Context Although differences in clinical characteristics exist between major depressive disorder (MDD) and bipolar disorder (BD), consistent structural brain abnormalities that distinguish the disorders have not been identified. Objectives To investigate structural brain changes in MDD using meta-analysis of primary studies; assess the effects of medication, demographic, and clinical variables; and compare the findings with those of a meta-analysis of studies on BD. Data Sources The MEDLINE, EMBASE, and PsycINFO databases were searched for studies from January 1, 1980, to February 2, 2010. Study Selection Two hundred twenty-five studies that used magnetic resonance imaging or x-ray computed tomography to compare brain structure in patients with MDD with that of controls were included in an online database, and 143 that measured common brain structures were selected for meta-analysis. Data Extraction Twenty-five variables, including demographic and clinical data, were extracted from each study, when available. For the meta-analysis, mean structure size and standard deviation were extracted for continuous variables, and the proportion of patients and controls with an abnormality in brain structure was extracted for categorical variables. Data Synthesis Compared with the structure of a healthy brain, MDD was associated with lateral ventricle enlargement; larger cerebrospinal fluid volume; and smaller volumes of the basal ganglia, thalamus, hippocampus, frontal lobe, orbitofrontal cortex, and gyrus rectus. Patients during depressive episodes had significantly smaller hippocampal volume than patients during remission. Compared with BD patients, those with MDD had reduced rates of deep white matter hyperintensities, increased corpus callosum cross-sectional area, and smaller hippocampus and basal ganglia. Both disorders were associated with increased lateral ventricle volume and increased rates of subcortical gray matter hyperintensities compared with healthy controls. Conclusions The meta-analyses revealed structural brain abnormalities in MDD that are distinct from those observed in BD. These findings may aid investigators attempting to discriminate mood disorders using structural magnetic resonance imaging data.

Structural neuroimaging studies in major depressive disorder. Meta-analysis and comparison with bipolar disorder

Magnetic resonance imaging studies in unipolar depression: Systematic review and meta-regression analyses

Data from the Camberwell Collaborative Psychosis Study were used to examine the proposition that there is an excess of life events preceding the onset of psychoses of all types. Of 97 patients from the study who had episodes within the past year that were datable, 51 had developed psychotic symptoms from an essentially symptom-free state, 29 had been suffering only from neurotic symptoms, and 17 had experienced a marked exacerbation of psychotic symptoms. DSM–III diagnoses were collapsed into three major groups: 51 cases of schizophrenia; 31 cases of mania; and 14 cases of depressive psychosis. Life-event histories were taken for the six months before onset, and when these were compared with equivalent histories from a psychiatrically healthy sample from the local general population, there was a significant excess of life events, particularly in the three months before onset of psychosis. This was apparent in all groups, and remained even when events were restricted to the independent category. The excess of events began rather earlier than has been found in previous studies. In our view, this study provides some of the strongest evidence for a link between life events and the emergence of psychotic symptoms.

Life events and psychosis

Mechanisms underlying embodiment, disembodiment and loss of embodiment.

Background 

White matter abnormalities have been implicated in the aetiology of major depressive disorder; however, the relationship between the severity of symptoms and white matter integrity is currently unclear.

Aims 

To investigate white matter integrity in people with major depression and healthy controls, and to assess its relationship with depressive symptom severity.

Method 

Diffusion tensor imaging data were acquired from 66 patients with recurrent major depression and a control group of 66 healthy individuals matched for age, gender and IQ score, and analysed with tract-based spatial statistics. The relationship between white matter integrity and severity of depression as measured by the Beck Depression Inventory was examined.

Results 

Depressive illness was associated with widespread regions of decreased white matter integrity, including regions in the corpus callosum, superior longitudinal fasciculus and anterior corona radiata, compared with the control group. Increasing symptom severity was negatively correlated with white matter integrity, predominantly in the corpus callosum.

Conclusions 

Widespread alterations in white matter integrity are evident in major depressive disorder. These abnormalities are heightened with increasing severity of depressive symptoms.

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White matter abnormalities and illness severity in major depressive disorder

Background: The corpus callosum enables the efficient linking of the two cerebral hemispheres. Reductions in the size of the anterior callosum have been described in geriatric depression, although findings in young adults have been much more equivocal. Methods: Data was acquired in 26 currently depressed (mean age 32.15 years, 5/26 male) and 28 remitted non-geriatric adults (mean age 36.36 years, 7/28 male), and 32 control subjects (mean age 34.41 years, 11/32 male). The total area, length and curvature of the callosum, and regional thickness along 39 points, from a mid-sagittal T1-weighted magnetic resonance image were compared across the groups. Results: Total area, length and curvature did not differ between the groups. The currently-depressed group showed expansions in the thickness of the posterior body and isthmus when compared to controls; this was not seen in remitted patients. Similar expansions were seen when comorbidly anxious patients were compared to depressed patients without anxiety. There was no difference between melancholic and non-melancholic patients, and medication status did not affect the results. Limitations: Currently-depressed patients showed higher rates of co-morbid anxiety and medication usage than remitted patients, although in the depression group as a whole there was no difference between medicated and unmedicated patients. Discussion: The corpus callosum shows expansions in regions connecting frontal, temporal and parietal regions in currently depressed patients only, suggestive of state-related changes in white matter in major depression that may reflect the effects of staterelated factors on white matter structure. © 2008 Elsevier B.V. All rights reserved.

Research report Corpus callosum size and shape in individuals with current and past depression

Tienda online donde Comprar The Neuropsychology of Mental Illness al precio 68,58 € de Stephen J. Wood | Nicholas B. Allen | Christos Pantelis, tienda de Libros de Medicina, Libros de Psiquiatria - Psiquiatria General

Comprar The Neuropsychology of Mental Illness | Stephen J. Wood | 9780521862899 | Cambridge University Press

Changes in brain volume are a common finding in Magnetic Resonance Imaging (MRI) studies of people with psychosis and numerous longitudinal studies suggest that volume deficits progress with illness duration. However, a major unresolved question concerns whether these changes are driven by the underlying illness or represent iatrogenic effects of antipsychotic medication. Here, we report MRI findings from a triple-blind randomised placebo-controlled study where 62 antipsychotic-naive patients with first episode psychosis (FEP) received either an atypical antipsychotic or a placebo pill over a treatment period of 6 months. Both FEP groups received intensive psychosocial therapy. A healthy control group (n=27) was also recruited. Structural MRI scans were obtained at baseline, 3-months and 12- months. Our primary aim was to differentiate illness-related brain volume changes from medication-related changes within the first 3 months of treatment. We secondarily investigated long-term effects at the 12-month timepoint. From baseline to 3 months, we observed a significant group x time interaction in the pallidum (p

/pdf/differentiating-the-effect-of-medication-and-illness-on-34oite5ew8.pdf

Differentiating the Effect of Medication and Illness on Brain Volume Reductions in First-Episode Psychosis: A Longitudinal, Randomized, Triple-blind, Placebo-controlled MRI study

Christos Pantelis

Papers

Research report Corpus callosum size and shape in individuals with current and past depression

Comprar The Neuropsychology of Mental Illness | Stephen J. Wood | 9780521862899 | Cambridge University Press

Differentiating the Effect of Medication and Illness on Brain Volume Reductions in First-Episode Psychosis: A Longitudinal, Randomized, Triple-blind, Placebo-controlled MRI study

Pituitary volume in psychosis Pituitary volume in psychosis

The Neuropsychology of Mental Illness: Schizophrenia