Selenium seems to have the ability to alleviate inflammatory signaling path-ways. Obesity is associated with chronic low-grade inflammation. Depression is also defined as an inflammatory disorder. PPAR-γ has been shown to have antidepressant-like effects The levels of inflammatory cytokines that are parameters associated with obesity―are also related to the severity of depression. Studies confirm an increased risk of depressive symptoms in middle-aged women. Therefore, it seems reasonable to consider the influence of selenium, PPAR-γ, and selected proinflammatory cytokines in the context of obesity and depression among middle-aged women.

The aim of this study was to evaluate the effect of serum selenium on PPAR-γ and selected proinflammatory cytokines (IL-1β, IL-6, TNF-α) in relation to depressive symptoms and obesity in middle-aged women.

The study sample included 443 middle-aged women living in north-western Poland. The research procedure: a survey performed using the authors’ questionnaire and the BDI, anthropometric measurements, and analysis of blood for the levels of selenium, cytokines, and genetic analysis of the PPAR-γ polymorphism.

It has been found that BMI increases along with the concentration of IL-6. No moderating effect of selenium was observed, although cut-off values for “p” were established for IL-β*Se (p=0.068) and IL-6*Se (p=0.068), so there is a potential association with these two markers. At high selenium levels, the effect of higher IL-β levels on a decrease in BMI was stronger. So was the effect of an increase in IL-6 levels on an increase in BMI.

No effect of selenium on PPAR-γ has been found in relation to depressive symptoms and obesity. 2. Higher selenium levels may have a beneficial effect on BMI even at high IL-β concentrations, however, at high IL-6 concentrations, this effect was not observed. 3. Selenium levels had no impact on depressive symptoms.

None Declared

Mood disorders are among the most prevalent and debilitating mental conditions in worldwide populations. Non-adherence to treatment recommendations may have serious consequences for patients with mood disorders. There are several methods to show whether the patient cooperates with the doctor and follows his recommendations, or whether he or she skips the prescribed doses of medications. These include objective methods, such as detecting the drug in the blood, urine or saliva by analysis or special markers, pill counting, electronic monitoring, and an electronic record of filled prescriptions. Subjective methods involve assessment of the patient, medical staff, and those in the patient’s immediate environment. The most commonly used subjective methods are an interview, filling out a questionnaire, and assessment by health care professionals and the patient’s relatives The problem arises when the patient inadvertently skips medications, which makes it difficult to assess adherence. This may be due to the severity of the disease and poorer cognitive function, and sometimes a change in daily routine.

The aim of the study was to identify factors influencing life satisfaction, disease acceptance and therapeutic adherence among people with mood disorders.

This survey-based study included 103 people with mood disorders. It was performed using the author questionnaire, and standardized research tools, namely: the Adherence to Refills and Medication Scale (ARMS), the Acceptance of Illness Scale (AIS), the Beck Depression Inventory (BDI), and the Satisfaction with Life Scale (SWLS).

The level of life satisfaction decreased with an increase in the severity of depressive symptoms (βstd. = -0.665, p < 0.001). Mood disorder patients with more severe depressive symptoms had significantly higher scores on the adherence scale (βstd. = 0.290, p = 0.003). Patients with higher levels of depressive symptoms showed a lower level of acceptance of the disease (βstd. = -0.215, p < 0.001).

1. 1. The dosage of medications taken, and the severity of depressive symptoms determine life satisfaction of people with mood disorders.

2. 2. Respondents with greater severity of depressive symptoms scored higher on the adherence scale, which means that they were more likely to be non-adherent to treatment recommendations. The type of mood disorder may affect patient adherence. Subjects with bipolar disorder showed higher and those with anxiety-depressive disorder—lower adherence than patients with depression.

3. 3. Subjects with more severe depressive symptoms showed a lower degree of acceptance of the disease.

None Declared

Nonadherence in transplantology stands for a not cooperating patient in terms of taking medication, having the laboratory, and imaging tests taken, missing appointments, not following dietary and lifestyle recommendations related to smoking tobacco, drinking alcohol, and other high-risk behaviours. Factors of not following therapeutic recommendations in patient after liver transplantation are high costs, psychiatric disorders, convictions regarding harmfulness of the immunosuppressive medicine and its side effects as well as rejection episodes, infections, stress related to suffering from a chronic disease and inadequate social support.

The aim of this study was to assess the adherence to therapeutic recommendations in patients after liver transplantation including the level of depression, anxiety, degree of acceptance of the disease and social support.

Study was carried out among 112 respondents after liver transplantation. The Delphi method was used and the following standardised tools were used: ISSB, AIS, BDI, STAI X-1 and X-2 as well as a questionnaire form regarding sociodemographic data.

An average level of adherence to therapeutic recommendations was on an average level (6.8±1.85). A statistically significant positive correlation between disease acceptance and following therapeutic recommendations was observed (r = –0.20, t = –2.040; p = 0.044). The adherence to recommendations increased with growing disease acceptance. Six factors were distinguished from the analysed predictors which in a relevant way influenced the level of adherence to therapeutic recommendations in the group of patients after liver transplantation. Regression model consisting of six independent variables explains 55% of variation of the dependent variable (r2corrected= 0,55, F(6, 98) = 22.127; p<0.001). Such positive factors include always following recommendations (β = –0.23; p = 0.002) and seeking various sources of information (β = –0.34; p<0.001), while negative ones constituted of illness duration (β = 0.18; p = 0.008), experiencing side effects (β = 0.40; p<0.001), suffering from concomitant diseases (β = 0,40; p<0,001).

Patients who have accepted their disease constitute a group that adheres to therapeutic recommendations to a lesser extent.

The main factors affecting adherence to therapeutic recommendations are the search for other sources of information and declarative adherence to therapeutic recommendations. Negative predictors- duration of disease, experiencing adverse effects of treatment, and comorbidities.

The way in which a physician communicates to the patients after liver transplantation the information about the results indicating that the medications were taken irregularly significantly more often influenced not following therapeutic recommendations which might suggest an unintended non-adherence.

None Declared

Vitamin D deficiency is a significant problem that affects the population living in most countries. This issue is independent of place of residence, gender, age or skin color. It is mainly influenced by the climate we live in and anti-healthy lifestyle, including bad eating habits.

The aim of the study was to evaluate lipid profile, glucose level, vitamin D level, taking into account sociodemographic variables, smoking and alcohol consumption. The study also included assessment of depression taking into account sociodemographic variables and vitamin D levels in perimenopausal women.

The study was conducted in a group of 191 women. The study consisted of two stages. The first part was carried out by means of a diagnostic survey with the use of questionnaire technique. The survey form consisted of two parts: a questionnaire that included questions about sociodemographic data and selected medical information, and the Beck Depression Inventory. The second stage of the study involved the collection of peripheral blood from each respondent in order to determine lipid profile, glycemia and serum vitamin D levels.

The age of the female respondents ranged from 45 to 65 years, mean age was 53.1±5.37 years, median 53 years. Vitamin D result was below normal in 78%. 77% had elevated total cholesterol levels. 91.6% of the respondents had HDL fraction cholesterol levels within the normal range. On the other hand, 64.4% were characterized by too high LDL fraction cholesterol and 84.8% of women showed normal triglyceride levels. Among the respondents, 91.1% had normal glycemic levels. Analysis of collected data showed a weak negative correlation between serum vitamin D concentration and concentrations of: total cholesterol (rho=-0.14; p=0.05), LDL fraction cholesterol (rho=-0.16; p=0.026) and triglycerides (rho=-0.22; p=0.002) of the examined women. Only in the case of HDL fraction cholesterol (p=0.067) there was no statistically significant correlation. There was also no statistically significant correlation between serum vitamin D levels and glycemia and severity of depression (p=0.152).

Most of the women studied did not manifest depressive disorders. Of the various factors affecting the severity of depression, only education was associated with depression severity.

Smoking adversely affects serum vitamin D concentration in the examined women.

Cessation of menstruation influenced carbohydrate metabolism and vitamin D concentration. Blood glucose concentration increased with the age of the studied women.

There was a relationship between vitamin D concentration and values of total cholesterol, LDL fraction cholesterol and triglycerides. Therefore, considering the biological functioning of the studied women, it is important to maintain normal vitamin D levels.

None Declared

Mining work and environment are the hardest and most difficult jobs in the labor market, increasing the risk of physical and mental illness. A study was conducted to determine the level of stress in mine workers and evaluate the relationship between depression and stress.

To determine the level of stress in mine workers and evaluate the relationship between depression and stress.

Questionnaires were collected from mine workers using the stress detection test (SRQ) and depression detection test (PHQ9) developed by the World Health Organization for doctors.

2.2% (95) of the respondents are male and 7.8% (8) are female workers. Of these, 70.9% work night shifts, 24.3% do not work night shifts, and 4.8% occasionally work night shifts. Comparing the stress levels of the respondents by age, 1.9% (2) of 20-24-year-olds are moderately stressed, 3.9% (4) of 25-29-year-olds are moderately stressed, and 4.8% (5) are stressed. 30-34-year-olds have moderate stress, 1.9% (2) have high stress, 1% (1) of 35-39-year-olds have moderate stress, 1.9% (2) have high stress, and 1% (1) have high stress. 40-44 have moderate, 1% (1) high, and 1% (1) 45-49 have moderate stress. The depression status of the participants compared to the 20-24-year-olds was 1% (1) transient mood depression, 1% (1) moderate depression, and 25-29-year-olds self-correcting transient mood 4.8% depression (5), 4.8% moderate depression (5), 1% (1) moderate depression, 1% (1) severe depression, 5.8% (6) depressed, 4.8% ((5)) moderate depression, 1.9% (2) moderate depression, 35-39-year-old spontaneous self-correction (68%). 7) with depression, 1.9% (2) with moderate depression, temporary self-correction at the age of 40-44 1.9% (2) with depression, 1% (1) with severe depression, temporary at the age of 45-49 2.9% (3) have depression. According to this, it can be considered that 25-44-year-olds are at risk of depression with a high depression index.

The study concluded that 25-44-year-olds are at risk of depression with a high depression index, indicating that they are at risk of depression.

None Declared

Postpartum depression (PPD) affects approximately 9% of new mothers and can have profound consequences on both maternal well-being and infant development. Additionally, around 50% of women experience depressive symptoms or mood disturbances during pregnancy and lactation. A growing body of research suggests a potential link between omega-3 polyunsaturated fatty acids (PUFAs) and mood regulation, particularly in the prevention of PPD. Omega-3 PUFAs, primarily docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are found in high concentrations in oily fish and seafood. Over the past century, dietary intake of omega-3 fatty acids has significantly declined in industrialized societies, coinciding with increased rates of mood disorders. Notably, populations with higher fish consumption, such as those in Hong Kong, China, and Japan, report lower incidences of depression compared to Western countries, where lower fish consumption has been linked to higher rates of PPD. During pregnancy and lactation, women become particularly depleted in omega-3 PUFAs, as these essential fats are preferentially diverted to support fetal development, potentially increasing the risk of depression in mothers.

This study aims to explore the effectiveness of omega-3 PUFAs in preventing PPD.

A comprehensive literature review was conducted to evaluate the effectiveness of Omega-3 in preventing PPD. The search was performed on PubMed using key terms such as “Omega-3,” “Postpartum Depression,” and “Prevention.”

In one study, women with low LCP intake were supplemented with 220 mg of DHA, which had no effect on depression, like in another study that reported no effect of 1,8 g of Omega-3 PUFAs on maternal depressive symptoms. Another trial involving 2,399 women found no significant difference in depressive symptoms between those receiving 800 mg of DHA and a control group during the first six months postpartum. A randomized controlled trial of 126 women at risk PPD also showed no benefit from EPA or DHA supplementation in reducing Beck Depression Inventory (BDI) scores compared to placebo. A meta-analysis of 11 trials (N = 3,181) similarly found no significant difference in depression scores between Omega-3 and placebo groups, and no association between the daily doses of DHA or EPA and PPD prevention

Based on the reviewed trials, there is insufficient evidence to recommend Omega-3 fatty acid supplementation (DHA and EPA) at any dosage for the prevention of postpartum depression.

None Declared

Affective disorders are in constant rise and they are a serious medical and social problem. All the latest studies suggest that the incidence of affective disorders is about 14%, which makes them one of the most common psychiatric disorders. Because of that, there is a need for alternative forms of treatment of affective disorders.

The main goal of this study is to evaluate the effectiveness of the combined treatment of pharmacotherapy together with the Neurofeedback method in the treatment of affective disorders in adult individuals.

A prospective randomized study including a total of 100 outpatients from University Clinic of Psychiatry in Skopje. The subjects were randomly divided into 2 groups of 50 patients, of which the patients in the study group were treated with a combined treatment that includes the neurofeedback method as an augmentation to antidepressant therapy, while the control group with monotherapy with antidepressant medications. Subjects were examined for 2 months, with evaluation of despressive symptoms 2 weeks after the start of treatment, and then after 1 month, using the following psychodiagnostic instruments: psychiatric interview; short non-standardized socio-demographic questionnaire, CGI, HAMD, HAMA and Beck depression scale.

Patients in the study group, treated with a combined approach of antidepressant therapy and the neurofeedback method, showed a significantly greater reduction in symptoms of depression and anxiety compared to patients in the control group treated with antidepressants as monotherapy. According to the HAMA anxiety scale, the mean score in the study group (SG) decreased by 2.86 points (p<0.0001), compared to a decrease of 0.84 points in the control group (CG) (p=0.0017). On the Beck Depression Scale, the mean score in the decreased by 2.08 points (p<0.0001), compared to a decrease of 0.44 points in the CG (p=0.022). On the HAMD depression scale, the average score in the study group (SG) decreased by 2.42 points (p<0.0001), while in the control group (CG) the decrease was 0.12 points (p=0.63), the CGI scale showed a significant reduction in global symptoms in (SG) (p=0.0035), which further confirms the positive effects of the combined treatment.

The research shows that neurofeedback treatment in addition to pharamcological therapy leads to significant improvement in depressive and anxiety symptoms.

None Declared

Electroconvulsive therapy (ECT) is an effective treatment for major depressive disorder (MDD). Only few studies have measured CSF in patients undergoing ECT; thus far, no prognostic candidate biomarkers for treatment response have been found (Kranaster et al. Neuropsychobiology. 2019;77(1):13-22). Neurofilament light chain (NfL) is a protein found in the axons of neurons. If elevated in blood or cerebrospinal fluid (CSF), it is an indicator of neuroaxonal damage. A recent study including 15 patients with MDD who underwent ECT found no significant change in serum NfL concentrations after completion of treatment (Besse et al. Eur Arch Psychiatry Clin Neurosci 2024; 274(5):1187-95). The astrocyte marker glial fibrillary acidic protein (GFAP) is elevated in MDD and neuroinflammatory diseases. Serum GFAP levels in 40 MDD patients decreased after ECT compared to baseline (Xu et al. Psychiatry Clin Neurosci. 2023; 77(12):653-64). No studies measuring CSF levels of both markers have been performed.

In this prospective study we aimed to measure changes in CSF of NfL and GFAP in patients undergoing an ECT series.

In a sample of 9 MDD patients undergoing bilateral ECT, CSF was analyzed before and after the 8th ECT session. Patients took antidepressant medication in a steady state over the course of ECT. A mixed-effects linear regression analysis was done using the log-transformed NfL and GFAP levels as outcome variables. The timepoint (pre-ECT, post-ECT) were entered as fixed effects, patient ID was included as a random effect to account for individual variability. We corrected for multiple testing and defined alpha = 0.05/2 = 0.025. Statistical analyses were performed using R version R-4.3.2.

The mean age ± SD was 34 ± 11 years, 6 out of 9 patients (67%) were women. Mean elevations of NfL by 19,9 pg/ml (95% CI: -120.3 to 160.0) and GFAP by 445.8 pg/ml (95% CI: -1279.6 to 2171.4), there was no significant change in NfL (p = 0.213) or GFAP (p = 0.362) levels after ECT. Figure 1 shows concentrations of both NfL and GFAP pre and post ECT.

Image:

This study found no significant changes of NfL or GFAP levels in CSF after an ECT series, suggesting no evidence of neuroaxonal damage or brain damage through astrocyte activation related to ECT. However, the small sample size may have obscured potential effects. Future research with larger sample sizes is therefore essential.

S. Riessland Grant / Research support from: This study was sponsored by the Austrian Science Fund (project number KLI 1098, principal investigator P. Baldinger-Melich) and the 2021 NARSAD Young Investigator grant (grant number 29950, principal investigator P. Baldinger-Melich). S. Rießland is partially funded by the Austrian Science fund and the NARSAD Young Investigator Grant., M. Ponleitner: None Declared, V. Millischer: None Declared, S. Macher: None Declared, R. Lanzenberger: None Declared, P. Rommer: None Declared, R. Frey: None Declared, D. Rujescu: None Declared, P. Baldinger-Melich Grant / Research support from: This study was sponsored by the Austrian Science Fund (project number KLI 1098, principal investigator P. Baldinger-Melich) and the 2021 NARSAD Young Investigator grant (grant number 29950, principal investigator P. Baldinger-Melich). The other authors have no conflict of interest related to this study to declare.

Depressive rumination has been the subject of increasing clinical and research interest in recent years. Numerous studies have demonstrated its central role in the etiopathogenesis and maintenance of depressive disorders. It refers to the struggle to control repetitive and passive thoughts with a hyper-focus on depressive symptoms, their causes, meanings and consequences. It is, therefore, a process that is often active in people with depressive mood and that can exacerbate and prolong depressive symptoms by promoting their chronicity. It can therefore be argued that depressive rumination may contribute to treatment resistance. The metacognitive model of major depressive disorder and its derived treatment focuses on rumination supporting beliefs and on their modification, with the aim of reducing their negative effects.

The aim of this study was to evaluate the improvement in depressive rumination using the metacognitive approach in TRD patients treated with intranasal esketamine.

Twenty-five patients (13F) with a mean age of 55.88 years (±11.31) diagnosed with treatment-resistant major depression (TRD) received an 8-session weekly metacognitive training (MCT) intervention in addition to the standard intranasal esketamine treatment protocol. Patients were assessed at baseline and after 3 and 6 months of treatment using the Penn State Worry Questionnaire (PENN) and the Ruminative Response Scale (RRS) to assess depressive rumination, and the Montgomery-Asberg Depression Rating Scale (MDRS) to assess depressive symptomatology.

At baseline MADRS and RRS total scores did not differ significantly by gender or age. To assess the effect of MCT as an adjunct to esketamine therapy, a repeated measures ANOVA was performed comparing participants at different time points (T0, T3, T6). The analysis showed an effect of treatment on MADRS total score (η²=0.45; F=18.22, p=0.001), MADRS item 9 (pessimistic thoughts) (η²=0.18; F=4.85, p=0.02) and RRS total score. Post-hoc comparisons were significant for MADRS and RRS total scores, with progressive decreases between T0 vs T3, T0 vs T6 and T3 vs T6; for item 9, comparisons were significant between T0 vs T3 and T0 vs T6, with stability between T3 and T6. MCT treatment combined with intranasal esketamine resulted in significant improvements in depressive symptoms. It also reduced depressive rumination and maladaptive metacognitive beliefs.

These preliminary results show that MCT as an adjunct to esketamine treatment is effective for depressive rumination, with stable results up to 6 months after treatment. The generalisability of the results is limited by the lack of a control group and the relatively small sample size. Further studies in larger populations and comparing MCT with other psychotherapies or usual care are needed to confirm these findings.

None Declared

Dissociative experiences are considered typical esketamione’s side effects. Several investigations have have shown that ketamine/esketamine-induced dissociation may be linked to improved responsiveness, although other studies have not supported this association. Despite these controversial findings, it’s possible that dissociative experiences are crucial to the antidepressant effects, at least in specific subtypes of depression. In fact, current understanding of the therapeutic potential of ketamine (the anaesthetic from which esketamine is derived) converges on the so-called “relaxed prior hypothesis”, suggesting that glutamatergic blockade up-weights bottom-up surprising somatosensory/affective states. Consequently, ketamine improves short-term plasticity in depression by enhancing sensitivity to interoceptive signals.

This study describes and discusses two case studies in which the experience of esketamine dissociation was particularly effective in enhancing antidepressant effects.

We selected 2 case studies for their paradigmatic description of “depersonalised depression” (Entfremdungsdepression). Patients were interviewed both 4 weeks before and at the peak of esketamine effects during a 6-month treatment. Following a neurophenomenological approach, we combined subjective reports from unstructured clinical interviews with review of previous objective neuroimaging results and neurocomputational models to elucidate the relationship between esketamine’s effects and interoceptive sensitivity. Patients were administered the HAM – D at T0 and T6 and the Dissociative Experience Scale (DES-II) and the Structured Clinical Interview for Depersonalization-Derealization Spectrum (SCI-DER) at T0.

According to our observations, esketamine-induced dissociation may be particularly effective in the depersonalised depression subtype, in which interoceptive awareness and interaffectivity are significantly impaired. In particular, disembodiment may suspend previously acquired patterns of feeling, perception and behaviour. As previously described by Richard Yansen, ketamine disrupts the assertion of bodily tensions so that they cannot tighten in the way they used to tighten, and they cannot hold back emotionally in the way they used to hold back: then many of the feelings behind the armour can pour out with a softening, cathartic release. Our patient D.P. sketches this phenomenon nicely when he says that “esketamine makes you change your own personal attitude, your own grammar”.

Consistent with previous findings, we suggest that esketamine-induced disembodiment allows for a temporary window of psychological plasticity and heightened sensitivity with the body regaining its permeability to affective affordances. Future research should address the relationship between esketamine-induced disembodiment, sensitivity to interoceptive signals, and depression outcomes.

None Declared

Cognitive distortion is a central feature of depression, encompassing dysfunctional personality styles and attitudes, and negative thinking. One of the cognitive schemas characteristics of depressed individuals is the tendency to overestimate causal responsibility for negative events, but not for positive ones. Total sleep deprivation (TSD) has been shown to cause rapid and sustained antidepressant effects in depressed patients and to revert the biased self description present in these patients.

The aim of the study was to investigate if TSD treatment would change cognitive distortion in a sample of patients diagnosed with major depressive disorder (MDD).

Seven patients with MDD (all females), completed the Cognition Questionnaire (CQ) to assess cognitive distortions and were assessed before and after TSD treatment. TSD protocol involved three cycle of sleep deprivation, each one lasted 36 hours and was followed by a night of recovery sleep. Light therapy was administered for 30 minutes at 3 am during waking nights and in the morning after the recovery sleep.

A significant reduction of the depressive symptomatology was observed at both objective (Hamilton depression rating scale -HDRS F=9.85, p=0.008) and subjective (Beck depression Inventory – BDI F=54.73, p<0.001) measures. Investigating the 5 dimensions assessed through the CQ, we observed that the reduction of the dimension “attribution of causality” ( r=-7707, p=0.043) and the total CQ score (r=-.8865, p=0.008) after TSD were significantly associated with the reduction of depressive symptomatology as measured by the BDI.

This is a preliminary study on the effect of TSD treatment on cognitive distortion in MDD. TSD treatment improved not only clinical symptoms but also cognitive distortion. Our preliminary findings suggest that TSD could be added to antidepressant treatment to rapidly improve the depressive symptomatology and cognitive distortion which may hamper the compliance with pharmacologic treatments and consequently the reduce the possibilities of a favouble outcome of pharmachologic interventions.

None Declared

The relevance of studying late-life depression is determined by the increase in its prevalence, difficulties in diagnosis and therapy. Depression in old age aggravates the course of comorbid somatic pathology, leads to a deterioration in the quality of life of the elderly, the development of mental insolvency and social maladjustment. In addition, depression accelerates the aging process, accompanied by an increased risk of mortality and the development of dementia.

To study the clinical features of late-life depression in patients of a gerontopsychiatric hospital.

Patients with depressive disorders who were treated in the conditions of the gerontopsychiatric hospital. The study used clinical, psychopathological and statistical methods. A total of 333 patients were examined: 87 men (26.1%) and 246 women (73.39%) aged 60 and older (average age 69.05±6.66). According to the ICD-10 classification, all patients were diagnosed with a depressive episode of various etiologies: in 20 patients (6.0%) - a single DE, in 86 patients- a depressive phase within the framework of the BAR(25.9%)and in most patients–227people– a depressive phase within the framework of DDR. According to the ICD-10criteria, depression corresponded to a moderate depressive episode in 246 patients (73.9%), a mild depressive episode in 64 (19.2%)and a severe depressive episode in 23 patients (6.9%).

Analysis of the psychopathological structure of the examined inpatient patients with late-age depression revealed the predominance of psychopathological conditions characteristic of late age, in the structure of which anxiety and anxiety-melancholy disorders dominated (152people-45.7% of cases), depression with the dominance of apathetic and adynamic disorders, which were observed in 135people (40.5%), were somewhat less common. Complex psychopathological depressions with a predominance of senesto-hypochondriac disorders, as well as delusional depressions, were less common – in 39 people–11.7% and 7 people-2.1% of cases, respectively. A characteristic feature of late-age depressions was the presence in their structure of dissomnic, anxiety and hypochondriac disorders, which were noted, respectively, in100%, 94.6% and 93.1% of cases, as well as subclinical cognitive disorders: subjective cognitive impairment (complaints of memory loss)- in 64.3% of patients.

The study shows the polymorphism of psychopathological symptoms of endogenous depression in late life, the presence of anxiety, senesto-hypochondriac, dissomnic and cognitive disorders in the structure of depression.

None Declared

According to epidemiological data, about a third of elderly and senile people suffer from mental disorders. The most common are depression and dementia. An urgent problem of modern research is the search for neurobiological correlates of the course and outcomes of late-life depression.

To study the outcomes of depression at a late age during a 3-year prospective follow-up in patients with various immunophenotypes.

A cohort of patients with depressive disorders who were treated in hospital and re-examined in 1 and 3 years. The work carried out a comparative analysis of the course of the disease in patients with different immunophenotypes. The follow-up observation group with immunophenotype A (group 1) included 20 people, 6 men (30.0%) and 14 women (70.0%), median age was 68 years old [62.5; 76.5]. 13 patients (65.0%) were diagnosed with a depressive episode of DE in the framework of recurrent depressive disorder (DDR-F33), 7 patients (35.0%) - in the framework of bipolar affective disorder (BAR-F31). The group with immunophenotype B (group 2) included 31 people, 10 men (32.3%) and 21 women (67.7%), median age was 68 years old [64.0; 72.0]. In 20 patients (64.5%) DDR was diagnosed, in 9 patients (29.0%) - BAR, and in 2 patients (6.5%) – single DE. The patients were examined using clinical, psychometric, immunological and follow-up assessment in 1 year and 3 years.

A comparative study of the course and outcomes of late-age depression in groups of patients with different immunophenotypes, both immediate (1 year) and distant (3 years of follow-up) showed a statistically significant predominance of a favorable course of the disease in patients of group 1 compared with patients of group 2.

In patients of group 1 (in 95% of cases), a favorable course of the disease was noted with the formation of qualitative remissions after 1 year and persisted after 3 years of follow-up. In most patients of the 2nd group, the unfavorable course of the disease prevailed, which was noted both with short-term (1 year - 83.9% of cases) and long-term (3 years - 87.1% of cases) observation. The unfavorable course of the disease in group 2 patients was characterized by a statistically significantly more frequent (p<0.05) formation of incomplete remissions with the preservation of residual depressive disorders, the development of repeated depressive phases on their background according to the type of “double depressions”, as well as cases of chronic depression by 3rd year of observation.

Cases of dementia formation and deaths were noted in this group.

The results of the follow-up observation of patients with late depression indicate that the variants of the further course of the disease are closely related to immunological features. The depressions of the apathetic-adynamic structure, in complete remissions in the anamnesis is a marker of a prognostically less favorable course of the disease.

None Declared

Depression is one of the most important medical and social problems in old age due to its high prevalence (10-25%) and a significant increase in the burden on social services and medical institutions. A diverse combination of biological factors of aging contributes to the polymorphism of clinical manifestations of late-life depression.

Study of the clinical features of depressed patients of late age of three identified neurobiochemical models of energy, antioxidant and glutamate metabolism.

The study material consisted of 52 hospitalized patients (40 women and 12 men) aged 60-86 years with a depressive episode of recurrent depressive disorder, bipolar affective disorder and a single depressive episode (ICD-10). The patients were examined by clinical, psychometric, biochemical and statistical methods. Before starting therapy, psychometric assessments were performed using the Hamilton Anxiety and Depression Rating Scales and the Mini-Mental Status Examination. On the same day, the activity of enzymes of energy (cytochrome c oxidase - CO), antioxidant (glutathione reductase - GR and glutathione S-transferase - GST) and glutamate (glutamate dehydrogenase - GDH) metabolism enzymes in blood platelets was determined in patients.

In patients with a decrease in energy and antioxidant metabolism (↓GR, GST, HD and ↑GDH), there was a predominance of shallow apathetic depression of a “seasonal” nature with the presence of mild cognitive impairment, a later age of manifestation, and a high incidence of cerebrovascular pathology. Patients with “disharmonious” metabolism (↓ GR, GST, GD and ↑ CO) were characterized by an early onset of the disease, its longer duration, more severe and complex depression with a pronounced anxiety component. Patients with a conditionally “normal” metabolism were more likely to experience typical melancholy depression and the lowest incidence of severe cerebrovascular pathology.

The relationship has been established between the clinical features of late-life depressions and changes in the activity of enzymes of energy, antioxidant and glutamate metabolism. It was revealed that the type of metabolism with “reduced” and “disharmonious” activity of these enzymes corresponds to the parameters of late and early manifesting depression. Thus, the clinical heterogeneity of late-life depression is closely related to different neurobiochemical types of metabolism.

None Declared

Studies on the psychological impact of a vegan diet and its effect on mental health are still, although the interdisciplinary literature points to significant diet-related cognitions associated with the active choice of a plant-based diet. This study addresses this research gap by framing veganism as an identity-associated aspect of self-concept in young vegans and examines the influence of self-esteem resulting from the vegan diet on symptoms of unipolar depression in a biopsychosocial framework model.

veganism as an identity-associated aspect of self-concept

influence of self-esteem resulting from the vegan diet on symptoms of unipolar depression

alternative perspective on the connections between psyche and nutrition

In a representative sample of n = 659 students from German universities, the absolute and additional influence of diet-related self-esteem on depressive symptoms was investigated using hierarchical regression, taking biopsychosocial covariates into account.

It was found that the self-esteem experience of the test subjects specifically gained from the vegan diet exerts a statistically significant influence on depressive symptoms (B = - 37, SE(B) = 0.02, p <.001) and can also explain a statistically significant additional proportion of the total variance in a biopsychosocial model of depression (ΔR2 = .18, F [1,649] = 272.34, p <.001). Together, the model of eight covariates and nutrition-related self-esteem can explain 57% of depressive symptoms (R2 = .57, F [9,649] = 94.81, p < .001¸ f2 = 0.13). This statistically significant influence of diet-related self-esteem also persists in an exploratory study of different severity levels of depressiogenic distress

The results provide evidence of a psychological impact factor in relation to a vegan diet and identify psychological consequences and thus open up a new research perspective in clinical psychology.

None Declared

Treatment-resistant Depression (TRD) nowadays it is consider a public health problem. Studies had demonstrate that TRD has higher prevalence of psychiatric comorbid conditions, twice the utilization of outpatient health care resources, 3 times the number of inpatient bed-days, and 23% higher all-cause mortality. Esketamine, the S-enantiomer of ketamine, has been recently approved for depression that has failed to respond to two or more antidepressants 2. Nevertheless, considering its steep cost, accessibility in Ecuador becomes a crucial factor. Comprehensive studies are essential to substantiate its efficacy

Evaluate the effectiveness and safety of esketamine nasal spray in a clinical sample of patients with TRD

This is an observational, retrospective and multicentric study comprising a total of 16 TRD patients treated with esketamine nasal pray, the sample was collected over a period of 2 years. Anamnestic data and psychometric assessment (MADRS and Columbia scale for suicidal ideation) were collected from medical records at baseline (T0), one month (T1) and two month (T2) follow-ups.

Clinical response was achieved in 68% at T1 and 81% by T2. Remission rates of 50% was detected by T2. Few side effects were seen in this study, 25% (4) present disossiacion 13% (3) hypertension and anxiety 12% (2) all of them were autolimited and no treatment was required. Based on the Columbia scale to assess suicidal ideation, the disappearance of suicidal risk was observed before T1 in all cases. It is important to emphasize that 2 of the patients taken into account for the study abandoned treatment before the time established. The first patient abandoned it in the second application for economic reasons and the second patient because he observed total remission of the symptoms by T1

Taking into account the results, it can be concluded that esketamine is a safe medication, given the low percentage of observed adverse effects, all of which were mild and self-limiting. Moreover, the high rates of clinical response and remission allow us to conclude its effectiveness. However, the restriced accessibility should be taken into acount due to the elevated cost of esketamine which also limits this study due to the small sample size

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Depression and myocardial infarction (MI) are leading causes of disability worldwide. Their interconnectedness, along with the burden that these impose on patients, is of particular clinical interest.

We conducted a systematic review, that aimed to synthesize recent data on the association between depression and MI, highlighting their outcomes and identifying contributing risk factors.

Data were extracted from 17 studies, including only prospective and longitudinal cohort studies, published between 2019 and 2024. These studies were selected from an initial pool of 67 relevant articles, retrieved from PubMed, PsycINFO, and Embase databases.

Prevalence of depression was higher among MI survivors (OR 1.21; 95% CI 1.15-1.27), with increased rates observed in patients with comorbid type 2 diabetes (IR 131.1; 95% CI 109.6-155.6). A significant correlation was found between depression and adverse clinical outcomes post-MI (HR 3.41; 95% CI 2.49-2.674), including 30-day hospital readmissions (HR 1.11; 95% CI 1.07-1.15). Additionally, individuals diagnosed with depression had a higher likelihood of experiencing MI (HR 2.07; 95% CI 1.79-2.40), particularly those from lower socioeconomic backgrounds (HR 1.47; 95% CI 1.36-1.60) or with chronic kidney disease (HR 1.29; 95% CI 1.03-1.62). However, depressed men and patients using SSRIs had a reduced risk of MI compared to women and non-SSRI users (HR 1.39; 95% CI 1.35-1.42 and HR 0.91; 95% CI 0.64-1.29, respectively).

Depression increases the risk of developing MI and worsens clinical outcomes, and vice versa. Comorbid conditions, including type 2 diabetes and chronic kidney disease, gender differences, and no antidepressant use, are critical factors that compound their association.

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Vagal Nerve Stimulation (VNS) therapy has emerged as a promising treatment for individuals suffering from treatment-resistant unipolar and bipolar depression. Initially approved for epilepsy, VNS therapy’s potential to improve mood symptoms in patients unresponsive to conventional treatments like antidepressants, psychotherapy, ECT, and TMS has garnered growing interest in psychiatry. This systematic review provides a comprehensive overview of the side effects associated with VNS therapy. It aims to offer a balanced perspective on the therapy’s safety profile, aiding informed decision-making for depression.

1. 1. To identify the most common side effects of VNS therapy.

A literature search was conducted within 2 databases (PubMed and Google Scholar). The PubMed search employed MeSH terms as follows: ((vagus nerve stimulation) OR (vagal nerve stimulation)) AND ((major depressive disorder) OR (MDD) OR (depression) OR (unipolar depression) OR (bipolar depression)) AND (side effects). Google Scholar search utilized Boolean operators as follows: “vagus nerve stimulation for depression” “adverse effects” “side effects.” Tools that were native to the browsers of these respective databases were used to apply the following filters: publication date (2019-2014), free full text, English, no abstracts, no miscellaneous documents and the remaining results were reviewed independently by 2 investigators to screen for the remaining inclusion and exclusion criteria. Specifically, studies were only included if they reported on the side effects of VNS therapy for depression. Studies were excluded if they did mention the side effects, or if they were not accessible to the investigators due to pay-walls, for example.

A total of 380 articles were identified from searching in both databases, and screening with application of our inclusion and exclusion criteria left 14 articles to be considered. The side effects of VNS therapy can range from mild and transient to more significant, and most frequently mentioned side-effects included: headache, local skin irritation, intolerable pain, and voice alteration (Jung 2023). Headache and dizziness was common for all forms of VNS, while local skin irritation was far more common in non-invasive methods of VNS involving electrodes, and serious complications from damage to the vagus nerve resulting in arrhythmias and aspiration (Bruer 2022) potentially impacting the overall quality of life and adherence to treatment.

Vagus Nerve Stimulation (VNS) offers a promising treatment option for patients with treatment-resistant depression, providing symptom relief when other therapies fail. However, side effects, particularly laryngeal, and variability in patient response highlight the need for personalized approaches. Future research on transcutaneous VNS and optimized protocols is essential to enhance outcomes.

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In recent years, the appealing aspect of strength training has grown beyond its physical benefits, promoting interest in its potential impact on mental health. Despite the curiosity, the association between it and depression remains unexplored.

The purpose of this study is to examine at the link between strength training intensity and depression levels among active gym-goers in Tunisia.

This is a cross-sectional study, conducted from February to March 2024. Participants were recruited online through social media platforms (Tunisian facebook groups and fitness forums) using a posted survey link. We’ve included respondents who are 18 years of age or older who have been active in strength training with a gym membership for 1 month or more. The respondents were required to answer a questionnaire that included questions related to socio-demographic data and to provide strength training intensity related details (sessions frequency, duration, perceived overall intensity using likert scale)

Depression levels were measured using the Patient Health Questionnaire-9 (PHQ-9).

The overall number of participants was 72, with 86% being male. The majority of responders (n=65, 90.2%) indicated that they performed strength training exercises at least three times per week, with an average session length of 45 minutes. In terms of strength training intensity, 38.8% (n= 28) of participants reported high-intensity sessions, 48.6%(n=35) moderate-intensity sessions, and the remaining participants reported low-intensity sessions.

The mean depression score on the PHQ-9 scale was 4.3 (SD = 2.1). Implying a prevalence of minimal to mild depressive symptoms among the research population.

Strength training intensity was found to have a negative correlation with depression scores (r = -0.36, p = 0.03), suggesting that higher intensity sessions were linked with fewer symptoms of depression.

This study serves to shed light upon the association between strength training intensity and depression levels among Tunisian gym-goers. The findings emphasise the positive impact of strength training with higher intensity, on depressive symptoms

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Over the past 30 years, cytokines have been extensively studied in relation to neuroplasticity, modulation of neuro-signaling, and various psycho-immunological aspects of depression. Interferon gamma (INF-γ) is traditionally recognized for its pro-inflammatory role, but it also possesses regulatory functions by antagonizing Transforming Growth Factor beta (TGF-β). TGF-β acts as an anti-inflammatory and regulatory cytokine. The interaction between these cytokines remains inadequately explored in patients with depression.

The aim of our study was to analyze the differences in serum concentrations of INF-γ and TGF-β between patients with Major Depressive Disorder (MDD) and healthy controls.

Blood samples were obtained from 55 patients who met the DSM-IV-R criteria for a current MDD episode without psychotic symptoms, and from 45 healthy controls, matched for age and gender. Participants were assessed using the Beck Depression Inventory (BDI) and the Hamilton Depression Rating Scale (HDRS). Serum concentrations of INF-γ and TGF-β were determined using enzyme-linked immunosorbent assays.

The concentration of TGF-β was significantly higher in patients compared to healthy controls, while no differences were observed for INF-γ between the groups. Moreover, INF-γ concentrations were statistically higher in patients with more severe depression, as measured by HDRS and BDI. TGF-β levels increased with severity only as assessed by HDRS. Among various factors (sociodemographic, clinical, and hereditary), INF-γ was positively correlated solely with the number of hospitalizations, whereas TGF-β levels correlated with the duration of treatment and symptoms.

The interplay between TGF-β and INF-γ is frequently considered a crucial component of the inflammatory hypothesis in depression. Further research is needed to understand why concentrations are elevated in patients with more severe forms of depression, yet show no correlation with other clinical or sociodemographic factors.

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