Late-onset depression has been associated with history of vascular disease and atherosclerosis. As immune dysregulation is critically involved in vascular disease. We hypothesized that responsiveness of late onset depression can be associated with level of inflammatory markers in these subjects.

Role of inflammatory mediator in antidepressant responses in late onset depression.

To study C-reactive protein as predictor of antidepressant response in late onset depression.

Depressed patient (as per ICD 10 DCR) age > 60 years recruited from department of psychiatry and complete clinical assessment done and base line depression severity measure on Hamilton Depression Rating Scale (HDRS). C reactive protein level was assessed at base line. Patient prescribed antidepressant medication and at 8 week follow up re assed for depression severity in HDRS. Data analyzed with spss.21 and spearman correlation was used.

Mean age of responder (n = 6) 63.5 ± 4.9 year and HDRS at base line 16 ± 1.9. Mean age of partial responder or non-responder (n = 19) 65.1 ± 6.1 year and HDRS at base line 18.5 ± 3.9. Continuous decrease in depression severity during study period and antidepressant response rate was 24%. Base line CRP level had negative correlation with antidepressant responsiveness (r = –0.6, P < 0.05).

Late onset depression was less responsive to antidepressant medication and poor antidepressant response rate was associated with higher level of CRP in late onset depression.

Document not received.

The authors have not supplied their declaration of competing interest.

Resilience in the psychiatric field, it is defined as the ability to recover from perceived adverse or changing situations through a dynamic process of adaptation. This process is influenced by personal characteristics, family and social resources and is expressed by positive coping skills. It is well known that resilience has an inverse relation with depression, however, the specific role of resilience in disorders like depression, personality disorders and psychosis is not fully understood.

Compare differences in resilience and coping skills in a sample of patients with depressive disorder in acute phase versus healthy controls.

We are conducting a cohort study to the date we recruited 82 inpatients admitted in our psychiatric ward. The data have been gathered from the 1st December 2014 and they will continue to be collected until the 1st December 2016, the healthy controls are represented by 67 subjects with similar socio-demographic features.

Inclusion criteria are: diagnosis of depressive disorders or dysthymia according to DSM-IV-TR diagnostic criteria, age > 18 years, proper understanding of Italian language, willingness to give written informed consent. We compared them with healthy controls with similar socio-demographic features.

Patients’ assessment includes the following tests:

– Resilience Scale for Adults (RSA);

– Brief-COPE Scale (Brief-COPE);

– Statistical analysis will be performed using SPSS for Windows, 21.0 (Armonk, NY: IBM Corporation).

Data collection is still ongoing.

From a preliminary analysis of data, we assume that the levels of resilience and coping of our patients is reduced compared with controls, however the recruitment during the acute phase could significantly influence final results.

The authors have not supplied their declaration of competing interest.

The course of depression during therapy in studies is usually monitored by scales like HAMD. Also the course of single items of the HAMD during therapy might be of specific interest as some symptoms are of highly predictive value. Furthermore early improvement during antidepressive therapy is a new aspect which came into the focus.

The objectives of this study were to reanalyze clinical data regarding early improvement as well as specific symptoms or symptom cluster – like sleep disturbances.

The aim of this study was to get deeper insight into the data structure of 2 RCTs (n = 398, 42 days treatment) comparing the efficacy of a hypericum extract (STW3-VI/900 mg once daily) to Placebo.

Data structure was evaluated by comparing the total scores of the HAMD-17 to a single item analysis and by calculating the factorial structure of the end of treatment data. The treatment potential was evaluated by calculating a positive predictive value from day 7 to the end of treatment. ANCOVA, factor analysis and regression methods were used.

The single item analyses were widely comparable to the highly significant treatment differences of the total scores as it were the calculated subscales. The positive predictive value of the treatment was about 75%.

The results underline the elsewhere proven treatment efficacy of STW3-VI regarding several new subscale aspects.

COI: The authors are employees of Steigerwald Arzneimittelwerk GmbH, Darmstadt, Germany.

Much attention has focused on body dysmorphic disorder among patients undergoing plastic surgeries, but there has been little evaluation of their past history of major depressive disorder (MDD).

To estimate the prevalence rate of past history of Major Depressive Disorder (MDD) in patients undergoing Blepharoplasty operation in a private ophthalmology hospital in Jeddah, Saudi Arabia.

All patients who have undergone blepharoplasty operation during the period from 5 April to 4 October 2016 (6 months) were included. Previous psychiatric history was taken from the patients by psychiatric assessment and self-assessment questionnaire, diagnosis of Major Depressive Disorder (MDD) confirmed previously by consultant psychiatrists in patients’ health records was included.

One hundred and forty-eight persons undergone blepharoplasty in the hospital from 5 April to 4 October 2016. They were 89 females (60%) and 59 males (40%). Among those 148 persons, 10 patients were previously diagnosed with major depressive disorder by consultant psychiatrists with a percentage of 6.8% where 5 were females (5.6% of 89 females) and 5 were males (8.5% of 59 males).

The number of individuals who present for blepharoplasty operation with a history of Major Depressive disorder needs to take a special consideration. A link between MDD and cosmetic operation decision should be further studied.

The authors have not supplied their declaration of competing interest.

Social support is one of the functions of social relationships that modify stress. Social supportive resources play important role in helping patients to adjust to the disease. Not much is known about social support in multiple sclerosis patients while it is one of the available interpersonal resources.

and aims To examine the specificity in perceived social support in multiple sclerosis patients.

The sample were 104 in-patients diagnosed with multiple sclerosis (both men and women; mean age 38, SD = 10). All patients included in this study filled out the 22-item Russian version of the social support questionnaire (F-SOZU-22, G. Sommer, T. Fydrich in 1989, adaptation developed by A. Kholmogorova in 2006). Among them there were patients with relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis.

The entire sample reported the normal level of social support. One can mention that multiple sclerosis patients did not differ in general level of perceived social support from the healthy subjects. The exception was the overall satisfaction of social support, which reflected its statistically higher level in multiple sclerosis patients (P < 0.05). Further analysis showed no significant differences in perceived social support in patients associated with gender factor and clinical forms of multiple sclerosis (P > 0.05).

The perceived social support in multiple sclerosis patients is characterized by normal levels of its emotional and instrumental components and inclusion in the network of close social relationships. However, the patients of both genders do not feel stability of these relations and have a deceased sense of security that can be a significant risk factor for depression.

The authors have not supplied their declaration of competing interest.

Personality disorders (PD) and Affective temperaments (AT) have been considered vulnerability factors for the development of mood disorder (MD).

To study the simultaneous presence of PD and AT in patients with DU and differences between unipolar depression (DD) and bipolar disorder BD.

An observational study was conducted. Patients were administered the Temperament Evaluation of Memphis, Pisa, Paris and San Diego questionnaire (TEMPS-A) for AT and the Structured Clinical Interview for DSM IV Axis II Disorders (SCID-II) for PD. The interrelationships of the different PD and AT were studied by factor analysis (principal component analysis, PCA) (orthogonal rotation, Varimax).

Participants were 156 adult patients with MD, 37.1% with DD and 62.9% with BD. DD patients presented with significantly more paranoid PD (P = 0.009), depressive (P = 0.029), anxious (P = 0.009) and irritable temperament (P = 0.006) compared to BD. PCA results showed four significant factors, explaining the 63.1% of total variance, corresponding to four potential groups of patients with specific PD and AT associations.

The comorbidity between MD and PD and AT may differentiate DD from BD. Specific patterns of comorbidity may be useful as they may substantially influence the course of the mood disorders and how patients respond to treatment.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

“Health Profile” of Nicosia was conducted in 2013–2014, within the framework of the program “Healthy Cities” in order to collect and analyse information on the state of health and health-related behaviors of the citizens of Nicosia in Cyprus.

To estimate the frequency of self-reported depressive disorders and examine burdening as well as factors influencing it.

Based on the 2011 census, a cross-sectional study was carried out on a representative random stratified sample, which was selected to be interviewed, including 477 men and 525 women, from the city area. Participants answered a questionnaire, which required among other items on self-perceived physical and mental health. Participants were also asked the following questions: “Do you have/had in the past depression or/and anxiety?” and “Have you received a medical diagnosis for this disorder?”

Approximately 70% of the sample reported they had experienced anxiety and depression (37% moderate and 33% severe episodes). Diagnosed depression was reported by 4%. Severe depressive disorders were more frequently reported by women (41%, P < 0.001), older aged citizens (70.2%, P < 0.001) widowed/divorced (45.5%, P < 0.001), persons with lower family income (< 1000 €, 79.7%, P < 0.001) and among people with chronic diseases (45.3%, P < 0.001).

The self-reported prevalence of anxiety and depression in the citizens of Nicosia is very high – probably reflecting a negative effect of the economic crisis –, and contrariwise diagnosis of the disorder is rarely provided and consequently therapy rarely offered. Specific population groups, such as women, elderly citizens, patients with chronic diseases are more vulnerable to depressive disorders requiring specialized medical attention.

The authors have not supplied their declaration of competing interest.

Treatment with pegylated interferon alpha (PEG-IFN-α) in patients with chronic hepatitis C (CHC) is associated with depressive symptomatology more frequently than other inflammatory diseases treated with PEG-IFN-α.

To prospectively evaluate the onset, course and resolution of depressive symptomatology in CHC patients treated with PEG-IFN-α.

Hamilton depression rating scale (HAMD) was used to asses depressive symptoms in 103 subjects with CHC prior to initiation of PEG-IFN-α (mean dose 152.6 ± 25.6 mcg; duration of therapy 48 weeks) and at the follow-up visits (4th, 12th, 24th, 48th and 72th week). Control group consisted of 103 CHC subjects, without PEG-IFN-α.

Our results showed a significant increase in HAMD scores as early as in the 4th week of PEG-IFN-a therapy compared to HAMD scores prior to initiation of PEG-IFN-α (38.8% vs. 24.3%). The peak of depressive symptomatology was evidenced in the 12th week (mean HAMD 9.34 ± 6.93), when almost 50% of patients had HAMD above 7. At the end of the treatment (48th week), 38.8% had HAMD above 7, and in the 72nd week (24 weeks after the therapy completion) prevalence of depression was decreased to the values lower than at baseline (23.3% vs. 24.3%). No change in prevalence of depression was detected in control group.

Our results are important because they show the overall course of depressive symptomatology during the interferon therapy. These data also show spontaneously resolution of depression 6 months after the completion of PEG-IFN-α. This study is the longest study in this area.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

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

Antidepressant treatment, although it is effective to improve the manifestations of major depression, may also induce or exacerbate some symptoms of sexual dysfunction. Symptoms such as decreased libido, anorgasmia, delayed ejaculation, erection difficulty or dyspareunia, affect the quality of life of the subject who suffers and the self-esteem, can lead to lack of adherence to treatment and in accordingly, the relapse of depressive symptoms. Serotonergic antidepressants are frequently associated with the onset of sexual dysfunction in sexually active patients exceeding 70%. Clinicians underestimate the actual incidence of dysfunction as the technical specifications of drugs show lower levels than 25% and spontaneous reports of patients do not exceed 20-40%.

Vortioxetina is a reuptake inhibitor of serotonin (5-HT) and is also an agonist of the 5-HT1A partial agonist 5-HT1B and an antagonist of 5-HT3, 5-HT1D and 5-HT7. Apparently, this molecule at doses of between 5 and 15 mg is safe and effective and does not cause sexual dysfunction. It is a well-tolerated and safe, with low incidence of sexual dysfunction.

To evaluate the action we have evaluated sexual dysfunction in patients with major depression before receiving treatment vortioxetina (whether state or not previously treated with other antidepressants) and at 2, 6 and 12 months after starting treatment with the drug. So we’ve used the SALSex scale (Scale for measuring sexual dysfunction secondary to psychotropic drugs).

The results of this study are still being analyzed.

The authors have not supplied their declaration of competing interest.

The major depression is associated with decreased cognitive functions in a range of areas, including attention, memory and executive functions. The cognitive symptoms of depression can have a profound effect on the ability of patients to keep out the tasks of daily living, and are significant factors that affect the ability to function both interpersonal and occupational level.

Vortioxetina have a multimodal action acting on various serotonin receptors in addition to inhibiting serotonin reuptake. Vortioxetina, is a new therapeutic tool seems to have shown efficacy in the treatment of cognitive symptoms of depression.

To evaluate this action we have evaluated the cognitive decline in patients with major depression before receiving treatment vortioxetina (whether state or not previously treated with other antidepressants) and at 2, 6 and 12 months after starting treatment with the drug. For that, we’ve used the Verbal Hearing Test King (RAVLT), which evaluates the auditory verbal short-term memory, the learning rate, the retention of information, and the differences between learning and recovery, and testing Digit substitution by symbols (DSST) that perform quick detection of brain dysfunctions by a conventional task.

The results of this study are still under analysis.

The authors have not supplied their declaration of competing interest.

Depression has a large impact on individual, family and society. This disorder can start early in life and often go untreated. The aim of current research was to investigate the effectiveness of subjective well being method in reduction of depression in high school students by using a cluster random sampling four hundreds students were selected from five different areas. All subjects answered the Kovaks Depression Questionnaire and hundred (fifty boys and fifty girls) had been selected who were under the mean score. The subjects were randomly assigned to four groups, two excremental, two controls. The intervention was used in an hour and a half each week for twelve weeks fifteen.

The data was analysed using manova that showed significant difference among experiment pan control groups on depression scores. But there were no difference between sexes.

The study suggest further study with longer intervention.

The authors have not supplied their declaration of competing interest.

Depression is now the fourth most common cause of invalidity. World Health Organization (WHO) predicts that by 2020 it will be the second most common cause (WHO, 2001). Beck Depression Inventory (BDI II) is highly reliable tool for measuring the intensity of depression.

The aim of this study was to assess the validity and reliability of the Czech version of BDI II. This was done on a representative sample of working population.

Results from 1027 participants were obtained. The sample was equally distributed among males and females. T-test showed that on average women suffered from higher depressive symptoms than males. Cronbach alpha showed high items consistency of 0,92 and confirmatory factor analysis found, as predicted, 3 factors: cognitive, somatic and affective.

Cronbach alpha and factor analysis showed high internal consistency and reliability of Czech version of BDI II. Czech version of BDI II is thus not only a translation but can be considered a psychometric tool that is comparable with the original version. The results of this study are therefore comparable with other available results.

The authors have not supplied their declaration of competing interest.

The aim of this study was to test the assumption that there seems to be association between depression and lifestyle choices. The hypothesis was that unhealthy lifestyle will have an association with increased score on BDI II.

Czech version of BDI II was used and a questionnaire of lifestyle was distributed among Czech economically active population. Combination of interviews (for older population) and questionnaires (for younger population) was used. Stepwise multiple linear regression was applied to test whether and to what extend is lifestyle associated with depression.

In total data from 1027 participants was collected; 675 persons aged 25–50 years and 352 persons aged 51–65 years. The model explains 31% of variance of depression and the model is highly significant F (8,1018) = 57.66, P = 0.001. Lifestyle choices that were found to be associated with depression were sleeping habits, regular eating and drinking habits and generally conscious adherence to healthy lifestyle.

Overall, an association was found between depression and certain lifestyle choices. Importantly it was also found conscious maintenance of healthy lifestyle is an important factor. This study thus confirmed the hypothesis that there is an association between depression and lifestyle. The most important factor of lifestyle in this study was shown to be regular sleeping pattern lasting at least 6 hours. Regular eating and maintaining drinking regime during the day were also found to be crucial.

The authors have not supplied their declaration of competing interest.

Perinatal depression is related to poorer outcomes for women and their children. Measurement indices that categorize perinatal depression as present or absent are commonly used in clinical practice and research efforts. Categorization minimizes the health effects of potentially different symptom clusters and may confound understanding of health outcomes.

The objective of this investigation is to explore the symptom clusters resulting from administering two commonly used depression screening instruments during pregnancy and postpartum.

(1) Identify the depressive symptom clusters for perinatal depression; (2) Test whether symptom clusters predict maternal and newborn outcomes, and if so, whether these differ from categorization analytics.

A secondary analysis was conducted on data from a longitudinal study of 139 women. They participated from their 3rd trimester of pregnancy through 8 months after birth and completed surveys at five times using the center for epidemiologic studies Depressed Mood Scale (CES-D) and the Edinburgh Postnatal Depression Survey (EPDS). Analysis procedures included cluster analysis and hierarchical regression.

Individual symptoms were reported by 2.9–31.7% of the sample. Separate clusters (CES-D = 4; EPDS = 2) were identified and, of these, two clusters were primary predictors of maternal and newborn outcomes. Results differed from that obtained with cut-score analytics.

Examination of depression symptom clusters as related to health outcomes during childbearing has significance for clinical practice and research, particularly for women who would not score as depressed on established screening instruments.

The authors have not supplied their declaration of competing interest.

Depressive disorders are known to impair health-related quality of life (HRQoL) both in the short and long term. However, the determinants of long-term HRQoL outcomes in primary care patients with depressive disorders remain unclear.

In a primary care cohort study of patients with depressive disorders, 82% of 137 patients were prospectively followed up for five years. Psychiatric disorders were diagnosed with SCID-I/P and SCID-II interviews; clinical, psychosocial and socio-economic factors were investigated by rating scales and questionnaires plus medical and psychiatric records. HRQoL was measured with the generic 15D instrument at baseline and five years, and compared with an age-standardized general population sample (n = 3707) at five years.

Depression affected the 15D total score and almost all dimensions at both time points. At the end of follow-up, HRQoL of patients in major depressive episode (MDE) was particularly low, and the association between severity of depression (Beck Depression Inventory, BDI) and HRQoL was very strong (r = −0.804). The most significant predictors for change in HRQoL were changes in BDI and Beck Anxiety Inventory (BAI) scores. The mean 15D score of depressive primary care patients at five years was much worse than in the age-standardized general population, reaching normal range only among patients who were in clinical remission and had virtually no symptoms.

Among depressive primary care patients, presence of current depressive symptoms markedly reduces HRQoL, with symptoms of concurrent anxiety also having a marked impact. For HRQoL to normalize, current depressive and anxiety symptoms must be virtually absent.

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

Although rarely reported, antidepressant discontinuation may induce hypomania or mania even in the absence of bipolar disorder [1,2].

We report two cases of antidepressant withdrawal induced mania.

Clinical process consultation and PubMed search were performed in November 2016 using the search keywords antidepressant, mania and discontinuation.

Case report 1: a dysthymic 60 years old woman with 20 years of psychiatric following had been treated with venlafaxine 150 mg/daily the past year. She abruptly stopped taking this drug, developing heightened mood, irritability and racing thoughts five days later. She was admitted at our hospital, initiating then valproate and antipsychotics. Two weeks later, the hypomania clinical state remitted completely.

Case report 2: a 64 years old woman, with a 12-year-old diagnosis of unipolar depression was brought to our emergency service with complaints of disorganized behavior, paranoid delusional ideas, excessive speech, irritable mood and reduced need for sleep, 1 week after abrupt trazodone 150 mg/daily discontinuation. Valproic acid 1000 mg/daily and olanzapine 20 mg/daily were introduced, with gradual improvement of symptoms. Two weeks later she was completely asymptomatic.

Psychiatrists should be aware of the risk of antidepressant withdrawal induced mania. More studies should be conducted about this subject, aiming for the clarification of risk factors and the establishment of clinical criteria for this phenomenon.

The authors have not supplied their declaration of competing interest.

Citalopram is a widely used antidepressant (AD), indicated for the treatment of Major Depressive Disorder (MDD), with a high and Selective Serotonin Reuptake Inhibitory action (SSRI), good efficacy and safety profile. Vortioxetine is a novel multimodal antidepressant compound, with a mixed action on Serotonin (both 5-HT agonism and antagonism). Its clinical efficacy has been established in several short and long term trials; furthermore it proved effective at mitigating cognitive dysfunction, which is addressed to as one of the main causes of social impairment in MMD patients.

To evaluate the relative efficacy and safety of Vortioxetine versus Citalopram, in patients suffering from MDD.

To assess whether Vortioxetine effectiveness and tolerability are comparable to those observed for previous antidepressants.

The main outcomes were efficacy (variance from baseline to 1 month) in the Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Rating Scale for Depression (HAM-D) and tolerability (adverse events). Changes in cognitive performance were assessed using the following specifics tools: Digit symbol substitution test (DSST), Trail Making Test A (TMT-A) and Hopkins Verbal Learning Test-Revised (HVLT-R).

Data collection is ongoing. According to Literature we expect to find a significant number of MDD patients on Vortioxetine to achieve a reduction in depressive symptoms from baseline, to report poor adverse events and to increase their cognitive performance.

As shown by recent literature, Vortioxetine might be an effective option in treating MMD with particular focus on cognitive dysfunction.

The authors have not supplied their declaration of competing interest.