Objectives
Prospection, the mental representation of possible futures, is usually adaptive. When it goes awry, however, it disrupts emotion and motivation. A negative view of the future is typically seen as one symptom of depression, but we suggest that such negative prospection is the core causal element of depression. Here, we describe the empirical evidence supporting this framework, and we explore the implications for clinical interventions.

Methods
We integrate several literatures: Using the database PsycInfo, we retrieved empirical studies with the keywords prospection, prediction, expectation, pessimism, mental simulation, future-thinking, future-directed thinking, foresight, and/or mental time travel, in conjunction with depression, depressed, or depressive.

Results
Three kinds of faulty prospection, taken together, could drive depression: Poor generation of possible futures, poor evaluation of possible futures, and negative beliefs about the future. Depressed mood and poor functioning, in turn, may maintain faulty prospection and feed a vicious cycle. Future-oriented treatment strategies drawn from cognitive-behavioural therapy help to fix poor prospection, and they deserve to be developed further.

Conclusions
Prospection-based techniques may lead to transdiagnostic treatment strategies for depression and other disorders.

Practitioner points
Faulty prospection may be the core process underlying depression.
Three general problems of prospection, taken together, could drive depression: Poor generation of possible futures, poor evaluation of possible futures, and negative beliefs about the future.
Faulty prospection can be helped using future-oriented treatment strategies from cognitive-behavioural therapy, and basic research on prospection points to additional future-oriented clinical strategies for alleviating depression.
More research is needed to determine whether prospection drives depression, and whether future-focused interventions are more effective than those focused on the past and present.

Depression and prospection.

Background Despite substantial research, uncertainty remains about the clinical and etiological heterogeneity of major depression (MD). Can meaningful and valid subtypes be identified and would they be stable cross-culturally? Method Symptoms at their lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾ 30 years, with recurrent DSM-IV MD. Latent class analysis (LCA) was performed in Mplus. RESULTS; Using the nine DSM-IV MD symptomatic A criteria, the 14 disaggregated DSM-IV criteria and all independently assessed depressive symptoms (n = 27), the best LCA model identified respectively three, four and six classes. A severe and non-suicidal class was seen in all solutions, as was a mild/moderate subtype. An atypical class emerged once bidirectional neurovegetative symptoms were included. The non-suicidal class demonstrated low levels of worthlessness/guilt and hopelessness. Patterns of co-morbidity, family history, personality, environmental precipitants, recurrence and body mass index (BMI) differed meaningfully across subtypes, with the atypical class standing out as particularly distinct. Conclusions MD is a clinically complex syndrome with several detectable subtypes with distinct clinical and demographic correlates. Three subtypes were most consistently identified in our analyses: severe, atypical and non-suicidal. Severe and atypical MD have been identified in multiple prior studies in samples of European ethnicity. Our non-suicidal subtype, with low levels of guilt and hopelessness, may represent a pathoplastic variant reflecting Chinese cultural influences.

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Subtypes of major depression: latent class analysis in depressed Han Chinese women.

Depressive Disorders (DD) are a great financial and social burden. Females display 70% higher rate of depression than males and more than 30% of these patients do not respond to conventional medications. Thus medication-refractory female patients are a large, under-served, group where new biological targets for intervention are greatly needed. We used real-time quantitative polymerase chain reaction (qPCR) to evaluate mRNA gene expression from peripheral blood leukocytes for 27 genes, including immune, HPA-axis, ion channels, and growth and transcription factors. Our sample included 23 females with medication refractory DD: 13 with major depressive disorder (MDD), 10 with bipolar disorder (BPD). Our comparison group was 19 healthy, non-depressed female controls. We examined differences in mRNA expression in DD vs. controls, in MDD vs. BPD, and in patients with greater vs. lesser depression severity. DD patients showed increased expression for IL-10, IL-6, OXTR, P2RX7, P2RY1, and TRPV1. BPD patients showed increased APP, CREB1, NFKB1, NR3C1, and SPARC and decreased TNF expression. Depression severity was related to increased IL-10, P2RY1, P2RX1, and TRPV4 expression. These results support prior findings of dysregulation in immune genes, and provide preliminary evidence of dysregulation in purinergic and other ion channels in females with medication-refractory depression, and in transcription and growth factors in those with BPD. If replicated in future research examining protein levels as well as mRNA, these pathways could potentially be used to explore biological mechanisms of depression and to develop new drug targets.

/pdf/dysregulation-of-leukocyte-gene-expression-in-women-with-41nv6dyaug.pdf

Dysregulation of leukocyte gene expression in women with medication-refractory depression versus healthy non-depressed controls

A adolescencia consiste em uma etapa do desenvolvimento humano marcada por inumeras transformacoes. Do ponto de vista da saude mental, representa um momento em que podem se manifestar diversos transtornos, tornando-se importante a sua adequada identificacao. Este e um estudo quantitativo, descritivo, com o objetivo de verificar a prevalencia de sintomas depressivos e de ansiedade em adolescentes concluintes do ensino medio numa escola publica brasileira do estado do Rio Grande do Sul. Participaram da pesquisa 70 adolescentes, com idades entre 16 e 19 anos, que responderam ao Inventario de Depressao de Beck (BDI) e Inventario de Ansiedade de Beck (BAI). Os resultados finais apontaram para uma maior taxa de sintomas minimos de depressao e ansiedade em comparacao com sintomas leves, moderados e graves, em relacao ao genero dos participantes. No que se refere ao turno de estudo, os resultados mostraram que ha significância estatistica, tanto para os escores do BDI (p = 0,002 ) , quanto para o BAI (p = 0,008), demonstrando que os alunos que estudam no turno da noite, apresentam mais sintomas depressivos e de ansiedade do que os que estudam no turno diurno. Conclui-se que sintomas depressivos e de ansiedade foram encontrados nos adolescentes do ensino medio desta amostra, apesar da sintomatologia indicada estar na faixa de intensidade minima.

/pdf/sintomas-depressivos-e-de-ansiedade-em-adolescentes-do-1587jrhbs2.pdf

Sintomas Depressivos e de Ansiedade em Adolescentes do Ensino Médio

Objective To explore the influence of family-related factors on suicide-related behaviors of patients with major depression disorder, and to provide scientific evidence for effective preventive measures. Methods A total of 852 outpatients at Renmin Hospital of Wuhan University were enrolled in this cross-sectional study from April 2019 to January 2021. The general demographic information and family-related information of the patients were collected via a general information questionnaire, the Family Assessment Device, the Egna Minnen av Barndoms Uppfostran, and the Childhood Trauma Questionnaire. Results Participants without suicide-related behaviors accounted for 10.45% of the total sample, those with suicidal ideation accounted for 47.54%, those with suicidal plans accounted for 24.77% and with suicidal attempts for 17.25%. Patients with major depression disorder who have lower education level, who were separated from their parents, who have severely impaired family function, who experienced childhood abuse, and whose parents adopted apathetic and severe child-rearing styles had a higher risk of suicide-related behaviors. In the multivariate regression model, degree of major depression disorder, education and child-rearing style were independent risk factors for suicide-related behaviors. Conclusion Patients with major depression disorder who have been separated from their parents, have severely impaired family function, were abused in childhood or have been exposed to improper childrearing styles have a greater risk of suicide. Family-related factors play a predictive role in suicide in patients with major depression disorder. More attention should be paid to family-related factors to reduce the occurrence of suicidal ideation and attempt.

https://www.frontiersin.org/articles/10.3389/fpsyt.2022.919610/pdf

The Influence of Family-Related Factors on Suicide in Major Depression Patients

BACKGROUND: Previous studies support Beck's cognitive model of vulnerability to depression. However, the relationship between his cognitive triad and other clinical features and risk factors among those with major depression (MD) has rarely been systematically studied. Method The three key cognitive symptoms of worthlessness, hopelessness and helplessness were assessed during their lifetime worst episode in 1970 Han Chinese women with recurrent MD. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. RESULTS: Compared to patients who did not endorse the cognitive trio, those who did had a greater number of DSM-IV A criteria, more individual depressive symptoms, an earlier age at onset, a greater number of episodes, and were more likely to meet diagnostic criteria for melancholia, postnatal depression, dysthymia and anxiety disorders. Hopelessness was highly related to all the suicidal symptomatology, with ORs ranging from 5.92 to 6.51. Neuroticism, stressful life events (SLEs) and a protective parental rearing style were associated with these cognitive symptoms. CONCLUSIONS: During the worst episode of MD in Han Chinese women, the endorsement of the cognitive trio was associated with a worse course of depression and an increased risk of suicide. Individuals with high levels of neuroticism, many SLEs and high parental protectiveness were at increased risk for these cognitive depressive symptoms. As in Western populations, symptoms of the cognitive trio appear to play a central role in the psychopathology of MD in Chinese women. Language: en

/pdf/cognitive-trio-relationship-with-major-depression-and-f9gmzzfj91.pdf

G. Huang

Papers

Cognitive trio: relationship with major depression and clinical predictors in Han Chinese women