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Depression: HELP
Articles from Copenhagen
Based on 728 articles published since 2008
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These are the 728 published articles about Depression that originated from Copenhagen 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 Editorial [Electroconvulsive therapy for whom?]. 2015

Jørgensen, Martin Balslev. ·Institut for Klinisk Medicin, Københavns Universitet. martin.balslev.joergensen@regionh.dk. ·Ugeskr Laeger · Pubmed #26376413.

ABSTRACT: -- No abstract --

2 Editorial Electroconvulsive therapy reappraised. 2014

Bolwig, T G. ·Psychiatric Center Copenhagen, Copenhagen, Denmark. bolwig@tdcspace.dk. ·Acta Psychiatr Scand · Pubmed #24571063.

ABSTRACT: -- No abstract --

3 Review Low on energy? An energy supply-demand perspective on stress and depression. 2018

Østergaard, Leif / Jørgensen, Martin Balslev / Knudsen, Gitte Moos. ·Dept. Neuroradiology and Center of Functionally Integrative Neuroscience, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus, Denmark. Electronic address: leif@cfin.au.dk. · Psychiatric Centre Copenhagen, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. · Dept. Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. ·Neurosci Biobehav Rev · Pubmed #30145282.

ABSTRACT: Are energy demands too high, or our energy resources either too low or inappropriately prioritized, as we develop stress and/or depression? We review evidence of dysregulated cellular energy homeostasis and energy depletion in stress and depression, identifying factors that might limit energy substrate availability. Resetting of cellular energy-sensors, splanchnic hypoxia, and catecholamine effects on blood viscosity emerge as mechanisms that might disrupt normal energy homeostasis, accelerate cell injury, and cause depression-like symptoms in severe or prolonged stress. In particular, a vicious cycle of capillary dysfunction, cellular hypoxia, and inflammation emerges as a mechanism, by which prolonged stress might accelerate the development of diseases, including depression, in later life. Oxygen is a substrate for both serotonin- and ATP-synthesis, and the review therefore analyzes evidence of reduced oxygen availability in neurological diseases with high incidence of depression. Blood supply and oxygen availability are also keys to the inference of neuronal activity by functional neuroimaging. We review how neurotransmitters interfere with blood flow regulation, affecting interpretations of neuroimaging studies in stress and depression.

4 Review Does S100B have a potential role in affective disorders? A literature review. 2018

Kroksmark, Hilda / Vinberg, Maj. ·a Psychiatric Centre Copenhagen, Rigshospitalet, University Hospital of Copenhagen , Copenhagen , Denmark. ·Nord J Psychiatry · Pubmed #29764272.

ABSTRACT: BACKGROUND: S100B is a calcium-binding protein located in glial cells; it is regarded as a potential biomarker in affective disorders. AIM: To review the literature investigating the role of S100B in patients with affective disorders. METHOD: A systematic review of original English language studies investigating S100B in serum, cerebrospinal fluid, plasma and lymphocytes, in patients with affective disorders, was conducted. The literature search was conducted within the PubMed database. Effect sizes were calculated to adjust for systematic measurement effects. RESULTS: Twenty studies were included, with a total of 1292 participants. Of these, 398 patients had or have had depressive disorder, 301 patients had bipolar disorder and 593 were healthy controls. S100B levels in serum were consistently elevated in studies with statistically significant results which investigated acute affective episodes (comprising major depressive episode in major depressive disorder, and both manic and depressive episodes in patients with bipolar disorder), in comparison to healthy controls. There were few studies assessing S100B levels in cerebrospinal fluid, plasma or lymphocytes, and these had inconsistent results. CONCLUSION: The results indicated that elevated S100B levels might be associated with mood episodes in affective disorders. However, the role of S100B, and its possible impact in affective disorders, requires further investigation and at the present S100B does not have a role as clinically biomarker in affective disorder. Future longitudinal multicentre studies with larger transdiagnostic real life patient cohorts are warranted.

5 Review [Fatigue syndrome: Stress, Burnout and depression in Urology.] 2018

Rodríguez-Socarrás, Moisés / Vasquez, Juan Luis / Uvin, Pieter / Skjold-Kingo, Pernille / Gómez Rivas, Juan. ·Servicio de Urología. Hospital universitario Alvaro Cunqueiro. Vigo. España. · Department of Urology. Copenhagen University Hospital Herlev. Copenhagen. Denmark. · Department of Urology. AZ Sint-Lucas. Ghent. Belgium. · Department of Urology. Aarhus University Hospital. Aarhus. Denmark. · Servicio de Urología. Hospital Universitario La Paz. Madrid. España. European Association of Urology/Young Academics Urologists. Uro-Technology and communications working party. (ESUT-YAUwp). Arnhem. The Netherlands. ·Arch Esp Urol · Pubmed #29336332.

ABSTRACT: OBJECTIVE: To determine the factors related to stress, Burnout and depression in urology, as well as consequences in residents and urologists, in addition to the possible applicable strategies to diminish and treat them. ACQUISITION OF THE EVIDENCE: Depression, stress and Burnout syndrome has become a problem in urology specialty. These topics have gained interest in international congresses and urological associations. Efforts are being made to find related factors as well as possible strategies and applicable support programs. SYNTHESIS OF EVIDENCE: Burnout frequency is higher among health professionals than general population, 40-76% in students and residents, its incidence has skyrocketed in recent years, in addition Urology is one of the specialties with highest incidence and severity. Its increase has been related to work overload, documentation, administrative/bureaucratic workload, hostile work environment; its consequences include poor work performance, medical errors, depression, substance abuse, disruption in family and couple relationships and suicidal ideation. Strategies for prevention including resilience training, lifestyle balance, teamwork, and support programs. CONCLUSION: Stress, burnout and depression are problems in urology, early detection, promoting individual techniques in resilience, lifestyle and teamwork are fundamental now and for the future of the specialty. Developing and implementing support programs should be seriously considered by health systems and urological associations.

6 Review Forgetting and emotion regulation in mental health, anxiety and depression. 2018

Nørby, Simon. ·a Danish School of Education , Aarhus University , Copenhagen , Denmark. ·Memory · Pubmed #28697639.

ABSTRACT: Does normal forgetting facilitate mental health and is forgetting impaired in affective disorders? This double-sided question may seem counterintuitive given the fact that forgetting is often associated with troubles in everyday life. However, forgetting does not only have destructive consequences, but also fulfils important functions. I consider the possibility that forgetting may function as a beneficial sorting mechanism which helps healthy people discard information that is undesirable and unpleasant. Thus, selective forgetting of negative memories may be part of emotion regulation, that is, people's attempts to control when and how they experience and express emotions. Such forgetting may allow for a focus on positive memories and thereby help form a mnemonic basis for optimism as well as active and explorative approach behaviour. Also, I consider the possibility that anxiety and depression may in part result from and be maintained by a diminished capacity to forget. A reduced ability to selectively forget negative memories may be one reason that such disorders are characterised by painful emotions such as fear and sadness as well as defensive and withdrawn behaviour. Overall, I review and reflect on evidence for and against functional forgetting in mental health and dysfunctional forgetting in affective disorders.

7 Review Anaesthesia for electroconvulsive therapy - new tricks for old drugs: a systematic review. 2018

Stripp, Tobias Kvist / Jorgensen, Martin Balslev / Olsen, Niels Vidiendal. ·1Department of Neuroscience and Pharmacology,The Health Faculty,University of Copenhagen,Copenhagen,Denmark. · 2Psychiatric Centre Copenhagen,University Hospital of Copenhagen,Copenhagen,Denmark. ·Acta Neuropsychiatr · Pubmed #28462732.

ABSTRACT: OBJECTIVE: The objective of this review is to investigate existing literature in order to delineate whether the use of anaesthesia and timing of seizure induction in a new and optimised way may improve the efficacy of electroconvulsive therapy (ECT). METHODS: PubMed/MEDLINE was searched for existing literature, last search on 24 June 2015. Relevant clinical studies on human subjects involving choice of anaesthetic, ventilation and bispectral index (BIS) monitoring in the ECT setting were considered. The references of relevant studies were likewise considered. RESULTS: Propofol yields the shortest seizures, etomidate and ketamine the longest. Etomidate and ketamine+propofol 1 : 1 seems to yield the seizures with best quality. Seizure quality is improved when induction of ECT is delayed until the effect of the anaesthetic has waned - possibly monitored with BIS values. Manual hyperventilation with 100% O2 may increase the pO2/pCO2-ratio, which may be correlated with better seizure quality. CONCLUSION: Etomidate or a 1 : 1 ketamine and propofol combination may be the best method to achieve general anaesthesia in the ECT setting. There is a need for large randomised prospective studies comparing the effect of methohexital, thiopental, propofol, ketamine, propofol+ketamine 1 : 1 and etomidate in the ECT treatment of major depressed patients. These studies should investigate safety and side effects, and most importantly have antidepressant efficacy and cognitive side effects as outcome measures instead of seizure quality.

8 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.

9 Review Exercise for patients with major depression: a systematic review with meta-analysis and trial sequential analysis. 2017

Krogh, Jesper / Hjorthøj, Carsten / Speyer, Helene / Gluud, Christian / Nordentoft, Merete. ·Faculty of Health Sciences, Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark. · Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. ·BMJ Open · Pubmed #28928174.

ABSTRACT: OBJECTIVES: To assess the benefits and harms of exercise in patients with depression. DESIGN: Systematic review DATA SOURCES: Bibliographical databases were searched until 20 June 2017. ELIGIBILITY CRITERIA AND OUTCOMES: Eligible trials were randomised clinical trials assessing the effect of exercise in participants diagnosed with depression. Primary outcomes were depression severity, lack of remission and serious adverse events (eg, suicide) assessed at the end of the intervention. Secondary outcomes were quality of life and adverse events such as injuries, as well as assessment of depression severity and lack of remission during follow-up after the intervention. RESULTS: Thirty-five trials enrolling 2498 participants were included. The effect of exercise versus control on depression severity was -0.66 standardised mean difference (SMD) (95% CI -0.86 to -0.46; p<0.001; grading of recommendations assessment, development and evaluation (GRADE): very low quality). Restricting this analysis to the four trials that seemed less affected of bias, the effect vanished into -0.11 SMD (-0.41 to 0.18; p=0.45; GRADE: low quality). Exercise decreased the relative risk of no remission to 0.78 (0.68 to 0.90; p<0.001; GRADE: very low quality). Restricting this analysis to the two trials that seemed less affected of bias, the effect vanished into 0.95 (0.74 to 1.23; p=0.78). Trial sequential analysis excluded random error when all trials were analysed, but not if focusing on trials less affected of bias. Subgroup analyses found that trial size and intervention duration were inversely associated with effect size for both depression severity and lack of remission. There was no significant effect of exercise on secondary outcomes. CONCLUSIONS: Trials with less risk of bias suggested no antidepressant effects of exercise and there were no significant effects of exercise on quality of life, depression severity or lack of remission during follow-up. Data for serious adverse events and adverse events were scarce not allowing conclusions for these outcomes. SYSTEMATIC REVIEW REGISTRATION: The protocol was published in the journal

10 Review Rate and predictors of conversion from unipolar to bipolar disorder: A systematic review and meta-analysis. 2017

Kessing, Lars Vedel / Willer, Inge / Andersen, Per Kragh / Bukh, Jens Drachman. ·Psychiatric Center Copenhagen, Department O and University of Copenhagen, Copenhagen, Denmark. · Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark. ·Bipolar Disord · Pubmed #28714575.

ABSTRACT: OBJECTIVES: For the first time to present a systematic review and meta-analysis of the conversion rate and predictors of conversion from unipolar disorder to bipolar disorder. METHODS: A systematic literature search up to October 2016 was performed. For the meta-analysis, we only included studies that used survival analysis to estimate the conversion rate. RESULTS: A total of 31 studies were identified, among which 11 used survival analyses, including two register-based studies. The yearly rate of conversion to bipolar disorder decreased with time from 3.9% in the first year after study entry with a diagnosis of unipolar disorder to 3.1% in years 1-2, 1.0% in years 2-5 and 0.8% in years 5-10. A total of eight risk factors were evaluated comprising gender, age at onset of unipolar disorder, number of depressive episodes, treatment resistance to antidepressants, family history of bipolar disorder, the prevalence of psychotic depression, the prevalence of chronic depression, and severity of depression. It was not possible to identify risk factors that were consistently or mainly confirmed to predict conversion across studies. CONCLUSIONS: The conversion rate from unipolar to bipolar disorder decreases with time. It was not possible to identify predictors of conversion that were consistently or mainly confirmed across studies, which may be due to variations in methodology across studies.

11 Review Does vital exhaustion increase the risk of type 2 diabetes? A prospective study. 2017

Volden, Sasia / Wimmelmann, Cathrine Lawaetz / Flensborg-Madsen, Trine. ·The Copenhagen City Heart Study, Hovedvejen, entrance 5, 1st floor, Frederiksberg Hospital, 2000 Frederiksberg, Denmark. Electronic address: sasia.volden@gmail.com. · Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 05 1353 Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark. Electronic address: calw@sund.ku.dk. · Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Building 05 1353 Copenhagen, Denmark; Center for Healthy Aging, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark. Electronic address: tfma@sund.ku.dk. ·J Psychosom Res · Pubmed #28712434.

ABSTRACT: BACKGROUND: There is evidence that both stress and depression have a causal relationship with type 2 diabetes suggesting that vital exhaustion (VE) too could be a risk factor. The association between VE and type 2 diabetes has, however, not been investigated prospectively. AIM: To prospectively investigate whether VE is associated with an increased risk of type 2 diabetes in a Danish population. METHODS: A prospective cohort study based on the Copenhagen City Heart Study (1991-1993). The degree of VE was measured among 9075 participants without type 1 or 2 diabetes at baseline. To detect type 2 diabetes in the follow-up period, two different approaches were used: In the first substudy, type 2 diabetes was defined based on blood samples and questionnaires from a follow-up study in 2001-2003 (N=4708). The second substudy was register-based, and the study population was linked to the Danish Hospital Discharge Register to detect registrations with type 2 diabetes until 2014. RESULTS: A high degree of VE was associated with an increased risk of developing type 2 diabetes in both substudies. In the first substudy, the OR for developing type 2 diabetes was 2.56 (95% CI, 1.53; 4,29, P<0,001) among the quartile of participants reporting the highest degree of VE. In the second substudy, the OR was 1.31 (95% CI, 0.99; 1.72, P=0.053) for this group. CONCLUSION: The results indicate that VE may be a useful measure in clinical practice in order to discover individuals at risk of type 2 diabetes.

12 Review A Systematic Review of the Clinimetric Properties of the 6-Item Version of the Hamilton Depression Rating Scale (HAM-D6). 2017

Timmerby, N / Andersen, J H / Søndergaard, S / Østergaard, S D / Bech, Per. ·Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark. ·Psychother Psychosom · Pubmed #28490031.

ABSTRACT: BACKGROUND: In a study aimed at identifying the items carrying information regarding the global severity of depression, the 6-item Hamilton Depression Rating Scale (HAM-D6) was derived from the original 17-item version of the scale (HAM-D17). Since then, the HAM-D6 has been used in a wide range of clinical studies. We now provide a systematic review of the clinimetric properties of HAM-D6 in comparison with those of HAM-D17 and the Montgomery Asberg Depression Rating Scale (MADRS). METHODS: We conducted a systematic search of the literature in PubMed, PsycInfo, and EMBASE databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Studies reporting data on the clinimetric validity of the HAM-D6 and either the HAM-D17 or MADRS in non-psychotic unipolar or bipolar depression were included in the synthesis. RESULTS: The search identified 681 unique records, of which 51 articles met the inclusion criteria. According to the published literature, HAM-D6 has proven to be superior to both HAM-D17 and MADRS in terms of scalability (each item contains unique information regarding syndrome severity), transferability (scalability is constant over time and irrespective of sex, age, and depressive subtypes), and responsiveness (sensitivity to change in severity during treatment). CONCLUSIONS: According to the published literature, the clinimetric properties of HAM-D6 are superior to those of both the HAM-D17 and MADRS. Since the validity of HAM-D6 has been demonstrated in both research and clinical practice, using the scale more consistently would facilitate translation of results from one setting to the other.

13 Review Effort-reward imbalance at work and risk of depressive disorders. A systematic review and meta-analysis of prospective cohort studies. 2017

Rugulies, Reiner / Aust, Birgit / Madsen, Ida Eh. ·National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen. rer@nrcwe.dk. ·Scand J Work Environ Health · Pubmed #28306759.

ABSTRACT: Objective The aim of this review was to determine whether employees exposed to effort-reward imbalance (ERI) at work have a higher risk of depressive disorders than non-exposed employees. Methods We conducted a systematic review and meta-analysis of published prospective cohort studies examining the association of ERI at baseline with onset of depressive disorders at follow-up. The work was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and a detailed study protocol was registered before literature search commenced (Registration number: CRD42016047581). We obtained a summary estimate for the association of ERI with risk of depressive disorders by pooling the study-specific estimates in a meta-analysis. We further conducted pre-defined sensitivity analyses. Results We identified eight eligible cohort studies, encompassing 84 963 employees and 2897 (3.4%) new cases of depressive disorders. Seven of the eight studies suggested an increased risk of depressive disorders among employees exposed to ERI. The pooled random-effects estimate was 1.49 [95% confidence interval (95% CI) 1.23-1.80, P<0.001], indicating that ERI predicts risk of depressive disorders. The estimate was robust in sensitivity analyses stratified by study quality, type of ERI ascertainment and type depressive disorder ascertainment, respectively. Conclusions Employees exposed to ERI were at increased risk of depressive disorder. Future studies on ERI and depressive disorders should examine if this association is stronger or weaker when ERI is measured repeatedly during follow-up and with other methods than self-report or when depressive disorders are ascertained with clinical diagnostic interviews.

14 Review Do Statins Have Antidepressant Effects? 2017

Köhler-Forsberg, Ole / Gasse, Christiane / Berk, Michael / Østergaard, Søren Dinesen. ·Psychosis Research Unit, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark. karkoe@rm.dk. · Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. karkoe@rm.dk. · Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. karkoe@rm.dk. · National Centre for Register-Based Research (NCRR), Aarhus University, Aarhus, Denmark. · iPSYCH, The Lundbeck Initiative for Integrated Research in Psychiatry, Aarhus, Denmark. · Deakin University, School of Medicine, IMPACT Strategic Research Centre, Geelong, VIC, Australia. · Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia. · The Florey Institute for Neuroscience and Mental Health, Parkville, VIC, Australia. · Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia. · Psychosis Research Unit, Aarhus University Hospital, Skovagervej 2, 8240, Risskov, Denmark. · Department of Clinical Medicine, Aarhus University, Aarhus, Denmark. ·CNS Drugs · Pubmed #28303466.

ABSTRACT: Statins are used widely in primary and secondary prevention of cardiovascular disease; a treatment effect that has long been thought to be due to their cholesterol-lowering properties. However, statins also have a wide range of anti-inflammatory effects independent of their lipid-lowering mechanisms. In depression, low-grade inflammation is a replicated finding, and several studies have shown antidepressant properties of diverse anti-inflammatory drugs. Large observational studies have suggested reduced risks of depression amongst those taking statins, an effect that is thought to be explained by the anti-inflammatory properties of this class of drugs. Also, preliminary randomized controlled trials (RCTs) have indicated that statins may have adjunctive antidepressant effects when used as add-on treatment to selective serotonin reuptake inhibitors (SSRIs). However, the RCTs were small and limited by low generalizability, and some early observational studies have pointed towards potential neuropsychiatric adverse effects of statin treatment. Nevertheless, based on the good tolerability and general safety of the statins, researchers are currently investigating the potential antidepressant properties of these agents. The present review aims to give an overview on the potential antidepressant effects of statins based on their anti-inflammatory properties, covering topics such as safety versus treatment effects, potential mechanisms of action and the possibility of targeted treatment (precision medicine).

15 Review Risk Estimates and Risk Factors Related to Psychiatric Inpatient Suicide-An Overview. 2017

Madsen, Trine / Erlangsen, Annette / Nordentoft, Merete. ·Danish Research Institute for Suicide Prevention, Copenhagen Mental Health center, 2900 Hellerup, Denmark. trine.madsen@regionh.dk. · Danish Research Institute for Suicide Prevention, Copenhagen Mental Health center, 2900 Hellerup, Denmark. Annette.Erlangsen@regionh.dk. · Department of Mental Health, Bloomberg Johns Hopkins School of Public Health, Baltimore, MD 21205, USA. Annette.Erlangsen@regionh.dk. · Institute of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark. Annette.Erlangsen@regionh.dk. · Danish Research Institute for Suicide Prevention, Copenhagen Mental Health center, 2900 Hellerup, Denmark. merete.nordentoft@regionh.dk. ·Int J Environ Res Public Health · Pubmed #28257103.

ABSTRACT: People with mental illness have an increased risk of suicide. The aim of this paper is to provide an overview of suicide risk estimates among psychiatric inpatients based on the body of evidence found in scientific peer-reviewed literature; primarily focusing on the relative risks, rates, time trends, and socio-demographic and clinical risk factors of suicide in psychiatric inpatients. Psychiatric inpatients have a very high risk of suicide relative to the background population, but it remains challenging for clinicians to identify those patients that are most likely to die from suicide during admission. Most studies are based on low power, thus compromising quality and generalisability. The few studies with sufficient statistical power mainly identified non-modifiable risk predictors such as male gender, diagnosis, or recent deliberate self-harm. Also, the predictive value of these predictors is low. It would be of great benefit if future studies would be based on large samples while focusing on modifiable predictors over the course of an admission, such as hopelessness, depressive symptoms, and family/social situations. This would improve our chances of developing better risk assessment tools.

16 Review Selective serotonin reuptake inhibitors versus placebo in patients with major depressive disorder. A systematic review with meta-analysis and Trial Sequential Analysis. 2017

Jakobsen, Janus Christian / Katakam, Kiran Kumar / Schou, Anne / Hellmuth, Signe Gade / Stallknecht, Sandra Elkjær / Leth-Møller, Katja / Iversen, Maria / Banke, Marianne Bjørnø / Petersen, Iggiannguaq Juhl / Klingenberg, Sarah Louise / Krogh, Jesper / Ebert, Sebastian Elgaard / Timm, Anne / Lindschou, Jane / Gluud, Christian. ·The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812 Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Rigshospitalet, DK 2100, Copenhagen, Denmark. jcj@ctu.dk. · Department of Cardiology, Holbæk Hospital, Holbæk, Denmark. jcj@ctu.dk. · The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Department 7812 Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Rigshospitalet, DK 2100, Copenhagen, Denmark. · Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark. ·BMC Psychiatry · Pubmed #28178949.

ABSTRACT: BACKGROUND: The evidence on selective serotonin reuptake inhibitors (SSRIs) for major depressive disorder is unclear. METHODS: Our objective was to conduct a systematic review assessing the effects of SSRIs versus placebo, 'active' placebo, or no intervention in adult participants with major depressive disorder. We searched for eligible randomised clinical trials in The Cochrane Library's CENTRAL, PubMed, EMBASE, PsycLIT, PsycINFO, Science Citation Index Expanded, clinical trial registers of Europe and USA, websites of pharmaceutical companies, the U.S. Food and Drug Administration (FDA), and the European Medicines Agency until January 2016. All data were extracted by at least two independent investigators. We used Cochrane systematic review methodology, Trial Sequential Analysis, and calculation of Bayes factor. An eight-step procedure was followed to assess if thresholds for statistical and clinical significance were crossed. Primary outcomes were reduction of depressive symptoms, remission, and adverse events. Secondary outcomes were suicides, suicide attempts, suicide ideation, and quality of life. RESULTS: A total of 131 randomised placebo-controlled trials enrolling a total of 27,422 participants were included. None of the trials used 'active' placebo or no intervention as control intervention. All trials had high risk of bias. SSRIs significantly reduced the Hamilton Depression Rating Scale (HDRS) at end of treatment (mean difference -1.94 HDRS points; 95% CI -2.50 to -1.37; P < 0.00001; 49 trials; Trial Sequential Analysis-adjusted CI -2.70 to -1.18); Bayes factor below predefined threshold (2.01*10 CONCLUSIONS: SSRIs might have statistically significant effects on depressive symptoms, but all trials were at high risk of bias and the clinical significance seems questionable. SSRIs significantly increase the risk of both serious and non-serious adverse events. The potential small beneficial effects seem to be outweighed by harmful effects. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42013004420.

17 Review Job strain as a risk factor for clinical depression: systematic review and meta-analysis with additional individual participant data. 2017

Madsen, I E H / Nyberg, S T / Magnusson Hanson, L L / Ferrie, J E / Ahola, K / Alfredsson, L / Batty, G D / Bjorner, J B / Borritz, M / Burr, H / Chastang, J-F / de Graaf, R / Dragano, N / Hamer, M / Jokela, M / Knutsson, A / Koskenvuo, M / Koskinen, A / Leineweber, C / Niedhammer, I / Nielsen, M L / Nordin, M / Oksanen, T / Pejtersen, J H / Pentti, J / Plaisier, I / Salo, P / Singh-Manoux, A / Suominen, S / Ten Have, M / Theorell, T / Toppinen-Tanner, S / Vahtera, J / Väänänen, A / Westerholm, P J M / Westerlund, H / Fransson, E I / Heikkilä, K / Virtanen, M / Rugulies, R / Kivimäki, M / Anonymous6130894. ·National Research Centre for the Working Environment,DK-2100 Copenhagen Ø,Denmark. · Finnish Institute of Occupational Health,FI-00250 Helsinki,Finland. · Stress Research Institute, Stockholm University,SE-106 91 Stockholm,Sweden. · Department of Epidemiology and Public Health,University College London,London WC1E 6BT,UK. · Institute of Environmental Medicine,Karolinska Institutet,SE-171 77 Stockholm,Sweden. · Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,DK-2400 Copenhagen,Denmark. · Federal Institute for Occupational Safety and Health (BAuA),D-10317 Berlin,Germany. · INSERM, U1085, Research Institute for Environmental and Occupational Health (IRSET), Epidemiology in Occupational Health and Ergonomics (ESTER) Team, F-49000, Angers,France. · Netherlands Institute of Mental Health and Addiction,3521 VS Utrecht,The Netherlands. · Department of Medical Sociology,University of Düsseldorf,40225 Düsseldorf,Germany. · Institute of Behavioral Sciences,University of Helsinki,FI-00014 Helsinki,Finland. · Department of Health Sciences,Mid Sweden University,SE-851 70 Sundsvall,Sweden. · Department of Public Health,University of Helsinki,FI-00014 Helsinki,Finland. · Unit of Social Medicine,Frederiksberg University Hospital,DK-2000 Copenhagen,Denmark. · The Danish National Centre for Social Research,DK-1052 Copenhagen,Denmark. · The Netherlands Institute for Social Research,2515 XP The Hague,The Netherlands. · Folkhälsan Research Center,FI-00290 Helsinki,Finland. · Occupational and Environmental Medicine,Uppsala University,SE-751 85 Uppsala,Sweden. ·Psychol Med · Pubmed #28122650.

ABSTRACT: BACKGROUND: Adverse psychosocial working environments characterized by job strain (the combination of high demands and low control at work) are associated with an increased risk of depressive symptoms among employees, but evidence on clinically diagnosed depression is scarce. We examined job strain as a risk factor for clinical depression. METHOD: We identified published cohort studies from a systematic literature search in PubMed and PsycNET and obtained 14 cohort studies with unpublished individual-level data from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium. Summary estimates of the association were obtained using random-effects models. Individual-level data analyses were based on a pre-published study protocol. RESULTS: We included six published studies with a total of 27 461 individuals and 914 incident cases of clinical depression. From unpublished datasets we included 120 221 individuals and 982 first episodes of hospital-treated clinical depression. Job strain was associated with an increased risk of clinical depression in both published [relative risk (RR) = 1.77, 95% confidence interval (CI) 1.47-2.13] and unpublished datasets (RR = 1.27, 95% CI 1.04-1.55). Further individual participant analyses showed a similar association across sociodemographic subgroups and after excluding individuals with baseline somatic disease. The association was unchanged when excluding individuals with baseline depressive symptoms (RR = 1.25, 95% CI 0.94-1.65), but attenuated on adjustment for a continuous depressive symptoms score (RR = 1.03, 95% CI 0.81-1.32). CONCLUSIONS: Job strain may precipitate clinical depression among employees. Future intervention studies should test whether job strain is a modifiable risk factor for depression.

18 Review Heart rate variability in bipolar disorder: A systematic review and meta-analysis. 2017

Faurholt-Jepsen, Maria / Kessing, Lars Vedel / Munkholm, Klaus. ·Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhgaen, Blegdamsvej 9, DK- 2100 Copenhagen, Denmark. Electronic address: maria@faurholt-jepsen.dk. · Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhgaen, Blegdamsvej 9, DK- 2100 Copenhagen, Denmark. ·Neurosci Biobehav Rev · Pubmed #27986468.

ABSTRACT: BACKGROUND: Heart rate variability (HRV) has been suggested reduced in bipolar disorder (BD) compared with healthy individuals (HC). This meta-analysis investigated: HRV differences in BD compared with HC, major depressive disorder or schizophrenia; HRV differences between affective states; HRV changes from mania/depression to euthymia; and HRV changes following interventions. METHODS: A systematic review and meta-analysis reported according to the PRISMA guidelines was conducted. MEDLINE, Embase, PsycINFO, The Cochrane Library and Scopus were searched. A total of 15 articles comprising 2534 individuals were included. RESULTS: HRV was reduced in BD compared to HC (g=-1.77, 95% CI: -2.46; -1.09, P<0.001, 10 comparisons, n=1581). More recent publication year, larger study and higher study quality were associated with a smaller difference in HRV. Large between-study heterogeneity, low study quality, and lack of consideration of confounding factors in individual studies were observed. CONCLUSIONS: This first meta-analysis of HRV in BD suggests that HRV is reduced in BD compared to HC. Heterogeneity and methodological issues limit the evidence. Future studies employing strict methodology are warranted.

19 Review The determinants of food choice. 2017

Leng, Gareth / Adan, Roger A H / Belot, Michele / Brunstrom, Jeffrey M / de Graaf, Kees / Dickson, Suzanne L / Hare, Todd / Maier, Silvia / Menzies, John / Preissl, Hubert / Reisch, Lucia A / Rogers, Peter J / Smeets, Paul A M. ·Centre for Integrative Physiology, University of Edinburgh,George Square,Edinburgh,EH8 9XD,UK. · Department Translational Neuroscience,Brain Center Rudolf Magnus, University Medical Center Utrecht,Utrecht,The Netherlands. · European University Institute,Via dei Roccettini 9,I-50014 San Domenico di Fiesole,Italy. · Nutrition and Behaviour Unit, School of Experimental Psychology, University of Bristol,12a Priory Road,Bristol BS8 1TU,UK. · Division of Human Nutrition,Wageningen University & Research Centre,Wageningen,Stippeneng 4,6708 WE,The Netherlands. · Department Physiology/Endocrine,Institute of Neuroscience and Physiology, The Sahlgrenka Academy at the University of Gothenburg,SE-405 30 Gothenburg,Sweden. · Laboratory for Social and Neural Systems Research, Department of Economics,University of Zurich,Bluemlisalpstrasse 10,8006 Zurich,Switzerland. · Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen; German Center for Diabetes Research (DZD e.V.),Tübingen,Germany. · Department of Intercultural Communication and Management,Copenhagen Business School,Porcelaenshaven 18a,DK - 2000 Frederiksberg,Denmark. ·Proc Nutr Soc · Pubmed #27903310.

ABSTRACT: Health nudge interventions to steer people into healthier lifestyles are increasingly applied by governments worldwide, and it is natural to look to such approaches to improve health by altering what people choose to eat. However, to produce policy recommendations that are likely to be effective, we need to be able to make valid predictions about the consequences of proposed interventions, and for this, we need a better understanding of the determinants of food choice. These determinants include dietary components (e.g. highly palatable foods and alcohol), but also diverse cultural and social pressures, cognitive-affective factors (perceived stress, health attitude, anxiety and depression), and familial, genetic and epigenetic influences on personality characteristics. In addition, our choices are influenced by an array of physiological mechanisms, including signals to the brain from the gastrointestinal tract and adipose tissue, which affect not only our hunger and satiety but also our motivation to eat particular nutrients, and the reward we experience from eating. Thus, to develop the evidence base necessary for effective policies, we need to build bridges across different levels of knowledge and understanding. This requires experimental models that can fill in the gaps in our understanding that are needed to inform policy, translational models that connect mechanistic understanding from laboratory studies to the real life human condition, and formal models that encapsulate scientific knowledge from diverse disciplines, and which embed understanding in a way that enables policy-relevant predictions to be made. Here we review recent developments in these areas.

20 Review Evidence for clinical progression of unipolar and bipolar disorders. 2017

Kessing, L V / Andersen, P K. ·Department O, Psychiatric Center Copenhagen, Copenhagen, Denmark. · University of Copenhagen, Copenhagen, Denmark. · Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark. ·Acta Psychiatr Scand · Pubmed #27858964.

ABSTRACT: OBJECTIVE: It is a widely held belief that affective disorders are progressive of nature; however, some recent reviews have questioned this belief. The objective of the present systematic literature review was to present evidence for associations between number of affective episodes and (i) the risk of recurrence of episodes, (ii) probability of recovery from episodes, (iii) severity of episodes, (iv) the threshold for developing episodes, and (v) progression of cognitive deficits in unipolar and bipolar disorders. METHOD: A systematic review comprising an extensive literature search conducted in Medline, Embase, and PsychInfo up to September 2016 and including cross-references from identified papers and reviews. RESULTS: Most of the five areas are superficially investigated and hampered by methodological challenges. Nevertheless, studies with the longest follow-up periods, using survival analysis methods, taking account of the individual heterogeneity all support a clinical progressive course of illness. Overall, increasing number of affective episodes seems to be associated with (i) increasing risk of recurrence, (ii) increasing duration of episodes, (iii) increasing symptomatic severity of episodes, (iv) decreasing threshold for developing episodes, and (v) increasing risk of developing dementia. CONCLUSION: Although the course of illness is heterogeneous, there is evidence for clinical progression of unipolar and bipolar disorders.

21 Review Enablers and barriers to implementing collaborative care for anxiety and depression: a systematic qualitative review. 2016

Overbeck, Gritt / Davidsen, Annette Sofie / Kousgaard, Marius Brostrøm. ·The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, København, Denmark. gritt.overbeck@sund.ku.dk. · The Research Unit for General Practice and Section of General Practice, Institute of Public Health, University of Copenhagen, København, Denmark. ·Implement Sci · Pubmed #28031028.

ABSTRACT: BACKGROUND: Collaborative care is an increasingly popular approach for improving quality of care for people with mental health problems through an intensified and structured collaboration between primary care providers and health professionals with specialized psychiatric expertise. Trials have shown significant positive effects for patients suffering from depression, but since collaborative care is a complex intervention, it is important to understand the factors which affect its implementation. We present a qualitative systematic review of the enablers and barriers to implementing collaborative care for patients with anxiety and depression. METHODS: We developed a comprehensive search strategy in cooperation with a research librarian and performed a search in five databases (EMBASE, PubMed, PsycINFO, ProQuest, and CINAHL). All authors independently screened titles and abstracts and reviewed full-text articles. Studies were included if they were published in English and based on the original qualitative data on the implementation of a collaborative care intervention targeted at depression or anxiety in an adult patient population in a high-income country. Our subsequent analysis employed the normalization process theory (NPT). RESULTS: We included 17 studies in our review of which 11 were conducted in the USA, five in the UK, and one in Canada. We identified several barriers and enablers within the four major analytical dimensions of NPT. Securing buy-in among primary care providers was found to be critical but sometimes difficult. Enablers included physician champions, reimbursement for extra work, and feedback on the effectiveness of collaborative care. The social and professional skills of the care managers seemed critical for integrating collaborative care in the primary health care clinic. Day-to-day implementation was also found to be facilitated by the care managers being located in the clinic since this supports regular face-to-face interactions between physicians and care managers. CONCLUSIONS: The following areas require special attention when planning collaborative care interventions: effective educational programs, especially for care managers; issues of reimbursement in relation to primary care providers; good systems for communication and monitoring; and promoting face-to-face interaction between care managers and physicians, preferably through co-location. There is a need for well-sampled, in-depth qualitative studies on the implementation of collaborative care in settings outside the USA and the UK.

22 Review Life Span Studies of ADHD-Conceptual Challenges and Predictors of Persistence and Outcome. 2016

Caye, Arthur / Swanson, James / Thapar, Anita / Sibley, Margaret / Arseneault, Louise / Hechtman, Lily / Arnold, L Eugene / Niclasen, Janni / Moffitt, Terrie / Rohde, Luis Augusto. ·ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. · Department of Pediatrics, University of California, Irvine, CA, USA. · MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK. · Department of Psychiatry and Behavioral Health at the Florida International University, Herbert Wertheim College of Medicine, Miami, FL, USA. · MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. · Department of Psychiatry, McGill University, Montreal, Quebec, Canada. · Department of Psychiatry, Nisonger Center, Ohio State University, Columbus, OH, USA. · Department of Psychology, University of Copenhagen, Copenhagen, Denmark. · Centre for Collaborative Health, Aarhus University, Aarhus, Denmark. · Department of Psychology and Neuroscience, Duke University, Durham, NC, USA. · ADHD Outpatient Program, Hospital de Clínicas de Porto Alegre, Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. lrohde@terra.com.br. · National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil. lrohde@terra.com.br. · Serviço de Psiquiatria da Infância e Adolescência, Hospital de Clinicas de Porto Alegre, 4o andar, Rua Ramiro Barcelos 2350, Porto Alegre, 90035-003, Brazil. lrohde@terra.com.br. ·Curr Psychiatry Rep · Pubmed #27783340.

ABSTRACT: There is a renewed interest in better conceptualizing trajectories of attention-deficit/hyperactivity disorder (ADHD) from childhood to adulthood, driven by an increased recognition of long-term impairment and potential persistence beyond childhood and adolescence. This review addresses the following major issues relevant to the course of ADHD in light of current evidence from longitudinal studies: (1) conceptual and methodological issues related to measurement of persistence of ADHD, (2) estimates of persistence rate from childhood to adulthood and its predictors, (3) long-term negative outcomes of childhood ADHD and their early predictors, and (4) the recently proposed new adult-onset ADHD. Estimates of persistence vary widely in the literature, and diagnostic criteria, sample characteristics, and information source are the most important factors explaining variability among studies. Evidence indicates that ADHD severity, comorbid conduct disorder and major depressive disorder, and treatment for ADHD are the main predictors of ADHD persistence from childhood to adulthood. Comorbid conduct disorder and ADHD severity in childhood are the most important predictors of adverse outcomes in adulthood among children with ADHD. Three recent population studies suggested the existence of a significant proportion of individuals who report onset of ADHD symptoms and impairments after childhood. Finally, we highlight areas for improvement to increase our understanding of ADHD across the life span.

23 Review Systematic review of randomized controlled trials of candidate treatments for cognitive impairment in depression and methodological challenges in the field. 2016

Miskowiak, K W / Ott, C V / Petersen, J Z / Kessing, L V. ·Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Denmark. Electronic address: kamilla@miskowiak.dk. · Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Denmark. Electronic address: caroline.vintergaard.ott@regionh.dk. · Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Denmark. Electronic address: jeff.zarp.petersen@regionh.dk. · Copenhagen Psychiatric Centre, Copenhagen University Hospital, Rigshospitalet, Denmark. Electronic address: lars.vedel.kessing@regionh.dk. ·Eur Neuropsychopharmacol · Pubmed #27745932.

ABSTRACT: Cognitive impairment is a core feature of Major Depressive Disorder (MDD) but treatments targeting cognition are lacking. Numerous pre-clinical and clinical studies have investigated potential cognition treatments, but overall the evidence is conflicting. We conducted a systematic search following the PRISMA guidelines on PubMed and PsychInfo to evaluate the extant evidence and methodological challenges in randomized controlled trials (RCTs) of biological, psychological and behavioural candidate treatments targeting cognition in MDD. Inclusion criteria were RCTs with a placebo control assessing potential pro-cognitive effects of candidate treatments in MDD. Two independent authors reviewed the studies and assessed their risk of bias with the Cochrane Collaboration׳s Risk of Bias tool. Twenty-eight eligible studies (24 biological and four psychological or behavioural studies) were identified. Cognition was the primary treatment target in ten (36%) trials and an additional treatment outcome together with mood symptoms in 18 (64%) trials. The risk of bias was high or unclear in 93% of trials due to potential selective outcome reporting or 'pseudospecificity' (unspecific cognitive improvement due to reduced depression severity), and/or insufficient details on how the allocation sequence was generated or how blinding was maintained. Several promising treatments were identified, including vortioxetine, erythropoietin, transcranial direct current stimulation and cognitive remediation. However, several common methodological challenges may impede advances in the field. In particular, future trials should select one cognitive composite score as primary outcome, screen for cognitive impairment before inclusion of participants and address 'pseudospecificity' issues. Together, these strategies may improve the success of future cognition trials in MDD.

24 Review A meta-analysis of randomized, placebo-controlled trials of vortioxetine for the treatment of major depressive disorder in adults. 2016

Thase, Michael E / Mahableshwarkar, Atul R / Dragheim, Marianne / Loft, Henrik / Vieta, Eduard. ·University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. Electronic address: thase@mail.med.upenn.edu. · Takeda Development Center Americas, Deerfield, IL 60015, USA. · H. Lundbeck A/S, Copenhagen, Denmark. · Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain. ·Eur Neuropsychopharmacol · Pubmed #27139079.

ABSTRACT: The efficacy and safety of vortioxetine, an antidepressant approved for the treatment of adults with major depressive disorder (MDD), was studied in 11 randomized, double-blind, placebo-controlled trials of 6/8 weeks׳ treatment duration. An aggregated study-level meta-analysis was conducted to estimate the magnitude and dose-relationship of the clinical effect of approved doses of vortioxetine (5-20mg/day). The primary outcome measure was change from baseline to endpoint in Montgomery-Åsberg Depression Rating Scale (MADRS) total score. Differences from placebo were analyzed using mixed model for repeated measurements (MMRM) analysis, with a sensitivity analysis also conducted using last observation carried forward. Secondary outcomes included MADRS single-item scores, response rate (≥50% reduction in baseline MADRS), remission rate (MADRS ≤10), and Clinical Global Impressions scores. Across the 11 studies, 1824 patients were treated with placebo and 3304 with vortioxetine (5mg/day: n=1001; 10mg/day: n=1042; 15mg/day: n=449; 20mg/day: n=812). The MMRM meta-analysis demonstrated that vortioxetine 5, 10, and 20mg/day were associated with significant reductions in MADRS total score (Δ-2.27, Δ-3.57, and Δ-4.57, respectively; p<0.01) versus placebo. The effects of 15mg/day (Δ-2.60; p=0.105) were not significantly different from placebo. Vortioxetine 10 and 20mg/day were associated with significant reductions in 9 of 10 MADRS single-item scores. Vortioxetine treatment was also associated with significantly higher rates of response and remission and with significant improvements in other depression-related scores versus placebo. This meta-analysis of vortioxetine (5-20mg/day) in adults with MDD supports the efficacy demonstrated in the individual studies, with treatment effect increasing with dose.

25 Review Male psychological adaptation to unsuccessful medically assisted reproduction treatments: a systematic review. 2016

Martins, Mariana Veloso / Basto-Pereira, Miguel / Pedro, Juliana / Peterson, Brennan / Almeida, Vasco / Schmidt, Lone / Costa, Maria Emília. ·Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal Center for Psychology at University of Porto, 4200-135 Porto, Portugal mmartins@fpce.up.pt. · School of Psychology, University of Minho, 4710-057 Braga, Portugal. · Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal Center for Psychology at University of Porto, 4200-135 Porto, Portugal. · School of Psychology, University of Minho, 4710-057 Braga, Portugal Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA. · Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA Faculty of Sciences, University of Porto, 4169-007 Porto, Portugal. · Section of Social Medicine, University of Copenhagen, 1014 Copenhagen K, Denmark. ·Hum Reprod Update · Pubmed #27008894.

ABSTRACT: BACKGROUND: Similarly to women, men suffer from engaging in fertility treatments, both physically and psychologically. Although there is a vast body of evidence on the emotional adjustment of women to infertility, there are no systematic reviews focusing on men's psychological adaptation to infertility and related treatments. OBJECTIVE AND RATIONALE: The main research questions addressed in this review were 'Does male psychological adaptation to unsuccessful medically assisted reproduction (MAR) treatment vary over time?' and 'Which psychosocial variables act as protective or risk factors for psychological maladaptation?' SEARCH METHODS: A literature search was conducted from inception to September 2015 on five databases using combinations of MeSH terms and keywords. Eligible studies had to present quantitative prospective designs and samples including men who did not achieve pregnancy or parenthood at follow-up. A narrative synthesis approach was used to conduct the review. OUTCOMES: Twelve studies from three continents were eligible from 2534 records identified in the search. The results revealed that psychological symptoms of maladjustment significantly increased in men 1 year after the first fertility evaluation. No significant differences were found two or more years after the initial consultation. Evidence was found for anxiety, depression, active-avoidance coping, catastrophizing, difficulties in partner communication and the use of avoidance or religious coping from the wife as risk factors for psychological maladjustment. Protective factors were related to the use of coping strategies that involve seeking information and attribution of a positive meaning to infertility, having the support of others and of one's spouse, and engaging in open communication about the infertility problem. WIDER IMPLICATIONS: Our findings recommend an active involvement of men during the treatment process by health care professionals, and the inclusion of coping skills training and couple communication enhancement interventions in counselling. Further prospective large studies with high-quality design and power are warranted.

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