DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: The Use of Melatoninergic Antidepressants for Stabilization of Remission in Depression Comorbid with Alcohol Abuse, Anxiety or Neuropsychiatric Disorders: A Systematic Review

URL: consortium-psy.com/jour/articl…

BACKGROUND: Depression is one of the most common mental disorders and is associated with a significant increase in the risk of mental and somatic comorbidities. The chronobiological theory of the pathogenesis of depression explains the relationship between the symptoms of depression and disturbance of circadian rhythm regulation. Disrupted circadian rhythms are also observed in other disorders such as alcohol use disorder, anxiety disorders, epilepsy, and Parkinson’s disease. Therefore, there is a growing interest in the use of medications with a melatoninergic mechanism of action in the treatment of depression comorbid with the aforementioned disorders.

AIM: This review aims to systematically examine the evidence for the use of melatoninergic antidepressants (agomelatine and fluvoxamine) in the treatment of depression comorbid with alcohol abuse, anxiety disorders (including phobic anxiety, panic, and generalized anxiety disorders), or neuropsychiatric disorders (such as epilepsy and Parkinson’s disease).

METHODS: This systematic review included experimental studies, systematic reviews, and meta-analyses published in English and Russian, which examined the use of fluvoxamine and agomelatine in adult patients with recurrent depressive disorder (ICD-10) or major depressive disorder (DSM-5) comorbid with alcohol abuse, anxiety or neuropsychiatric disorders. The search was conducted in the PubMed, Cochrane Library and eLIBRARY scientific databases. The quality of the selected studies was assessed using the Cochrane Risk of Bias tool, which is used to evaluate the risk of systematic errors in clinical studies. The results were presented as a narrative synthesis and grouped by the comorbidities evaluated.

RESULTS: A total of 20 articles were reviewed (with a pooled sample size of n=1,833 participants). The results suggest that melatoninergic antidepressants might help in reducing depressive and anxiety symptoms, improve sleep, decrease alcohol cravings, and alleviate the severity of motor symptoms in Parkinson’s disease. Moreover, the use of pharmacogenetic testing to select the medication and dosage may enhance its therapeutic effectiveness.

CONCLUSION: The review demonstrates a significant lack of clinical data and guidelines on the use of melatoninergic medications for the treatment of depression comorbid with other disorders. In this regard, it is currently difficult to draw a definitive conclusion regarding the efficacy and safety of agomelatine and fluvoxamine in the treatment of these comorbidities. Available studies suggest an improvement in the clinical manifestations of the comorbidities. Future research directions might include the development and implementation of double-blind, randomized clinical trials to study the use of melatoninergic medications in patients with depression comorbid with other disorders.

URL: consortium-psy.com/jour/articl…

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DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: Comparison of Immune and Systemic Inflammation Parameters in Patients with a Depressive Episode in Bipolar Disorder and Major Depressive Disorder: A Scoping Review

URL: consortium-psy.com/jour/articl…

BACKGROUND: Many studies have aimed to investigate and compare immune system and systemic inflammation parameters in patients with bipolar disorder (BD) and major depressive disorder (MDD) suffering from a depressive episode. However, no systematic review of the results has been conducted so far.

AIM: The aim of this study was to conduct a scoping review of research studies comparing immune and systemic inflammation parameters in patients with BD and MDD during a depressive episode.

METHODS: The search for studies was conducted in the Medline and eLIBRARY databases for the period from January 1994 to December 2022. Open-access articles written in English and Russian were selected. The review included original studies that compared groups of patients with BD and MDD (diagnosed based on the DSM-IV, DSM-5, or ICD-10 criterion) by immune and systemic inflammation parameters (such as the counts, ratio, and functions of blood cells, erythrocyte sedimentation rate, concentrations of immunoglobulins, cytokines, acute phase proteins, complement components, and autoantibodies).

RESULTS: The review included 24 studies. Current depressive episodes in patients with BD were associated with higher concentrations of chemokines (C-C motif chemokine ligand 3 (CCL3), CCL4, CCL5, CCL11), platelet-derived growth factor B, and interleukin 9 (IL-9) (two studies in each case), whereas patients with MDD tended to have higher concentrations of soluble tumor necrosis factor receptor 1 and immunoglobulin G to oxidized low-density lipoproteins (two studies each). Patients with BD and MDD had comparable concentrations of IL-8 (five studies); IL-2 and IL-10 (four studies each); IL-13 and gamma interferon (three studies each); IL-17, IL-1Rα, the vascular endothelial growth factor, as well as white blood cells, monocyte, and platelet counts (two studies each). Contradictory results were obtained for the levels of tumor necrosis factor-α (the concentrations did not differ in five studies, were elevated in BD patients in five studies, were elevated in MDD patients in two studies), IL-6 (the concentrations did not differ in eight studies and were elevated in BD patients in four studies), C-reactive protein (the concentrations did not differ in six studies, were elevated in BD patients in two studies), IL-4 (the concentrations did not differ in three studies and were elevated in MDD patients in two studies), IL-1β and the neutrophil count (the levels did not differ in one study each and were elevated in BD patients in two studies). Several studies have demonstrated an association between immune and systemic inflammation parameters and the severity of depressive and anxiety symptoms, melancholic depression, age of mood disorder onset, body mass index, and imipramine equivalent.

CONCLUSION: Some immune and systemic inflammation parameters are associated with a current depressive episode in patients with MDD or BD. These parameters may be considered as potential biomarkers for a differential diagnosis of these disorders.

URL: consortium-psy.com/jour/articl…

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DATE: December 28, 2024 at 07:00PM
SOURCE: Consortium Psychiatricum

TITLE: Prevalence of Anxiety and Depressive Disorders in a Sample of Moscow Residents: Comparison of the GAD-7 and HADS Results with a Clinical Assessment

URL: consortium-psy.com/jour/articl…

BACKGROUND: Anxiety and depressive disorders are the most common mental disorders. Detecting a disorder at an early stage can prevent the development of severe disorders and preserve the patient’s functioning ability. Simple and reliable screening tools based on self-completion of questionnaires can be used for this purpose. However, it is not always the case that the scores of the self-questionnaire align with those of the clinician.

AIM: To estimate the prevalence of anxiety-depressive disorders using the GAD-7 and HADS self-report questionnaires compared to psychiatrist assessment.

METHODS: The study included individuals aged 18 to 65 years, living in Moscow, Russia, without psychiatric disorders, who participated in an online study using the HADS (Hospital Anxiety and Depression Scale, HADS-A and HADS-D) and GAD-7 (Generalized Anxiety Disorder 7-item scale). Anxiety disorder was diagnosed when the total score was ≥10 on the GAD-7 and/or ≥10 on the HADS-A scale, and depression was defined when the total score was ≥9 on the HADS-D scale. Then, 82 randomly selected participants attended an anonymous consultation with a psychiatrist.

RESULTS: The study included 1,097 individuals (72% female), median age 29 (23; 37) years. As a result of testing, anxiety disorder was found in 168 (15%); depressive disorder — in 152 (14%) respondents. At medical verification, anxiety was diagnosed in 18 (22%); depression — in 19 (23%) people. The sensitivity of the HADS-D subscale for physician-diagnosed cases of depression was 61%, and specificity was 73%. The sensitivity of the HADS-A and GTR-7 subscale in identifying cases of anxiety disorder was 58%, specificity 59%. Sixteen percent were first diagnosed with a personality disorder or schizotypal disorder.

CONCLUSION: The level of anxiety and depression in our sample of the population of Moscow, Russia, was higher than the global level. Self-assessment based on the questionnaire seems to not fully reflect the real state of a patient, as evidenced by the differences with the psychiatrist’s assessment.

URL: consortium-psy.com/jour/articl…

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DATE: December 29, 2024 at 11:02AM
SOURCE: PSYCHOLOGY TODAY

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DATE: December 29, 2024 at 10:01AM
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