Epidemiological and Clinical Characterization Following a First Psychotic Episode in Major Depressive Disorder: Comparisons With Schizophrenia and Bipolar I Disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS).

Published May 31, 2013

Schizophr Bull. 2013 May 28;
Owoeye O, Kingston T, Scully PJ, Baldwin P, Browne D, Kinsella A, Russell V, O’Callaghan E, Waddington JL

While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions. HubMed – depression

Heightened emotional contagion in mild cognitive impairment and Alzheimer’s disease is associated with temporal lobe degeneration.

Proc Natl Acad Sci U S A. 2013 May 28;
Sturm VE, Yokoyama JS, Seeley WW, Kramer JH, Miller BL, Rankin KP

Emotional changes are common in mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Intrinsic connectivity imaging studies suggest that default mode network degradation in AD is accompanied by the release of an emotion-relevant salience network. We investigated whether emotional contagion, an evolutionarily conserved affect-sharing mechanism, is higher in MCI and AD secondary to biological alterations in neural networks that support emotion. We measured emotional contagion in 237 participants (111 healthy controls, 62 patients with MCI, and 64 patients with AD) with the Interpersonal Reactivity Index Personal Distress subscale. Depressive symptoms were evaluated with the Geriatric Depression Scale. Participants underwent structural MRI, and voxel-based morphometry was used to relate whole-brain maps to emotional contagion. Analyses of covariance found significantly higher emotional contagion at each stage of disease progression [controls < MCI (P < 0.01) and MCI < AD (P < 0.001)]. Depressive symptoms were also higher in patients compared with controls [controls < MCI (P < 0.01) and controls < AD (P < 0.0001)]. Higher emotional contagion (but not depressive symptoms) was associated with smaller volume in right inferior, middle, and superior temporal gyri (PFWE < 0.05); right temporal pole, anterior hippocampus, parahippocampal gyrus; and left middle temporal gyrus (all P < 0.001, uncorrected). These findings suggest that in MCI and AD, neurodegeneration of temporal lobe structures important for affective signal detection and emotion inhibition are associated with up-regulation of emotion-generating mechanisms. Emotional contagion, a quantifiable index of empathic reactivity that is present in other species, may be a useful tool with which to study emotional alterations in animal models of AD. HubMed – depression

Mindfulness-based Narrative Therapy for Depression in Cancer Patients.

Clin Psychol Psychother. 2013 May 28;
Rodríguez Vega B, Bayón Pérez C, Palaotarrero A, Fernández Liria A

Mindfulness-based narrative therapy (MBNT) is a therapeutic intervention for the treatment of depression in cancer patients. In a previous randomized controlled trial, MBNT was found to ameliorate anxiety and depression, improve functional dimensions of quality of life, and enhance treatment adherence. In this review, we describe MBNT and its technical characteristics in the context of other psychotherapeutic interventions for depression in cancer patients. We highlight needed adjustments to other narrative approaches and recommend clinical modifications tailored to the needs of cancer patients that are intended to encompass the client’s initial depressive narrative. The narrative construction is supported by emotional regulation and attachment relationships on the one hand and by individual and social linguistic capabilities on the other. Through destabilization of the depressive narrative, MBNT facilitates the emergence of new meanings using both verbal and non-verbal techniques based on mindfulness. The attitude and practice of mindfulness are integrated throughout the therapeutic process. In summary, MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients. Copyright © 2013 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: In this review, we describe mindfulness-based narrative therapy (MBNT) for the treatment of depression in cancer patients.In a previous controlled trial, we found significant benefits of MBNT in terms of reducing depressive symptoms and improving treatment adherence and quality of life in depressed, non-metastatic cancer patients.Narrative construction is socially and neurobiologically derived.MBNT makes use of linguistic interventions, promotes mindfulness and emotional regulation, and can be adapted specifically for use with cancer patients.MBNT is proposed as an interesting and promising intervention, particularly for patients with somatic pathologies. HubMed – depression

Evolution of bipolar disorders in adolescents: About 30 cases.

Tunis Med. 2013 May; 91(5): 300-3
Hadjkacem I, Ayadi H, Walha A, Khmekhem K, Moalla Y, Ghribi F

Background: Bipolar disorders in adolescence are of a great importance, partly because of the relapsing character of this disorder and its impact in terms of psychosocial adjustment. aim: To study the evolution of bipolar disorders in adolescents. methods: We conducted a descriptive and retrospective survey on 30 adolescents followed in the child and adolescent psychiatry department of Sfax for bipolar disorders diagnosed according to the DSM-IV TR criteria. results: The average number of the thymic episodes /year was 1.36±0.75. The average duration of the maniac episodes was 39. 75 day±24.79 and that of the depressive episodes was 78.75 days ± 43.73. The average duration of the inter critical intervals was 13.78 months ±11. 29. The complete remission was noted in 42.8% of the cases whereas the passage to chronicity was noticed in 3.6% of the cases. The family adaptation was satisfactory in 63.3% of the cases whereas the repercussion of the disorder on the school level was obvious. The social adaptation was non satisfactory in 53.3% of the cases. The suicide attempts were found in 10% of the cases. Conclusion : The findings of the present study justify an early identification of bipolar disorders in adolescents as well as the initiation of appropriate therapy. The early intervention will permit to reduce the duration and the severity of the episodes. It will also limit the deleterious impact on the life of the subject and decrease the risk of suicide, which seems to be raised when the subject is not or is badly treated. HubMed – depression