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Background: Treatment-resistant depression (TRD) is a severe public health problem and a condition uncommonly addressed by psychological therapies. This paper presents a theoretical model, grounded in established learning principles and in the perspective of behavioral activation (BA), to explain its constitution and development. Method: A review of theoretical models and empirical research on TRD was conducted in major databases. Results: The model reflects how patients with TRD are more susceptible to becoming trapped in their condition by seeking to avoid discomfort through avoidance and escape behaviors, which increasingly drives them away from sources of positive reinforcement. Based on this model, a BA-based intervention protocol is suggested for the treatment of TRD. Through six phases (in a total of thirteen sessions), the protocol guides the intervention towards the reestablishment of personalized routines to increase the probability of reinforcement and reduce avoidance behaviors. Conclusions: Although the model holds significant potential to become an effective intervention in TRD, future research will allow the evaluation of the efficacy of the protocol as a standalone intervention. [ABSTRACT FROM AUTHOR]

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors – cognitive overgeneralisation, rumination and social problem-solving – as mediating factors in the relationship between childhood trauma and symptoms of depression. Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling. Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies. Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problemsolving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Adherence to antidepressants is essential for good outcomes when treating depressive disorders. The objective of the current study was to evaluate the adherence, acceptability and tolerability of venlafaxine XR at a dose of 300 mg/day, administered in one or two tablets, after a treatment period of 6 ± 2 months in patients with major depressive disorder (MDD). Subjects and methods: Observational, cross-sectional study of routine clinical practice in 590 outpatients with MDD who attended at public or private centers all over country, of whom 361 and 229 received one (300 mg) or two tablets (150+150 mg o 225+75 mg) of venlafaxine XR, respectively. The study data were obtained from the interview with the patient, the clinical history and validated questionnaires. Results: The Haynes-Sackett method and the Morisky-Green questionnaire revealed that adherence to treatment was similar in both groups. The patients who received the dose of venlafaxine XR in one tablet showed greater satisfaction with the treatment according to the TSQM-9 questionnaire. The MADRS scale revealed that in 23% of the patients the MDD had remitted, and only in 9% it remained severe, in 26% it was moderate and in 42% mild. The same result was obtained with the PHQ-9 questionnaire. In general, the patients showed good tolerability to high doses of venlafaxine XR with both dosing regimens, and the most common adverse effects were sexual dysfunction, sweating and constipation. Conclusions: Adherence to treatment with venlafaxine XR 300 mg/day in one or two tablets was similar. Patients who received a single tablet showed greater satisfaction with the treatment. The safety profile of high dose venlafaxine was favorable and there were dropouts or clinically significant elevations that affected the dosing regimen. [ABSTRACT FROM AUTHOR]

True premenstrual dysphoric disorder (PMDD) is hard to diagnose. It has been suggested that women's expectations influence the symptoms of this disorder, which could increase their vulnerability to depression. This study aimed to estimate PMDD in a group of women by comparing their self-diagnosis with clinical evaluation; differentiate between PMDD symptoms and their intensity and its subthreshold form, determining its social-employment and relational consequences, finding differences in symptoms and vulnerability to depression; and identifying possible cognitive vulnerability to depression in PMDD. 105 women participated, 85 from the general population and 20 women with Major Depressive Disorder were selected. For the self-diagnosis, they filled out several self-reports and PMDD Criteria Indicators A, B, C (APA) and D (by author). The clinical diagnosis was made using a semi-structured interview following DSM-5 criteria. PMDD was overestimated when it was self-reported (51,76%) compared to clinical evaluation (5,88%). Therefore, retrospective and self-reported evaluation could bias what they remember and overestimate the indicators of the disorder and their severity. Cognitive vulnerability to depression for PMDD was not supported. [ABSTRACT FROM AUTHOR]

Copyright of Clínica Contemporánea: Revista de Diagnóstico Psicológico, Psicoterapia y Salud is the property of Colegio Oficial de Psicologos de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La psilocibina es un alcaloide psicodélico producido naturalmente por diversas especies de hongos, especialmente del género Psilocybe, cuyo uso por parte de culturas precolombinas ha sido ampliamente documentado. En la última década, tras años de estigmatización y restricción de uso, se han reactivado las investigaciones sobre las potencialidades terapéuticas de este psicodélico clásico para el tratamiento de múltiples trastornos psiquiátricos, entre ellos el trastorno depresivo mayor. La depresión es un desorden afectivo del estado de ánimo cuya prevalencia mundial se ha incrementado considerablemente en los últimos años y cuyo tratamiento con fármacos convencionales tiene limitada eficacia. Los hallazgos recientes señalan que la psilocibina, en cambio, pueden tener un efecto antidepresivo rápido y sostenido, incluso en individuos con depresión resistente al tratamiento. Aunque aún no se han dilucidado por completo los mecanismos subyacentes a dicho efecto, se ha planteado que estaría mediado por cambios a nivel de neurotransmisión, de plasticidad estructural y funcional y de conectividad de diferentes redes cerebrales. En esta revisión narrativa se presenta una síntesis de la evidencia clínica a favor del efecto antidepresivo de la psilocibina, se exponen algunos mecanismos de acción plausibles que han sido objeto de estudio y se discuten algunos interrogantes y perspectivas del uso del alcaloide en el ámbito clínico.

Copyright of Arquivos de Ciências da Saúde da UNIPAR is the property of Associacao Paranaense de Ensino e Cultura and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objetivos. Comparar el desempeño neuropsicológico entre adultos con Trastorno Depresivo Mayor (TDM) y adultos sin depresión en tres dominios cognitivos: atención, memoria explícita y función ejecutiva. Materiales y métodos. 18 adultos con TDM y 15 adultos sin depresión se evaluaron a través de pruebas neuropsicológicas como Stroop, TMT, TAVEC, figura de Rey, Wisconsin-64, entre otras, y se compararon sus resultados. Resultados. No se encontraron diferencias en memoria explícita, pero sí en una medida de atención sostenida y en las medidas de conceptualización, organización perceptual y análisis/síntesis en función ejecutiva, con peores resultados para los adultos con TDM; las quejas de memoria también fueron significativas en éstos. Conclusiones. Las fallas en memoria, frecuentemente reportadas en los estudios y referidas por los pacientes, pueden deberse principalmente a fallas importantes en la atención o la función ejecutiva, las cuales explicarían las dificultades para la codificación y la evocación de la información.

Introduction: There may be a discordance between diagnoses at admission and discharge of mentally ill patients with major issues regarding their diagnostic stability. The objective of this brief report was to determine the diagnostic stability of major depressive disorder at patients’ discharge and if the diagnosis of their hospital admission had been retained. Methodology: This was a pilot, descriptive, cross-sectional, and retrospective observational study. A non-probabilistic sampling of consecutive cases was used. We reviewed the medical records, at admission and discharge, of patients with an initial diagnosis of major depressive disorder, hospitalized in the Department of Psychiatry of the ‘Hospital de Clínicas’ of the National University of Asunción, Paraguay, during the months of October to December 2020. Results: Fifty-three patients with a diagnosis of major depression on their hospital admission were included in the study (mean age = 35.7 ± 16.5 years). 79.2 % were women, 52.8 % were single, and 37.7 % were from the Central province of Paraguay. The most frequent diagnosis at discharge was borderline personality disorder, in 35.8% of cases. Major depressive disorder was confirmed in 15.1% of cases. No significant relationship was found between any discharge diagnosis and sociodemographic data. Conclusion: The results of this study, although preliminary, described the trajectories of diagnoses in the Psychiatry Department of a University hospital, but confirmatory studies are needed.

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Kranion is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are a variety of educational interventions for families who have a relative with a mental health disorder. However, for those with one or more emotion dysregulation disorders, there are limited options. This article reports on the results of a pilot project using a quasi‐experimental design with a sample of 270 (intervention = 217, control = 53) to assess an intervention, Getting Off the Emotional Roller Coaster Skill‐Building Family Education Course (GOER Family Course), for families coping with and managing emotion regulation disorders in a loved one which are often misdiagnosed or co‐occurring. This intervention was effective in reducing caregiver burden [F(1, 120) = 12.25, p = 0.001], while improving attitudes, knowledge, and skills [F(1, 170) = 6.16, p = 0.014]. It fills an important gap in available resources for families faced with challenges and responsibilities that these disorders can present, especially when inaccurately diagnosed or receiving ineffective treatment. While there is a need for further research and adaptation to virtual learning, the preliminary results show positive effects. [ABSTRACT FROM AUTHOR]

The convergences between the symptoms of Major Depression Disorder as exposed in DSM-5 and Saint Thomas Aquinas' doctrine on sadness as exposed in Summa Theologica, I-II, qq. 35-39 are analyzed. The Magisterium of the Catholic Church has exhorted for centuries to study of the Aquina's doctrine and to put it in dialogue with the sciences. Thomism is compatible with current psychopathology, provides a comprehensive vision of human being, and contributes to forging a «healthy psychology» based on Christian anthropology. [ABSTRACT FROM AUTHOR]

The functioning of the frontal lobes is related to executive functions, which are human high order mental functions. These functions are altered in major depressive disorder (MDD) and may alter the daily living activities of patients. We conducted a neuropsychological testing of frontal lobes with a group of pharmacological treated outpatients with MDD diagnosis and without drug treatment (n = 14) and contrasted with a control group (n=7). The results indicate that patients with clinical pharmacology treatment show a better performance in executive functions neuropsychological tests. Specially in metamemory, planning, working memory, inhibitory control and follow-up instructions, as well as attentional control and memory. However, this clinical pharmacology treated patients still have difficulty on planning, remembering, and manipulating information needed in daily living activities. This suggests that clinical pharmacological treatment may partially improve executive functioning of patients with MDD. However, patients still experience difficulties in daily living activities. As conclusion, it may be important the inclusion of neuropsychological or cognitive therapies, involving executive functions therapy to come along with clinical pharmacology therapy for MDD patients. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: en el contexto latinoamericano se está generando evidencia sobre el empleo de instrumentos derivados de la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud en psiquiatría y salud mental. Este estudio corresponde a la primera investigación de carácter explicativo en población con trastornos mentales graves en tres países de Sudamérica. El objetivo es determinar un modelo explicativo de discapacidad en una muestra de personas con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría en Chile, Colombia y Ecuador. Materiales y métodos: se llevó a cabo un estudio multicéntrico, observacional, correlacional, de corte transversal, a partir de un muestreo probabilístico en Colombia y un muestreo por conveniencia en Chile y Ecuador. En total, participaron 803 adultos con trastornos mentales graves, en contacto con servicios ambulatorios de psiquiatría en Concepción (Chile), Cali (Colombia) y Quito (Ecuador). Resultados: el 91.3 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final incluyó las variables explicativas país (Colombia; β=6.724); edad (β=−0.163); escolaridad (β=−0.5029); síntomas actuales de depresión (β=23.26); episodio psicótico (β=4.795); episodio hipomaniaco/maniaco (β=7.498; t=3.711); tener práctica religiosa (β=−2.834), y tener cuidador (β=10.363). Obtuvo un coeficiente de determinación de 0.3275 (F [23, 760]=16.09; p < 0.001, R2∆=30.71), que explica el 32.75% de la discapacidad de las personas de la muestra de los tres países participantes. Conclusiones: en un modelo multivariado de discapacidad para trastornos mentales graves, los síntomas actuales y la presencia de cuidador son las principales variables explicativas de discapacidad.

Introduction. The depressive disorder coexists in a high prevalence with a substance-related disorder, which is associated with a worst prognosis. The therapeutic interventions for this co-morbidity lack of the appropriate scientific support. The existing evidence suggest that the currently available anti-depressive drugs are of minor efficacy in this group of patients. An alternative would be the use of different drugs with distinctive neurobiological mechanism of action. The aim of this study was to describe the clinical development of a series of patients affected by this comorbidity under treatment with tianeptine under usual clinical practices. Methods. Study design corresponds to a post-authorization, observational, retrospective, multicentric, study under usual clinical practice study. The clinical history of the last consecutive 100 patients diagnosed of major depressive and substance-related disorders under treatment with tianeptine for at least 3 months was reviewed. The following scales were evaluated in 3 times (basal, intermediate, final): HDRS, ICG and SDS. Results. Most patients were treated by a combination of anti-depressive drugs together with psychotherapy. At the end of follow-up, 70 % patients had a clinical remission in accordance with HDRS and 76 % of them had a mild or significant improvement in ICG. Regarding the use of substances, the most remarkable decreases were obtained in the consumption of alcohol, and cocaine. Conclusion. Tianeptine could be a useful drug for the treatment of patients with dual diagnosis of depression and substance-related disorder, together with other therapeutic interventions. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between depressive symptoms and pathological personality functioning (PPF) and specific indicators of pathological personality patterns. The participants were 446 adults from the general population. Part of the sample (n = 237) answered scales evaluating the PPF (Dimensional Clinical Personality Inventory - screening (IDCP-Screening)) and symptoms of depression (Baptist Depression Scale - screening (EBADEP-Screening)); another part (n = 209) answered tests evaluating personality disorders (PD) (SCID-II personality questionnaire; SCID-II-PQ) and symptoms of depression (EBADEP-screening). The results indicated that both PPF and PD showed positive associations with depressive symptoms, although associations with PPF were stronger. The PD most associated with depressive symptoms were avoidant, dependent, and borderline. Findings suggest that PPF and specific pathological patterns are risk factors for the onset of depressive symptoms. [ABSTRACT FROM AUTHOR]

Copyright of SMAD Revista Electronica Salud Mental, Alcohol y Drogas is the property of Universidade de Sao Paulo, Escola de Enfermagem de Ribeirao Preto and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción: en Ecuador existen parámetros de calificación de discapacidad basados en la Clasificación Internacional del Funcionamiento de la Discapacidad y la Salud, pero los avances en investigación en el ámbito de la psiquiatría y la salud mental aún son escasos. Se empleó la Escala de Evaluación de Discapacidad de la Organización Mundial de la Salud para determinar el grado de discapacidad en población consultante. Materiales y métodos: estudio observacional, de corte transversal y correlacional. Usando un muestreo por conveniencia, se recogió información sobre discapacidad en una muestra de 297 adultos con trastornos mentales graves en contacto con servicios ambulatorios de psiquiatría. Se estimó un modelo de regresión lineal que determinó el aporte de variables sociodemográficas, clínicas y sociales. Resultados: el 89.2 % de la muestra presentó algún grado de discapacidad. El modelo multivariado final para el total de la muestra incluyó las variables explicativas edad (β = −0.234), escolaridad (β = −0.552), ser pensionado (β = 39.44), presencia de episodio depresivo actual (β = 21.654) y tener cuidador (β = 9.574), que explican el 37.46 % de la discapacidad de las personas con trastornos mentales graves atendidas en servicios de psiquiatría y salud mental en Quito. Conclusión: la discapacidad en personas con trastornos mentales graves que están en contacto con servicios de salud de Quito involucra cambios en el desempeño de actividades en escenarios familiares y comunitarios. Se identificó una proporción de discapacidad moderada y severa que demanda respuestas institucionales que incluyan el acompañamiento de cuidadores y aborden barreras actitudinales.

The objective of this study was to identify comorbidity between PTSD and MDD in people who are victims of forced displacement and associated factors. A research with a quantitative approach, a nonexperimental cross-sectional design and a descriptive-analytical scope was carried out. 120 people, of both genders, from 18 to 57 years old, selected through a non-probabilistic convenience sampling, were evaluated. A structured clinical interview for Axis I diagnoses (SCID-I) was used based on the DSM IV criteria for PTSD and MDD, after the application of a questionnaire of sociodemographic data and clinical history with which the factors of risks and associated symptoms were registered. The prevalence for PTSD was 48%, 32% for MDD, and 21% for comorbidity, associated with suicidal ideation and attempt and rumination symptoms. The results were discussed in light of other prevalence studies and the importance of associated risk factors in understanding the comorbidity between PTSD and MDD. [ABSTRACT FROM AUTHOR]

About 30% of major depressive disorder (MDD) patients are classified as resistant to treatment (treatment-resistant depression, TRD). Among the factors associated with unfavourable treatment outcomes, stressful life events play a relevant role, and trauma-focused psychotherapy has been successfully proposed for the treatment of patients with a history of such events. Stressful experiences are related to enhanced inflammation and, recently, microRNAs (miRNAs) have emerged as potential mediators of the association between these experiences and psychiatric disorders. To date, no study has explored the effects of stressful life events on miRNAs in MDD patients. The objective of the present study was to assess possible miRNA blood expression alterations in TRD patients induced by the exposure to stressful life events and to investigate the effects of trauma-focused psychotherapy on the expression profiles of the same miRNAs, as well as their possible predictivity in relation to therapy outcome. The basal levels (T0) of seven candidate miRNAs (miR-15a/miR-29a/miR-125b/miR-126/miR-146a/miR-195/let-7f) were measured in the whole blood of 41 TRD patients. A subgroup of patients (n = 21) underwent trauma-focused psychotherapy; for all of them, miRNA levels were also longitudinally assessed (T4: after 4 weeks of treatment; T8: end of treatment; T12: follow-up visit), contextually to clinical evaluations. miR-146a levels negatively correlated with recent stressful life event scores (p =.001), whereas the levels of miR-15a, miR-29a, miR-126, miR-195, and let-7f changed during the psychotherapy (best p = 1.98*10−9). miR-29a was also identified as a response predictor, with lower baseline levels predicting non-response (p =.019) or worse improvement in mood symptoms (p =.032). The study results could contribute to clarify the underlying molecular mechanisms and to identify novel biomarkers of stressful experiences and response to targeted treatments. The peripheral levels of microRNAs implicated in inflammation are correlated to recent stressful life events in treatment-resistant depressed patients and modified by trauma-focused psychotherapy; some of them could represent predictive biomarkers of response to psychotherapy. [ABSTRACT FROM AUTHOR]

Childhood maltreatment and difficulties in emotion regulation are common in patients with Borderline Personality Disorder (BPD) and Depressive Disorders (DD). This study examines differences between patients with BPD and patients with DD, regarding childhood maltreatment and difficulties in emotion regulation as well as the mediating effect of different aspects of emotion regulation deficits on the association between childhood maltreatment and BPD-symptoms. A total of 305 participants, 177 with BPD and 128 with DD completed an assessment including the Childhood Trauma Questionnaire (CTQ), the Emotion Regulation Scale (DERS), the Brief Symptom Inventory (BSI), and the Structured Clinical Interview for DSM-IV (SCID). Data was analyzed using multiple analyses of variances and mediation analyses. Patients with BPD reported more childhood maltreatment and more difficulties in emotion regulation than patients with DD. When general symptom severity, age, and gender were included in the analysis as covariates only group differences regarding 'impulse control difficulties' (F(1,299) = 38.97, p <.001, ηp2 =.115), 'limited access to emotion regulation strategies' (F(1,299) = 4.66, p =.032, ηp2 =.015), and 'lack of emotional clarity' (F(1,299) = 9.38, p =.002, ηp2 =.030) remained statistically significant. A mediation analysis, including above-mentioned covariates, indicated an association between emotional abuse and BPD-symptoms, which was mediated by difficulties in emotion regulation (indirect effect B =.012, 95% CI [.001;.031], R2 =.429). Subscale analyses revealed 'impulse control difficulties' as the aspect of difficulties in emotion regulation that has the greatest impact on this association (B =.021, 95% CI [.003;.045]). Patients with BPD display more childhood maltreatment and difficulties in emotion regulation than patients with DD. Difficulties in emotion regulation, especially difficulties in impulse control, seem to play an important role in the association between childhood emotional abuse and BPD-symptoms. Patients with BPD report more childhood maltreatment and more emotion regulation difficulties than patients with DD and difficulties in emotion regulation, specifically impulse control, play an important role in the association between childhood emotional abuse and BPD symptoms. [ABSTRACT FROM AUTHOR]

Background: Population-attributable risk (PAR) may help estimate the potential contribution of adverse childhood experiences (ACEs) to serious clinical presentations of depression, characterized by suicidality, previous psychiatric admissions, and episode recurrence. Objective: To determine the PAR of ACEs for serious clinical presentations of depression (high suicide risk, previous psychiatric admissions, and recurrent depression) in outpatients with ICD-10 clinical depression. Method: Systematic chart review of 1,013 adults who were assessed and/or treated in a mental health clinic in Santiago, Chile for a major depressive episode. Data were collected on demographics and clinical characteristics of depression. Exposure to ACEs was determined with the Brief Physical and Sexual Abuse Questionnaire, assessing seven types of ACEs. Multivariable logistic regression analysis was used to assess the association between exposure to ACEs and suicidality, previous psychiatric admissions, and recurrence. Predicted probabilities were used for calculations of PAR. Results: Of the 1,001 study participants with complete data, 53.3% had recurrent depression, 13.5% had high suicide risk, and 5.0% had previous psychiatric admissions. Exposure to at least one ACE was recorded for 69.0% of the sample. Exposure to at least one ACE and specific types of ACEs (i.e. childhood sexual abuse and traumatic separation from caregiver) were associated with serious clinical presentations of depression. A dose-response relationship was observed between cumulative exposure to ACEs and the most serious clinical presentations of depression. ACEs were attributed to a significant proportion of disease: 61.6% of previous psychiatric admissions, 45.0% of high suicide risk, and 14.5% of recurrent depression. Conclusions: A substantial proportion of serious clinical presentations of depression among outpatients are associated with ACEs. Early detection of depressive episodes associated with ACEs, and tailored treatment for these patients, may potentially reduce the incidence of serious complications in this population. In a sample of 1,001 depressed outpatients in Santiago, Chile, and according to population-attributable risk calculations, adverse childhood experiences contributed to nearly half of cases with high suicide risk and almost two thirds of those with previous psychiatric admissions. [ABSTRACT FROM AUTHOR]

Major depressive disorder is a clinical entity characterized by a clinical pattern with a core of emotional symptoms (depressed mood and anhedonia), accompanied by cognitive and somatic alterations that produce a marked functional disturbance, as well as significant discomfort. This article reviews the neurobiology of the disorder, and the therapeutic effects of mirtazapine, an antidepressant that acts simultaneously on the noradrenergic and serotoninergic systems. Due to the mechanism of action, mirtazapine enhances the release of these neurotransmitters in the central nervous system. Current meta-analysis show that mirtazapine is one of the most effective treatments in the approach to patients with Major depressive disorder. Additionally, its efficacy and safety have been studied in special populations, including the elderly and patients with comorbidities. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Adverse childhood experiences (ACE) are associated with an increased risk of major depressive disorder (MDD) and hypothalamic-pituitary-adrenal (HPA) axis dysregulation. Within the HPA axis, corticotropin-releasing hormone and vasopressin (AVP) synergistically stimulate the release of adrenocorticotropic hormone, which promotes cortisol release. The cleavage product copeptin is produced during AVP synthesis and is a surrogate marker of AVP release. Children with ACE and young adults with depressive symptoms have higher levels of copeptin than healthy controls. Objective: To uncover the effects of MDD and ACE on copeptin levels in adult females. Methods: We recruited 94 women (mean age: 34.0 ± 3.6 years): 23 with MDD and ACE, 24 with MDD without ACE, 22 with ACE without MDD, and 25 healthy controls. ACE was defined as repeated sexual or physical abuse at least once a month over at least one year before the age of 18 years. MDD was defined by the DSM-IV criteria. Copeptin plasma levels were measured with an immunoluminometric assay. Results: The four groups did not differ in demographic variables. We found a significant negative correlation between body mass index (BMI) and copeptin plasma levels (r = −.21; p =.045). Copeptin plasma levels did not differ between the four groups after controlling for BMI. Conclusion: Neither MDD nor ACE was associated with altered plasma copeptin levels. Thus, copeptin does not seem to play a major role in MDD and ACE in adult females. • Copeptin correlated negatively with body mass index in adult females • No association between major depressive disorder and copeptin in adult females• No association between adverse childhood experiences and copeptin in adult females [ABSTRACT FROM AUTHOR]

A pesar de su relevancia clínica y de su importancia como problema de salud pública existen importantes deficiencias en el abordaje de la depresión. Las guías clínicas basadas en la evidencia son útiles para mejorar los procesos y los resultados clínicos, y para facilitar su implementación se ha ensayado su transformación en sistemas informatizados de apoyo a las decisiones clínicas. En este artículo se describen los fundamentos y principales características de una nueva guía clínica informatizada para el manejo de la depresión mayor desarrollada en el sistema sanitario público de Cataluña. Esta herramienta ayuda al clínico a establecer diagnósticos de depresión fiables y precisos, a elegir el tratamiento idóneo a priori según las características de la enfermedad y del propio paciente, y enfatiza en la importancia de un seguimiento sistemático para evaluar la evolución clínica y adecuar las intervenciones terapéuticas a las necesidades del paciente en cada momento.

El trastorno depresivo mayor es una enfermedad que se caracteriza por la presencia de diferentes síntomas, que van desde no poder comer o dormir, hasta el no disfrute de las actividades que antes resultaban placenteras, ideas de minusvalía y suicidio. Las investigaciones del campo de las neurociencias y de las enfermedades psiquiátricas en especial, tienden cada vez más a buscar los posibles orígenes genéticos que expliquen su desarrollo y progresión. En esta revisión de la literatura se presenta lo reportado en estudios que no solo describen la enfermedad desde los trastornos neurofisiológicos, sino también desde alteraciones genéticas y epigenéticas, con el fin de brindar un mayor entendimiento de las bases moleculares y fisiopatológicas de esta patología psiquiátrica.

Introducción: en Colombia, según la Encuesta Nacional de Salud Mental realizada en 2015, la prevalencia de vida de depresión mayor, trastorno afectivo bipolar y esquizofrenia es del 9,1 %, 1,3 % y 1 %, respectivamente. Estos trastornos mentales graves se caracterizan por ser asumidos desde una postura nosográfica que no incorpora la interacción entre el contexto y la persona. La discapacidad es una dimensión de los trastornos mentales graves, y requiere ser investigada desde herramientas como la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud. Conocer su frecuencia y los factores personales y ambientales que la explican puede facilitar la implementación de estrategias para mejorar la calidad de vida de esta población. Materiales y métodos: se llevó a cabo un estudio exploratorio, observacional, de corte transversal, para determinar la prevalencia y describir el aporte de variables sociodemográficas, clínicas y psicosociales en un modelo explicativo de discapacidad en personas con trastornos mentales graves que asisten a servicios de salud mental y psiquiatría de una institución especializada de Cali (Colombia). Resultados: el 65,9 % de la muestra presenta algún grado de discapacidad; el 46,2 %, discapacidad moderada; el 19,4 %, discapacidad severa; y el 0,4 %, discapacidad extrema. El modelo explicativo incluye el aporte de variables sociodemográficas, clínicas y psicosociales. Conclusión: este estudio demuestra que la frecuencia de discapacidad en la población con TMG es recurrente, y al parecer poco estudiada, vinculando el desempeño desde cada dominio que hace parte de la vida diaria. Los resultados de la investigación permiten identificar el aporte de factores personales y ambientales en la discapacidad experimentada por esta población en Cali.

Desde la incorporación del trastorno depresivo mayor en el Diagnostic and Statistical Manual of Mental Disorders (DSM-III) de 1980, hasta su actualización en el DSM-IV-TR, el sistema clasificatorio DSM consideró necesario incluir el criterio de “exclusión por duelo”, con el objetivo de diferenciar la tristeza normal, vinculada a una pérdida, de un trastorno mental, como el trastorno depresivo mayor. En su última versión (DSM-5), esta excepción fue suprimida, dando lugar a una controversia que se extiende hasta nuestros días. El debate ha confrontado a quienes están a favor de mantener y extender la exclusión a otros estresores y aquellos que han querido erradicarla. Nuestra hipótesis es que estas posiciones darían cuenta de dos matrices clínicas y epistemológicas cualitativamente diversas ligadas a las trasformaciones mayores que han experimentado las ciencias de la salud y la psiquiatría. Mostramos que este debate involucró una renovación profunda del sentido de la práctica psiquiátrica, un cambio en la función del diagnóstico y el modo de concebir la etiología de la enfermedad mental, así como, una reformulación del estatuto del sufrimiento del paciente para el acto médico.

Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors. Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed. Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels. Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors - cognitive overgeneralisation, rumination and social problem-solving - as mediating factors in the relationship between childhood trauma and symptoms of depression. Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants ( N  = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling. Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies. Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.

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The characteristic symptoms of Mild Cognitive Impairment (MCI) may overlap with those of neuropsychiatric disorders such as Major Depressive Disorder (MDD), due to the possible cognitive losses of both conditions. The differentiation between them is essential to direct treatment and possible neuropsychological and clinical prognosis. The aim of this study was to perform the differential diagnosis between MCI and MDD through a clinical case in which clinical neuropsychological and sociocultural evaluation were performed, controlling the influence of these variables. The patient R.G., 64 years old was evaluated through a complete neuropsychological battery (prospective memory, semantic memory, immediate, recent and late verbal episodic memory, auditory-verbal learning, divided and concentrated attention, executive functions, constructive praxis and oral language), neuropsychiatric interview (depression, anxiety and apathy) and functionality evaluation. A covariance analysis was performed for Crawford's unique case to control effects of symptoms of depression. The impairments observed are related to executive functions, specifically the inhibitory control and cognitive flexibility components, measured through both verbal and visuospatial evaluation. Additionally, the patient presented deficits in late episodic memory and learning of new auditory-verbal information. The results of Crawford's analysis indicated that cognitive impairments related to executive functions, auditory-verbal learning and retroactive interference are better explained by MCI symptoms than by current MDD symptoms. The data obtained regarding alterations in executive functions and episodic memory may be associated with MCI. However, from the evaluation of neuropsychiatric symptoms, the patient presented symptoms compatible with the diagnosis of mild and recurrent MDD. It is hypothesized that, over time, MDD may lead to cognitive impairments that do not revert to cognitive normality even during periods of euthymia, as it suggests criteria for MCI with neuropsychiatric symptoms. The neuropsychological evaluation works as a tool for the differential diagnosis and for the evaluation of neuropsychiatric, neurocognitive and sociodemographic measures. [ABSTRACT FROM AUTHOR]

Since the incorporation of the major depressive disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980, and until its update in the DSMIV- TR, the DSM classification system considered it necessary to include the criterion of "bereavement exclusion", with the aim of differentiating normal sadness linked to a loss, from a mental disorder, such as the major depressive disorder. In its latest version (DSM- 5), this exception was removed, giving rise to a controversy that continues to this day. The debate has set those who are in favor of maintaining this exclusion and extending it to other stressors against those who have intended to eradicate it. Our hypothesis is that these positions account for two qualitatively diverse clinical and epistemological matrices, linked to major transformations in health sciences and in psychiatry. We show that this debate involved a profound renewal of the meaning of psychiatric practice, a change in the function of diagnosis and in the way of conceiving the etiology of mental disorders, as well as a reformulation of the patient's suffering status for the medical act. [ABSTRACT FROM AUTHOR]

Background: Major Depressive Disorder (MDD) in adolescence has a high prevalence and risk of disability, but current treatments show limited effectiveness and high drop-out and relapse rates. Although the role of distressing experiences that relate to the development and maintenance of MDD has been recognized for decades, the efficacy of a trauma-focused treatment approach for MDD has hardly been studied. Objective: To determine the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a stand-alone intervention in adolescents diagnosed with MDD. We hypothesized that reprocessing core memories related to the onset and maintenance of MDD using EMDR therapy would be associated with a significant decrease in depressive and comorbid symptoms. Method: We recruited 32 adolescents (12–18 years) fulfilling DSM-IV criteria for mild to moderate-severe MDD from an outpatient youth mental health care unit. Treatment consisted of six weekly 60-min individual sessions. Presence or absence of MDD classification (ADIS-C), symptoms of depression (CDI), symptoms of posttraumatic stress (UCLA), anxiety (SCARED), somatic complaints (CSI), and overall social-emotional functioning (SDQ) were assessed pre and post-treatment and 3 months after treatment. Results: 60.9% of the adolescents completing treatment no longer met DSM-IV criteria for MDD after treatment anymore, and 69.8% at follow-up. Multilevel analyses demonstrated significant posttreatment reductions of depressive symptoms (CDI: Cohen’s d = 0.72), comorbid posttraumatic stress, anxiety and somatic complaints, while overall social-emotional functioning improved. These gains were maintained at 3-month follow-up (Cohen’s d = 1.11). Severity of posttraumatic stress reactions significantly predicted the posttreatment outcome; however, duration of MDD, number of comorbid disorders, or having a history of emotional abuse, emotional neglect or physical neglect were not predictive for outcome. Conclusions: This is the first study suggesting that EMDR therapy is associated with a significant reduction of depressive symptoms and comorbid psychiatric problems in adolescents with mild to moderate-severe MDD. [ABSTRACT FROM AUTHOR]

The purpose of this research is to develop an item pool to assess Major Depressive Disorder (MDD). To do so, we elaborated 150 items divided into two sets (A and B), and then had those items rated by a sample 501 adults from the cities of Parnaíba-PI and João Pessoa- PB. As for the results, the factor analysis using the Hull Method revealed the salience of a large general factor that produced excellent alpha values in both item sets (.93 and .96, respectively), thus ensuring the unidimensionality and local independence of the items. Regarding the calibrations, the obtained estimates indicated the need to exclude and change the response categories of some items, which were recategorized, and had their parameters reestimated. The item pool presented sound psychometric properties, and it can now be included in computerized adaptive testing. [ABSTRACT FROM AUTHOR]

Background: The study presents the use of the Unified Protocol (UP) in a case of a male diagnosed with major depressive disorder and schizoid and depressive personality traits. The therapeutic focus of UP is to identify maladaptive behaviors of emotion regulation and to train new regulation strategies such as cognitive re-appraisal or emotional exposure exercises. Method: This is a single-case research study. The intervention was carried out in twenty 1-hour sessions for 6 months. After treatment completion, follow-ups were conducted at three, six, and twelve months. Results: The results of the 12-month follow-up revealed a clinically significant change in depressive symptomatology (RCIBDI-II = -5.51), negative affect (RCINEGATIVE PANAS = -3.61), quality of life (RCIICV-Sp = 4.61) and schizoid (RCIMCMIIII- Schizoid = -4.36) and depressive (RCIMCMI-III-Depressive = -5.24) personality traits. Schizoid and depressive personality traits did not interfere with the application, course, and compliance with treatment. These results are discussed with regard to similar studies, also based on the use of the UP to work on emotion regulation in the treatment of emotional disorders with clinical comorbidity. Conclusions: The training of emotion regulation strategies through UP could be an effective proposal to treat emotional disorders with pathological personality traits comorbidity. [ABSTRACT FROM AUTHOR]