Agomelatine is a melatonergic agonist and 5-HT2C antagonist with demonstrated antidepressant efficacy in clinical trials. The aim of the non-interventional study VIVALDI was to examine the antidepressant efficacy and tolerability of agomelatine in depressed patients in daily practice.

3317 outpatients aged > 18 years with first or recurrent depressive episodes were observed by 665 German psychiatrists over 12 weeks. Patients were treated with agomelatine 25–50 mg once daily at bedtime. Antidepressant efficacy was evaluated by the svMADRS (short version MADRS) and CGI scales, effects on sleep and daily activity by a patient questionnaire (CircScreen).

At inclusion, patients showed moderate to severe depression (svMADRS: 0 = 30.6), demonstrating an steady and marked clinical improvement during the 12 weeks of agomelatine treatment (svMADRS: 0 = 12.8). The responder rate (≥50% reduction of svMADRS) rose steadily from 12.3% (2 weeks) to 42.7% (6 weeks) and 65.8% (12 weeks). After 3 months, 54.8% of patients were in remission (svMADRS ≤12). On the CGI scale, 22.8% of patients responded (CGI-I ≤2) after 2 weeks and 72.4% after 12 weeks of treatment with agomelatine. Decrease in repeated and early morning awakenings, and increase daily activities were observed after 12 weeks in 81.5%, 82% and 56.6% of patients, respectively. The tolerability of agomelatine was good.

The antidepressant efficacy of agomelatine on depressive symptoms and daytime activities, as well as its tolerability observed in controlled trials were confirmed by the results of the non-interventional study VIVALDI.

Unaffected healthy 1st degree relatives of patients with major depressive disorder (MDD) are 3.6 times more liable to develop the disease themselves than the standard population without the history of the disorder. Neural correlates of this liability are of particular interest since the phenomenon does not always have behavioral manifestations and early detected can enhance quicker and better MDD prevention.

The objective of our study was to establish neuronal correlates of susceptibility MDD in unaffected healthy 1st degree relatives of patients with MDD. Inhibition of emotional information was examined in the present study.

The aim of the study was to better understand the development of MDD and the role of altered inhibition of emotional processing in it. That, in consequence, may contribute to establishing new methods of prevention and quicker detection of MDD liability.

Twenty-one unaffected healthy 1st degree relatives of patients with MDD and twenty-five matched healthy controls underwent a functional magnetic resonance imaging procedure with a task involving inhibition of emotional processing of positive, negative and neutral emotional information. 2 × 3 ANOVA was performed to establish if the two groups differed significantly in the inhibition of one of the three types of emotions.

The unaffected healthy 1st degree relatives displayed an increased neural activation during the inhibition of negative emotional information in the bilateral middle cingulate cortex (MCC) and the left caudate nucleus (p< 0.05, family wise error).

The overactivation of the MCC and caudate nucleus can be a marker of MDD liability

Depressive disorder at women associated important neurobiological (cortical atrophy) and somatic vulnerabilities. (metabolic syndrome, hypertension, coronary heart disease and diabetes mellitus associated with weight gain).

Retrospective study on 100 women patient lot, 36–55 years, hospitalized in Psychiatry Clinic of Craiova from January 1st 2007 to December 31st 2009. The inclusion criteria are: depressive disorder (HDS score 20–24), without somatic disorders. The final assessment was realized for this items: remission level (full, partially remission, persistent depression), cognitive impairment (MMSE), weight gain (+7.5 kg from baseline), somatic disorders.

For patients with cognitive impairment, persistence depression and weight gain we effectuated the psychostress evaluation and brain computer tomography.

Full remission - 40% of patients; partially remission - 37%; persistence depression: 23% (HAD >18).

Cognitive impairment - MMSE < 25 - all the patients with persistence depression and 5 patients with partially remission, 72 patients does not have cognitive impairment.

Weight gain: >7kg from baseline - 45 patients.

Somatic disorders: hypertension: 32 patients; coronary heart disease: 27 patients; diabetes mellitus: 21 patients.

At patients with persistence depression, cognitive impairment and weight gain (12 patients) the CT revealed cortical atrophy, calcification of choroid plexus and ventricular enlargement.

All the patients had high scores on the Lloyd Stress Scale.

Weight gain and high scores for psychosocial stress can be in the future markers for the prediction of evolution risk in depression at women and is required the association of psychopharmacological treatment with psychokinetotherapeutic and psychotherapeutic methods for the decrease of psychostress.

Today there is a large number of antidepressant drugs. However, the effect of treatment is often suboptimal. Unlike other antidepressants agomelatine has a novel neurochemical mechanism. It is an MT1 and MT2 melatonergic receptor agonist and a selective antagonist of the 5-HT2C receptors. In this open-label 8-week study we aimed to investigate the efficacy of agomelatine on depressive symptoms in patients with major depression. Secondary endpoints were the effect of agomelatine on anhedonia.

Thirty major depressive patients received a flexible dose (25–50 mg; per os, daily) of agomelatine. Depressive (Hamilton Depression Scale) and anxious (Hamilton Anxiety Scale) symptoms, anhedonia (Snaith Hamilton Rating Scale), and sleep quality (Leeds Sleep Evaluation Questionnaire) were assessed.

Twenty-four patients (80%) completed 8 weeks of treatment. Significant improvements were seen at all visits on the HAM-D (p< .05), HAM-A(p< .01), SHAPS (p< .05), LSEQ (p< .05). Nine subjects (30%) were responders and 5 (17%) remitters at week 1; 18 (60%) were remitters by the end of the trial. There was no serious adverse event. No aminotrasferase elevations were noted.

In line with previous studies, in which agomelatine was associated with early clinical improvement this study also provides evidence of an early response and the findings of improvements in depression scores. Beside this is the first study where agomelatine was effective in the treatment of anhedonia. Additional trials are needed to delineate the place of agomelatine in the contemporary pharmacotherapy for depressive disorders.

Major depression was the fourth most important determinant of the burden of human disease in 1990 and is expected to rank second in the world by 2020.

As the causes of depression are complex, the identification of modifiable risk and protective factors, and understanding the processes through which they operate is crucial.

The main aim of the present study is to identify potential risk factors to the development of depression.

A total of 304 college students completed an on line questionnaire which assessed: depressive symptomathology (IACLIDE; Vaz Serra, 1994), pessimism (LOTR; Scheier, Carver, & Bridges, 1994), dysfunctional attitudes (DAS; Weissman & Beck, 1978) and neuroticism (EPQ; Eysenck & Eysenck, 1969).

The main results indicated that pessimism, dysfunctional attitudes, and neuroticism correlated significantly and positively with depressive symptomathology.

The results suggested that pessimism, dysfunctional attitudes, and neuroticism can be considered risk factors for depression and important variables to be included in the depression prevention program under development. Overall, the results of this study indicate that understanding the relationships between these variables may be important to the prevention of depression.

In this study we examine potential mechanisms by which the stimulation of hippocampal neurogenesis may generate an antidepressant effect.

Study-1: Adult male rats (N = 24) were trained to segregate relevant from irrelevant spatial cues (spatial segregation); tested on this task four and 8-weeks late; then exposed (on week 8) to a modified version of the task that conflicted with the memory of the initially learned experience (mnemonic segregation); and then euthanized to detect hippocampal neurogenesis. Study-2: Adult rats (N = 24) were trained in the spatial segregation task; three-days later, half were re-tested on the same task and half the tested on the modified task (mnemonic segregation); and euthanized immediately to detect neurons that were synaptically active during task performance.

Study-1: Good performers on the modified task (mnemonic segregation) had significantly greater rates of hippocampal neurogenesis, but the increase was only in immature neurons and not in new neurons that had completed maturation. Performance on spatial segregation task was unrelated to proficiency in mnemonic segregation or rates of neurogenesis. Study-2: Performance on the mnemonic segregation unrelated to neurogenesis rates, but inversely correlated to synaptic activation of mature hippocampal neurons, which in turn inversely correlated with immature neuron rates.

Taken together, the data suggests that neurogenesis facilitates detection of subtle changes to experiences established over several weeks (not days); this occurs prior to forming synapses; and maybe associated with suppression of mature hippocampal neurons that presumably mediate older, interfering, experiences.

Results show that participants in the exercise group improved their quality of life parameters, suggesting that exercise could be an effective therapeutic adjuvant for non-remitted MDD patients.

In recent years, physical exercise has shown some promising results as an adjuvant therapy for several psychological disorders, helping to improve not only depression parameters but also quality of life. However, and due to the different populations, settings and exercise programs, not all studies have shown a positive association.

To assess the effect of a moderate intensity 12 week exercise program on the quality of life of a population sample of patients with non-remitted Major Depressive Disorder (MDD).

Study design Prospective, randomized, two-arm, parallel assignment. Population 150 individuals diagnosed with MDD according to DSM-IV criteria, taking combined therapy in doses considered appropriate for at least 9 months, without showing clinical remission, defined as having an HAMD17 total score ≤ 7, attending the out-patient psychiatry clinic, were initially screened through an interview with a psychiatrist. Those meeting study criteria were randomized to one of two groups: control (N = 11) and aerobic exercise (N = 22). Study protocol Exercise group: moderate intensity exercise program for 12 weeks, in addition to their usual pharmacological therapy. Control group: regular daily activities and their usual pharmacological therapy. Instruments WHOQOL-Bref and SF-36, two validated instruments to assess quality of life.

At the end of the exercise program, participants in the exercise group showed improvement on the physical domain of SF-36 and on the social domain of WHOQOL-Bref (p < 0.05).

Results suggest that exercise could help improve some aspects of the quality of life in non-remitted MDD patients.

In recent years, physical exercise has shown some promising results as an adjuvant therapy for several psychological disorders. However, and due to the different populations, settings and exercise programs, not all studies have shown a positive association.

To assess the effect of a moderate intensity 12 week exercise program on depression and functional parameters in a population sample of patients with non-remitted Major Depressive Disorder (MDD).

Study design Prospective, randomized, two-arm, parallel assignment. Population 150 individuals diagnosed with MDD according to DSM-IV criteria, taking combined therapy in doses considered appropriate for at least 9 months, without showing clinical remission, defined as having an HAMD17 total score ≤ 7, attending the out-patient psychiatry clinic, were initially screened through an interview with a psychiatrist. Those meeting study criteria were randomized to one of two groups: control (N = 11) and aerobic exercise (N = 22). Study protocol Exercise group: moderate intensity exercise program for 12 weeks, in addition to their usual pharmacological therapy. Control group: regular daily activities and their usual pharmacological therapy. Assessed parameters HAMD17, Beck Depression Inventory (BDI), Global Assessment of Functioning (GAF), Clinical Global Impression Scale - Severity (CGI-S).

Participants in the exercise group showed better depression and functional parameters at the end of the study, both compared to the beginning of the study and compared to the control group (lower HAMD17, BDI and CGI-S and higher GAF, p < 0.05).

Results suggest that exercise could be an effective adjuvant therapy for non-remitted MDD patients.

In this descriptive - analytic study 150 university student were asked to fill in the satisfaction with life Scale (SWLS) and trust (21question).

The data is analyzed by SPSS software and chi-sqdne statistical tests.

1. 1- There is significant relationship between satisfaction with life scal & extent of students trust in God.

2. 2- The more the extents of students trust in God the more their satisfaction life scale is.

3. 3- There is no significant relationship between satisfaction with life scal and students trust extent in terms of education, birth order, sex, age variable.

At present, 121 million worldwide suffer from a treatment-requiring depression. Treatment recommendations include pharmacotherapeutic and psychotherapeutic procedures. However, lacking resources in psychotherapy complicate the process of implementation. Therefore, researchers are increasingly working on computer-based psychotherapy programmes. But will these programmes be accepted by patients - and if yes, how would they use them?

Obtaining information on how patients assess and wish to use online psychotherapy programmes, using the example of the web-based programme “Deprexis”. The programme can be used to bridge waiting times, for phase-prophylactic purposes and to accompany the therapy. Based on elements of CBT, CBASP, IPT and ACT, clinical and scientific experts have developed this evidence-based intervention and positively evaluated it in an RCT (Meyer, B., Berger, T., Caspar, F., et al., 2009).

In an online survey, the acceptance and desired use of the programme in the target group of patients were inquired.

The participants (N = 421) were interviewed regarding the application and acceptance of “Deprexis” as well as depressive symptoms and resulting functional restrictions (PHQ-9).

The participants had clinically relevant scores on the depression scale (average: 14.6 points). 93% wished to use an online programme. 42% assessed it as a low-threshold test for psychotherapy, 29% considered it a suitable tool for the bridging of waiting times. 17% even regarded it as a potential replacement for psychotherapy.

The results indicate high acceptance within the target group and reveal fields of application as a complementary measure at various stages of the treatment process.

The hepatitis C virus infection (HVC) represents a public health problem that affects the 3% of world population. The currently recommended treatment is Pegylated Interferon (PegIFN) alpha and Ribavirin (RBV) during 24 or 48 weeks. This treatment has been associated with high rates of neuropsychiatric side effects, mainly depression. Recent studies have documented impairment in health related quality of life (SF-36) in these patients.

To study the induced depression and quality of life of chronic HVC patients under antiviral treatment.

Three hundred seventeen consecutive HCV patients, who received PegIFN alpha and RBV, were assessed using the SCID interview for DSM-IV. Moreover, the PHQ, the HADS and the SF-36 were administered at baseline, 4, 12, 24, and/or 48 weeks of treatment.

Two hundred twenty-four (64.7%) of patients were men, the mean (SD) age was 43.6 (10.6), and 130 (40.1%) had history of mood disorder. One-hundred eleven (41%) of the sample had a depressive disorder during the treatment. There was a significant difference in the total SF-36 score and in all subscales (p < 0.001). HADS subscale of depression was highly correlated with SF-36 total score (p < 0.001).

During the antiviral treatment, HVC patients had a higher incidence of induced depression. Both physical and mental component scores of SF-36 in induced depressed patients were significantly worse.

This study has been supported in part by Spanish grants: FIS E08/00268, Dra. Martín-Santos, and Dr. Solà.

There is a significant incidence of depression, also in adolescents. Bright light therapy, which is reported to be effective treating depressive adults, could provide safe, economic, and effective rapid recovery also in adolescents.

We treated depressed adolescents with bright white (2,500 Lux) light for one hour a day (morning) and for another week with placebo. Saliva samples were collected 1 week and just before and immediately after treatment and placebo and 1 week later and assayed for Cortisol and melatonin respectively to observe any change in circadian timing. Beck’s depression inventory scales were administered.

Two volunteers, between 14 and 17 years old, completed the study. Both patients experienced mood improvement. Average BDI scores improved 5 points. There were no significant treatment effects or time-by-treatment interactions. No significant adverse reactions were observed. The assays of saliva showed significant differences between treatment and placebo.

Antidepressant response to bright light treatment in this age group was statistically superior to placebo (Clinically significant overall improvement of 16%).

Comorbid depression in somatic illness is highly prevalent. However, most depression questionnaires show violation of unidimensionality and hypersensitivity of items.

The Depression Screening (DESC) is a new self-rating scale for the measurement of depression severity that we developed from a calibrated Rasch-homogeneous item bank (N = 367) to improve short depression assessment in patients beyond psychiatric settings.

To present data for both parallel forms (10 questions each) of the DESC, and to examine its Rasch model qualities in different patient groups and a representative German general population sample.

Patient groups with depression, heart disease, neurological or otolaryngological disease (N = 333) were investigated with the DESC accompanied by diagnostic interviews and established depression scales. The demographic sample (N = 2509) was interviewed face to face, too. Adherence to Rasch model assumptions was determined with analysis of model fit, and further measures. Norm values were calculated.

Both DESC versions feature different but highly correlated item sets. Cut-off scores with good sensitivity (0.82, 0.81) and specificity (0.78, 0.77) for the diagnosis of an affective disorder were developed with ROC analyses. No serious Differential Item Functioning in Rasch analyses for both scales was found. In the German validation sample the Rasch dimension “depression” explained 68.5% and 69.3% respectively of the variance. Validity was determined through sufficient intercorrelations with other scales (e.g. BDI, HADS).

Our studies support the good psychometric RASCH qualities of both DESC forms and offer important advancements in depression screening being of use for time-limited clinical and research applications.

The previous studies reported that elevated serum cholesterol levels (≥ 200 mg/dl) were associated with poorer response to fluoxetine and nortiptyline treatment in patients with depression.

The aim of this study was to examine the relationship between pretreatment serum cholesterol levels and clinical response to treatment with different antidepresants among inpatients with depressive disorder.

One hundred and four inpatients with depressive disorder who did not respond to previous treatment were enrolled in a six-week open study. New treatment (different antidepressant monotherapies, combinations or augmentations) was chosen according to clinical judgment. Serum cholesterol levels were obtained before starting new treatment. Cholesterol levels were classified as either elevated (≥ 200 mg/dl) or nonelevated. Clinical response was defined as ≥ 50% decrease in the Montgomery Åsberg Depression Rating Scale (MADRS) score at endpoint compared to baseline.

Forty-six patient (44%) were classified as having elevated cholesterol levels at baseline. Patients with elevated cholesterol levels did not significantly differ in gender ratio, baseline MADRS score, duration of current episode and number of previous episodes but were significantly older than patients with nonelevated cholesterol levels. After adjusting for age, gender, and Body Mass Index (BMI), we did not find significant differences in response rate and as well as in the pretreatment-posttreatment change in MADRS between patients with elevated cholesterol and patients with nonelevated levels.

We did not demonstrate association between pretreatment cholesterol level and response to treatment in depressive disorder.

Study was supported by the grant NS10368 IGA MZ CR.