Journal of Affective Disorders (J AFFECT DISORDERS )

Publisher: International Society for Affective Disorders, Elsevier


The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, anxiety and panic. It is interdisciplinary and aims to bring together different approaches for a diverse readership. High quality papers will be accepted dealing with any aspect of affective disorders, including biochemistry, pharmacology, endocrinology, genetics, statistics, epidemiology, psychodynamics, classification, clinical studies and studies of all types of treatment.

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    Journal of affective disorders (Online)
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    • Publisher last contacted on 18/10/2013
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Research shows great individual variation in changes in posttraumatic stress symptoms (PTSSs) after major traumas of terrorist attacks, military combat, and natural disasters. Earlier studies have identified specific mental health trajectories both in children and adults. This study aimed, first, to identify potential PTSS-related trajectories by using latent class growth analyses among children in a three-wave assessment after the 2008/2009 War on Gaza, Palestine. Second, it analyzed how family- and child related factors (e.g., attachment relations, posttraumatic cognitions (PTCs), guilt, and emotion regulation) associate with the trajectory class membership.
    Journal of Affective Disorders 03/2015;
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    ABSTRACT: Abstract Background Major depression (MD) is associated with deficits in selective attention. Previous studies in adults with MD using event-related potentials (ERPs) reported abnormalities in the neurophysiological correlates of auditory selective attention. However, it is yet unclear whether these findings can be generalized to MD in adolescence. Thus, the aim of the present ERP study was to explore the neural mechanisms of auditory selective attention in adolescents with MD. Methods 24 male and female unmedicated adolescents with MD and 21 control subjects were included in the study. ERPs were collected during an auditory oddball paradigm. Results Depressive adolescents tended to show a longer N100 latency to target and non-target tones. Moreover, MD subjects showed a prolonged latency of the P200 component to targets. Across groups, longer P200 latency was associated with a decreased tendency of disinhibited behavior as assessed by a behavioral questionnaire. Limitations To be able to draw more precise conclusions about differences between the neural bases of selective attention in adolescents vs. adults with MD, future studies should include both age groups and apply the same experimental setting across all subjects. Conclusions The study provides strong support for abnormalities in the neurophysiolgical bases of selective attention in adolecents with MD at early stages of auditory information processing. Absent group differences in later ERP components reflecting voluntary attentional processes stand in contrast to results reported in adults with MD and may suggest that adolescents with MD possess mechanisms to compensate for abnormalities in the early stages of selective attention.
    Journal of Affective Disorders 02/2015; 172:445-452.
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    ABSTRACT: This study assessed the efficacy of the Falloon model of psychoeducational family intervention (PFI), originally developed for schizophrenia management and adapted to bipolar I disorder. The efficacy of the intervention was evaluated in terms of improvement of patients׳ social functioning and reduction of family burden.Methods This was a multicentre, real-world, controlled, outpatient trial carried out in 11 randomly recruited Italian mental health centres. Enroled patients and key-relatives were consecutively allocated either to receive PFI and Treatment As Usual (TAU) or to a waiting list receiving TAU alone. The efficacy of the intervention was evaluated in terms of improvement in patients׳ social functioning (primary outcome) and reduction of family burden (secondary outcome).ResultsOf the 137 recruited families, 70 were allocated to the experimental group and 67 to the control group. At the end of the intervention, significant improvements in patients׳ social functioning and in relatives׳ burden were found in the treated group compared to TAU. This effect of the intervention remained also after controlling for several confounding patient׳s socio-demographic and clinical factors. The experimental intervention had an impact also on other outcome measures, such as patients׳ clinical status and personal burden.LimitationsLack of an active control group.Conclusions The results of this study clearly show that the psychoeducational family intervention according to the Falloon model is effective in improving the social outcome of patients with bipolar I disorder.
    Journal of Affective Disorders 02/2015; 172:291-299.
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    ABSTRACT: Background: Suicidal ideation is an important indicator for subsequent suicidal behaviour, yet only a proportion of ideators transit from thought to action. This has led to interest surrounding the factors that distinguish ideators who attempt from non-attempters. The study aimed to identify distinct classes of life event categories amongst a sample of ideators and assess the ability of the classes to predict the risk of a suicide attempt. Methods: A subsample of ideators was extracted based on responses to the suicidality section of the Adult Psychiatric Morbidity Survey (N=7403). Fifteen stressful life events (SLEs) were categorised into six broad categories. Results: Using Latent Class Analysis (LCA), three distinct classes emerged; class 1 had a high probability of encountering interpersonal conflict, class 2 reported a low probability of experiencing any of the SLE categories, whereas class 3 had a high probability of endorsing multiple SLE categories. The Odd Ratios for attempted suicide were highest amongst members of Class 3. Limitations: The use of broad event categories as opposed to discrete life events may have led to an underestimation of the true exposure to SLEs. Conclusions: The findings suggest the experience of multiple types of SLEs may predict the risk of transitioning towards suicidal behavior for those individuals who have contemplated suicide. In application, this re-emphasizes the need for a routine appraisal of risk amongst this vulnerable group and an assessment of the variety of events which may signal the individuals who may be at immediate risk.
    Journal of Affective Disorders 01/2015;
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    ABSTRACT: Background: The psychological transmission of the noxious effects of a major trauma from one generation to the next remains unclear.The present study aims to identify possible mechanisms explaining this transmission among families of Holocaust Survivors (HS). We hypothesized that the high level of depressive and anxiety disorders (DAD) among HS impairs family systems, which results in damaging coping strategies of their children (CHS) yielding a higher level of DAD. Methods: 49 CHS completed the Resilience Scale for Adults, the Hopkins Symptom CheckList-25, the 13-Item Sense of Coherence (SOC) scale, and the Family Adaptability and Cohesion Scale. We test a mediation model with Family types as the predictor; coping strategies (i.e.Resilience or SOC) as the mediator; and DAD as the outcome variable. Results: Results confirm that the CHS' family types are more often damaged than in general population. Moreover, growing in a damaged family seems to impede development of coping strategies and, therefore, enhances the occurrence of DAD. Limitations: The present investigation is correlational and should be confirmed by other prospective investigations. Conclusions: At a theoretical level we propose a mechanism of transmission of the noxious effects of a major trauma from one generation to the next through family structure and coping strategies. At a clinical level, our results suggest to investigate the occurrence of trauma among parents of patients consulting for DAD and to reinforce their coping strategies.
    Journal of Affective Disorders 01/2015; 171:48-53.
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    ABSTRACT: Background Stress plays an important role in the onset and recurrence of bipolar disorder (BD). Resilience is the ability to cope with stress or adversity. Few studies have examined resilience in BD, and this study aimed to investigate the clinical correlates of resilience in euthymic patients with BD. Methods A total of 62 outpatients with BD type I, II, and not otherwise specified (NOS) who were in remission and 62 healthy individuals matched with the BD group in terms of age and sex were recruited. All participants completed the Connor–Davidson Resilience Scale and Barratt Impulsiveness Scale. A psychiatrist interviewed the subjects to assess clinical characteristics. Multiple linear regression analysis was used to determine factors associated with resilience. Results The BD group had significantly higher levels of impulsivity and lower levels of resilience compared with the control group. Degree of impulsivity, number of depressive episodes, Clinical Global Impression (CGI) scores, and length of education were significantly correlated with resilience. Attention impulsivity, non-planning impulsivity, and number of depressive episodes were associated with low levels of resilience, even when age, sex, length of education, and CGI scores were controlled. Limitations Because tertiary hospital patients were recruited, the generalizability of the findings is limited. Conclusions This study shows that low levels of resilience are related to high levels of impulsivity and to an increased number of depressive episodes in euthymic patients with BD. Given the reciprocal relationship between resilience and impulsivity, efforts to enhance resilience and reduce impulsivity may make important contributions to the treatment of patients with BD.
    Journal of Affective Disorders 01/2015; 170:172–177.
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    ABSTRACT: Background Depression later in life may have a more somatic presentation compared with depression earlier in life due to chronic somatic disease and increasing age. This study examines the influence of the presence of chronic somatic diseases and increasing age on symptom dimensions of late-life depression. Methods Baseline data of 429 depressed and non-depressed older persons (aged 60–93 years) in the Netherlands Study of Depression in Old Age were used, including symptom dimension scores as assessed with the mood, somatic and motivation subscales of the Inventory of Depressive Symptomatology-Self Report (IDS-SR). Linear regression was performed to investigate the effect of chronic somatic diseases and age on the IDS-SR subscale scores. Results In depressed older persons a higher somatic disease burden was associated with higher scores on the mood subscale (B=2.02, p=0.001), whereas higher age was associated with lower scores on the mood (B=−2.30, p<0.001) and motivation (B=−1.01, p=0.006) subscales. In depressed compared with non-depressed persons, a higher somatic disease burden showed no different association with higher scores on the somatic subscale (F(1,12)=9.2; p=0.003; partial η2=0.022). Limitations Because the IDS-SR subscales are specific for old age, it was not feasible to include persons aged <60 years to investigate differences between earlier and later life. Conclusions It seems that neither higher somatic disease burden nor higher age contributes to more severe somatic symptoms in late-life depression. In older old persons aged ≥70 years, late-life depression may not be adequately recognized because they may show less mood and motivational symptoms compared with younger old persons.
    Journal of Affective Disorders 01/2015; 170:196–202.
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    ABSTRACT: Background: The use of the family history method is recommended in family studies as a type of proxy interview of non-participating relatives. However, using different sources of information can result in bias as direct interviews may provide a higher likelihood of assigning diagnoses than family history reports. The aims of the present study were to: 1) compare diagnoses for threshold and subthreshold mood syndromes from interviews to those relying on information from relatives; 2) test the appropriateness of lowering the diagnostic threshold and combining multiple reports from the family history method to obtain comparable prevalence estimates to the interviews; 3) identify factors that influence the likelihood of agreement and reporting of disorders by informants. Methods: Within a family study, 1621 informant-index subject pairs were identified. DSM-5 diagnoses from direct interviews of index subjects were compared to those derived from family history information provided by their first-degree relatives. Results: 1) Inter-informant agreement was acceptable for mania, but low for all other mood syndromes. 2) Except for mania and subthreshold depression, the family history method provided significantly lower prevalence estimates. The gap improved for all other syndromes after lowering the threshold of the family history method. 3) Individuals who had a history of depression themselves were more likely to report depression in their relatives. Limitations: Low proportion of affected individuals for manic syndromes and lack of independence of data. Conclusions: The higher likelihood of reporting disorders by affected informants entails the risk of overestimation of the size of familial aggregation of depression.
    Journal of Affective Disorders 01/2015; 171:120-127.
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    ABSTRACT: Background Depression and headache are highly prevalent in clinical settings. The co-occurrence of headache may impact choice of antidepressants, healthcare utilisation, and outcomes in patients with depression. The current study aims to examine the cost-effectiveness and cost-utility of different antidepressants for treating patients with depression and comorbid headache disorders. Methods Adult patients prescribed with antidepressants for depression (n=96,501) were identified from the National Health Insurance Research Database in Taiwan. A cost-effectiveness and cost-utility analysis was conducted comparing selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs), and by the presence of comorbid headache disorders and other pain conditions. Results In this study, SSRIs dominated SNRIs in both cost-effectiveness and cost-utility. As revealed in the cost-effectiveness acceptability curves, TCAs were likely to have a cost-utility advantage compared to SSRIs and SNRIs in improving quality-adjusted life years (QALYs) for patients with comorbid headache; SSRIs remained as the most cost-effective option for patients with other pain conditions. Limitations Limitations include the use of proxy definition of remission as effectiveness measure and the adoption of utility values from previous studies. Conclusions Given a pre-determined willingness-to-pay level, TCAs can be considered as a cost-effective option to improve QALYs for depressed patients with headache disorders. Future research is needed to further clarify factors influencing the cost-effectiveness and cost-utility of pharmacological treatments in depressed patients with specific pain conditions.
    Journal of Affective Disorders 01/2015; 170:255–265.
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    ABSTRACT: Background Increases in suicide deaths by gassing, particularly carbon monoxide poisoning from burning barbecue charcoal, have occurred in many parts of East Asia and resulted in rises in overall suicide rates in some countries. Recent trends in gas poisoning suicides outside Asia have received little attention. Methods We analysed suicides by gassing in England and Wales (2001–2011) using national suicide mortality data enhanced by free text searching of information sent by coroners to the Office for National Statistics (ONS). We conducted specific searches for suicides involving barbecue charcoal gas, helium, and hydrogen sulphide. We analysed coroners׳ records of eight people who used helium as a method of suicide, identified from systematic searches of the records of four coroners. Results Gassing accounted for 5.2% of suicide deaths in England and Wales during 2001–2011. The number of gas suicides declined from 368 in 2001 to 174 by 2011 (a 53% reduction). The fall was due to a decline in deaths involving car exhaust and other sources of carbon monoxide. There was a rapid rise in deaths due to helium inhalation over the period, from five deaths in the two year period 2001–2002 to 89 in 2010–2011 (a 17-fold increase). There were small rises in deaths involving hydrogen sulphide (0 cases in 2001–2002 versus 14 cases in 2010–2011) and barbecue charcoal gas (1 case in 2001–2002 versus 11 cases in 2010–2011). Compared to individuals using other methods, those suicides adopting new types of gas for suicide were generally younger and from more affluent socioeconomic groups. The coroners׳ records of four of the eight individuals dying by helium inhalation whose records were reviewed showed evidence of Internet involvement in their choice of method. Limitations We were not able to identify the source of carbon monoxide (car exhaust or barbecue charcoal) for over 50% of cases. Conclusion Increases in helium inhalation as a method of suicide have partially offset recent decreases in suicide by the use of car exhaust. Public health measures are urgently needed to prevent a potential epidemic rise in the use of helium similar to the recent rises in charcoal burning suicides in East Asia.
    Journal of Affective Disorders 01/2015; 170:190–195.
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    ABSTRACT: Zinc is a trace element released from glutamatergic terminals, and modulates the pre- and postsynaptic areas, giving a diverse biological response. Zinc is a natural ligand that inhibits the N-methyl-d-aspartate (NMDA) receptor and regulates the excessive release of glutamate. Moreover, zinc exhibits an antidepressant-like profile, as demonstrated in both preclinical and clinical studies. Recent reports indicate that the GPR39 Zn2+-sensing receptor is an important target for zinc "transmission" (its activation modulates/induces diverse biochemical pathways involved in neuroprotection). Preclinical studies provide evidence that zinc deficiency leads to depressive-like behavior related to down-regulation of the GPR39 Zn2+-sensing receptor. Zinc binds to the GPR39 and triggers signals, leading to CRE-dependent gene transcription, resulting in increases in proteins such as brain-derived neurotrophic factor (BDNF), that plays a pivotal role in antidepressant action. Chronic administration of many antidepressants induces GPR39 up-regulation, which suggests that the Zn2+-sensing receptor may be considered as a new target for drug development in the field of depression.
    Journal of Affective Disorders 01/2015; 174:89-100.
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    ABSTRACT: Background The relationship between psychomotor agitation in unipolar depression and mood-switching from depression to manic, hypomanic and mixed states has been controversial. We investigated the future risk of initial mood-switching as a function of psychomotor agitation in unipolar depression. Methods We identified 189 participants diagnosed with major depressive disorder (MDD). We divided all patients with MDD into two categories (1) agitated patients (n=74), and (2) non-agitated patients (n=115). These groups were prospectively followed and compared by time to mood-switching. Kaplan–Meier survival curves, log-rank test for trend for survivor functions, and Cox proportional hazard ratio estimates for a multivariate model were conducted to examine the risk of mood-switching by psychomotor agitation. Results During follow-up, mood-switching occurred in 20.3% of the agitated patients and 7.0% of the non-agitated patients. In the Kaplan–Meier survival estimates for time to incidence of mood-switching with agitated or non-agitated patients, the cumulative probability of developing mood-switching for agitated patients was higher than those for non-agitated patients (log-rank test: χ2=7.148, df=1, p=0.008). Survival analysis was also performed using Cox proportional hazards regression within a multivariate model. The agitation remained significantly associated with incidence of mood-switching (HR=2.98, 95% CI: 1.18–7.51). Limitations We did not make a clear distinction between antidepressant-induced mood-switching and spontaneous switching. Conclusions The main finding demonstrated that MDD patients with agitation were nearly threefold as likely to experience mood-switching, suggesting that psychomotor agitation in MDD may be related to an indicator of bipolarity.
    Journal of Affective Disorders 01/2015; 170:185–189.
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    ABSTRACT: Background The Overall Anxiety Severity and Impairment Scale is a brief generic measure for anxiety that encompasses frequency and intensity as well as behavioral and functional aspects of anxiety. This study was conducted to elucidate aspects of reliability, validity, and interpretability, such as equivalence of factor loadings across non-clinical and clinical populations, convergence and discriminance of related variables, and performance of detecting diagnostic and medical status of anxiety disorders. Methods Non-clinical and clinical Japanese populations were taken from a panelist pool registered with an internet survey company (total n=2830; 619 panic disorder, 576 for social anxiety disorder, 645 for obsessive-compulsive disorder, a 619 for major depressive disorder, and 371 for non-disorder panelists). Conventional measures of anxiety, depression, mental health and measures for discriminant validity were administered in addition to OASIS. Results Exploratory and confirmatory factor analyses indicated good fit to data for the one-factor model of OASIS. Multi-group confirmatory factor analysis showed the equivalence of the factor loadings between those of non-clinical and clinical subsamples. The OASIS reliability was confirmed by internal consistency and test–retest coefficients. Receiver operating characteristic curve analyses showed that OASIS and conventional anxiety measures have fair performance for detecting diagnostic and medical status as anxiety disorders. Limitations Participants were limited to a Japanese population of people who had registered themselves at an internet survey company. Conclusions Along with useful information to interpret OASIS, the results suggest the reliability and validity of OASIS in Japanese populations. These results also suggest cross-cultural validity.
    Journal of Affective Disorders 01/2015; 170:217–224.
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    ABSTRACT: Background The course and predictors of women׳s mood following childbirth have informed clinically significant phenomena, such as postpartum depression (PPD), with some contradictory findings due to methodological limitations. It is important to further investigate mood during this unique period of time to inform assessment and improve interventions. Methods Recently delivered mothers (n=216) recruited from the maternity unit at a University hospital completed sociodemographic questions and the Daily Experiences Questionnaire (DEQ), a measure of Negative Affect (NA) and Positive Affect (PA), for 10 consecutive days. The Structured Clinical Interview for DSM-IV was administered to assess postpartum depression diagnosis. Results Growth curve modeling (GCM) techniques revealed average trends in mood following delivery. NA changed in a curvilinear fashion with a peak at day 5. PA declined rapidly during the days immediately following delivery and then stabilized. Women diagnosed with PPD experienced higher overall levels of NA and lower levels of PA from delivery to 10 days postpartum. Patterns of mood varied as a function of neuroticism and several well-established sociodemographic variables. Limitations Small sample size and relatively few ethnic minority participants may affect generalizability of the findings. Conclusions NA changed in a pattern consistent with the “peaking phenomenon”. Well-established risk factors of the blues had significant associations with mood from delivery to day 10. Increased understanding into the nature of NA and PA in the early postpartum, and its role in identifying women susceptible to experiencing PPD, can inform screening and therapeutic interventions for PPD.
    Journal of Affective Disorders 01/2015; 174:201-208.