Effects of childhood multiple maltreatment experiences on depression of socioeconomic disadvantaged elderly in Brazil.

Childhood maltreatment is a risk factor for depression in nonelderly individuals. We investigated the effect of childhood abuse and neglect on the development of geriatric depression and its severity in socioeconomically disadvantaged individuals. A cross-sectional study investigated 449 individuals aged 60-103 years sorted by data using the enrollment list health coverage from the city of Porto Alegre, Brazil. The fifteen-item Geriatric Depression Scale was used to assess depression. The Childhood Trauma Questionnaire was used to identify emotional and physical neglect, in addition to emotional, physical, and sexual abuse. Geriatric depression was associated with emotional and physical abuse and neglect. Emotional abuse and neglect, as well as physical abuse, increased the odds of an individual developing severe depression. Correlations were observed for combined forms of maltreatment, with two to five maltreatment types producing mild to moderate symptoms. Similar trends were observed for severe symptoms in a limited number of cases. The cross-sectional design limit causal inference. Retrospective measurement of childhood maltreatment may increase recall and response bias. Late-life depression and its severity significantly correlated with the extent of childhood emotional and physical abuse and neglect. Thus, research should focus on supporting trauma survivors late in life, particularly when they come from low or middle income countries because these patients have higher rates of depression in elderly populations

Influence of childhood abuse and neglect subtypes on late-life suicide risk beyond depression.

The association of childhood maltreatment and suicide has been extensively examined within the population. Depression figures as a main cause for the elevated suicide rate in advanced ages and is often related to childhood maltreatment. The purpose of the present study was to examine the relationship between childhood maltreatment subtypes and suicide risk, testing geriatric depression as a moderator. This is a cross-sectional study looking at a sample of 449 individuals 60 year s old or older from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy, Brazil (EMI-SUS/POA). Childhood maltreatment (Childhood Trauma Questionnaire), geriatric depressive symptoms (Geriatric Depression Scale), and suicide risk (Mini International Neuropsychiatric Interview) were assessed. The subtypes of childhood abuse and neglect were significantly associated with suicide risk. In the multivariate analysis, controlling for age, gender, income, marital status, ethnicity, smoking, and geriatric depression symptoms, all trauma subtypes remained associated with suicide risk with the exception of physical neglect (EA = 3.65; PA = 3.16; SA = 5.1; EN = 2.43; PN = 1.76). The present study showed that childhood maltreatment subtypes predicted suicide risk, and geriatric depression does not directly mediate this relation

Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure

Background: The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers. Methods: Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS]), and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma) were analyzed. Results: Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39%) of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients) and TBARS (compared with both the nonmelancholic subset and controls) and returned higher IL-6 levels than controls. Both depressive groups generated higher PCC scores than controls, with no difference between melancholic and nonmelancholic subsets. Conclusion: A sign-based measure to rate melancholia was able to replicate and extend biological findings discriminating melancholic depression. Signs of psychomotor disturbance may be a useful diagnostic measure of melancholia. © 2014 Spanemberg et al

Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure

Lucas Spanemberg,1,2 Marco Antonio Caldieraro,1 Edgar Arrua Vares,1 Bianca Wollenhaupt-Aguiar,3,4 Márcia Kauer-Sant’Anna,3,4 Sheila Yuri Kawamoto,1 Emily Galvão,3–5 Gordon Parker,6,7 Marcelo P Fleck1,8 1Mood Disorders Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, 2Department of Psychiatry, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, 3INCT Translational Medicine, Hospital de Clínicas de Porto Alegre, 4Bipolar Disorders Program and Laboratory of Molecular Psychiatry, Universidade Federal do Rio Grande do Sul, 5Centro Universitário Metodista, Porto Alegre, Brazil; 6School of Psychiatry, University of New South Wales, 7Black Dog Institute, Sydney, NSW, Australia; 8Neuromodulation Research Clinic, Douglas Mental Health University Institute, Montréal, ON, Canada Background: The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers.Methods: Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS]), and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma) were analyzed. Results: Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39%) of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients) and TBARS (compared with both the nonmelancholic subset and controls) and returned higher IL-6 levels than controls. Both depressive groups generated higher PCC scores than controls, with no difference between melancholic and nonmelancholic subsets. Conclusion: A sign-based measure to rate melancholia was able to replicate and extend biological findings discriminating melancholic depression. Signs of psychomotor disturbance may be a useful diagnostic measure of melancholia. Keywords: melancholic depression, oxidative stress, inflammatory cytokines, brain-derived neurotrophic facto

Biological differences between melancholic and nonmelancholic depression subtyped by the CORE measure

Background: The purpose of this study was to compare melancholic patients rated by the CORE measure of observable psychomotor disturbance with nonmelancholic and control subjects across a set of biomarkers. Methods: Depressed patients were classified as melancholic or nonmelancholic by using the CORE measure. Both groups of patients, as well as control subjects, were compared for a set of clinical and laboratory measures. Serum levels of brain-derived neurotrophic factor, of two markers of oxidative stress (protein carbonyl content [PCC] and thiobarbituric acid reactive substances [TBARS]), and of several immunity markers (interleukin [IL]-2, IL-4, IL-6, IL-10, IL-17, tumor necrosis factor-alpha, and interferon-gamma) were analyzed. Results: Thirty-three depressed patients and 54 healthy controls were studied. Depressive patients showed higher IL-4, IL-6, and PCC values than healthy controls. Thirteen (39%) of the depressed patients were assigned as melancholic by the CORE measure. They generated lower interferon-gamma (compared with nonmelancholic depressed patients) and TBARS (compared with both the nonmelancholic subset and controls) and returned higher IL-6 levels than controls. Both depressive groups generated higher PCC scores than controls, with no difference between melancholic and nonmelancholic subsets. Conclusion: A sign-based measure to rate melancholia was able to replicate and extend biological findings discriminating melancholic depression. Signs of psychomotor disturbance may be a useful diagnostic measure of melancholia. © 2014 Spanemberg et al

Translation and cross-cultural adaptation of the Rating Scale for Countertransference (RSCT) to American English

Abstract Introduction: The Rating Scale for Countertransference (RSCT) - originally, Escala para Avaliação de Contratransferência (EACT) - is a self-administered instrument comprising questions that assess 23 feelings (divided into three blocs, closeness, distance, and indifference) that access conscious countertransferential emotions and sentiments. This paper describes the process of translation and cross-cultural adaptation of the RSCT into American English. Methods: This study employed the guidelines proposed by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force for Translation and Cultural Adaptation which define 10 steps for translation and cross-cultural adaptation of self-report instruments. Additionally, semantic equivalence tools were employed to select the final versions of terms used. The author of the RSCT gave permission for translation and took part in the process. The instrument is available for use free of charge. Results: Analysis of the back-translation showed that just seven of the 23 terms needed to be adjusted to arrive at the final version in American English. Conclusions: This study applied rigorous standards to construct a version of the RSCT in American English. This version of the RSCT translated and adapted into American English should be of great use for accessing and researching countertransferential feelings that are part of psychodynamic treatment