Depressive Symptoms in Crohn’s Disease: Relationship With Immune Activation and Tryptophan Availability.

Depressive symptoms in Crohn’s disease: relationship with immune activation and tryptophan availability.

PLoS One. 2013; 8(3): e60435
Guloksuz S, Wichers M, Kenis G, Russel MG, Wauters A, Verkerk R, Arts B, van Os J

Crohn’s disease (CD) is associated with immune activation and depressive symptoms. This study determines the impact of anti-tumor necrosis factor (TNF)-? treatment in CD patients on depressive symptoms and the degree to which tryptophan (TRP) availability and immune markers mediate this effect. Fifteen patients with CD, eligible for anti-TNF-? treatment were recruited. Disease activity (Harvey-Bradshaw Index (HBI), Crohn’s Disease Activity Index (CDAI)), fatigue (Multidimensional Fatigue Inventory (MFI)), quality of life (Inflammatory Bowel Disease Questionnaire (IBDQ)), symptoms of depression and anxiety (Symptom Checklist (SCL-90), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS)), immune activation (acute phase proteins (APP)), zinc and TRP availability were assessed before treatment and after 2, 4 and 8 weeks. Anti-TNF-? increased IBDQ scores and reduced all depression scores; however only SCL-90 depression scores remained decreased after correction for HBI. Positive APPs decreased, while negative APPs increased after treatment. After correction for HBI, both level and percentage of ? fraction were associated with SCL-90 depression scores over time. After correction for HBI, patients with current/past depressive disorder displayed higher levels of positive APPs and lower levels of negative APPs and zinc. TRP availability remained invariant over time and there was no association between SCL-90 depression scores and TRP availability. Inflammatory reactions in CD are more evident in patients with comorbid depression, regardless of disease activity. Anti-TNF-? treatment in CD reduces depressive symptoms, in part independently of disease activity; there was no evidence that this effect was mediated by immune-induced changes in TRP availability. HubMed – depression

Symptomatic menopausal transition increases the risk of new-onset depressive disorder in later life: a nationwide prospective cohort study in taiwan.

PLoS One. 2013; 8(3): e59899
Chen MH, Su TP, Li CT, Chang WH, Chen TJ, Bai YM

The role of the menopausal transition and associated menopausal symptoms in the occurrence of depressive disorders has been discussed and debated for a long time. Most previous clinical studies had limited case samples, and did not control the attributable risk of medical comorbidities.Patients with a diagnosis of symptomatic menopausal transition and without a psychiatric history were enrolled in 2000 in Taiwan, and compared with age-matched controls (1?4). These subjects were followed to the end of 2010 to investigate the association between symptomatic menopausal transition and new-onset depressive disorder; the effect of medical comorbidities was also assessed.A total of 5,837 women with symptomatic menopausal transition were identified, and compared with 23,348 age-matched controls in 2000. The follow-up showed that symptomatic menopausal transition was an independent risk factor for major depression (hazard ratio[HR]: 2.18, 95%CI: 1.79?2.65) and any depressive disorder (HR: 2.34, 95%CI: 2.08?2.63) after adjusting age at enrollment, monthly income, residence location, level of urbanization, and comorbid medical diseases. In addition, medical comorbidities, including cerebrovascular disease (HR: 1.77, 95% CI: 1.52?2.07), cardiovascular diseases (HR: 1.35, 95% CI: 1.15?1.57), congestive heart failure (HR: 1.35, 95% CI: 1.04?1.75), and liver diseases (HR: 1.19, 95% CI: 1.03?1.36) increased the risk of developing any depressive disorder.Our population cohort study, with the largest study sample and medical record diagnosis thus far, supports an association between symptomatic menopausal transition and depressive disorder in midlife women, and an increased risk of depressive disorder with medical comorbidities. HubMed – depression

Markers of disease severity are associated with malnutrition in Parkinson’s disease.

PLoS One. 2013; 8(3): e57986
Sheard JM, Ash S, Mellick GD, Silburn PA, Kerr GK

In Parkinson’s disease (PD), commonly reported risk factors for malnutrition in other populations commonly occur. Few studies have explored which of these factors are of particular importance in malnutrition in PD. The aim was to identify the determinants of nutritional status in people with Parkinson’s disease (PWP).Community-dwelling PWP (>18 years) were recruited (n?=?125; 73M/52F; Mdn 70 years). Self-report assessments included Beck’s Depression Inventory (BDI), Spielberger Trait Anxiety Inventory (STAI), Scales for Outcomes in Parkinson’s disease – Autonomic (SCOPA-AUT), Modified Constipation Assessment Scale (MCAS) and Freezing of Gait Questionnaire (FOG-Q). Information about age, PD duration, medications, co-morbid conditions and living situation was obtained. Addenbrooke’s Cognitive Examination (ACE-R), Unified Parkinson’s Disease Rating Scale (UPDRS) II and UPDRS III were performed. Nutritional status was assessed using the Subjective Global Assessment (SGA) as part of the scored Patient-Generated Subjective Global Assessment (PG-SGA).Nineteen (15%) were malnourished (SGA-B). Median PG-SGA score was 3. More of the malnourished were elderly (84% vs. 71%) and had more severe disease (H&Y: 21% vs. 5%). UPDRS II and UPDRS III scores and levodopa equivalent daily dose (LEDD)/body weight(mg/kg) were significantly higher in the malnourished (Mdn 18 vs. 15; 20 vs. 15; 10.1 vs. 7.6 respectively). Regression analyses revealed older age at diagnosis, higher LEDD/body weight (mg/kg), greater UPDRS III score, lower STAI score and higher BDI score as significant predictors of malnutrition (SGA-B). Living alone and higher BDI and UPDRS III scores were significant predictors of a higher log-adjusted PG-SGA score.In this sample of PWP, the rate of malnutrition was higher than that previously reported in the general community. Nutrition screening should occur regularly in those with more severe disease and depression. Community support should be provided to PWP living alone. Dopaminergic medication should be reviewed with body weight changes. HubMed – depression

Anxiety and depression in patients with amputated limbs suffering from phantom pain: a comparative study with non-phantom chronic pain.

Int J Prev Med. 2013 Feb; 4(2): 218-25
Kazemi H, Ghassemi S, Fereshtehnejad SM, Amini A, Kolivand PH, Doroudi T

Phantom limb pain (PLP) is approximately a common condition after limb amputation, which potentially affects the quality of life. We aimed to evaluate anxiety and depression in patients with amputated limbs suffering from PLP and to compare these psychological dysfunctions with that of patients with non-phantom chronic pain.A total number of 16 male amputees with PLP and 24 male age-matched patients with non-phantom chronic pain were recruited in this study, which was performed at Khatam-Al-Anbia Pain Clinic, Tehran, Iran. A validated Persian version of the hospital anxiety and depression scale (HADS) was used to compare two psychological dysfunctions – anxiety and depression – between the two groups of study.The mean of total anxiety score was significantly lower in patients with PLP (8.00 ± 3.93 vs. 11.25 ± 5.23; P = 0.041) and the prevalence of anxiety caseness (HADS-A score ? 11) was also lower in the PLP group (25% vs. 58.3%; P = 0.112, power = 31.7%). The mean of total depression score was 7.69 ± 5.51 and 9.38 ± 6.11 in patients of PLP and chronic pain groups, respectively (P = 0.340, power = 15%). Consequently, the prevalence of depression caseness (HADS-D score ? 11) was lower in PLP patients (37.5% vs. 50%; P = 0.710, power = 8%).Our results indicate that depression and anxiety are not more common in PLP patients, whereas they are more prevalent in subjects with non-phantom chronic pain. These lower levels of anxiety and depression in PLP compared with chronic pain is a new finding that needs to be evaluated further, which may lead to new insights into the pathogenesis of phantom pain in further studies. HubMed – depression

Problems with Self Esteem – Problems with self esteem are very common. They accompany every mood disorder like depression and anxiety. Many people try to ignore these problems but they …