then interventions that succeeded in addressing these issues would contribute the most to reducing suicidal ideation and, possibly, suicidal behaviour in later life.
HubMed – depression

[Depression and dementia: perspectives from clinical studies].

Filed under: Depression Treatment

Brain Nerve. 2012 Dec; 64(12): 1387-97
Nozaki S, Yoshimura K, Mimura M

Abstract
In this review, we present an overview of clinical studies that addressed the relationship between depression and dementia or cognitive decline. Cross-sectional studies and meta-analyses have repeatedly shown an association between late-life depression (LLD) and dementia, particularly Alzheimer’s disease (AD) and vascular dementia; however, the findings of cohort studies have been inconsistent. Furthermore, studies on the association between depression with a younger age of onset and dementia have yielded inconsistent results. Regarding cognitive decline associated with LLD, several studies have reported an association between LLD and mild cognitive impairment, suggesting that depression itself can cause persistent cognitive impairment. Other studies have compared the cognitive profile between LLD and depression with a younger age of onset, but their results have been inconclusive, especially regarding the association between memory impairment and the age of onset of depression. LLD is associated with vascular change and white matter degeneration of the brain, as shown by magnetic resonance imaging (MRI). Recently, several studies reported an association between gray matter change and LLD. Studies currently in progress employ functional brain imaging methods such as single-photon emission computed tomography, functional MRI, and positron emission tomography.
Clinically, it is important to understand how subtypes of depression can be defined in terms of risk of developing dementia, and to devise effective treatments. One paper explored the possibility of detecting depression associated with AD by measuring the blood A?40/A?42 levels, and other studies have suggested that symptoms of apathy and loss of interest are associated with conversion of depression to AD. Unfortunately, current antidepressants may have limited efficacy on depression with dementia; therefore, further investigation for devising methods of predicting conversion of depression to dementia and subsequent treatment is required.
HubMed – depression

Pure docosahexaenoic acid can improve depression behaviors and affect HPA axis in mice.

Filed under: Depression Treatment

Eur Rev Med Pharmacol Sci. 2012 Nov; 16(13): 1765-73
Jiang LH, Liang QY, Shi Y

Aim of this study was to identify whether docosahexaenoic acid (DHA) has a vital antidepressant by hypothalamic-pituitary-adrenal axis (HPA axis) or not. Mice were divided into 2 groups: control group and DHA dietary group. DHA dietary group was treated with DHA dietary everyday for consecutive 50 days. The forced swimming test and tail suspension test were conducted. Hypothalamic and erythrocyte fatty acids and monoamine neurotransmitters levels in hypothalamus were assayed; corticosterone, adrenocorticotropic hormone and corticotropin-releasing factor in serum, hypothalamus and pituitary were assayed, respectively. (1) In the forced swimming test, DHA dietary significantly decreased immobility time, whereas swimming time and climbing time were increased. In tail suspension test?DHA dietary significantly shortened immobility time. (2) DHA dietary increased the ration of n-3/n-6 (polyunsaturated fatty acids) and DHA level in hypothalamic and erythrocyte fatty acids; (3) DHA dietary significantly increased 5-hydroxytryptamine, 5-hydroxyindoleacetic acid and dopamine levels in hypothalamus; (4) DHA dietary significantly decreased serum corticosterone level by 20.23% and serum adrenocorticotropic hormone level by 25.13%; significantly increased serum corticotropin releasing factor level by 21.92%. Besides, DHA dietary decreased arginine vasopressin level by 20.11% in hypothalamus, by 23.76% in pituitary tissues, respectively; (5) DHA dietary decreased corticotropin-releasing factor levels by 30.83% in hypothalamus, by 29.75% in pituitary tissues, respectively. In hypothalamus, DHA dietary decreased significantly adrenocorticotropic hormone level by 19.14%, but insignificantly decreased adrenocorticotropic hormone level in pituitary. DHA shows an antidepressant property. Moreover, DHA has multiple effects on depression including the monoamine neurotransmitter systems, red blood cell membranes and HPA axis.  
HubMed – depression

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