Top PDF Breaking the Stigma: Major Depressive Disorder

Breaking the Stigma: Major Depressive Disorder

Breaking the Stigma: Major Depressive Disorder

In recent years, the conversations about mental health and mental illness have slowly been gaining attention, in part through media coverage of celebrities’ struggles and suicides. While mental health is increasingly being discussed within the public community, there remains a stigma surrounding mental disorders which is derived from a lack of public education and understanding of them. Major depressive disorder (MDD) is just one of the mental disorders impacting people globally, and while mental disorders are medically accepted as illnesses, members of the public still struggle to acknowledge the validity of a diagnosis. Due to social pressures, people who suffer from MDD, or other mental illnesses, may be influenced to deny their disorder and feel ashamed of it, and this could prevent them from seeking necessary help from mental health professionals (Corrigan, P. W., Druss, B. G., & Perlick, D. A. 2014).
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Self-stigma as a mediator between social capital and empowerment among people with major depressive disorder in Europe : the ASPEN study

Self-stigma as a mediator between social capital and empowerment among people with major depressive disorder in Europe : the ASPEN study

effect ofn adverse consequences of stressors by enhancing individuals‟ self-efficacy [37]. Differently, our model shows that self-stigma is a mediator of the impact of individual social capital on empowerment. We assume that people experiencing more social support and with higher interpersonal trust will suffer less from the negative consequences due to stigma. In the analyses of stress processes, stress related to prejudice and discrimination has been figured as an additional source of stress that acts as a mediator between a series of disadvantaged social statuses and mental health problems [28] and there is also evidence that stigma leads to depression [39]. In this regard, a previous study [17] proposed a model the model of positive and negative effects of social relationships on well-being and depression by Ibarra-Rovillard and colleagues [22] is of interest in which social relationships are considered to contribute to improved well-being when providing help to face negative life stressors (e.g. emotional support, instrumental support, informational support), but only when these acts are perceived as satisfying basic psychological needs (e.g. sense of belonging, feeling to be able to cope with difficulties). We hypothesize that people with MDD‟s perceptions of the availability of emotional support or advices on how to face problems may increase positive in-group perception of people with MDD [10] and, in turn, decrease the likelihood of stereotype agreement. On the basis of our results, it is suggested that higher social capital might foster the level of individual sense of empowerment directly and also by reducing the appraisal of stigma as a source of stress. Social support from family, friends and social network and interpersonal trust may be considered social and psychological resources to cope with threats to individual identity as discrimination [5]. In this sense, family psycho-education, peer support and coaching should be stimulated in order to prompt the activation of supportive networks and to improve effective empowering coping strategies to enhance individual skills for coping with self-stigma [29]. However, there is also well established evidence in the literature suggesting that stigma negatively impacts on social networks of people with mental illness [27].
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Self-stigma in borderline personality disorder – cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders

Self-stigma in borderline personality disorder – cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders

Due to the several factors significantly related to the self- stigma, we decided to calculate a multiple regression analysis to find essential elements. The dependent variable was the ISMI-TS scale while CGI-O, CGI-S, the age of onset, diagnosis, years of education, partnership, number of hospitalizations, and employment were independent vari- ables (see variables in Table 3). The method applied was a stepwise regression analysis. The resultant model explained 28.9% of the dependent variable. The strongest factors con- nected to self-stigma was being without partner, number of hospitalizations, and the severity of the disorder measured by CGI-O and CGI-S.
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A systematic review of St. John’s wort for major depressive disorder

A systematic review of St. John’s wort for major depressive disorder

Pharmacotherapy and psychotherapy are established treatments and have been shown to be effective to treat depressive disorders, such as major depressive disorder (MDD). However, stigma, costs, discomfort with, or lack of availability of, mental health treatment, side effects of medication, and other factors cause many individuals to not seek standard treatments. For centuries, extracts of the herb St. John ’ s wort (botanical name Hypericum per- foratum L., SJW) have been used to treat various condi- tions, including depressive disorders. Existing clinical practice guidelines vary in their recommendations to in- clude SJW as a treatment option for treating depressive disorders [5]. A Cochrane Review of SJW for depression documented available research studies published to 2008 and found a beneficial effect compared to both placebo and other antidepressant therapies across 29 double- blind randomized controlled trials (RCTs) [6]. The re- view concluded that the available evidence suggested that hypericum extracts tested in the included trials are superior to placebo and patients with major depression and are similarly effective as standard antidepressants, and have fewer side effects than standard antidepres- sants. Overall, SJW has been considered safe but side ef- fects have been noted, including photosensitivity, elevated thyroid stimulating hormones, hypertensive cri- sis, and induction of mania [7]. In addition, preparations of SJW vary in the amounts of active compounds they contain, which may make it difficult to compare across studies [8].
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Vortioxetine versus placebo for treatment of major depressive disorder

Vortioxetine versus placebo for treatment of major depressive disorder

(3).Depression is a serious, common, and a recurring disorder linked to diminished functioning, quality of life, medical morbidity, and mortality (4). There has been a 37.5% increase in health, life years lost to depression over the past two decades (5). Depression was the third- leading cause of the global burden of disease in 2004 and the leading cause of burden of disease in high- and middle- income countries. It is projected to be the leading cause globally in 2030 (6). While effective treatments for depression are available, they are used. Barriers to treatment include geography, socioeconomic status, system capacity, treatment costs (direct and indirect), low mental health literacy, cultural beliefs, and stigma (7, 8). A 2010 study found that 75% of primary care patients with depression in urban areas could identify more than one structural, psychological, cultural, or emotional barrier to accessing behavioral treatments. The rate was substantially higher in rural areas (9). Vortioxetine is one of the newer options available in this important area of therapeutics ,that approved by the FDA in September 2013 for treatment of episodes of major depressive disorder (10).More than 30 pharmacotherapy options are available for unipolar depression, including: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), serotonin- norepinephrine reuptake inhibitors (SNRIs), bupropion, serotonin antagonist/reuptake inhibitors, second- generation antipsychotics, alpha 2
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Major depressive disorder- Clinical Depression

Major depressive disorder- Clinical Depression

environmental factors are also implicated. Bipolar disorder is often treated with mood stabilizing medications and psychotherapy. In serious cases, in which there is a risk of harm to oneself or others, involuntary commitment may be used. These cases generally involve severe manic episodes with dangerous behavior or depressive episodes with suicidal ideation. There are widespread problems with social stigma, stereotypes, and prejudice against individuals with a diagnosis of bipolar disorder. People with bipolar disorder exhibiting psychotic symptoms can sometimes be misdiagnosed as having schizophrenia.
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Personality features, dissociation, self-stigma, hope, and the complex treatment of depressive disorder

Personality features, dissociation, self-stigma, hope, and the complex treatment of depressive disorder

decreases the antidepressant efficacy in depression. Thus, one of the aims of this investigation was to determine whether the self-stigma considerably contributes to the treatment efficiency of the systematic therapy of the major depressive disorders. As for the impact of self-stigma on the combined pharmacological and psychotherapeutic effectiveness, an inverse relationship was found. The firm correlation between internalized stigma and the change of the psychopathology and severity of the disorder during the treatment evaluated by a psychiatrist supports the hypothesis that patients who highly stigmatize themselves improve noticeably less during the systematic treatment than the patients with lower levels of internalized stigma. The most relevant subscale from the
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The Relationship between Major Depressive Disorder and Personality Traits.

The Relationship between Major Depressive Disorder and Personality Traits.

It should be mentioned that experiencing depressive symptoms could affect self-reporting of the personality traits even in inter- episode recovery. For example, depression may decrease the probability of self- conception of SD and on the other hand may intensify the self-administration of HA (25). Besides, we should mention the importance of differences in personality traits of different samples. For instance, it was reported that comparing to Americans, Finns have higher scores in NS and HA and lower scores in RD and P (37). In this study, in both groups, only NS had a significant correlation with age which is congruent with other studies that had reported NS decreased as people aged (38, 39) .
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Parvalbumin Promoter Methylation Altered in Major Depressive Disorder

Parvalbumin Promoter Methylation Altered in Major Depressive Disorder

GABA is the most important and abundant inhibitory neurotransmitter in the central nervous system. Recently, psychiatric disorders have been linked with abnormalities of GABAergic neurotransmission in schizophrenia, bipolar disorder and MDD. In MDD, there have been multiple reports of altered GABA content in plasma, cerebrospinal fluid (CSF) and brains of depressed patients as well as changes in GABA-related gene and protein expression [9,16-18]. Moreover, altered mRNA GABAA receptor subunit expression was found in postmortem frontal cortex in depressed suicide victims [19]. Postmortem microarray studies in a cohort of suicides reported that GABA-related gene expression was altered in suicides both with and without depression in prefrontal cortex [20], limbic system [21] and also global brain [22]. Moreover, an association of depression with GABA-related genes indicated by differences in gene expression between suicides with and without depression has been reported [20-22]. These findings indicate that GABAergic neurotransmission is likely to be dysregulated in depression and suicide.
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THE ROLE OF FOLIC ACID IN THE TREATMENT OF MAJOR DEPRESSIVE DISORDER

THE ROLE OF FOLIC ACID IN THE TREATMENT OF MAJOR DEPRESSIVE DISORDER

Objective: Depressive symptoms are the most common neuropsychiatric manifestation of folic acid deficiency. The objective of this research is to determine the role of folic acid in tge treatment of major depressive disorder (MDD). Method: 60 outpatients with MDD and matched 30 healthy controls constituted the sample. The Personal Information Form was used to determine the sociodemographic features of the patient and the control groups. Hamilton Depression Rating Scale (HDRS) and the criteria of MDD of DSM-IV were used to diagnos the MDD. 30 of the outpatients
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Phenobarbital Treatment and Major Depressive Disorder in Children With Epilepsy

Phenobarbital Treatment and Major Depressive Disorder in Children With Epilepsy

Although there was a nonsignificant tend- ency to treat patients with partial complex seizures with carbamazepine and to treat patients with gen- eralized seizures with phenobarbital, th[r]

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The role of neuroinflammation and neurovascular dysfunction in major depressive disorder

The role of neuroinflammation and neurovascular dysfunction in major depressive disorder

Abstract: Although depression has generally been explained with monoamine theory, it is far more multifactorial, and therapies that address the disease’s pathway have not been developed. In this context, an understanding of neuroinflammation and neurovascular dysfunction would enable a more comprehensive approach to depression. Inflammation is in a sense a type of allostatic load involving the immune, endocrine, and nervous systems. Neuroinflammation is involved in the pathophysiology of depression by increasing proinflammatory cytokines, activating the hypothalamus–pituitary–adrenal axis, increasing glucocorticoid resistance, and affecting sero- tonin synthesis and metabolism, neuronal apoptosis and neurogenesis, and neuroplasticity. In future, identifying the subtypes of depression with increased vulnerability to inflammation and testing the effects of inflammatory modulating agents in these patient groups through clinical trials will lead to more concrete conclusions on the matter. The vascular depression hypothesis is supported by evidence for the association between vascular disease and late-onset depression and between ischemic brain lesions and distinctive depressive symptoms. Vascular depression may be the entity most suitable for studies of the mechanisms of depression. Pharmacothera- pies used in the prevention and treatment of cerebrovascular disease may help prevent vascular depression. In future, developments in structural and functional imaging, electrophysiology, chronobiology, and genetics will reveal the association between depression and brain lesions. This article aims to give a general review of the existing issues examined in the literature pertain- ing to depression-related neuroinflammatory and vascular functions, related pathophysiology, applicability to depression treatment, and directions for future research.
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Neuronal connectivity in major depressive disorder: a systematic review

Neuronal connectivity in major depressive disorder: a systematic review

Background: The causes of major depressive disorder (MDD), as one of the most common psychiatric disorders, still remain unclear. Neuroimaging has substantially contributed to understanding the putative neuronal mechanisms underlying depressed mood and motivational as well as cognitive impairments in depressed individuals. In particular, analyses addressing changes in interregional connectivity seem to be a promising approach to capture the effects of MDD at a systems level. However, a plethora of different, sometimes contradicting results have been published so far, making general conclusions difficult. Here we provide a systematic overview about connectivity studies published in the field over the last decade considering different methodological as well as clinical issues.
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Hypermethylation in the ZBTB20 gene is associated with major depressive disorder

Hypermethylation in the ZBTB20 gene is associated with major depressive disorder

twins discordant for depression has identified a region of the genome consistently hypermethylated in the de- pressed cohort, a result that was replicated in an unre- lated case-control population. Excitingly, the DMR occurs within the coding region of the ZBTBT20 gene, which is associated with the structural integrity of the hippocampus. This supports current research regard- ing the etiology of MDD, which suggests it may be driven by a disorder of neuron structure [42-44]. Analysis of brain tissue and expression data in the re- gion also supports a model whereby misexpression of ZBTB20 may be associated with depression. This study represents the largest and most comprehensive study so far of genome-wide methylation differences in MZ pairs discordant for MDD and suggests that larger col- laborative epigenetic twins studies are cost-effective and could provide even more clues to the etiology of complex traits.
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Complementary and alternative medicine for the treatment of major depressive disorder

Complementary and alternative medicine for the treatment of major depressive disorder

Main message In a large meta-analysis, St John’s wort was found to be equivalent to antidepressant drugs with fewer side effects. Exercise reduced depressive scores in 3 meta-analyses. Omega-3 fatty acids reduced depressive scores in a meta-analysis of 16 trials, but publication bias was identified. Oral SAM-e monotherapy reduced depressive scores in 4 of 5 small randomized controlled trials. Folate deficiency is associated with more severe and refractory depression, and supplementation reduced depressive scores in 2 of 3 randomized controlled trials. Acupuncture demonstrated limited efficacy in 1 meta-analysis and 5 other trials.
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Towards a Comprehensive Psychobiological Model of Major Depressive Disorder

Towards a Comprehensive Psychobiological Model of Major Depressive Disorder

DOI: 10.4236/ojd.2018.72003 32 Open Journal of Depression the global population (Wang et al., 2017). Major depression has become the second leading contributor to the global disability burden by 2010 (Ferrari et al., 2010). The basic symptoms are depressed mood and loss of interest or pleasure (American Psychiatric Association, 2013). Clinical relevant neurobiological hy- potheses of major depressive disorder comprise genetics, stress, chronobiology, neurochemistry (neurotransmitters, receptors etc.), and immunoendocrinology. However, we lack a thorough understanding of the etiopathophysiology of major depression (Hasler, 2010). Although most hypotheses are “neurocentric”, there is growing evidence that the glial cell system, especially astrocytes, play a signifi- cant role in the pathophysiology of depression (Verkhratsky et al., 2014; Dallerac & Rouach, 2016).
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Mitochondrial dysfunction, oxidative stress, and major depressive disorder

Mitochondrial dysfunction, oxidative stress, and major depressive disorder

Abstract: There is controversy about depression being a physical illness, in part because a reproducible, sensitive, and specific biologic marker is not available. However, there is evidence that mitochondrial dysfunction and oxidative stress may be associated with abnormal brain function and mood disorders, such as depression. This paper reviews selected human and animal studies providing evidence that intracellular mitochondrial metabolic dysfunction in specific brain regions is associated with major depressive disorder. This supports the hypothesis that chronic mitochondrial dysfunction in specific tissues may be associated with depression. Evaluation of mitochondrial dysfunction in specific tissues may broaden the perspective of depression beyond theories about neurotransmitters or receptor sites, and may explain the persistent signs and symptoms of depression.
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CLASSIFICATION OF BIPOLAR DISORDER, MAJOR DEPRESSIVE DISORDER, AND HEALTHY STATE USING VOICE

CLASSIFICATION OF BIPOLAR DISORDER, MAJOR DEPRESSIVE DISORDER, AND HEALTHY STATE USING VOICE

The current screening methods for mental disorders use biomarkers such as saliva [2], blood [3], electrocardiogram [4], and electroencephalogram [5], but these are invasive and high cost because special equipment and medicines are needed. Some non- invasive methods include self-administered psychological tests such as the General Health Questionnaire [6] and the Beck Depression Inventory [7]. Self-administered psychological tests are relatively easy, but reporting bias cannot be eliminated. Reporting bias is defined as selective under- or overestimation of certain information influenced by the responder’s consciousness/unconsciousness [8]. Bipolar disorder and major depressive disorder are two types of depression and divided based on their respective symptoms. Bipolar disorder is a mental disease with alternating manic and depressive states, with a difficult differential diagnosis from unipolar depressive state during a depressive episode [9]. It is particularly difficult to diagnose using a single self-administered psychological test, and the differences between these two diseases can be difficult to identify.
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Immune-inflammatory response changes in patients with major depressive disorder

Immune-inflammatory response changes in patients with major depressive disorder

24 outpatients (M/F = 8/16; mean age = 46.79 ± 12.97) with a Major Depressive Disorder (MDD) during a Major Depres- sive Episode (MDE) and 20 healthy controls (M/F = 8/12, mean age  =  40.05  ±  11.02) were recruited at the Institute of Psy- chiatry of the Catholic University in Rome. Depression severity was assessed with 21-items-Hamilton Depression Rating Scale (HDRS), while anhedonia and psychomotor retardation were evaluated with Snaith-Hamilton Pleasure Scale (SHAPS) and Depression Retardation Rating Scale (DRRS). Blood samples for the determination of hs-CRP, TNF-α, IL-6 and sIL-6R were collect- ed. Cytokines were measured using commercial enzyme linked immunosorbent assays (ELISA). Levels of hs-CRP were measured using nephelometric assay.
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Cost-effectiveness evaluation of escitalopram in major depressive disorder in Italy

Cost-effectiveness evaluation of escitalopram in major depressive disorder in Italy

Background: Depression has a lifetime prevalence of 10%–25% among women and 5%–12% among men. Selective serotonin reuptake inhibitors (SSRIs) are the most used and the most cost-effective treatment for long-term major depressive disorder. Since the introduction of generic SSRIs, the costs of branded drugs have been questioned. The objective of this study was to assess the cost-effectiveness (€ per quality-adjusted life year [QALY]) of escitalopram (which is still covered by a patent) compared with paroxetine, sertraline, and citalopram, the patents for which have expired.
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