Reading language of the eyes in female depression.

Aberrations in non-verbal social cognition have been reported to coincide with major depressive disorder. Yet little is known about the role of the eyes. To fill this gap, the present study explores whether and, if so, how reading language of the eyes is altered in depression. For this purpose, patients and person-by-person matched typically developing individuals were administered the Emotions in Masked Faces task and Reading the Mind in the Eyes Test, modified, both of which contained a comparable amount of visual information available. For achieving group homogeneity, we set a focus on females as major depressive disorder displays a gender-specific profile. The findings show that facial masks selectively affect inferring emotions: recognition of sadness and anger are more heavily compromised in major depressive disorder as compared with typically developing controls, whereas the recognition of fear, happiness, and neutral expressions remains unhindered. Disgust, the forgotten emotion of psychiatry, is the least recognizable emotion in both groups. On the Reading the Mind in the Eyes Test patients exhibit lower accuracy on positive expressions than their typically developing peers, but do not differ on negative items. In both depressive and typically developing individuals, the ability to recognize emotions behind a mask and performance on the Reading the Mind in the Eyes Test are linked to each other in processing speed, but not recognition accuracy. The outcome provides a blueprint for understanding the complexities of reading language of the eyes within and beyond the COVID-19 pandemic.

Sex-Based Impact of Creatine Supplementation on Depressive Symptoms, Brain Serotonin and SSRI Efficacy in an Animal Model of Treatment-Resistant Depression.

BACKGROUND: Rates of major depressive disorder (MDD) increase with living at altitude. In our model, rats housed at moderate altitude (in hypobaric hypoxia) exhibit increased depression-like behavior, altered brain serotonin and a lack of antidepressant response to most selective serotonin reuptake inhibitors (SSRIs). A forebrain deficit in the bioenergetic marker creatine is noted in people living at altitude or with MDD. METHODS: Rats housed at 4500 ft were given dietary creatine monohydrate (CRMH, 4% w/w, 5 weeks) vs. un-supplemented diet, and impact on depression-like behavior, brain bioenergetics, serotonin and SSRI efficacy assessed. RESULTS: CRMH significantly improved brain creatine in a sex-based manner. At altitude, CRMH increased serotonin levels in the female prefrontal cortex and striatum but reduced male striatal and hippocampal serotonin. Dietary CRMH was antidepressant in the forced swim test and anti-anhedonic in the sucrose preference test in only females at altitude, with motor behavior unchanged. CRMH improved fluoxetine efficacy (20 mg/kg) in only males at altitude: CRMH + SSRI significantly improved male striatal creatine and serotonin vs. CRMH alone. CONCLUSIONS: Dietary CRMH exhibits sex-based efficacy in resolving altitude-related deficits in brain biomarkers, depression-like behavior and SSRI efficacy, and may be effective clinically for SSRI-resistant depression at altitude. This is the first study to link CRMH treatment to improving brain serotonin.

Resting-state activity and functional connectivity of insula and postcentral gyrus related to psychological resilience in female depressed patients: A preliminary study.

BACKGROUND: Psychological resilience is a protective factor of depression. However, the neuroimaging characteristics of the relationship between psychological resilience and brain imaging in depression are not very clear. Our objectives were to explore the brain functional imaging characteristics of different levels of resilience in female patients with depression. METHODS: Resting-state functional magnetic resonance imaging (rs-fMRI) was performed on 58 female depressed patients. According to the resilience score, participants were divided into three groups: Low resilience (Low-res), Medium resilience (Med-res) and High resilience (High-res). We compared the differences in the amplitude of low-frequency fluctuations (ALFF) and functional connectivity (FC) among the three groups and correlated psychological resilience with ALFF and FC. RESULTS: According to ALFF, there was a higher activation in RI and RPG in the High-res compared with Med-res and Low-res, but no significant differences between Med-res and Low-res. The FC between the RPG and supramarginal gyrus (SG) in the High-res was significantly stronger than that in the Med-res and the Low-res, and the FC of the Med-res is stronger than that of the Low-res. Both ALFF and FC were positively correlated with the score of resilience. LIMITATIONS: The sample size of this study was relatively small and it lacked healthy controls. The results of this study could be considered preliminary. CONCLUSIONS: Among female patients with depression, patients with higher psychological resilience had higher resting state activation in the RI and RPG and had a stronger interaction between the RPG and the SG.

Sex-based changes in rat brain serotonin and behavior in a model of altitude-related vulnerability to treatment-resistant depression.

RATIONALE: Rates of depression and suicide increase with altitude. In our animal model, rats housed at moderate altitude vs. at sea level exhibit increased depressive symptoms in the forced swim test (FST) and lack of response to selective serotonin reuptake inhibitors (SSRIs). Depression and SSRI resistance are linked to disrupted serotonergic function, and hypobaric hypoxia may reduce the oxygen-dependent synthesis of serotonin. We therefore tested brain serotonin in rats housed at altitude. METHODS: Sprague-Dawley rats were housed at altitude (4,500 ft, 10,000 ft) vs. sea level for 7-36 days. Brain serotonin was measured by ELISA, or behavior evaluated in the FST, sucrose preference (SPT), or open-field tests (OFT). RESULTS: After 2 weeks at 4,500 ft or 10,000ft vs. sea level, serotonin levels decreased significantly at altitude in the female prefrontal cortex, striatum, hippocampus, and brainstem, but increased with altitude in the male hippocampus and brainstem. Female brain serotonin decreased from 7 to 36 days at 4,500 ft, but males did not vary. At 2 weeks and 24 days, females at altitude exhibit lower brain serotonin and increased depressive symptoms in the FST and SPT, with motor behavior unaltered. In males, serotonin, passive coping in the FST and OFT immobility increased with altitude at 2 weeks, but not at 24 days. Male SPT behavior did not change with altitude. CONCLUSIONS: Females may be more vulnerable to depressive symptoms at altitude, while males may be resilient. Chronic hypoxic stress at altitudes as low as 4,500 ft may cause a brain serotonin imbalance to worsen vulnerability to depression and SSRI resistance, and potentially worsen suicide risk.

Symptoms assessed in studies on perimenopausal depression: A narrative review.

The menopausal transition constitutes a phase of major biopsychosocial changes associated with an elevated risk for the development of depression. Perimenopausal depression is highly prevalent and usually characterized by core symptoms of a major depressive disorder combined with menopausal complaints such as vasomotor symptoms or other physical complaints. However, a distinct definition of the condition is lacking. The aim of this review is to portray the symptoms assessed in studies on perimenopausal depression in order to provide relevant information on the current understanding of this condition. A literature search was conducted using the databases PubMed, Cochrane Library, and PsycINFO. A total of 37 studies were included. Various assessment tools have been used to measure symptoms related to perimenopausal depression. Fifteen symptoms were identified. Depressed mood was assessed across all studies. Low energy or sleep disturbances, as acknowledged symptoms of a major depressive disorder, were surveyed in most studies. However, the assessment of menopausal complaints was rather heterogeneous. While vasomotor symptoms were often measured, other menopausal symptoms such as mood swings or pain were investigated less frequently. Sexual problems were only rarely assessed. Studies on perimenopausal depression regularly include the assessment of core symptoms of a major depressive disorder, but the assessment of menopausal complaints is inconsistent. While certain symptoms are commonly measured, others are not assessed. Such inconsistencies underline an ambiguous understanding of perimenopausal depression, which in turn affects the evaluation and treatment of the condition. Thus, the use of the existing guidelines on perimenopausal depression is recommended.

Shape Deformation in the Brainstem of Medication-Naïve Female Patients with Major Depressive Disorder.

OBJECTIVE: Although neuroimaging studies have shown volumetric reductions, such as the anterior cingulate, prefrontal cortices, and hippocampus in patients with major depressive disorder (MDD), few studies have investigated the volume of or shape alterations in the subcortical regions and the brainstem. We hypothesized that medication-naïve female adult patients with MDD might present with shape and volume alterations in the subcortical regions, including the brainstem, compared to healthy controls (HCs). METHODS: A total of 20 medication-naïve female patients with MDD and 21 age-matched female HCs, underwent 3D T1-weighted structural magnetic resonance scanning. We analyzed the volumes of each subcortical region and each brainstem region, including the midbrain, pons, and medulla oblongata. We also performed surface-based vertex analyses on the subcortical areas and brainstem. RESULTS: Female patients with MDD showed non-significant volumetric differences in the subcortical regions, whole brainstem, and each brainstem region compared to the HCs. However, in the surface-based vertex analyses, significant shape contractions were observed in both cerebellar peduncles located on the lateral wall of the posterior brainstem [threshold-free cluster enhancement, corrected for family-wise error (FWE) at p<0.05] in patients with MDD. CONCLUSION: We revealed shape alterations in the posterior brainstem in female patients with MDD.

Assessment of perimenopausal depression: A review.

BACKGROUND: Within the female life cycle, the perimenopause is considered as a critical period for the development of depression. Prevalence rates are particularly high during this phase. Perimenopausal depression is characterized by affective symptoms as well as menopause-specific somatic complaints. Currently, a variety of questionnaires are used to assess mood during the perimenopause. The aim of this review is to determine the instruments employed to assess perimenopausal depression. METHODS: We searched the databases PubMed, Cochrane Library and PsycINFO for human studies investigating perimenopausal depression, and subsequently screened for the assessment instruments used to measure mood and menopause. A total of 37 articles were included. RESULTS: Altogether, 14 different instruments were applied to assess mood during menopause. The CES-D was by far the most frequently used depression scale, appearing in 16 out of the 37 studies. The methods used to identify perimenopausal status and symptoms were inconsistent. LIMITATIONS: Due to lacking information about data and methodology, a selection bias is conceivable. Additionally, a publication bias is possible. Finally, there is inevitable subjectivity in the screening process of a systematic search. CONCLUSIONS: The assessment of depression in the menopausal transition is highly heterogeneous, reducing the overall comparability of study results. Furthermore, menopausal complaints are not sufficiently taken into account. Accordingly, the use of a menopause-specific depression scale is highly recommended in order to account for physical and mood-related symptoms in the menopausal transition.

Neural correlates of depression in women across the reproductive lifespan - An fMRI review.

INTRODUCTION: Depressive disorders in women emerge largely during transitions in their reproductive aging cycle, which can be attributed to internal endocrine possesses that affect emotion-associated brain circuits. A review was performed to outline the neural basis in depression during female puberty, premenstrual dysphoric disorder (PMDD), postpartum depression disorder (PPD) and perimenopausal depression disorder. METHODS: For this review, Web of science, Pubmed and PsychInfo databases were searched for functional brain imaging studies addressing reproductive cycle-related mood disorder. The results are summarized and discussed within a broader theoretical framework of major depression disorder (MDD) to determine how reproductive-sensitive phases contribute to affective symptoms and how they relate to the neurobiology of MDD. RESULTS: Neural activation patterns of all depressive disorders related to female reproductive cycle, except for puberty depression, differ from these observed in MDD. While the PMDD results are widely divergent, the activation patterns in PPD show general hypoactivation in all respects. LIMITATIONS: Systematic comparisons between the diverse depression disorders are impeded by the heterogeneous experimental protocols used on different samples, reproductive aging stages and depression types. CONCLUSION: Given that hormonal fluctuations strongly influence the development of a reproductive cycle-related depression, it is possible that the hormonal and neural patterns are indicative of distinct mood disorder with phase specific biotypes, that only show behavioral similarities to MDD. Understanding the similarities and differences in the neural functioning of female cycle-related mood disorders evaluated against MDD might help elucidate the role of neuroendocrine involvement in development of depression in women, and potentially facilitate the search for prevention and treatment approaches for women' reproductive-related depressions.

[Acupuncture for female depression: a randomized controlled trial].

OBJECTIVE: to observe the effect differences and safety between acupuncture and sham acupuncture for female depression on the basis of conventional western medicine therapy. METHODS: Forty-two patients with depression who met the criteria were randomly assigned into an observation group and a control group, 21 patients in each group. The basic treatment in the two groups was fluoxetine. The patients in the observation group were treated with acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4) and bilateral Shangqu (KI 17). Sham acupuncture was used at the above points in the control group. The treatment was given once a day on the first 3 days and once every 3 days after that, totally for 8 weeks. The scores of self-rating depression scale (SDS) and Montgomery Asberg depression rating scale (MADRS) were compared before and after 4-week and 8-week treatment in the two groups. The effects and adverse reactions were evaluated. RESULTS: After 4-week and 8-week treatment, the SDS and MADRS scores were significantly lower than those before treatment in the two groups (all P<0.05), and the scores in the observation group were lower than those in the control group (both P<0.05). The improvements of SDS and MADRS scores in the observation group before and after treatment were better than those in the control group (both P<0.05). The total effective rates of SDS, MADRS scores were 85.7% (18/21), 90.5% (19/21) in the observation group, which were better than 38.1% (8/21), 57.1% (12/21) in the control group (both P<0.05). The adverse reactions in the observation group were significantly lower than those in the control group (P<0.05). CONCLUSION: Acupuncture combined with fluoxetine are effective and safe for female depression.

Comparison of the Bupropion versus Aripiprazole Adjunctive Therapy for the Treatment of Female Depression : Post-Hoc Analyses from a Randomized Prospective Open-Label Multi-Center Study / 우울ㆍ조울병

OBJECTIVES: The purpose of this study was to examine effects of adjunctive aripiprazole versus bupropion, on depressive symptoms of female depression.METHODS: Sixty six female patients with major depressive disorders were enrolled from a six-week, randomized prospective open-label multi-center study. Participants were randomized to receive aripiprazole (2.5–10 mg/day) or bupropion (150–300 mg/day). Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale (HAM-D17), Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores, and Clinical Global Impression-Severity (CGI-S) were obtained at baseline and after one, two, four, and six weeks. Changes on individual items of HAM-D17 were assessed as well as on composite scales (anxiety, insomnia and drive), and on four core subscales that capture core depression symptoms.RESULTS: Overall, both treatments improved depressive symptoms, without causing serious adverse events. There were significant differences in the HAM-D17 total score (p=0.046) and CGI-S (p=0.004), between aripiprazole and bupropion augmentation, favoring aripiprazole over bupropion. Aripiprazole revealed significantly greater effect size in depressed mood (p=0.006), retardation (p=0.005), anxiety psychic (p=0.032), and general somatic symptom (p=0.01).CONCLUSION: While both treatments were effective, results of this study suggested that aripiprazole may be preferable, in treating general and core symptoms of female depression.

Acupuncture for female depression: a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>to observe the effect differences and safety between acupuncture and sham acupuncture for female depression on the basis of conventional western medicine therapy.</p><p><b>METHODS</b>Forty-two patients with depression who met the criteria were randomly assigned into an observation group and a control group, 21 patients in each group. The basic treatment in the two groups was fluoxetine. The patients in the observation group were treated with acupuncture at Zhongwan (CV 12), Xiawan (CV 10), Qihai (CV 6), Guanyuan (CV 4) and bilateral Shangqu (KI 17). Sham acupuncture was used at the above points in the control group. The treatment was given once a day on the first 3 days and once every 3 days after that, totally for 8 weeks. The scores of self-rating depression scale (SDS) and Montgomery Asberg depression rating scale (MADRS) were compared before and after 4-week and 8-week treatment in the two groups. The effects and adverse reactions were evaluated.</p><p><b>RESULTS</b>After 4-week and 8-week treatment, the SDS and MADRS scores were significantly lower than those before treatment in the two groups (all <0.05), and the scores in the observation group were lower than those in the control group (both <0.05). The improvements of SDS and MADRS scores in the observation group before and after treatment were better than those in the control group (both <0.05). The total effective rates of SDS, MADRS scores were 85.7% (18/21), 90.5% (19/21) in the observation group, which were better than 38.1% (8/21), 57.1% (12/21) in the control group (both <0.05). The adverse reactions in the observation group were significantly lower than those in the control group (<0.05).</p><p><b>CONCLUSION</b>Acupuncture combined with fluoxetine are effective and safe for female depression.</p>

Changes of sex hormone in female depression patients of kidney deficiency and liver depression and the intervention traditional Chinese medicine / 国际中医中药杂志

Objective To study the changes of sex hormone levels and the intervention of Chinese medicine female depression patients of kidney deficiency and liver depression type.Methods According to CCMD-3 and ICD-10 depressive episodes diagnostic criteria and the Chinese medicine dialectical criteria,120 patients from March 2007 to March 2011 were selccted and randomly recruited into a treatment group (n=60) and a control group (n=60),respectively.The treatment group was treated with traditional Chinese medicine with the functions of tonifying kidney and soothing liver,while the control group was treated with paroxetine.Both groups were treated for 12 weeks.Another healthy group of 60 cases was also setup.HAMD score and symptom score were used to observe the curative effects,the changes of E2,P,and PRL were observed in the patients and healthy persons.Results In the treatment group:E2 levels increased,PRL decreased,compared with the same group before treatment,the difference was statistically significant,[before treatment,E2=(103.6±28.24)pmol/L,after treatment,E2=(167.7± 30.46)pmol/L,P＜0.01; before treatment,PRL=(32.5 ±7.61)μg/L,after treatment,PRL=(15.3±5.92)μg/L,P＜0.01],Compared with the healthy group,the difference was not statistically significant,[healthy group E2=(176.3±33.63) pmol/L,PRL=(12.7±5.23) μg/L,P＞0.05) ].Although the E2 level of the control group after treatment was significantly elevated than the same group before the treatment [before treatment E2=(101.3±27.18)pmol/L,after treatment E2=(142.1 ±30.11)pmol/L,P＜0.01 ],but compared with healthy controls,the differences were statistically significant [healthy group E2=(176.3±33.63)pmol/L,P＜0.01].Conclusion The method of tonifying kidney and soothing liver has effective interventions on sex hormone secretion in depression patients and improvement in patients with depressive mood.