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Background: Recurrent depressive disorder (RDD) is mainly manifested as a low mood, negative and pessimistic mood, and often presents suicidal tendencies when severe. This study reports on a patient with RDD who experienced rat poison poisoning occurring tongue biting. The patient's psychiatric symptoms improved after receiving emergency management and subsequent combined medical care. Case presentation: The patient was a 51-year-old female with RDD complicated with rat poison poisoning. Tongue bite occurred on the third day of hospitalization. She received emergency treatment. Depression, anxiety and suicide risk assessment, safety management and caregiver-health education were conducted on the day of admission and before discharge. At the follow-up after discharge, the risk of suicide was reduced. Conclusions: Suicide in patients with RDD is characterized by repetition and complexity. The occurrence of clinical cases involving tongue bite after gastric lavage is rare. Suicide assessment and emergency management play an auxiliary role in the treatment of patients with recurrent depressive disorder. [ABSTRACT FROM AUTHOR]

Abstract Background Recurrent depressive disorder (RDD) is mainly manifested as a low mood, negative and pessimistic mood, and often presents suicidal tendencies when severe. This study reports on a patient with RDD who experienced rat poison poisoning occurring tongue biting. The patient’s psychiatric symptoms improved after receiving emergency management and subsequent combined medical care. Case presentation The patient was a 51-year-old female with RDD complicated with rat poison poisoning. Tongue bite occurred on the third day of hospitalization. She received emergency treatment. Depression, anxiety and suicide risk assessment, safety management and caregiver-health education were conducted on the day of admission and before discharge. At the follow-up after discharge, the risk of suicide was reduced. Conclusions Suicide in patients with RDD is characterized by repetition and complexity. The occurrence of clinical cases involving tongue bite after gastric lavage is rare. Suicide assessment and emergency management play an auxiliary role in the treatment of patients with recurrent depressive disorder.

Objective: Treatment and management for difficult-to-treat depression are challenging, especially in a subset of patients who are at high risk for relapse and recurrence. The conditions that represent this subset are recurrent depressive disorder (RDD) and bipolar disorder (BD). In this context, we aimed to examine the effectiveness of maintenance transcranial magnetic stimulation (TMS) on a real-world clinical basis by retrospectively extracting data from the TMS registry data in Tokyo, Japan. Methods: Data on patients diagnosed with treatment-resistant RDD and BD who received maintenance intermittent theta burst stimulation (iTBS) weekly after successful treatment with acute iTBS between March 2020 and October 2023 were extracted from the registry. Results: All patients (21 cases: 10 cases with RDD and 11 cases with BD) could sustain response, and 19 of them further maintained remission. In this study, maintenance iTBS did not exacerbate depressive symptoms in any of the cases, but may rather have the effect of stabilizing the mental condition and preventing recurrence. Conclusions: This case series is of great clinical significance because it is the first study to report on the effectiveness of maintenance iTBS for RDD and BD, with a follow-up of more than 2 years. Further validation with a randomized controlled trial design with a larger sample size is warranted. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this study was to analyze the impact of pharmacogenetic-guided antidepressant therapy on the 12-month evolution of the intensity of depressive symptoms in patients with recurrent depressive disorder (RDD) in comparison to a control group of depressive subjects who were treated conventionally. (2) Methods: This prospective longitudinal study was conducted between 2019 and 2022, and the patients were evaluated by employing the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impressions Scale: Severity and Improvement. We followed them up at 1, 3, 6, and 12 months. (3) Results: Of the 76 patients with RDD, 37 were tested genetically (Group A) and 39 were not (Group B). Although the patients from Group A had statistically significantly more severe MDD at baseline than those from Group B (p < 0.001), by adjusting their therapy according to the genetic testing, they had a progressive and more substantial reduction in the severity of RDD symptoms [F = 74.334; η2 = 0.674; p < 0.001], indicating a substantial association with the results provided by the genetic testing (67.4%). (4) Conclusions: In patients with RDD and a poor response to antidepressant therapy, pharmacogenetic testing allows for treatment adjustment, resulting in a constant and superior reduction in the intensity of depression and anxiety symptoms. [ABSTRACT FROM AUTHOR]

(1) Background: The aim of this study was to analyze the impact of pharmacogenetic-guided antidepressant therapy on the 12-month evolution of the intensity of depressive symptoms in patients with recurrent depressive disorder (RDD) in comparison to a control group of depressive subjects who were treated conventionally. (2) Methods: This prospective longitudinal study was conducted between 2019 and 2022, and the patients were evaluated by employing the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A) and the Clinical Global Impressions Scale: Severity and Improvement. We followed them up at 1, 3, 6, and 12 months. (3) Results: Of the 76 patients with RDD, 37 were tested genetically (Group A) and 39 were not (Group B). Although the patients from Group A had statistically significantly more severe MDD at baseline than those from Group B (p < 0.001), by adjusting their therapy according to the genetic testing, they had a progressive and more substantial reduction in the severity of RDD symptoms [F = 74.334; η2 = 0.674; p < 0.001], indicating a substantial association with the results provided by the genetic testing (67.4%). (4) Conclusions: In patients with RDD and a poor response to antidepressant therapy, pharmacogenetic testing allows for treatment adjustment, resulting in a constant and superior reduction in the intensity of depression and anxiety symptoms.

Our study refers to a current topic, the treatment of patients with recurrent depressive disorder (RDD), for which pharmacogenetically guided antidepressant therapy offers the prospect of a personalized, more effective prescription. The functional outcome has become in the last decades of interest for cross-sectional diagnosis in psychiatric genetics. It is essential to know the clinical, demographic, and psychosocial variables that are associated with long-term functioning. The present study is a prospective clinical trial analyzing the clinical impact of pharmacogenomics on the management of patients with RDD. Applying a longitudinal model of analysis to samples of patients with RDD genetically tested as well as to patients who did not benefit from genetic testing, we compared the improvement of functionality measured by the Global Assessment of Functioning (GAF) score. The results indicate an improvement in function in genetically tested patients after three months and up to one year of treatment compared to nongenetically tested patients. One of the main qualities of our research is the longitudinal design that allows the follow-up of patients over a year by using the GAF to assess the functionality of patients at five specific intervals, starting from baseline and after treatment optimization. The information provided by our research could be used to develop an algorithm to personalize the management of patients with RDD according to the results of genetic tests. [ABSTRACT FROM AUTHOR]

The aim of this analysis was to investigate the socio-demographic and clinical profile, the effectiveness, and the association of pharmacological treatment in patients who underwent electroconvulsive therapy during the last 10 years in the largest psychiatric hospital in Romania. This study includes 249 patients aged between 18 and 73 years old. Recurrent depression was the most frequent diagnosis for which ECT was performed (T = 96, 38.55%), followed by schizophrenia (T = 72, 28.91%). The most frequent indication for ECT was treatment resistance (T = 154, 61.84%), followed by persistent suicidal ideation (T = 54, 21.68%) and catatonia (T = 42, 16.86%). In 111 (44.60%) cases included in this study, re-hospitalization was required after performing ECT, while 138 (55.40%) participants did not require any further hospital readmissions. Significant differences were found between these groups in terms of socio-demographic data, diagnosis, number of ECT sessions performed, and association of psychotropic medication during and after the procedure, therefore two separate patient profiles were found based on these characteristics. Patients necessitating re-hospitalization post-ECT were mainly males aged 25–44 diagnosed with schizophrenia and underwent a greater number of ECT sessions (7–12), whereas those not requiring re-hospitalization were predominantly females aged 45–64 with recurrent depressive disorder for which 4–6 ECT sessions were performed. [ABSTRACT FROM AUTHOR]

Among the numerous neuropsychiatric manifestations of multiple sclerosis (MS), depression is one of the most common psychiatric comorbidities. Depression has been associated with poor quality of life, aggravation of symptoms of MS, and poor adherence to treatment in MS. Diagnosing and managing depression in MS can be challenging. Psychiatrists, neurologists, and other allied professionals need to collaborate to manage depression effectively. There is a need for greater awareness and vigilance for depression in this vulnerable population. We present a case of MS with recurrent depressive disorder and subsequently discuss the literature relating to depression in MS.

Nowadays, nervous tissue damage proteins in serum are considered promising drug targets and biomarkers of Mood Disorders. In a cross-sectional naturalistic study, the S100B, MBP and GFAP levels in the blood serum were compared between two diagnostic groups (patients with Depressive Episode (DE, n = 28) and patients with Recurrent Depressive Disorder (RDD, n = 21)), and healthy controls (n = 25). The diagnostic value of serum markers was assessed by ROC analysis. In the DE group, we did not find changed levels of S100B, MBP and GFAP compared with controls. In the RDD group, we found decreased S100B level (p = 0.011) and increased MBP level (p = 0.015) in comparison to those in healthy controls. Provided ROC analysis indicates that MBP contributes to the development of a DE (AUC = 0.676; 95%Cl 0.525–0.826; p = 0.028), and S100B and MBP have a significant effect on the development of RDD (AUC = 0.732; 95%Cl 0.560–0.903; p = 0.013 and AUC = 0.712; 95%Cl 0.557–0.867; p = 0.015, correspondingly). The study of serum markers of nervous tissue damage in patients with a current DE indicates signs of disintegration of structural and functional relationships, dysfunction of gliotransmission, and impaired secretion of neurospecific proteins. Modified functions of astrocytes and oligodendrocytes are implicated in the pathophysiology of RDD. [ABSTRACT FROM AUTHOR]

The aim of this analysis was to investigate the socio-demographic and clinical profile, the effectiveness, and the association of pharmacological treatment in patients who underwent electroconvulsive therapy during the last 10 years in the largest psychiatric hospital in Romania. This study includes 249 patients aged between 18 and 73 years old. Recurrent depression was the most frequent diagnosis for which ECT was performed (T = 96, 38.55%), followed by schizophrenia (T = 72, 28.91%). The most frequent indication for ECT was treatment resistance (T = 154, 61.84%), followed by persistent suicidal ideation (T = 54, 21.68%) and catatonia (T = 42, 16.86%). In 111 (44.60%) cases included in this study, re-hospitalization was required after performing ECT, while 138 (55.40%) participants did not require any further hospital readmissions. Significant differences were found between these groups in terms of socio-demographic data, diagnosis, number of ECT sessions performed, and association of psychotropic medication during and after the procedure, therefore two separate patient profiles were found based on these characteristics. Patients necessitating re-hospitalization post-ECT were mainly males aged 25–44 diagnosed with schizophrenia and underwent a greater number of ECT sessions (7–12), whereas those not requiring re-hospitalization were predominantly females aged 45–64 with recurrent depressive disorder for which 4–6 ECT sessions were performed.

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Objective:Electroconvulsive therapy (ECT) has been used for treatment of depression and psychosis for a long time. A less known way of use is as a maintenance treatment for keeping patients stable during remission. Recently ECT has been increasingly used for schizophrenia and depression after remission of the acute exacerbation.Methods:In this study, we examined files of 24 patients diagnosed as having treatment-resistant schizophrenia (14) or recurrent depression (10) who were treated with ECT on an outpatient basis.Results:Patients with depression and schizophrenia were followed up for minimum 2 months and maximum 54 months with ECT. The remission rate in both groups were 70%. None of the patients quitted treatment due to adverse effects.Conclusion:Biases and stigmatization cause a decreased rate of use of ECT in outpatient settings. However, the literature indicates that the morbidity and morbidity due to ECT are negligible. Although our data were collected retrospectively, they showed that ECT might be an option for a maintenance or continuation treatment of recurrent depression and treatment-resistant schizophrenia. Our findings should be supported by randomized studies.

Objective: to perform a comparative study of the clinical features of atypical depression (AtD) in affective disorders of various origins: in bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD).Patients and methods. A sample of 250 depressed patients aged 18 to 65 years were examined, of which 77 participants (50 women and 27 men) with symptoms of AtD were included to the study. Group 1 included 35 patients with BAD, group 2 – 18 patients with RDR, and group 3 – 24 patients with diagnoses including PD. The patients' condition was assessed using the diagnostic criteria for affective disorders according to ICD-10 and DSM-5 with a Montgomery-Asberg Depression Rating Scale (MADRS).Results and discussion. AtD detection rate was 30.8%, including 45.4% in BAD, 23.4% – in RDR, and 31.2% – in PD. AtD manifested at the age of about 20 years, and was more common in women. AtD in BAD occurred more often in individuals with cycloid, hyperthymic, and hysterical features. Affective fluctuations before the disease onset, a significantly greater number of depressive episodes in history were characteristic. The most frequent typical depressive symptoms included: daily and seasonal mood fluctuations, morning deterioration of well-being, decreased appetite. High comorbidity with metabolic endocrine diseases was observed. AtD in RDR often began spontaneously in individuals with emotionally labile, psychasthenic, and hysterical features. The most common typical depressive symptoms included melancholy, derealization, weakness, ideas of self-accusation, suicidal thoughts and attempts. A high comorbidity with cardiovascular diseases was found. AtD in PD occurred more often in psychasthenic individuals. The most characteristic symptoms included: increased appetite, anxiety, asthenia, superficial night sleep, hypochondriacal inclusions. Comorbidity with skin and gastrointestinal diseases was observed.Conclusion. The identified features of the clinical picture and course of AtD in BAD, RDR, and PD can be used for earlier and more accurate evaluation of affective disorders and the adequate treatment administration.

Objective: to evaluate the treatment effectiveness for atypical depression (AtD) depending on its nosology: in bipolar affective disorder (BAD), recurrent depressive disorder (RDD) and psychogenic depression (PD).Patients and methods. A total of 250 patients with depression were screened, of which 77 patients with symptoms of AtD were enrolled in the study, 35 of them with BAD, 18 with RDD, and 24 with PD. Patients in all three groups received an antidepressant (AD) or a mood stabilizer (MS) monotherapy, or a combination of AD and antipsychotic (A), AD and A, MS and A, as well as a combination of AD, A and MS. The patients' condition was assessed clinically using a specially designed questionnaire and MADRS and CGI scales at the baseline and the 2nd, 3rd, 4th, 6th, 12th weeks of treatment. Quality of life satisfaction was assessed with the Q-LES-Q-SF (Scoring the Quality-of-Life Enjoyment and Satisfaction Questionnaire) scale at the treatment onset and after the 12th week of treatment.Results and discussion. Treatment regimens that included AD were the most eff in all groups of patients with AtD. The proportion of responders among those who received AD for bipolar disorder (75% or more) was significantly higher than among those who did not receive it (˂50%). In the RDD and PD groups, patients responded significantly better to AD monotherapy (RDD – 93.2%; PD – 91.5%) compared to other regimens. Agomelatine was the most frequently used (31.8%) and effective AD in all groups. Also, escitalopram, vortioxetine, and venlafaxine (p˂0.05) showed high efficacy, good tolerance, and absence of side effects that aggravate the main symptoms that characterize AtD. Among the antipsychotics in combination with AD, sulpiride was significantly more effective in patients with PD (p˂0.05). The highest rates of quality of life satisfaction were achieved in the BAD group, the lowest – in patients with PD (p˂0.05), which indirectly indicates the quality of remission, which is determined not only by the degree of reduction of depressive symptoms but also by the patients' subjective perception of their mental state.Conclusion. The inclusion of AD in the AtD treatment regimen significantly increases its effectiveness in patients of all groups, including BAD. AtD treatment should be administered not only taking into account its clinical signs and severity, but also depending on the nosology of the disease, the characteristics of its course. During drug administration, it is necessary to consider the spectrum of side effects, especially those that increase the symptoms of AtD itself.

Objective: Electroconvulsive therapy (ECT) has been used for treatment of depression and psychosis for a long time. A less known way of use is as a maintenance treatment for keeping patients stable during remission. Recently ECT has been increasingly used for schizophrenia and depression after remission of the acute exacerbation. Methods: In this study, we examined files of 24 patients diagnosed as having treatment-resistant schizophrenia (14) or recurrent depression (10) who were treated with ECT on an outpatient basis. Results: Patients with depression and schizophrenia were followed up for minimum 2 months and maximum 54 months with ECT. The remission rate in both groups were 70%. None of the patients quitted treatment due to adverse effects. Conclusion: Biases and stigmatization cause a decreased rate of use of ECT in outpatient settings. However, the literature indicates that the morbidity and morbidity due to ECT are negligible. Although our data were collected retrospectively, they showed that ECT might be an option for a maintenance or continuation treatment of recurrent depression and treatment-resistant schizophrenia. Our findings should be supported by randomized studies. [ABSTRACT FROM AUTHOR]

Introduction To improve the effectiveness of treatment for atypical depression, it is necessary to revise the accumulated experience, taking into account new knowledge and drugs. Objectives Comparative study of the efficacy and safety of therapy for atypical depression (AtD) in the structure of bipolar affective disorder (BAD), recurrent depressive disorder (RDR) and psychogenic depression (PD). Methods Clinical and clinical follow-up methods examined 77 patients with AtD, of which 35 - with bipolar disorder, 18 - with RDR and 24 - with PD. Patients in all three groups received monotherapy with an antidepressant or a mood stabilizer, or a combination of antidepressant and antipsychotic, antidepressant and mood stabilizer, mood stabilizer and antipsychotic, as well as a combination of antidepressant, antipsychotic and mood stabilizer. Results Agomelatine was the most frequently used (27.3%) and effective in reducing MADRS in all groups both in monotherapy and in combination with other drugs. Also in the PD group, escitalopram and vortioxetine were highly effective. Of the antipsychotics, when combined with antidepressants, sulpiride was found to be the most effective. When comparing the tolerance of antidepressants in all groups showed the best results (by the CGI scale), agomelatine and venlafaxine, in the BAR group is also vortioxetine. Conclusions The best strategy for effective and safe treatment of atypical depression is the use of modern antidepressant, which does not increase the symptoms of the atypical spectrum and, if necessary, can be supplemented with some antipsychotics. Disclosure No significant relationships.

The problem of depression will remain relevant for many years, due to the extremely widespread prevalence of mental disorders. According to various epidemiological studies, depression affects from 14% to 25% of the population. Timely and adequate treatment of mood disorders is a very important problem around the world, because according to the WHO, it is one of the leading causes of disability among the working population. Depression negatively affects all components of the lives of patients and their relatives, reduces their standard of living and the degree of social functioning. An important aspect of depressive disorders is that they are characterized by a recurrent course, a tendency to form resistant forms and pose a significant threat due to the development of suicide risk in this category of patients. But at the present stage of development of science and practice, the detection and classification of depression in the general medical network are associated with significant difficulties. Therefore, research aimed at studying the clinical and psychopathological features in patients with CP in different types of DR is relevant and will improve the diagnostic criteria and increase the effectiveness of treatment of different types of DR. The aim of the study was to identify specific manifestations of emotional, psychomotor, somato-vegetative and sensory disorders in patients with cognitive impairment in different types of depressive disorders. Object and methods of research. 362 patients with cognitive impairment in depressive disorders (DD) were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 patients with prolonged depressive reaction (PDR). A set of research methods was used: clinicalpsychopathological and statistical. Results. Specific clinical and psychopathological features of depressive manifestations were established in patients with cognitive impairment in various types of DD, which were expressed in the presence of psychomotor, somato-vegetative, emotional and sensory impairments. A sleep and appetite disorders, weight loss, cardiovascular symptoms, hypesthesia, anesthesia, inhibition of movements, hypomimia, hypotension, sensitivity, emotional lability and anxiety were recorded in patients with RDD. A constipation, decreased appetite and weight, sexual dysfunctions, hypoesthesia, senestopathy, body structure disorders, inhibition of movements, hypomimia, muscle adynamia, hypotymia, apathy, emotional coldness and ambivalence of emotions were recorded in patients with BAD. A vegetative-visceral crises, headaches, sexual dysfunctions, gastrointestinal symptoms, hyperesthesia, anxiety, hypotension, a sense of fear, emotional lability and sensitivity were recorded in patients with PDR. Conclusions. Clinical and psychopathological analysis of depressive manifestations in patients with cognitive disorders in depressive disorders allowed identifying specific manifestations of emotional, psychomotor, somatoautonomic and sensory disorders that are characteristic of different types of depression, which will further help improve differential diagnosis and preventive measures.

To estimate costs of pharmacotherapy of recurrent depressive disorder (RDD) in a hospital-based care. In the study, we analyzed the real-world practice in hospital-based care and the costs of RDD pharmacotherapy. A total of 119 case histories of patients who received a diagnosis of RDD and were hospitalized in 2017 were retrospectively analyzed. The study examined sociodemographic data, clinical and economic data, the frequency of prescribing medications, and medical expenses per 1 hospitalization and per day. The sample (N = 119) was divided into 3 groups according to the International Classification of Diseases-10th Revision code and the severity of the disease. The cost conversion factor was 1 euro equals 89.92 rubles. Antidepressants and antipsychotic drugs prevailed in the structure of prescriptions (32% and 36%, respectively). Antidepressants had the largest share in the total cost structure (about 41%), while the total cost of antidepressants and antipsychotics reached a total of 70%. Less than half of the costs were drugs included in the Russian RDD hospital treatment standard. The most expensive group in terms of pharmacotherapy costs per patient was the group "patients with RDD of moderate severity" (F33.1)—€61.1 ± 92.0 per case of hospitalization; this diagnosis was made in 80% of hospitalized patients. Assessment of real-world practices and costs of treatment of patients with RDD allows for more widespread implementation of management methods that allow making a choice in favor of more cost-effective drugs for the treatment of RDDs in Russia. [ABSTRACT FROM AUTHOR]

362 patients with cognitive impairment in depressive disorders were examined: 123 patients with recurrent depressive disorder (RDD), 141 patients with bipolar affective disorder (BAD) and 98 people with prolonged depressive reaction (PDR). Socio-demographic characteristics included distribution by age, sex, level of education, marital status, characteristics and sphere of professional activity and place of residence. Socio-demographic indicators of patients with cognitive impairment in depressive disorders were determined. It was found that among the examined persons prevalence of females (51,96 %), only in the group of patients with BAD there were more men (53,90 %). Persons aged 30-44 years prevailed (38,12 %). There were more young people (18-29 years) among patients with PDR (21,43 %) and BAD (31.21 %), and middle-aged people (45-59 years) and the elderly (60-65 years) were more among patients with RDD (37,40 % and 17,07 %). The level of education in patients with cognitive impairment in depressive disorders was dominated by persons with secondary specialized (33,25 %) and graduated education (33,26 %). The majority of patients were city residents (66,46 %), married (34,91 %), among patients with PDR there were more single people (41,84 %), among patients with RDD and BAD were more divorced persons (21,95 % and 26,95 %, respectively). In terms of employment, patients with cognitive impairments in depressive disorders were characterized by a predominance of working people (48,63 %), who were mainly engaged in mental work (61,22 %); 29,58 % of patients were unemployed, 21,77 % patients were retired. The number of persons with physical nature of work was higher among patients with PDR (54,72 %) than with RDD and BAD (36,21 % and 25,40 %, respectively), among whom patients with mental nature of work prevailed (63,79 % and 74,60 %, respectively) and there were more pensioners (27,64 % and 23,40 %, respectively). Hereditary burden of the main disease with somatic pathology was found in 90 patients with depressive disorders (24,86 %), the presence of alcohol dependence in relatives was found in 71 patients with depressive disorders (19,61 %) and the presence of depressive disorders in relatives was found in 64 patients with depressive disorders (17,68 %). At the same time, hereditary burden of depressive disorders distinguished patients with RDD and BAD from patients with PDR (21,95 %, p = 0.009 and 19,15 %, p = 0.024, respectively), among whom there were more patients with hereditary burden in the form of personality anomalies in relatives (8,13 %, p = 0.012 and 9,93 %, p = 0.026, respectively). Thus, certain socio-demographic characteristics of patients with cognitive impairment in depressive disorders should be taken into account in the differential diagnosis of these disorders.

The paper reviews Russian and foreign literature on atypical depression (AtD). It sets forth the historical aspects of identifying AtD among other depressive disorders: the authors have traced the path from depression with individual atypical manifestations to a syndrome with a clearly defined pattern and inclusion criteria in the international DSM-4 and DSM-5 classifications. The paper gives epidemiological indicators and shows their diversity due to various approaches to the determination and clinical assessment of AtD. It analyzes the results of studying AtD in the presence of various affective disorders, such as recurrent depressive disorder, bipolar affective disorder, and psychogenic depression, and notes their heterogeneity in both symptoms and genesis. The authors present approaches to treating AtD and the results of investigating drug (antidepressant) and non-drug (cognitive-behavioral psychotherapy, increased physical activity therapy) treatments.

The article presents an overview of the literature on the causes of mood disorders and their impact on the nature and severity of pathological processes in the oral cavity. 25 patients with diagnoses of depressive episode and recurrent depressive disorder between the ages of 20 and 60 were examined. The control group consisted of 15 apparently healthy individuals of similar age and sex who applied to the dental office to dental health. The common methods of dental examination were used. The complaints, the duration of symptoms, frequency of treatment to the dentist, the nature of personal oral hygiene were investigated. It was found that the main factors affecting the intensity of caries, its complications and periodontal disease in the patients examined were the duration and severity of psychopathology

In this study, we observed the sex differences in functional brain activity in patients with recurrent depressive disorder (RDE) and assessed the correlation between abnormal functional brain activity changes and clinical symptoms. A total of 40 patients with RDE (19 male and 21 female) and 42 healthy controls (HCs) (20 male and 22 female) met the inclusion criteria. Analysis of images using regional homogeneity (ReHo) and further analysis of the correlation between abnormal brain areas and clinical symptoms of the different sexes with RDE groups were carried out. For the main effects of sex (male vs. female), there were statistically significant differences in ReHo among the four groups in the right middle temporal gyrus, right thalamus, and left posterior cerebellar lobe. For the effects of the sex-by-group interaction, there were statistically significant differences in ReHo among the four groups in the left middle frontal gyrus, left precentral gyrus, and right insula. Post hoc analyses showed that compared with the female RDE group, the male RDE group had decreased ReHo in the left middle frontal gyrus and right insula. In the female RDE group, the ReHo values of the left middle frontal gyrus were positively correlated with the 17-item Hamilton Rating Scale for Depression (HAMD-17) scores. This study provides new insights into the clinical targeting of different sexes for RDE.

Objective: Bipolar disorder (BD), particularly BD-II, is frequently misdiagnosed as recurrent depressive disorder (RDD) because past hypomanic episodes are missed. The self-report Hypomania Checklist-32 (HCL-32) is a sensitive and reliable instrument with validated transcultural stability for detecting a history of hypomanic symptoms. The 33-item Hypomania Checklist (HCL-33) is a slightly modified version of the HCL-32. Alongside the HCL-33 self-report version, a new instrument for external assessment was developed. The objective was validation of the psychometric properties and the accuracy of the Russian version of the HCL-33 to identify BD in patients with a current diagnosis of RDD. Method: The HCL-33 was completed by 150 outpatients and inpatients with a formal diagnosis of RDD in two Moscow state psychiatric settings. International Classification of Disorders (ICD-10) diagnoses were established using the Russian version of the Mini International Neuropsychiatric Interview (MINI). Results: A screening score of 16 on the HCL-33 was the optimal cut-off that maximized sensitivity (0.71) and specificity (0.69) for the BD diagnosis. The highest Area Under the Curve (AUC) value during Receiver Operator Characteristic (ROC) analysis was 0.773 distinguishing between BD and RDD. The Cronbach's alpha was 0.91, indicating good internal consistency. Principal component analysis identified two factors, “active/elated” and “risk-taking/irritable”. Limitations: The study scope was limited by the specific nature of the sample and the absence of comparison with other BD screening scales including HCL-32. Conclusions: The Russian version of the HCL-33 is a sensitive, accurate and reliable instrument for the screening of BD patients with depression.

Objective: to study of the individual aspects of the relationship and interaction of menstrual and generative function and depressive disorders in women. Patients and methods. 120 women aged 18–65 years with recurrent depressive disorder (RDD) who had experienced at least two depressive episodes (a study group) and 120 mentally healthy women of the same age (a control group) were clinically examined using a specially designed map with subsequent statistical processing of the findings. Results and discussion. In 71.7% of women, depression manifests itself during hormonal rearrangement periods (puberty, postpartum, and menopause). 65.0% of women with RDD have premenstrual syndrome (PMS), the pattern of which shows depressive symptoms. Depression affects menstrual function: the later onset and irregularity of menstruation, the earlier restoration of menstrual function after childbirth, and the earlier onset of premenopause, which has an adverse impact on generative function (a reduction in the number of pregnancies, births, and babies). Depression, the onset of which is observed during puberty, exerts the most malignant effect on menstrual and generative function. Overall, depressive patients are less socially and family-friendly than healthy women. Menstrual and generative function and adaptation minimally suffer in women with postmenopausal depression. Conclusion. The onset of depressive disorders is associated with the hormonal rearrangement periods. The presence of depressive symptoms in the pattern of PMS is a prognostic sign of future depression or indicates partial remission. At the same time, menstrual function is impaired in women suffering from RDD, which along with psychic manifestations of depression (a decrease in sexual drive and contacts, as well as anesthesia of feelings, etc.) leads to infertility.

• Most ecological studies about lithium in drinking water report a reduction in suicide in general population, mostly in males. • Most trials, uncontrolled and controlled open label, show a reduction in the risk of suicide under long-term lithium use. • Evidence seems to attribute an intrinsic anti-suicidal property of lithium, independent of its efficacy as mood stabilizer. Suicide contributes to 1–4 % of deaths worldwide every year. We conducted a systematic review aimed at summarizing evidence on the use of lithium for the prevention of suicide risk both in mood disorders and in the general population. We followed the PRISMA methodology (keywords: "lithium", "suicide" AND "suicidal" on Pubmed, Cochrane CENTRAL, Clinicaltrial.gov, other databases). Inclusion criteria: lithium therapy in mood disorder or found in drinking water or scalp in the general population. Exclusion criteria: no lithium administration. From 918 screened references, 18 prospective (number of participants: 153786), 10 retrospective (number of participants: 61088) and 16 ecological studies (total sample: 2062) were included. Most of the observational studies reported a reduction in suicide in patients with mood disorders. All studies about lithium treatment's duration reported that long-term lithium give more benefits than short-term lithium in suicide risk The evidence seems to attribute an intrinsic anti-suicidal property of lithium, independent of its proven efficacy as a mood stabilizer. [ABSTRACT FROM AUTHOR]

Abstract Background Alice in Wonderland syndrome (AIWS) is a rare neuropsychiatric syndrome that typically manifests in distortion of extrapersonal visual image, altered perception of one’s body image, and a disturbed sense of the passage of distance and time. Several conditions have been reported to contribute to AIWS, although its biological basis is still unknown. Here, we present the first case demonstrating a clear concurrence of recurrent depressive disorder and AIWS. The clinical manifestations and pre- and post-treatment fluorodeoxyglucose positron-emission tomographic (FDG-PET) images provide insights into the psychopathological and biological basis of AIWS. Case presentation We describe a 63-year-old Japanese male who developed two distinct episodes of major depression concurrent with AIWS. In addition to typical AIWS perceptual symptoms, he complained of losing the ability to intuitively grasp the seriousness of news and the value of money, which implies disturbance of high-order cognition related to estimating magnitude and worth. Both depression and AIWS remitted after treatment in each episode. Pre-treatment FDG-PET images showed significant hypometabolism in the frontal cortex and hypermetabolism in the occipital and parietal cortex. Post-treatment images showed improvement of these abnormalities. Conclusions The clinical co-occurrence of depressive episodes and presentation of AIWS can be interpreted to mean that they have certain functional disturbances in common. In view of incapacity, indifference, devitalization, altered perception of one’s body image, and disturbed sense of time and space, the features of AIWS analogous to those of psychotic depression imply a common psychopathological basis. These high-order brain dysfunctions are possibly associated with the metabolic abnormalities in visual and parietotemporal association cortices that we observed on the pre- and post-treatment FDG-PET images in this case, while the hypometabolism in the frontal cortex is probably associated with depressive symptoms.

Purpose: The article aims at presenting the current state of knowledge concerning the relationship between psychomotor retardation, balance control and modulation of bioelectric brain activity and the patient’s mental state, temperament traits and selected cognitive functions in patients suffering from recurrent depressive disorder. Views: The article contains an overview of research published between 1998 and 2018 based on PubMed, Google Scholar databases on both the main symptoms of depression with particular focus on psychomotor functions, and the relationship between motor activity and temperament traits (in particular neuroticism, trait anxiety, depressive temperament and the dominance of the BIS – Behavioral Inhibition System over the BAS – Behavioral Activation System), as well as selected cognitive functions (e.g. processing speed, attention span, operating memory and visual-spatial memory). The latter, as reported by studies both in this group of patients (recurrent depression) and in other groups (e.g. schizophrenia) may also be lowered during the remission period. The article lists simple and easily available tools that have been used for years in neurological and psychological clinical work, along with quantitative methods of data collection (QEEG, actigraphy, posturography). Conclusions: In patients with recurrent depressive disorders, a change in motor functions is observed, manifested by a motor retardation and changes in the balance and gait dynamics, as well as changes in the quantitative assessment of bioelectric brain activity. The relationship between these biological parameters and clinical symptoms of depression and their usefulness as biomarkers of depression is currently being evaluated in an experimental study conducted by the authors. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) is a major public health concern. Preadolescent onset depression can be severe and can lead to serious consequences. MDD often has onsetearly in life and frequently follows a recurrent course. MDD though not so common in children, its presentation may be atypical leading to underdiagnosis and undertreatment. The diagnosis and management of childhood-onset depression poses a lot of challenge due to different and atypical presentations in children. We report a case of an 8-year - old boy, with the diagnosis of MDD, recurrent episode, severe, full remission, with atypical features by using DSM-5 criteria after repeated mental state examinations, rating scale, exploring history from parents, family members and observation in the ward. There was a significant improvement in his illness following three weeks of treatment with fluoxetine, lithium and supportive psychotherapy. [ABSTRACT FROM AUTHOR]

This publication provides algorithm for biological treatment of Recurrent Depressive Disorder (RDR). Algorithm is presented in the form of schemes of step-by-step selection of therapeutic interventions depending on the degree of evidences of their effectiveness in randomized controlled studies. The treatment tolerability were assessed as well, and level of recommendation of the intervention was also indicated. Data from Russian and foreign literature (systematic reviews, meta-analyses) and contemporary clinical recommendations of international expert groups. Algorithm is provided with text explanations and step-by-step comments. The sources of the extent evidences and the literature recommended for additional information are also provided.

Objective: to investigate the clinical features of depression within bipolar affective disorders types I and II (BADI and BADII).Patients and methods. An examination was made in 100 depressive patients, including 25 with BADI, 37 with BADII, and 38 with recurrent depressive disorder (RDD) (a comparison group). The patients' status was evaluated in accordance with the ICD-10 and DSM-V affective disorder criteria, by using a specially developed questionnaire.Results. BAD-related depression has features distinguishing it from RDD: sexual preference (men); an earlier age of disease onset; a shorter duration, but a higher frequency of exacerbations; a greater tendency for the continuum; a more marked decrease in social and family adaptation; development in people with predominantly hyperthymic premorbid; more frequently a family history of affective disorders, schizophrenia, and alcoholism; high comorbidity with metabolic diseases and psychoactive substance abuse; worse health more commonly in autumn and winter; a predominant anxious affect and an obviously decreasing interest in the structure of depression; a higher incidence of atypical sleep, appetite, and weight disorders; high suicidal activity; higher motor retardation (in BADI); relatively small involvement of somatic complaints in BAD I and frequent panic attacks in BADII.Conclusion. Knowledge of the specific features of BAD-related depression will be able to make a more accurate differential diagnosis and to perform more effective treatment in these patients.

Research studies conducted in recent years have confirmed that in the absence of medical illnesses, depressive disorders are associated with upregulation of many inflammatory cytokines such as tumor necrosis factor-aplha (TNF-α), interleukin-1 and 6 (IL-1,IL-6). The main objective of the study was to examine whether recurrent depressive disorders (rDD) are accompanied by more profound inflammatory disturbances than the first episode of depression (ED-I). The analysis included the expression of mRNA and protein levels of three interleukins namely. IL-1, IL-6 and IL-10.

Background: People with diagnosed depression often express a reduced olfactory capacity, although previous studies exhibited mixed results. However, research focused mainly on psychiatric inpatients and potential influence variables were rarely considered. We therefore examined the influence of severity, course and duration of depression on olfactory function.Methods: 101 out-patients with depressive disorders (mean age = 37.8y, SD = 12.6y; 64 women) underwent a detailed medical anamnesis, tests of olfactory threshold and identification and tests of cognitive function. The participants were grouped according to their severity, course and duration of depression.Results: While severity of depressive symptoms did not affect olfactory function, course and duration of depression did. Recurrent depressive disorders were associated with reduced odor identification, and the duration of disease was negatively related to odor threshold. Those results were partly explained by reported frequent colds, which were more prevalent among long lasting depressive patients, and by poor verbal fluency, which was more frequent among recurrent depression.Limitations: The interpretation is limited by the cross-sectional research design that does not allow causal interpretation, and by the assessment of medical history which was based on patients´ reports.Conclusions: Our results support the idea that depression is not uniformly related to olfactory impairment, but depends on duration and course of depression. The results generate the hypothesis that reduced olfactory identification is caused by cognitive impairment in recurrent depression. Moreover, the relation between olfactory threshold and depression might be partially caused by a cumulative damage of the olfactory epithelium after frequent respiratory diseases. [ABSTRACT FROM AUTHOR]

Depressive disorder is considered as an important medico-social problem due to its severity, chronic nature, and high level of clinical polymorphism. The precise biological mechanism of this pathology is still unknown. The latest data confirms the role of the glutamatergic system in the pathogenesis of depression. Here, 79 patients with depressive disorders (50 diagnosed with a "single depressive episode" and 29 with "recurrent depressive disorder") who were treated with selective serotonin reuptake inhibitors (SSRIs) and 27 healthy control donors underwent complex clinical and biochemical examinations. The depression severity at the baseline and on the 14th and 28th days of treatment, as well as during remission, was evaluated using the 17-item Hamilton Depression Rating Scale (HDRS-17). The therapy response was evaluated using the CGI-I scale. The blood serum glutamate concentration was measured at the baseline. The concentration of glutamate was significantly higher in the group of patients compared to the controls. No difference in this parameter was observed between groups of patients. A positive correlation between the severity of depression at the 28th day and the glutamate concentration was found in the groups of patients with recurrent depressive disorder. No association between glutamate concentration and the CGI-I scale score, as well as remission, was found. A high glutamate level in blood serum of patients with depressive disorders could be an indicator of glutamatergic system dysregulation. This value in the future may be used as a predictor of the effectiveness of SSRI treatment in patients with recurrent depressive disorder. [ABSTRACT FROM AUTHOR]

Introduction Adverse effects with bleeding disorders are often associated with the administration of SSRI in depression, although the exact mechanisms remain contradicting. This study is aimed at detecting and exploring the mechanisms of SSRI-induced changes in platelet reactivity in non-responding patients with Recurrent Depressive Disorder (RDD) and life-long exposure to antidepressants. Materials and methods Thirty-one patients and thirty-one healthy controls were included in the study. A comprehensive approach which includes evaluation of peripheral markers and microscopic analyses of platelet morphology changes has been used. Results RDD SSRI patients have shown blunted aggregatory responses towards collagen and epinephrine. Evident differences in the microscopic evaluation of platelet morphology were observed between the groups, with inherent absence of micro-aggregates and platelet shape changes within the patients; after quantification, the sensitivity and specificity of this method were assessed as high. The abnormalities were found in association with lower platelet serotonin content and high fluctuations of free plasma serotonin levels. Changes in the levels of CRP, fibrinogen and nitric oxide were not observed. Macroplatelets were also detected within RDD SSRI patients via increased MPV, PDW and P-LCR, which were associated with discoid shape and without procoagulant activity. Conclusions The microscopic evaluation might be useful as a simple method for detection of SSRI-reduced platelet function for research purposes or systematic correlations with other biochemical parameters. The mechanisms involved in SSRI-reduced platelet function in non-responding RDD patients are complex, including combined effects of lower platelet serotonin content, high fluctuations in plasma serotonin concentration and abnormal α-AR function. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the stigma and its correlates among patients with severe mental disorders. Patients with diagnosis of schizophrenia (N = 707), bipolar disorder (N = 344) and recurrent depressive disorder (N = 352) currently in clinical remission from 14 participating centres were assessed on Internalized Stigma of Mental Illness Scale (ISMIS). Patients with diagnosis of schizophrenia experienced higher level of alienation, sterotype endorsement, discrimination experience and total stigma when compared to patients with bipolar disorder and recurrent depressive disorder. Patients with bipolar disorder experienced higher stigma than those with recurrent depressive disorder in the domain of stigma resistance only. Overall compared to affective disorder groups, higher proportion of patients with schizophrenia reported stigma in all the domains of ISMIS. In general in all the 3 diagnostic groups’ stigma was associated with shorter duration of illness, shorter duration of treatment and younger age of onset. To conclude, this study suggests that compared to affective disorder, patients with schizophrenia experience higher self stigma. Higher level of stigma is experienced during the early phase of illness. Stigma intervention programs must focus on patients during the initial phase of illness in order to reduce the negative consequences of stigma. [ABSTRACT FROM AUTHOR]

Background: Stigma is very common among caregivers of patients with severe mental disorder; however, there is lack of national level data from India. Aim: To assess affiliate stigma and its correlates among caregivers of patients with severe mental disorders. Method: For this, caregivers of patients with schizophrenia (N = 707), bipolar disorder (N = 344) and recurrent depressive disorder (N = 352) were assessed on Stigma scale for Caregivers of People with Mental Illness and General Health Questionnaire. Results: Caregivers of patients with schizophrenia reported significantly higher stigma than patients with bipolar disorder and recurrent depressive disorder. Caregiver of patients with bipolar disorder reported significantly greater stigma than the caregivers of patients with recurrent depressive disorder. Higher caregiver stigma in all the diagnostic groups was associated with higher psychological morbidity in caregivers. Higher stigma in caregivers of schizophrenia was seen when the patient had younger age of onset and longer duration of treatment. In the bipolar disorder group, higher stigma in caregivers was seen when patient had higher residual manic symptoms. Conclusion: This study suggests that caregivers of patients with schizophrenia experience higher stigma than the caregivers of patients with bipolar disorder and recurrent depressive disorder. Higher stigma is associated with higher psychological morbidity in the caregivers. Therefore, the clinicians managing patients with severe mental disorders must focus on stigma and psychological distress among the caregivers and plan intervention strategies to reduce stigma. [ABSTRACT FROM AUTHOR]

Background Many researchers have found that the inflammatory process in the body and the brain may result in psychiatric disorders. Meta-analyses of cross-sectional studies have reported increase in inflammatory markers in depression. However, the direction of the association remains unclear. Aims To compare the levels of C-reactive protein (CRP) and Interleukin-6 (IL-6) in depressed and healthy controls. To study the associations of these biomarkers with severity and number of depressive episodes. Methods A total of 72 subjects with major depression and 60 healthy controls were studied. CRP and IL-6 were measured in all subjects. Results No significant differences were noted between depressed patients and healthy controls with regard to CRP (p = 0.29) and IL-6 (p = 0.50). Those who were suffering from severe depression based on Beck’s Depressive Inventory (BDI), were positively correlated with raised CRP (p = 0.011) in comparison to patients with mild to moderate depression. Single and recurrent depressive disorder (RDD) were not associated with significant rise in CRP (p = 0.866) and IL-6 (p = 0.531). Conclusions Severity of depression is correlated with elevated CRP but not with IL-6. No association found between number of depressive episodes and levels of CRP and IL-6. It is possible that immune dysregulation is not generally present in depression, but might be restricted to particular subgroups of depressed patients. Several factors that could influence the depression and inflammation relationship need further investigation. [ABSTRACT FROM AUTHOR]

The study focuses on psychosocial functioning of female Turkish immigrants in Austria with recurrent depressive disorder participating in self-help groups. Self-help groups guided by group leaders of Turkish descent should increase autonomy in participants, providing the opportunity to follow their ethnic health beliefs. Turkish immigrant women (n= 43) with recurrent depressive disorder participated in self-help groups over four months. Qualitative data of participants and group leaders, containing interviews, group protocols and supervision protocols of group leaders were analyzed using the qualitative content analysis for effects on psychosocial function, such as interaction with others, illness beliefs and benefit from self-help group. Women reported feelings of being neglected and violated by their husbands. They stated that they had gained strength and had emancipated themselves from their husbands. Self-help groups functioned as social resources and support for changes in participants' lives. Further interventions should integrate the functional value of depressive symptoms and focus on social support systems and social networks. [ABSTRACT FROM AUTHOR]

Objective: to study the efficacy of paxil in the treatment of depression of varying severity in elderly male. Patients and methods. Thirty-five males aged 50—78 years with depressive symptoms of varying severity in the framework of a depressive episode [n = 14 (40%)], recurrent depressive disorder [n = 12 (34.3%)], and bipolar affective disorder [n = 9 (25.7%)] were examined. The efficacy of paxil 20—40 mg/day was clinically evaluated using psychometric scales (CGI, HDRS, and UKU) on days 7, 14, 28, and 42. Results. Paxil was found to be highly effective in treating depressions in elderly males. The mean HDRS scores decreased from 24.7±0.3 to 4.9±1.1. By day 42, the reduction in depressive symptoms was 80.2%. 74.3% of the patients achieved recovery and a borderline state according to the CGI-S scale. There was cessation of asthenic symptoms and adynamia at week 1 of therapy, hypothymia at week 2, and anxiety caused by the consecutive manifestations of stimulating, antidepressant, and anxiolytic effects.

Background : To compare the disability among patients with bipolar disorder and recurrent depressive disorder in remission. Settings and Design : Cross-sectional study of outpatients. Materials and Methods : Patients in the remission phase of the illness were taken for the study. Disability assessment was done using Indian Disability Evaluation and Assessment Scale. Treatment compliance was measured using medication adherence rating scale. Statistical Analysis : Between group comparison. Results : A total of 40 patients were included in the study, 25 in bipolar and 15 in recurrent depressive disorder group. There was no difference between the groups in the domain of self care. The bipolar patients had more impairment in interpersonal activities than recurrent depressive disorder (RDD) group, this difference was statistically significant (P =0.004). The bipolar patients had more impairment in communication and understanding (P =0.009) and in work (P =0.011). The mean total score for disability was more for bipolar patients (P =0.0001). The total duration of illness had significant influence on communication and understanding, work, and total disability scores. The total number of episodes significantly influenced the impairment in interpersonal activities, communication and understanding, work, and total disability scores. The impairment in self care was significantly associated with the total number of psychotic episodes (P =0.0013). No significant relation was found between treatment compliance and disability. Conclusions : The patients with mood disorders had significant disability even during the periods of remission. The impairment was more for the bipolar patients compared with the RDD patients.

Purpose Significant impairment of some psychological functions, including cognitive functioning, has been characteristically found in depressed patients. Memory disturbances may be related to the levels of thyroid hormones (TH) that are under the influence of different mechanisms and molecules, including deiodinase type 1(D1) – an important determinant of circulating triiodothyronine (T3). We investigated the relationship between two functionally known polymorphisms within the DIO1 gene, i.e. DIO1 a-C/T and DIO1 b-A/G, and cognitive functioning in patients diagnosed with recurrent depressive disorder (rDD). In the planned analysis we mainly concentrated on the frontal function: working memory, executive functions and verbal fluency. Materials and methods Genetic variants were genotyped in 128 patients using a method based on polymerase chain reaction (PCR). Cognitive functions were assessed by the Trail Making Test, the Stroop Test and the Verbal Fluency Test (VFT). Results No significant associations were found between DIO1 polymorphisms and cognitive functioning in rDD. Only the CT and TT genotypes of the DIO1 a variant were significantly related to verbal fluency. There were no significant differences between the distribution of the genotypes and demographic/medical variables. Conclusions Based on the study, the examined polymorphisms are not an important risk or protective factor for cognitive impairment in depressive patients. Functional variants within the DIO1 gene that affect triiodothyronine (T3) levels seem not to be associated with cognitive functions. Nevertheless, considering the fact that the DIO1 gene is related to the course and management of depression, further studies on a larger sample size might be suggested. [ABSTRACT FROM AUTHOR]

Background In a previous randomized controlled trial in patients with three or more previous depressive episodes, mindfulness-based cognitive therapy (MBCT) appeared to be equally effective in those who were depressed and those who were in remission at the start of the trial. Aim The aim of this study is to compare the 1-year outcome of MBCT in 124 remitted and 58 depressed patients who participated in the original trial and who were all offered MBCT either immediately or after a waiting period of 3 months. Methods The course of depressive symptoms, rumination, mindfulness skills, and quality of life over the course of treatment and the 1-year follow-up period was analyzed. Linear mixed modeling was used to compare the outcome between remitted and depressed patients at baseline. Results In the whole sample, levels of depression and rumination decreased and mindfulness and quality of life increased over treatment. Levels of depressive symptoms, mindfulness, and quality of life remained stable over the 1-year follow-up period. Rumination further decreased. Remitted and depressed patients at the start of the trial did not differ in terms of outcome during or after treatment. Conclusions Long-term outcome after MBCT in depressed patients was comparable to those who were in remission at the start of the trial. These findings lend further support to the notion that recurrent depressed patients meeting the criteria of a depressive episode do not need to be excluded from MBCT. [ABSTRACT FROM AUTHOR]

ObjectiveBrain-derived neurotrophic factor (BDNF) plays a critical role in brain plasticity processes and serum levels have been demonstrated to be altered in patients with different mental disorder including suicidal behaviour. The objective of this study was to examine the association between serum BDNF levels as a possible peripheral indicator of suicide behaviour in subjects suffering from depression, personality disorders (PDs) and adjustment disorders (ADs) with or without suicide attempt.MethodsThe research included 172 randomly selected individuals suffering from recurrent depressive disorder (RDD; F 33.2), emotionally unstable PD (F 60.3) and AD (F 43.2), with or without attempted suicide according to the criteria of the ICD-10 (International Statistical Classification of Diseases and Related Health Problems 10th Revision) and 60 phenotypically health control subjects. In the group of patients, 73% subjects took some form of psychopharmacotherapy. Serum BDNF levels were measured by enzyme linked immunosorbent assay.ResultsSubjects with PD and AD with suicide attempts had significantly lower serum BDNF levels than those without suicide attempts. In groups of subjects with PD and AD, those taking psychopharmacotherapy had higher serum BDNF levels. In the group of subjects with RDD, there were no differences with respect to suicide attempts or psychopharmacotherapy. Logistical regression analysis was indicated that psychopharmcotherapy and serum BDNF levels statistically correlated with suicide attempts.ConclusionThe lower levels of BDNF in subjects suffering from PD and AD with suicide attempts, suggest that the serum BDNF level is a potential marker of suicidal behaviour, independent of mental disorders. [ABSTRACT FROM PUBLISHER]