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One of the most evaluated eye tracking tasks in schizophrenia (SZ) and bipolar disorder (BD) are smooth pursuit eye movements. They rely on the maintenance of slowly moving object on the fovea. While most of the studies evaluated tracking of a target that moves in the fronto-parallel plane, only two assessed vergence eye movements (VEM), which relies on the pursuit of object that moves in depth. The aim of our study was to compare VEM performance in SZ and BD. We evaluated 28 SZ patients, 32 BD patients and 25 healthy controls (HC). Participants underwent thorough optometric examination before eye tracking task. VEM were measured with the use of infrared eye tracker and dedicated vergence stimuli generator. SZ patients showed higher mean break and recovery points of fusion and shorter correct tracking time than HC. BD individuals revealed tracking accuracy deficits and higher number of saccades than HC. Compared to BD, SZ patients showed decrease of maximal convergence and divergence. Moreover, they presented tracking accuracy deficits of non-dominant eye: altered eyes positioning error during convergence and divergence gain. Exploratory analysis revealed significant gender differences between groups in terms of binocular VEM parameters. In this study we have recognized pattern of eye movement disturbances differentiating abovementioned groups. SZ patients showed decreased vergence tracking range with shorter tracking time and impaired accuracy of non-dominant eye, while BD patients showed higher number of saccades with decreased tracking accuracy. Neuroimaging studies are necessary to identify neuronal underpinnings of VEM impairments in SZ and BD.

Background: The clinical effects of smartphone-based interventions for bipolar disorder (BD) have yet to be established. Objectives: To examine the efficacy of smartphone-based interventions in BD and how the included studies reported user-engagement indicators. Methods: We conducted a systematic search on January 24, 2022, in PubMed, Scopus, Embase, APA PsycINFO, and Web of Science. We used random-effects meta-analysis to calculate the standardized difference (Hedges’ g) in pre-post change scores between smartphone intervention and control conditions. The study was pre-registered with PROSPERO (CRD42021226668). Results: The literature search identified 6034 studies. Thirteen articles fulfilled the selection criteria. We included seven RCTs and performed meta-analyses comparing the pre-post change in depressive and (hypo)manic symptom severity, functioning, quality of life, and perceived stress between smartphone interventions and control conditions. There was significant heterogeneity among studies and no meta-analysis reached statistical significance. Results were also inconclusive regarding affective relapses and psychiatric readmissions. All studies reported positive user-engagement indicators. Conclusion: We did not find evidence to support that smartphone interventions may reduce the severity of depressive or manic symptoms in BD. The high heterogeneity of studies supports the need for expert consensus to establish ideally how studies should be designed and the use of more sensitive outcomes, such as affective relapses and psychiatric hospitalizations, as well as the quantification of mood instability. The ISBD Big Data Task Force provides preliminary recommendations to reduce the heterogeneity and achieve more valid evidence in the field.

Afektivni poremećaji, emocionalni su poremećaji koji predstavljaju mentalne bolesti kao što je depresija. Elektroencefalografija neinvazivna je tehnika kojom se snima električna aktivnost mozga. U ovom radu analizirane su EEG snimke osoba dijagnosticiranih s afektivnim poremećajem te snimke zdravih osoba. Provedena je klasifikacija korištenjem entropije kao značajke signala modelima strojnog učenja. Affective disorders are emotional disorders that represent mental illnesses such as depression. Electroencephalography is a non-invasive technique that records the electrical activity of the brain. In this paper, EEG recordings of persons diagnosed with affective disorder and recordings of healthy persons were analyzed. The classification using entropy as a feature of the signal was performed by machine learning models.

Affective disorders represent psychopathological entities lying on a continuum, characterized by high prevalence and functional impairment. A delay in treatment initiation might increase the burden associated with affective spectrum disorders. The present study was aimed at analyzing the correlates of a long duration of untreated illness (DUI) in these conditions. We recruited subjects diagnosed with affective disorders, both in- and outpatients, and collected information concerning socio-demographic, clinical, and psychopathological characteristics. Long DUI was defined according to previous research criteria as2 years for Bipolar Disorders or1 year for Depressive Disorders. Bivariate analyses were performed to compare subjects with a long and short DUI (p0.05). A logistic regression was operated to evaluate the correlates of long DUI. In the present sample (n=135), 34.1% (n=46) subjects showed a long DUI. This subgroup presented with more physical comorbidities (p=0.003), higher body mass index (BMI) (p0.001), more frequent anxiety onset (p=0.018), younger onset age (p=0.042), and more severe depressive symptoms (Hamilton Depression Rating Scale item 1-depressed mood (p=0.032) and item 2-guilt feelings (p=0.018)). At the logistic regression, higher severity of depressed mood (OR 1.568), higher BMI (OR 1.264), and younger age at onset (OR 0.935) were associated with long DUI. The present study confirmed a possible role of DUI as a construct underpinning higher clinical severity in affective spectrum disorders, possibly linked to worse illness course and unfavorable outcomes. Intervention strategies targeting physical comorbidities and depressive symptoms severity may decrease disease burden in subjects with a long DUI.

Background: While Cognitive Behavioral Therapy (CBT) is recommended as first-line treatment for depression, a significant minority do not show an adequate treatment response. Despite evidence for the efficacy of Mindfulness-Based Therapies (MBT) both in treating current depression and preventing relapse, it remains unknown whether MBT and CBT are equivalent in the treatment of current depression. Methods: Five databases were searched for randomized controlled trials (RCTs) directly comparing MBT with CBT and including depression as primary or secondary outcome. Results: When pooling the results of 30 independent RCTs with a total of 2750 participants, MBT and CBT were statistically significantly equivalent at both post-intervention (Hedges's g = −0.009; p < .001) and follow-up (g = −0.033; p = .001). Supplementary Bayesian analyses provided further support for the alternative hypothesis of no difference between MBT and CBT. When exploring possible sources of heterogeneity, the differences at follow-up were smaller between CBT and mindfulness-based cognitive therapy (MBCT) than between CBT and mindfulness-based stress-reduction (MBSR) (Slope = 0.37;p = .022). Conclusion: The currently available evidence suggests that that MBT and CBT are equally efficacious in treating current adult depression. It remains unclear whether the similar effects of the two intervention types are due to different mechanisms or common factors.

To examine the prevalence of 12-month mood disorders and receipt of mental health treatment among a volunteer sample of higher education students during the 2nd and 3rd COVID-19 wave in the Flanders region. Web-based self-report surveys were obtained from 9101 students in higher education in the Flemish College Surveys (FLeCS) in Flanders, Belgium. As part of the World Health Organization's World Mental Health–International College Student Initiative, we screened for 12-month mood disorders (major depressive episode (MDE), mania/hypomania), and service use. We used poststratification weights to generate population-representative data on key socio-demographic characteristics. 50.6% of the respondents screened positive for 12-month mood disorders (46.8% MDE, of which 22.9% with very severe impact). Use of services was very low, with estimates of 35.4% for MDE, 31.7% for mania, and 25.5% for hypomania. Even among students with very severe disorders, treatment rates were never higher than 48.3%. Most common barriers for not using services were: the preference to handle the problem alone (83.4%) and not knowing where to seek professional help (79.8%). We found a high unmet need for mood problems among college students; though caution is needed in interpreting these findings given the volunteer nature of the sample. A reallocation of treatment resources for higher education students should be considered, particulary services that focus on innovative, low-threshold, and scalable interventions.

A nosografia dos transtornos do humor e do afeto relaciona-se diretamente com as formas de apreensão dos quadros clínicos em cada contexto histórico. É indagado se o resgate histórico contribuiria para melhor compreensão e utilização da atual nosologia dos transtornos de humor. Objetiva-se realizar uma revisão histórica e crítica acerca de suas transformações conceituais e nosológicas com enfoque ao campo médico-psiquiátrico. O recorte pretendido se inicia com a proposição da “Insanidade Maníaco-Depressiva” por Emil Kraepelin em 1899, que é confrontada com as propostas pós-kraepelianas, em especial as de Karl Leonhard. Analisa-se a influência dessas na criação dos sistemas diagnósticos operacionalizados, DSM e CID. O “Transtorno Bipolar” foi um constructo introduzido pelo DSM-III e se mantém em uso até os dias atuais. Aborda-se também propostas posteriores, como a do “Espectro Bipolar”. Nosography of mood and affective disorders is directly related to how clinical pictures are understood in each historical context. Inquiring on whether a historical recollection would contribute to a better understanding and use of the current nosology of mood disorders, the study carries out a historical and critical review of its conceptual and nosological transformations on the medical-psychiatric field. Starting from Emil Kraepelin’s “Manic-Depressive Insanity,” proposed in 1899, the text confronts this concept with post-Kraepelian proposals, especially those of Karl Leonhard. It then analyzes their influence in the creation of two operationalized diagnostic systems — DSM and ICD. “Bipolar Disorder,” a construct introduced by the DSM-III, remains in use today. Later proposals are also addressed, such as the “Bipolar Spectrum”. La nosographie des troubles de l’humeur et des troubles affectifs est directement liée à la manière dont les tableaux cliniques sont compris dans chaque contexte historique. En se demandant si un rappel historique contribuerait à une meilleure compréhension et utilisation de la nosologie actuelle des troubles de l’humeur, l’étude procède a un examen historique et critique de ses transformations conceptuelles et nosologiques dans le domaine médico-psychiatrique. Partant de la “Folie maniaco-dépressive” d’Emil Kraepelin, proposée en 1899, l’article confronte ce concept aux propositions post-Kraepeliennes, notamment celles de Karl Leonhard. On analyse ensuite leurs influence dans la création de systèmes de diagnostic opérationnalisés — le DSM et la CIM. Le “trouble bipolaire”, une construction introduite par le DSM-III, est toujours utilisé aujourd’hui. D’autres propositions sont égalemment abordées, comme le “spectre bipolaire”. La nosografía de los trastornos afectivos está directamente relacionada con las formas en que se aprehenden las condiciones clínicas en cada contexto histórico. Se pregunta si la revisión histórica contribuiría a una mejor comprensión y uso de la nosología actual de los trastornos del humor. El objetivo de este artículo es realizar una revisión histórica y crítica de sus transformaciones conceptuales y nosológicas con un enfoque en el campo médico-psiquiátrico. El recorte comienza con la propuesta en el texto “Locura maníaco-depresiva”, de Emil Kraepelin, en 1899, que se enfrenta a propuestas postkraepelianas, especialmente las de Karl Leonhard. Se analiza la influencia de estas propuestas en la creación de sistemas diagnósticos operacionalizados, el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) y la Clasificación Internacional de Enfermedades (CID). El “trastorno bipolar” es una construcción introducida por el DSM-3 y sigue en uso hoy. También se abordan propuestas posteriores, como la del “espectro bipolar”.

A growing body of evidence indicates that early-life exposure to selective serotonin reuptake inhibitor has long-term consequences on the offspring's pain in addition to affective disorders like anxiety disorder and major depression. Serotonin, besides its role in regulating pain and emotions, promotes neuronal network formation. The prefrontal cortex and the amygdala are two key brain regions involved in the modulation of pain and its affective comorbidities. Thus, the aim of this review is to understand how early-life selective serotonin reuptake inhibitor exposure alters the developing prefrontal cortex and amygdala and thereby underlies the long-term changes in pain and its affective comorbidities in later life. While there is still limited data on the effects of early-life selective serotonin reuptake inhibitor exposure on pain, there is a substantial body of evidence on its affective comorbidities. From this perspective paper, four conclusions emerged. First, early-life selective serotonin reuptake inhibitor exposure results in long-term nociceptive effects, which needs to be consistently studied to clarify. Second, it results in enhanced depressive-like behaviour and diminished exploratory behaviour in adult rodents. Third, early-life selective serotonin reuptake inhibitor exposure alters serotonergic levels, transcription factors expression, and brain-derived neurotrophic factor levels, resulting in hyperconnectivity within the amygdala and the prefrontal cortex. Finally, it affects antinociceptive inputs of the prefrontal cortex and the amygdala in the spinal cord. We conclude that early-life selective serotonin reuptake inhibitor exposure affects the maturation of prefrontal cortex and amygdala circuits and thereby enhances their antinociceptive inputs in the spinal cord.

BackgroundAnxiety and depressive disorders often co-occur and the order of their emergence may be associated with different clinical outcomes. However, minimal research has been conducted on anxiety-anxiety comorbidity. This study examined factors associated with anxiety comorbidity and anxiety-MDD temporal sequence.MethodsOnline, self-report data were collected from the UK-based GLAD and COPING NBR cohorts (N = 38,775). Logistic regression analyses compared differences in sociodemographic, trauma, and clinical factors between single anxiety, anxiety-anxiety comorbidity, anxiety-MDD (major depressive disorder) comorbidity, and MDD-only. Additionally, anxiety-first and MDD-first anxiety-MDD were compared. Differences in familial risk were assessed in those participants with self-reported family history or genotype data.ResultsAnxiety-anxiety and anxiety-MDD had higher rates of self-reported anxiety or depressive disorder diagnoses, younger age of onset, and higher recurrence than single anxiety. Anxiety-MDD displayed greater clinical severity/complexity than MDD only. Anxiety-anxiety had more severe current anxiety symptoms, less severe current depressive symptoms, and reduced likelihood of self-reporting an anxiety/depressive disorder diagnosis than anxiety-MDD. Anxiety-first anxiety-MDD had a younger age of onset, more severe anxiety symptoms, and less likelihood of self-reporting a diagnosis than MDD-first. Minimal differences in familial risk were found.LimitationsSelf-report, retrospective measures may introduce recall bias. The familial risk analyses were likely underpowered.ConclusionsAnxiety-anxiety comorbidity displayed a similarly severe and complex profile of symptoms as anxiety-MDD but distinct features. For anxiety-MDD, first-onset anxiety had an earlier age of onset and greater severity than MDD-first. Anxiety disorders and comorbidity warrant further investigation and attention in research and practice.

The objective of the study was to evaluate changes of laboratorial and clinical parameters in patients with mixed anxiety and depressive disorder. Thus, we established a change of immune and metabolic statuses in patients with mixed anxiety and depressive disorder. We also exposed statistically significant correlations between anxiety and depression and immune and metabolic statuses of all study participants.

Recently, empirical evidence from perinatal studies has led researchers to pay more attention to fathers. The need to evaluate male suffering led at first to using the same screening tools developed for mothers. However, these instruments present validity concerns with fathers, and today the need to assume a gender-based perspective is clear. The Perinatal Assessment of Paternal Affectivity (PAPA) is a self-reported questionnaire for the screening of a variety of psychological and behavioral dimensions related to affectivity as experienced by fathers during the perinatal period. In the present study, the psychometric properties of the maternal version of the scale (Perinatal Assessment of Maternal Affectivity; PAMA) were examined. The study, based on 225 mothers and their partners (n = 215), used a cross-sectional design with a single assessment at the third trimester of pregnancy. Results indicated a one-factor structure for a seven-item version of the PAMA, which showed adequate internal consistency reliability and was associated in the expected direction with other clinically relevant variables (depression, psychological distress, perceived stress and dyadic adjustment). The findings suggest the usefulness of developing gender sensitive screening tools for the detection of perinatal affective disorders.

Affektive Störungen sind mit einer hohen Krankheitslast verbunden, welche durch verzögerte Diagnosestellung und Wartezeiten bei der Bestimmung der Behandlungsstrategie verstärkt wird. Die Identifikation von Parametern, die zur klinischen Entscheidungsfindung beitragen, könnte die Versorgungssituation entscheidend verbessern. Die vorliegende Arbeit widmet sich in diesem Sinne ausgewählter aufgabenbezogener Parameter im Elektroenzephalogramm (EEG), untersucht die Reliabilität dieser in einer Gruppe gesunder Proband*innen, erforscht Gemeinsamkeiten und Unterschiede bei der unipolaren und bipolaren Depression und untersucht letztlich den potentiellen Nutzen dieser Parameter beim frühen Erkennen von Response und non-Response in der pharmakologischen antidepressiven Behandlung. Die Untersuchung frontaler sowie parietaler aufgabenbezogener Alpha EEG-Asymmetrie in einer Stichprobe von 23 gesunden Proband*innen zeigte moderate bis hohe Within-Session Reliabilität und mäßige bis moderate Between-Session Reliabilität nach einer Woche (Pearson Korrelationskoeffizienten). Exploratorische Analysen und deskriptive Interpretationen deuten auf einen möglichen Einfluss des Ableitungsortes sowie intrapsychischer Faktoren hin. Varianzanalysen aufgabenbezogener frontaler Alpha-1 und Alpha-2-Asymmetrie und Theta-Power während eines einfachen Gesichtsverarbeitungsparadigmas in einer Stichprobe von 33 unipolar und 22 bipolar depressiv Erkrankten sowie 32 gesunden Kontrollen, zeigten Unterschiede in der Alpha-1-Asymmetrie für den Vergleich unipolar depressiver und gesunder Kontrollen sowie einen differentiellen Einfluss der Stimulusbedingung (happy/sad) auf Theta-Power in den Patient*innengruppen. Nach Ergebnissen einer ROC-Kurven-Analyse differenzierte Alpha-1-Asymmetrie Kontrollproband*innen und depressive Patient*innen mit einer Genauigkeit von .69. Stimulusbezogene Theta-Power differenzierte zwischen der Gruppe bipolar und unipolar depressiver mit einer Genauigkeit von .83. In der Untersuchung von 45 Patient*innen in den ersten Wochen einer pharmakologisch antidepressiven Behandlung wurden non-Responder und Responder hinsichtlich ihrer aufgabenbezogenen EEG-Asymmetrie (frontale und okzipitale Alpha-1 und Alpha-2) und frontalen midline Theta-Power zu Behandlungsbeginn und nach einer Woche verglichen. Varianzanalysen zeigten einen differentiellen Effekt der Stimulusbedingung auf die Alpha-1-Asymmetrie in der Gruppe der Responder zu Behandlungsbeginn sowie eine Veränderung dieser Aktivierung nach einer Woche. Analysen frontaler Alpha-2, okzipitaler Alpha-1 und Alpha-2-Asymmetrie sowie Theta-Power zeigten keine Unterschiede. Die Ergebnisse der vorliegenden Arbeit ergänzen bisherige Befunde, die neurobiologische Unterschiede und Gemeinsamkeiten unipolarer und bipolarer Depression untersuchten. Die Ergebnisse liefern zudem Hinweise, dass neurochemische Effekte innerhalb antidepressiver Response in Zusammenhang mit Veränderungen in der Verarbeitung emotionaler Stimuli stehen und im Rahmen einer EEG-Messung sichtbar gemacht werden könnten. Ein Verständnis dieser Prozesse kann entscheidend zum Verständnis pathologischer Veränderungen im emotionalen Erleben und Verhalten beitragen und Entwicklungen für die klinische Praxis leiten. Die vorliegende Dissertation deutet auf mögliche Einflussfaktoren wie Ableitungsort der hirnelektrischen Aktivität, analysierte Sub-Frequenzbänder, Valenz der Stimuli und intrapsychische Faktoren hin, die in zukünftigen Studien Beachtung finden sollten., The burden of affective disorders is increased by delays in determining the correct diagnosis and pharmacological treatment for the individual. Identification of parameters that can guide clinical decision processes has the potential to improve clinical care substantially. In this context, this dissertation focuses on selected task-related parameters of the electroencephalogram (EEG), investigates reliability of these parameters in a group of healthy individuals, studies commonalities and differences in unipolar and bipolar depression and investigates the use of these parameters in early identification of response and non-response in the pharmacological treatment of depression. Investigation of frontal and parietal task-related alpha EEG-asymmetry in a sample of 23 participants demonstrated moderate to high within-session reliability for stimulus-related alpha asymmetry for all electrode sites and conditions. Between-session reliability after one week was fair for frontomedial and moderate for frontolateral asymmetry. Exploratory analyses and descriptive interpretations pointed to a potential influence of electrode site and internal factors. Analysis of variance of frontal alpha-1 and alpha-2 asymmetry, and theta power in a sample of unipolar (n=33) and bipolar (n=22) depressed participants and controls (n=32), revealed differences in alpha-1 asymmetry between unipolar depressed and controls as well as a differential impact of stimulus condition (happy/sad) on theta power between the bipolar and unipolar depressed patients. ROC-analyses showed that alpha-1 asymmetry classified controls and depressed groups with an accuracy of .69. Valence-related theta classified bipolar from unipolar depressed with an accuracy of .83. In a study of 45 patients in their first week of antidepressant pharmacological therapy, we investigated responders’ and non-responders’ task-related EEG asymmetry (frontal and occipital alpha-1, alpha-2) and power (frontal midline theta) at baseline and one week after initiation of treatment. Analysis of variance showed a differential effect of stimulus condition on alpha-1 asymmetry in responders at baseline with a change in this pattern one week later. No significant results were found for frontal alpha-2, occipital alpha-1 and alpha-2 asymmetry, or frontal midline theta power. The current work contributes to research on neurobiological similarities and differences in unipolar and bipolar depression. Furthermore, the results point to an association between neurochemical effects and emotional information processing during antidepressant response. Understanding the underlying processes constitutes an important step in understanding pathological changes and can guide developments in clinical practice. The current work further highlights potential influencing factors that future research might take into account, such as influence of electrode site, analyzed sub-bands, valence of stimuli, and intrapersonal factors.

Study objectiveTo examine first-time depression, anxiety, stress disorders or psychotropic drug prescriptions within one year after incident heart failure (HF).DesignNationwide Epidemiological registry study.SettingNational patient registries.ParticipantsPatients in Denmark with a first-time HF diagnosis during 2005–2015.InterventionsNone.Main outcome measuresIncidences of depression, anxiety, stress disorders or first-time prescription of a psychotropic drug were determined.ResultsA total of 94,712 HF patients and 473,560 matched controls were included (median age 74.0 [64.0–81.0] years, 60.8 % males). At one year after incident HF, 11.9 % met the primary composite endpoint (depression, anxiety, or stress disorders or prescription of related psychotropic drugs), with 8.6 % outpatients and 13.3 % in-patients, versus 2.4 % of the controls. Starting psychotropic medication accounted for most of the composite endpoint events, as 11.6 % of the HF patients started antidepressants, anxiolytics, hypnotics, or sedative drugs (2.4 % among controls), while 0.6 % received a registered diagnosis of depression, anxiety, or stress disorder (ConclusionA substantial part of patients with newly diagnose heart failure started treatment with psychotropic drugs whereas only a small fraction was registered with depression, anxiety, or stress disorders within one-year follow-up. The incidences were significantly higher than in the background population. Study objectiveTo examine first-time depression, anxiety, stress disorders or psychotropic drug prescriptions within one year after incident heart failure (HF).DesignNationwide Epidemiological registry study.SettingNational patient registries.ParticipantsPatients in Denmark with a first-time HF diagnosis during 2005–2015.InterventionsNone.Main outcome measuresIncidences of depression, anxiety, stress disorders or first-time prescription of a psychotropic drug were determined.ResultsA total of 94,712 HF patients and 473,560 matched controls were included (median age 74.0 [64.0–81.0] years, 60.8 % males). At one year after incident HF, 11.9 % met the primary composite endpoint (depression, anxiety, or stress disorders or prescription of related psychotropic drugs), with 8.6 % outpatients and 13.3 % in-patients, versus 2.4 % of the controls. Starting psychotropic medication accounted for most of the composite endpoint events, as 11.6 % of the HF patients started antidepressants, anxiolytics, hypnotics, or sedative drugs (2.4 % among controls), while 0.6 % received a registered diagnosis of depression, anxiety, or stress disorder (ConclusionA substantial part of patients with newly diagnose heart failure started treatment with psychotropic drugs whereas only a small fraction was registered with depression, anxiety, or stress disorders within one-year follow-up. The incidences were significantly higher than in the background population.

BackgroundNeuro-immune pathways are engaged in antenatal and postpartum depression. Aims: To determine if immune profiles influence the severity of prenatal depression above and beyond the effects of adverse childhood experiences (ACE), premenstrual syndrome (PMS) and current psychological stressors.MethodsUsing the Bio-Plex Pro human cytokine 27-plex test kit, we assayed M1 macrophage, T helper (Th)-1, Th-2, Th-17, growth factor, chemokine, T cell growth immune profiles as well as indicators of the immune inflammatory response system (IRS) and compensatory immunoregulatory system (CIRS) in 120 pregnant females in the early ( 24 weeks) pregnancy. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess severity of antenatal depression.ResultsCluster analyses showed that the combined effects of ACE, relationship dissatisfaction, unwanted pregnancy, PMS, and upregulated M1, Th-1, Th-2 and IRS immune profiles and the ensuing early depressive symptoms shape a stress-immune-depression phenotypic class. Elevated IL-4, IL-6, IL-8, IL-12p70, IL-15, IL-17 and GM-CSF are the primary cytokines associated with this new phenotypic class. All immune profiles (except CIRS) were significantly associated with the early EPDS score, independent of the effects of psychological variables and PMS. There was a shift in immune profiles from early to late pregnancy, with an increase in the IRS/CIRS ratio. The late EPDS score was predicted by the early EPDS score, adverse experiences, and immune profiles, mainly the Th-2 and Th-17 phenotypes.ConclusionsActivated immune phenotypes contribute to early and late perinatal depressive symptoms above and beyond the effects of psychological stressors and PMS.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic is having a great impact on individuals from all over the world, particularly on individuals with mental disorders. Several studies found more pronounced psychiatric symptoms, notably symptoms of depression and anxiety. AIM To assess the situation of patients with serious mental illness (SMI: Affective disorders and schizophrenia) regarding their mental health outcome during the pandemic. METHODS A systematic search using the databases PubMed and MEDLINE was conducted, employing the key words “COVID-19”, “SARS-CoV-2”, “psychiatric/mental disorder/illness”, “affective/mood disorder”, “bipolar disorder”, “(major) depression”, “schizoaffective disorder”, and “schizophrenia”. Studies that had been published up until January 9, 2021 were included. Information of studies in languages other than English and German was mostly taken from their English abstracts. RESULTS The literature search concluded in the finding of 36 studies containing relevant clinical data. A general impairment of the mental health of individuals with SMI could be detected, particularly in individuals with affective disorders, as compared to those with schizophrenia. Compared to healthy controls, symptoms of anxiety, depression, and stress were more pronounced in individuals with SMI. Relevant factors found that impacted their mental health were age, resilience, and socioeconomic environment, especially the shortage of mental health services, lack of social support, and inadequate information about COVID-19. CONCLUSION In light of these results, mental health services should be reinforced, notably the use of telemental health services. Furthermore, supplying individuals with SMI with adequate information about the COVID-19 pandemic and increasing their resilience is important. When researching the impact of the COVID-19 pandemic on individuals with SMI, standardization as well as follow-up studies are needed to enable better comparability and understanding.

BACKGROUND: The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders.METHODS: A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders.RESULTS: All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders.CONCLUSION: NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.

Background: The Netherlands Study of Depression and Anxiety (NESDA; Nbaseline=2981) is an ongoing longitudinal, multi-site, naturalistic, cohort study examining the etiology, course, and consequences of depression and anxiety. In this article we synthesize and evaluate fifteen years of NESDA research on prominent psychological risk factors for the onset, persistence, recurrence, and comorbidity of affective disorders. Methods: A narrative review of 62 NESDA articles examining the specificity and predictive value of neuroticism, behavioral inhibition, repetitive negative thinking, experiential avoidance, cognitive reactivity, locus of control, (implicit) self-esteem, (implicit) disorder-specific self-associations, and attentional bias for the course of affective disorders. Results: All self-reported risk factors showed cross-sectional relationships with singular and comorbid affective disorders, and prospective relationships with the development and chronicity of depression and anxiety disorders. High neuroticism, low self-esteem, and negative repetitive thinking showed most prominent transdiagnostic relationships, whereas cognitive reactivity showed most pronounced depression-specific associations. Implicit self-esteem showed predictive validity for the persistence and recurrence of anxiety and depression over and above self-reported risk factors. Automatic approach-avoidance behavior and attentional bias for negative, positive, or threat words showed no relationship with affective disorders. Conclusion: NESDA identified both (a) transdiagnostic factors (e.g., neuroticism, low implicit self-esteem, repetitive negative thinking) that may help explain the comorbidity between affective disorders and overlap in symptoms, and (b) indications for disorder-specific risk factors (e.g., cognitive responsivity) which support the relevance of distinct disorder categories and disorder-specific mechanisms. Thus, the results point to the relevance of both transdiagnostic and disorder-specific targets for therapeutic interventions.

Adjustment disorder (AjD) is a is a maladaptive emotional or behavioral reaction to a stressful event or change in a person's life. Compared to other previously validated tools, the International Adjustment Disorder Questionnaire (IADQ) stands out as one of the most reliable and handy one for AjD. Since no homologous instrument exists now, in this study we aimed to validate an Italian version of the IADQ.21206 subjects (80.4% females) during the initial stages of the SARS-CoV-2 pandemic were recruited. We conducted a confirmatory factor analysis (CFA), testing two latent models, a monofactorial and a bifactorial one. Concurrent validity by correlating the total and the two factors' scores with measures of depression, anxiety, and post-traumatic stress was then estimated. We finally estimated the rates of AjD among the population, and a a binary logistic regression was conducted to analyze the predictors of such disorder.CFA showed a bi-factorial validity, with both excellent incremental and comparative fit indices. The IADQ scores correlated strongly with symptoms of depression, anxiety, and stress. In the Italian sample, the prevalence of probable AjD was 8.23%. Female gender, being engaged, widowed, and having COVID-19-related stressors resulted as significant independent risk factors for AjD.IADQ is an easy-to-use, brief, and psychometrically sound self-report measure for AjD. Thus, it may be considered a reliable tool for both research and clinical settings. To the best of our knowledge, our study reported for the first time the prevalence of AjD during COVID-19 pandemic.

Zonulin measurement was funded by Institut Allergosan (Graz, Austria). Introduction: The bidirectional connection between the brain and the gut within psychiatric entities has gained increasing scientific attention over the last years. As a regulator of intestinal permeability, zonulin acts as a key player on the interface of this interplay. Like several psychiatric disorders, intestinal permeability was associated with inflammation in previous findings. Methods: In this study we explored differences in zonulin serum levels in currently depressed (n = 55) versus currently euthymic (n = 37) individuals with an affective disorder. Further, we explored sex differences and possible influences on zonulin and affective symptoms like medication, age, body mass index, and smoking status. Results: Serum zonulin was significantly higher in females than in men independent from affective status (z = -2.412, p = .016). More specifically, females in the euthymic subgroup had higher zonulin levels than euthymic men (z = -2.114, p = .035). There was no difference in zonulin serum levels in individuals taking or not taking a specific psychopharmacotherapy. We found no correlation between zonulin serum levels and depression severity. Discussion: Increased serum zonulin levels as a proxy for increased intestinal permeability in women may indicate a state of elevated susceptibility for depression-inducing stimuli. Publisher PDF

Background: We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). Methods: 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (

Contains fulltext : 245998.pdf (Publisher’s version ) (Open Access) Objectives: Frailty marks an increased risk for adverse health outcomes. Since childhood trauma is associated with the onset of physical and mental health diseases during the lifespan, we examined the link between childhood trauma and multidimensional frailty. Method: A cross-sectional study embedded in a clinical cohort study (ROM-GPS) of older (>=60 years) patients (n=182) with a unipolar depressive-, anxiety- and/or somatic symptom disorder according to DSM-criteria referred to specialized geriatric mental health care. Frailty was assessed with the Tilburg Frailty Indicator (TFI), comprising a physical, psychological, and social dimension. Physical, sexual and psychological abuse and emotional neglect before the age of 16 years was measured with a structured interview. Results: Of 182 patients, 103 (56.6%) had experienced any childhood trauma and 154 (84.6%) were frail (TFI sum score >=5). Linear regression analyses, adjusted for lifestyle, psychological and physical-health factors, showed that the presence of any type of childhood trauma was not associated with the TFI sum score, however when considered separately, physical abuse was (ß=0.16, p=.037). Regarding the specific frailty dimensions, any childhood trauma was associated with social frailty (ß=0.18, p=.019), with emotional neglect as main contributor. Conclusion: These findings demonstrate a complex link between different types of childhood trauma and multidimensional frailty among older psychiatric patients. Regarding the three dimensions of frailty, social frailty seems most affected by childhood trauma. This may have been underestimated until now and should receive more attention in clinical care and future research. 7 p.

Affective disorders are frequently observed in chronic pain, with major depressive disorder being the first most common comorbidity and generalized anxiety being the second (Radat et al., 2013). The relationship between chronic pain and affective disorders is bidirectional and patients suffering from either condition are more likely to develop the other one than the general population (Antioch et al., 2020; Bair et al., 2003; Bondesson et al., 2018; Viana et al., 2018). The comorbidity is associated with worse outcomes and poorer treatment response (Bair et al., 2003). Hence, there is a need to understand the mechanisms characterizing this comorbidity and to find biomarkers associated with it. The reward system is altered in chronic pain, depression, and anxiety, and it has been proposed that deficits in the different aspects of reward, such as reward learning, appetitive approach behaviour, and response to consummation, can underlie the development of both chronic pain and affective disorders (Rizvi et al., 2021). To test this hypothesis, we will analyse task-fMRI data as well as the behavioural reward-related data of 698 subjects from the IMAGEN dataset, who performed a Monetary Incentive Delay (MID) task. The fMRI data collected at the age of 19 will be used to predict the change in the level of pain, depression, and anxiety at the age of 22, assessed through self-reported questionnaires. Multi-Task Learning will be used to train a model that can contemporarily predict both pain and depression or anxiety. In fact, studies have shown that some alterations are specific to the comorbidities, and they are not present in the disorders that compose them when taken alone (Zhang et al., 2021; Zhou et al., 2019; Zhu et al., 2019). The aim is to identify specific neurosignatures of the comorbidity using different contrasts, and evaluate their predictive importance compared to behavioural variables. For this reason, the neurosignatures showing a significant predictive accuracy will be used to build a second-level model, together with reward-related behavioural variables. The neurosignatures will be examined in another dataset (CBP-PREDICT) containing patients with subacute back pain (SABP), chronic back pain (CBP), and healthy controls. We will focus on brain regions associated with reward, trying to understand if reward-associated variables can be used to characterize the comorbidity between chronic pain and affective disorders.

Background: Associations between psychiatric syndromes and religion/spirituality (R/S) are confounded by a diversity of descriptive instruments, the interpretation of statistical correlations, and the highly individual experience of illness. Method: This presentation focuses on three major syndromes in psychiatric patients: (a) delusions with religious content, (b) depressive conditions, and (c) anxiety disorders. Results: The content of delusions is marked by cultural factors, including religious concepts. There is empirical evidence that R/S may have a supportive role in patients with schizophrenia. Affective disorders show a more varied pattern of causality—a better outcome in about 60%, but in 10%, there seems to be a higher incidence in patients with a conservative, guilt-oriented, religious background. In anxiety disorders, a meta-analysis could not find a correlation between R/S and clinical syndromes. However, research into the emerging field of “spiritual struggles” has shown an interaction between subjective anxieties and religious conflicts, strongly influenced by the level of neuroticism beyond religious factors. Conclusions: The correlation of R/S and dysfunctional psychological experience may be summarized in three concepts (culture, conflict, and coping), modulated by the neurobiological basis of psychiatric disorders.

Alcohol dependence (AD) and affective disorders (ADs) are serious medical and socio-economic problems of modern society. It is hypothesized that both disorders share a common neurobiological basis. Phosphatidylinositol-4-phosphate-5-kinase type 2 alpha (PIP5K2A) plays an essential role in neuronal phosphoinositide signaling pathways. Nonsynonymous rs10828317 mutation of the PIP5K2A gene leads to conformational changes of the PIP5K2A protein and a decrease in the functional activity of this enzyme. In this study, we assessed the possibility of using the rs10828317 polymorphic variant of the PIP5K2A gene as a marker of AD and ADs.Objective: to study the associations of the PIP5K2A (rs10828317) polymorphism with AD and ADs clinical course.Patients and methods. We enrolled 255 patients with AD and 325 patients with ADs. 126 patients with AD and 71 patients with ADs underwent a comprehensive clinical, clinical-dynamic, psychodiagnostic assessment using a set of clinical scales and tests, including Structured Interview Guide For The Hamilton Depression Rating Scale, Seasonal Affective Disorders Version (SIGH-SAD), Alcohol Use Disorders Identification Test (AUDIT), The Obsessive-Compulsive Drinking Scale for craving in alcohol (OCDS).Results and discussion. PIP5K2A (rs10828317) polymorphism in patients with AD was associated with the OCDS mean score after the inpatient treatment; in patients with ADs - with the severity of atypical depression symptoms assessed by SIGH-SAD at the time of admission.Conclusion. The results of our pilot study indicate the involvement of PIP5K2A (rs10828317) polymorphism in the AD and ADs pathophysiology.

Objective: To evaluate the prevalence and patterns of psychiatric disorders in epilepsy patients at the Korle-Bu Teaching hospital, Accra, Ghana.Design: The study design was a cross-sectional surveySetting: The study was conducted at the Neurology Clinic of the Department of Medicine and Therapeutics, Korle-nBu Teaching hospital, Accra, Ghana.Participants: A total of one hundred and sixty-six patients diagnosed with epilepsy aged at least 18 years and accessing services at the neurology clinic participated in the study.Main Outcome Measure: Prevalence and patterns of psychiatric disorders among patients diagnosed with epilepsy using the Brief Symptom Inventory.Results: The mean age for onset of epilepsy was 20.1 ± 16.9 years, and generalized epilepsy (73.2%) was the major type of epilepsy identified. The aetiology of the epilepsy condition was unknown in most patients (71.1%). The estimated mean Brief Symptom Inventory scores in all the nine diagnostic psychiatry characteristics (Depression, Anxiety, Somatization, Hostility, Phobic Anxiety, Obsessive Compulsive Disorder, Psychoticism, Interpersonal Sensitivity, and Paranoid Ideation) were higher in the epilepsy patients compared to the normative data scores for non-patients. Global Severity Index scores for females were significantly higher (p=0.002) than the scores for males on all the psychological outcomes except hostility.Conclusion: Psychological disorders were prevalent among epilepsy patients, with females more likely to experience psychological problems than males. The findings call for a holistic approach in managing epilepsy to highlight and manage some exceptional psychological comorbidities.

Background: Smartphone-based symptom monitoring has gained increased attention in psychiatric research as a cost-efficient tool for prospective and ecologically valid assessments based on participants’ self-reports. However, a meaningful interpretation of smartphone-based assessments requires knowledge about their psychometric properties, especially their validity. Objective: The goal of this study is to systematically investigate the validity of smartphone-administered assessments of self-reported affective symptoms using the Remote Monitoring Application in Psychiatry (ReMAP). Methods: The ReMAP app was distributed to 173 adult participants of ongoing, longitudinal psychiatric phenotyping studies, including healthy control participants, as well as patients with affective disorders and anxiety disorders; the mean age of the sample was 30.14 years (SD 11.92). The Beck Depression Inventory (BDI) and single-item mood and sleep information were assessed via the ReMAP app and validated with non–smartphone-based BDI scores and clinician-rated depression severity using the Hamilton Depression Rating Scale (HDRS). Results: We found overall high comparability between smartphone-based and non–smartphone-based BDI scores (intraclass correlation coefficient=0.921; P, Finanziert durch den Open-Access-Publikationsfonds der Westfälischen Wilhelms-Universität Münster (WWU Münster).

Introduction: Valid and reliable methods for diagnosing depression are essential. The present study aimed to test the performance of a new diagnostic interview for depression focusing on the core symptoms of depression. Method: We developed a diagnostic interview for depression: the CORE Diagnostic Interview, CORE-DI, which assesses each of the core features of depression on the four dimensions: quality, reactivity, globality, and fluctuations over time. The diagnostic performance of this interview was tested in a clinical study including 83 individuals presenting with various depressive symptoms, who were interviewed independently (1) by means of the CORE-DI and the Mini-International Neuropsychiatric Interview (M.I.N.I.), and (2) by highly skilled specialists in depression representing gold standard diagnoses. Results: We compared the outcome of the CORE-DI, the M.I.N.I., and the diagnosis made by clinicians, respectively, versus the gold standard diagnosis, using diagnostic efficiency statistics. The CORE-DI diagnosed depression with a high specificity (0.91, 95% CI: 0.85–0.97, for International Classification of Diseases [ICD]-10 criteria and 0.88, 95% CI: 0.81–0.95, for Diagnostic and Statistical Manual of Mental Disorders [DSM-5] criteria) compared to both M.I.N.I (specificity 0.44, 95% CI: 0.33–0.55) and clinical diagnoses (specificity 0.76, 95% CI: 0.67–0.85). The sensitivity of the CORE-DI was 0.61 (95% CI: 0.55–0.72) for ICD-10 criteria and 0.67 (95% CI: 0.57–0.77) for DSM-5 criteria. Discussion/Conclusion: The CORE-DI increased the specificity of the depression diagnosis substantially compared to clinical diagnoses and the diagnoses obtained by M.I.N.I. The results point to the usefulness of an elaborated and systematic assessment of the core symptoms in the examination of patients with depressive symptoms and thereby indicate a way for further development of specific diagnostic tools for depression in both clinical and research settings. However, it should be noted that the sensitivity of the CORE-DI was modest, and the psychometric properties of the CORE-DI might be different in other settings with higher or lower prevalence or severity of depressive symptoms.

Povratni depresivni poremećaj vrsta je afektivnog poremećaja. Rad se bavi klasifikacijom zapisa signala EEG-a dobivenih elektroencefalografijom u dvije klase: klasu depresivnih i klasu zdravih. Iz signala EEG-a izdvojeni su intervali kada pacijent miruje zatvorenih očiju te je provedena predobrada svih signala kako bi se iz njih uklonile smetnje i zadržali samo korisni dijelovi. Za opisani problem klasifikacije korišteno je nekoliko konvolucijskih neuronskih mreža različitih arhitektura i treniranih različitim postupcima. Rad uspoređuje njihove mjere vrednovanja i potrebna vremena treniranja međusobno, ali i s originalnim radovima iz kojih su preuzete arhitekture mreža. Korištena baza podataka dobivena je iz Klinike za psihijatriju Vrapče. Iz nje su izdvojeni zapisi signala EEG-a zdravih ljudi i pacijenata s povratnim depresivnim poremećajem s teškom trenutnom epizodom te je provedeno balansiranje ulaznog skupa podataka. Recurrent depressive disorder is a type of affective disorder. This paper deals with the classification of EEG signal recordings obtained from electroencephalography in two classes: depressed and healthy. The resting state segments where the patients have their eyes closed were extracted from the EEG signals. The signals were also preprocessed in order to eliminate noise and keep only the relevant parts. Multiple convolutional neural networks with different architectures and training procedures were used to solve the classification problem. The paper compares their performance measures and training execution times both mutually and with the results from the original papers in which the architectures were proposed. The database was provided by the Vrapče Psychiatric Hospital. EEG signal recordings of the healthy people and the patients with recurrent depressive disorder with severe current episode were extracted from it and subsampled to form a balanced set.

Mood instability is a core characteristic of, and risk factor for, mood disorders including bipolar disorder (BD) and major depressive disorder (MDD). However, little is currently understood of the wider, clinical, behavioural, and cognitive correlates of mood instability, and the neural mechanisms that may underlie it. It is hoped that a more thorough understanding of this pathophysiological basis may aid in better distinguishing between disorders, in predicting the onset and severity of symptoms, and in developing better suited targets for therapeutic intervention. Therefore, the current thesis aims to explore the profile of mood instability using a translational neuroscience approach combining remote technology, wearable devices, and neuroimaging techniques, in order to investigate the temporal dynamics of this relationship. Throughout this thesis data is presented from the Cognition and Mood Evolution across Time (COMET) study. The COMET study is a prospective, between-subjects experimental cohort study conducted over 10 weeks. Seventy-four participants took part, 37 of whom screened in for risk of BD using the Mood Disorder Questionnaire (MDQ) (MDQ7; high MDQ group), and 37 who did not (MDQ5; low MDQ group). All participants underwent a battery of multi-modal investigations, including remote monitoring of mood and activity, as well as cognitive testing and functional magnetic resonance imaging (fMRI). Clinical assessments revealed that 9 out of 37 high MDQ participants met criteria for one or more DSM-IV axis I psychiatric disorder (chapter 2). Given the emergence of new technologies and the ubiquity of internet access, I first explored whether prospective monitoring of daily mood could capture longitudinal mood instability in the high MDQ group (chapter 3). High MDQ individuals showed greater variability in daily mood ratings compared to low MDQ individuals, and reported significantly greater absolute negative affect across time. They also had significantly greater clinical symptoms of mania, depression, and anxiety, and reported greater variability across these measures. Additionally, increased levels of negative affect were reported in high MDQ participants who met criteria for an axis I disorder, regardless of classification, compared to those without a diagnosis. Therefore, analyses showed that daily mood monitoring could capture dynamic mood instability in individuals who screen in for BD. Despite screening in on a tool that targets manic and hypomanic symptoms, mood instability seemed to be more strongly associated with experiences of negative affect. While confirming the presence of mood instability in the high MDQ group, these results also paved the way for a closer examination of the related behavioural dynamics, a common symptom of mood disorders often manifesting in the form of circadian rest-activity disruptions. The subsequent study aimed to explore whether longitudinal actigraphy monitoring could distinguish between high MDQ participants and low MDQ participants, and also examined the influence of concurrent mood instability (chapter 4). High MDQ individuals showed significantly lower circadian relative amplitude, a marker of differentiation between daytime and night-time activity, driven by reduced levels of daytime activity. Relative amplitude was also differentially associated with mood instability and absolute negative mood in high MDQ participants and low MDQ participants, who also showed significant association with both night-time and daytime activity and mood instability. Together, these findings suggest that disruptions in circadian rhythms in mood disorders persist outside of the effects of clinical diagnosis and functional impairment, and are significantly impacted by the experience of mood instability. Subsequently, the second part of my thesis aimed to determine whether an overarching disruption in neural homeostatic mechanisms may be responsible for both regulating mood and circadian rhythms. Thus, resting-state fMRI was carried out at two time points during the COMET study, and analyses explored both static and dynamic patterns of functional connectivity, so as to more accurately capture the temporally dynamic experience of mood instability. Firstly (chapter 5), whole-brain analyses using the ICA method did not demonstrate network variability between groups and across time. Similarly, and using a seed-based approach, there was no difference in specific connectivity with the emotion processing and regulation regions of the amygdala and insula between groups or across time. This paved the way for more nuanced analyses of the dynamic patterns of functional connectivity that may be present. Therefore, subsequent analyses (chapter 6) aimed to build on this by exploring whether mood instability is reflected in altered patterns of dynamic neural connectivity, representing an overarching disruption in neural homeostatic mechanisms. A sliding-window approach was employed in order to characterise dynamic functional connectivity. Results revealed a comparative level of activation within four distinct meta-states (namely, highly interconnected, DMN, sensorimotor, and low connectivity) across all participants and scan sessions. When assessing dynamic properties, high MDQ individuals were found to occupy a greater number of meta-states and change more frequently across states than those in the low MDQ group. This pattern of instability was found to persist across sessions in the high MDQ group, whilst the low MDQ group showed a pattern of habituation or regulation across these metrics over time. Analyses of the relationship between dynamic properties with mood measures revealed a pattern of lowered variability in functional connectivity as a function of mood instability, as well as a potentially protective association between dynamic properties and circadian rest-activity patterns. Together, these findings uncover more dynamically nuanced details of the pathophysiology of mood and related instabilities. Led by the need to better understand the wide-ranging correlates of fluctuating mood and to improve clinical outcomes for patients with mood disorders, the aim of this thesis was to build a profile of the translational neuroscientific nature of mood instability. As the first study to do this, I was able to uncover the beginnings of an overarching disruption in neural homeostatic mechanisms that are responsible for regulating mood and related clinical and behavioural outcomes. It is hoped that the doctoral research presented here will encourage continued investigation of this transdiagnostic marker employing further novel and sophisticated methods, in order to capture the temporally dynamic nature of mood instability. Ultimately, such research will prove valuable in transforming our understanding of mood disorders and in the search for better-targeted therapeutic interventions.

Previous studies have indicated that vitamin (Vit) D deficiency is frequent in psychiatric patients, regardless of diagnostic category. We aimed to assess whether acute psychiatric relapses in inpatients was associated with Vit D deficiency compared to stabilized outpatients. The cohort (152 total patients, 75 males and 77 females) had a mean age of 47.3 ± 14.4 years at admission and was grouped according to psychiatric diagnosis. Psychopathological symptom severity was assessed by the Brief Psychiatric Rating Scale (BPRS), a multidimensional symptom inventory. Total calcium serum levels were measured using standard laboratory methods, while plasma levels of 25-OH-Vit D and parathyroid hormone (PTH) were measured by automated chemiluminescence immunoassays. The psychiatric inpatient subgroup showed a significant difference in serum levels of 25-OH-Vit D and PTH (p < 0.001). Correlation analysis between serum levels of 25-OH-Vit D and BPRS total and subitem scores indicated a significantly negative relationship. In addition, linear regression analysis evidenced that the inpatient condition might predict low PTH and 25-OH-Vit D serum levels. Hospitalized psychiatric patients are at increased risk for Vit D deficiency regardless of their diagnostic categories. The mechanism underlying the association between acute psychiatric relapses and Vit D deficiency remains unclear. Therefore, screening for Vit D deficiency should pertain to the health assessment of patients with major psychiatric disorders.

Background: Research on prevalence of cognitive frailty phenotypes in community-dwelling older adults in different countries is important to estimate their prevalence and to determine the influence of cognitive reserve and mental health in order to prevent frailty. The aims of this study were to estimate the prevalence of reversible and potentially reversible cognitive frailty (R-CF, PR-CF) in a Portuguese sample of old adults and explore the associations between these phenotypes and demographic, comorbidity, social support, cognitive reserve and mental health factors. Methods: We assessed frailty (Fried criteria) in 250 community-dwelling older adults (179 women) aged 60 years or over (mean 71.04 years) without dementia, neurological or psychiatric disorders. Subjective cognitive decline and Mild cognitive impairment were diagnosed according to standard criteria. The questionnaires Charlson Index, Medical Outcomes Study Social Support, Cognitive Reserve Index and General Health were used for assessing comorbidity, social support, cognitive reserve and mental health, respectively. Results: Prevalence of R-CF was 14%, and that of PR-CF, 15.2%. Cognitive frailty profiles differed significantly in relation to education, comorbidity, mental health, and cognitive reserve, but not in age or sex. Multivariate logistic regression showed that age, sex, comorbidity, social support, mental health, and cognitive reserve together predicted R-CF and PR-CF (90% specificity 75% sensitivity) with significant OR for mental health and cognitive reserve. Discussion: Cognitive reserve and mental health are important factors predicting R-CF and PR-CF. We recommend assessing these factors for early detection of cognitive frailty and promoting psychological well-being and lifestyles that increase cognitive reserve in adults This work was financially supported by ERDF funds through the National Research Agency (Spanish Ministry of Science, Innovation and Universities; Projects Ref. PSI2017-89389-C2-1-R and PID2020-114521RB-C21) and the Galician Government [GRC (GI-1807-USC); Ref: ED431-2017/27; ED431C-2021/04]; all with ERDF/FEDER funds SI

Traditional therapeutic methods in psychiatry, such as psychopharmacology and psychotherapy help many people suffering from mental disorders, but in the long-term prove to be effective in a relatively small proportion of those affected. Therapeutically, resistant forms of mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder lead to persistent distress and dysfunction in personal, social, and professional aspects. In an effort to address these problems, the translational approach in neuroscience has initiated the inclusion of novel or modified unconventional diagnostic and therapeutic techniques with promising results. For instance, neuroimaging data sets from multiple modalities provide insight into the nature of pathophysiological mechanisms such as disruptions of connectivity, integration, and segregation of neural networks, focusing on the treatment of mental disorders through instrumental biomedical methods such as electro-convulsive therapy (ECT), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS) and deep brain stimulation (DBS). These methodologies have yielded promising results that have yet to be understood and improved to enhance the prognosis of the severe and persistent psychotic and affective disorders. The current review is focused on the translational approach in the management of schizophrenia and mood disorders, as well as the adaptation of new transdisciplinary diagnostic tools such as neuroimaging with concurrently administered psychopathological questionnaires and integration of the results into the therapeutic framework using various advanced instrumental biomedical tools such as ECT, TMS, tDCS and DBS.

Aim. To determine gender differences in self-reported social functioning of patients with comorbidity of affective disorders (ADs) and chronic coronary artery disease. Materials and methods . Self-reported social functioning of 248 cardiological patients (194 men (78.2%) and 54 women (21.8%)) with chronic coronary artery disease (CAD) and ADs was studied using the Social Adaptation Self-evaluation Scale (SASS). The mean age of patients with chronic CAD in men was (57.2 ± 6.5) years, and in women (59.3 ± 7.1), p = 0.04. Qualitative and quantitative indicators were investigated using the Mann – Whitney, Wilcoxon and T-test; χ2 (Pearson›s goodness-of-fit test) was used to estimate the frequencies. Results . ADs were represented by chronic mood disorders (45%), first-time depressive episodes (DEs) 24%, recurrent DEs 24.5%, as well as bipolar II disorder (BD II) 6.5%. ADs in 42.4% of patients were associated with psychosocial stressors (mainly, loss), p = 0.02. Men statistically significantly more often (37.1%, 72/194) than women (16.7%, 9/54) communicated more scarcely with others as a result of projection mechanisms, a high level of hostility, passive aggressiveness and lack of initiative, typical for patients with ADs, p = 0.003. Conclusion. The social functioning of patients with ADs and chronic coronary artery disease was complicated irrespective of gender. Women were single and bereaved of their children more often than men. Due to the low level of communication outside the family and outside of professional activity, most of the patients maintained communication mainly with the family. However, due to ADs, they were not able to feel support from family members and rarely initiated communication with other people (men did it statistically significantly more often than women).

Background Although the body of research concerning neurodevelopmental disorders is vast, there is a scarcity of longitudinal studies beyond late adolescence, and of studies taking co-existing disorders into account. The present study aimed to investigate outcome in adulthood for children with attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) diagnosed at 6.6 years of age. Methods Out of a screening-based population cohort of 589 individuals, 62 (10 female) diagnosed with ADHD+DCD at mean age 6.6 years naïve to stimulant treatment were followed into adulthood through national registries. Results were compared to a screen- and assessment negative population matched group from the same cohort (PM group, n = 51) and a registry-matched (RM group, n = 410) group of the same county and age. Results At 30 to 31 years of age, five deaths had occurred; one in the ADHD+DCD group and two each in the comparison groups. In time to event analyses of the composite outcome of any psychiatric disorder, psychotropic prescription, sick pension or criminal sentence, events occurred at a significantly higher rate in the ADHD+DCD group (p = 0.0032, vs PM group p = 0.0115, vs RM group p = 0.0054). The ADHD+DCD group had significantly higher rates of psychiatric diagnoses, prescriptions of psychoactive medications and occurrence of sick pension than both comparison groups. Further, the ADHD+DCD group had significantly lower educational attainment compared to both comparison groups, more years with unemployment, and overall higher welfare recipiency. Rates of pain diagnoses and analgesic prescriptions did not separate the groups. Conclusion ADHD+DCD entailed a less favorable outcome in adulthood compared to a non-clinical comparison group and a registry-matched population. Neurodevelopmental disorder diagnosed upon school entry is of prognostic utility with respect to function in adulthood, and warrants early identification and management.

Only a few studies seem to address suicidality as an effect of the COVID-19 pandemic in persons previously affected by psychiatric disorders. The relationship between fear and stress caused by the COVID-19 pandemic and the level of social support and suicidality in patients diagnosed with affective and stress-induced psychiatric disorders prior to the onset of the COVID-19 pandemic were investigated. This study was observational and involved 100 participants. The examined period was from April 2020 to April 2022. The Fear of COVID-19 Scale (FCV-19S), the Oslo Social Support Scale 3 (OSSS-3) and general psychiatric interviews were used to obtain data. A statistically significant relationship between the impact of COVID-19-related distress on the occurrence of suicidality and the year of the pandemic χ2(2, N = 100) = 8.347, p = 0.015 was observed. No statistically significant correlation was found between suicidal behavior, stress intensity, fear and the score on the social support scale (p > 0.05). Fear related to the COVID-19 pandemic can only be seen as a contributor to suicidality. Overall, social support does not always act protectively. Previously stressful experiences such as wars, poverty and natural disasters seem to play a significant role in the resilience to each new public health crisis.

Immune dysregulation is implicated in the pathophysiology of both bipolar and major depressive disorder, while immune cell ratios (IRCs) have recently been proposed as clinically applicable immune biomarkers. We investigated IRCs differences in affective disorders and their association with current mood episodes and clinical features. This retrospective cohort study analyzed neutrophil–lymphocyte (NLR), monocyte–lymphocyte (MLR), and platelet–lymphocyte (PLR) ratios upon admission in 135 affective disorder in-patients with mania (MA, n = 36), bipolar depression (BiD, n = 38), and unipolar depression (MDD, n = 61). Demographic, clinical, and immune data were extracted from medical records. Monocyte count was significantly higher in BiD compared to MDD (p < 0.001). Multivariable regression models suggested higher NLR in MA compared to MDD (p = 0.039), higher MLR in both MA and BiD compared to MDD (p < 0.001 and p = 0.004 respectively), while we found neither group differences in PLR nor an effect of type and duration of hospitalization, current psychotic, or suicidal features and psychiatric history on IRCs. Here, we show that IRCs are elevated in bipolar disorder versus MDD and affected by mood episode, while MLR could be especially valuable in the differential diagnosis between bipolar and unipolar depression. IRCs represent inexpensive, routinely accessible and clinically applicable biomarkers with diagnostic validity in affective disorders that could be easily implemented as illness activity indicators, to better follow the course of illness and eventually predict relapse or treatment response and, thus, guide therapeutic targeting.

Bipolar disorder (BD) patients show neurological abnormalities in form of neurological and cerebellar soft signs (NSS and CSS). NSS represents heterogeneous group of symptoms representing i.a. deficits of motor coordination, sequencing of complex motor acts and sensory integration. CSS were introduced as group of the neurological deficits of posture, gait, kinetic functions, eye movements and speech, associated more specifically to cerebellar abnormalities than NSS. Studies show significant effect size variability of those symptoms in BD group suggesting the existence of differing subpopulations. The aim of our study was to evaluate the effect of BD type, stage and the history of psychotic symptoms (HoPS) on the severity of CSS and NSS as none of the previous studies had verified the role of those categories.This study involved 181 participants: 116 euthymic BD patients (66 BD I, 50 BD II) and 65 healthy controls (HC). CSS was assessed with the International Cooperative Ataxia Rating Scale and NSS with Neurological Evaluation Scale. Patients were divided into early and late stage of the disorder according to Kapczinski's criteria. Rater was blind to patients' stage, type and HoPS.Staging was related to vast majority of CSS and NSS scores. HoPS was related to oculomotor deficits. The effect of BD type was the least significant. Late stage BD showed more severe CSS and NSS than HC in every measure. There were no differences between early stage BD and HC, apart of posture and gait disturbances. Except of sensory integration scores, late stage BD showed higher CSS and NSS rates than early stage patients.In this hitherto the largest study of neurological abnormalities in BD we have shown significant role of staging in CSS and NSS severity. Progression criteria based on inter-episode psychosocial functioning may stand as unrecognised factor responsible for variability observed in previous studies evaluating neurological abnormalities in BD. Our study suggests that in clinical practice NSS and CSS may be potentially used as easy-to-assess biological marker of BD staging. Observed severity of neurological impairments of BD patients may more likely correspond to the disease progression than to BD type and HoPS.

A propensity to experience psychological distress and their expression in the form of somatic symptoms and to seek medical help for them is called Somatization. It is basically an inception of some psychiatric conditions like Affective Disorders (anxiety and depression) and Somatoform Disorders. A Somatoform Disorder is a category of mental disorder in which physical symptoms that suggest physical condition or injury cannot be explained fully by a general medical condition. This possibility must always be considered when patient has recurring somatic complaints for at least six months. Depression and Somatic Symptoms Disorder can easily be recognized when they present separately or in association with each other. But the main hurdle is to develop a holistic approach and strategy to not be misguided by the intimidating nature of presenting physical symptoms. For that detailed evaluation should be carried out and every single possibility along with somatization should be kept under consideration, which would enable to recognize and treat the illness earlier and save considerable amount of time and resources as well.

Objective: Epilepsies are severe chronic neurological diseases that impair several domains in life and are often accompanied by various somatic and psychiatric comorbidities. Associations between epilepsy and its comorbidities remain poorly understood. As epidemiological research mainly relies on cross-sectional designs and descriptive results, homogeneities regarding comorbidities in individuals suffering from epilepsy remain uncovered. Therefore, we aimed to identify clusters of individuals based on selected seizure-related variables and somatic comorbidities, and their respective risk of experiencing affective disorders, using a Latent Class Analysis (LCA). Methods: Latent class analysis, is a model-driven statistical approach, which aims at latent, unobservable clusters on selected disease features. LCA has therefore the potential for uncovering previously unobservable groups or classes with similar comorbidity patterns. It allows for comparisons between those classes regarding risk or promotive factors – such as affective disorders. Our data derives from the Austrian cohort of the European Study on Burden and Care of Epilepsy (ESBACE; http://www.esbace.eu/). In ESBACE, multiple factors were collected to get a detailed picture on prevalence, epilepsy-related variables and comorbidities in a population-based cohort from the region of Salzburg, Austria. We used LCA to identify epilepsy-somatic-comorbidity-clusters and further, compared them to the observed the risk of suffering from affective disorders. Results: The prevalence of epilepsy in the study region was 9.14/1000 inhabitants. LCA unveiled a three-cluster solution, of which one cluster, mainly consisting of individuals with mixed seizure types, higher age, and discrete somatic comorbidities (stroke, cardiovascular – and respiratory/pulmonary diseases) had a higher risk of experiencing affective disorders. Significance: To our knowledge, this is the first large scale study that uses LCA to identify epilepsy-related comorbidity phenotypes, and therefore it might open a new way for epidemiological research.

Emotion dysregulation (ED) is characterized by rigid and frequent use of maladaptive emotion regulation (ER) strategies. Conceptualized as a transdiagnostic feature, ED may occur in both clinical and non-clinical populations, including people diagnosed with bipolar disorder (BD) and their first-degree relatives (FDRs), though expected to manifest with differential clinical features. To this end, we conducted a systematic review and meta-analysis of the literature comparing people with BD to healthy controls (HCs) or FDRs, from inception up to November 25, 2021, across major databases. Random-effects meta-analyses considered twenty-eight studies assessing ER/ED with a validated scale. Patients with BD differed from HCs in adopting more maladaptive ER strategies, such as rumination, risk-taking behaviors, negative focus, and less adaptive ones. Unaffected FDRs differed from people with BD, yet to a lower extent, suggesting that ED may span a continuum. ED in BD should be widely explored to better understand its course and management, with specific interventions aimed at reducing its burden on both high-risk and full-threshold populations.

The attempts to clarify the origin of eating disorders (ED) have not been completely successful and their etiopathogenesis remains unknown. Current research shows an activation of the immune response in neuropsychiatric diseases, including ED. We aimed to investigate immune response parameters in patients with ED and to identify psychological factors influencing the inflammatory response. The relationship between inflammation markers and impulsivity and affective symptomatology was explored as well. Thirty-four adult female patients with current diagnosis of ED, none of them under psychopharmacological treatment (excluding benzodiazepines), were included in this study. Patients were compared with a healthy control group of fifteen adult females. The levels of inflammatory markers and indicators of oxidative/nitrosative stress were evaluated in plasma and/or in peripheral blood mononuclear cells (PBMCs). Subjects were assessed by means of different ED evaluation tools. Additionally, the Barratt Impulsiveness Scale, the Montgomery-Asberg Depression Rating Scale and the Hamilton Anxiety Rating Scale were also employed. Patients with ED shown increased plasma levels of the pro-inflammatory nuclear factor kappa B (NFκB) and the cytokine tumor necrosis factor-alpha (TNF-α), among other factors and an increment in the oxidative/nitrosative stress as well as increased glucocorticoid receptor (GR) expression levels in their PBMCs. Moreover, the inflammatory prostaglandin E2 (PGE2) correlated with impulsiveness and the anti-inflammatory prostaglandin J2 (15d-PGJ2) correlated with depressive symptomatology. Our results point towards a relationship between the immune response and impulsiveness and between the immune response and depressive symptomatology in female adult patients with ED.

Objectives Predictors for unfavorable treatment outcome in major depressive disorder (MDD) applicable for treatment selection are still lacking. The database of a longitudinal multicenter study on 1079 acutely depressed patients, performed by the German research network on depression (GRND), allows supervised and unsupervised learning to further elucidate the interplay of clinical and psycho‐sociodemographic variables and their predictive impact on treatment outcome phenotypes. Experimental Procedures Treatment response was defined by a change of HAM‐D 17‐item baseline score ≥50% and remission by the established threshold of ≤7, respectively, after up to eight weeks of inpatient treatment. After hierarchical symptom clustering and stratification by treatment subtypes (serotonin reuptake inhibitors, tricyclic antidepressants, antipsychotic, and lithium augmentation), prediction models for different outcome phenotypes were computed with random forest in a cross‐center validation design. In total, 88 predictors were implemented. Results Clustering revealed four distinct HAM‐D subscores related to emotional, anxious, sleep, and appetite symptoms, respectively. After feature selection, classification models reached moderate to high accuracies up to 0.85. Highest accuracies were observed for the SSRI and TCA subgroups and for sleep and appetite symptoms, while anxious symptoms showed poor predictability. Conclusion Our results support a decisive role for machine learning in the management of antidepressant treatment. Treatment‐ and symptom‐specific algorithms may increase accuracies by reducing heterogeneity. Especially, predictors related to duration of illness, baseline depression severity, anxiety and somatic symptoms, and personality traits moderate treatment success. However, prospectives application of machine learning models will be necessary to prove their value for the clinic.

Несмотря на то что по результатам множества исследований становятся все более очевидными различия в психопатологии у пациентов с разными типами фенотипической асимметрии, ее влияние на эффективность и побочные эффекты терапии остается крайне малоизученным. Материалы и методы: Обследовано 100 пациентов с эндогенными аффективными расстройствами. Для каждого пациента определялся индивидуальный профиль функциональной асимметрии и оценивалась эффективность проводимой фармакотерапии. Результаты: Пациенты со смешанным профилем асимметрии более других склонны к обострениям состояния на фоне лечения, чаще нуждаются в аугментации антидепрессантов нейролептиками, имеют большее количество рецидивов в год и тенденцию к более длительным госпитализациям. У левшей значительно чаще, чем у остальных пациентов, отмечаются побочные эффекты терапии. Выводы: Необходим дифференцированный подход к лечению эндогенных аффективных расстройств с учетом различий в фенотипической функциональной асимметрии.

Background Suicide risk of psychiatric patients has proven to be strongly increased in the months after discharge from a psychiatric hospital. Despite this high risk, there is a lack of systematic research on the causes of this elevated suicide risk as well as a lack of treatment and intervention for patients at high risk after discharge. The main objective of this pilot study is, firstly, to examine the factors contributing to the elevated suicide risk and, secondly, to investigate whether an additional setting of care starting at discharge may reduce suicidality. Methods In this multi-centre pilot study, treatment as usual is complemented by an additional 18-month post-discharge setting of care for psychiatric patients at high risk for suicide. Two groups of patients differing in the amount of post-discharge personal contacts will be compared. One group of patients will be offered continuous personal contacts after discharge (months 1–6: monthly contacts; months 6–18: every 2 months) while another group of patients will receive contacts only at months 6, 12, and 18 after discharge. Data on suicidality, as well as associated with other symptoms, treatment, and significant events, will be collected. In the case of health-related severe events, the setting of care allows the patient to have the opportunity to connect with the doctor or therapist treating the patient. Discussion The results of this study will contribute to identifying critical factors raising suicide risk after discharge and will demonstrate the potential influence on suicide prevention of a setting of care with regular personal contact after discharge. Trial registration ZMVI1-2517FSB135 – funded by the German Federal Ministry of Health.

The relationship between cognitive impairment (CI) and depression is complicated: h\the latter can be one of the symptoms of Alzheimer’s disease or may precede the onset of CI. Depression also has cognitive symptoms that alter the clinical presentation of the disease. Patients with depressive pseudodementia experience difficulties concentrating, confusion concurrent with impaired memory and thinking, whereas the patient’s answers to certain questions often resemble the vague pseudoamnestic pattern of the impairment. Mnestic disorders occur in at least 40% of patients with depression, and if the latter is diagnosed in the patient who already has dementia, the rate of cognitive decline may be faster. The mechanisms underlying the development of CI can also affect the development of depression. When assessing the risk of dementia in depression, it is necessary to take into account the time from the onset of a major depressive episode until moderate CI appears, to carry out a detailed analysis of neuropsychological testing for Alzheimer’s disease and to use the current lifetime markers for amyloidosis and neurodegeneration. Serotonergic antidepressants and non-pharmacological cognitive behavioral and psychotherapeutic procedures play the most important role in the treatment of depression and dementia.

Patients with bipolar disorder and schizophrenia often suffer from severe cognitive impairment even during times of remission. This study investigated the pathomechanisms underlying their deficits in cognitive control. A combined oddball–incongruence fMRI task was applied to examine similarities and differences of neural activation patterns between patients and healthy controls. Bipolar and schizophrenia patients demonstrated hyperactivations in the intraparietal cortex during the oddball condition. Furthermore, bipolar patients revealed diagnosis-specific hyperactivation in the left middle frontal gyrus, precentral gyrus, anteroventral prefrontal cortex and orbitofrontal cortex regions compared to schizophrenia patients and healthy individuals. In comparison to healthy controls the patients showed hypoactivations in the inferior frontal junction and ventral pathway during the cognitively more demanding incongruence. Taken together, bipolar patients seem to recruit frontal and parietal areas during the oddball condition to compensate for potential deficits in their attentional network. During more challenging tasks, i.e., the incongruence condition, their compensatory mechanisms seem to collapse leading to hypoactivations in the same frontal areas as well as the ventral pathway.

A clinical case of a rare genetic oculo-auriculo-vertebral syndrome (Goldenhar syndrome) is presented in a young man of 18 years old, who was first sent for examination and treatment to the psychiatric ward. A retrospective analysis of anamnestic information indicates the emergence of psychopathological disorders in childhood in the form of a delay in psychoverbal development, emotional immaturity, and delays in the development of social behavior. Subsequently, persistent encephalasthenic and neurosis-like disorders were complicated by the addition of affective disorders of the depressive-dysphoric type and psychotic disorders. The lack of a timely integrated therapeutic approach with the addition of psychopharmacotherapy, psychotherapy and social therapy led to the formation of specific personality changes in organic etiology with significant disorders in the emotional sphere (lability of emotions, irritability, outbursts of anger, constant resentment and dissatisfaction with others), a decrease in the level of cognitive activity and a tendency to chronic course of neurosis-like and affective disorders. A statement of persistent pronounced violations of mental functions during follow-up observation caused severe restrictions in the main areas of life (communication, behavior control, education, work) and social maladaptation of the patient, which was the basis for referral to medical and social examination with the establishment of a disability group.

Introduction. Patients with type 2 diabetes are more likely to have concomitant depression. In addition, there are some studies that have alluded to a direct relationship between overweight and diabetes and daytime drowsiness.The aim of this study was to study the relationship of metabolic disorders, anthropometric data with daytime sleepiness and depression in patients with type 2 diabetes.Material and methods. A general clinical study consisted in interviewing the patient (complaints, medical history), obtaining physical data (anthropometry) – height (cm), weight (kg), neck circumference (cm), waist circumference (cm), hip circumference (cm). The object of the study was the whole blood and blood plasma of patients in order to determine the level of fasting plasma glucose, glycosylated hemoglobin and other blood biochemical parameters. To verify violations in the emotional-volitional sphere, the Beck Depression Inventory and the Epworth Sleepiness Scale were used.Results. All patients had visceral obesity, the waist circumference is significantly higher than normal, both in men and women. In accordance with the Epworth drowsiness scale, on average, borderline insomnia was recorded in the examined patients with type 2 diabetes. Drowsiness rate correlated with waist circumference (r = 0,65) and hips (0,67), age (0.34) only in male patients. The level of depression correlated with age in female patients (r = 0.37, p < 0,05) and male (r = 0,6, p < 0,05) and did not correlate with drowsiness in both groups. The level of depression was 16, which corresponds to mild to moderate depression. However, the rate of depression is negligible, but higher among female patients (14.00 [6.00; 18.00] versus 19.00 [10.50; 20.00], p = 0,047).Conclusions. Increased daytime sleepiness and depression accompany patients with type 2 diabetes, regardless of gender. The dependence between the severity of decreased daily activity and increased anthropometric indicators and age can be seen in male patients, which may illustrative of increasing androgen deficiency in men and its contribution to the development of metabolic disorders, including obesity. Depressive states have deeper manifestations in female patients with type 2 diabetes compared to male patients, which may indicate both emotional instability of female patients and a more pronouncedeffect of the disease itself on the psychoemotional background in women.