Computer based trainings (CBTs) are established in the rehabilitation of mentally ill people to recover cognitive skills (Medalia et al., 2009). The Critique to some CBTs are lack of preparation for real life scenario, no use of tasks that simultaneously engage multiple cognitive processes and lack of enhancing motivation (Medalia & Choi, 2009). This may be summarized as a lack of biotic design in CBTs.

In depressive disorders besides other symptoms a lack of energy/motivation, forgetfulness and difficulty in concentrating are observable. The goal of this pilot study was to develop a new “biotic” designed CBT (Mebitrain) and evaluate its effect on global working memory (GWM) and motivation with data from patients suffering from depression.

To test whether Mebitrain enhances GWM (measured before and after a ten day training period with the LGT from Bäumler) and motivation (measured before and after training with custom rating scales and during the training with time and performance) five depressive (ICD diagnoses F31.0, F33.2, F32.3) patients were tested.

Differences between pre- (mean 33.6 ± 10.35) and post- (mean 38 ± 6) LGT values show a marginal significant trend (p = 0.1) with moderate effect size (d = .54).

The time finishing the training decreased per training session significantly with an increasing in performance (r = −.788, p < .005).

First results indicate that the development of a biotic designed training and its application may increase global cognitive functions and motivation in depressive patients. Limitations (e.g. sample size, transfer, etc.) of this pilot study are discussed.

Systemic lupus erythematosus (SLE) as a prototypic autoimmune disorder are characterized by autoantibody formation against nuclear antigens.

To evaluate the effect of depression, age, weight, smoking, sunlight exposure and alcohol drinking on antinuclear (ANA) and anti-double-stranded-DNA-antibody (anti-dsDNA) level in lupus-patients.

To evaluate the effect of depression and some individual or lifestyle-habits on lupus.

Comparison of 46 variables along with their intercorrelations was done in ANA-positive patients and ANA-negative healthy subjects.

Depression status and its prevalence in lupus-patients were higher than controls. Furthermore, more depressed patients had higher ANA and anti-dsDNA level which their level had a direct correlation with the age and weight of patients. However, ANA was more correlated with age and anti-dsDNA with weight. Higher ANA titer was also associated with higher consumption of alcohol and permanent hair products which after controlling for age and weight, only the first correlation remained significant. Anti-dsDNA titer was also positively associated with some of lifestyle habits which after controlling for age and weight, only the correlations with hookah consumption and sunlight exposure remained significant. Moreover the percentage of eosinophils was directly correlated with the level of tow aforesaid autoantibodies.

These findings suggest that depression score along with age and weight of ANA-positive lupus-patients as well as some of their health-related habits such as hookah smoking, direct sunlight exposure and alcohol drinking may affect the titer of autoantibodies in these patients. Further studies are required to evaluate the role of these factors in the exacerbations of SLE.

Neurotrophines such as brain-derived neurotrophic factor (BDNF) and neurotrophin 3 (NT3) have been implicated in the pathogenesis of depression and the therapeutic mechanism of antidepressants. Several clinical studies on depressive disorder (DD) have shown that levels of blood BDNF are diminished in depression and increase during antidepressant treatment. So far, only few studies have examined concentrations of neurotrophic factors in post-mortem brain tissue of individuals who suffered from DD.

The objective of the study was to show whether BDNF and NT3 levels in post-mortem brain tissue of individuals who suffered from recurrent DD and who had been treated with antidepressants differed compared to controls.

Specimens from cortical and limbic areas of post-mortem brain tissue of 7 individuals with an ante-mortem diagnosis of recurrent depressive disorder based on ICD-10 criteria (F33.0–F33.8) who received no psychotropic medication other than selective serotonin re-uptake inhibitors 6 months preceding death were selected. We compared the concentrations of BDNF and NT3 with 14 matched controls without any history of psychiatric disorder or treatment with psychotropic drugs.

We detected no significant differences of either NT 3 or BDNF concentrations in any of the brain regions examined in patients who had suffered from DD and had been treated with antidepressants compared to controls.

These findings could be interpreted as a neurotrophic effect of antidepressant treatment in patients with recurrent DD, supporting the notion that depression improvement is associated with neuroplastic changes. However, more research using post-mortem brain tissue is needed.

Depressive disorders (DD) are common and disabling. Patients with DD often have to do a long way before seeing a mental health specialist.

To investigate characteristics of the period before hospitalization to psychiatric hospital of patients with DD.

To define clinical peculiarities of DD, investigations, treatment of depressive patients before hospitalization.

The RDC of ICD-10 and «Structured Interview Guide for the Hamilton Depression Rating Scale, Seasonal Affective Disorders Version» were used.

After informed agreement 102 patients with DD for the first time admitted to the psychiatric hospital were examined. The average duration of DD before psychiatric examination was 19,1 months (up to 312 months). The average number of visits to primary care (PC) was 3,6 (up to 49), the average number of investigations was 2,4 (up to 8). The most part of visits to PC felt at patients with heart complaints (р = 0,02), the less to patients with loss of energy (р = 0,0007). With the prolongation of DD the number of investigations, medications in PC and absence days increased (r > 0,2, р < 0,05). Patients with heart and gastrointestinal complaints had more investigations (р = 0,01; р = 0,03). 38,2% of patients were prescribed tranquilizers and only 23,5% antidepressants, but 54,2% of them had suboptimal dossages.

To summarize, in real clinical practice patients with DD still haven’t enough opportunities for early diagnostics and treatment. Systematic recognition of patient with DD, professional training of PC doctors of different specialities are cruicial.

Like other European countries, the Defined Daily Dose (DDD) of antidepressants prescribed in Scotland increased almost fivefold in the fifteen years to 2007/8. The incidence and prevalence of depression has not changed over that period. It is not known whether this rise represents appropriate practice.

To assess the impact of stepped, collaborative care for depression on population antidepressant use.

A new depression service called “Doing Well” was implemented in 15/30 primary care practices in Renfrewshire, Scotland from July 2004 (population 76,013). Prescribing in these practices was compared with the remaining 15 “control” practices in Renfrewshire and with Scotland nationally.

Doing Well offered prompt assessment and access to guided self-help or brief CBT or IPT. Antidepressants were not recommended for patients with a PHQ score < 15, though patient preference and clinical judgement were used to guide prescribing decisions.

Antidepressant use followed a “rational” profile, increasing with depression severity:

• PHQ score at referral antidepressant use

• 0–5 0%

• 6–10 24%

• 11–15 37%

• 16–20 59%

• 21–27 70%

• total 53%

Average annual DDDs of antidepressants increased by 3.8% in the Doing Well practices, 11.8% in the control practices and 12.9% in Scotland during the four years to June 08. This represents a relative reduction in DDDs in the intervention area.

Providing rapid, local access to brief psychological therapies and rational prescribing support was associated with a relative reduction in the rise of antidepressant use, but a modest increase in prescribing overall.

Beside psychological distress of breast cancer diagnosis and patophysiological characteristics of breast cancer it is also known that different treatments could have influence on mental well-being. The aim of this study was to investigate treatment of depression, anxiety and breast cancer in Slovenian female patients.

In the study were included 314 female patients with breast cancer treated at the Institute of Oncology Ljubljana between September 2004 and July 2005. Only 18 patients were not surgically treated. Majority (80%) of all patients were treated also with chemotherapy. In combination with chemotherapy 43% of all patients received also radiotherapy and 50% received also hormonal therapy. Altogether 72 (22,9%) patients expressed clinically important serious anxiety (Hospital Anxiety and Depression (HAD) score of 11 or more on anxiety subscale), 39 (12,4%) clinically significant serious depression (HAD score of 11 or more on depression subscale) and 51 (16,2%) clinically significant depression and anxiety combined (HAD score of 11 or more on both subscales). Among patients with clinically significant serious anxiety 19 (26,4%) patients were psychiatrically treated before inclusion into study. Among patients with clinically significant serious depression 13 (33,3%) patients were psychiatrically treated before inclusion into study and among patients with clinically significant serious anxiety and depression 24 (47,0%) patients were psychiatrically treated before inclusion into study.

Less then half of patients with breast cancer with comorbid clinically significant expressed serious anxiety and/or depression has been psychiatrically treated before the inclusion in the study.

Depression and simple phobia are the most prevalent mental illnesses among employees leading to an increased number of sick days, decreased social and professional function, job satisfaction, quality of life and increased risk of loss of work.

Around 25% of the working population is affected by psychiatric symptoms in a way that is painful to the individual, but not of such severity that is qualifies as a genuine disease.

Untreated and not early identified these cases could lead to actual mental illness.

Moreover, less than half of those currently suffering from depression are provided with the correct diagnosis in general practice, and less the half, diagnosed correctly, receive the proper medical treatment.

To identify, treat and thereby interrupt pre-existing cases of mental illness in the workplace. To prevent worsening of minor cases of psychiatric illness and symptomatic cases not considered a genuine disease.

To develop models for early tracing and treatment of mental illness in the workplace with consequent improved health status and quality of life for the individual and improved economy for the workplace and the public.

This intervention study includes larger companies with more than 100 employees in the Region of North Denmark.

The study design is a before-after study using self-reporting questionnaires as a basis for identification of cases of mental illness and follow-up of treatment. The study uses clinical interview and examination for determining the need for treatment.

Results not yet available.

Clinicians treating patients with Major Depressive Disorder (MDD) might favor one second-generation antidepressant (SGA) because of perceived benefits for the accompanying symptoms of MDD.

To compare the efficacy of bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, mirtazapine, nefazodone, paroxetine, sertraline, trazodone, and venlafaxine for the treatment of the accompanying symptoms of MDD.

This review is part of a larger review on the comparative effectiveness of SGAs for MDD. We searched MEDLINE, Embase, The Cochrane Library, and the International Pharmaceutical Abstracts up to May 2010. Two persons independently reviewed the literature, abstracted data, and rated the risk of bias.

We located 26 head-to-head and 7 placebo-controlled trials that provided evidence for this review. We did not locate any studies on treating accompanying appetite change, low energy, melancholia, or psychomotor change. There was no evidence for many comparisons and we were unable to conduct quantitative analysis for any comparisons. For the comparisons that were studied, we concluded that the SGAs are similarly efficacious for treating anxiety, insomnia, pain, and somatization. The strength of the evidence for these conclusions is low (meaning further research is very likely to have an important impact on our confidence in the estimate of the effect and is likely to change the estimate).

Our findings indicate that the existing evidence does not warrant the choice of one second-generation antidepressant over another based on greater efficacy for the accompanying symptoms of depression.

Nonrespons in first -line drug treatment of patients suffering from depression in psychiatric outpatient populations is a severe problem.

The non respons rate is up tot 30% and the non remission rate more than 50% in the first line of treatment with antidepressants in this population.

To devellop more rapid and efficious drug treatment strategies in depression.

During the last few years several strategies to improve outcome in depression have been under investigation. A few have proven to be valuable.

Medline search 2005–2010 into treatment resistent depression, combination therapy, augmentation therapy, drug therapy.

There is growing evidence for the value of the combination of antidepressants and of combining antidepressants with antipsychotics.

Treatment options as pindolol addition to antidepressants, substance P or folic acid addition do not seem of clinical significance yet.

The same is true for treatment methods who directly influence the glucocorticoid system such as glucocorticoid receptor antagonists.

NMDA antagonists look promising but more research into this option is needed.

There are two outstanding and much promising relatively new treatment options with: Combinations of antidepressants and with combinations of an antidepressant with an antipsychotic.

Antidepressants that combine serotonergic (SSRI) and noradrenergic (NaRI) actions may have greater efficacy in treating depression than SSRI monotherapy. This theory has not been tested in any trials examining augmentation of SSRIs with a NaRI.

Does augmenting SSRIs with reboxetine, a NaRI, in depressed patients unresponsive to first line treatment, result in improved antidepressant efficacy?

In a naturalistic observational study, 30 patients with moderate to severe depression (ICD-10) who failed to respond to at least 20 mg of a SSRI, were augmented with reboxetine (4 mg increased to 8 mg if tolerated). BDI-II was measured before and 6 weeks after introduction of reboxetine. Changes in BDI scores were analysed using paired t-test.

20 out of 30 patients were able to tolerate the combination of SSRI and reboxetine treatment for at least 6 weeks. There was a significant reduction in mean BDI-II scores from 36.6 at baseline to 27.2 at six weeks follow-up (t = 4.13, df = 29, p < 0.001). 13 out of 30 previously unresponsive patients showed a response (reduction in BDI score of at least 10 points) to combination treatment, with 5 patients achieving remission (BDI < 12) over the six weeks.

Reboxetine augmentation of SSRIs can be tolerated by a majority of patients and results in a significant increase in response rates. It is a treatment strategy that should be considered in patients with moderate to severe depression who fail to respond to first line treatment with an SSRI.

Health education programs that address risk factors for depression and promote positive mental health are approaches that can improve mental wellbeing. We investigated the effectiveness of a health promotion program for reducing levels of depression, anxiety and stress and for promoting appropriate help-seeking behaviour.

Fifty-five adults 55+years (43 female, 12 male) self-selected to attend the Healthy & Wise program - a group-based, 8 × 2hr session health-literacy program for promoting positive physical, mental and social functioning in a rural setting. A questionnaire was administered at base-line and post-intervention which included the DASS-21 to measure depression, anxiety and stress levels.

No significant change in depression scores (mean = 3.60pre-3.51post). Anxiety scores increased (mean 2.92pre-3.51post) (p = .036) correlating with age (p = .029) and change in physical health status (p = .002).

Stress scores increased (mean 4.81pre-5.59post) (p = .05) correlating with age (p = .033) and change in physical health status (p = .016).

Most participants (pre = 96.36%, post = 98%) indicated they would be likely to seek help from a GP if depressed. Men who mainly rely on their spouse for support were more likely to seek help from a psychologist or psychiatrist (p = .038).

There was no significant change in DASS-21 scores for depression. There was an increase in anxiety and stress levels which may be attributable to older participants experiencing a decline in physical health during the program. Participants remained firm in their preference for seeking help from their GP for depression. Further evaluation is needed to determine whether: at-risk-populations need to be targeted; the intervention has an impact at 12-month follow-up.

We examined the effects of affect and emotional suppression (ES) on short-term life satisfaction (LS) and depression. In doing so, we considered the dimension of activation for positive affect (PA) and negative affect (NA).

The final sample included the data collected from 496 undergraduate and graduate students (240 men and 256 women). Participants answered seven questionnaires for assessing activated PA and NA, ES of PA and NA, short-term LS, and depression, three of which were used for another study. All of them were Japanese versions, answered on the past week.

Results from hierarchical regression analyses showed that LS was positively associated with PA and negatively with NA, but that its positive association was stronger in activated PA than deactivated PA while its negative association was stronger in deactivated NA than activated NA. Similar findings were obtained for depression. The significant interactions suggested:

1. (1) higher scores of ES of PA weaken the positive association between activated PA and LS in both sexes;

2. (2) higher scores of ES of NA strengthen the negative association between activated NA and LS in men and weaken the association in women; and

3. (3) the positive association between activated NA and depression is weakened by higher scores of ES of NA in women.

This study suggested that activated and deactivated affect differ in their relations to life satisfaction and depression. Moreover, it is likely that although ES of PA and NA influences health, its effects would be different between men and women.

This study interested in gathering data on the prevalence of depression and its contributing factors among final year medical students in USM.

A cross-sectional study was done. A total of 187 final year medical students of the 2007/2008 batch were selected as in study subjects. The Malay Beck's Depression Inventory (M-BDI_ was administered to identify depressed students. Data were collected during housemanship course, one week after their final summative examination.

A total of 92 (49.2%) students responded to this survey. The percentage of depression among the students was 21.7%: approximately 19.5% with mild depression and 2.2% with moderate depression respectively. The mean M-BDI scores were found to be significantly increased among female medical students (p < 0.05), those in difficulties with peer and love relationships (p < 0.01), and those with poor general health status (p < 0.001). Logistic regression showed female students, those in difficulties with love relationship and those with poor general health were at higher risk to develop depression (X2 (df) = 26.59 (3), p < 0.001). Multi-factorial ANOVA analysis showed that two factors contribute to depression among final year medical students which were gender and general health status (F (df) = 5.934 (13), p < 0.001).

The prevalence of depression among medical student was high. Female medical students, those in difficulties with love relationship, and poor general health status were at high risk to develop depression. Gender and general health status were determinant factors of depression among USM final year medical students.