Emotional control in selected somatic and psychiatric diseases.

THE AIM: was to assess the level of subjective control of emotional states among patients treated for dermatological and gastrointestinal somatic diseases compared to those with depressive and anxiety disorders. The results were related to the analyzed dimensions of emotion regulation in healthy subjects. MATERIALS AND METHODS: The reports of the conducted studies were compiled for a total of 310 people, including 120 patients diagnosed with a somatic disease (psoriasis, rosacea, irritable bowel syndrome, and gastroesophageal reflux), as well as 96 patients diagnosed with depressive disorders and 30 patients with anxiety disorders. The control group consisted of healthy subjects (64 individuals). To assess the psychological variables analyzed, the subjects completed the Emotion Regulation Questionnaire developed by J. Brzezinski. RESULTS: The study showed that the patients suffering from a chronic somatic symptom disorder, similarly to those treated for depression and anxiety disorders, differed from the healthy individuals in most aspects of emotional control. The patients with dermatological and gastrointestinal diseases differed statistically significantly from the patients with depression and the patients with anxiety disorders in relation to three dimensions of emotional control. Patients with a somatic disease are characterized by higher emotional and rational motivation, lower emotional resilience and lower emotional arousal. CONCLUSIONS: A chronic disease co-occurs with the emotional sphere of a person's daily functioning. Regardless of the diagnosis in terms of somatic disorders and mental illnesses, the way in which emotional states are controlled can be an important factor in the onset of the disease, coping with it as well as the treatment process.

Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases.

Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.

Pharmacogenetics and Schizophrenia-Can Genomics Improve the Treatment with Second-Generation Antipsychotics?

Schizophrenia (SCZ) is a complex psychiatric disorder of multifactorial origin, in which both genetic and environmental factors have an impact on its onset, course, and outcome. Large variability in response and tolerability of medication among individuals makes it difficult to predict the efficacy of a chosen therapeutic method and create universal and precise guidelines for treatment. Pharmacogenetic research allows for the identification of genetic polymorphisms associated with response to a chosen antipsychotic, thus allowing for a more effective and personal approach to treatment. This review focuses on three frequently prescribed second-generation antipsychotics (SGAs), risperidone, olanzapine, and aripiprazole, and aims to analyze the current state and future perspectives in research dedicated to identifying genetic factors associated with antipsychotic response. Multiple alleles of genes involved in pharmacokinetics (particularly isoenzymes of cytochrome P450), as well as variants of genes involved in dopamine, serotonin, and glutamate neurotransmission, have already been identified as ones of significant impact on antipsychotic response. It must, however, be noted that although currently obtained results are promising, trials with bigger study groups and unified protocols are crucial for standardizing methods and determining objective antipsychotic response status.

Specificity of quality of life assessment in people with mental disorders. / Specyfika oceny jakosci zycia u osób z zaburzeniami psychicznymi.

Quality of life is an integral element of a new perspective on health. Even though the definition and structure of the concept of quality of life are still being debated, researchers exploring the topic agree that it has both objective and subjective dimensions. When the quality of life of patients is examined somatically, the objectives formulated in the study procedure are usually easily achieved, particularly when the basic hypothesis is that good physical health generates a high quality of life. However, where mental diseases and dysfunctions are investigated, and the analysis involves a large number of variables constituting quality of life, the relationship is not so clear-cut. Consequently, in addition to methodological accuracy the researcher must put a major focus on the patients and their manifestations. The thesis stating that it is impossible to measure quality of life in this population, or worse still, that there is no need for such measurements, is indefensible, considering that people with mental disorders have the same right to a good life as healthy individuals, and achieving an improvement in their quality of life becomes an increasingly common target among anticipated therapeutic benefits. Looking at the issue from the perspective of findings obtained in multiple studies, it is evident that quality-of-life measurements are not easy, but a successful attempt may provide researchers with a source of valuable non-clinical data and even enhance their personal satisfaction.

Ways of Coping with Stress among Patients with Depressive Disorders.

BACKGROUND: Experiencing stressful life events and ways of coping with them can predispose to the onset of depressive mood disorders, while depression itself can be responsible for severe stress and can weaken resilience to stressors. Thus, variables relevant to the onset of depressive episodes and the course of depression have significant relationships with coping strategies to stressors. The aim of this research was to evaluate the most commonly used stress-coping strategies in patients treated for depression compared to patients with anxiety disorders and to healthy subjects. METHODS: The multidimensional coping inventory (COPE Inventory) by C. S. Carver, M. F. Scheier, and J. K. Weintraub, covering 15 stress response strategies included in more general and overarching coping styles, was used in the study. RESULTS: Patients with depression differed from the healthy subjects in a statistically significant way. Statistical analysis showed that people with depression are less likely than healthy subjects to use Active Coping, Planning, Seeking of Instrumental and Emotional Social Support, Suppression of Competing Activities, and Positive Reinterpretation. In contrast, they are more likely to use Denial, Mental Disengagement, and Behavioral Disengagement compared to those not treated for mental disorders. The patients with depressive disorders, compared to the group of patients with anxiety disorders, scored significantly differently on stress coping strategies in only two types of actions taken in stressful situations. CONCLUSION: The patients with depression differed from the healthy subjects in terms of the highest number of the stress coping strategies assessed. Compared to the healthy individuals, a tendency toward an avoidant behavior style was prevalent among the depressed patients. There was no statistically significant difference between the patients with the first episode of the disease and recurrent depressive disorders in terms of stress coping strategies.

Expression of p11 in Patients with Depression.

(1) Background: Some studies suggest that the p11 protein, belonging to the so-called S100 family and located, i.a., in the nucleus accumbens of the brain, is responsible for the occurrence of depression. This protein is encoded by the S100A10 gene. The aim of our study was to evaluate the expression of the S100A10 gene at the mRNA and protein levels in patients with depressive disorders and to determine the impact of p11 in the etiopathogenesis of depression; (2) Methods: A total of 290 people (190 depressed patients, 100 healthy controls) participated in the study. Socio-demographic and clinical data were collected. The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale (HDRS). Venous blood was collected from all participants. RT-PCR was used to evaluate gene expression at the mRNA level, while enzyme-linked immunosorbent assay (ELISA) was used to evaluate gene expression at the protein level; (3) Results: The results indicate slightly increased S100A10 gene expression (both at the protein and mRNA levels) in patients with depression, but these values do not reach statistical significance; (4) Conclusions: Due to the fact that the study was limited by the participation of patients already undergoing antidepressant treatment, its results may confirm that pharmacological treatment affecting serotonin neurotransmission is effective in upregulation of p11 in patients with depression.

Personality Traits and Inflammation in Depressive Disorders.

Depression is a psychiatric disorder of heterogeneous etiology. One of the leading theories suggests an inflammatory background to it. It is often found in the scientific literature that certain personality traits, such as high neuroticism, low extroversion and conscientiousness, are being associated with depression. We combined biochemical tests of IL-1 and IL-6 serum levels and scores in the personality test EPQ-R among 50 depressed patients and 37 healthy participants. The results confirmed increased serum levels of IL-1 and IL-6 in a study group when compared to healthy volunteers. Additionally, personality traits (psychoticism and neuroticism) were increased in the depressed group when compared to healthy volunteers. The authors analyzed correlations in both groups. However, only one statistically significant link was observed in IL-6 and K levels (scale associated with the need for social acceptance) in the control group.

Assessing the Mental Condition of Paramedics and Nurses during the SARS-CoV-2 Pandemic.

BACKGROUND: The COVID-19 pandemic has significantly affected many aspects of life. The aim of this study was to assess the mental state of medical personnel most involved with patients affected by SARS-CoV-2. METHODS: The survey research was conducted between October 2021 and March 2022. The study group included 46 paramedics, 48 nurses, and 6 individuals from both professions, ranging in age from 21 to 67 years. Data were collected using paper questionnaires that contained 44 questions. RESULTS: During the pandemic, respondents maintained good contact with their colleagues and were competent enough to help their patients. The main factors that influenced their stress or dissatisfaction were the number of patients and the number of tasks. The nurses and paramedics most frequently reported symptoms related to tension, insomnia, and problems with intellectual performance. The pandemic situation led to the abandonment of hobbies and deterioration of relationships with friends and family. CONCLUSION: As a result of high stress levels, paramedics and nurses frequently suffered from tension and insomnia. The factors described were associated with poorer well-being of the subjects in various functional areas, even before the pandemic period. This was mainly related to the large number of patients and the tasks. However, this work, as well as studies by other authors, come to alarming conclusions that should draw attention to the mental state of medical staff, as this is the group that is highly responsible for the medical care of patients, especially in such a difficult time as a pandemic.

Cognitive Behavioral Therapy of Patients with Somatic Symptoms-Diagnostic and Therapeutic Difficulties.

In every somatic disease we can find a psychological element, just as it is not uncommon for numerous physical symptoms to occur in a mental disease. Nowadays, the patient is no longer just the "owner" of the sick organ but is considered and treated as a "whole". The interpenetration of somatic manifestations with mental health problems forces patients who experience subjective suffering, including mental suffering, from current symptoms to visit specialists from different fields of medicine, and their treatment does not bring about any improvement. Cognitive behavioral psychotherapy (CBT) is one form of therapy that attempts to respond to the needs of an increasing-in recent years-number of patients who demonstrate somatic disorders of a multifaceted nature. The co-occurrence of physical and mental disorders repeatedly makes it impossible to determine which symptoms were the cause and which were the effect; hence, it is difficult to establish clear boundaries between the categories of these disorders and diseases. The therapist, to whom the patient with somatic diseases is eventually referred, may be faced with a diagnostic dilemma, the solution of which will give direction to further psychotherapeutic work. The common feature of this group of patients is a strong focus on physical ailments, while omitting or almost completely ignoring the psychological factors involved. The purpose of this paper is to present the causally diverse circumstances in which a patient with physical symptoms needs diagnosis and therapeutic support from the perspective of a cognitive behavioral approach.

Inflammatory versus Anti-inflammatory Profiles in Major Depressive Disorders-The Role of IL-17, IL-21, IL-23, IL-35 and Foxp3.

BACKGROUND: The authors of this research study intended to verify whether there are any changes in gene expression in depressed patients without coexisting inflammatory diseases for selected immune-inflammatory factors that are particularly important in autoimmune disease pathogenesis (IL-17, IL-21, IL-23, IL-35, Foxp3). METHODS: The study was carried out on a group of 190 patients with depression and 100 healthy volunteers. The severity of depressive symptoms was assessed using the Hamilton Depression Scale. RT-PCR was used to evaluate mRNA expression and ELISA was used to measure protein expression of these genes. RESULTS: The level of gene expression for IL-17, IL-21, IL-23, and IL-35 was substantially higher in the group of patients with depression compared to the control group. The mean mRNA expression of Foxp3 was considerably reduced in patients suffering from depressive disorders. There was a statistically significant correlation between the number of hospitalizations and the expression of specific inflammatory factors. CONCLUSIONS: Expression of specific inflammatory genes may be a factor in the etiopathogenesis of depressive disorders. The duration of the disease seems to be more important for the expression of the genes in question than the severity of depression. These cytokines may affect the metabolism of neurotransmitters and neuroendocrine functions in the brain as well as be a marker and a new potential therapeutic target for recurrent depressive disorders.

Participation of an expert psychologist in the interrogation of a witness in the light of Polish criminal law. / Udzial bieglego psychologa w przesluchaniu swiadka w swietle polskiego prawa karnego.

In the Polish penalty procedure, the witness is an important source of evidence. The court assesses his credibility in the light of the free assessment of evidence directives' principles (Article 7 of the Code of Criminal Procedure - CCP). In a situation where there is doubt about the mental state of the witness, his mental development condition, his ability to perceive or recreate perceptions, the court or the prosecutor, according to the content of Article 192 §2 of the CCP, may order an interrogation of awitness with the participation of, among others, expert psychologist. This may take place, for example, in case of a witness with mental disorders or awitness in old age. Opinions drawn up by an expert psychologists are also very helpful in the process of assessing the credibility of the witness's testimony, especially in interrogation of a witness under the age of 15 (Article 185a and b of the CCP). The psychologist may also take part in interrogation of a witness in cases related to offenses specified in Article 197-199 of the CC (Article 185c § 3 of the CCP). The presence of an expert psychologist in the courtroom or in a place specifically designated by the procedural authorities, is conditioned by the disclosure of circumstances justifying the suspicion of the existence of factors that disrupt or exclude the ability to perceive, remember and reproduce observations and reporting facts. These circumstances are not always the real doubts concerning the mental state of the witness, and the role of an expert psychologist in these tasks is often not fully used.

Coping with stress, control of emotions and biochemical markers as a common protective element in the inflammatory response to stress. / Style radzenia sobie ze stresem, kontrola emocji i wykladniki biochemiczne jako wspólny element protekcyjny w zapalnej reakcji na stres.

OBJECTIVES: Based on a comprehensive approach to the problem of stress, we have decided to evaluate all components of a stress response - immunological (IL-1, IL-2, IL-6, IL-10, CRP, TNF-alpha) and hormonal one (CRH, ACTH), as well as to evaluate the psychological indicators of stress, coping with stress, and controlling emotional reactions as psychological markers that predispose to the most beneficial adaption in relation to stressors affecting flight personnel taking part in peace missions abroad. METHODS: The research studies being the subject matter of the project were conducted among 113 antiterrorists and 123 representatives of aircrew (236 respondents in total) who participated in peace missions outside Poland. The study was conducted both before departure and during the missions. The study included a biochemical evaluation (IL-1, IL-2, IL-6, IL-10, CRP, TNF-alpha, CRH, ACTH) as well as a psychological assessment based on the Perceived Stress Scale by S. Cohen (PSS-10) and the Courtauld Emotional Control Scale (CECS) by M. Watson and S. Greer, and the COPE Inventory by J. Corver. RESULTS: Based on a statistical analysis of the variables, a relationship between the level of perceived stress and the methods of coping with it as well as between the selected methods of emotion control and inflammatory response indicators, was found. CONCLUSIONS: In difficult situations, accompanied by an increase in the variables responsible for the biochemical inflammatory response of an organism, the effective model of coping with difficult situations and emotioncontrol increases, while the subjective level of perceived stress drops.

The importance of TCF4 gene in the etiology of recurrent depressive disorders.

BACKGROUND: A recurrent depressive disorder is one of the most commonly diagnosed disease entities among psychiatric disorders. The prevalence and morbidity of depression are constantly increasing. Numerous studies have demonstrated the role of genetic factors in the etiology of depressive disorders. Many studies are being conducted to identify genes that predispose to depression. The purpose of this study was to investigate the role of TCF4 gene in the etiology of recurrent depressive disorders and, in particular, to assess expression of the TCF4 gene at the mRNA and protein level in patients with recurrent depressive disorders versus healthy individuals. MATERIAL AND METHODS: The examined population consisted of 170 individuals suffering from depression and 90 healthy individuals. The expressions of the TCF4 gene at the mRNA and protein level were assessed. RESULTS: Decreased TCF4 expression at the mRNA and protein level was found in patients with depressive disorder versus healthy individuals. Expression of the studied gene was not affected by the patients' sex and age. The statistical analysis also showed no correlation between the expression of TCF4 at the mRNA and protein level and the number of episodes or the severity of symptoms. Among the clinical manifestations of depression, only the duration of the illness correlated with the expression of TCF4 at the mRNA level. CONCLUSIONS: Expression of TCF4 at the mRNA and protein level may be significant in the pathomechanism of recurrent depressive disorder and it is not dependent on sex and age.

Assessment of type 1 and type 3 deiodinase expression levels in depressive disorders.

A depressive disorder is a disease characterized by a heterogenous background. The important processes observed and diagnosed in depressed patients indicate that the etiology of depression may include disturbances in thyroid hormone (TH) levels and the occurrence of immune-inflammatory activation. Type 1 (DIO1) and type 3 (DIO3) iodothyronine deiodinases are the enzymes which determine the peripheral and tissue levels of TH, but also interfere with immunological cells and inflammatory processes. We aimed to investigate the levels of DIO1 and DIO3 in the patients suffering from recurrent depressive disorders (rDD). Data collected from 91 rDD patients and 105 healthy controls were analyzed. The diagnoses were made based on the ICD-10 criteria (F33.0-F33.8). The expression levels of DIO1 and DIO3 were estimated using the polymerase chain reaction method and the enzyme-linked immunosorbent assay (ELISA). The expression of DIO1 on mRNA/protein levels in the rDD patients was reduced in comparison to the control subjects, while the expression of DIO3 was higher in the patients suffering from depression. No significant relationship was found between the investigated DIOs and other clinical parameters. Our results indicate and suggest a role of DIO1 and DIO3-related pathways in the pathophysiology of depression. The results represent a promising way to investigate the biological markers of depression.

Single-Nucleotide Polymorphisms of Genes Involved in Repair of Oxidative DNA Damage and the Risk of Recurrent Depressive Disorder.

BACKGROUND Depressive disorder, including recurrent type (rDD), is accompanied by increased oxidative stress and activation of inflammatory pathways, which may induce DNA damage. This thesis is supported by the presence of increased levels of DNA damage in depressed patients. Such DNA damage is repaired by the base excision repair (BER) pathway. BER efficiency may be influenced by polymorphisms in BER-related genes. Therefore, we genotyped nine single-nucleotide polymorphisms (SNPs) in six genes encoding BER proteins. MATERIAL AND METHODS Using TaqMan, we selected and genotyped the following SNPs: c.-441G>A (rs174538) of FEN1, c.2285T>C (rs1136410) of PARP1, c.580C>T (rs1799782) and c.1196A>G (rs25487) of XRCC1, c.*83A>C (rs4796030) and c.*50C>T (rs1052536) of LIG3, c.-7C>T (rs20579) of LIG1, and c.-468T>G (rs1760944) and c.444T>G (rs1130409) of APEX1 in 599 samples (288 rDD patients and 311 controls). RESULTS We found a strong correlation between rDD and both SNPs of LIG3, their haplotypes, as well as a weaker association with the c.-468T>G of APEXI which diminished after Nyholt correction. Polymorphisms of LIG3 were also associated with early onset versus late onset depression, whereas the c.-468T>G polymorphism showed the opposite association. CONCLUSIONS The SNPs of genes involved in the repair of oxidative DNA damage may modulate rDD risk. Since this is an exploratory study, the results should to be treated with caution and further work needs to be done to elucidate the exact involvement of DNA damage and repair mechanisms in the development of this disease.

Polymorphisms in the type I deiodinase gene and frontal function in recurrent depressive disorder.

PURPOSE: Significant impairment of some psychological functions, including cognitive functioning, has been characteristically found in depressed patients. Memory disturbances may be related to the levels of thyroid hormones (TH) that are under the influence of different mechanisms and molecules, including deiodinase type 1(D1) - an important determinant of circulating triiodothyronine (T3). We investigated the relationship between two functionally known polymorphisms within the DIO1 gene, i.e. DIO1a-C/T and DIO1b-A/G, and cognitive functioning in patients diagnosed with recurrent depressive disorder (rDD). In the planned analysis we mainly concentrated on the frontal function: working memory, executive functions and verbal fluency. MATERIALS AND METHODS: Genetic variants were genotyped in 128 patients using a method based on polymerase chain reaction (PCR). Cognitive functions were assessed by the Trail Making Test, the Stroop Test and the Verbal Fluency Test (VFT). RESULTS: No significant associations were found between DIO1 polymorphisms and cognitive functioning in rDD. Only the CT and TT genotypes of the DIO1a variant were significantly related to verbal fluency. There were no significant differences between the distribution of the genotypes and demographic/medical variables. CONCLUSIONS: Based on the study, the examined polymorphisms are not an important risk or protective factor for cognitive impairment in depressive patients. Functional variants within the DIO1 gene that affect triiodothyronine (T3) levels seem not to be associated with cognitive functions. Nevertheless, considering the fact that the DIO1 gene is related to the course and management of depression, further studies on a larger sample size might be suggested.

Influence of Pharmacotherapy on Cognitive Functions in Depression: A Review of the Literature.

In addition to irregularities relating to the emotional sphere, the cognitive impairment in depression is a part of the clinical picture of this affective disorder. Some of the cognitive deficits may be associated with the severity of psychopathological symptoms of depression, while others are more established and can also occur during periods of remission. The participation in cognitive functioning of people with depression have a number of factors: the severity of symptoms, concurrent anxiety disorders, gender, age, education, duration of the disease, and number of previous episodes, as well as general somatic health or medication used. The pharmacological treatment may have varying impact on the different areas of cognition. Research on pharmacotherapy for depression and its impact on cognitive functioning continue and are very popular among clinicians and researchers. The relationship between antidepressants and cognitive abilities is always modulated by the type of depressive disorder, neurobiological factors, and demographic variables. This article presents a review of the studies relating to assessment of the effects of various antidepressants on cognitive abilities among patients with depression.

Evaluation of changes in the width of gingiva in children and youth. Review of literature.

Comprehensive health care in children and youth includes periodic oral examinations. The mucogingival complex undergoes significant changes during development. The factors that impact the width of attached and keratinized gingiva during this period of life are: tooth eruption phase, the position in the arch, the type of frena attachment and oral hygiene. Along with the child's development the width of attached and keratinized gingiva increases, except for the period of tooth replacement, when a temporary narrowing of attached gingiva of erupting permanent teeth is observed. The understanding of physiological processes of the mucogingival complex is prerequisite for diagnostics and treatment of gingival abnormalities in children and youth. Therefore close cooperation between paediatrician and dental specialists: paedodontist, orthodontist and periodontologist is essential.

[The use of psychotropic drugs during breast-feeding]. / Stosowanie leków psychotropowych u kobiet karmiacych piersia.

Breast milk is the best source of nutrients and provides much better protection than immune modified milk. In the United States around 500 000 cases of mental disorders affecting pregnant women are diagnosed each year. It is estimated that approximately 1/3 of these women need psychotropic drugs in a period of breast-feeding. Despite the serious consequences of depression and its well-known effect on a newborn, the women are still reluctant to begin pharmacological treatment. The fear of side effects unfortunately still plays an important role in making such a decision. It has been proved that all psychiatric drugs can transfer into breast milk, but their levels are very low or even negligible for the newborn. Most laboratory tests do not reveal an adequate sensitivity to detect these low concentrations. One have to remember that in case of any disturbing symptoms which may result from the use of these drugs, the only procedure is to discontinue breastfeeding immediately. The knowledge of these effects of particular groups of psychotropic drugs in breast-feeding mothers is essential for every practitioner. This knowledge should also be available not only to psychiatrists, but gynecologists and pediatricians as well. For this reason, it seems to be reasonable to summarize the results of previously published studies dealing with the topic.

Association between single nucleotide polymorphisms of MUTYH, hOGG1 and NEIL1 genes, and depression.

BACKGROUND: An elevated levels oxidative modified DNA bases and a decreased efficiency of oxidative DNA damage repair were found in patients with depression disorders, including recurrent type (rDD). The glycosylases are involved in base excision repair (BER), which eliminates oxidative DNA damage. Therefore, we genotyped the single nucleotide polymorphisms (SNPs) of genes encoding three glycosylases: hOGG1, MUTYH and NEIL1. METHODS: We selected three polymorphisms: c.977C > G - hOGG1 (rs1052133), c.972G > C - MUTYH (rs3219489) and c.*589G > C - NEIL1 (rs4462560). A total of 555 DNA samples (257 cases and 298 controls) were genotyped using TaqMan probes. RESULTS: The C/C genotype and allele C of the c.*589G > C decreased the risk of rDD occurrence, while the G/G genotype and allele G of the same SNP increased the risk. This polymorphism had a stronger association with early-onset depression (patients with first episode <35 years of age) than with late-onset depression (first episode ≥ 35 years of age). We did not find any significant differences in distribution of alleles and genotypes of other SNPs; however, the G/G genotype of the c.972G > C increased the risk of late-onset rDD. We also found that combined genotype C/C-C/C of c.977C > G and c.*589G > C significantly reduced the risk of rDD. LIMITATIONS: Limited sample size and ethnic homogeneity of the studied population. CONCLUSION: This is the first study to show that SNPs of genes involved in DNA repair, particularly in BER pathway, may modulate the risk of rDD. These results further support the hypothesis on the involvement of DNA repair mechanisms in pathogenesis of depression.