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Depression: HELP
Articles from Duke University
Based on 818 articles published since 2008

These are the 818 published articles about Depression that originated from Duke University during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. 2016

Siu, Albert L / Anonymous2730856 / Bibbins-Domingo, Kirsten / Grossman, David C / Baumann, Linda Ciofu / Davidson, Karina W / Ebell, Mark / García, Francisco A R / Gillman, Matthew / Herzstein, Jessica / Kemper, Alex R / Krist, Alex H / Kurth, Ann E / Owens, Douglas K / Phillips, William R / Phipps, Maureen G / Pignone, Michael P. ·Mount Sinai School of Medicine, New York2James J. Peters Veterans Affairs Medical Center, Bronx, New York. · University of California, San Francisco. · Group Health Research Institute, Seattle, Washington. · University of Wisconsin, Madison. · Columbia University, New York, New York. · University of Georgia, Athens. · Pima County Department of Health, Tucson, Arizona. · Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts. · Independent consultant, Washington, DC. · Duke University, Durham, North Carolina. · Fairfax Family Practice, Fairfax, Virginia13Virginia Commonwealth University, Richmond. · New York University, New York. · Veterans Affairs Palo Alto Health Care System, Palo Alto, California16Stanford University, Stanford, California. · University of Washington, Seattle. · Brown University, Providence, Rhode Island. · University of North Carolina, Chapel Hill. ·JAMA · Pubmed #26813211.

ABSTRACT: DESCRIPTION: Update of the 2009 US Preventive Services Task Force (USPSTF) recommendation on screening for depression in adults. METHODS: The USPSTF reviewed the evidence on the benefits and harms of screening for depression in adult populations, including older adults and pregnant and postpartum women; the accuracy of depression screening instruments; and the benefits and harms of depression treatment in these populations. POPULATION: This recommendation applies to adults 18 years and older. RECOMMENDATION: The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. (B recommendation).

2 Editorial Do We Ever Escape the Consequences of Childhood Deprivation? 2016

Blazer, Dan G. ·Duke University Medical Center, Durham, NC. Electronic address: dan.g.blazer@dm.duke.edu. ·Am J Geriatr Psychiatry · Pubmed #27569266.

ABSTRACT: -- No abstract --

3 Editorial The brave new world of healthcare delivery: just where are we in our understanding of e-health methods for insomnia and depression management? 2015

Edinger, Jack D. ·Division of Pulmonology, Critical Care and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO; Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC. ·Sleep · Pubmed #25581925.

ABSTRACT: -- No abstract --

4 Editorial Late life depression: a historical perspective upon a maturing field of inquiry. 2014

Blazer, Dan G. ·a JP Gibbons Professor Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA. ·Aging Ment Health · Pubmed #24824508.

ABSTRACT: -- No abstract --

5 Review Chest Pain: If It Is Not the Heart, What Is It? 2018

Rushton, Sharron / Carman, Margaret J. ·Duke University School of Nursing, DUMC Box 3322, Durham, NC 27710, USA. Electronic address: Sharron.Rushton@duke.edu. · Georgetown University School of Nursing and Health Studies, St. Mary's Hall, 3700 Reservoir Road Northwest, Washington, DC 20007, USA. ·Nurs Clin North Am · Pubmed #30100007.

ABSTRACT: Noncardiac chest pain is an angina-type discomfort without indication of ischemia. Diagnosis can be difficult because of its heterogeneous nature. Classification varies by specialty; gastroenterology uses the terminology gastroesophageal reflux disease related versus non-gastroesophageal reflux disease related. Other disciplines recognize noncardiac chest pain etiologies as having gastrointestinal, musculoskeletal, psychiatric, or pulmonary/other as underlying etiologies. Diagnostics yield a specific cause for effective treatment, which is aimed at the underlying etiology, but it is not always possible. Some patients with noncardiac chest pain have comorbidities and ongoing pain that lead to decreased quality of life and continued health care use.

6 Review Psychosocial Aspects of Fertility and Assisted Reproductive Technology. 2018

Stanhiser, Jamie / Steiner, Anne Z. ·Reproductive Endocrinology and Infertility, University of North Carolina, Chapel Hill, NC, USA. Electronic address: jamie_stanhiser@med.unc.edu. · Duke University Hospital, 2301 Erwin Road, Durham, NC 27710, USA. ·Obstet Gynecol Clin North Am · Pubmed #30092929.

ABSTRACT: Psychosocial aspects of fertility, infertility, and assisted reproductive technology (ART) can significantly impact patients' sense of self-identity and personal agency, mental well-being, sexual and marital relationships, reproductive efficiency, compliance with treatment, and pregnancy outcomes. Research is needed to understand how stress, anxiety, depression, mood disorders, and psychotropic medications impact fertility and infertility treatment. The psychosocial implications of ART on our society include a shift toward older maternal age at conception, the complexities of third-party reproduction, and consideration for the psychological and socioeconomic barriers to receiving care. Clinicians must understand, screen for, and identify couples struggling with the psychological and social aspects of fertility and ART.

7 Review The conundrum of depression clinical trials: one size does not fit all. 2018

Khan, Arif / Mar, Kaysee Fahl / Brown, Walter A. ·Northwest Clinical Research Center, Bellevue, Washington. · Department of Psychiatry, Duke University School of Medicine, Durham, North Carolina. · Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island, USA. ·Int Clin Psychopharmacol · Pubmed #29939890.

ABSTRACT: In this paper we review the history of antidepressant (AD) development, since the discovery of imipramine in 1957 to the present day. Through this exploration we will show that the increasing placebo response is likely a red herring and that a higher magnitude of placebo response is not an adequate explanation for AD trials' high failure rates. As a better explanation for their lack of success, we will examine some of the fundamental flaws of AD clinical trials and their origins in historical forces. We focus on underpowering, which occurs as a consequence of unrealistic expectations for AD performance. In addition, we describe the lack of precision in the depression outcome measurements for the past 40 years and show how these measures contrast with those used in clinical trials of other chronic diseases, which use simpler outcome measures. Finally, we describe the role of regulatory agencies in influencing clinical trial design and how the assumption that 'one size fits all' for the past 60 years has led to flawed design of AD clinical trials.

8 Review The Psychosocial and Clinical Well-Being of Women Living with Human Immunodeficiency Virus/AIDS. 2018

George Dalmida, Safiya / Kraemer, Kyle R / Ungvary, Stephen / Di Valerio, Elizabeth / Koenig, Harold G / Holstad, Marcia McDonnell. ·University of Alabama, Capstone College of Nursing, 650 University Boulevard, Tuscaloosa, AL 35487, USA. Electronic address: sfgeorge@ua.edu. · Department of Psychology, University of Alabama, Box 870348, Tuscaloosa, AL 35487-0348, USA. · Department of Biological Sciences, University of Alabama, Box 870344, Tuscaloosa, AL 35487, USA. · Department of Psychiatry, Duke University Medical Center, 10 Duke Medicine Circle, Durham, NC 27710, USA; Department of Medicine, King Abdulaziz University, Jeddah 22252, Saudi Arabia. · Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, Atlanta, GA 30322, USA. ·Nurs Clin North Am · Pubmed #29779514.

ABSTRACT: This study examined factors impacting the psychological well-being of women living with human immunodeficiency virus/AIDS and the impact of depression on clinical outcomes. Nearly two-thirds of participants in this cross-sectional study reported significant depressive symptoms. Compared with women living with human immunodeficiency virus/AIDS without depressive symptoms, those with depression reported significantly poorer health outcomes. Health care providers should regularly screen these women for and adequately treat depression, and must collaborate with mental health providers and pastoral care counselors to address the mental health needs of women living with human immunodeficiency virus/AIDS to optimize their human immunodeficiency virus-related outcomes.

9 Review Cognitive effects of transcranial direct current stimulation treatment in patients with major depressive disorder: An individual patient data meta-analysis of randomised, sham-controlled trials. 2018

Martin, Donel M / Moffa, Adriano / Nikolin, Stevan / Bennabi, Djamila / Brunoni, André R / Flannery, William / Haffen, Emmanuel / McClintock, Shawn M / Moreno, Marina L / Padberg, Frank / Palm, Ulrich / Loo, Colleen K. ·School of Psychiatry, Black Dog Institute, University of New South Wales, Hospital Rd., Randwick, Sydney NSW 2031, Australia. Electronic address: donel.martin@unsw.edu.au. · School of Psychiatry, Black Dog Institute, University of New South Wales, Hospital Rd., Randwick, Sydney NSW 2031, Australia. · Department of Clinical Psychiatry, Clinical Investigation Center 1431 Inserm, EA 481 Neurosciences, University Hospital of Besancon and FondaMental Foundation, Créteil, France. · Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Laboratory of Neuroscience (LIM27) and National Institute of Biomarkers in Psychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany. · Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. · Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil. · Department of Psychiatry and Psychotherapy, Ludwig Maximilian University Munich, Munich, Germany. ·Neurosci Biobehav Rev · Pubmed #29660416.

ABSTRACT: Transcranial direct current stimulation (tDCS) has emerged as a promising new treatment for major depression. While recent randomised, sham-controlled studies found tDCS to have antidepressant effects, it remains to be determined whether a tDCS treatment course may also enhance cognitive function independent of mood effects in depressed patients. This systematic review and individual patient data (IPD) meta-analysis examined cognitive outcomes from randomised, sham-controlled trials of tDCS treatment for major depression. Seven randomised, sham-controlled trials (n = 478 participants, 260 in active and 218 in sham) of tDCS for major depression were included. Results showed no cognitive enhancement after active tDCS compared to sham for the 12 cognitive outcomes investigated. Active relative to sham tDCS treatment was associated with reduced performance gains on a measure of processing speed (β = -0.33, 95% CI -0.58; -0.08, p = 0.011). Active tDCS treatment for depression did not show cognitive benefits independent of mood effects. Rather, tDCS treatment relative to sham stimulation for major depression may instead be associated with a reduced practice effect for processing speed.

10 Review Advances in Pharmacotherapy of Late-Life Depression. 2018

Beyer, John L / Johnson, Kim G. ·Duke University Medical Center, Durham, NC, USA. · Duke University Medical Center, Durham, NC, USA. kim.g.johnson@duke.edu. ·Curr Psychiatry Rep · Pubmed #29627920.

ABSTRACT: This paper reviews recent research on late-life depression (LLD) pharmacotherapy, focusing on updated information for monotherapy and augmentation treatments. We then review new research on moderators of clinical response and how to use the information for improved efficacy. RECENT FINDINGS: A recent review shows that sertraline, paroxetine, and duloxetine were superior to placebo for the treatment of LLD. There is concern that paroxetine could have adverse outcomes in the geriatric population due to anticholinergic properties; however, studies show no increases in mortality, dementia risk, or cognitive measures. Among newer antidepressants, vortioxetine has demonstrated efficacy in LLD, quetiapine has demonstrated efficacy especially for patients with sleep disturbances, and aripiprazole augmentation for treatment resistance in LLD was found to be safe and effective. Researchers have also been identifying moderators of LLD that can guide treatment. Researchers are learning how to associate moderators, neuroanatomical models, and antidepressant response. SSRI/SNRIs remain first-line treatment for LLD. Aripiprazole is an effective and safe augmentation for treatment resistance. Studies are identifying actionable moderators that can increase treatment response.

11 Review Depression and Cardiovascular Disorders in the Elderly. 2018

Jiang, Wei. ·Department of Psychiatry and Behavioral Sciences, Duke University Health System, Durham, NC 27710, USA; Department of Medicine, Duke University Health System, Durham, NC 27710, USA. Electronic address: jiang001@mc.duke.edu. ·Psychiatr Clin North Am · Pubmed #29412846.

ABSTRACT: The world's older population continues to grow at an unprecedented rate. This trend amplifies the necessity of improving the care of older patients with chronic health problems. Of those with chronic health problems, those with cardiovascular diseases and depression are particularly challenging due to the multifaceted nature of these conditions. This review discusses the significance of this aging trend and ways to better care for this particular population.

12 Review Parental involvement in adolescent depression interventions: A systematic review of randomized clinical trials. 2018

Dardas, Latefa Ali / van de Water, Brittney / Simmons, Leigh Ann. ·School of Nursing, The University of Jordan, Amman, Jordan. · Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA. · School of Nursing, Duke University, Durham, North Carolina, USA. ·Int J Ment Health Nurs · Pubmed #29277947.

ABSTRACT: Despite the widespread research recommendations for psychiatric nurses and other mental health professionals to include parents in adolescent depression treatment, no systematic reviews have yet synthesized the findings from intervention studies that included parents in the treatment and/or prevention of adolescent depression. Therefore, this systematic review was conducted to (i) identify and describe clinical trials that included parents as an integral component of adolescent depression interventions, (ii) examine the effectiveness of these trials in reducing depressive symptoms, and (iii) evaluate their methodological quality. We systematically searched the databases PubMed and PsycINFO. The search strategy adhered to the PRISMA statement to guide identification and selection of articles. Further, a structured evaluation form was adapted from the CONSORT statement and methodological literature to evaluate the elicited clinical trials. A total of 288 unique articles met criteria for abstract level screening, 45 articles were selected for full-text review, and 16 articles were included in the final analysis. We found that (i) available approaches to include parents in adolescent depression interventions vary in their theoretical stance, purpose, sample characteristics, and measured outcomes, (ii) the health outcomes of these approaches seemed to be contingent upon the nature of parental involvement, and (iii) effective translation of these approaches into practice needs to be considered in the light of their methodological rigour. Our review revealed a variety of promising approaches to utilize the parental and family contexts as a means of preventing or treating adolescent depression. However, more research is needed to determine which interventions, within what contexts, and using what resources will facilitate the best health outcomes for adolescents with depression and their parents.

13 Review The relationship of person-specific eveningness chronotype, greater seasonality, and less rhythmicity to suicidal behavior: A literature review. 2018

Rumble, Meredith E / Dickson, Daniel / McCall, W Vaughn / Krystal, Andrew D / Case, Doug / Rosenquist, Peter B / Benca, Ruth M. ·Department of Psychiatry, University of Wisconsin, Madison, United States. Electronic address: rumble@wisc.edu. · Department of Psychiatry, University of Wisconsin, Madison, United States. · Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, United States. · Department of Psychiatry, University of California, San Francisco, United States; Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States. · Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States. · Department of Psychiatry and Human Behavior, University of California, Irvine, United States. ·J Affect Disord · Pubmed #29179142.

ABSTRACT: BACKGROUND: Epidemiological data have demonstrated seasonal and circadian patterns of suicidal deaths. Several reviews and meta-analyses have confirmed the relationship between sleep disturbance and suicidality. However, these reviews/meta-analyses have not focused on seasonal and circadian dysfunction in relation to suicidality, despite the common presence of this dysfunction in patients with mood disorders. Thus, the current literature review analyzed studies investigating person-specific chronotype, seasonality, and rhythmicity in relation to suicidal thoughts and behaviors. METHODS: Study authors reviewed articles related to individual-level chronotype, seasonality, and rhythmicity and suicidality that were written in English and not case reports or reviews. RESULTS: This review supports a relationship between an eveningness chronotype, greater seasonality, and decreased rhythmicity with suicidal thoughts and behaviors in those with unipolar depression, as well as in other psychiatric disorders and in children/adolescents. LIMITATIONS: These findings need to be explored more fully in mood disordered populations and other psychiatric populations, in both adults and children, with objective measurement such as actigraphy, and with chronotype, seasonality, and rhythmicity as well as broader sleep disturbance measurement all included so the construct(s) most strongly linked to suicidality can be best identified. CONCLUSIONS: Eveningness, greater seasonality, and less rhythmicity should be considered in individuals who may be at risk for suicidal thoughts and behaviors and may be helpful in further tailoring assessment and treatment to improve patient outcome.

14 Review Efficacy of antidepressants: bias in randomized clinical trials and related issues. 2018

Wang, Sheng-Min / Han, Changsu / Lee, Soo-Jung / Jun, Tae-Youn / Patkar, Ashwin A / Masand, Prakash S / Pae, Chi-Un. ·a Department of Psychiatry , The Catholic University of Korea College of Medicine , Seoul , Republic of Korea. · b International Health Care Center, Seoul St. Mary's Hospital, College of Medicine , The Catholic University of Korea , Seoul , Republic of Korea. · c Department of Psychiatry , Korea University, College of Medicine , Seoul , Republic of Korea. · d Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA. · e Global Medical Education , New York , NY , USA. ·Expert Rev Clin Pharmacol · Pubmed #28893095.

ABSTRACT: INTRODUCTION: Countless antidepressant randomized trials were conducted and showed statistically significant benefits of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) over placebo. Meanwhile, critics are increasing regarding the efficacy of antidepressants in the treatment of MDD because at least a proportion of clinical trials could be hampered by various biases. In contrast, number of failed trials is increasing in the recent years which have made developing psychiatric medications progressively more time-consuming and expensive. Areas covered: Biases and related issues in clinical trials for antidepressants can be identified as an important common contributing factor to the two paradoxical phenomenon. This review identifies possible biases that can occur before, during, and after clinical trials of antidepressant. Expert commentary: Recent studies not only may over-estimate efficacy of antidepressants, but also may exaggerate placebo response because of various biases. Sponsorship and publication biases have been one of the targets of the criticism and ethical debate. Thus, initiating new trend of research by re-organizing academic-industry partnership will be the most important task in the next five years.

15 Review Depression Among Older Adults: A 20-Year Update on Five Common Myths and Misconceptions. 2018

Haigh, Emily A P / Bogucki, Olivia E / Sigmon, Sandra T / Blazer, Dan G. ·Department of Psychology, University of Maine, Orono, ME. Electronic address: emily.a.haigh@maine.edu. · Department of Psychology, University of Maine, Orono, ME. · Duke University Medical Center, Durham, NC. ·Am J Geriatr Psychiatry · Pubmed #28735658.

ABSTRACT: Is depression among older adults symptomatically different than younger adults? Is it more common or chronic or difficult to treat? Is depression in late life more likely to be attributed to psychological problems? Twenty-years ago, Dan Blazer, a pioneer known for his groundbreaking work on depression in older adulthood, conducted an important review of the existing literature to refute five commonly held beliefs about depression in late life. Now, two decades later, we call upon selected articles that are representative of our current knowledge to provide an update and identify research priorities. The research consensus spanning the past 20 years suggests that when compared with their younger counterparts, depression in older adults is not more common and is not more often caused by psychological factors. Although some studies have suggested that depression in late life may be symptomatically different and characterized by a more somatic presentation, there is insufficient empirical evidence to conclude that depression presents differently across adulthood. Overall, older adults respond to psychological interventions as well as younger adults, although evidence suggests that antidepressants are less efficacious in late life. Finally, compared with middle-aged adults, depression in older adults is associated with a more chronic course (i.e., higher rate of relapse), which is likely moderated by medical comorbidity. This special article summarizes our current understanding of the nature and treatment of late-life depression and highlights areas of inquiry in need of further study.

16 Review The Impact of Cannabis Use Disorder on Suicidal and Nonsuicidal Self-Injury in Iraq/Afghanistan-Era Veterans with and without Mental Health Disorders. 2018

Kimbrel, Nathan A / Meyer, Eric C / DeBeer, Bryann B / Gulliver, Suzy B / Morissette, Sandra B. ·Durham Veterans Affairs Medical Center, Durham, NC, USA. · VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA. · Duke University Medical Center, Durham, NC, USA. · VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA. · Central Texas Veterans Health Care System, Temple, USA. · Texas A&M University Health Science Center, College Station, TX, USA. · Warriors Research Institute, Baylor, Scott & White Healthcare System, Waco, TX, USA. · The University of Texas at San Antonio, San Antonio, TX, USA. ·Suicide Life Threat Behav · Pubmed #28295524.

ABSTRACT: The objective of this study was to assess the association between cannabis use disorder (CUD) and self-injury among veterans. As expected, after adjusting for sex, age, sexual orientation, combat exposure, traumatic life events, traumatic brain injury, posttraumatic stress disorder, depression, alcohol use disorder, and noncannabis drug use disorder, CUD was significantly associated with both suicidal (OR = 3.10, p = .045) and nonsuicidal (OR = 5.12, p = .009) self-injury. CUD was the only variable significantly associated with self-injury in all three models examined. These findings are consistent with prior research among civilians and suggest that CUD may also increase veterans' risk for self-injurious behavior.

17 Review Diagnostic Accuracy of Screening Tests and Treatment for Post-Acute Coronary Syndrome Depression: A Systematic Review. 2017

Nieuwsma, Jason A / Williams, John W / Namdari, Natasha / Washam, Jeffrey B / Raitz, Giselle / Blumenthal, James A / Jiang, Wei / Yapa, Roshini / McBroom, Amanda J / Lallinger, Kathryn / Schmidt, Robyn / Kosinski, Andrzej S / Sanders, Gillian D. ·From Duke University School of Medicine, Veterans Affairs Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), Durham Veterans Affairs Evidence Synthesis Center, Durham, North Carolina, and Southern California Permanente Medical Group, Anaheim, California; and University of Washington, Boise, Idaho. ·Ann Intern Med · Pubmed #29132152.

ABSTRACT: Background: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. Purpose: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles. Study Selection: English-language studies of post-ACS patients that evaluated the diagnostic accuracy of depression screening tools or compared the safety and effectiveness of a broad range of pharmacologic and nonpharmacologic depression treatments. Data Extraction: 2 investigators independently screened each article for inclusion; abstracted the data; and rated the quality, applicability, and strength of evidence. Data Synthesis: Evidence from 6 of the 10 included studies showed that a range of depression screening instruments produces acceptable levels of diagnostic sensitivity, specificity, and negative predictive values (70% to 100%) but low positive predictive values (below 50%). The Beck Depression Inventory-II was the most studied tool. A large study found that a combination of cognitive behavioral therapy (CBT) and antidepressant medication improved depression symptoms, mental health-related function, and overall life satisfaction more than usual care. Limitation: Few studies, no evaluation of the influence of screening on clinical outcomes, and no studies addressing several clinical interventions of interest. Conclusion: Depression screening instruments produce diagnostic accuracy metrics that are similar in post-ACS patients and other clinical populations. Depression interventions have an uncertain effect on cardiovascular outcomes, but CBT combined with antidepressant medication produces modest improvement in psychosocial outcomes. Primary Funding Source: Agency for Healthcare Research and Quality (PROSPERO: CRD42016047032).

18 Review Beyond serotonin: newer antidepressants in the future. 2017

Rakesh, Gopalkumar / Pae, Chi-Un / Masand, Prakash S. ·a Department of Psychiatry and Behavioral Sciences , Duke University Medical Center , Durham , NC , USA. · b Department of Psychiatry , The Catholic University of Korea College of Medicine , Seoul , Republic of Korea. · c Academic Medicine Education Institute , Duke-NUS Medical School , Singapore , Singapore. · d Global Medical Education , New York , NY , USA. ·Expert Rev Neurother · Pubmed #28598698.

ABSTRACT: INTRODUCTION: There are numerous antidepressants for the treatment of major depressive disorder (MDD) on the market. However, inadequate treatment response, therapeutic lag between drug administration and the onset of clinical improvement, and safety/tolerability issues with the use of contemporary antidepressants have accelerated the search for newer antidepressants with novel mechanisms of action. Areas covered: The authors review novel antidepressants with rapid efficacy for diverse MDD symptoms and have fewer adverse effects (AEs). Mechanisms of action for novel therapeutic molecules are through glutamatergic, opiate, cholinergic receptors and neuroplasticity. We enumerate results from human trials with novel agents in all phases, highlighting proximity to approval and therapeutic potential based on quality of evidence. Expert commentary: There is a huge unmet need to diversify conventional antidepressant targets. Glutamatergic and opiate agents may be most promising among newer therapeutic agents. It is also important to develop advanced but flexible synergistic treatment strategies with newer therapeutic agents that are usable in routine clinical practice. This would include combining newer molecules with existing antidepressants and using molecules that target specific symptom dimensions of MDD. These strategies would lead to a systematic approach to tackle treatment resistant depression (TRD) and treatment of residual symptoms in partially remitted MDD.

19 Review Cognitive enhancing effects of rTMS administered to the prefrontal cortex in patients with depression: A systematic review and meta-analysis of individual task effects. 2017

Martin, Donel M / McClintock, Shawn M / Forster, Jane J / Lo, Tin Yan / Loo, Colleen K. ·School of Psychiatry, Black Dog Institute, University of New South Wales, Sydney, Australia. · Neurocognitive Research Laboratory, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA. ·Depress Anxiety · Pubmed #28543994.

ABSTRACT: BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is an approved therapeutic treatment of major depressive disorder and has increasing clinical use throughout the world. However, it remains unclear whether an rTMS course for depression may also produce cognitive enhancement. In a recent meta-analysis of sham-controlled randomized controlled studies (RCTs) conducted in patients with neuropsychiatric conditions, no evidence was found for generalized cognitive enhancing effects across cognitive domains with active compared to sham rTMS. Notwithstanding, there remains the possibility of cognitive effects following an rTMS course that are more highly specific, for example, in specific clinical conditions, or at the individual task level. This study aimed to determine whether a therapeutic rTMS course in patients with depression is associated with cognitive enhancing effects at the task level. METHODS: A systematic review and meta-analysis of outcomes on individual neuropsychological tasks from sham-controlled RCTs where an rTMS course was administered to the dorsolateral prefrontal cortex (DLPFC) in patients with depression. RESULTS: Eighteen studies met the inclusion criteria. Active rTMS treatment showed no specific enhancing effects on the majority of cognitive tasks. Modest effect size improvements with active compared to sham rTMS treatment were found for performance on the Trail Making Test Parts A (g = 0.28, 95% CI = 0.06-0.50) and B (g = 0.26, 95% CI = 0.06-0.47). CONCLUSION: A therapeutic rTMS course administered to the prefrontal cortex for depression may produce modest cognitive enhancing effects specific to psychomotor speed, visual scanning, and set-shifting ability.

20 Review Challenging assumptions from emotion dysregulation psychological treatments. 2017

Neacsiu, Andrada D / Smith, Megan / Fang, Caitlin M. ·Duke University Medical Center, USA. Electronic address: andrada.neacsiu@duke.edu. · University of Washington, USA. · Duke University, USA. ·J Affect Disord · Pubmed #28527311.

ABSTRACT: BACKGROUND: Contemporary treatments assume that the inability to downregulate negative emotional arousal is a key problem in the development and maintenance of psychopathology and that lack of effective regulation efforts and a preference to use maladaptive regulation strategies is a primary mechanism. Though ubiquitous, there is limited empirical evidence to support this assumption. Therefore, the aim of the current study was to examine whether self-reported emotion dysregulation equated to difficulties reducing emotional arousal during a behavioral task and to primary use of maladaptive strategies to manage negative emotions. METHODS: 44 anxious and depressed adults with high emotion dysregulation induced negative distress using autobiographic memory recall. After induction, participants were instructed to downregulate but were not provided any specific instructions in strategies to use. Self-reported emotional arousal was assessed before and after induction and after regulation. Qualitative descriptions of regulation efforts were collected and codedinto effective and maladaptive strategies. RESULTS: The task was successful in inducing emotional arousal and participants were successful in their efforts to down regulate negative emotions. Additionally, effective regulation strategies were used more frequently than maladaptive strategies. LIMITATIONS: Data collected was exclusively self-report and the sample size was small. CONCLUSION: Adults who report high emotion dysregulation may still have effective emotion regulation strategies in their behavioral repertoire and are more likely to engage in these effective strategies when given an unspecific prompt to regulate negative emotional arousal. Despite reporting problems with emotion regulation, adults with anxiety and depression can successfully downregulate distress when prompted to do so.

21 Review Key updates in the clinical application of electroconvulsive therapy. 2017

Weiner, Richard D / Reti, Irving M. ·a Department of Psychiatry and Behavioral Sciences , Duke University School of Medicine , Durham , NC , USA. · b Department of Psychiatry and Behavioral Sciences , Johns Hopkins University School of Medicine , Baltimore , MD , USA. ·Int Rev Psychiatry · Pubmed #28406327.

ABSTRACT: ECT is the oldest and most effective therapy available for the treatment of severe major depression. It is highly effective in individuals with treatment resistance and when a rapid response is required. However, ECT is associated with memory impairment that is the most concerning side-effect of the treatment, substantially contributing to the controversy and stigmatization surrounding this highly effective treatment. There is overwhelming evidence for the efficacy and safety of an acute course of ECT for the treatment of a severe major depressive episode, as reflected by the recent FDA advisory panel recommendation to reclassify ECT devices from Class III to the lower risk category Class II. However, its application for other indications remains controversial, despite strong evidence to the contrary. This article reviews the indication of ECT for major depression, as well as for other conditions, including catatonia, mania, and acute episodes of schizophrenia. This study also reviews the growing evidence supporting the use of maintenance ECT to prevent relapse after an acute successful course of treatment. Although ECT is administered uncommonly to patients under the age of 18, the evidence supporting its use is also reviewed in this patient population. Finally, memory loss associated with ECT and efforts at more effectively monitoring and reducing it are reviewed.

22 Review Self-Regulation and Psychopathology: Toward an Integrative Translational Research Paradigm. 2017

Strauman, Timothy J. ·Department of Psychology and Neuroscience, Duke University, Durham, North Carolina 27708; email: tjstraum@duke.edu. ·Annu Rev Clin Psychol · Pubmed #28375727.

ABSTRACT: This article presents a general framework in which different manifestations of psychopathology can be conceptualized as dysfunctions in one or more mechanisms of self-regulation, defined as the ongoing process of managing personal goal pursuit in the face of internal, interpersonal, and environmental forces that would derail it. The framework is based on the assertion that self-regulation is a critical locus for the proximal influence on motivation, cognition, emotion, and behavior of more distal factors such as genetics, temperament, socialization history, and neurophysiology. Psychological theories of self-regulation are ideal platforms from which to integrate the study of self-regulation both within and across traditional disciplines. This article has two related goals: to elucidate how the construct of self-regulation provides a unique conceptual platform for the study of psychopathology and to illustrate that platform by presenting our research on depression as an example.

23 Review Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. 2017

Mendenhall, Emily / Kohrt, Brandon A / Norris, Shane A / Ndetei, David / Prabhakaran, Dorairaj. ·School of Foreign Service, Georgetown University, Washington, DC, USA. Electronic address: em1061@georgetown.edu. · Department of Psychiatry, Duke Global Health Institute, Duke University, Durham, NC, USA. · MRC Developmental Pathways for Health Research Unit, Faculty of Health, University of the Witwatersrand, Johannesburg, South Africa. · Department of Psychiatry, University of Nairobi, Nairobi, Kenya; Africa Mental Health Foundation, Nairobi, Kenya. · Public Health Foundation of India, Centre for Chronic Disease Control, New Delhi, India; London School of Hygiene & Tropical Medicine, London, UK. ·Lancet · Pubmed #28271846.

ABSTRACT: The co-occurrence of health burdens in transitioning populations, particularly in specific socioeconomic and cultural contexts, calls for conceptual frameworks to improve understanding of risk factors, so as to better design and implement prevention and intervention programmes to address comorbidities. The concept of a syndemic, developed by medical anthropologists, provides such a framework for preventing and treating comorbidities. The term syndemic refers to synergistic health problems that affect the health of a population within the context of persistent social and economic inequalities. Until now, syndemic theory has been applied to comorbid health problems in poor immigrant communities in high-income countries with limited translation, and in low-income or middle-income countries. In this Series paper, we examine the application of syndemic theory to comorbidities and multimorbidities in low-income and middle-income countries. We employ diabetes as an exemplar and discuss its comorbidity with HIV in Kenya, tuberculosis in India, and depression in South Africa. Using a model of syndemics that addresses transactional pathophysiology, socioeconomic conditions, health system structures, and cultural context, we illustrate the different syndemics across these countries and the potential benefit of syndemic care to patients. We conclude with recommendations for research and systems of care to address syndemics in low-income and middle-income country settings.

24 Review The importance of physical function to people with osteoporosis. 2017

Kerr, C / Bottomley, C / Shingler, S / Giangregorio, L / de Freitas, H M / Patel, C / Randall, S / Gold, D T. ·ICON Patient Reported Outcomes, W. Diamond Avenue, Suite 1000, Gaithersburg, MD, 20878, USA. · University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada. · Geriatric Education and Research in Aging Sciences Centre, Hamilton, ON, Canada. · Research Institute for Aging, Waterloo, ON, Canada. · ICON Patient Reported Outcomes, W. Diamond Avenue, Suite 1000, Gaithersburg, MD, 20878, USA. hdefreitas@mapigroup.com. · Mapi, Translation and Innovation Hub Building, 80 Wood Lane, White City, London, W12 0BZ, UK. hdefreitas@mapigroup.com. · National Osteoporosis Foundation, 251 18th Street South, Suite 630, Arlington, VA, 22202, USA. · Duke University Medical Center, Durham, NC, 27710, USA. ·Osteoporos Int · Pubmed #28265717.

ABSTRACT: There is increasing need to understand patient outcomes in osteoporosis. This article discusses that fracture in osteoporosis can lead to a cycle of impairment, driven by complex psychosocial factors, having a profound impact on physical function/activity which accumulates over time. More information is required on how treatments impact physical function. INTRODUCTION: There is increasing need to understand patient-centred outcomes in osteoporosis (OP) clinical research and management. This multi-method paper provides insight on the effect of OP on patients' physical function and everyday activity. METHODS: Data were collected from three sources: (1) targeted literature review on OP and physical function, conducted in MEDLINE, Embase and PsycINFO; (2) secondary thematic analysis of transcripts from patient interviews, conducted to develop a patient-reported outcome instrument. Transcripts were re-coded to focus on OP impact on daily activities and physical function for those with and without fracture history; and (3) discussions of the literature review and secondary qualitative analysis results with three clinical experts to review and interpret the importance and implications of the findings. RESULTS: Results suggest that OP, particularly with fracture, can have profound impacts on physical function/activity. These impacts accumulate over time through a cycle of impairment, as fracture leads to longer term detriments in physical function, including loss of muscle, activity avoidance and reduced physical capacity, which in turn leads to greater risk of fracture and potential for further physical restrictions. The cycle of impairment is complex, as other physical, psychosocial and treatment-related factors, such as comorbidities, fears and beliefs about physical activity and fracture risk influence physical function and everyday activity. CONCLUSION: More information on how treatments impact physical function would benefit healthcare professionals and persons with OP in making treatment decisions and improving treatment compliance/persistence, as these impacts may be more salient to patients than fracture incidence.

25 Review How is depression experienced around the world? A systematic review of qualitative literature. 2017

Haroz, E E / Ritchey, M / Bass, J K / Kohrt, B A / Augustinavicius, J / Michalopoulos, L / Burkey, M D / Bolton, P. ·Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States. Electronic address: EHaroz1@jhu.edu. · Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, United States. · Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States. · Duke University, Duke Global Health Institute & Department of Psychiatry and Behavioral Sciences, Durham, NC 27710, United States. · School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, United States. · Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States. · Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, United States; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205, United States. ·Soc Sci Med · Pubmed #28069271.

ABSTRACT: To date global research on depression has used assessment tools based on research and clinical experience drawn from Western populations (i.e., in North American, European and Australian). There may be features of depression in non-Western populations which are not captured in current diagnostic criteria or measurement tools, as well as criteria for depression that are not relevant in other regions. We investigated this possibility through a systematic review of qualitative studies of depression worldwide. Nine online databases were searched for records that used qualitative methods to study depression. Initial searches were conducted between August 2012 and December 2012; an updated search was repeated in June of 2015 to include relevant literature published between December 30, 2012 and May 30, 2015. No date limits were set for inclusion of articles. A total of 16,130 records were identified and 138 met full inclusion criteria. Included studies were published between 1976 and 2015. These 138 studies represented data on 170 different study populations (some reported on multiple samples) and 77 different nationalities/ethnicities. Variation in results by geographical region, gender, and study context were examined to determine the consistency of descriptions across populations. Fisher's exact tests were used to compare frequencies of features across region, gender and context. Seven of the 15 features with the highest relative frequency form part of the DSM-5 diagnosis of Major Depressive Disorder (MDD). However, many of the other features with relatively high frequencies across the studies are associated features in the DSM, but are not prioritized as diagnostic criteria and therefore not included in standard instruments. The DSM-5 diagnostic criteria of problems with concentration and psychomotor agitation or slowing were infrequently mentioned. This research suggests that the DSM model and standard instruments currently based on the DSM may not adequately reflect the experience of depression at the worldwide or regional levels.