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Sustained medically unexplained physical symptoms in euthymic patients with recurrent depression: Predictive value for recurrence and associations with omega 3- and 6 fatty acids and 5-HTTLPR?
- Source :
- Journal of affective disorders, 136(3), 604-611. Elsevier, Journal of Affective Disorders, 136(3), 604-611. ELSEVIER SCIENCE BV
- Publication Year :
- 2012
-
Abstract
- Background: Identification of potentially modifiable risk factors for recurrence in recurrent depression could provide opportunities to improve preventive interventions. In this study we aimed to examine the predictive value of medically unexplained physical symptoms (MUPS) on time to recurrence in recurrent depression. Additionally, to elucidate pathophysiological mechanisms that could explain the relations between MUPS and depression, we investigate the association between a sustained high level of MUPS, and (I) omega (omega)-3 and 6 fatty acid (FA)-status and (II) functional polymorphisms in the promoter region of the serotonin transporter gene (5-HTTLPR). Methods: Based on three Physical Symptom Checklist (PCS) scores over 12 months, we defined two groups of remitted recurrently depressed patients: 41 patients with a sustained high number of MUPS and 34 patients with a sustained low number or no MUPS. Patients were followed-up for 3.5 years while recurrence of their depression was monitored. In addition, we analyzed patients' erythrocyte's FA-profiles and triallelically genotyped their 5-HTTLPR. Results: A sustained high level of MUPS predicted consecutive depression recurrence over 3.5 years (adjusted relative risk 2.8). FA-status and distribution of 5-HTTLPR variant frequencies did not differ between patients with sustained high compared to low/absent MUPS-levels. Limitations: Our sample was relatively small. Conclusion: Remitted recurrently depressed patients with sustained MUPS have a considerably increased risk of recurrence. Having sustained MUPS is not associated with either erythrocyte omega - 3 or -6 FA-levels or 5-HTTLPR polymorphism. Recognition and reducing MUPS in an early state could prevent a (depressive) relapse. (C) 2011 Elsevier BM. All rights reserved
- Subjects :
- Male
SOMATOFORM DISORDERS
Erythrocytes
5-HTTLPR
law.invention
Quality of life
Randomized controlled trial
law
Recurrence
Risk Factors
QUALITY-OF-LIFE
Promoter Regions, Genetic
Depression (differential diagnoses)
Randomized Controlled Trials as Topic
Serotonin Plasma Membrane Transport Proteins
Middle Aged
RANDOMIZED CONTROLLED-TRIAL
Prognosis
PREVALENCE
Clinical Psychology
Psychiatry and Mental health
Predictive value of tests
Major depressive disorder
Female
Recurrence/relapse
Psychology
Adult
SEROTONIN-TRANSPORTER
medicine.medical_specialty
PRIMARY-CARE PATIENTS
Predictive Value of Tests
Internal medicine
Fatty Acids, Omega-6
Fatty Acids, Omega-3
medicine
COMPLAINTS
Humans
Fatty acids
Psychiatry
Depressive Disorder, Major
Polymorphism, Genetic
Medically unexplained physical symptoms
MAJOR DEPRESSION
medicine.disease
Medically unexplained physical symptoms (MUPS)
Relative risk
PAINFUL SOMATIC SYMPTOMS
FOLLOW-UP
Predictor
Subjects
Details
- Language :
- English
- ISSN :
- 01650327
- Volume :
- 136
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of affective disorders
- Accession number :
- edsair.doi.dedup.....61362045001aa41305e384325f18433f