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There was no deterioration in cognitive performance in BD+ compared to BD- patients. Nevertheless, BD+ displayed increased WM-related dPFC activity at follow-up compared with BD- patients. This change in dPFC response was independent of mood symptoms and medication.
The study did not account for type or frequency of affective episodes.
The study identifies cognitive impairment and WM-related hypo-activity in dPFC early during the course of BD. Increased high-load WM related dPFC activity over the follow-up period in BD+ versus BD- patients in the absence of changes in cognitive performance may reflect an episode-related reduction in PFC efficiency.
The study identifies cognitive impairment and WM-related hypo-activity in dPFC early during the course of BD. Increased high-load WM related dPFC activity over the follow-up period in BD+ versus BD- patients in the absence of changes in cognitive performance may reflect an episode-related reduction in PFC efficiency.
Research findings on the factor structure and invariance of the Center for the Epidemiological Studies Depression Scale (CES-D) are inconclusive. Besides, very few studies have examined factorial invariance of the scale over time. Related studies based on Chinese adolescents are also sparse. This study attempted to examine the factor structure of the CES-D and its invariance across gender and time over a one-year period among adolescents in mainland China.
A total of 3,010 adolescents (mean age=13.16 years, 1,730 boys) completed a questionnaire including the CES-D at Wave 1 and 2,648 of them completed the same survey one year later. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to examine the factor structure of the CES-D. Factorial invariance of the resultant factor structure was tested using cross-sectional multi-group CFA (girls vs. boys) at Wave 1 and Wave 2 and longitudinal CFA (Wave 1 vs. Wave 2).
EFA and CFA revealed a three-factor model of the CES-D, including "somatic complaints," "depressed affect," and "positive affect." Additionally, findings supported the factorial invariance across gender and over time for the three-factor model.
Limitations of the present study included a lack of adolescents from different areas in mainland China (particularly rural areas) and only a one-year follow-up.
This pioneering study suggests that there are three stable dimensions of the CES-D in Chinese adolescents in mainland China which are invariant across gender and over time.
This pioneering study suggests that there are three stable dimensions of the CES-D in Chinese adolescents in mainland China which are invariant across gender and over time.
Trajectories of postpartum depressive symptoms up to 1 year after childbirth and the related risk factors remain unclear. Accordingly, this study aimed to examine the 1-year trajectories of postpartum depressive symptoms and their associated risk factors.
A total of 22,493 pregnant women were recruited between July 2013 and September 2016 in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Among them, 11,668 women with no missing data were included in the analyses. Depressive symptoms were assessed at 1 month and 1 year postpartum using the Edinburgh Postnatal Depression Scale. Multinominal logistic regression analysis was conducted after adjusting for covariates.
The prevalence of depression was 13.9% at 1 month and 12.9% at 1 year postpartum. We identified four depression trajectories, i.e., "persistent (depressed throughout the 1 year postpartum)" (6.0%), "recovered (depressed at 1 month postpartum and recovered within a year)" (7.9%), "late-onset (became depressed after 1 month postpartum)" (6.8%), and "resilient (not depressed throughout 1 year postpartum)" (79.2%). selleck kinase inhibitor Psychological distress during pregnancy was significantly associated with all trajectories (persistent odds ratio [OR]=10.24, 95% confidence interval (CI)=8.40-12.48; recovered OR=3.78, 95%CI=3.28-4.36; and late-onset OR=3.96, 95%CI=3.40-4.62).
Postpartum depression was evaluated only by a self-administered questionnaire and the dropout rate was not neglectable.
This study highlighted the high prevalence of depressive symptoms at 1 year postpartum and found that half of the depressive symptoms at 1 year were late-onset. The findings suggest the necessity of long-term follow-up (up to 1 year) for perinatal mental health.
This study highlighted the high prevalence of depressive symptoms at 1 year postpartum and found that half of the depressive symptoms at 1 year were late-onset. The findings suggest the necessity of long-term follow-up (up to 1 year) for perinatal mental health.
Possession of the ε4 allele of apolipoprotein E (APOE4) is related to the incidence of depression in old age. We investigated whether the presence of APOE4 is also associated with subsequent depression recurrence in a wide range of age groups.
Altogether, 163 patients with major depressive disorder (MDD) after remission were recruited between August 2004 and March 2016 and followed up prospectively. The patients were divided into two groups APOE4 carriers and non-carriers. We compared the time to recurrence of depression between the two groups. Kaplan-Meier survival curves, log-rank test for trend for survivor functions, and Cox proportional hazard ratio estimates for a multivariate model were conducted to examine the effect of the APOE4 allele on risk of a depression recurrence.
Cumulative probability of developing a depression recurrence was higher in APOE4 carriers than non-carriers. Presence of an APOE4 allele remained significantly associated with the incidence of depression recurrence.
All patients were treated with one or two different antidepressants, which may have had different effects on patients with MDD. Second, participants in the present study comprised patients with both first and multiple episodes of MDD. Third, we did not have the statistical power to perform a stratified analysis in consideration of heterozygous or homozygous genotypes of APOE4.
Possession of an APOE4 allele may increase the risk of depression recurrence.
Possession of an APOE4 allele may increase the risk of depression recurrence.
Gendered depressive symptom trajectories have long been documented. In the past few decades, China has witnessed volatile gender equity development, while it is unclear how gendered depression trajectories vary by age and cohort under this uneven social change.
Using three-wave (2012, 2016, and 2018) data from the China Family Panel Studies (N=33,858, 72,653 person-years), this study examines how gendered depression trajectories evolve over the life course (ages 16-65) and vary across birth cohorts.
The gender gap in depressive symptoms has been growing as people get older. The cohort comparisons show that the depression levels are higher among younger cohorts than among older cohorts. The gender disparity in depressive symptoms has narrowed among younger rural cohorts, mainly driven by the deteriorated mental health of rural males instead of the improved mental health of rural females.
Data covering a six-year span can hardly reveal how the period effects shape depression trajectories and thus are unable to simultaneously show age, period, and cohort effects.
Overall, this study suggests that social changes, such as gender equity development, may shape the age and cohort variations in gender disparity in depressive trajectories. Scholars and policymakers should pay more attention to the worsening mental health condition of younger cohorts, especially in rural areas.
Overall, this study suggests that social changes, such as gender equity development, may shape the age and cohort variations in gender disparity in depressive trajectories. Scholars and policymakers should pay more attention to the worsening mental health condition of younger cohorts, especially in rural areas.
Previous research has shown that after one month of full dose nightly treatment with zolpidem (priming), subjects with chronic insomnia (CI) switched to intermittent dosing with medication and placebos were able to maintain their treatment responses. This approach to maintenance therapy is referred to as partial reinforcement. The present study sought to assess whether priming is required for partial reinforcement or whether intermittent dosing with placebos (50% placebos and 50% active medication) can, by itself, be used for both acute and extended treatment.
55 CI subjects underwent a baseline evaluation (Phase-1) and then were randomized to one of two conditions in Phase-2 of the study one month of (1) nightly medication use with standard-dose zolpidem (QHS [n=39]) or (2) intermittent dosing with standard-dose zolpidem and placebos (IDwP [n=16]). In Phase-3 (three months), the QHS group was re-randomized to either continued QHS full dose treatment (FD/FD) or to IDwP dose treatment (FD/VD). Treatment response rates and Total Wake Time (TWT=[SL+WASO+EMA]) were assessed during each phase of the study.
In Phase-2, 77% (QHS) and 50% (IDwP) subjects exhibited treatment responses (p=0.09) where the average change in TWT was similar. In Phase-3, 73% (FD/FD), 57% (FD/VD), and 88% (VD/VD) of subjects exhibited continued treatment responses (p=0.22) where the average improvement in TWT continued with FD/FD and remained stable for FD/VD and VD/VD (p<0.01).
These results suggest that intermittent dosing with placebos can maintain effects but do not allow for the additional clinical gains afforded by continuous treatment.
These results suggest that intermittent dosing with placebos can maintain effects but do not allow for the additional clinical gains afforded by continuous treatment.
To examine the individual and combined effects of daytime sleepiness and insomnia disorder (ID) on measures of cognitive functioning.
This study was conducted at a medical center using a cross-sectional research design.
35 persons with ID (Mage=40.6 years; 25 women) and 54 normal sleepers (NS; Mage=31.5 years; 38 women).
Participants underwent two nights of home-based polysomnography (PSG) followed by daytime testing with a four-trial Multiple Sleep Latency Test (MSLT). Before each MSLT nap, they completed a computer-administered battery of reaction time tasks. Measures of response latencies and response accuracy were tabulated and used as dependent measures. The ID and NS groups were each subdivided into "alert" (eg, MSLT mean latency>8min) and "sleepy" (eg, MSLT mean latency≤8min) subgroups to identify hyperaroused persons with ID and allow for their comparisons with the other participant subgroups.
Multivariate analyses of variance showed a significant main effect for level of daytime sleepiness (F [1, 84]=8.52, p=0.0045) on simpler performance tasks and a significant main effect for presence vs. absence of ID (F [1,84]=6.62, p=0.012) on complex tasks. A lack of significant participant type x MSLT alertness level interactions in study analyses suggested those ID participants with presumed hyperaousal were not relatively more impaired than the other participant subgroups.
Daytime performance deficits on simple tasks seem most dependent on individuals' levels of daytime sleepiness, whereas performance deficits on more complex tasks appears related to the presence of ID. Therefore, it seems best to use complex performance measures both to document cognitive deficits among those with ID and to determine if insomnia treatments reduce such impairments.
ClinicalTrials.gov Identifier NCT02290405.
ClinicalTrials.gov Identifier NCT02290405.
