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Depression: HELP
Articles by Robert A. Schoevers
Based on 115 articles published since 2010
(Why 115 articles?)
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Between 2010 and 2020, R. Schoevers wrote the following 115 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5
1 Review Inflammatory markers and treatment outcome in treatment resistant depression: A systematic review. 2019

Yang, Chenghao / Wardenaar, Klaas J / Bosker, Fokko J / Li, Jie / Schoevers, Robert A. ·Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China; University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands. · University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands. · Tianjin Mental Health Institute, Tianjin Anding Hospital, Tianjin, China. · University Centre of Psychiatry, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands. Electronic address: r.a.schoevers@umcg.nl. ·J Affect Disord · Pubmed #31357161.

ABSTRACT: BACKGROUND: A substantial percentage of depressed patients do not respond satisfactorily to conventional antidepressant treatment. This treatment resistant depression (TRD) may be partly related to inflammatory processes in the central nervous system. Accordingly, peripheral inflammatory markers might serve to predict treatment response with novel but still experimental forms of antidepressant treatment. METHODS: A literature search on treatment of TRD and inflammatory markers was performed using the PubMed/Medline database on November 8th 2018, and 95 articles were retrieved initially, which were subsequently screened and selected only when the inclusion and exclusion criteria were met. RESULTS: Ten studies were recruited. In five studies higher baseline interleukin-6 (IL-6) or C-reactive protein (CRP)/high-sensitivity-CRP (hsCRP) in blood predicted better response to medication with anti-inflammatory characteristics, such as ketamine and infliximab. One study found that higher IL-6 predicted worse response to antidepressant treatment in patients with TRD. No evidence was found for the predictive value of other inflammatory markers (e.g., Tumor Necrosis Factor-α, Interferon-γ). LIMITATIONS: The number of available studies was limited; included studies showed considerable methodological variation and used different definitions for TRD. CONCLUSION: The inflammatory markers IL-6 and CRP/hsCRP could hold promise as markers for the prediction of treatment response in TRD. Clearly, this field of research is still far from mature but it could pave the way for novel and efficacious treatments for at least the inflammatory type of TRD with more well-designed studies and more convincing results.

2 Review [rTMS for treatment resistant depression - proposal for a treatment protocol]. 2018

van Belkum, S M / de Boer, M K / Taams, G-J / Schutter, D J L G / Aleman, A / Schoevers, R A / Haarman, B C M. · ·Tijdschr Psychiatr · Pubmed #30484569.

ABSTRACT: BACKGROUND: At present, the use of repetitive transcranial magnetic stimulation (rtms) for treatment-resistant depression is sufficiently substantiated to be applied in clinical practice. In the Netherlands, it will be reimbursed when offered in combination with cognitive behavior therapy.
AIM: Proposal for a clinical treatment protocol for rtms in The Netherlands.
METHOD: A study of the literature and a critical appraisal of available international guidelines for rtms.
RESULTS: rtms is a safe treatment for patients suffering from a moderate to severe depressive disorder that is relatively treatment-resistant. The duration of the effect is still unknown. It is advised to stimulate the left dorsolateral prefrontal cortex using an intensity of 120% of the resting motor threshold, with a frequency of 10 Hz and using 3000 pulses per session during a total of 20-30 sessions.
CONCLUSION: The proposed treatment protocol is favored based on the available evidence when rtms is used as a treatment aimed to acutely decrease the severity of depressive symptoms. It is further proposed to systematically collect technical and outcome data on treatment with rtms to further improve treatment with rtms in clinical practice.

3 Review Huntingtin gene repeat size variations affect risk of lifetime depression. 2017

Gardiner, Sarah L / van Belzen, Martine J / Boogaard, Merel W / van Roon-Mom, Willeke M C / Rozing, Maarten P / van Hemert, Albert M / Smit, Johannes H / Beekman, Aartjan T F / van Grootheest, Gerard / Schoevers, Robert A / Oude Voshaar, Richard C / Roos, Raymund A C / Comijs, Hannie C / Penninx, Brenda W J H / van der Mast, Roos C / Aziz, N Ahmad. ·Departments of Neurology, Leiden University Medical Centre, Leiden, The Netherlands. · Departments of Human Genetics, Leiden University Medical Centre, Leiden, The Netherlands. · Departments of Clinical Genetics, and Leiden University Medical Centre, Leiden, The Netherlands. · Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark. · Departments of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands. · Department of Psychiatry, and EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands. · Department of Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands. · Department of Psychiatry, Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium. · Departments of Neurology, Leiden University Medical Centre, Leiden, The Netherlands. N.A.Aziz@lumc.nl. · Department of Neurodegenerative Disease, UCL Huntington's Disease Centre, University College London Institute of Neurology, London, United Kingdom. N.A.Aziz@lumc.nl. ·Transl Psychiatry · Pubmed #29225330.

ABSTRACT: Huntington disease (HD) is a severe neuropsychiatric disorder caused by a cytosine-adenine-guanine (CAG) repeat expansion in the HTT gene. Although HD is frequently complicated by depression, it is still unknown to what extent common HTT CAG repeat size variations in the normal range could affect depression risk in the general population. Using binary logistic regression, we assessed the association between HTT CAG repeat size and depression risk in two well-characterized Dutch cohorts─the Netherlands Study of Depression and Anxiety and the Netherlands Study of Depression in Older Persons─including 2165 depressed and 1058 non-depressed persons. In both cohorts, separately as well as combined, there was a significant non-linear association between the risk of lifetime depression and HTT CAG repeat size in which both relatively short and relatively large alleles were associated with an increased risk of depression (β = -0.292 and β = 0.006 for the linear and the quadratic term, respectively; both P < 0.01 after adjustment for the effects of sex, age, and education level). The odds of lifetime depression were lowest in persons with a HTT CAG repeat size of 21 (odds ratio: 0.71, 95% confidence interval: 0.52 to 0.98) compared to the average odds in the total cohort. In conclusion, lifetime depression risk was higher with both relatively short and relatively large HTT CAG repeat sizes in the normal range. Our study provides important proof-of-principle that repeat polymorphisms can act as hitherto unappreciated but complex genetic modifiers of depression.

4 Review Using patient self-reports to study heterogeneity of treatment effects in major depressive disorder. 2017

Kessler, R C / van Loo, H M / Wardenaar, K J / Bossarte, R M / Brenner, L A / Ebert, D D / de Jonge, P / Nierenberg, A A / Rosellini, A J / Sampson, N A / Schoevers, R A / Wilcox, M A / Zaslavsky, A M. ·Department of Health Care Policy,Harvard Medical School,Boston, MA,USA. · Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE),University of Groningen, University Medical Center Groningen,Groningen,The Netherlands. · Department of Veterans Affairs,Office of Public Health,Washington, DC,USA. · VISN 19 Mental Illness Research Education and Clinical Center,University of Colorado,Anschutz Medical Campus,Anschulz, CO,USA. · Department of Psychiatry and Depression Clinical and Research Program,Harvard Medical School and Massachusetts General Hospital,Boston, MA,USA. · Department of Epidemiology,Janssen Research and Development,Titusville, NJ,USA. ·Epidemiol Psychiatr Sci · Pubmed #26810628.

ABSTRACT: BACKGROUNDS: Clinicians need guidance to address the heterogeneity of treatment responses of patients with major depressive disorder (MDD). While prediction schemes based on symptom clustering and biomarkers have so far not yielded results of sufficient strength to inform clinical decision-making, prediction schemes based on big data predictive analytic models might be more practically useful. METHOD: We review evidence suggesting that prediction equations based on symptoms and other easily-assessed clinical features found in previous research to predict MDD treatment outcomes might provide a foundation for developing predictive analytic clinical decision support models that could help clinicians select optimal (personalised) MDD treatments. These methods could also be useful in targeting patient subsamples for more expensive biomarker assessments. RESULTS: Approximately two dozen baseline variables obtained from medical records or patient reports have been found repeatedly in MDD treatment trials to predict overall treatment outcomes (i.e., intervention v. control) or differential treatment outcomes (i.e., intervention A v. intervention B). Similar evidence has been found in observational studies of MDD persistence-severity. However, no treatment studies have yet attempted to develop treatment outcome equations using the full set of these predictors. Promising preliminary empirical results coupled with recent developments in statistical methodology suggest that models could be developed to provide useful clinical decision support in personalised treatment selection. These tools could also provide a strong foundation to increase statistical power in focused studies of biomarkers and MDD heterogeneity of treatment response in subsequent controlled trials. CONCLUSIONS: Coordinated efforts are needed to develop a protocol for systematically collecting information about established predictors of heterogeneity of MDD treatment response in large observational treatment studies, applying and refining these models in subsequent pragmatic trials, carrying out pooled secondary analyses to extract the maximum amount of information from these coordinated studies, and using this information to focus future discovery efforts in the segment of the patient population in which continued uncertainty about treatment response exists.

5 Review Treatment of depression with low-strength transcranial pulsed electromagnetic fields: A mechanistic point of view. 2016

van Belkum, S M / Bosker, F J / Kortekaas, R / Beersma, D G M / Schoevers, R A. ·University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC 30, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: s.m.van.belkum@umcg.nl. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC 30, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC 30, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Neuroscience, P.O. Box 196, 9700 AD Groningen, The Netherlands. · Department Chronobiology, University of Groningen, Nijenborgh 7, 9747 AG Groningen, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC 30, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), CC 30, P.O. Box 30.001, 9700 RB Groningen, The Netherlands. ·Prog Neuropsychopharmacol Biol Psychiatry · Pubmed #27449361.

ABSTRACT: BACKGROUND: Mood disorders constitute a high burden for both patients and society. Notwithstanding the large arsenal of available treatment options, a considerable group of patients does not remit on current antidepressant treatment. There is an urgent need to develop alternative treatment strategies. Recently, low-strength transcranial pulsed electromagnetic field (tPEMF) stimulation has been purported as a promising strategy for such treatment-resistant depression (TRD). The mode of action of this new technique is however largely unknown. METHODS: We searched PubMed for literature reports on the effects of tPEMF and for information regarding its working mechanism and biological substrate. RESULTS: Most studies more or less connect with the major hypotheses of depression and concern the effects of tPEMF on brain metabolism, neuronal connectivity, brain plasticity, and the immune system. Relatively few studies paid attention to the possible chronobiologic effects of electromagnetic fields. LIMITATIONS: We reviewed the literature of a new and still developing field. Some of the reports involved translational studies, which inevitably limits the reach of the conclusions. CONCLUSION: Weak magnetic fields influence divergent neurobiological processes. The antidepressant effect of tPEMF may be specifically attributable to its effects on local brain activity and connectivity.

6 Review Oral ketamine for the treatment of pain and treatment-resistant depression†. 2016

Schoevers, Robert A / Chaves, Tharcila V / Balukova, Sonya M / aan het Rot, Marije / Kortekaas, Rudie. ·Robert A. Schoevers, MD PhD, Tharcila V. Chaves, MSc, Sonya M. Balukova, MSc, University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), Groningen; Marije aan het Rot, PhD, Department of Psychology and Research School of Behavioral and Cognitive Neurosciences; Rudie Kortekaas, PhD, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands r.a.schoevers@umcg.nl. · Robert A. Schoevers, MD PhD, Tharcila V. Chaves, MSc, Sonya M. Balukova, MSc, University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), Groningen; Marije aan het Rot, PhD, Department of Psychology and Research School of Behavioral and Cognitive Neurosciences; Rudie Kortekaas, PhD, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. ·Br J Psychiatry · Pubmed #26834167.

ABSTRACT: BACKGROUND: Recent studies with intravenous (i.v.) application of ketamine show remarkable but short-term success in patients with MDD. Studies in patients with chronic pain have used different ketamine applications for longer time periods. This experience may be relevant for psychiatric indications. AIMS: To review the literature about the dosing regimen, duration, effects and side-effects of oral, intravenous, intranasal and subcutaneous routes of administration of ketamine for treatment-resistant depression and pain. METHOD: Searches in PubMed with the terms 'oral ketamine', 'depression', 'chronic pain', 'neuropathic pain', 'intravenous ketamine', 'intranasal ketamine' and 'subcutaneous ketamine' yielded 88 articles. We reviewed all papers for information about dosing regimen, number of individuals who received ketamine, number of ketamine days per study, results and side-effects, as well as study quality. RESULTS: Overall, the methodological strength of studies investigating the antidepressant effects of ketamine was considered low, regardless of the route of administration. The doses for depression were in the lower range compared with studies that investigated analgesic use. Studies on pain suggested that oral ketamine may be acceptable for treatment-resistant depression in terms of tolerability and side-effects. CONCLUSIONS: Oral ketamine, given for longer time periods in the described doses, appears to be well tolerated, but few studies have systematically examined the longer-term negative consequences. The short- and longer-term depression outcomes as well as side-effects need to be studied with rigorous randomised controlled trials.

7 Review Daily symptom ratings for studying premenstrual dysphoric disorder: A review. 2016

Bosman, Renske C / Jung, Sophie E / Miloserdov, Kristina / Schoevers, Robert A / aan het Rot, Marije. ·Department of Psychology, University of Groningen, The Netherlands. Electronic address: r.bosman@ggzingeest.nl. · Department of Psychology, University of Groningen, The Netherlands. · School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands. · University of Groningen, University Medical Centre Groningen, Department of Psychiatry, Groningen, The Netherlands. · Department of Psychology, University of Groningen, The Netherlands; School of Behavioural and Cognitive Neurosciences, University of Groningen, The Netherlands. ·J Affect Disord · Pubmed #26406968.

ABSTRACT: BACKGROUND: To review how daily symptom ratings have been used in research into premenstrual dysphoric disorder (PMDD), and to discuss opportunities for the future. METHODS: PsycINFO and Medline were systematically searched, resulting in the inclusion of 75 studies in which (1) participants met the diagnostic criteria for late luteal phase dysphoric disorder (LLPDD) or PMDD and (2) diaries were used to study LLPDD/PMDD. RESULTS: To date, diaries have been used to gain insight into the aetiology and phenomenology of PMDD, to examine associated biological factors, and to assess treatment efficacy. We found low consistency among the diaries used, and often only part of the menstrual cycle was analysed instead of the whole menstrual cycle. We also observed that there was substantial variability in diagnostic procedures and criteria. LIMITATIONS: This review excluded diary studies conducted in women with premenstrual syndrome, women seeking help for premenstrual complaints without a clear diagnosis, and women without premenstrual complaints. CONCLUSIONS: Prospective daily ratings of symptoms and related variables provide a valuable and important tool in the study of PMDD. This paper addresses some options for improving the use of diaries and proposes the use of experience sampling and ecological momentary assessment to investigate within-person variability in symptoms in more detail.

8 Review Biomarker approaches in major depressive disorder evaluated in the context of current hypotheses. 2015

Jentsch, Mike C / Van Buel, Erin M / Bosker, Fokko J / Gladkevich, Anatoliy V / Klein, Hans C / Oude Voshaar, Richard C / Ruhé, Eric G / Eisel, Uli L M / Schoevers, Robert A. ·University of Groningen, University Medical Centre of Groningen, University Centre of Psychiatry, Groningen, The Netherlands. ·Biomark Med · Pubmed #25731213.

ABSTRACT: Major depressive disorder is a heterogeneous disorder, mostly diagnosed on the basis of symptomatic criteria alone. It would be of great help when specific biomarkers for various subtypes and symptom clusters of depression become available to assist in diagnosis and subtyping of depression, and to enable monitoring and prognosis of treatment response. However, currently known biomarkers do not reach sufficient sensitivity and specificity, and often the relation to underlying pathophysiology is unclear. In this review, we evaluate various biomarker approaches in terms of scientific merit and clinical applicability. Finally, we discuss how combined biomarker approaches in both preclinical and clinical studies can help to make the connection between the clinical manifestations of depression and the underlying pathophysiology.

9 Review Influence of personality on the outcome of treatment in depression: systematic review and meta-analysis. 2014

Newton-Howes, Giles / Tyrer, Peter / Johnson, Tony / Mulder, Roger / Kool, Simone / Dekker, Jack / Schoevers, Robert. · ·J Pers Disord · Pubmed #24256103.

ABSTRACT: There continues to be debate about the influence of personality disorder on the outcome of depressive disorders and is relative interactions with treatment. To determine whether personality disorder, both generically and in terms of individual clusters, leads to a worse outcome in patients with depressive disorders and whether this is influenced by type of treatment, a systematic electronic search of MEDLINE, CINAHL, and PsycINFO from 1966, 1982, and 1882, respectively, until February 2007 was undertaken. The keyword terms depression, mental illness, and personality disorder were used. All references were reviewed and personal correspondence was undertaken. Only English language papers were considered. Any English language paper studying a depressed adult population was considered for inclusion. Studies needed to clearly define depression and personality disorder using peer-reviewed instruments or International Classification of Disease/Diagnostic Statistical Manual criteria. Outcome assessment at greater than 3 weeks was necessary. Final inclusion papers were agreed on by consensus by at least two reviewers. All data were extracted using predetermined criteria for depression by at least two reviewers in parallel. Disagreement was settled by consensus. Complex data extraction was confirmed within the study group. Data were synthesized using log odds ratios in the Cochrane RevMan 5 program. The finding of comorbid personality disorder and depression was associated with a more than double the odds of a poor outcome for depression compared with those with no personality disorder (OR 2.16, CI 1.83-2.56). This effect was not ameliorated by the treatment modality used for the depressive disorder. This finding led to the conclusion that personality disorder has a negative impact on the outcome of depression. This finding is important in considering prognosis in depressive disorders.

10 Review Data-driven subtypes of major depressive disorder: a systematic review. 2012

van Loo, Hanna M / de Jonge, Peter / Romeijn, Jan-Willem / Kessler, Ronald C / Schoevers, Robert A. ·Department of Psychiatry, University Medical Center Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands. ·BMC Med · Pubmed #23210727.

ABSTRACT: BACKGROUND: According to current classification systems, patients with major depressive disorder (MDD) may have very different combinations of symptoms. This symptomatic diversity hinders the progress of research into the causal mechanisms and treatment allocation. Theoretically founded subtypes of depression such as atypical, psychotic, and melancholic depression have limited clinical applicability. Data-driven analyses of symptom dimensions or subtypes of depression are scarce. In this systematic review, we examine the evidence for the existence of data-driven symptomatic subtypes of depression. METHODS: We undertook a systematic literature search of MEDLINE, PsycINFO and Embase in May 2012. We included studies analyzing the depression criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) of adults with MDD in latent variable analyses. RESULTS: In total, 1176 articles were retrieved, of which 20 satisfied the inclusion criteria. These reports described a total of 34 latent variable analyses: 6 confirmatory factor analyses, 6 exploratory factor analyses, 12 principal component analyses, and 10 latent class analyses. The latent class techniques distinguished 2 to 5 classes, which mainly reflected subgroups with different overall severity: 62 of 71 significant differences on symptom level were congruent with a latent class solution reflecting severity. The latent class techniques did not consistently identify specific symptom clusters. Latent factor techniques mostly found a factor explaining the variance in the symptoms depressed mood and interest loss (11 of 13 analyses), often complemented by psychomotor retardation or fatigue (8 of 11 analyses). However, differences in found factors and classes were substantial. CONCLUSIONS: The studies performed to date do not provide conclusive evidence for the existence of depressive symptom dimensions or symptomatic subtypes. The wide diversity of identified factors and classes might result either from the absence of patterns to be found, or from the theoretical and modeling choices preceding analysis.

11 Review [Staging and profiling of unipolar depression]. 2012

Peeters, F P M L / Ruhé, H G / Beekman, A T F / Spijker, J / Schoevers, R / Zitman, F / Schene, A. · ·Tijdschr Psychiatr · Pubmed #23138623.

ABSTRACT: BACKGROUND: Not only is the heterogeneous concept of depression too comprehensive, it is also insufficiently differentiated. This serves as a barrier to scientific research and obscures the symptoms that should indicate what treatment is required. AIM: To describe an accurate model for staging and profiling depression. METHOD: We placed depressive disorders in the context of the entire course of the disorder and we regarded the course as a continuum of psychopathology. RESULTS: First of all we distinguish five stages: (1) the prodromal phase, (2) the first depressive episode, (3) residual symptoms following an episode, (4) the relapse episode and (5) the chronic and/or treatment-resistant depression. The higher the stage, the greater the need for complex and specialised treatment. As characteristics for profiling we distinguish (a) aetiological and pathophysiological variables and (b) clinical factors. The latter are the ones that mainly influence treatment from stage 2 onwards. CONCLUSION: In our article we give a tentative overview of possible characteristics for profiling. At the moment the clinical factors are the ones used most for assessment. Current research into the value of aetiological characteristics for profiling will increase the applicability of a staging and profiling model.

12 Review Mood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies. 2012

aan het Rot, Marije / Hogenelst, Koen / Schoevers, Robert A. ·Department of Psychology, University of Groningen, Netherlands. m.aan.het.rot@rug.nl ·Clin Psychol Rev · Pubmed #22721999.

ABSTRACT: In the past two decades, the study of mood disorder patients using experience sampling methods (ESM) and ecological momentary assessment (EMA) has yielded important findings. In patients with major depressive disorder (MDD), the dynamics of their everyday mood have been associated with various aspects of their lives. To some degree similar studies have been conducted in patients with bipolar disorder (BD). In this paper we present the results of a systematic review of all ESM/EMA studies in MDD and BD to date. We focus not only on the correlates of patients' everyday mood but also on the impact on treatment, residual symptoms in remitted patients, on findings in pediatric populations, on MDD/BD specificity, and on links with neuroscience. After reviewing these six topics, we highlight the benefits of ESM/EMA for researchers, clinicians, and patients, and offer suggestions for future studies.

13 Review A systematic review of instruments to measure depressive symptoms in patients with schizophrenia. 2012

Lako, Irene M / Bruggeman, R / Knegtering, H / Wiersma, D / Schoevers, R A / Slooff, C J / Taxis, K. ·Rob Giel Research Center (RGOc), Department of Psychiatry (UCP), University Medical Center Groningen (UMCG), University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. i.m.lako@umcg.nl ·J Affect Disord · Pubmed #22099566.

ABSTRACT: BACKGROUND: Depressive symptoms require accurate recognition and monitoring in clinical practice of patients with schizophrenia. Depression instruments developed for use in depressed patients may not discriminate depressive symptoms from negative psychotic symptoms. OBJECTIVE: We reviewed depression instruments on their reliability and validity in patients with schizophrenia. METHODOLOGY: A systematic literature search was carried out in three electronic databases. Psychometric properties were extracted for those instruments of which reliability, divergent, concurrent and predictive validity were reported in one or more publications. RESULTS: Forty-eight publications described the reliability and validity of six depression instruments in patients with schizophrenia. The only self-report was the Beck Depression Inventory (BDI). The Brief Psychiatric Rating Scale-Depression subscale (BPRS-D), Positive and Negative Syndrome Scale-Depression subscale (PANSS-D), Hamilton Rating Scale for Depression (HAMD), Montgomery Asberg Depression Rating Scale (MADRS) and Calgary Depression Scale for Schizophrenia (CDSS) were clinician rated. All instruments were reliable for the measurement of depressive symptoms in patients with schizophrenia. The CDSS most accurately differentiated depressive symptoms from other symptoms of schizophrenia (divergent validity), correlated well with other depression instruments (concurrent validity), and was least likely to miss cases of depression or misdiagnose depression (predictive validity). CONCLUSIONS: We would recommend to use the CDSS for the measurement of depressive symptoms in research and in daily clinical practice of patients with schizophrenia. A valid self-report instrument is to be developed for the use in clinical practice.

14 Clinical Trial Combined sleep deprivation and light therapy: Clinical treatment outcomes in patients with complex unipolar and bipolar depression. 2019

Sikkens, D / Riemersma-Van der Lek, R F / Meesters, Y / Schoevers, R A / Haarman, B C M. ·University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC44,P.O. Box 30.001, 9700 RB Groningen, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, CC44,P.O. Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: b.c.m.haarman@rug.nl. ·J Affect Disord · Pubmed #30611915.

ABSTRACT: BACKGROUND: The combination of sleep deprivation and light therapy, called combined chronotherapy, may yield positive short- and long-term results, even in patients with treatment resistant depression (TRD). The implementation of combined chronotherapy in daily clinical practice is rare. This study describes the implementation and the effectiveness in a clinical setting. METHODS: Twenty six depressed patients with unipolar or bipolar depression received combined chronotherapy consisting of three nights of sleep deprivation with alternating recovery nights, light therapy, and continuation of antidepressant medication. Inventory of Depressive Symptoms C (IDS-C) scores were determined before chronotherapy and at week 1, 2, and 4. Paired t-tests were used to compare the IDS-C scores over time. RESULTS: The mean pre-treatment IDS-C score was 39.3 ± 9.6, the mean score in week 2 was 28.4 ± 10.2, and 28.6 ± 14.0 in week 4. A subsample of patients with psychiatric co-morbidities showed a reduction in depression severity from a mean score of 42.9 ± 11.0 to a mean score of 34.9 ± 13.0 after 4 weeks. The overall response rate was 34.6%, the remission rate 19.2%. LIMITATIONS: This open label case series has a relative small sample size and no control group CONCLUSION: In a clinical setting patients with major depressive disorder or bipolar disorder benefited significantly from combined chronotherapy. This chronotherapeutic intervention appears to have a rapid effect that lasts for at least several weeks, even in patients with psychiatric comorbidity or TRD. Indicating that chronotherapy can be a valuable treatment addition for depressed patients.

15 Article Gender Differences in Developing Biomarker-Based Major Depressive Disorder Diagnostics. 2020

Jentsch, Mike C / Burger, Huibert / Meddens, Marjolein B M / Beijers, Lian / van den Heuvel, Edwin R / Meddens, Marcus J M / Schoevers, Robert A. ·Brainscan BV, 7418 AH Deventer, The Netherlands. · Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Department of General Practice, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Department of Psychiatry, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands. · Department of Mathematics and Computer Science, Eindhoven University of Technology, 5612 AZ Eindhoven, The Netherlands. · Research School of Behavioral and Cognitive Neurosciences, University of Groningen, 9713 AV Groningen, The Netherlands. ·Int J Mol Sci · Pubmed #32344909.

ABSTRACT: The identification of biomarkers associated with major depressive disorder (MDD) holds great promise to develop an objective laboratory test. However, current biomarkers lack discriminative power due to the complex biological background, and not much is known about the influence of potential modifiers such as gender. We first performed a cross-sectional study on the discriminative power of biomarkers for MDD by investigating gender differences in biomarker levels. Out of 28 biomarkers, 21 biomarkers were significantly different between genders. Second, a novel statistical approach was applied to investigate the effect of gender on MDD disease classification using a panel of biomarkers. Eleven biomarkers were identified in men and eight in women, three of which were active in both genders. Gender stratification caused a (non-significant) increase of Area Under Curve (AUC) for men (AUC = 0.806) and women (AUC = 0.807) compared to non-stratification (AUC = 0.739). In conclusion, we have shown that there are differences in biomarker levels between men and women which may impact accurate disease classification of MDD when gender is not taken into account.

16 Article Depression profilers and immuno-metabolic dysregulation: Longitudinal results from the NESDA study. 2020

Lamers, Femke / Milaneschi, Yuri / Vinkers, Christiaan H / Schoevers, Robert A / Giltay, Erik J / Penninx, Brenda W J H. ·Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands. Electronic address: f.lamers@amsterdamumc.nl. · Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands. · Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, The Netherlands; Amsterdam UMC, Department of Anatomy and Neurosiences, Amsterdam Neuroscience, Amsterdam, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands. · Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. ·Brain Behav Immun · Pubmed #32272220.

ABSTRACT: BACKGROUND: Major depressive disorder (MDD) is linked to higher cardio-metabolic comorbidity that may in part be due to the low-grade inflammation and poorer metabolic health observed in MDD. Heterogeneity of MDD is however large, and immune-inflammatory and metabolic dysregulation is present in only part of the MDD cases. We examined the associations of four depression dimensional profilers (atypical energy-related symptom dimension, melancholic symptom dimension, childhood trauma severity, and anxious distress symptom dimension) with immuno-metabolic outcomes, both cross-sectionally and longitudinally. METHODS: Three waves covering a 6-year follow-up (>7000 observations) of the Netherlands Study of Depression and Anxiety (NESDA) were used. Depression profilers were based on the Inventory of Depressive Symptomatology, the Beck Anxiety Inventory, and the Childhood Trauma index. An inflammatory index (based on IL-6 and CRP), a metabolic syndrome index (based on the five metabolic syndrome components), and a combination of these two indices were constructed. Mixed models were used for cross-sectional and longitudinal models, controlling for covariates. RESULTS: Of the four depression profilers, only the atypical, energy-related symptom dimension showed robust associations with higher scores on the inflammatory, metabolic syndrome and combined inflammatory-metabolic indexes cross-sectionally, as well as at follow-up. The melancholic symptom dimension was associated with lower scores on the metabolic syndrome index both cross-sectionally and longitudinally. CONCLUSION: The atypical energy-related symptom dimension was linked to poorer immune-inflammatory and metabolic health, while the melancholic symptom dimension was linked to relatively better metabolic health. Persons with high atypical energy-related symptom burden, representing an immuno-metabolic depression, may be the most important group to target in prevention programs for cardiometabolic disease, and may benefit most from treatments targeting immuno-metabolic pathways.

17 Article Stability of chronotype over a 7-year follow-up period and its association with severity of depressive and anxiety symptoms. 2020

Druiven, Stella J M / Hovenkamp-Hermelink, Johanna H M / Knapen, Stefan E / Kamphuis, Jeanine / Haarman, Benno C M / Penninx, Brenda W J H / Antypa, Niki / Meesters, Ybe / Schoevers, Robert A / Riese, Harriëtte. ·Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Department of Psychiatry, Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Department of Psychiatry, EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. · Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, The Netherlands. ·Depress Anxiety · Pubmed #32065480.

ABSTRACT: BACKGROUND: Chronotype is an individual's preferred timing of sleep and activity, and is often referred to as a later chronotype (or evening-type) or an earlier chronotype (or morning-type). Having an evening chronotype is associated with more severe depressive and anxiety symptoms. Based on these findings it is has been suggested that chronotype is a stable construct associated with vulnerability to develop depressive or anxiety disorders. To examine this, we test the stability of chronotype over 7 years, and its longitudinal association with the change in severity of depressive and anxiety symptoms. METHODS: Data of 1,417 participants with a depressive and/or anxiety disorder diagnosis and healthy controls assessed at the 2 and 9-year follow-up waves of the Netherlands Study of depression and anxiety were used. Chronotype was assessed with the Munich chronotype questionnaire. Severity of depressive and anxiety symptoms were assessed with the inventory of depressive symptomatology and Beck anxiety inventory. RESULTS: Chronotype was found to be moderately stable (r = 0.53) and on average advanced (i.e., became earlier) with 10.8 min over 7 years (p < .001). Controlling for possible confounders, a decrease in severity of depressive symptoms was associated with an advance in chronotype (B = 0.008, p = .003). A change in severity of anxiety symptoms was not associated with a change in chronotype. CONCLUSION: Chronotype was found to be a stable, trait-like construct with only a minor level advance over a period of 7 years. The change in chronotype was associated with a change in severity of depressive, but not anxiety, symptoms.

18 Article Development of the Ketamine Side Effect Tool (KSET). 2020

Short, Brooke / Dong, Vanessa / Gálvez, Verònica / Vulovic, Vedran / Martin, Donel / Bayes, Adam J / Zarate, Carlos A / Murrough, James W / McLoughlin, Declan M / Riva-Posse, Patricio / Schoevers, Robert / Fraguas, Renerio / Glue, Paul / Fam, Johnson / McShane, Rupert / Loo, Colleen K. ·School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia; Gosford Hospital, Gosford, Australia. · School of Psychiatry, University of New South Wales and Black Dog Institute, Sydney, Australia. · Corporacio Sanitaria Parc Tauli, Universitat Autonoma de Barcelona, I3PT, Institut d'Investigacio i Innovacio Parc Tauli, Sabadell, Barcelona, Spain. · University of New South Wales, Sydney, Australia. · School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia. · Division of Intramural Research Program, National Institute of Mental Health, MD, United States. · Depression and Anxiety Centre for Discovery and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, United States. · Department of Psychiatry, Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland. · Department of Psychiatry and Behavioral Sciences at Emory University, Atlanta, GA, United States. · The University Medical Center Groningen (UMCG), Groningen, the Netherlands. · Department and Institute of Psychiatry, University of Sao Paulo (USP), School of Medicine, Division of Psychiatry and Psychology, University Hospital (HU), USP Laboratório de Investigação Médica, Recife, Brazil. · Southern DHB and Hazel Buckland Chair in Psychological Medicine, University of Otago, Dunedin, New Zealand. · Department of Psychological Medicine, National University Hospital; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. · Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, United Kingdom. · School of Psychiatry, University of New South Wales, Sydney, Australia; St George Hospital, Sydney, Australia; Black Dog Institute, Sydney, Australia; Wesley Hospital, Sydney, Australia. Electronic address: colleen.loo@unsw.edu.au. ·J Affect Disord · Pubmed #32056935.

ABSTRACT: BACKGROUND: Currently, no specific, systematic assessment tool for the monitoring and reporting of ketamine-related side effects exists. Our aim was to develop a comprehensive Ketamine Side Effect Tool (KSET) to capture acute and longer-term side effects associated with repeated ketamine treatments. METHODS: Informed by systematic review data and clinical research, we drafted a list of the most commonly reported side effects. Face and content validation were obtained via feedback from collaborators with expertise in psychiatry and anaesthetics, clinical trial piloting and a modified Delphi Technique involving ten international experts. RESULTS: The final version consisted of four forms that collect information at time points: screening, baseline, immediately after a single treatment, and longer-term follow-up. Instructions were developed to guide users and promote consistent utilisation. LIMITATIONS: Further evaluation of feasibility, construct validity and reliability is required, and is planned across multiple international sites. CONCLUSIONS: The structured Ketamine Side Effect Tool (KSET) was developed, with confirmation of content and face validity via a Delphi consensus process. This tool is timely, given the paucity of data regarding ketamine's safety, tolerability and abuse potential over the longer term, and its recent adoption internationally as a clinical treatment for depression. Although based on data from depression studies, the KSET has potential applicability for ketamine (or derivatives) used in other medical disorders, including chronic pain. We recommend its utilisation for both research and clinical scenarios, including data registries.

19 Article Experienced Burden of and Adherence to Smartphone-Based Ecological Momentary Assessment in Persons with Affective Disorders. 2020

van Genugten, Claire R / Schuurmans, Josien / Lamers, Femke / Riese, Harriëtte / Penninx, Brenda Wjh / Schoevers, Robert A / Riper, Heleen M / Smit, Johannes H. ·Department of Research and Innovation, GGZ inGeest, Specialized Mental Health Care, 1081 Amsterdam, The Netherlands. · Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, 1081 Amsterdam, The Netherlands. · Interdisciplinary Centre for Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Centre Groningen, University of Groningen, 9713 Groningen, The Netherlands. · Department of Clinical, Neuro and Developmental Psychology, Clinical Psychology Section, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, 1081 Amsterdam, The Netherlands. · Institute of Telepsychiatry, University of Southern Denmark, 5000 Odense, Denmark. ·J Clin Med · Pubmed #31979340.

ABSTRACT: (1) Background: The use of smartphone-based ecological momentary assessment (EMA) questionnaires in affective disorder research has rapidly increased. Though, a thorough understanding of experienced burden of and adherence to EMA is crucial in determining the usefulness of EMA. (2) Methods: Persons with current affective disorders (

20 Article Decreased functional connectivity of the insula within the salience network as an indicator for prospective insufficient response to antidepressants. 2019

Geugies, H / Opmeer, E M / Marsman, J B C / Figueroa, C A / van Tol, M J / Schmaal, L / van der Wee, N J A / Aleman, A / Penninx, B W J H / Veltman, D J / Schoevers, R A / Ruhé, H G. ·University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands. Electronic address: hannekegeugies@gmail.com. · University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands. · Department of Psychiatry, Amsterdam UMC, Locatie AMC, University of Amsterdam, Amsterdam, the Netherlands. · Department of Psychiatry, Amsterdam UMC, Locatie VUmc, VU University Amsterdam, Amsterdam, the Netherlands; Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. · Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University, Leiden, the Netherlands. · University Medical Center Groningen, Department of Neuroscience, Cognitive Neuroscience Center, University of Groningen, Groningen, the Netherlands; Department of Psychology, University of Groningen, Groningen, the Netherlands. · Department of Psychiatry, Amsterdam UMC, Locatie VUmc, VU University Amsterdam, Amsterdam, the Netherlands. · University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; University of Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Groningen, the Netherlands. · University Medical Center Groningen, University Center for Psychiatry, Mood and Anxiety Disorders, University of Groningen, Groningen, the Netherlands; Department of Psychiatry, Amsterdam UMC, Locatie AMC, University of Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: h.g.ruhe@gmail.com. ·Neuroimage Clin · Pubmed #31795046.

ABSTRACT: Insufficient response to treatment is the main cause of prolonged suffering from major depressive disorder (MDD). Early identification of insufficient response could result in faster and more targeted treatment strategies to reduce suffering. We therefore explored whether baseline alterations within and between resting state functional connectivity networks could serve as markers of insufficient response to antidepressant treatment in two years of follow-up. We selected MDD patients (N = 17) from the NEtherlands Study of Depression and Anxiety (NESDA), who received ≥ two antidepressants, indicative for insufficient response, during the two year follow-up, a group of MDD patients who received only one antidepressant (N = 32) and a healthy control group (N = 19) matched on clinical characteristics and demographics. An independent component analysis (ICA) of baseline resting-state scans was conducted after which functional connectivity within the components was compared between groups. We observed lower connectivity of the right insula within the salience network in the group with ≥ two antidepressants compared to the group with one antidepressant. No difference in connectivity was found between the patient groups and healthy control group. Given the suggested role of the right insula in switching between task-positive mode (activation during attention-demanding tasks) and task-negative mode (activation during the absence of any task), we explored whether right insula activation differed during switching between these two modes. We observed that in the ≥2 antidepressant group, the right insula was less active compared to the group with one antidepressant, when switching from task-positive to task-negative mode than the other way around. These findings imply that lower right insula connectivity within the salience network may serve as an indicator for prospective insufficient response to antidepressants. This result, supplemented by the diminished insula activation when switching between task and rest related networks, could indicate an underlying mechanism that, if not sufficiently targeted by current antidepressants, could lead to insufficient response. When replicated, these findings may contribute to the identification of biomarkers for early detection of insufficient response.

21 Article Oral esketamine for treatment-resistant depression: rationale and design of a randomized controlled trial. 2019

Smith-Apeldoorn, Sanne Y / Veraart, Jolien K E / Kamphuis, Jeanine / van Asselt, Antoinette D I / Touw, Daan J / Aan Het Rot, Marije / Schoevers, Robert A. ·Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO box 30.0001, 9700, RB, Groningen, The Netherlands. s.y.apeldoorn@umcg.nl. · Department of Psychiatry, University of Groningen, University Medical Center Groningen, PO box 30.0001, 9700, RB, Groningen, The Netherlands. · Department of Psychiatry, PsyQ Haaglanden, Parnassia Psychiatric Institute, The Hague, The Netherlands. · Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Psychology, University of Groningen, Groningen, The Netherlands. ·BMC Psychiatry · Pubmed #31783823.

ABSTRACT: BACKGROUND: There is an urgent need to develop additional treatment strategies for patients with treatment-resistant depression (TRD). The rapid but short-lived antidepressant effects of intravenous (IV) ketamine as a racemic mixture have been shown repeatedly in this population, but there is still a paucity of data on the efficacy and safety of (a) different routes of administration, and (b) ketamine's enantiomers esketamine and arketamine. Given practical advantages of oral over IV administration and pharmacodynamic arguments for better antidepressant efficacy of esketamine over arketamine, we designed a study to investigate repeated administration of oral esketamine in patients with TRD. METHODS: This study features a triple-blind randomized placebo-controlled trial (RCT) comparing daily oral esketamine versus placebo as add-on to regular antidepressant medications for a period of 6 weeks, succeeded by a follow-up of 4 weeks. The methods support examination of the efficacy, safety, tolerability, mechanisms of action, and economic impact of oral esketamine in patients with TRD. DISCUSSION: This is the first RCT investigating repeated oral esketamine administration in patients with TRD. If shown to be effective and tolerated, oral esketamine administration poses important advantages over IV administration. TRIAL REGISTRATION: Dutch Trial Register, NTR6161. Registered 21 October 2016.

22 Article Using network analysis to examine links between individual depressive symptoms, inflammatory markers, and covariates. 2019

Fried, E I / von Stockert, S / Haslbeck, J M B / Lamers, F / Schoevers, R A / Penninx, B W J H. ·Department of Clinical Psychology, Leiden University, Leiden, The Netherlands. · Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. · Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands. · Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. · Department of Psychiatry and Neuroscience Campus Amsterdam, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. ·Psychol Med · Pubmed #31615595.

ABSTRACT: BACKGROUND: Studies investigating the link between depressive symptoms and inflammation have yielded inconsistent results, which may be due to two factors. First, studies differed regarding the specific inflammatory markers studied and covariates accounted for. Second, specific depressive symptoms may be differentially related to inflammation. We address both challenges using network psychometrics. METHODS: We estimated seven regularized Mixed Graphical Models in the Netherlands Study of Depression and Anxiety (NESDA) data (N = 2321) to explore shared variances among (1) depression severity, modeled via depression sum-score, nine DSM-5 symptoms, or 28 individual depressive symptoms; (2) inflammatory markers C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α); (3) before and after adjusting for sex, age, body mass index (BMI), exercise, smoking, alcohol, and chronic diseases. RESULTS: The depression sum-score was related to both IL-6 and CRP before, and only to IL-6 after covariate adjustment. When modeling the DSM-5 symptoms and CRP in a conceptual replication of Jokela et al., CRP was associated with 'sleep problems', 'energy level', and 'weight/appetite changes'; only the first two links survived covariate adjustment. In a conservative model with all 38 variables, symptoms and markers were unrelated. Following recent psychometric work, we re-estimated the full model without regularization: the depressive symptoms 'insomnia', 'hypersomnia', and 'aches and pain' showed unique positive relations to all inflammatory markers. CONCLUSIONS: We found evidence for differential relations between markers, depressive symptoms, and covariates. Associations between symptoms and markers were attenuated after covariate adjustment; BMI and sex consistently showed strong relations with inflammatory markers.

23 Article Major depressive disorder is associated with changes in a cluster of serum and urine biomarkers. 2019

van Buel, Erin M / Meddens, Marcus J M / Arnoldussen, Eduard A / van den Heuvel, Edwin R / Bohlmeijer, Willem C / den Boer, Johan A / Muller Kobold, Anna / Boonman-de Winter, Leandra J M / van Rumpt, Dirk / Timmers, Lambertus F J / Veerman, Mattheus F A / Kamphuis, Johannes S / Gladkevich, Anatoliy V / Schoevers, Robert A / Luiten, Paul G M / Eisel, Ulrich L M / Bosker, Fokko J / Klein, Hans C. ·Groningen Institute for Evolutionary Life Sciences (GeLIFES), University of Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands. · Brainlabs BV, Deventer, The Netherlands. · Department of Mathematics & Computer Science, Eindhoven University of Technology, Eindhoven, The Netherlands. · Office for Neuropsychiatry, Psychotherapy and Expertise, Brummen, The Netherlands. · Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; PRA Health Sciences, Groningen, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands. · Amphia Academy, Amphia Hospital, Breda, The Netherlands. · SHO Center for Medical Diagnostics, Velp, The Netherlands. · General Practitioner's Office BERGH, 's Heerenberg, The Netherlands. · STAR-MDC Laboratories, Rotterdam, The Netherlands. · Department of Clinical Chemistry and Hematology, Gelre Hospital, Apeldoorn, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands; Research School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands. Electronic address: r.a.schoevers@umcg.nl. · Groningen Institute for Evolutionary Life Sciences (GeLIFES), University of Groningen, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, The Netherlands; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. ·J Psychosom Res · Pubmed #31470255.

ABSTRACT: Major Depressive Disorder (MDD) is a heterogeneous disorder with a considerable symptomatic overlap with other psychiatric and somatic disorders. This study aims at providing evidence for association of a set of serum and urine biomarkers with MDD. We analyzed urine and serum samples of 40 MDD patients and 47 age- and sex-matched controls using 40 potential MDD biomarkers (21 serum biomarkers and 19 urine biomarkers). All participants were of Caucasian origin. We developed an algorithm to combine the heterogeneity at biomarker level. This method enabled the identification of correlating biomarkers based on differences in variation and distribution between groups, combined the outcome of the selected biomarkers, and calculated depression probability scores (the "bio depression score"). Phenotype permutation analysis showed a significant discrimination between MDD and euthymic (control) subjects for biomarkers in urine (P < .001), in serum (P = .02) and in the combined serum plus urine result (P < .001). Based on this algorithm, a combination of 8 urine biomarkers and 9 serum biomarkers were identified to correlate with MDD, enabling an area under the curve (AUC) of 0.955 in a Receiver Operating Characteristic (ROC) analysis. Selection of either urine biomarkers or serum biomarkers resulted in AUC values of 0.907 and 0.853, respectively. Internal cross-validation (5-fold) confirmed the association of this set of biomarkers with MDD.

24 Article Sleep, circadian rhythm, and physical activity patterns in depressive and anxiety disorders: A 2-week ambulatory assessment study. 2019

Difrancesco, Sonia / Lamers, Femke / Riese, Harriëtte / Merikangas, Kathleen R / Beekman, Aartjan T F / van Hemert, Albert M / Schoevers, Robert A / Penninx, Brenda W J H. ·Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands. · University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, Groningen, The Netherlands. · Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland. · Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands. ·Depress Anxiety · Pubmed #31348850.

ABSTRACT: BACKGROUND: Actigraphy may provide a more valid assessment of sleep, circadian rhythm (CR), and physical activity (PA) than self-reported questionnaires, but has not been used widely to study the association with depression/anxiety and their clinical characteristics. METHODS: Fourteen-day actigraphy data of 359 participants with current (n = 93), remitted (n = 176), or no (n = 90) composite international diagnostic interview depression/anxiety diagnoses were obtained from the Netherlands Study of Depression and Anxiety. Objective estimates included sleep duration (SD), sleep efficiency, relative amplitude (RA) between day-time and night-time activity, mid sleep on free days (MSF), gross motor activity (GMA), and moderate-to-vigorous PA (MVPA). Self-reported measures included insomnia rating scale, SD, MSF, metabolic equivalent total, and MVPA. RESULTS: Compared to controls, individuals with current depression/anxiety had a significantly different objective, but not self-reported, PA and CR: lower GMA (23.83 vs. 27.4 milli-gravity/day, p = .022), lower MVPA (35.32 vs. 47.64 min/day, p = .023), lower RA (0.82 vs. 0.83, p = .033). In contrast, self-reported, but not objective, sleep differed between people with current depression/anxiety compared to those without current disorders; people with current depression/anxiety reported both shorter and longer SD and more insomnia. More depressive/anxiety symptoms and number of depressive/anxiety diagnoses were associated with larger disturbances of the actigraphy measures. CONCLUSION: Actigraphy provides ecologically valid information on sleep, CR, and PA that enhances data from self-reported questionnaires. As those with more severe or comorbid forms showed the lowest PA and most CR disruptions, the potential for adjunctive behavioral and chronotherapy interventions should be explored, as well as the potential of actigraphy to monitor treatment response to such interventions.

25 Article The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis. 2019

Boschloo, Lynn / Bekhuis, Ella / Weitz, Erica S / Reijnders, Mirjam / DeRubeis, Robert J / Dimidjian, Sona / Dunner, David L / Dunlop, Boadie W / Hegerl, Ulrich / Hollon, Steven D / Jarrett, Robin B / Kennedy, Sidney H / Miranda, Jeanne / Mohr, David C / Simons, Anne D / Parker, Gordon / Petrak, Frank / Herpertz, Stephan / Quilty, Lena C / John Rush, A / Segal, Zindel V / Vittengl, Jeffrey R / Schoevers, Robert A / Cuijpers, Pim. ·Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. · Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA. · Center for Anxiety and Depression, Mercer Island, Washington, WA, USA. · Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. · Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada. · Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. · Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Department of Psychology, University of Notre Dame, Notre Dame, IN, USA. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr University Bochum, Bochum, Germany. · Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. · Duke-National University of Singapore Graduate Medical School, Singapore. · Department of Psychiatry, Duke Medical School, Durham, NC, USA. · Texas Tech University Health Sciences Center, Permian Basin, TX, USA. · Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada. · Department of Psychology, Truman State University, Kirksville, MO, USA. ·World Psychiatry · Pubmed #31059603.

ABSTRACT: A recent individual patient data meta-analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM-defined depressive disorder. We used an update of that dataset, based on seventeen randomized clinical trials, to examine the comparative efficacy of antidepressant medication vs. CBT in more detail by focusing on individual depressive symptoms as assessed with the 17-item Hamilton Rating Scale for Depression. Five symptoms (i.e., "depressed mood" , "feelings of guilt" , "suicidal thoughts" , "psychic anxiety" and "general somatic symptoms") showed larger improvements in the medication compared to the CBT condition (effect sizes ranging from .13 to .16), whereas no differences were found for the twelve other symptoms. In addition, network estimation techniques revealed that all effects, except that on "depressed mood" , were direct and could not be explained by any of the other direct or indirect treatment effects. Exploratory analyses showed that information about the symptom-specific efficacy could help in identifying those patients who, based on their pre-treatment symptomatology, are likely to benefit more from antidepressant medication than from CBT (effect size of .30) versus those for whom both treatments are likely to be equally efficacious. Overall, our symptom-oriented approach results in a more thorough evaluation of the efficacy of antidepressant medication over CBT and shows potential in "precision psychiatry" .

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