This study examined the efficacy of a probiotic in reducing depressive symptom severity in people with subthreshold depression. In a double-blind, randomised, placebo-controlled trial, a probiotic (1 × 10^9 live cells per strain: Limosilactobacillus fermentum LF16 (DSM26956), Lacticaseibacillus rhamnosus LR06 (DSM21981), Lactiplantibacillus plantarum LP01 (LMG P-21021) and Bifidobacterium longum 04 (DSM23233)) or placebo was taken daily for 12 weeks. Data were collected at baseline, 6 and 12 weeks including psychological symptom severity (Beck Depression Inventory, BDI; Patient Health Questionnaire, PHQ; Hospital Anxiety Depression Scale, HADS; and Depression Anxiety and Stress Scale, DASS). Biomarkers of glycaemia, inflammation (high-sensitivity C-reactive protein, hs-CRP), antioxidant status (total glutathione (GSH)) and stress (cortisol awakening response, CAR) were also measured. Thirty-nine participants (nineteen probiotic; twenty placebo) were enrolled. There were no significant between-group differences in the examined psychological symptom severity scores, despite certain significant within-group changes observed in both groups from baseline to 6 and/or 12 weeks of follow-up. Regarding biomarkers, the probiotic group showed reduced hs-CRP (–1520; 95 % CI –273·7, −2766·2 ng/dl) and CAR (–0·28; 95 % CI −0·05, −0·51 μg/dl) at 12 weeks, but increased total GSH (3·9; 95 % CI 0·1, 7·5 ng/dl) at 6 weeks, compared with the placebo. The current study reported favourable decreases in depressive symptoms in both groups. Although the within-group changes observed in the probiotic group were supported by favourable inflammatory, antioxidant status and stress biomarker changes compared with the placebo, further research is required to shed more light on the role of gut microbiota modulation on emotional regulation.

In observational studies, vitamin D deficiency is associated with depressive symptoms. However, randomised controlled trials (RCT) with vitamin D supplementation have not been conclusive. In the present study 206 subjects were randomised to vitamin D (100 000 IU (2500 µg) as a bolus dose followed by 20 000 IU (500 µg) per week) and 202 to placebo. The Beck Depression Inventory-II (BDI-II) was filled in at baseline and after 4 months at the end of the study. At baseline the mean age was 51·4 and 52·5 years and mean serum 25-hydroxyvitamin D (25(OH)D) 32·5 and 35·1 nmol/l in the vitamin D and placebo groups, respectively. Among the 408 subjects, 193 had a BDI-II score >4, and forty-five had a score >13. Twenty-three subjects were using anti-depressant or mood-stabilising drugs. At the end of the study, there were no significant differences in Δ BDI-II score (score at the end of the study minus score at baseline), regardless of analysing all subjects, subjects with or without psycopharmaca, or if performing subgroup analyses based on baseline and final serum 25(OH)D levels combined with categories of baseline BDI-II scores >4 or >13. In conclusion, we have not been able to demonstrate any significant effect of vitamin D supplementation on depressive symptoms. However, few of our subjects were clinically depressed. Future RCT should include subjects with more severe vitamin D deficiency as well as more depressed subjects than in our study. In such a setting vitamin D may probably be more relevant as an augmenter of standard antidepressant medication/treatment.

Beck Depression Inventory-II (BDI-II) is one of the most-used rating scales. It was developed as a tool administered either as a self-rating or interview-based, observer-rating scale.

Negative affect or stress is often found to increase energy intake for high palatable energy-rich foods and hence weight gain. Reduced brain serotonin (5-HT) function is known to increase stress vulnerability and the risk for eating-related disturbances. A short (S) allele polymorphism in the serotonin transporter gene (5-HTTLPR) is associated with a less efficient functioning brain serotonin system and therefore higher stress vulnerability. It has been suggested that this genotype may be directly linked to an increased risk for weight gain and/or obesity. However, a high amount of variability has been apparent in replicating such a direct gene on weight gain relationship. A most recent suggestion is that this gene by weight relationship might be moderated by an additional (cognitive) vulnerability factor involving repetitive negative thinking (rumination). Our objective was to investigate whether the S-allele of 5-HTTLPR contributes to weight gain particularly in high cognitive ruminating individuals. A total of 827 healthy young male and female college students (aged 21·3 (sd 3·0) years; BMI 16–41·7 kg/m2) were genotyped for the 5-HTTLPR polymorphism and assessed for rumination (Event Related Ruminative Index) and body weight. In line with the hypothesis, a hierarchical regression model showed that higher BMI scores were observed in specifically high ruminating S'-carriers (P=0·031, f²=0·022). These results suggest that cognitive rumination may be a critical moderator of the association between 5-HTTLPR and body mass.

Fifty-two Australian couples who had experienced the death of at least one member of a multiple birth (twin or higher order), with at least one survivor of that birth, were interviewed about their experiences at the time of the death, and since. This study compared parents' coping after the twins' deaths using the Beck Depression Inventory II, Perinatal Grief Scale, and unstructured interviews with some structured queries. Parents provided information on the influence of family, community and medical staff. According to retrospective reports, mothers experienced significantly more depression and grief than fathers at the time of loss. Both parents found the death of their twins grievous, but fathers, unlike mothers, were not encouraged to express their emotions. Although parents generally agreed about what helped them cope, fathers believed that they should be able to cope regardless of their grief. The strength of parents' spiritual beliefs had increased significantly since their loss, and there was some evidence that depressed and grieving mothers turned to spiritual support. Parents whose children died earlier reported levels of depression similar to those reported by parents whose children died later. To date, this is the largest study of grief in couples who have experienced the death of a twin and who have a surviving twin or higher order multiple.

The Beck Depression Inventory-II (BDI-II) is widely used for assessing depression in neurorehabilitation. Given the concern that the somatic items might be misleading, we examined its factor structure in 353 inpatients. Exploratory factor analysis was undertaken to compare two- to five-factor solutions. Confirmatory factor analysis was then used to test the best exploratory solutions for goodness of fit on a subsample. Both provided strong support for a general depression factor and two specific factors, one somatic and one cognitive/affective. The BDI-II provides a meaningful score of overall depression, and it can also yield two subscores—one measuring somatic symptoms and the other measuring psychological symptoms of depression. To avoid confusing the common symptoms of neurological disability with depression in neurorehabilitation, clinicians need to consider all three scores carefully. (JINS, 2009, 15, 142–147.)

Negative thoughts about the self are a core component of Beck's cognitive triad of depression, and are seen by some as the central cognitive symptom of the disorder. The role of negative thoughts about the self in secondary depression associated with medical illness is less clear: thoughts relating to hopelessness and helplessness rather than guilt, self blame and failure may be more prominent. This study tested the hypothesis that the cognitive symptoms of depression in cancer patients would be less negatively self-referent than a psychiatric control group. Forty patients with cancer referred to a psychological medicine department were matched for age, sex and BDI score with 40 patients referred to a psychological therapies department for CBT. The cognitive-affective section of the BDI (items 1–14) was divided into a negative self-referent cognitions subscale (items 3, 5, 7, 8) and a mood-motivation subscale. These two subscales were then compared with the somatic-performance subscale (items 15–21). As a percentage of the total matched BDI score, the cancer patients had more somatic symptoms (42.7 v 34.8%), equivalent mood/motivation symptoms (44.5 v 45.6%) and less negative self-referent symptoms (12.8 v 19.5%). This difference may apply more to mild symptoms than moderate-severe symptoms. Some preliminary support for the hypothesis is therefore available.

Sixty seven opiate dependent addicts receiving methadone maintenance completed the Beck Depression Inventory. A high level of depressive symptoms was found. Eighteen (27%) scored in the moderately depressed range while thirty eight (56%) scored in the severely depressed range. There was no statistically significant association between either sex or HIV status and level of symptom reporting. The clinical implications of depressive symptoms in opiate addicts are discussed.