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Major Depressive Disorder (MDD) is prevalent, often chronic, and requires ongoing monitoring of symptoms to track response to treatment and identify early indicators of relapse. Remote Measurement Technologies (RMT) provide an exciting opportunity to transform the measurement and management of MDD, via data collected from inbuilt smartphone sensors and wearable devices alongside app-based questionnaires and tasks.
To describe the amount of data collected during a multimodal longitudinal RMT study, in an MDD population.
RADAR-MDD is a multi-centre, prospective observational cohort study. People with a history of MDD were provided with a wrist-worn wearable, and several apps designed to: a) collect data from smartphone sensors; and b) deliver questionnaires, speech tasks and cognitive assessments and followed-up for a maximum of 2 years.
A total of 623 individuals with a history of MDD were enrolled in the study with 80% completion rates for primary outcome assessments across all timepoints. 79.8% of people participated for the maximum amount of time available and 20.2% withdrew prematurely. Data availability across all RMT data types varied depending on the source of data and the participant-burden for each data type. We found no evidence of an association between the severity of depression symptoms at baseline and the availability of data. 110 participants had > 50% data available across all data types, and thus able to contribute to multiparametric analyses.
RADAR-MDD is the largest multimodal RMT study in the field of mental health. Here, we have shown that collecting RMT data from a clinical population is feasible.
Subjects with high neuroticism are more likely to interpret ordinary situations as negative, this might contribute towards mood and anxiety. The aim of our study was to determine the localization of neuroticism-related resting state functional connectivity (RSFC) differences between the two groups of high and low neuroticism, and to confirm our hypothesis that subjects with high neuroticism show hyperconnectivity in the affective network and hypoconnectivity in the cognitive control and attention networks.
Forty three healthy participants underwent resting state fMRI and completed the NEO Five Factor Personality Inventory. SPM8 and CONN software was used to pre-process and analyse resting state fMRI data. Correlation maps were produced between seed regions of the affective, cognitive control, attention and default mode networks and differences were analysed between groups fully corrected for multiple testing across the whole brain.
Participants with high neuroticism displayed significantly greater functional connectivity in the affective network. There was significantly less functional connectivity in the cognitive control network and ventral attention network for participants with high neuroticism scores when compared to those with low neuroticism scores.
Affective network hyperconnectivity might be related to emotional problems or mood disorders that are associated with high neuroticism. The hypoconnectivity seen in the cognitive control network might have to do with inattention and cognitive deficits that have consistently been found depression and anxiety disorders. Thus, oversensitivity in affective systems and at the same time reduced cognitive control might be in line with increased stress sensitivity and emotional lability in subjects with high neuroticism.
Background. In situations of chronic stress vasopressin plays an important role in regulating the hypothalamic–pituitary–adrenal axis. The aim of the current study was to investigate the role of anterior pituitary vasopressin V3 receptors in maintaining the hypercortisolism seen in melancholic depression.
Method. Fourteen patients with major depression and 14 age- and sex-matched healthy comparison subjects were recruited. Desmopressin (ddAVP) 10 μg was given intravenously and ACTH and cortisol release was monitored for 120 min.
Results. The mean±S.E.M. ACTH response in the depressives was 28·4±4·3 ng/l and in the healthy subjects was 18·8±4·9 ng/l (P=0·04). The mean±S.E.M. cortisol response in the depressives was 261·8±46·5 nmol/l and in the healthy subjects was 107·3±26·1 nmol/l (P<0·01).
Conclusions. Patients with major depression have augmented ACTH and cortisol responses to desmopressin indicating enhanced V3 responsivity.
Background. Past studies have found inconsistent evidence
that substance use disorders are related
to earlier onset of schizophrenia or more severe symptoms. This study examines
severity of current substance use disorders and onset of psychotic illness
in a multi-facility sample.
Methods. Data are from the Suffolk County Mental Health Project,
an epidemiological study of
first admission psychosis. The SCID and instruments measuring symptomatology,
background characteristics were administered. Respondents were stratified
into three groups: (a) no
life-time substance diagnosis; (b) in remission or reporting current
mild use at admission; and (c)
current moderate–severe substance abuse at admission.
Results. Using the SCID severity rating, 17·4% of males
and 6·2% of the females had moderate or
severe current substance abuse, while 41·5% of males and 68·2%
of females had no lifetime
substance diagnosis. In almost all cases categorized as moderate–severe,
the substance diagnosis
predated onset of psychosis. Females categorized as moderate–severe
had an earlier age of onset of
psychosis than did females in the other groups. There were only slight
differences in symptom
severity among the groups but more marked antisocial behaviour in the moderate–severe
Variables discriminating the moderate–severe from non-abuse groups
were BPRS thought
disturbance, adult anti-social behaviour and current cigarette smoking
for males and adult antisocial
behaviour and child–teen antisocial behaviour for females.
Conclusions. Severity of substance abuse does not appear to
be a pivotal correlate of the early
features of psychotic illness.
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