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Depression: HELP
Articles by Gordon B. Parker
Based on 104 articles published since 2009
(Why 104 articles?)
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Between 2009 and 2019, G. B. Parker wrote the following 104 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Editorial The benefits of antidepressants: news or fake news? 2018

Parker, Gordon. ·Scientia professor,Black Dog Institute,School of Psychiatry,University of New South Wales,Australia. ·Br J Psychiatry · Pubmed #30027876.

ABSTRACT: Although antidepressant drugs are commonly effective, several meta-analyses of antidepressant drug trials undertaken decades after their introduction suggested that they were effectively acting as placebos. A recent meta-analysis concluded that they were effective. Both conclusions have been widely taken up by the media. This paper seeks to explain the disconnect.Declaration of interestNone.

2 Editorial Bringing melancholia out of the shadows. 2012

Parker, Gordon. · ·Braz J Psychiatry · Pubmed #23429807.

ABSTRACT: -- No abstract --

3 Editorial Issues for DSM-5: whither melancholia? The case for its classification as a distinct mood disorder. 2010

Parker, Gordon / Fink, Max / Shorter, Edward / Taylor, Michael Alan / Akiskal, Hagop / Berrios, German / Bolwig, Tom / Brown, Walter A / Carroll, Bernard / Healy, David / Klein, Donald F / Koukopoulos, Athanasios / Michels, Robert / Paris, Joel / Rubin, Robert T / Spitzer, Robert / Swartz, Conrad. · ·Am J Psychiatry · Pubmed #20595426.

ABSTRACT: -- No abstract --

4 Editorial Predicting onset of bipolar disorder from subsyndromal symptoms: a signal question? 2010

Parker, Gordon. · ·Br J Psychiatry · Pubmed #20118448.

ABSTRACT: This issue reports a community-based study quantifying the extent to which subthreshold hypomanic or depressive symptoms in childhood or adolescence predicted subsequent formal bipolar disorder status and mental health service attendance. This editorial emphasises the low predictive power of the signal and considers early intervention implications.

5 Editorial Blue is the new black. 2009

Parker, Gordon. · ·World J Biol Psychiatry · Pubmed #19629857.

ABSTRACT: -- No abstract --

6 Editorial Antidepressants on trial: how valid is the evidence? 2009

Parker, Gordon. · ·Br J Psychiatry · Pubmed #19118316.

ABSTRACT: A recent meta-analysis concluded that newer antidepressant drugs are equivalent to or no better than placebos, a conclusion at some variance with their commonly judged clinical effectiveness. The 'disconnect' between randomised controlled trials and clinical practice would benefit from dissection of contributing factors, and redressing limitations to current trial procedures.

7 Review Identifying and differentiating melancholic depression in a non-clinical sample. 2019

Parker, Gordon / Tavella, Gabriela / Hadzi-Pavlovic, Dusan. ·School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia. ·J Affect Disord · Pubmed #30245251.

ABSTRACT: BACKGROUND: Differentiating melancholic and non-melancholic depressive disorders and evaluating whether they differ categorically or dimensionally has had a lengthy history, but has not previously been evaluated in a non-clinical adolescent sample. METHODS: We studied a sample of 1579 senior high school students and evaluated the capacity of the Sydney Melancholia Prototype Index (SMPI) to differentiate melancholic from non-melancholic depression, both using a 'top down' strategy of imposing a pre-established cut-off score and a 'bottom up' strategy of employing latent class analyses. RESULTS: The two strategies respectively generated prevalence figures of 3.4% and 8.1% of the students having experienced a melancholic depressive episode and with the difference reflecting the LCA assigning some students who did not reach the pre-established cut-off score for the SMPI in the putative melancholic class. The principal latent class analysis failed to generate pristine melancholic and non-melancholic depressive classes, in that it also generated an 'intermediate' as well as a non-clinical depressive class. Both SMPI strategies identified similar symptoms-such as anhedonia and anergia-and several illness correlates that best differentiated those assigned melancholia status, and both strategies confirmed melancholia assignment being associated with factors indicative of more severe depressive disorders and of likely melancholic depression. LIMITATIONS: Data were assessed by self-report only, only lifetime depression was assessed, and no other depressive diagnostic validating measure was administered. CONCLUSIONS: The SMPI appears capable of identifying and differentiating melancholic from non-melancholic depression in a non-clinical adolescent sample.

8 Review Comparison of guidelines for the treatment of unipolar depression: a focus on pharmacotherapy and neurostimulation. 2018

Bayes, A J / Parker, G B. ·School of Psychiatry, UNSW, Sydney, NSW, Australia. · Black Dog Institute, Sydney, NSW, Australia. ·Acta Psychiatr Scand · Pubmed #29577229.

ABSTRACT: OBJECTIVE: To determine the level of agreement across a set of evidence-based guidelines for management of the unipolar depressive disorders and with a focus on physical treatments. METHOD: A literature search was undertaken using the terms 'depression', 'depressive' and 'guidelines', using PubMed, Cochrane Database of Systematic Reviews and the National Guideline Clearinghouse. Twelve national psychiatric or professional guideline-producing organizations were identified from the period 2007-2017, with guidelines qualitatively reviewed by two assessors. RESULTS: For major depressive disorder (MDD), there was general consensus to use an antidepressant (AD) in cases of greater severity, although disagreement on AD use in mild to moderate depression. There was some agreement on choice of AD class in first-line treatment recommendations, though great variability in second- and third-line management particularly in recommended augmentation and combined AD strategies. Electroconvulsive therapy was considered in all but one guideline, with other neurostimulation treatments being less consistently covered and with variable recommendations. Finally, there was low consistency in the management of dysthymia, persistent depressive disorder and treatment resistant depression. CONCLUSION: Our review identifies varying levels of consistency in guideline recommendations. Strategies to improve reliability in guideline formulation should also improve their validity.

9 Review Pancreatic Cancer and Depression: A Narrative Review. 2017

Parker, Gordon / Brotchie, Heather. ·School of Psychiatry, University of New South Wales; and Black Dog Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia. ·J Nerv Ment Dis · Pubmed #28557883.

ABSTRACT: Depression is a common concomitant of pancreatic cancer, and, because it often occurs before the cancer is diagnosed, its occurrence is likely to be intrinsic to the condition rather than a reaction to such a diagnosis. Because pancreatic cancer is associated with a very high mortality, its early detection is a key task. We therefore review relevant literature to determine whether the depression is prototypically distinctive and whether its identification might lead to earlier diagnosis of pancreatic cancer. We report on the epidemiology and prognosis of pancreatic cancer and on the prevalence, description, and possible mechanisms involved for the occurrence of any associated depressive state, before reviewing the comparative utility of depression in relation to other risk factors in aiding diagnosis. Published studies fail to identify any distinct depressive prototypic phenotype to depression associated with pancreatic cancer. Although it is a relatively common concomitant of pancreatic cancer, the utility of depression as a marker of the condition is not suggested from a key study evaluating its contribution in relation to other symptoms and risk factors.

10 Review Vitamin D and depression. 2017

Parker, Gordon B / Brotchie, Heather / Graham, Rebecca K. ·School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia. ·J Affect Disord · Pubmed #27750060.

ABSTRACT: OBJECTIVE: To examine whether vitamin D deficiency or insufficiency is associated with depression and whether vitamin D supplementation is an effective treatment for depression. METHOD: Empirical papers published in recent years were identified using three search engines and online databases - PubMed, Google Scholar and Cochrane Database. Specific search terms used were 'vitamin D', 'depression' and 'treatment' and articles were selected that examined the association between vitamin D deficiency/insufficiency and depression, vitamin D supplementation and Vitamin D as a treatment for depression. Our review weighted more recent studies (from 2011), although also considered earlier publications. RESULTS: Empirical studies appear to provide increasing evidence for an association between vitamin D insufficiency and depression, and for vitamin D supplementation and augmentation in those with clinical depression who are vitamin D deficient. Methodological limitations associated with many of the studies are detailed. LIMITATIONS: Articles were restricted to those in the English language while publication bias may have weighted studies with positive findings. CONCLUSIONS: There remains a need for empirical studies to move beyond cross-sectional designs to undertake more randomised controlled longitudinal trials so as to clarify the role of vitamin D in the pathogenesis of depression and its management, as well as to establish whether currently suggested associations are clinically significant and distinctive.

11 Review The properties and utility of the CORE measure of melancholia. 2017

Parker, Gordon / McCraw, Stacey. ·School of Psychiatry, the University of New South Wales, Sydney, NSW, Australia; The Black Dog Institute, Sydney, NSW, Australia. ·J Affect Disord · Pubmed #27721186.

ABSTRACT: BACKGROUND: The CORE measure was designed to assess a central feature of melancholia - signs of psychomotor disturbance (PMD) - and so provide an alternate non-symptom based measure of melancholia or of its probability. This review evaluates development and application studies undertaken over the last 25 years to consider how well it has met its original objectives. METHODS: All studies published using the CORE measure as either the only or an adjunctive measure of melancholia were obtained and are considered in this review. RESULTS: Findings suggest high reliability in quantifying CORE scores can be achieved and that it has construct validity as a measure of PMD. A number of application studies assessing socio-demographic factors, cognitive and motor impairment, dexamethasone suppression and thyrotropin-releasing hormone, response to psychotherapy and to electroconvulsive therapy support its validity as a measure of melancholia, while functional brain imaging studies suggest that the measure identifies regions of decreased connectivity. LIMITATIONS: Use of the CORE benefits from rater training and for subjects to be assessed at or near nadir of their depressive episode. There have been insufficient studies evaluating genetic factors, and the treatment response of CORE-defined melancholic patients to antidepressant drugs of differing classes. CONCLUSIONS: The CORE, either as a proxy or direct measure of melancholia, provides a strategy for assigning depressed subjects a diagnosis or melancholic or non-melancholic depression or for estimating the probability of melancholia.

12 Review Acute coronary syndrome and depression: A review of shared pathophysiological pathways. 2015

Granville Smith, Isabelle / Parker, Gordon / Rourke, Poppy / Cvejic, Erin / Vollmer-Conna, Uté. ·School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia. · School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia ute@unsw.edu.au. ·Aust N Z J Psychiatry · Pubmed #26219293.

ABSTRACT: OBJECTIVE: To examine the evidence for shared pathophysiological pathways in acute coronary syndrome and major depression and to conceptualise the dynamic interplay of biological systems and signalling pathways that link acute coronary syndrome and depression within a framework of neuro-visceral integration. METHODS: Relevant articles were sourced via a search of published literature from MEDLINE, EMBASE and PubMed using a variety of search terms relating to biological connections between acute coronary syndrome and depression. Additional articles from bibliographies of retrieved papers were assessed and included where relevant. RESULTS: Despite considerable research efforts, a clear understanding of the biological processes connecting acute coronary syndrome and depression has not been achieved. Shared abnormalities are evident across the immune, platelet/endothelial and autonomic/stress-response systems. From the available evidence, it seems unlikely that a single explanatory model could account for the complex interactions of biological pathways driving the pathophysiology of these disorders and their comorbidity. CONCLUSION: A broader conceptual framework of mind-body or neuro-visceral integration that can incorporate the existence of several causative scenarios may be more useful in directing future research and treatment approaches for acute coronary syndrome-associated depression.

13 Review Acute coronary syndrome-associated depression: the salience of a sickness response analogy? 2015

Granville Smith, Isabelle / Parker, Gordon / Cvejic, Erin / Vollmer-Conna, Uté. ·School of Psychiatry, University of New South Wales, Australia. Electronic address: i.granvillesmith@unsw.edu.au. · School of Psychiatry, University of New South Wales, Australia. Electronic address: g.parker@unsw.edu.au. · School of Psychiatry, University of New South Wales, Australia. Electronic address: e.cvejic@unsw.edu.au. · School of Psychiatry, University of New South Wales, Australia. Electronic address: ute@unsw.edu.au. ·Brain Behav Immun · Pubmed #25746589.

ABSTRACT: Depression emerging in conjunction with acute coronary syndrome (ACS) is thought to constitute a distinct high-risk phenotype with inflammatory determinants. This review critically examines the notion put forward in the literature that ACS-associated depression constitutes a meaningful subtype that is qualitatively different from depressive syndromes observed in psychiatric patients; and evaluates the salience of an analogy to the acute sickness response to infection or injury as an explanatory model. Specific features differentiating ACS-associated depression from other phenotypes are discussed, including differences in depression symptom profiles, timing of the depressive episode in relation to ACS, severity of the cardiac event, and associated immune activation. While an acute sickness response analogy offers a plausible conceptual framework, concrete evidence is lacking for inflammatory activity as the triggering mechanism. It is likely that ACS-associated depression encompasses several causative scenarios.

14 Review Melancholia and catatonia: disorders or specifiers? 2015

Parker, Gordon / McClure, Georgia / Paterson, Amelia. ·University of New South Wales, Randwick, Sydney, Australia, g.parker@unsw.edu.au. ·Curr Psychiatry Rep · Pubmed #25417594.

ABSTRACT: The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 defines mental disorders as syndromes and also introduced disorder "specifiers" with the aim of providing increased diagnostic specificity by defining more homogeneous subgroups of those with the disorder and who share certain features. While the majority of specifiers in DSM-5 define a specific aspect of the disorder such as age at onset or severity, some define syndromes that appear to meet the DSM-5 definition of a mental disorder. Specifically, melancholia is positioned in DSM-5 as a major depressive disorder (non-coded) specifier, while catatonia is listed as both a disorder secondary to a medical condition and as a specifier associated with other mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder. Despite decades of research supporting melancholia's status as a categorical "disorder" (a higher-order construct than a specifier), failure to provide convincing support for its disorder status has contributed to its current positioning in DSM-5. As DSM-5 has similar symptom criteria for major depression and for its melancholia specifier, research seeking to differentiate melancholic and non-melancholic depression according to DSM-5 criteria will have limited capacity to demonstrate "melancholia" as a separate disorder and risks melancholia continuing to be reified as a low-order specifier and thus clinical marginalization. There have been few advances in catatonia research in recent years with its positioning largely relying on opinion and clinical observation rather than on empirical studies.

15 Review Melancholia: definition and management. 2014

Parker, Gordon / Paterson, Amelia. ·School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, New South Wales, Australia. ·Curr Opin Psychiatry · Pubmed #24270479.

ABSTRACT: PURPOSE OF REVIEW: To overview historical ascriptions and the current nosological status of melancholia, before reporting diagnostic strategy, biological marker and treatment studies. RECENT FINDINGS: As melancholia has never been satisfactorily differentiated by reliance on symptoms, strategies that adopt a more prototypic approach and incorporate illness correlates in conjunction with symptoms appear to provide greater precision in differentiating melancholic and nonmelancholic depression. An early indicative biological marker--hyperactive Hypothalamic-Pituitary-Adrenal axis functioning--remains supported, whereas a number of other recently proposed candidate markers require clarification. Implications for treatment from recent clinical trials are also discussed. SUMMARY: We note that the Diagnostic and Statistical Manual 5 (DSM-5) definition of melancholia [as for Diagnostic and Statistical Manual IV (DSM-IV)] may be limited in its differentiating capacity and so compromise research into melancholia's causes and treatments. Clarifying melancholia's status, primary causes and differential treatment responsiveness awaits more precise definition of this depressive condition.

16 Review A case for reprising and redefining melancholia. 2013

Parker, Gordon. ·University of New South Wales, Sydney, Australia. g.parker@blackdog.org.au ·Can J Psychiatry · Pubmed #23547640.

ABSTRACT: OBJECTIVE: To identify limitations to severity-based classifications of depression, and to argue for positioning melancholia as a distinct melancholic subtype. METHOD: An overview of relevant literature was conducted. RESULTS: First, dimensionalizing depressive disorders effectively aggregates multiple heterogeneous depressive types and syndromes, and thus limits, if not prevents, identification of differential causes and treatments. Second, the melancholic depressive subtype can be defined with some relative precision, and that as it shows quite distinct differential treatment responsiveness, identification should be a clinical priority. CONCLUSION: Melancholia can be positioned and classified as a distinct depressive subtype.

17 Review Mobile mental health: review of the emerging field and proof of concept study. 2011

Harrison, Virginia / Proudfoot, Judith / Wee, Pang Ping / Parker, Gordon / Pavlovic, Dusan Hadzi / Manicavasagar, Vijaya. ·School of Psychiatry, University of New South Wales, Sydney, Australia. ·J Ment Health · Pubmed #21988230.

ABSTRACT: BACKGROUND: The ubiquitous nature of mobile phones and their increasing functionality make them an ideal medium for the delivery of large-scale public health information and interventions. While mobile phones have been used to this end in behavioural and physical health settings, their role in monitoring and managing mental health is in its infancy. AIMS: The purpose of this paper is (1) to provide an overview of the field of mobile mental health and (2) by way of illustration, describe an initial proof of concept study carried out to assess the potential utility and effectiveness of a newly developed mobile phone and web-based program in the management of mild-to-moderate stress, anxiety and depression. METHODS: Over 6 weeks, participants were given access to "myCompass": an interactive self-help program, which includes real-time self-monitoring with short message service prompts and brief online modules grounded in cognitive behavioural therapy. RESULTS: Preliminary analyses found that participants' symptoms of stress, anxiety, depression and overall psychological distress were significantly reduced after using myCompass. Improvements were also found in functional impairment and self-efficacy. CONCLUSIONS: These preliminary results support the feasibility of implementing mobile phone-based interventions with the potential of improving psychological wellbeing.

18 Review A consensus statement for safety monitoring guidelines of treatments for major depressive disorder. 2011

Dodd, Seetal / Malhi, Gin S / Tiller, John / Schweitzer, Isaac / Hickie, Ian / Khoo, Jon Paul / Bassett, Darryl L / Lyndon, Bill / Mitchell, Philip B / Parker, Gordon / Fitzgerald, Paul B / Udina, Marc / Singh, Ajeet / Moylan, Steven / Giorlando, Francesco / Doughty, Carolyn / Davey, Christopher G / Theodoros, Michael / Berk, Michael. ·School of Medicine, Deakin University, Geelong, Victoria, Australia. ·Aust N Z J Psychiatry · Pubmed #21888608.

ABSTRACT: OBJECTIVE: This paper aims to present an overview of screening and safety considerations for the treatment of clinical depressive disorders and make recommendations for safety monitoring. METHOD: Data were sourced by a literature search using MEDLINE and a manual search of scientific journals to identify relevant articles. Draft guidelines were prepared and serially revised in an iterative manner until all co-authors gave final approval of content. RESULTS: Screening and monitoring can detect medical causes of depression. Specific adverse effects associated with antidepressant treatments may be reduced or identified earlier by baseline screening and agent-specific monitoring after commencing treatment. CONCLUSION: The adoption of safety monitoring guidelines when treating clinical depression is likely to improve overall physical health status and treatment outcome. It is important to implement these guidelines in the routine management of clinical depression.

19 Review Does gender influence response to differing psychotherapies by those with unipolar depression? 2011

Parker, Gordon / Blanch, Bianca / Crawford, Joanna. ·School of Psychiatry, University of New South Wales, Sydney, Australia. g.parker@blackdog.org.au ·J Affect Disord · Pubmed #20580094.

ABSTRACT: BACKGROUND: There have been few studies that have specifically examined for any impact of gender on response to psychotherapy for those with depression. We therefore undertook a review and report findings. METHOD: A literature review was conducted by first seeking to identify studies via relevant search engines and then examining a number of secondary sources. RESULTS: There was no clear or consistent evidence to suggest that gender has any impact on response to psychotherapy. CONCLUSIONS: The review identified relatively few studies, so limiting our capacity to draw more than provisional conclusions. As some studies of response to antidepressant drugs have suggested differential gender response, such gender differences may then be expected to reflect biological influences rather than any general tendency for gender to influence response to therapy non-specifically.

20 Review Gender differences in depression. 2010

Parker, Gordon / Brotchie, Heather. ·School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, Australia. g.parker@unsw.edu.au ·Int Rev Psychiatry · Pubmed #21047157.

ABSTRACT: It is commonly suggested that a female preponderance in depression is universal and substantial. This review considers that proposition and explanatory factors. The view that depression rates are universally higher in women is challenged with exceptions to the proposition helping clarify candidate explanations. 'Real' and artefactual explanations for any such phenomenon are considered, and the contribution of sex role changes, social factors and biological determinants are overviewed. While artefactual factors make some contribution, it is concluded that there is a higher order biological factor (variably determined neuroticism, 'stress responsiveness' or 'limbic system hyperactivity') that principally contributes to the gender differentiation in some expressions of both depression and anxiety, and reflects the impact of gonadal steroid changes at puberty. Rather than conclude that 'anatomy is destiny' we favour a diathesis stress model, so accounting for differential epidemiological findings. Finally, the impact of gender on response to differing antidepressant therapies is considered briefly.

21 Article Measuring the consequences of a bipolar or unipolar mood disorder and the immediate and ongoing impacts. 2018

Parker, Gordon / McCraw, Stacey / Tavella, Gabriela / Hadzi-Pavlovic, Dusan. ·School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Prince of Wales Hospital, Randwick 2031, Sydney, Australia. ·Psychiatry Res · Pubmed #30145304.

ABSTRACT: Mood disorders may lead to major life consequences. This study builds on our preliminary examination of the impact of an extensive set of consequences and was undertaken in a larger clinical sample. Two hundred and forty four adults diagnosed with either unipolar depressive disorder or a bipolar disorder (type I or II) were administered an online survey of 60 items, listing potential consequences of having a mood disorder. Participants estimated the degree of impact (0-100) of each consequence on their life initially, and in the longer term. Items loading highly on the first 'general' factor of a bi-factor analysis were examined. Most items were affirmed by at least 75% of the sample. Significant group differences emerged on ten items. The bipolar group was 1.44-2.27 times more likely to experience difficulty with debts, education, speeding fines, increased risk of harm and delayed family planning. The unipolar group was 1.11-1.67 times more likely to experience social withdrawal, lowered life satisfaction, decreased overall wellbeing and ambition, and missed opportunities. Only one positive consequence (i.e. increased empathy) was identified. This extensive range of mood disorder consequences was highly endorsed by both BP and UP patients and with substantial immediate and ongoing impacts reported.

22 Article Personalised relaxation practice to improve sleep and functioning in patients with chronic fatigue syndrome and depression: study protocol for a randomised controlled trial. 2018

Macnamara, Claire L / Cvejic, Erin / Parker, Gordon B / Lloyd, Andrew R / Lee, Gina / Beilharz, Jessica E / Vollmer-Conna, Ute. ·Department of Human Behaviour (Psychiatry), UNSW, Level 1, 30 Botany Street, Sydney, NSW, 2052, Australia. · School of Public Health, University of Sydney, Sydney, Australia. · Black Dog Institute, Prince of Wales Hospital, Randwick, Sydney, Australia. · Viral Immunology Systems Program, The Kirby Institute, University of New South Wales, Sydney, Australia. · Department of Human Behaviour (Psychiatry), UNSW, Level 1, 30 Botany Street, Sydney, NSW, 2052, Australia. ute@unsw.edu.au. ·Trials · Pubmed #29996933.

ABSTRACT: BACKGROUND: Chronic fatigue syndrome (CFS) and major depressive disorder (MDD) are both debilitating but heterogeneous conditions sharing core features of fatigue, unrefreshing sleep, and impaired functioning. The aetiology of these conditions is not fully understood, and 'best-practice' treatments are only moderately effective in relieving symptoms. Unrecognised individual differences in the response to such treatments are likely to underlie poor treatment outcomes. METHODS/DESIGN: We are undertaking a two-group, parallel, randomised controlled trial (RCT) comparing the effects of a personalised relaxation intervention on sleep quality, daytime symptoms, and functioning in patients with CFS (n = 64) and MDD (n = 64). Following identification of the method that best enhances autonomic responding (such as heart rate variability), participants randomised to the active intervention will practise their recommended method nightly for 4 weeks. All participants will keep a sleep diary and monitor symptoms during the trial period, and they will complete two face-to-face assessments, one at baseline and one at 4 weeks, and a further online assessment to evaluate lasting effects of the intervention at 2 months. Assessments include self-report measures of sleep, wellbeing, and function and monitoring of autonomic responses at rest, in response to the relaxation method and during nocturnal sleep. Treatment outcomes will be analysed using linear mixed modelling. DISCUSSION: This is the first RCT examining the effects of a personalised relaxation intervention, pre-tested to maximise the autonomic relaxation response, in patients with unrefreshing sleep and fatigue attributed to CFS or MDD. Detailed monitoring of sleep quality and symptoms will enable sensitive detection of improvements in the core symptoms of these debilitating conditions. In addition, repeated monitoring of autonomic functioning can elucidate mechanisms underlying potential benefits. The findings have translational potential, informing novel, personalised symptom management techniques for these conditions, with the potential for better clinical outcomes. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry (ANZCTR), ACTRN12616001671459 . Registered on 5 December 2016.

23 Article White matter alterations in the internal capsule and psychomotor impairment in melancholic depression. 2018

Hyett, Matthew P / Perry, Alistair / Breakspear, Michael / Wen, Wei / Parker, Gordon B. ·School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. · Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. · Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia. · Metro North Mental Health Service, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. · Black Dog Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia. ·PLoS One · Pubmed #29672517.

ABSTRACT: Emerging evidence suggests that structural brain abnormalities may play a role in the pathophysiology of melancholic depression. We set out to test whether diffusion-derived estimates of white matter structure were disrupted in melancholia in regions underpinning psychomotor function. We hypothesized that those with melancholia (and evidencing impaired psychomotor function) would show disrupted white matter organization in internal capsule subdivisions. Diffusion magnetic resonance imaging (dMRI) data were acquired from 22 melancholic depressed, 23 non-melancholic depressed, and 29 healthy control participants. Voxel-wise fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) values were derived for anterior, posterior, and retrolenticular limbs of the internal capsule and compared between groups. Neuropsychological (reaction time) and psychomotor functioning were assessed and correlated against FA. Fractional anisotropy was distinctly increased, whilst RD was decreased, in the right anterior internal capsule in those with melancholia, compared to controls. The right anterior limb of the internal capsule correlated with clinical ratings of psychomotor disturbance, and reduced psychomotor speed was associated with increased FA values in the right retrolenticular limb in those with melancholia. Our findings highlight a distinct disturbance in the local white matter arrangement in specific regions of the internal capsule in melancholia, which in turn is associated with psychomotor dysfunction. This study clarifies the contribution of structural brain integrity to the phenomenology of melancholia, and may assist future efforts seeking to integrate neurobiological markers into depression subtyping.

24 Article Personality: Distraction or driver in the diagnosis of depression. 2018

Berk, Michael / Boyce, Philip / Hamilton, Amber / Morris, Grace / Outhred, Tim / Das, Pritha / Bassett, Darryl / Baune, Bernhard T / Lyndon, Bill / Mulder, Roger / Parker, Gordon / Singh, Ajeet B / Malhi, Gin S. ·School of Medicine, IMPACT Strategic Research Centre, Deakin University, Barwon Health, Geelong, VIC, Australia. · Orygen the National Centre of Excellence in Youth Mental Health and Orygen Research Centre, the Department of Psychiatry, Florey Institute for Neuroscience and Mental Health, the University of Melbourne, Melbourne, VIC, Australia. · Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, University of Sydney, Sydney, NSW, Australia. · Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia. · Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia. · CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia. · Private Practice in Psychiatry and Division of Psychiatry, The University of Western Australia, Crawley, WA, Australia. · Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia. · Mood Disorders Unit, Northside Clinic, Greenwich, NSW, Australia. · ECT Services Northside Group Hospitals, Greenwich, NSW, Australia. · Department of Psychological Medicine, University of Otago-Christchurch, Christchurch, New Zealand. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · Black Dog Institute, Sydney, NSW, Australia. ·Personal Ment Health · Pubmed #29457699.

ABSTRACT: -- No abstract --

25 Article Cognition in depression: Can we THINC-it better? 2018

Baune, Bernhard T / Malhi, Gin S / Morris, Grace / Outhred, Tim / Hamilton, Amber / Das, Pritha / Bassett, Darryl / Berk, Michael / Boyce, Philip / Lyndon, Bill / Mulder, Roger / Parker, Gordon / Singh, Ajeet B. ·Mood Assessment and Classification (MAC) Committee, Australia; Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia. Electronic address: gin.malhi@sydney.edu.au. · Mood Assessment and Classification (MAC) Committee, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, St Leonards, NSW, Australia; Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia; CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; Private Practice in Psychiatry and Division of Psychiatry, University of Western Australia, Perth, WA, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; School of Medicine, IMPACT Strategic Research Centre, Deakin University, Barwon Health, Melbourne, Victoria, Australia; Department of Psychiatry, Orygen Research Centre, and the Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; Discipline of Psychiatry, Sydney Medical School, Westmead Clinical School, University of Sydney, Sydney, NSW, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; Sydney Medical School Northern, University of Sydney, Sydney, NSW, Australia; Mood Disorders Unit, Northside Clinic, Greenwich, NSW, Australia; ECT Services Northside Group Hospitals, Greenwich, NSW, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; Department of Psychological Medicine, University of Otago - Christchurch, Christchurch, New Zealand. · Mood Assessment and Classification (MAC) Committee, Australia; Shool of Psychiatry, University of New South Wales, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia. · Mood Assessment and Classification (MAC) Committee, Australia; School of Medicine, IMPACT Strategic Research Centre, Deakin University, Barwon Health, Melbourne, Victoria, Australia. ·J Affect Disord · Pubmed #28869910.

ABSTRACT: BACKGROUND: Cognitive compromise is a common experience for patients with depression and other mood disorders. Depressed patients sustain deficits in working memory and attentional distortions in emotional processing and negative attention biases, which may contribute to maintaining their depressive state. METHODS: The Mood Assessment and Classification (MAC) Committee comprised academic psychiatrists with clinical expertise in the management of mood disorders. The independently convened committee met to discuss contentious aspects of mood disorders diagnosis and assessment with the express aim of informing clinical practice and future research. RESULTS: The Committee specifically identified cognition as an important aspect for clinicians to consider in the context of depression and mood disorders. This article highlights some of the barriers to assessment and proposes tools that have the potential to be implemented in clinical practice. LIMITATIONS: The conclusions drawn within this article are based on expert opinion. We have noted the limitations of the literature that informs this opinion. CONCLUSIONS: As cognitive ability has been closely linked to patients' ability to achieve functional recovery, it is imperative that clinicians are able to identify patients with cognitive deficits and are equipped with tools to conduct effective cognitive assessments. Examining cognitive factors may generate a deeper understanding of the pathogenesis of depression and mood disorders which can ultimately be used to inform treatment.

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