Three-Year Prognosis of Late-Life Depression in an Outpatient Geriatric Psychiatry Clinic: Medical Comorbidities Worsen Outcomes.

Depression is one of the most important reasons for psychiatric referrals in elderly patients. Geriatric depression can be chronic and is associated with an increased risk of dementia. We aimed to determine the prognosis of major depression patients and associated risk factors regarding persistence of depression. Patients who were admitted to the tertiary geriatric psychiatric outpatient unit of Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul between January and December 2018 and were diagnosed with major depression according to DSM-5 diagnostic criteria were included in the study. A structured telephone interview was conducted with between February-April 2022. For detailed clinical evaluation, Turkish version of Structured Clinical Interview for DSM-5-Disorders/Clinician Version (SCID-5/CV-TR), Telephone Cognitive Screen (T-cogS-TR), Geriatric Depression Scale (GDS), Clinical Dementia Rating Scale (CDR), Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) and Beck Anxiety Inventory (BAI) were used. Of the 123 patients interviewed, 40.9% were diagnosed with major depression and 14.6% with minor depression. 43.4% showed significant anxiety and depression symptoms. Dementia developed in 14.6% of the patients. Only 29.5% of the patients recovered completely. Hypertension, orthopedic disease or arthritis, cancer, and absence of prior work experience were found to be predictors of current depression diagnosis. Geriatric depression has an unfavorable prognosis despite continued antidepressant treatment and may even serve as a prodrome for future dementia. Timely management of co-morbid medical conditions such as hypertension can potentially improve the prognosis of geriatric depression.

Are bipolar disorder, major depression, and suicidality linked with Toxoplasma gondii? A seromolecular case-control study.

OBJECTIVE: The existence of predisposing effects of latent Toxoplasma gondii (T. gondii) infection in bipolar disorder (BD), major depression (MD), and even suicide attempt (SA) has long been debatable. This conjecture remains unclear because there is a lack of evidence regarding how T. gondii manipulates the brain and behavior. METHODS: We investigated the influence of T. gondii infection on BD and MD patients with or without SA compared to age-, sex-, and province-matched healthy controls (HCs) concurrently with serology and molecular-based evaluations. We prospectively assessed 147 volunteers with BD, 161 with MD, and 310 HCs. RESULTS: T. gondii seropositivity rates were 57.1% for BD, 29.2% for MD, 64.8% for SA, and 21.3% for HC. Binary logistic regression analyses revealed that T. gondii positive Immunoglobulin G (IgG) status may be a prominent tendentious agent for BD (OR = 3.52; 95% CI [2.19-5.80]; p < 0.001) and SA (OR = 17.17; 95% CI [8.12-36.28]; p < 0.001), but not for MD (OR = 1.21; 95% CI [0.74-1.99]; p = 0.45). Nevertheless, the T. gondii DNA ratios determined by polymerase chain reaction (PCR) were linked to BD and MD. CONCLUSION: Our findings strongly support the burgeoning interest in the possibility that latent T. gondii infection may be relevant to the etiology of BD and SA, although this connection remains ambiguous.