Browsing by Subject "depression"

This review focuses on neurotrophic factors, especially CDNF, and Amyotropic lateral sclerosis (ALS). This review finds out which neurotrophic factors have been studied in clinical trials of ALS and what kind of results have been got. Neurotrophic factors are important for development and function of neurons because they prevent apoptosis of neurons. They also play role in differentiation, development and migration of neurons. It is also known that many of the neurotrophic factors have protective and restorative properties. ALS is a rare neurodegenerative disease which causes the destruction of motor neurons and leads to death in three years. The disease degenerate the upper and lower motor neurons. Symptoms are muscle weakness, muscle atrophy, cramps and problems with swallowing. At the moment there is no cure for ALS so it is important to study neurotrophic factors that could prevent the progression of the disease and perhaps to protect or repair destroyed motor neurons. This is why it is important to study potential of CDNF in ALS. The experimental part consists of three different parts. The purpose of the first part study was to determine the distribution of CDNF after intraventricular delivery at different time points. CDNF was labeled with 125I (125I-CDNF). The distribution was determined by gammacounter and autoradiography. To determine the stability of the injected 125-I CDNF we performed SDS-PAGE. The second part studied the diffusion volume of CDNF after intraventricular injection with seven wild type mice. After stereotaxic surgery CDNF-immunohistochemistry staining from coronal sections was done. The last experimental part studied the effect of single intracerebral injection of CDNF on motivation, locomotor activity, anxiety and depression with male and female mice. Light-dark box, open field, rotarod, forced swim test (FST), elevated plus maze and fear conditioning were carried out with male mice. After behavioural tests mice were sacrified for HPLC-analysis. Light-dark box and IntelliCage were carried out with female mice before c-fos staining. Gammacounter and autoradiography shows that 125I-CDNF distributes widely after intracerebroventricular injection. It spread throughout to the brain and also all the way to the spinal cord after one and three hours from injection. After 24 hours 125I-CDNF was cleared so the CDNF signal was very weak. SDS-PAGE showed the stability of radioactive CDNF. CDNF increased locomotor activity and decreased anxiety in male mice. But a statistically significant difference appeared in forced swim test and fear conditioning test. HPLC-analysis supported these results partly. CDNF also increased motivation of female mice in IntelliCage experiment. C-fos staining was observed in CDNF group and PBS group so quantitative analysis should be done from these sections so that reliable conclusions could be done. However, because CDNF distributed to spinal cord and it showed some effect on locomotor activity, motivation and depression it might be potential for ALS disease.

Hypoteserna i föreliggande undersökning tog avstamp i Jacks (1991) teori samt Jacks och Alis (2010) undersökningar om att tysta ner sig själv i nära relationer, vilka dock reviderades i ljuset av senare forskning. Harter (1999), Hautamäki (2010) och Thompson (1995) visade att hur man tystar ner sig själv inte berodde på kön, utan att det kunde finnas en variation gällande att tysta ner sig själv inom båda könen beroende på individens tolkning av sin könsidentitet i olika kontext. Syftet med föreliggande undersökning var att studera hur variationen av upplevd könsidentitet inom könen sammanhänger med att tysta ner sig själv och depression. Mätinstrumenten var Silencing the Self-skalan (STSS) (Jack & Dill, 1992), Becks Depression Inventory BDI-II (1991) och Bems (1974, 1981) Sex Role Inventory (BSRI). Undersökningens sampel var från TKK (n=88), barnträdgårdslärarlinjen vid OKL (n=54) och sspeciallärarutbildningen vid OKL (n=37). Samplen utvaldes med syfte att nå ett tillräckligt antal traditionellt feminina (Barnträdgårds- och speciallärarutbildningen) och traditionellt maskulina män (Tekniska universitetet). Resultaten visade att män tystade ner sig själva mer än kvinnor oberoende av kontext, och att det att man tystar ner sig själv sammanhängde med depression hos bägge könen. Jacks och Dills (1992) teser om att kvinnor skulle tysta ner sig mer än män fick därmed inte stöd, men resultaten överensstämde med aktuella internationella och finländska resultat. Att tysta ner sig själv sammanhängde med upplevd könsidentitet, positivt med odifferentierad könsidentitet och negativt med androgyn könsidentitet. Därmed visade resultaten att man tystade ner sig själv signifikant mera vid Tekniska högskolan, där förekomsten av odifferentierad könsidentitet var vanligare, än vid Lärarutbildningen. Diskussionen behandlar vikten av att undersöka upplevd könsidentitet istället för könsskillnader i ett samhälle i vilka mer jämlika könsroller möjliggör varierande upplevelser av könsidentitet, också androgyna lösningar i Bems (1981) efterföljd. Dessutom är det viktigt att fördjupa kunskapen om de varierande funktioner som att tysta ner sig själv kan ha för män och kvinnor.

Objective: Both stress-related exhaustion and depression have previously been associated with a decline in cognitive performance, but there is a lack of evidence on whether these conditions have different associations with different cognitive domains and whether they have additive effects on cognitive performance. Furthermore, very little is known about the cognitive effects of chronic stress-related exhaustion. Consequently, the aims of this study were to 1) examine the associations between current stress-related exhaustion and cognitive performance, 2) investigate whether different developmental trajectories of stress-related exhaustion are differently associated with cognitive performance, 3) compare the association between stress-related exhaustion and cognitive performance to the relationship between depressive symptoms and cognitive performance, 4) examine if individuals with comorbid stress-related exhaustion and depression have lower cognitive performance than individuals with at most one of these conditions (i.e., whether clinical stress-related exhaustion and clinical depression might have additive effects on cognitive performance). Methods: The data used in the study was a Finnish population-based sample of six cohorts born between 1962 and 1977 from the Cardiovascular Risk in Young Finns Study. Stress-related exhaustion was assessed using the Maastricht Questionnaire, depressive symptoms with the Beck Depression Inventory, and cognitive performance with four subtests of the Cambridge Neuropsychological Test Automated Battery, measuring visuospatial associative learning, reaction time, sustained attention, and executive functions. Cognitive performance and depressive symptoms were assessed in 2012, and stress-related exhaustion in 2001, 2007, and 2012. Participants were 35 to 50 years old in 2012. Linear associations between stress-related exhaustion and cognitive performance (N = 905) and depressive symptoms and cognitive performance (N = 904) were examined by conducting multivariate regression analyses. Age, sex, socioeconomic status, and parents’ socioeconomic status were controlled in the regression models. Additionally, multivariate analyses of variance were performed to investigate the different developmental trajectories of stress-related exhaustion and their relation to cognitive performance (N = 541) and the associations of comorbid stress-related exhaustion and depression with cognitive performance (N = 1273). Results and conclusion: The main finding was that high stress-related exhaustion is associated with slower reaction times, but not with performance in spatial working memory, visuospatial associative learning, or executive functions. Ongoing, chronic stress-related exhaustion was more strongly associated with slower reaction times than short-term exhaustion experienced years ago. Compared to depressive symptoms, high stress-related exhaustion was associated with slower reaction times also when subclinical cases were included, whereas only clinical levels of depressive symptoms had an association with slower reaction times. There were no differences in cognitive performance between individuals with only stress-related exhaustion or depression and those with comorbid stress-related exhaustion and depression, which supports the notion that these conditions do not have additive effects on cognitive performance. These findings add to the existing evidence of the cognitive effects of stress-related exhaustion in the general population and have several practical implications. Further research is needed on the topic, preferably with longitudinal designs, more comprehensive cognitive measures, and clinical assessment of the psychiatric symptoms.

Aims: In earlier research it has been found that music can elicit strong emotional responses, and that mood affects the way they are processed. The brain basis of musical emotions has however been studied less than that of facial emotions. Also, there have been no studies on how depressed mood affects musical emotions in the brain. In the present study, both the effect of depressed mood state and that of depressive disorder on neural processing of musical emotions is studied. The aim is to identify brain regions affected, and to model the effective connectivity between these regions and the impact of depressed mood state and depressive disorder on this system. Methods: A functional magnetic resonance imaging (fMRI) experiment was conducted, in which 56 adult subjects listened to emotional (happy, sad, and fearful) music. The experiment consisted of two conditions: in the implicit condition the subjects were asked how many instruments were playing, and in the explicit which of the three emotions best characterised the musical excerpt. The subjects also completed the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Profile of Mood States (POMS). The behavioural and imaging data were analysed both within the general linear model (GLM) to identify affected brain regions and the dynamic causal modelling (DCM) framework to model how sensory inputs enter the brain system and how experimental conditions modulate connections between specified brain regions. Results and conclusions: The subjects were mostly not clinically depressed (76%) and the MADRS scores were not correlated with neural activity in the brain. The POMS Depression scale was however associated with attenuated activity in the right posterior cingulate cortex (PCC) while listening to happy and fearful music under the implicit condition. As PCC has been associated with internally directed cognition and the management of brain's attention networks, this attenuation is likely to reflect the incongruence between stimuli and mood state, which would result in increased attention and/or a decrease in explorative cognitive activity. Comparisons of DCM models consisting of PCC, superior temporal gyrus (STG) and the amygdala indicated that auditory stimuli enter into this system via the auditory cortex in STG. The analyses could not determine whether the emotional content of the stimuli modulates connectivity between these regions, but MADRS and POMS scores were associated with amygdala connectivity. This is in line with the view that depressive disorder disrupts the amygdala's role in orienting to affective information.

Tiivistelmä – Referat – Abstract Mental disorders are among the leading causes of global disease burden and years lived with disability. Their pathogenesis is poorly understood and there are enormous challenges in the development of biomarkers to aid in diagnosis and more effective therapeutic options. It has been documented that the microbiota-gut-brain axis shows alterations in mental disorders such as anxiety, depression, autism spectrum disorders, bipolar disorder and schizophrenia. Here we study the gut microbiota of individuals with axis I mental disorders and their unaffected siblings by 16S RNA gene amplicon sequencing. In the Central Valley of Costa Rica, a total of 37 participants were recruited and diagnosed using a Best Estimate Diagnosis protocol. For each of the individuals diagnosed with a mental disorder a healthy sibling was selected after matching by age and gender. A total of 13 pairs of 26 siblings, affected and unaffected, was used for the analysis. In a subsequent analysis, individuals were also divided into the three categories of “unaffected” (UA), “affected without psychosis” (AA) and “affected with psychosis” (AP). They underwent clinical assessments about their habits and diet and about resilience (Connor-Davidson Resilience Scale), current status (SADS-C) and disability (WHODAS 2.0). Their fecal samples were collected freshly and stored at -80°C. DNA was extracted, libraries constructed by PCR and subjected for Illumina MiSeq 300 paired-end 16S RNA amplicon sequencing for analysis of the gut microbiota. The sequencing data were analyzed using the R packages mare and vegan for gut microbiota composition, diversity and richness, taking into account the identified confounders. All participants were of Hispanic ethnicity, residents of the San José Greater Metropolitan Area, adults and 69% of them were women. Affected individuals had major depression, bipolar affective disorder, psychosis non-otherwise specified or schizoaffective disorder. Based on beta-diversity analysis as a measure of the community-level microbiota variation, it was found that the use of levothyroxine (R2=0.08, p=0.005) and of irbesartan (R2=0.068 ,p=0.001) had a significant impact on the microbiota composition and hence the use of these drugs was included as confounder in further analyses. Several statistically significant differences in the relative abundance of intestinal bacteria were identified: Differences were found in the relative abundance of bacterial families Peptostreptococcaceae, Ruminococcaceae, Porphyromonadaceae, and in bacterial genera Pseudomonas, Barnesiella, Odoribacter, Paludibacter, Lactococcus, Clostridium, Acidaminococcus and Haemophilus. Our results indicate that affected individuals have more pro-inflammatory Proteobacteria (Pseudomonas) and less bacteria associated to healthy phenotype, such as Barnesiella and Ruminococcaceae, the former being dose-dependently depleted in AP and AA compared to UA. Furthermore, we documented decreased bacterial richness among affected participants while no significant differences were detected in alpha diversity. Our study identified significant differences in the microbiota of individuals affected by mental illness when comparing to their healthy siblings. The results may have important implications for the holistic understanding of mental health and its diagnosis and therapeutics. Larger studies to confirm these findings would be justified.

Objectives: Depression presents one of the biggest global health concerns today. According to the network theory, mental disorders, such as depression, reflect co-occurring intercorrelating symptom effects. Thus, studying the properties of depressive symptom networks could enhance knowledge about the etiology of depression. In this study, network structures of men and women of the general population are compared, to enhance understanding of higher prevalence rates of depression in women. Although gender differences of depression are widely studied, this is the first study comparing the depressive symptom network structures of adult men and women in the general population. Methods: The data (n = 567 men; n= 886 women) are from a national age cohort study (LASER). Partial correlation networks of BDI-II symptoms were compared in two time-points. Results: Estimated networks had distinct gender differences. Men had lower mean scores, but more changes in the network structure across time, more negative edges, and higher network density. “Agitation” was highly central only in the men’s networks. Women showed changes in mean sum scores, but network structures had few changes, and symptoms formed three distinct communities in both time-points. “Fatigue” was reported significantly more by women and was highly central only in the women’s networks. Implications: Differences in symptom networks between men and women may explain the gender-related differences in the prevalence of depression. Negative edges in the men’s networks and the symptom communities in the women’s networks are targets for more research. Fatigue could be a valuable target for preventing and treating women’s depression.

Objective. The FRIENDS programme is a group cognitive behavioural therapy (CBT) programme, developed for the prevention and treatment of child and adolescent anxiety and depression. In the context of prevention, FRIENDS has been extensively researched; however, little research has been conducted on FRIENDS in a treatment setting and with different populations. To help fill this gap, the aim of the present study was to evaluate the effectiveness of the Finnish version of FRIENDS in reducing internalising symptoms in children diagnosed with psychiatric and neuropsychiatric disorders. Methods. The present study was conducted at Helsinki University Hospital (HUS) Child Psychiatry outpatient clinics in the Helsinki metropolitan area, Finland. The participating children (n = 99, mean age = 9.45 years, range 6–13 years, 68.7 % boys) were randomly assigned to either FRIENDS (n = 52) or a waitlist control group (n = 47), which received treatment as usual for a period of 3 months before the intervention. The children’s internalising symptoms were assessed using parent- and teacher-report questionnaires (Child Behavior Checklist and Teacher’s Report Form) at referral to treatment, pre-treatment, post-treatment, and six-month follow-up. Results and conclusions. In both groups, there was a medium-sized statistically significant decrease in parent-reported internalising symptoms immediately after the intervention; however, these improvements were not retained at six-month follow-up. Teacher-reported internalising symptoms followed a similar pattern of decrease during the intervention and increase during follow-up; however, these changes were smaller in magnitude and did not reach statistical significance, possibly due to loss of statistical power caused by missing data. Neither parent- or teacher-reports showed an intervention effect, with children’s internalising symptoms exhibiting similar changes regardless of whether they belonged to the intervention group or the waitlist control group, which received treatment as usual during the wait period. These results raise questions on the durability of treatment effects and the superiority of FRIENDS over active waitlist control conditions or treatment as usual when treating children diagnosed with diverse psychiatric and neuropsychiatric disorders in a community setting where treatment adherence and integrity may not be ideal.

Background and objectives: Currently in Finland, there are over 66 000 women living with breast cancer. The five-year survival rate is 90.6 %. Breast cancer and its treatments are known to impair patients’ health-related quality of life (HRQoL). The current study is a part of an open prospective randomized Breast cancer and exercise (BREX) -study in Finland conducted to investigate whether supervised exercise training shortly after the adjuvant treatments of breast cancer patients could prevent osteoporosis and improve patient’s quality of life. This master thesis examines cross-sectional and prospective associations between the sense of coherence (SOC) and the HRQoL of breast cancer survivors. Methods: 537 long-term breast cancer survivors and controls who participated in a prospective randomized physical exercise intervention with twelve months of supervised exercise training were followed up five years. 406 participants who finished the 5-year follow-up and filled the SOC questionnaire were included in the final analyzes. The SOC was measured by 13-item Finnish and Swedish short forms of Orientation to life Questionnaire (SOC-13) at 3 years. Cancer-specific HRQoL was measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) version 3 and general HRQoL by the 15D. Associations between the SOC and the HRQoL were studied by logistic regression analyze. Results and conclusion: The SOC was associated with the cancer-specific and the general HRQoL at the 3-year (p < .001) and at the 5-year follow-up (p < .001). The relationship was the most significant for the general HRQoL, global health / quality of life and emotional and cognitive functions. Weak SOC increases the risk of low cancer-specific and low general HRQoL after the adjuvant treatments of breast cancer. Strong SOC as an inner resource may serve as a protective psychological factor in the adaptation process of breast cancer survivors. The SOC-13 questionnaire might be useful in targeting patients vulnerable to decrease in the HRQoL and in planning psychosocial interventions.

Objective. Transdiagnostic models of psychopathology assume that the commonalities across disorders may outweigh their differences. While these models acknowledge that disorder-specific symptoms and features undoubtedly exist, the same underlying factors are perceived to cause and maintain various disorders. In recent years, this approach has received growing attention and several new forms of therapy have been developed based on it. These may be well-suited for the treatment of mixed-diagnosis groups or individuals with comorbid disorders, and as such, they hold the promise of being very cost-effective. One of the most established transdiagnostic treatments is the Unified Protocol (UP), designed to help patients suffering from depression and the full range of anxiety disorders. The purpose of the present study is to review the evidence regarding the efficacy and effectiveness of the UP for the transdiagnostic treatment of adult anxiety and depression. Methods. For this review, systematic literature searches were performed using the PsychInfo and PubMed online databases in October 2018. The search term used was “Unified Protocol”. The search yielded 114 results in PsychInfo and 138 in PubMed. Ten of these matched the following study selection criteria and were included in the current review: a) the study measured either the efficacy or effectiveness of the cognitive-behavioral UP therapy developed by Barlow (2011), b) treatment was delivered face-to-face in either individual or group setting, c) treatment followed the UP therapist guide without major modifications, d) participants suffered from an anxiety disorder or depression, e) participants were over 18 years of age, d) the study was published in 2015 or later, and f) the study was published in English in a peer-reviewed journal. Results and conclusions. The UP appeared both efficacious and efficient in reducing the severity of adult anxiety and depression as well as the number of comorbid diagnoses; however, there were some conflicting findings regarding recovery rates and effect sizes. The results achieved were comparable to those achieved using diagnosis-specific cognitive-behavioral therapy. The UP treatment had a positive impact on the patients’ functioning and quality of life and the amount of positive and negative affect they experienced. Treatment retention was generally high, particularly when treatment was delivered individually, and the UP received high ratings from those who participated in the studies. All in all, the current empiric evidence regarding the UP appears fairly promising. However, these results must be interpreted with caution, as the research concerning the UP is still in its infancy and a large part of it has been conducted by researchers affiliated with the treatment.

In this study I examine how textiles were patched and darned in Finland from the 1920s to the 1960s, and how changes in everyday life affected it. Modernization, the following of fashion and the rise of ready-made clothes industry in the 1920s declined into a shortage of textiles and a demand on self-sufficiency during the war years in the 1940s. After the war clothes were bought ready from shops and their value related to people's assets was reduced. Alike, people's attitudes towards textiles and mending them changed. The data for my study consisted of articles from Kotiliesi, Omin käsin and Emäntälehti from 1924 to 1959, contemporary guidebooks from 1920 to 1966 and craft teacher students' samples and notebooks from the the 1920s to the 1940s. In addition I interviewed four women who were born between the years 1918 and 1938, three orally and one with written questionnaire. Because mending textiles has hardly been studied in previous research, I needed to gather the information from many sources. I used different qualitative data analysis and discourse analysis methods to put together pieces of the story. In the 1920s and the 1930s mending textiles was considered almost a platitude. Especially in the countryside the majority of clothes and home textiles were self-made or made to order, although in the cities ready-made clothes could already be purchased. The value of a single cloth was considerable and because of that a lot of time was spent on mending it and different instructions how to darn by hand or with a sewing machine were published in women's magazines and contemporary guidebooks. New textiles were hard to purchase during the depression caused by the Winter War and the Continuation War, therefore good care had to be taken of the textiles already found from homes. Instructions and articles focused especially on advices on how to patch socks. After the war mending of textiles was often emotionally connected to the shortage of the wartime and the amount of mending instructions given in women's magazines decreased. New type of nylon socks reduced the need to darn and patch them, but Kotiliesi still published articles on how to mend different types of clothes, though the instructions were directed to skillful light-fingered women. Publishing articles about mending in women's magazines ended in the 1950s, but the women I interviewed told that they have continued mending until present-day. At the end of my study I consider why mending is still current in the 21st century.