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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    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • 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.
  • Journal of Affective Disorders 02/2015; 172:291-299.
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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: 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 Temperament characteristics have been suggested to be associated with mental health outcomes, especially depression, but the direction of the association is unknown. In this study, we tested whether temperament characteristics, as defined by the Buss–Plomin adulthood emotionality–activity–sociability (EAS) temperament model, predict depressive symptoms or whether depressive symptoms predict changes in temperament characteristics. Methods Participants comprised a population-based sample of 719 men and 1020 women from the Young Finns study aged 20–35 years at baseline in 1997 and who responded to repeated surveys of temperament and depressive symptoms in four study phases from 1997 to 2012. The associations were tested using linear regression models, repeated cross-lagged structural equation models, parallel latent growth curve models and two-dimensional continuous-time state space model (Exact Discrete Model). Results Both low sociability (β=−0.12, p<0.001) and high negative emotionality (β=0.34, p<0.001) predicted subsequent increased depressive symptoms, whereas earlier depressive symptoms predicted increased negative emotionality (β=0.50, p<0.001), but not low sociability. Limitations The depressive symptoms scale applied may not be used for measuring clinically recognized depression. Conclusions Our findings suggest that the direction of the association is from low sociability to depressive symptoms rather than the reverse, but the association between negative emotionality and depressive symptoms seems to be reciprocal.
    Journal of Affective Disorders 01/2015; 170:203–212.
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    ABSTRACT: Background Bipolar disorder (BD) is associated with an increase of psychiatric and physical comorbidities, but the effects of these disorders on general hospital-based mortality are unclear. Consequently, we investigated whether the burden of comorbidity and its relevance on hospital-based mortality differed between individuals with and without BD during a 12.5-year observation period in general hospital admissions. Methods During 1 January 2000 and 30 June 2012, 621 individuals with BD were admitted to three General Manchester Hospitals. All comorbidities with a prevalence ≥1% were compared with those of 6210 randomly selected and group-matched hospital controls of the same age and gender, regardless of priority of diagnoses. Comorbidities that increased the risk for hospital-based mortality (but not mortality outside of the hospitals) were identified using multivariate logistic regression analyses. Results Individuals with BD had a more severe course of disease than controls that was associated with a higher total number of in-hospital deaths. Individuals with BD compared to controls had a substantial higher burden of comorbidities, the most frequent comorbidities included asthma, type-2 diabetes mellitus (T2DM), and alcohol dependence. 18 other diseases with a surplus of diabetes related complications were also increased. Fourteen comorbidities contributed to the prediction of hospital-based mortality in univariate analyses. Risk factors for hospital-based mortality in multivariate analyses were ischemic stroke, pneumonia, bronchitis, chronic obstructive pulmonary disease, T2DM, and hypertension. The impact of T2DM on hospital-based mortality was higher in individuals with BD than in controls. Limitations The study design was not assigned to assess the type of BD, the current bipolar status, and if individuals with BD were treated with medication. It was neither possible to compare drug effects, nor to compare the adherence to treatment between samples. Conclusion In one of the largest samples of individuals with BD in general hospitals, the excess comorbity in individuals with BD compared to controls is in particular caused by asthma and T2DM. T2DM and its complications cause significant excess hospital-based mortality in individuals with BD.
    Journal of Affective Disorders 12/2014; 169(2014):170-178.
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    ABSTRACT: Background Brain abnormalities in fronto-temporal structures have been implicated in major depressive disorder (MDD). This study aims to identify their anatomical distribution and their relation to the time course of the disease. Methods A whole-brain voxel based morphometry analysis was conducted to assess gray and white matter alterations in 56 participants with a lifetime history of MDD, including currently depressed (cMDD) and remitted patients (rMDD), and 33 matched healthy controls (HC). Results Compared to HC, MDD participants showed increased white matter volume (WMV) in the uncinate fasciculus (UF) and decreased gray matter density (GMD) on the ventromedial prefrontal cortex (vmPFC). The increased WMV in UF was driven by both cMDD and rMDD groups and positively correlated with depression scores. The GMD decrease in the vmPFC resulted mainly from abnormalities in rMDD and was not correlated with depression scores. Finally, temporal UF and vmPFC white matter showed strong structural covariance suggesting functional interactions between these two brain regions. Limitations The retrospective and cross-sectional design of the study limits the generalizability of the results. Information concerning ongoing treatment did not allow the exploration of interactions between medication and observed abnormalities. The duration of the remission period could have influenced abnormalities in the subgroup of remitted patients. Conclusions Fronto-temporal alterations in MDD consist of alterations in a cortico-limbic network involving the ventromedial prefrontal cortex and temporal white matter tracts. State-like abnormalities in the UF survive remission and persist as trait-like abnormalities together with alteration in the vmPFC.
    Journal of Affective Disorders 11/2014;
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    ABSTRACT: Background: Mania and depression in bipolar disorder (BP) manifest two extremes of aberrant emotional, physiologic and behavioral arousal states despite similarities in treatment response and neurocognitive deficits. We used resting-state functional magnetic resonance imaging (rsfMRI) to explore the common and unique abnormal functional connectivity underlying acute manic or depressed state in BP. Methods: 18 patients with bipolar mania (BM), 10 patients with bipolar depression (BD) and 28 healthy controls underwent resting-state functional magnetic resonance imaging scanning. Left and right amygdala seed-to-voxel based functional connectivity were assessed and compared among the three groups. The relationships between aberrant functional connectivity and the severity of clinical symptoms, number of episodes, illness duration were investigated. Results: Compared to healthy controls, both BM and BD groups showed reduced functional connectivity between bilateral amygdala and inferior frontal gyrus (orbital), striatum, right lingual gyrus and posterior cerebellar lobe. Furthermore right amygdala-hippocampal connectivity was decreased in BD but increased in BM. No significant correlations were found between strength of abnormal functional connectivity and clinical characteristic in BD or BM. Limitations: No euthymic subjects were recruited, and the patients in current study were all on medication. Conclusions: The presence of substantial overlap in the pattern of disturbed connectivity between amygdala and frontal, striatal, lingual and cerebellar regions suggests mood state-independent dysconnectivity. The contrasting pattern of functional connectivity between right amygdala and hippocampus in BD and BM provides a novel lead to the probable mechanistic differences in these two extremes of mood states.
    Journal of Affective Disorders 10/2014;