Depression is a common companion of systemic lupus erythematosus that substantially contribute to patient's suffering and a decreased quality of life. The relationship between depressive symptoms and disease immune processes is not well understood.

To further understand the relationship between lupus and depression, a patient cohort was examined for correlations between clinical presentation, biological parameters and psychosocial evaluation.

Seventy-two lupus patients were screened for depressive symptoms, clinically and psychologically characterized using a battery of instruments, including assessments for depression, anxiety, fatigue, pain and overall health. Scores from these assessments were correlated with lupus clinical profile and biological parameters namely the immune profile.

Forty-two percent of the patients had scores indicative of depression using the HADS Depression scale. Strong correlation was found between pain and depression. Moderate correlation was found between several lupus symptoms, such as mouth ulcers, rash, and arthritis, and psychological evaluation. There was low to moderate correlation between complement levels, C-reactive protein and psychological indicators, but no other lab tests correlated well with the psychological tests.

The correlation of depressive symptoms, complement and C-reactive protein with depressive symptoms suggests that these may be mediated by disease activity and share pathophysiological mechanisms. The overall weakness of correlations with biological markers demonstrates that more specific tests need to be developed. The study of lupus associated depression may, furthermore clarify the role of immune dysfunction in the pathophysiology of this psychiatric disorder.

The authors have not supplied their declaration of competing interest.

Depression is one of the most common mental illnesses in the elderly and its consequences are severe.

To measure the prevalence of depression in elderly cancer patients and subsequently determine the sociodemographic and clinical factors correlated with this disorder.

We conducted a descriptive and analytical cross-sectional study of patients aged over than 65 years old, suffering from cancer and who had no cognitive impairment, admitted in 2013 in the Oncology and palliative care unit of Gabes regional Hospital (Tunisia). We used a self-rating questionnaire to detect sociodemographics and clinical variables, the Geriatric depression scale (GDS) to assess depressive symptoms, and the Activity of Daily Living to determine the degree of autonomy.

At the end of our investigation, we included 60 patients. The prevalence of depression was 48%. Depression was significantly correlated with: marital status (widower subjects were more depressed (74% vs. 34%, P = 0.007)), less degree of autonomy (80% vs. 38%, P = 0.04), fatigue (62% vs. 26%, P = 0.007), pain (59% vs. 26%, P = 0.02), family psychiatric history (80% vs. 20%, P = 0.02), family history of death by cancer (72% vs. 38%, P = 0.01), WHO condition (67% vs. 34%, P = 0.04) and the presence of co morbidity in particularly diabetes (69% vs. 41%, P = 0.05).

Depression is prevalent in oncogeriatric environments. This could compromise quality of support and care of these patients. Close collaboration between oncologist and psychiatrist is needed to support and relieve these patients.

The authors have not supplied their declaration of competing interest.

Depression may have numerous effects on cognition. A little investigated topic is the perception of the grammatical gender.

The aim of this study is to examine whether there is a different understanding of grammatical gender in Greek-speaking young women with and without depressive symptomatology regarding names of cars that are female or neutral according to the modern Greek language.

Two-hundred fourteen women from Greece (Mean age = 19.59, SD age = 3.60, 18 min–50 max) were examined with the ZUNG Self Rating Depression Scale and a language test that comprised of 38 names of car brands, which were characterized in linguistics either as female or neutral. Half of women scored high in the ZUNG Depression scale.

Results indicated that overall there are no statistically significant differences between women with or without depression in their gender perception of the words (P > .005). In addition to that, there are no statistically significant differences between the names of car brands that are related to large size cars and/or expensive car models.

This research suggests that although there is a tendency to consider the existence of depressive symptomatology as detrimental on cognition, this does not seem to hold true for the perception of the gender of the words as examined by linguistics.

The authors have not supplied their declaration of competing interest.

The author has not supplied his/her declaration of competing interest.

Activation syndrome consists of 10 suicides associated symptoms, which is induced by antidepressant treatment. These are anxiety, agitation, manic episodes, sleep disruption, irritability, hostility, aggressiveness, impulsivity, akathisia and mania/hypomania. This syndrome is reported to be associated with a bipolar disorder diathesis. The aim of this study is to evaluate lifetime hypomanic symptoms with major depressive disorder, who are prescribed antidepressant medication, and to investigate whether there is a relationship between these symptoms and the development of AS.

Sixty consecutive outpatients with the diagnosis of major depressive disorder who were naturalistically given antidepressant treatment were examined prospectively. Patients were assessed three times; at baseline, 2 and 4 weeks later. At baseline visit, clinical characteristics of patients including Ghaemi criteria were assessed, life-time history of hypomanic symptoms were assessed with the Hypomania-Checklist-32. In all three interviews, Barnes Akathisia Rating Scale, Hamilton Rating Scale for Depression, Hamilton Anxiety Rating Scale and Young Mania Rating Scale were applied to detect the symptoms of AS. The patients who present at least one of the 10 symptoms were considered to have AS.

Of the 60 patients 25(41.7%) developed AS. The most prevalent symptoms of AS are insomnia (31.7%), anxiety (25%) and irritability (15%). Significant difference was found between patients with and without AS, with regard to HCL-32 test scores. A moderate correlation between the number of AS symptoms and HCL-32 test scores were determined. AS was found to be significantly more frequent in patients with mere hypersomnia and both increased appetite and hypersomnia those without these symptoms.

The findings of this study suggest that certain features of BPS might be associated with the development of AS. Antidepressant treatment of depressive illnesses in this spectrum which are misdiagnosed as unipolar may reveal these symptoms that will complicate the current episode and destabilize the longitudinal course. For this reason, clinicians should evaluate the patients who present antidepressant induced symptoms meticulously and be careful not to overlook the characteristics of BPS.

Major depressive disorder (MDD) is a prevalent burdensome disease, which frequently remains untreated. The duration of untreated illness (DUI) is modifiable parameter and a valid predictor of outcome. Previous investigation in patients with MDD revealed a DUI of different years, while recent reports have documented a reduction of DUI across time, in patients with different psychiatric disorders.

The present study was aimed to investigate potential differences in terms of DUI and related variables in patients with MDD across time.

An overall sample of 188 patients with MDD was divided in two subgroups on the basis of their epoch of onset (onset before and after year 2000). DUI and other onset-related variables were assessed through a specific questionnaire and compared between the two subgroups.

The whole sample showed a mean DUI of approximately 4.5 years, with a lower value in patients with more recent onset compared to the other subgroup (27.1 ± 42.6 vs. 75.8 ± 105.2 months, P < .05). Moreover, patients with onset after 2000 reported higher rates of onset-related stressful events and lower ones for benzodiazepines prescription (65% vs. 81%; P = 0.02; 47% vs. 30%; P = 0.02).

The comparison of groups with different epochs of onset showed a significant reduction in terms of DUI and benzodiazepines prescription, and a higher rate of onset-related stressful events in patients with a more recent onset. Reported findings are of epidemiologic and clinical relevance in order to evaluate progress and developments in the diagnostic and therapeutic pathways of MDD in Italian and other countries.

The authors have not supplied their declaration of competing interest.

Various studies showed the efficacy and tolerability of WS® 5570 (Hyperiplant® Rx, Dr. Willmar Schwabe GmbH & Co. KG) for the treatment of acute mild-to moderate depression. Beneficial effects of WS® 5570 have been also shown in patients with moderate-to-severe depression.

We present a subgroup analysis of a double blind, randomised trial to compare the therapeutic efficacy of WS® 5570 with paroxetine in patients suffering from a major depressive episode with moderate symptom intensity. This analysis on moderately depressed patients treated with WS® 5570 tries to support the hypothesis that WS® 5570 is an effective remedy in patients with major depression and moderate symptom intensity.

Moderate depression was defined by a baseline Hamilton Depression Rating Scale (HAM-D) total score between 22 and 25. Sixty-four patients received, after a single blind placebo run-in phase of 3–7 days, either 3 × 300 mg/day WS® 5570 or 20 mg/day paroxetine for six weeks. The change of the HAM-D total score was used to describe the efficacy of WS® 5570 compared with paroxetine in the subgroup of patients with moderate depression.

The reduction of the HAM-D total score was significantly more pronounced in patients treated with 3 × 300 mg/day WS® 5570 compared to 20 mg/day paroxetine. After six weeks, responder (87.1%) and remission rates (60.6%) to WS® 5570 were significantly higher than to paroxetine (71%/42.4%).

After six weeks, patients treated with WS® 5570 showed a higher reduction in depression severity score and yielded greater response and remission rates compared with patients treated with paroxetine.

Supported by Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany

Self-stigma is a maladaptive psychosocial phenomenon that may disturb many areas of patient's life. In connection with maladaptive coping strategies should make mental health recovery more difficult. Specific coping strategies may be connected with the self-stigma and also with the severity of the disorder. The objective of the study was to explore the relationship between coping strategies, the severity of the disorder and self-stigma in outpatients with depressive disorder.

Eighty-one outpatients, who met ICD-10 criteria for depressive disorders, were enrolled in the cross-sectional study. Data on sociodemographic and clinical variables were recorded. All probands completed standardized measurements: The Stress Coping Style Questionnaire (SVF-78), the Internalized Stigma of Mental Illness Scale (ISMI), and the Clinical Global Impression (CGI).

The patients with depression overuse negative coping strategies, especially escape tendency and resignation. Using of positive coping is in average level. Coping strategies are significantly associated with the self-stigma. Negative coping (especially resignation and self-accusation) increase the self-stigma, using of positive coping (primarily underestimation, reaction control, and positive self-instruction) have a positive impact to decreased self-stigma. The level of self-stigma correlated positively with total symptom severity score.

The present study revealed the important association between coping strategies and self-stigma in outpatients with depressive disorders. Decreasing the use of negative strategies, and strengthening the use of positive coping may have a positive impact to self-stigma reduction.

The authors have not supplied their declaration of competing interest.

The international guideline for treating depression has been widely used.

The current study focused on the maintenance treatment section of the third revision of Korean Medication Algorithm for Depressive Disorder (KMAP-DD)

A 44-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for depressive disorder. Of the 144 committee members, 79 psychiatrists responded to the survey. Each treatment strategy or treatment option was evaluated with the nine-point scale.

Most clinicians answered to maintain both antidepressants (AD) and atypical antipsychotics (AAP) for psychotic depression in remission state. The duration of AD maintenance: from 19.8 weeks to 46.8 weeks for patients in remission of the first episode, from 34.8 weeks to 78.4 weeks for the second depressive episode, and long-term continuation for three or more depressive episodes. Aripiprazole was the most preferred AAP. The preferred doses of AD and AAP in maintenance treatment were about 75% and 50% of those in acute treatment The maintenance of AAP in the psychotic depression in remission was similar to the AD, although shorter and less.

The maintenance strategies of KMAP-DD 2017 were similar to those of KMAP-DD 2012. Most clinicians preferred to maintain AD for substantial duration after achieving remission. The maintenance of AAP was also preferred, but the duration was shorter than AD.

The authors have not supplied their declaration of competing interest.

Emerging evidence suggests that sedentary behaviour, specifically time spent taking part in screen-based activities, such as watching television, may be associated with mental health outcomes in young people [1]. However, recent reviews have found limited and conflicting evidence for both anxiety and depression [2].

The purpose of the study was to explore associations between screen time at age 16 years and anxiety and depression at 18.

Subjects (n = 1958) were from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK-based prospective cohort study. We assessed associations between screen time (measured via questionnaire at 16 years) and anxiety and depression (measured in a clinic at 18 years using the Revised Clinical Interview Schedule) using ordinal logistic regression, before and after adjustment for covariates (including sex, maternal education, family social class, parental conflict, bullying and maternal depression).

After adjusting for potential confounders, we found no evidence for an association between screen time and anxiety (OR = 1.02; 95% CI 0.95–1.09). There was weak evidence that greater screen time was associated with a small increased risk of depression (OR = 1.05, 95% CI 0.98–1.13).

Our results suggest that young people who spend more time on screen-based activities may have a small increased risk of developing depression but not anxiety. Reducing youth screen time may lower the prevalence of depression. The study was limited by screen time being self-reported, a small sample size due to attrition and non-response, and the possibility of residual confounding. Reverse causation cannot be ruled out.

The authors have not supplied their declaration of competing interest.

Rumination is a negative coping strategy defined as repetitive and passive focusing on negative feelings such as depression. The Ruminative Response Scale (RRS) is a widely used instrument to measure rumination, but there is continuing argument about the construct validity of the RRS, because of probable overlap between the measurement of depression and that of rumination. The RRS-Revised, which removed 12 items of the RRS, is suggested as a more valid instrument for measuring rumination. Therefore, we translated RRS-R into Korean and explored the reliability, validity and factor structure in patients with major depressive disorders.

Seventy-nine patients with major depressive disorder took the Korean version of RRS, RRS-R, State Trait Anxiety Inventory, Beck Depression Inventory and Penn State Worry Questionnaire. We performed exploratory factor analysis of RRS-R, and tested construct validity, internal reliability and test-retest reliability.

The internal and test-retest reliability of RRS-R was high. Factor analysis revealed that RRS-R is composed of two factors. “Brooding” factor explained 56.6% and “Reflection” factor explained 12.5%. RRS-R, especially “Brooding” factor, was highly correlated with other clinical symptoms such as depression, anxiety and worry.

In this study, we find out the RRS-R is more reliable and valid than the original RRS in Korean patients with depression because the RRS-R is free from the debate about the overlap of item with BDI. We also revealed that “Brooding” is highly correlated with depressive symptoms. RRS-R may be a useful instrument to explore the implication of “Brooding” in depression.

The author has not supplied his/her declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Compared to healthy controls, adults with major depressive disorder (MDD) showed stronger activation in dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) in resolving emotional conflict. Whether subthreshold depression (StD) at an advanced age is also accompanied by similar changes in brain activation in coping with emotional conflict remained unknown.

By using face-word Stroop task, the current study explored the neural correlates of emotional interference processing in old adults with StD.

Participants were 19 community-dwelling older adults with StD assessed by the Center for Epidemiologic Studies Depression scale (CES-D) scores. We collected magnetic resonance images of their brain compared to images of 18 healthy aged-matched adults. We used SPM to analyze differences in brain activations in emotional interference processing between the two groups.

Results showed that elderly individuals with StD have stronger activation in DLPFC, ACC, default mode network (DMN) and visual extrastriate cortex compared to healthy controls. Furthermore, the brain activations of the DLPFC, DMN and visual extrastriate cortex were significantly associated with participants’ behavioral interference effect in StD.

Stronger brain activation in DLPFC, ACC, DMN and extrastriate cortex in old adults with StD suggests that the working efficiency of their brain is quite low and their cognitive control is impaired to some extent.

The authors have not supplied their declaration of competing interest.

To study the clinical - psychopathological characteristics of patients with resistant depression.

We examined 96 patients aged 18–48 years (mean age 34.7 0 ± 1.0 years). The investigated patients were divided into two groups: 1st -TRD with positive affectivity - 59 (61.4%); 2nd - curable depression - 37 (38.6 %). Selection of patients was made according to following criteria: ICD - 10: (F31) - bipolar disorder; (F32) - depressive episode; (F33) - recurrent depressive disorder.

In group 1 patients received amitriptyline (TCA) - 50 mg - 2 times/day in one of 2 consecutive courses (within 6 weeks) and they showed no clinical benefit. In group 2 patients received amitriptyline - 50 mg 2 times/day for 2 consecutive courses. When analyzing the number of depressive episodes the statistically greater number was observed 1-3 episodes in group 2 - in 45.9% of patients than in group 1 - 16.9%, predominant 5-8 episodes - in 44.1% of patients in group 1, than in group 2 - 13.5%. Remissions, observed in group 2, were characterized by longer duration and have a higher quality than in patients of group 1. There is a tendency to shorten remission especially in group 1.

The highest correlation dependence showed such factors as: frequency of depressive episodes, duration of episode 1, severity of depressive episode 1, quality of remission after depressive episode 1, number of responders at early stages of antidepressant therapy of I-st attack.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Pathogenesis of metabolic syndrome (MS) and depression (MDD) is complex and insufficiently explored. In addition to chronic stress, psychotrauma, hypercortisolemia and immunological factors, some personality features may have an impact. Type D personality, most influential personality type in psychosomatic medicine, consists of two dimensions: negative affect (NA) and social inhibition (SI). Individuals with type D personality are more anxious, irritable and depressed and they do not share these emotions with others because of their fear of rejection. Type D personality was proven to be a risk factor for some MS components, as well as for the occurrence of depressive symptoms in cardiac patients.

To investigate the association of type D personality with MS and its components in MDD patients.

Cross-sectional study was conducted on the sample of 80 patients with depression and 40 healthy subjects as the control group. Mini International Neuropsychiatric Interview (MINI questionnaire) and Hamilton Rating Scale for Depression (HDRS-17) were used for the diagnosis of depression. Type D personality was determined by DS14 questionnaire. The MS diagnosis was made according to ATP III criteria.

The presence of type D personality did not significantly contribute to the probability of developing MS in patients with depression. NA was associated with abdominal obesity, low HDL-cholesterol and hypertension.

Negative affect was proven to be an independent risk factor in the pathogenesis of obesity, hypertension, and reduced level of HDL-cholesterol, while type D personality in general did not have predictive value for the MS development.

The authors have not supplied their declaration of competing interest.

The problem of emigration and re-emigration in Ukraine is among the most actual state and social problems.

To research clinical-psychopathological peculiarities of depressions in “working” emigrants and re-emigrants.

The investigation was carried out in Ternopil Region. Psychogenic depressive disorders (F43.21 and F43.22 according to ICD-10) were diagnosed in 69 non-emigrants, 68 emigrants, and 67 re-emigrants; endogenous ones (F31.3, F31.4, F32.1, F32.2, F33.1, and F33.2 according to ICD-10) were diagnosed in 65, 66, and 63 persons correspondingly; and organic ones (F06.3 according to ICD-10) were diagnosed in 64, 62, and 61 persons correspondingly.

It was found out an influence of emigration and re-emigration factors on psychoemotional sphere of the patients. The influence of the emigration factor was the most manifested in patients with psychogenic depressive disorders and was a less manifested in patients with endogenous and organic depression. Re-emigrants had the most severe depressive symptoms that might be explained by an impact of psychosocial factors. In the syndromological structure of depressive disorders it was determined that re-emigrants were more affected by typical affective syndromes – vital and apathic depression, whereas emigrants were more affected by atypical affective syndromes, including anxious-depressive and agitation ones. It might be explained by an influence of objective social-psychological factors as well as an intrapsychic transformation of actual stressors connected with emigration and re-emigration.

Emigration should be considered as a factor promoting a pathologically characterological development towards anxious-depressive changes, whereas re-emigration should be considered as a factor of asthenic-depressive and apathic-depressive transformations.

The authors have not supplied their declaration of competing interest.

Data on accordance and clinical significancy of objective (doctor, psychometric scales) and subjective (patient with depression) assessment of severity of depression are almost lacking. Aim of the multicenter study “EMOTION” was to compare prognostic value of doctor's and patient's assessment of depressive symptoms severity as for its grading and treatment outcome.

Study sample consist of 107 depressive patients. The study used clinical and psychometric (HDRS, SHAPS, CGI-S, CGI-I, PGI-S, PGI-I, Visual Analog Scale) methods.

Our data suggest that there's statistically significant (Р ˂ 0.001) discrepancy between doctors’ (CGI-S) and patients’ (PGI-S) assessment of depressive symptoms’ severity at first visit. Concordant opinions were found only in “marked depression” (37.49% of doctors and 36.59% of patients) and in “borderline depression” (4.79% of doctors and 3.79% of patients). Otherwise, doctors’ and patients’ opinions were discordant. Doctors’ scores were more extreme (severe and extremely severe depression); patients’ scores were more “moderate”. We have found inconsistence between HDRS and CGI-S scores. In the course of reduction of depression severity during antidepressive treatment (agomelatine) doctors’ and patients’ scores were more and more in line with each other.

We have found leveling of prognostic value of psychometric assessment of depression severity by doctors and patients (in terms of reduction of depressive symptoms severity and treatment outcome) during antidepressive therapy. It is possible that in some HDRS items scores were overestimated.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.