COGNITIVE FUNCTIONS IN FIRST-EPISODE DEPRESSION AND RECURRENT DEPRESSIVE DISORDER

Background: Cognitive deficits in the course of depressive disorders affect mainly memory, attention and the frontal functions. They are associated with both an earlier onset of symptoms and prolonged episodes. The main aim of the study was to verify the hypothesis of differences in the effectiveness of cognitive processes between patients with a first episode of depression (ED-I) and recurrent depressive disorders (rDD). Subjects and methods: The study comprised 210 subjects: patients with ED-I (n=60) and patients with rDD (n=150). The assessment of cognitive functions was based on performance of the Trail Making Test, the Stroop Test, the Verbal Fluency Test, the California Verbal Learning Test (CVLT) and the digit span from WAIS-R. Results: There were no statistically significant differences between the analysed groups in the severity of depressive symptoms. The negative impact of depressive symptoms on the effectiveness of cognitive functions was observed. The ED-I group recorded better results compared to the rDD group in terms of the speed of information processing, visual-spatial and auditory-verbal memory and executive functions, auditory-verbal immediate and delayed memory, ability to learn and verbal fluency. The same differences were observed with respect to the patients from the ED-I group and the patients with the second episode of depression (ED-II) in the course of rDD. Conclusions: There are significant differences in cognitive functioning of patients with a depressive episode and recurrent depressive disorders. These differences are already visible from the second episode of a major depressive disorder. Memory, verbal fluency and frontal functions are reduced

Mechanisms underlying neurocognitive dysfunctions in recurrent major depression

Recent work shows that depression is intimately associated with changes in cognitive functioning, including memory, attention, verbal fluency, and other aspects of higher-order cognitive processing. Changes in cognitive functioning are more likely to occur when depressive episodes are recurrent and to abate to some degree during periods of remission. However, with accumulating frequency and duration of depressive episodes, cognitive deficits can become enduring, being evident even when mood improves. Such changes in cognitive functioning give depression links to mild cognitive impairment and thereby with neurodegenerative conditions, including Alzheimer\u27s disease, Parkinson\u27s disease, schizophrenia, and multiple sclerosis. Depression may then be conceptualized on a dimension of depression - mild cognitive impairment - dementia. The biological underpinnings of depression have substantial overlaps with those of neurodegenerative conditions, including reduced neurogenesis, increased apoptosis, reactive oxygen species, tryptophan catabolites, autoimmunity, and immune-inflammatory processes, as well as decreased antioxidant defenses. These evolving changes over the course of depressive episodes drive the association of depression with neurodegenerative conditions. As such, the changes in cognitive functioning in depression have important consequences for the treatment of depression and in reconceptualizing the role of depression in wider neuroprogressive conditions. Here we review the data on changes in cognitive functioning in recurrent major depression and their association with other central conditions

EXPRESSION OF SIR1-SIR7 GENES IN THE COURSE OF RECURRENT DEPRESSIVE DISORDERS

Background: The role of sirtuins as a pathogenetic element of some mental disorders is becoming increasingly more common. They participate in many cellular processes, such as ageing, transcription, apoptosis, inflammatory processes, post-translational modification of proteins, gene transcription silencing, activation of DNA repair mechanisms, and regulation of many metabolic processes. The aim of this paper is to verify the statistical hypothesis assuming the difference in expression at the level of mRNA in genes for sirtuins 1-7 between patients with recurrent depressive disorders (rDD) and patients from the control group, and the hypothesis assuming the relation between the expression at the level of mRNA for these genes and clinical variables in the course of recurrent depressive disorders. Subjects and methods: A total of 198 individuals took part in the study (rDD gropup, N=99; control group, N=99). Results: SIR-1 and SIR-6 expression at the mRNA level was significantly higher among the people with rDD as compared to the subjects from the control group. A reversed relationship was observed for SIR-2, SIR 3, SIR-4 and SIR-5. Statistically significant correlations were observed only in the case of SIR-1 and the number of depression episodes (negative relationship), as well as SIR-5 and the severity of depression measured by the Hamilton Depression Rating Scale (positive relationship). Conclusions: Expression at the mRNA level for selected sirtuins is a factor that significantly differentiates people with depressive episodes from healthy ones. SIR-1 and SIR-6 expression at the mRNA level was significantly higher among the people with depression as compared to the subjects from the control group. A reversed relationship (also statistically significant) was observed for SIR-2, SIR-3, SIR-4 and SIR-5

Wczesne nieadaptacyjne schematy Younga i ich związki z wybranymi zaburzeniami psychicznymi

Maladaptive cognitive schemas are emotional and cognitive patterns that are detrimental to the individual and have their roots in early childhood and are developed and replicated in later life. According to Young, the creator of the schema theory, the presence of distorted beliefs and specific cognitive schemas can be the basis for personality and chronic mental disorders. The aim of this paper is to present conclusions from the analysis of the literature on the relationship between maladaptive cognitive schemas and selected mental disorders, i.e. depressive disorders, bipolar affective disorders, addictions, obsessive-compulsive disorders, and social phobia.Nieadaptacyjne schematy poznawcze są szkodliwymi dla jednostki wzorami emocjonalnymi i poznawczymi, które swojekorzenie mają we wczesnym dzieciństwie i są rozwijane oraz powielane w ciągu późniejszego życia. Zgodnie z koncepcjąYounga — twórcy teorii schematów, obecność zniekształconych przekonań i określonych schematów poznawczychmoże się stać podłożem dla zaburzeń osobowości oraz chronicznych zaburzeń psychicznych. Celem niniejszej pracy jestprzedstawienie wniosków z analizy literatury przedmiotu w zakresie związku nieadaptacyjnych schematów poznawczychz wybranymi zaburzeniami psychicznymi: zaburzeniami depresyjnymi, zaburzeniami afektywnymi dwubiegunowymi,uzależnieniami, zaburzeniami obsesyjno-kompulsyjnymi oraz fobią społeczną

HUMAN NEUROPSIN GENE IN DEPRESSION

Background: Neuropsin (NP, kallikrein 8, KLK8) - a kallikrein gene-related (KLK) endoprotease - plays a key role in neuroplasticity processes, since intracellular signal cascades and regulation of gene expression are engaged in long-term synaptic plasticity. The main aim of this paper is to compare expression of the human neuropsin gene on the mRNA level in a group of patients diagnosed with depression and in a group of healthy subjects who have never been treated psychiatrically. Subjects and methods: 291 people, aged 18-67, were qualified to participate in the experiment: major recurrent depression group (MRD) and the control group (CG). Designations were carried out for the human NP gene (hNP). Results: For hNP gene expression at the mRNA level was higher in patients with depression than in the CG (p<0.005). A Spearman\u27s rank correlation analysis did not reveal any statistically significant relationship between the intensity of the disease measured using the HDRS scale and expression on the mRNA level for the hNP gene. Expression for the hNP gene in the entire group analysed increased with age of the examined individuals (p<0.005). Conclusion: Expression of the hNP gene on the mRNA level, evaluated based on peripheral blood, is significantly higher in the patients with MRD than in the healthy subjects

Interleukin 1 level, cognitive performance, and severity of depressive symptoms in patients treated with systemic anticancer therapy: a prospective study

Aim To assess the relationship between cognitive functions, severity of depressive symptoms, and expression of interleukin 1 (IL)-1 in patients treated with systemic anticancer therapy. Methods This prospective study, conducted in 2017-2018, involved 55 patients (56% men) subjected to systemic anticancer therapy. Forty-one patients had lung cancer (74.55%) and 14 had breast cancer (25.45%). Patients’ mean age was 55.5 ± 9.3 (from 26 to 65 years). Neuropsychological tests were conducted twice: on the day of qualifying for the study before the start of chemotherapy and after the end of the full treatment cycle. We assessed patients’ cognitive functioning using Trail Making Test A&B (TMT), Stroop Color-Word Interference Test, and Verbal Fluency Test (VFT). Severity of depressive symptoms and the level of IL-1 expression were also examined.Results After chemotherapy, patients had significantly lower expression of IL-1α (P < 0.005) and IL-1β (P < 0.001) at the protein level. They also had lower severity of depressive symptoms (borderline significant, P = 0.063), needed more time to complete the first part of the Stroop test (P = 0.03), and had worse score on the first part of the VFT (P < 0.001). Before chemotherapy there was a significant negative correlation between IL-1β expression and the speed at which the first part of the TMT test was completed. Conclusions The severity of depressive symptoms after chemotherapy was lower than before chemotherapy. Patients’ cognitive performance did not significantly deteriorate after chemotherapy, except the performance at the first part of the Stroop test and the first part of the VFT

Elevated Level of DNA Damage and Impaired Repair of Oxidative DNA Damage in Patients with Recurrent Depressive Disorder

Background: Depressive disorder (DD), including recurrent DD (rDD), is a severe psychological disease, which affects a large percentage of the world population. Although pathogenesis of the disease is not known, a growing body of evidence shows that inflammation together with oxidative stress may contribute to development of DD. Since reactive oxygen species produced during stress may damage DNA, we wanted to evaluate the extent of DNA damage and efficiency of DNA repair in patients with depression. Material and Methods: We measured and compared the extent of endogenous DNA damage – single- and double-strand breaks, alkali-labile sites, and oxidative damage of the pyrimidines and purines – in peripheral blood mononuclear cells isolated from rDD patients (n=40) and healthy controls (n=46) using comet assay. We also measured DNA damage evoked by hydrogen peroxide and monitored changes in DNA damage during repair incubation. Results: We found an increased number DNA breaks, alkali-labile sites, and oxidative modification of DNA bases in the patients compared to the controls. Exposure to hydrogen peroxide evoked the same increased damage in both groups. Examination of the repair kinetics of both groups revealed that the lesions were more efficiently repaired in the controls than in the patients. Conclusions: For the first time we showed that patients with depression, compared with non-depresses individuals, had more DNA breaks, alkali-labile sites, and oxidative DNA damage, and that those lesions may be accumulated by impairments of the DNA repair systems. More studies must be conducted to elucidate the role of DNA damage and repair in depression

Suicides of patients at psychiatric hospitals — preliminary studies

 Wstęp. U osób leczonych psychiatrycznie do samobójstwa dochodzi także podczas hospitalizacji lub wkrótce po wypisie ze szpitala. Część pacjentów przed samobójstwem zaprzecza występowaniu myśli suicydalnych. Uzasadnia to konieczność badań nad czynnikami ryzyka samobójstwa u hospitalizowanych pacjentów leczonych psychiatrycznie. Celem pracy była charakterystyka demograficzna pacjentów hospitalizowanych psychiatrycznie, którzy dokonali samobójstwa w trakcie pobytu w szpitalu lub tydzień po wypisie oraz ustalenie okoliczności samobójstwa, częstości występowania wybranych przez pacjentów metod samobójstwa, związku samobójstwa z diagnozą psychiatryczną i wcześniejszymi zachowaniami samobójczymi (S), a także z czasem trwania zaburzeń psychicznych i liczbą hospitalizacji. Materiał i metody. W przeprowadzonych badaniach retrospektywnych analizie poddano historie chorób 23 pacjentów dwóch dużych szpitali psychiatrycznych (z terenu Łodzi), którzy zginęli śmiercią samobójczą w trakcie hospitalizacji lub w pierwszym tygodniu po wypisie ze szpitala. Dla każdego pacjenta wypełniano ankietę, która zawierała wybrane zmienne. Wyniki. Wśród analizowanych przypadków samobójstw (1988−2011) przeważały kobiety (56%). Co piąta ofiara samobójstwa miała poniżej 20 lat, a co czwarta powyżej 60. Większość ofiar miała wykształcenie podstawowe oraz była na rencie chorobowej/emeryturze. Blisko co trzeci pacjent dokonał zamachu S będąc na przepustce. Najczęstszą metodą samobójstwa było powieszenie. Myśli samobójcze przed targnięciem się na życie potwierdzono u blisko 40% pacjentów, a próby samobójcze stwierdzono tylko u dwoch osób. Najczęstsza diagnoza to zaburzenia psychotyczne, a także depresyjne. Większość ofiar była hospitalizowana dwa lub więcej razy, a czas trwania choroby przekraczał rok. Wnioski. Do grupy wysokiego ryzyka samobójstwa należą pacjenci hospitalizowani psychiatrycznie poniżej 20. roku życia, z zaburzeniami psychotycznymi, wielokrotnie hospitalizowani. Konieczne jest rejestrowanie wszystkich zachowań samobójczych w szpitalach psychiatrycznych.  Introduction. Suicides in psychiatrically treated patients are also recorded while patients are hospitalised or immediately after discharge. Some of the patients deny any suicidal thoughts before committing suicide, justifying the necessity to study risk factors, which may lead to suicide in hospitalised, psychiatrically treated patients. The aim of the study was a demographic characteristic of psychiatrically hospitalised patients, who had committed suicide, either during hospitalisation or within a week from discharge. An attempted analysis aimed at determining the circumstances of committed suicide, the prevalence of suicide methods, selected by the patients, the relationship of committed suicide with earlier psychiatric diagnosis and previous suicidal behaviours, as well as with the duration of psychic disorders and the number of hospitalisations. Material and methods. Retrospective studies were carried out. The analysis comprised 23 medical records of patients from two large psychiatric hospitals (Lodz, Poland). The selected medical records concerned the patients, who either died by suicide during hospitalisation or within one week from discharge. A questionnaire with selected variables was filled up for each of the patients. Results. Women prevailed (56%) among the suicidal cases, analysed over the period from 1988 up to 2011. Each 5th victim of suicide was below 20 and each 4th was below 60 years old. Most of the victims had completed primary education and had been receiving either retirement or disablement benefit. Almost each 3rd patient committed suicide while being on a pass. Hanging was the most frequent method of suicide. Suicidal thoughts before suicide commitment were confirmed by almost 40%, while suicidal attempts were confirmed in two patients only. Psychotic disorders were most frequently diagnosed, followed by depressive disorders. In the majority of the suicidal victims, two or more hospitalisations were recorded with disease duration above one year. Conclusions. The high-risk group of suicide includes psychiatrically hospitalised patients below 20 years of age, with psychotic disorders, repeatedly hospitalised. The procedures at psychiatric hospitals should include recording of suicidal behaviours, suicide risk assessments and a strict compliance to the principles of treating a patient in suicidal crisis, with a special emphasis on eliminating any availability of suicide methods, as suicide prevention.

THE MMPI-2 NEUROTIC TRIAD SUBSCALES AND DEPRESSION LEVELS AFTER PHARMACOLOGICAL TREATMENT IN PATIENTS WITH DEPRESSIVE DISORDERS - CLINICAL STUDY

Background: Affective disorders provide for one third of the main causes of psychiatric inpatient care, both in male and female subjects. An early diagnosis of the disease with precise identification of the character of its particular symptoms are key important factors for the efficacy of treatment. The goal of the study was an identification of possible associations between scores of the neurotic triad in the MMPI-2 test (hypochondria - Hs, depression - D, hysteria - Hy), evaluated at initial hospitalization period with remission degree assessed by the Hamilton Depression Rating Scale (HDRS), following eight weeks of treatment with SSRI. Subjects and methods: A group of 50 subjects took part in the study. The MMPI-2 test and HDRS were used in the study. The HDRS was performed at the therapy onset and reapplied after 8 weeks of its continuation. The MMPI-2 test was applied at the beginning of treatment. Results: Higher scores in Hs (p=0.007), D (p=0.021) and Hy scales (p=0.001) are associated with the higher degree of depression, measured by the HDRS at the therapy onset. The highest performance in Hs scale (p=0.003) and Hy scale (p=0.001) evaluated on admission, was associated with the highest depression level after pharmacological treatment. Conclusion: The higher the degree of hypochondria and hysteria symptoms, measured by the MMPI-2 test at the onset of therapy in patients with depressive disorders, the higher severity of depression is being found after 8 weeks of therapy with SSRI agents, measured by the HDRS scale