Plasma BDNF Levels Vary in Relation to Body Weight in Females

Brain derived neurotrophic factor (BDNF) has been implicated in the pathophysiology of depression as well as neuropsychiatric and neurodegenerative disorders. Recent studies show a role of BDNF in energy metabolism and body weight regulation. We examined BDNF levels in plasma and cerebrospinal fluid (CSF) samples from age matched elderly depressed and control subjects. Also, the association of BDNF levels with age, gender, body weight, body mass index (BMI), and cognitive performance was evaluated. We did not find any significant differences in plasma and CSF BDNF levels between depressed and control subjects. Plasma BDNF levels were negatively correlated with age (but not with BMI and body weight), when analyses were performed including both depressed and control subjects. A significant reduction in plasma BDNF levels was observed in females as compared to male subjects, and the change in BDNF levels were significantly and positively related to body weight in females. Furthermore, significant increases in Total Recall and Delayed Recall values were found in females as compared to males. In conclusion, the lower BDNF levels observed in females suggest that changes in peripheral BDNF levels are likely secondary to an altered energy balance. However, further studies using larger sample size are warranted

Depression in the Elderly: Clinical Features and Risk Factors

Depression in elderlies is not known quite well and thus cannot be treated adequately. The fact that elderliness is accepted as a property of depressive symptoms both by the relatives of the patients and doctors is one of the factors which make it difficult to recognize depression. Existence of multiple physical diseases in elderlies, use of multiple medicines, occurrence of pharmacokinetic and pharmacodynamics changes depending on the age necessitate to take several factors into account while diagnosing and using medicines. In this study, clinical properties and risk factors of depression in old age period was reviewed and the properties of such depressions were summarized

A phenomenological comparison of elderly depression and adult depression

Objective: Phenomenological differences which are seen in elderly depression difficulties in the diagnosis of depression in elderly people. In this study, it was aimed to compare the phenomenological features of elderly depression and adult depression. Methods: This study included 40 patients aged 18-60 years with major depressive disorder (MDD) and 40 patients over 60 years of age with major depressive disorder (MDD). The Structured Clinical Interview for DSM-IV (SCID-I), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Psychiatric Rating Scale (BPRS) and the Standardized Mini-Mental State Examination (SMMSE) were applied to the patients. Results: Both groups participating in the study consisted of the patients with moderate depressive symptoms and without psychotic symp- toms. There was no difference between the elderly and adult groups with MDD in terms of the HAM-D and HAM-A total scores. The MADRS and BPRS total scores were higher in the elderly group with MDD compared to the adult group with MDD. The HAM-D difficulty in falling asleep, midnight awakening, early morning awakening and hypochondriasis subscores were higher but the HAM-D suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The MADRS total score and the MADRS inner tension and difficulty in sustaining attention subscores were higher but the MADRS suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The rate of the first depressive episode was 40% in the elderly group with MDD and 52.5% in the adult group with MDD, respectively. The history of depression in first-degree relatives was lower in the elderly group with MDD compared to the adult group with MDD. The HAM-D feeling of guilt subscore was lower, however, the HAM-D midnight awakening and early morning awakening subscores were higher in the elderly patients with the first depressive episode compared to the elderly patients with recurrent major depressive episodes. Discussion: Our results show that sleep disturbances, attention problems and hypochondriacal symptoms were higher; however, suicidal ideation was lower in elderly depression compared to adult depression. Our results also show that feeling of guilt in elderly people may give a clue for previous depressive episodes

A phenomenological comparison of elderly depression and adult depression

Objective: Phenomenological differences which are seen in elderly depression difficulties in the diagnosis of depression in elderly people. In this study, it was aimed to compare the phenomenological features of elderly depression and adult depression. Methods: This study included 40 patients aged 18-60 years with major depressive disorder (MDD) and 40 patients over 60 years of age with major depressive disorder (MDD). The Structured Clinical Interview for DSM-IV (SCID-I), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A), the Montgomery-Asberg Depression Rating Scale (MADRS), the Brief Psychiatric Rating Scale (BPRS) and the Standardized Mini-Mental State Examination (SMMSE) were applied to the patients. Results: Both groups participating in the study consisted of the patients with moderate depressive symptoms and without psychotic symp- toms. There was no difference between the elderly and adult groups with MDD in terms of the HAM-D and HAM-A total scores. The MADRS and BPRS total scores were higher in the elderly group with MDD compared to the adult group with MDD. The HAM-D difficulty in falling asleep, midnight awakening, early morning awakening and hypochondriasis subscores were higher but the HAM-D suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The MADRS total score and the MADRS inner tension and difficulty in sustaining attention subscores were higher but the MADRS suicidal ideation subscore was lower in the elderly group with MDD compared to the adult group with MDD. The rate of the first depressive episode was 40% in the elderly group with MDD and 52.5% in the adult group with MDD, respectively. The history of depression in first-degree relatives was lower in the elderly group with MDD compared to the adult group with MDD. The HAM-D feeling of guilt subscore was lower, however, the HAM-D midnight awakening and early morning awakening subscores were higher in the elderly patients with the first depressive episode compared to the elderly patients with recurrent major depressive episodes. Discussion: Our results show that sleep disturbances, attention problems and hypochondriacal symptoms were higher; however, suicidal ideation was lower in elderly depression compared to adult depression. Our results also show that feeling of guilt in elderly people may give a clue for previous depressive episodes

The effect of hysterectomy and/or oophorectomy on sexual satisfaction

Methods aEuro integral Forty sexually active women underwent a hysterectomy and/or oophorectomy, for benign gynecological diseases. Patients were interviewed 15 days prior to their operation and again in the 3rd and 6th months after the surgical procedure. Depressive symptoms, anxiety symptoms and sexual satisfaction were measured by the Hamilton Depression Rating Scale, the Hamilton Anxiety Scale and the Golombock Rust Inventory of Sexual Satisfaction (GRISS), respectively. Repeated-measures analyses of variance (ANOVA) examined alterations in anxiety, depression and sexual satisfaction. Independent t-test and Mann--Whitney U tests compared the numerical data.Results aEuro integral The women had mild depressive symptoms before the surgery; however, these symptoms lessened between 3 and 6 months after the surgery. Similarly, the level of anxiety symptoms decreased during the postoperative period. Based on the GRISS cut-off point, it was found that the patients had problems in the sub-dimensions of frequency, communication, and avoidance in the pre-operative period. This pre-existing sexual dissatisfaction continued after the surgery, and sensuality and anorgasmia problems increased. Satisfaction, sensuality, avoidance and anorgasmia GRISS scores were significantly higher after the operation than before. Therefore, the patients' sexual satisfaction was decreased after the operation.Conclusions aEuro integral Patients were dissatisfied with frequency and communication, and they had high levels of avoidance before operation. In the postoperative period, sexual dissatisfaction increased. Although depression and anxiety decreased after the operation, we found that hysterectomy and/or oophorectomy had negative effects on sexual satisfaction

disorder: Comparison of bipolar disorder and schziophrenia

The aim of this study was to compare schizoaffective disorder, bipolar disorder and schizophrenia based on H-1-MRS metabolite values in dorsolateral prefrontal cortex and executive functions. The subjects comprised 15 patients with bipolar disorder type I (BD), 15 with schizophrenia (SCH), 15 with schizoaffective disorder (SAD) and 15 healthy controls. We performed proton magnetic resonance spectroscopy (H-1-MRS) of the dorsolateral prefrontal cortex (DLPFC) bilaterally. Levels of N-acetyl aspartate (NAA), choline-containing compounds (Cho) and creatine-containing compounds (Cr) were measured in the DLPFC using H-1-MRS. We administered the Wisconsin Card Sorting Test (WCST) and the Stroop Test (ST) to evaluate executive functions. The SAD, BD and SCH patients had lower levels of NAA than the control group. The SAD and BD patients had low levels of Cho compared to the control group. The left DLPFC Cr levels in all of the patient groups and the right DLPFC Cr levels in the BD and SAD groups were lower than in the control group. The levels of NAA Cho and Cr were not related to executive functions and attention performance. Cr level were related to attention processes, only in SCH. Our results indicate that NAA levels are reduced in schizoaffective disorder, bipolar disorder and schizophrenia, but the reduction in the levels of NAA is not a distinctive feature among these three illnesses. Schizoaffective and bipolar disorders have similar features related to the levels of compounds containing Cho and Cr. This similarity may be related to these illnesses both having an affective basis. (C) 2012 Elsevier Inc. All rights reserved

Psychodramatic group therapy on Alzheimer patients' caregiver relatives

Objective: The objective of the study was to provide support to Alzheimer's disease (AD) caregiver in coping with the difficulties of acquiring knowledge on the disease and of providing care to the patient. The effects of psychodramatic group therapy on the mental symptoms and care burden were examined. Methods: Patient relatives who participated in the Denizli Alzheimer Association activities also took part in the study. Psychiatric examinations the participants were carried out prior to group therapy, sociodemographic data form and scales were applied. A total of 11 sessions for the first group and 12 second for the second group were carried out as 1 day per week for a period of 2-2.5 hours. A total of 11 individuals completed the first group and 9 individuals completed the second group. Hospital Anxiety Depression Scale (HAD), Caregiver Burden Inventory (CBI) were applied before and after group therapy. Results: All participants of the first group were female with an age interval of 46-65 years. They were all children of the patients excluding two participants and majority was high school-university graduates. It was determined after group therapy that HAD total and anxiety scores, CBI total and social burden scores decreased. The age interval of the second group participants was 53-83 years and the only male member was also the oldest individual to take part in the study. They were all spouses of the patients excluding two members and all were primary school graduates save for 1 literate member. No statistically significant difference was observed between the scale scores before and after group therapy. It was observed when the two groups were evaluated together that there were statistically significant decreases in HAD and total anxiety scores, CBI total score but that there were no changes in the other scores. Group studies started with the establishment of group rules, going over the expectations from groups and warm-up games. Psychodramatic techniques were used to gamify issues such as the symptoms of the disease, frequently experienced behavioral problems, difficulties related with caregiving and methods for coping with them, things that can be experienced as the disease progresses, communication problems within the family, inability to ask for help regarding caregiving, placing in a care center. Participation to the groups was regular and the members were quite supportive. Patient relatives had the opportunity to share the difficulties they experience as well as to express their emotions. Conclusion: Psychoeducation on AD caregiver relatives reduces anxiety symptoms and care burden in addition to providing mental support. Our results lead us to think that when caregivers are spouses of the patients, they feel the burden of caregiving more since they are also elderly and that they cannot benefit sufficiently from sources of support

and the Effects of Treatment: An (HMRS)-H-1 Study

Objective: Neuronal degeneration in the prefrontal cortex during depression results in altered production of neurochemical metabolites. The aim of the present study is to examine changes in neurochemical metabolites in the prefrontal cortex and evaluate the effects of psychodrama group therapy and pharmacotherapy on neurochemical metabolism in the first episode depression using (HMRS)-H-1 methodology.Method: Eighteen drug-free female patients with diagnosed first-episode major depression according to DSM-IV criteria and 10 healthy female subjects were enrolled in the study. The Hamilton Rating of Depression Scale (HAM-D) was used to asses the severity of depression in each of the study participants. Proton magnetic resonance spectroscopy ((HMRS)-H-1) was applied to the right prefrontal cortex both before and after treatment and the concentration of N-Asetil Aspartate (NAA), choline (Cho), and creatine (Cr) were measured. All patients were prescribed ant-depressant medication at the time of the evaluation (essitalopram 10-20 mg/g). In addition, a psychodrama group therapy session was conducted in which 10 patients participated in one 3-hour session each week. HAM-D and (HMRS)-H-1 were repeated after 16 weeks.Result: Prior to treatment, the HAM-D score in the patient group was 14.55 +/- 4.55 while the HAM-D score was 3.88 +/- 2.47 after 16 weeks of treatment. The severity of symptoms among the patient group was determined to be mild/moderate. No neurochemical abnormalities were identified in the right prefrontal cortex of depressed patients compared to the healthy subjects in the baseline measurements and no significant change was observed in neurochemical metabolites following treatment with pharmacotherapy or pharmacotherapy with group psychotherapy.Conclusion: Our results identified no neurodegeneration, cell membrane dysfunction, alterations in energy metabolism, or altered neurochemical metabolite levels in patients undergoing a first episode of mild/moderate depression. Further studies will be needed to evaluate the effects of alternate treatments and the presence or absence of neuronal damage during follow-up of patients with depression

Decreased serum BDNF levels in major depressive patients

Background: Brain-derived neurotrophic factor (BDNF) plays an important role in neuronal plasticity. The aim of the present study was to measure serum BDNF levels in depression and to analyze the relationship between BDNF levels and severity of depression.Methods: Thirty patients meeting the DSM-IV criteria for major depressive disorder and 40 normal control subjects were recruited for this study. Patients had not used psychotropic drugs. The severity of depression was assessed by the Hamilton Rating of Depression Scale (HAM-D). Serum BDNF levels were determined by using ELISA.Results: HAM-D scores were 17.09 +/- 4.96 in depressed patients. We determined that the serum BDNF levels of the depression patients were lower than those of the healthy control group (respectively, 1453.42 +/- 144.51 pg/ml, 1632.23 +/- 252.93 pg/ml, t = 3.467, p = 0.001, independent t test). No correlation was found between the patients' serum BDNF levels and HAM-D scores (p > 0.05, Pearson correlation analysis).Conclusions: Our results suggest that serum BDNF levels are low in depression. However it was not found association between serum BDNF levels and the severity of depression. (C) 2011 Elsevier GmbH. All rights reserved

disorder A proton magnetic resonance spectroscopy study

The aim of this study was to investigate proton magnetic resonance spectroscopy metabolite values in the medial prefrontal cortex of individuals with euthymic bipolar disorder. The subjects consisted of 15 patients with euthymic bipolar disorder type 1 and 15 healthy controls. We performed proton magnetic resonance spectroscopy of the bilateral medial prefrontal cortex and measured levels of N-acetyl aspartate, choline and creatine. Levels of these three metabolites in the medial prefrontal cortex were found to be lower in patients with bipolar disorder compared with healthy controls. A positive correlation was found between illness duration and choline levels in the right medial prefrontal cortex. Our study suggests that during the euthymic period, there are abnormalities in cellular energy and membrane phospholipid metabolism in the medial prefrontal cortex, and that this may impair neuronal activity and integrity