OXTR-Related Markers in Clinical Depression: a Longitudinal Case–Control Psychotherapy Study

We investigated stability and change of plasma and urinary oxytocin as well as OXTR DNA methylation patterns through psychotherapy. Furthermore, we explore the potential impact of inpatient psychotherapy on oxytocin-related biomarkers and vice versa by differentiating patients who remitted from depression versus non-remitters. Blood and urine samples were taken from 85 premenopausal women (aged 19–52), 43 clinically depressed patients from a psychosomatic inpatient unit, and 42 healthy control subjects matched for age and education at two points of time. Serum and urine oxytocin was measured using standard ELISA, and DNA methylation of the OXTR gene was assessed using bisulfite sequencing at the time of admission (baseline) and at discharge and from controls at matched time points. Oxytocin plasma levels were not associated with depression and were influenced by neither time in healthy controls nor psychotherapy in patients. Non-remitting depressed patients had significantly lower oxytocin urine levels before and after psychotherapy treatment. We found significantly lower exon 1 OTXR methylation in depressed patients over time and these differences were driven by patients remitting due to psychotherapy. A reverse pattern — higher levels of methylation in remitters — was found for exon 2 OXTR DNA methylation. Plasma oxytocin, urinary oxytocin, and OXTR DNA methylation patterns were intrapersonally relatively stable. OXTR-related factors were seemingly unaffected by inpatient psychotherapeutic treatment, but we found significant differences between remitting and non-remitting patients in urinary oxytocin and OXTR DNA methylation. If replicated, this suggests that OXTR-related markers may predict inpatient treatment outcomes of clinically depressed patients.

Benefits of Using Activity Recommender Technology for Self-management of Depressive Symptoms

Behavioral Activation (BA)therapy has shown to be effective in treating depression. Recommending healthy activities is a core principle in Behavioral Activation (BA), which is typically done by the therapist. However, most BA smartphone applications do not recommend specific activities. This article reports quantitative results from an 8-week feasibility study of a previously presented smartphone-based BA recommender system. The system supports the planning and enacting of pleasurable activities and promotes activation of diverse activity types. Enrollment included 43 clinically depressed patients who installed the system on their phone and initiated activity scheduling. Twenty-nine patients used the system daily for more than a week.These patients presented a significant reduction in depressive symptoms during the study period. They displayed a more personalized usage approach and created recurring health goals comprising of their own customized activities. Furthermore, they took inspiration within various types of activities, thereby displaying more activity diversity. This study suggests that enacting a diverse mixture of activities that promote good sleep, personal hygiene, exercise, social contact, and leisure time can be essential in managing depressive symptoms. A smartphone-based activity recommender system can help patients achieve this.

Let the team fix it?—Performance and mood of depressed workers and coworkers in different work contexts

Depression in the workplace is a significant factor for reduced personal well-being and productivity. Consequently, this has negative effects on the economic success of the companies in which depressed people are employed. In addition, the economy has to deal with the significant burden of this illness on the health system. In this paper, we investigated how different working contexts—working in a group or individually—influenced depressed individuals towards higher or lower well-being and productivity. We examined this using a laboratory experiment. In this setting, we were also able to analyze how, in turn, a depressive individual impacted the productivity and affective situation of their workgroup, reflecting the company perspective. The experimental design mimicked the very basic processes of a workplace in a stylized way. We used two distinct samples: subclinically and clinically depressed, both working in a group with healthy controls. As expected, we found generally lower performance in the clinically depressed sample, but in the subclinically depressed sample, we only found this in the individual work context. In contrast to our expectations, the performance of subclinically depressed individuals working in groups with healthy controls was even higher than that of healthy controls in homogenously healthy groups. The performance of the entire group with a depressed member was lower for the sample with clinically manifested depression, while the performance of groups with a subclinically depressed participant was significantly higher than the performance of homogeneously non-depressed control groups. We discuss our results with a focus on the design of workplaces to both re-integrate clinically depressed employees and prevent subclinically depressed employees from developing major depression.

Biased Maintenance of Attention on Sad Faces in Clinically Depressed Youth: An Eye-Tracking Study

The role of negative attention biases (AB), central to cognitive models of adult depression, is yet unclear in youth depression. We investigated negative AB in depressed compared to healthy youth and tested whether AB are more pronounced in depressed than at-risk youth. Negative AB was assessed for sad and angry faces with an eye-tracking paradigm [Passive Viewing Task (PVT)] and a behavioural task [Visual Search Task (VST)], comparing three groups of 9–14-year-olds: youth with major depression (MD; n = 32), youth with depressed parents (high-risk; HR; n = 49) and youth with healthy parents (low-risk; LR; n = 42). The PVT revealed MD participants to maintain attention longer on sad faces compared to HR, but not LR participants. This AB correlated positively with depressive symptoms. The VST revealed no group differences. Our results provide preliminary evidence for a negative AB in maintenance of attention on disorder-specific emotional information in depressed compared to at-risk youth.

Biobehavioral correlates of an fMRI index of striatal tissue iron in depressed patients

Dopaminergic function is a critical transdiagnostic neurophysiological dimension with broad relevance in psychiatry. Normalized T2*-weighted (nT2*w) imaging has been previously investigated as a method to quantify biological properties of tissue in the striatum (e.g., tissue iron), providing a widely available, in vivo marker with potential relevance to dopaminergic function; but no prior study to our knowledge has examined this neuroimaging marker in clinical depression. In a treatment-seeking, clinically depressed sample (n = 110), we quantified tissue iron (nT2*w) in striatal regions. We assessed test-retest reliability and correlated values with dimensional features across levels of analysis, including demographic/biological (sex, age, Body Mass Index), neuroanatomical (hippocampal atrophy, which was quantified using a recently validated machine-learning algorithm), and performance-based (Affective Go/NoGo task performance) indices with relevance to depressive neurocognition. Across patients, decreased tissue iron concentration (as indexed by higher nT2*w) in striatal regions correlated with indices of decreased cognitive-affective function on the Affective Go/NoGo task. Greater caudate nT2*w also correlated with greater hippocampal atrophy. Striatal tissue iron concentrations were robustly lower in female patients than males but gender differences did not explain relations with other neurocognitive variables. A widely available fMRI index of striatal tissue properties, which exhibited strong psychometric properties and can be readily quantified from most fMRI datasets irrespective of study-specific features such as task design, showed relevance to multiple biobehavioral markers of pathophysiology in the context of moderate-to-severe, treatment-resistant depression. Striatal tissue iron may play a role in dimensional and subgroup-specific features of depression, with implications for future research on depression heterogeneity.

How negative mood hinders belief updating in depression: results from two experimental studies

Background In two experimental studies, we tested the hypothesis that negative mood would hinder the revision of negative beliefs in response to unexpectedly positive information in depression, whereas positive mood was expected to enhance belief updating. Methods In study 1 (N = 101), we used a subclinical sample to compare the film-based induction of sad v. happy mood with a distraction control group. Subsequently, participants underwent a well-established paradigm to examine intra-individual changes in performance-related expectations after unexpectedly positive performance feedback. In study 2, we applied the belief-updating task from study 1 to an inpatient sample (N = 81) and induced sad v. happy mood via film-clips v. recall of autobiographic events. Results The results of study 1 showed no significant group differences in belief updating; the severity of depressive symptoms was a negative predictor of belief revision, though, and there was a non-significant trend suggesting that the presence of sad mood hindered belief updating in the subgroup of participants with a diagnosed depressive episode. Study 2 revealed that participants updated their expectations significantly less in line with positive feedback when they underwent the induction of negative mood prior to feedback, relative to positive mood. Conclusions By indicating that the presence of negative mood can hinder the revision of negative beliefs in clinically depressed people, our findings suggest that learning from new experiences can be hampered if state negative mood is activated. Thus, interventions relying on learning from novel positive experiences should aim at reducing state negative mood in depression.

Depression in females: comparison of patients visiting urban and rural teaching hospitals of Peshawar, Khyber Pakhtunkhwa

Introduction: Even though frequency of depression is documented globally, the spectrum of depression and its inciting factors in Pakistan are unique to the local cultural and social beliefs. Objective: To compare the status of depression and its provoking socio-cultural factors among urban and rural females attending selected hospitals of Peshawar. Materials & Methods: A cross-sectional comparative study was conducted from March to May 2017 on 93 female patients attending two selected urban and rural teaching hospitals of Peshawar. Data were collected on Beck Depression Inventory through convenience sampling, and were analyzed for descriptive statistics by SPSS version 20. Comparisons were done by the Chi Square test and the Student’s T test keeping p≤0.05 as significant. Results: Out of 93 female patients, a final 89 females (53 urban and 36 rural) were included due to incomplete data entries. More urban females were in the normal, mild or borderline clinically depressed categories (38/53, 71.7%), compared to rural females (15/36, 41.7%), more of whom were in moderate, severe and extremely depressed categories (21/36, 58.3%); the difference was significant (p=0.025). Among the many factors leading to depression, there were significant differences in poor socio-economic status (p=0.011), illiteracy (p=0.003) and hostile in-laws (p=0.016), all of which were mainly due to females of rural area rather than urban females. Conclusion: Rural females suffered significantly greater depression compared to their urban counterparts related to poor socio-economic status, illiteracy, and hostile in-laws. Keywords: Depression; Anxiety; Stress; Female; Marriage; Domestic Violence.