Depression (differential diagnoses)

About: Depression (differential diagnoses) is a research topic. Over the lifetime, 56557 publications have been published within this topic receiving 2048357 citations.

Depressive disorders and immunity: 20 years of progress and discovery.

Abstract: Since the inception of Brain, Behavior and Immunity twenty years ago, many exciting developments have occurred regarding the relationship between depression and the immune system. These developments have increasingly put the field of psychoneuroimmunology into a clinical context with important translational implications. Initial studies focused on the impact of depression on relatively narrowly defined immunologic endpoints, which ultimately found their relevance in studies examining the effect of depression on immunologically-based diseases including infectious illnesses, autoimmune disorders, and cancer as well as more recently cardiovascular disease. Mechanistic studies have also greatly contributed to an understanding of those facets of depression, which might mediate these effects. More recently, the reciprocal influences of the immune system on the brain and behavior including depression have taken center stage. Increasing data now indicate that activated inflammatory processes can influence multiple aspects of CNS function including neurotransmitter metabolism, neuroendocrine function, and information processing leading to behavioral changes in humans that bespeak depression. These latter developments have intrigued scientists investigating the pathophysiology of depression and warrant consideration as some of the most exciting new developments in psychiatry in the past 20 years. What the future holds is a world of promise as multiple translational targets derived from the cytokine model of depression work their way into the clinical arena as drug targets for further development. Moreover, the work has served to instantiate brain-immune interactions as an essential component in psychiatric and medical co-morbidities and their impact on health and illness.

Association of Serum Interleukin 6 and C-Reactive Protein in Childhood With Depression and Psychosis in Young Adult Life: A Population-Based Longitudinal Study

Abstract: IMPORTANCE: Longitudinal studies have linked the systemic inflammatory markers interleukin 6 (IL-6) and C-reactive protein (CRP) with the risk of developing heart disease and diabetes mellitus, which are common comorbidities for depression and psychosis. Recent meta-analyses of cross-sectional studies have reported increased serum levels of these inflammatory markers in depression, first-episode psychosis, and acute psychotic relapse; however, the direction of the association has been unclear. OBJECTIVE: To test the hypothesis that higher serum levels of IL-6 and CRP in childhood would increase future risks for depression and psychosis. DESIGN, SETTING, AND PARTICIPANTS: The Avon Longitudinal Study of Parents and Children (ALSPAC)is a prospective general population birth cohort study based in Avon County, England. We have studied a subsample of approximately 4500 individuals from the cohort with data on childhood IL-6 and CRP levels and later psychiatric assessments. MEASUREMENT OF EXPOSURE: Levels of IL-6 and CRP were measured in nonfasting blood samples obtained in participants at age 9 years. MAIN OUTCOMES AND MEASURES: Participants were assessed at age 18 years. Depression was measured using the Clinical Interview Schedule-Revised (CIS-R) and Mood and Feelings Questionnaire (MFQ), thus allowing internal replication; psychotic experiences (PEs) and psychotic disorder were measured by a semistructured interview. RESULTS: After adjusting for sex, age, body mass index, ethnicity, social class, past psychological and behavioral problems, and maternal postpartum depression, participants in the top third of IL-6 values compared with the bottom third at age 9 years were more likely to be depressed (CIS-R) at age 18 years (adjusted odds ratio [OR], 1.55; 95% CI, 1.13-2.14). Results using the MFQ were similar. Risks of PEs and of psychotic disorder at age 18 years were also increased with higher IL-6 levels at baseline (adjusted OR, 1.81; 95% CI, 1.01-3.28; and adjusted OR, 2.40; 95% CI, 0.88-6.22, respectively). Higher IL-6 levels in childhood were associated with subsequent risks of depression and PEs in a dose-dependent manner. CONCLUSIONS AND RELEVANCE: Higher levels of the systemic inflammatory marker IL-6 in childhood are associated with an increased risk of developing depression and psychosis in young adulthood. Inflammatory pathways may provide important new intervention and prevention targets for these disorders. Inflammation might explain the high comorbidity between heart disease, diabetes mellitus, depression, and schizophrenia.

Depression, intellectual impairment, and Parkinson disease

Abstract: To determine the prevalence of depression in Parkinson disease (PD) we evaluated 55 consecutive patients without dementia and 31 of their spouses. All subjects completed the Beck depression inventory and a quantitative mini-mental state examination. Using the Beck criteria, 47% of the patients and 12% of the spouses rated themselves as significantly depressed. Mental state scores were significantly lower in the patients. There was a correlation between the severity of depression and cognitive impairment, particularly for calculation, digit span, and visuomotor skills. The severity of parkinsonism, particularly bradykinesia, also paralleled cognition. There was a slight but significant relationship between parkinsonism and depression. These results confirm the high incidence of depression in PD, and suggest that depression in Parkinson patients may be accompanied by mild intellectual impairment and inattention which is independent of the severity of the illness.

"Atypical" depression following childbirth

Abstract: It is well known that women are often depressed after child-birth, but only those ill enough to be admitted to hospital have received much study. A random sample of 305 maternity hospital patients was given a questionnaire designed to measure anxiety and depression associated with childbirth in the seventh month of pregnancy and again 6-8 weeks after delivery. Potential depressives, whose scores had increased, and potential controls, free from depression, with unchanged or diminished scores, were thus obtained, and the diagnosis was confirmed or excluded by clinical interview. Depressives were followed up by questionnaire one year later. Thirty-three (10-8 per cent.) subjects developed puerperal depression. In only one of these was the illness classical; in the rest it was atypical. Twelve depressives (3.9 per cent. of the total population studied) had not improved after one year. There were also 19 subjects (6.2 per cent.) with new or exacerbated psychological symptoms who were classified as doubtfully depressed. Depressives differed most from controls in their M.P.I. scores. Their neuroticism scores were highly significantly greater, and their extraversion scores significantly less. It is unsure whether these scores represented their previous personalities, or simply the fact that they were depressed. At probably significant levels, more depressives had a history of recent dysmenorrohea, more had been married for less than three years, fewer had obstetric complications in pregnancy, and more suffered "Maternity Blues" in the early puerperium. There were no significant differences in respect of previous psychiatric, physical or obstetric disorder, age, endocrine abnormality, complicated labour or obvious psychological or social factors. Atypical depression is, therefore, a common and important complication of the puerperium, about which more needs to be known.