This experimental trial aims to describe the experiences felt by a group of patients diagnosed with different psychotic disorders (schizophrenia, delusional chronic disorder, etc.) in which the use of Benzodiazepine derivatives were related to emergence of lucid dreaming and dissociative events (to see oneself out of your one body, etc.), and to a lesser extent had subsequent depressive symptoms. Fifty-six patients were monitored and linked to the emergence of depressive symptoms related to the use of Benzodiazepines or sedative-hypnotic. While on this treatment, they had vivid or lucid dreaming.

To explore the relationship between occurrence of drug dreams (DDs) and daytime negative affect with lucid awakening during the course of a 9-week treatment.

Using the dream journal methodology, 56 participants reported occurrence of dreams, dream content, and ratings of affect. The relationships between the experience of DD, dream content (“active” vs “passive”), and affect were analysed using mixed model methods.

The experience of DD was associated with higher levels of negative affect (P < 0.001). The occurrence of DD did not decrease significantly over the 9 weeks of the study. Benzodiazepine users reported a higher occurrence of Lucid Awakening (P < 0.05) than the other drug groups (zolpidem and clometiazol).

These results are consistent with the hypothesis that DD can act as drug-conditioned stimuli to elevate negative affect. Although correlational, such findings support the implementation of psychological and pharmacological interventions aimed at minimizing the impact of DD on patients with lucid awakening and psychosis.

The authors have not supplied their declaration of competing interest.

Sunshine increases placebo effect in major depressive disorder (MDD) patients (Gailledreau et al., 2015). Kokras et al. (2014) showed that sunshine induces different responses in female than male mice in preclinical models of depression.

To determine whetehr the sunshine induced placebo effect exhibits gender differences in human.

Data from 9 double-blind, randomized, placebo-controlled studies of antidepressants conducted by the French GICIPI network were reviewed. MADRS (5) or HAM-D 17 (4) were used as the main efficacy tool. For each patient, variation of scores (Delta MADRS/Delta HAM-D) between two consecutive visits were correlated with the average sunshine index observed at noon between these visits. Sunshine indexes were provided by Météo-France. Correlations were computed with Microsoft Excel.

Analysis of both genders (n = 52) showed no statistically significant (NS) correlation (r2 = 0.0064) between sunshine and score variations. Analysis of males (n = 8) failed to demonstrate any significant correlation in cloudy (< 1000 Joules/cm2), variable (1000–2000 Joules/cm2) or sunny (> 2000 Joules/cm2) weather. Analysis of females (n = 44) showed NS correlation as well for cloudy or variable weather (r2 = 0.0016), but a strong correlation was observed for females exposed to sunny weather: r2 = 0, 315, n = 20, P < 0.01. This correlation was even stronger in the subpopulation of females aged less than 50 years: r2 = 0.6398, n = 12, P < 0.001.

The hypothesis underlying this correlation between sunshine index and variations of MADRS/HAMD scales will be discussed.

Sunshine increases placebo effect in female patients aged less than 50. This insufficiently known effect may be responsible for failure of a number of double-blind, randomized, studies of antidepressant compounds.

The authors have not supplied their declaration of competing interest.

There is a hypothesis in cognitive psychology that long-term memory retrieval is improved by intermediate testing than by restudying the information. The effect of testing has been investigated with the use of a variety of stimuli. However, almost all testing effect studies to date have used purely verbal materials such as word pairs, facts and prose passages.

Here byzantine music symbol–word pairs were used as to-be-learned materials to demonstrate the generalisability of the testing effect to symbol learning in participants with and without depressive symptoms.

Fifty healthy (24 women, M age = 26.20, SD = 5.64) and forty volunteers with high depressive symptomatology (20 women, M age = 27.00, SD = 1.04) were examined. The participants did not have a music education. The examination material was completely new for them: 16 byzantine music notation stimuli, paired with a verbal label (the ancient Greek name of the symbol). Half of the participants underwent intermediate testing and the others restudied the information in a balanced design.

Results indicated that there were no statistically significant differences in final memory test performance after a retention interval of 5 minutes for both groups of participants with low and high level depressive symptomatology (P > 0.005). After a retention interval of a week, tested pairs were retained better than repeatedly studied pairs for high and low depressive symptomatology groups (P < 0.005).

This research suggests that the effect of testing time on later memory retrieval can also be obtained in byzantine symbol learning.

The authors have not supplied their declaration of competing interest.

The antidepressant efficacy and tolerance of agomelatine, MT1/MT2 agonist and 5-HT2C antagonist, has been proven in clinical trials. Non interventional studies give the opportunity to evaluate these properties in real life.

To evaluate the efficacy and tolerance of agomelatine in depressed outpatients in Switzerland.

Non-interventional study in 934 depressed (51.2% severely) patients given 25–50 mg agomelatine for 12 and 24 weeks. Main endpoints were change in MADRS score, and response (≥50% reduction in total score) and remission (MADRS ≤12) rates. CGI was also assessed. Reported adverse drug reactions, sexual dysfunction, and weight changes were recorded. Liver function tests were performed according to the summary of product characteristics.

MADRS total score decreased significantly (P < 0.0001) from baseline (29.5 ± 8.9) to weeks 12 (12.8 ± 9.6) and 24 (9.7 ± 8.6). Responder rate was 66.8% and 78.3% and remission rate 54.2% and 70.2% at weeks 12 and 24, respectively. Results corroborated by CGI scores, were similar for severely depressed patients. Early improvers (MADRS ≥ 20% reduction after 2 weeks; 461 patients) had the highest responder and remission rates. Agomelatine was well tolerated and no relevant weight changes or deleterious sexual function was reported. Ten patients had ALT/AST>3ULN, thereof 2 without baseline and one with elevated baseline. Most physicians rated the efficacy and tolerance of agomelatine as “good or very good”.

Long-term agomelatine treatment improved mood symptoms of depressed patients with high levels of response and remission and a favorable tolerance profile.

The authors have not supplied their declaration of competing interest.

Depression is a life threatening psychiatric disorder. STAR-D study stated that remission rates decrease, and relapse rates increase. It produces chronic diseases and worsens mean health when co-morbid with these diseases. The depressive symptoms in humans are analogous to the ‘sickness behavior’ syndrome seen in animals when injected by pro-inflammatory cytokines.

This study was done to clarify the relation between the severity of depression and serum level of tumor necrosis factor alpha (TNF), so improving the quality of pharmacological management.

This study was done to prove that inflammatory process is involved in the pathogenesis of depression by assessing the serum level tumor necrosis factor alpha (TNF alpha)

Our study is comparing between 60 patients with major depressive disorder and 30 healthy controls regarding the serum level of tumor necrosis factor alpha. Patients were diagnosed by a semi-structured interview using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Patients were subdivided into mild, moderate and severe depression according to Hamilton Rating Scale for Depression (17 items). Assessment of serum level of tumor necrosis factor alpha was done using enzyme- linked immunoassay technique.

Serum level of TNF alpha was significantly higher among patients than among controls (Z = 4.710* P ≤ 0.001*) regardless the severity of depression.

Serum TNF alpha can be used as a biomarker of depression but not for the disorder severity. However, further study is needed to detect if there is a relation between major depressive disorder and serum level of other inflammatory markers as C-reactive protein.

The authors have not supplied their declaration of competing interest.

Depression is one of several preventable causes of disability worldwide, with coronary heart disease (CHD) being the largest cause of disability. Depression has been confirmed as a risk factor for CHD.

Few studies tried to find an interrelation between depression and a risk of cardiovascular mortality according to systematic coronary risk evaluation (SCORE) chart.

The aim of study was to examine the correlation of depression with the risk of cardiovascular mortality (SCORE).

Study was conducted in 2015 within the framework of National Research Programme BIOMEDICINE. All patients aged 18 and older at 24 primary care facilities were interviewed with a sociodemographic questionnaire supplemented by measurements of blood pressure and total cholesterol. Within 2 weeks after the visit psychiatrist administered the Mini International Neuropsychiatric Interview (MINI) by telephone. SCORE was assessed using high risk chart.

Totally 920 patients age 40–69 were included in the data analysis. According to the MINI 9.3%(95%CI 7.5–11.5%) of 40–69 years old patients had current depression. Current depression was more common among women than men, 10.4% and 6.8%, respectively. The prevalence of current depression was highest among patients with SCORE 3–4%. Multivariate logistic regression did not suggest statistically significant odds ratio for having depression based on SCORE.

Only one of the measurements used for SCORE (smoking status) was significant predictor for having current depression, while systolic blood pressure and total cholesterol were not significant predictors for depression. As pharmacotherapies for reducing blood pressure and cholesterol are widely used by patients further research should include use of these medicines as potential mediators.

The authors have not supplied their declaration of competing interest.

Even though the association between dermatological conditions in pregnancy with psychiatric findings is vital for patient management, studies on these issues are limited.

To determine the frequency and nature of dermatological problems in pregnant women having primary psychiatric illness.

To establish an association between cutaneous manifestations in pregnancy with the hypothesis that psychiatric illness also has a role in pregnancy.

This was a case control study and non probability convenient sampling was used on 50 pregnant patients with cutaneous manifestations along with psychiatric illness and 50 age matched non pregnant patients free from dermatological conditions and psychiatric illness. The Diagnostic and Statistical Manual of Mental Disorders (DSM IV) Criteria was used to diagnose psychiatric illness and for skin manifestations patients underwent a physical examination of skin.

Pregnant patients with depressive disorders were associated with atopic eruption of pregnancy [odds ratio (OR) 1.19; 95% (CI): 1.13–1.49], pruritic urticarial papules [(OR) 2.89; 95% (CI): 2.55–2.97], plaques of pregnancy [(OR) 2.14; 95% (CI): 2.01–2.39], prurigo of pregnancy [(OR) 1.33; 95% (CI): 1.17–1.45], intrahepatic cholestasis of pregnancy [(OR) 2.45; 95% (CI): 2.29–2.67], pemphigoid gestationis [(OR) 1.57; 95% (CI): 1.50–1.68], impetigo herpetiformis [(OR) 1.83; 95% (CI): 1.65–2.24], and pruritic folliculitis of pregnancy [(OR) 2.34; 95% (CI): 2.20–3.62], psoriasis [(OR) 1.75; 95% (CI): 1.64–2.37], melasma [(OR) 1.88; 95% (CI): 1.63–2.49], intrahepatic cholestasis [(OR) 2.77; 95% (CI): 2.14–3.48].

The results of the study support the hypothesis, that there is an association between psychiatric and skin diseases in pregnancy.

The authors have not supplied their declaration of competing interest.

The global burden of depression is high for women in both high income and low-and-middle income countries WHO. Depression is particularly common during pregnancy and in the postnatal period and phenomenology said to be the same as in non-child bearing age. Despite high prevalence of prenatal and postnatal depression in Pakistan, research on the effectiveness of psychological interventions is limited.

This study aimed to assess the feasibility of group interpersonal psychotherapy (IPT) intervention for maternal depression in Karachi, Pakistan.

A total of 50 mothers aged 18 years and above with children below 3 years of age, and experiencing mild to moderate depression were recruited. Assessments were done using Edinburgh Postnatal Depression Scale (EPDS) Rosenberg's Self-Esteem Scale and EuroQol-5D at baseline, 3 months, and 6 months. Rosenberg's Self-Esteem Scale and EQ-5D were also used to measure self-esteem and health related quality of life. Participants were randomly assigned into IPT plus treatment as usual (TAU) and TAU groups. Ten sessions of group IPT were delivered to intervention group.

Results indicated significant difference between intervention and control group on EPDS. The mean score at baseline for the IPT group (mean = 14.76) reduced to (mean = 6.40) (P < 0.000) at 3-month and to (mean = 6.64) (P < 0.001) at 6-month intervals as compared to TAU (mean = 11.44) (P < 0.000) at 3-month and to (mean = 11.08) at 6-month (P < 0.001) after randomisation.

IPT is a successful fit for women with maternal depression in low-income areas and IPT can be the appropriate treatment option as it is time limited, specific, and evidence based.

The authors have not supplied their declaration of competing interest.

Prevalence of Common Mental Disorders (CMD) is high in low and middle-income countries. The prevalence rate of postnatal depression in Pakistani women and its effect on the growth and development of young children and child mortality is very high. Despite availability of interventions to improve maternal health, the major issue in implementation of those interventions is because of limited availability of trained health professionals.

The aim of this study is to deliver CBT based intervention called “change your life with 7 sheets of paper” to women with mild to moderate PND through trained Traditional Birth Attendants (TBAs).

During first stage of this rather blind feasibility randomized control trial 5 TBAs were trained to deliver CBT. Total 36 participants with PND having child between the ages 0–12 months will be recruited from community. Participants will be assessed using Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9) and World Health Organization Quality of Life scale at baseline and then at 3 months. Eight group sessions of CBT will be delivered by trained TBAs.

Outcome assessments will be done after completion of intervention of intervention i.e., 3 months after baseline. Preliminary findings will be presented in the conference.

Findings from this trial will help us to understand how the involvement of TBAs can help in overcoming the challenge of non-availability of trained health professionals and in attainment of millennium development goals of reducing mother and child mortality.

The authors have not supplied their declaration of competing interest.

Depression has been linked to decreased levels of vitamin D in adults and the altered dietary intake of calcium and vitamin D has been reported to have implications for the development of depressive symptoms. Although, the relation between vitamin D and depression has been established, it is not yet clear whether the supplementation of vitamin D could affect the clinical manifestation of depression. Therefore, the aim of this study was to determine whether the supplementation of vitamin D could affect the development/course of depression.

A systematic literature search was performed for randomized control trials (RCTs) in which vitamin D was supplemented and depression was measured.

Six studies were identified as being eligible to be included in this review. The results regarding the supplementation of vitamin D and its effect on the course and manifestation of depression were conflicting. One study concluded that the supplementation of vitamin D3 had beneficial effect in depression and another study reported no improvement in the indices of mental well-being in the vitamin D supplemented group and rejected the hypothesis that an annual high dose of vitamin D3 could prevent depressive symptoms. The remainder four studies reported inconclusive results regarding vitamin D supplementation and the course of depression.

As current literature displayed contradictory results and no sound conclusion could be drawn regarding the supplementation of vitamin D and its effect on depression, there is a need of RCTs to determine whether the supplementation of vitamin D levels could affect depression.

The authors have not supplied their declaration of competing interest.

Family plays a pivotal function in life of all human being and their significance even increases with the age. However, living in a elderly home may result in a multitude of losses which must be addressed by individual through the process of grief.

The purpose of this study was to explore situations of loss and grief among institutionalizes elders.

It is a qualitative, descriptive and exploratory research. Data was collected from two Portuguese elderly homes in the municipality of Viseu, Portugal. A purposeful sample of 7 elders was recruited, and audiotaped face-to-face semi-structured interviews were conducted.

Three dimensions of emotional loss were created: loss by death, loss by separation and other losses. Loss by separation was further divided into three subcategories: marriage separation, family separation and separation of peers living in the elderly home. The death of a loved one reminds the elderly individual of his/her own mortality, complicating the process of mourning. Separation, however is much more difficult to overcome because there is a loss among the living, with the possibility to lose the meaning of life with the other one.

Understanding loss and grief among elderly people is fundamental for nursing care, in order to help them with the process of coping and to prevent institutionalization to become an unpleasant experience. This will also offer health care facilities suggested ways to reduce or combat loneliness and depression among the elderly people.

The authors have not supplied their declaration of competing interest.

The aim of this study was to assess period prevalence and risk factors of peripartum depression in South Korean women.

Two thousand four hundred and forty-nine women in their first trimester of pregnancy were recruited, 1355 women were followed to the end of the study (1 month after delivery), 423 women are before the 1 month after delivery, 671 were dropped out. There were four time points of assessment – 12, 24, 36 weeks of gestation and 1 month after delivery. Depressive symptoms were assessed using the validated Korean version of the Edinburgh Postnatal Depression Scale. Risk factors were assessed across the demographic features, past histories, obstetric histories, and psychological status.

The prevalence of peripartum depressive symptoms (above 10 points of K-EPDS) was found to be 18.8% at 1st trimester, 12.9% at 2nd trimester, 12.6% at 3rd trimester, and 15.7% at 1 month after delivery. Identified risk factors of depression at 1st trimester were unmarried status, employed status, low family income, familial history and past history of depression, multigravida, unplanned pregnancy, hyperemesis, and threatened abortion. In psychological aspects, higher distress, lower marriage satisfaction, and lower quality of life increased the risk of depression. The analyses to identify risk factors of postpartum depression will be performed after the deliveries of recruited mothers are complete.

A substantial proportion of mothers suffered from peripartum depression from their early pregnancy in Seoul, Korea. Intervention based on identified risk factors would be recommended to help depressive pregnant mothers.

The authors have not supplied their declaration of competing interest.

Depression is one of the main causes of incapacity worldwide. Research has shown that mindfulness practice, self-compassion promotion, and spiritual well-being are beneficial for depressed individuals.

Analyze the associations between compassion, mindfulness, and spiritual well-being, during and after a therapeutic intervention (concluded less than a year ago).

To determine if mindfulness, self-compassion, and spiritual well-being are predictors of depression.

Patients diagnosed with chronic depression were treated in a residential therapeutic community for a period of six to eight months. The 63 participants (M = 32.84, SD = 10.24, range = 15–50 years old; 32 during treatment; 31 after treatment) were assessed with the Beck Depression Inventory, the Questionnaire of the Five Facets of Mindfulness, the Self-Compassion Scale, and the Spiritual Well-Being Questionnaire.

There were differences in mindfulness, self-compassion, spiritual well-being and depression by sex, existence of previous psychiatric treatment, moment of the study (during versus after intervention), and depression levels. After intervention the group had higher levels of mindfulness and self-compassion (common humanity) and lower levels of over-identification, compared with group during treatment. The predictors of depression were the self-judgment dimension of the self-compassion scale and, negatively, the mindfulness dimensions of non-reactivity and non-judging, and the spiritual well-being dimension of personal well-being.

Results confirm the relationship between the study variables and depression. This reinforces the importance of intervention based on positive psychology enhancing positive areas of human experience, rather than focusing on psychological pain, weaknesses, and disabilities.

The authors have not supplied their declaration of competing interest.

The cerebral blood flow (CBF) is an absolute measure that superior to the relative measure of neural activity, blood oxygenation-level-dependent (BOLD). The previous studies have reported CBF abnormalities in the adult depressive patients. However, it is not clear whether the abnormal CBF could be improved in the remitted geriatric depression (RGD).

We enrolled 82 RGD patients and 90 age and education matched healthy controls. All the subjects underwent 3-T MRI with pseudo arterial spin labeling (pASL), and the pASL data were analysis voxel-by-voxel with control the gray matter volume.

Compared with the healthy controls, the RGD patients demonstrated higher relative CBF value in left inferior temporal gyrus and left precuneus; while lower relative CBF value in right medial temporal and occipital cortex, right insula operculum (including parts of frontal, temporal and parietal cortex) and insula, right medial frontal cortex. When compared with the remitted early onset depression (EOD), the remitted late onset depression (LOD) showed lowed relative CBF value in right angular gyrus. While there was no significantly different relative CBF value between the RGD patients accompany with MCI and RGD patients with cognitive normal.

The late life depression persists with CBF abnormalities in the remitted state. And it is implicit that hyperperfusion in the left brain cortex and hypoperfusion in the right brain cortex could be the specific form to RGD patients.

The authors have not supplied their declaration of competing interest.

Although the relationship between the content of stress and serious diseases, such as depression is not so obvious, underlying mechanisms encouraging more and more authors to define a ‘civilization syndrome’ as a link between our modern lifestyle, the civilization we live and psychosocial health problems. With regard to the ‘civilization syndrome’, there are several new candidates that have been spotted as the challenges for psychiatric research, like burnout, infertility and solitude. All these phenomena seem to increase epidemically and require urgent conceptual and therapeutic studies.

. The program was addressed to three groups of patients with burnout, infertility, and social relationship/loneliness crisis.

Using the new stress reduction program (SRP), engaging both pharmacological and psychotherapeutic approach, and also several lifestyle factors, like physiotherapy, nutrition aspects, coaching, social media contact and monitoring, most of patients improved in terms of emotional and behavioral markers, in short- and long-term (4–6 months) observations.

Patients and clients (N43) with F3.x-F4.x disorders according to ICD-10.

A variety of PRS scales were used to assess patients’ improvement outcomes. Significant reductions (4–6 months) were observed at Maslach Burnout Inventory (–23.4%, P = 0.000), Fertility Problem Inventory (–34.5%, P = 0.000), UCLA Loneliness Scale, ver. 3 (–43.3%, P = 0.000), and Perceived Stress Scale (44.0%, P = 0.000).

This program interplays between stress and mental health problems and opens up new possibilities for diagnosis and therapy, focusing on the challenges of civilization, and especially opens up preventive options in stress-related problems and diseases, which represent a growing health burdens in modern society.

The authors have not supplied their declaration of competing interest.

Depression is associated with the metabolic syndrome (MS). Recently, the concept of ‘metabolic depression’ has been proposed based on a protracted course of depressive symptoms over time.

Within the Netherlands study of depression in older persons, we examined whether metabolic dysregulation predicted the two-year course of depression.

A cohort study (n = 285) of depressed persons (≥60 years) with two-year follow up. Depression was classified according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Severity of depression was assessed with sum score as well as subscale scores of the Inventory of Depressive Symptomatology (IDS) at six-month intervals. The metabolic syndrome was defined according the National Cholesterol Education Program (NCEP-ATP III). We applied logistic regression and linear mixed models adjusted for a wide range of confounders and severity of depression at baseline.

The number of MS-components predicted non-remission at two-years (OR = 1.28 [95% CI: 1.00–1.58], P = 0.047), which was driven by waist-circumference, HDL-cholesterol and triglycerides. MS was only associated with the somatic symptom subscale score of the IDS over time, but not with its sum score (interaction time × somatic subscale, P = 0.002). This effect was driven by waist circumference, elevated fasting glucose level and hypertension.

Metabolic dysregulation predicts the course of late-life depression. This effect seems to be driven by visceral obesity (as indicated by the waist circumference) and lipid dysregulations and with respect to the somatic symptoms of depression.

The authors have not supplied their declaration of competing interest.

Although self-compassion has been pointed as an effective strategy for coping with depression, there are not any studies investigating its association with lifetime history of depression (LTHD).

To compare self-compassion levels in pregnant women with vs. without LTHD and to analyze if self-compassion dimensions are significant predictors of LTHD.

Four hundred and twenty-seven pregnant women with a mean age of 33 years (±4.785) in their second trimester of pregnancy completed the Self Compassion Scale validated for pregnancy (SCS; Bento et al., 2015) and a new self-report questionnaire to evaluate the presence of LTHD according to DSM-5 criteria for depression.

Ninety-seven (23.0%) women had LTHD. Bisserial Spearmen correlations between LTHD and SCS total score were significant, negative and moderate (r = –0.31). SCS subscales, except Common Humanity, showed significant correlations: Self-Kindness/SK (r = –0.130), self-judgement (SJ) (0.313), isolation (0.357), mindfulness (r = –0.102), over-identification (OI) (r = 0.393). Independent sample t tests revealed that women with vs. without LTHD had significantly lower levels of total SCS, SK and Mindfulness scores and higher levels of SJ, Isolation and OI.Logistic regression (assumptions were fulfilled, Tabachnick and Fidell, 2007) showed that the SCS explained 26.7%–43.6% of the LTHD variance and correctly classified 86.9%; the odds ratio (OR) was.865 (95% CI 0.834–0.898; P < 0.001). The model composed by the correlated dimensions explained 15.9%–24.0% and correctly classified 80.6%. Odds ratios: SK = 0.017; SJ = 0.021; isolation = 16.027; mindfulness = 0.167 and OI = 20.178 (all P < 0.05).

Self-compassion, specifically the ability to treat oneself with care and understanding and to be aware and accepting one's present-moment experiences, decrease the probability of having LTHD.

The authors have not supplied their declaration of competing interest.

Depression is recognized as more frequent psychiatric disorder in epilepsy patients with significant impact on their health-related quality of life.

To analyze the occurrence and clinical particularities of different types of interictal depression in epilepsy patients.

One hundred and fourteen epilepsy patients with interictal depression were assessed with a clinical interview and Hamilton depression and anxiety rating scales. Diagnostic criteria of ICD-10 and of the International League Against Epilepsy (ILAE) were used.

A total of 45.6% of patients met ILAE criteria of inerictal dysforic disorder (IDD) with predominance of depressive mood, irritability, fear and atypical pain. All patients had chronic epilepsy with specific epileptic personality changes. Comorbid adjustment disorders (depressive and anxious-depressive reactions) were diagnosed in 27.2% of patients. The most frequent trigger situations were: family problems, serious illness, unemployment, financial difficulties. In more than half of patients were registered specific personality changes whose severity was in inverse ratio with trauma severity. A total of 18.4% of patients met criteria of comorbid affective disorder (depressive and bipolar) with some specific clinical traits due to personality changes. In 8.8% of patients, anticonvulsant-induced depression was observed; it was clinically simple, resolved after offending medication withdrawal.

Observed depressive disorders were heterogeneous: comorbid or attributed to epilepsy or its treatment. The most frequent condition was IDD. Specific personality changes may contribute to higher susceptibility and development of psychogenic depression. We emphasize the importance of treatment history (possibility of anticonvulsant-induced depression).

The authors have not supplied their declaration of competing interest.

We previously discovered that spadin, a short analogue of the propeptide (PE) released from the maturation of sortilin, displays potent antidepressant properties. Since the PE level can be measured in the blood, we aimed to investigate how the PE serum concentration is regulated in mice. We wondered whether the PE serum levels vary between healthy subjects and patients with major depressive disorder (MDD).

We developped a dosing method based on the AlphaScreen™ technology (Perkin) which allow to selectively detect both PE, spadin and metabolic products from these peptides with a detection range of 1 ng/mL.

We found that insulin significantly up-regulated serum PE concentration from 26.15 ± 2.63 to 41.43 ± 6.27 nM (P = 0.0318). Analysis during circadian cycle in mice revealed that the amount of PE and its derivatives significantly varied during the cycle being higher during the period of maximal activity (dark period). We also measured serum insulin concentration between 1 and 7 pm and observed a significant rise confirming the relationships between insulin and PE concentration. We showed that the serum level of PE is lower in depressive patients than in healthy non-psychiatric. We observed that the weaker level of PE in depressive patients can recover the level of healthy subjects after a chronic antidepressant treatment.

Dosing the serum level of PE could be a promising approach for the diagnosis of depression and to determine the remission of the disease.

The authors have not supplied their declaration of competing interest.

The urgency of depression treatment in patients with cardiovascular diseases (CVD) is determined by the increasing prevalence of affective disorders. For these patients, tolerance and safety of antidepressants are of great importance.

To obtain additional data on therapeutic efficacy and tolerance of agomelatine in the treatment of mild to moderate depressive disorders in cardiologic practice in Russia.

Eight hundred and ninety-six adult patients with CVD (86.5% arterial hypertension, 29.5% stable angina, 16% myocardial infarction, 23.6% conduction disturbances, 17.6% chronic heartfailure) were treated with agomelatine 25-50 mg for 12 weeks. Depression and anxiety symptoms were evaluated via Hospital Anxiety and Depression Scale (HADS), Clinical Global Impression (CGI-S and CGI-I), Visual Analog Scale (VAS), Spielberger Anxiety Scale (SAS), Whitely Hypochondria Index (WHI) and quality of life questionnaire (SF-36). Safety and tolerance were also monitored according to the summary of product characteristics recommendations.

HADS scores decreased throughout the study and severe anxiety rate decreased from 95.9% to 15%. After 12 weeks of treatment, remission (HADS < 7) rate was 84.6%. Subjective assessment of patient health significantly improved (P < 0.00001). WHI decreased significantly (P < 0.00001). Physical and mental health significantly improved (P < 0.00001). Heart rate and blood pressure decreased. Treatment acceptability was considered “excellent” by 82% of doctors and 75% of patients.

Agomelatine significantly improved depressive symptoms, anxiety and hypochondria in depressed patients with CVD and demonstrated good tolerance. This suggests the possibility of wide and safe use of agomelatine for treatment of depression in patients with CVD.

The authors have not supplied their declaration of competing interest.