Publications (17) View all
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Article: A double-blind dose-finding pilot study of docosahexaenoic acid (DHA) for major depressive disorder.
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ABSTRACT: We examined the antidepressant efficacy and dose-response pattern of the n-3 docosahexaenoic acid (DHA). Thirty-five depressed adult outpatients (46% women; mean age 42+/-14 years) with a 17-item Hamilton-Depression Scale (HAM-D-17) score of >or=18 were randomized into one of three double-blind dosing arms for 12 weeks. Group A (n=14): 1 g/day of oral DHA; Group B (n=11): 2 g/day; and Group C (n=10): 4 g/day. We measured HAM-D-17 scores, plasma DHA, eicosapentaenoic acid (EPA), and n-6/n-3 ratio. Completer response rates (>or=50% decrease in HAM-D-17 score) were 83% for Group A, 40% for Group B, and 0% for Group C; Groups A and B had significant decreases in HAM-D-17 scores (p<0.05). For completers and intent-to-treat subjects, plasma DHA increased significantly (p<0.05), EPA had little change (p>0.05), and n-6/n-3 decreased significantly (p<0.05). DHA may be effective for depression at lower doses.European Neuropsychopharmacology 07/2008; 18(9):639-45. · 4.05 Impact Factor -
Article: Residual cognitive impairments in remitted depressed patients
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ABSTRACT: Depressive disorders are associated with various cognitive impairments. Studies on whether or not these impairments persist into the euthymic phase have shown conflicting results, due to differences in test versions and in study samples. In this paper, we aimed to compare the cognitive performance of remitted depressed patients with that of age- and gender-matched healthy volunteers across a wide range of cognitive domains. In two studies, we found few differences on neutral as well as emotional information processing tests. The findings indicate that remitted depressed patients who use antidepressant medication still show an increased recognition of facial expression of fear compared to healthy controls. Patients also performed worse on a test of recognition of abstract visual information from long-term memory. No other residual cognitive impairments were found. These results indicate that most of the cognitive impairments associated with depression resolve with recovery through medication, even when recovery is incomplete. Considering the finding that remitted depressed patients have higher levels of cognitive reactivity, future studies may investigate the possibility that these cognitive impairments have not resolved but have become latent, and may therefore easily be triggered by small changes in mood state. Depression and Anxiety 0:1–10, 2007. © 2007 Wiley-Liss, Inc.Depression and Anxiety 05/2008; 25(6):E27 - E36. · 4.18 Impact Factor -
Article: The effects of experimentally lowered serotonin function on emotional information processing and memory in remitted depressed patients.
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ABSTRACT: It has been well documented that acute tryptophan depletion (ATD) induces symptoms in remitted depressed patients treated with an SSRI. ATD also has effects on cognition, both in patients and in healthy samples. The exact nature of ATD-induced cognitive changes in depression remains unclear. It is also unclear whether cognitive effects can be induced through partial ('low-dose') depletion. The aim of this study is to investigate the differential effects of low-dose and high-dose ATD on emotional information processing and mood in remitted depressed patients. Eighteen remitted depressed patients received high-dose and low-dose ATD in a randomized, double-blind, within-subjects crossover design. Mood was assessed before and after administration of the depletion drink. Five hours after administration, patients conducted tests measuring neutral and emotional information processing. High-dose ATD increased depressive symptoms and induced a temporary depressive 'relapse' in half of the patients. High-dose ATD also decreased the recognition of fear and impaired learning and memory retrieval. The impaired learning occurred only in mood-responders. Low-dose ATD had no effects on mood but speeded the recognition of facial expressions of disgust. Accurate recognition of sad faces at baseline was associated with mood response to ATD. High-dose ATD leads to changes in memory and in the recognition of negative facial expressions in SSRI-treated remitted depressed patients. The effect of low-dose ATD on mood and cognition seems to be quite limited. Emotional information processing at baseline predicts mood-response to ATD.Journal of Psychopharmacology 03/2008; 22(6):653-62. · 3.04 Impact Factor -
Article: Residual cognitive impairments in remitted depressed patients.
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ABSTRACT: Depressive disorders are associated with various cognitive impairments. Studies on whether or not these impairments persist into the euthymic phase have shown conflicting results, due to differences in test versions and in study samples. In this paper, we aimed to compare the cognitive performance of remitted depressed patients with that of age- and gender-matched healthy volunteers across a wide range of cognitive domains. In two studies, we found few differences on neutral as well as emotional information processing tests. The findings indicate that remitted depressed patients who use antidepressant medication still show an increased recognition of facial expression of fear compared to healthy controls. Patients also performed worse on a test of recognition of abstract visual information from long-term memory. No other residual cognitive impairments were found. These results indicate that most of the cognitive impairments associated with depression resolve with recovery through medication, even when recovery is incomplete. Considering the finding that remitted depressed patients have higher levels of cognitive reactivity, future studies may investigate the possibility that these cognitive impairments have not resolved but have become latent, and may therefore easily be triggered by small changes in mood state.Depression and Anxiety 02/2008; 25(6):E27-36. · 4.18 Impact Factor -
Article: The effects of serotonin manipulations on emotional information processing and mood.
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ABSTRACT: Serotonin is implicated in both mood and cognition. It has recently been shown that antidepressant treatment has immediate effects on emotional information processing, which is much faster than any clinically significant effects. This review aims to investigate whether the effects on emotional information processing are reliable, and whether these effects are related to eventual clinical outcome. Treatment-efficiency may be greatly improved if early changes in emotional information processing are found to predict clinical outcome following antidepressant treatment. Review of studies investigating the short-term effects of serotonin manipulations (including medication) on the processing of emotional information, using PubMed and PsycInfo databases. Twenty-five studies were identified. Serotonin manipulations were found to affect attentional bias, facial emotion recognition, emotional memory, dysfunctional attitudes and decision making. The sequential link between changes in emotional processing and mood remains to be further investigated. The number of studies on serotonin manipulations and emotional information processing in currently depressed subjects is small. No studies yet have directly tested the link between emotional information processing and clinical outcome during the course of antidepressant treatment. Serotonin function is related to several aspects of emotional information processing, but it is unknown whether these changes predict or have any relationship with clinical outcome. Suggestions for future research are provided.Journal of Affective Disorders 12/2007; 103(1-3):43-62. · 3.52 Impact Factor
