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Related Concept Videos

Depressive Disorders: Etiology01:27

Depressive Disorders: Etiology

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Depressive disorders result from a complex interplay of biological, psychological, and sociocultural factors, each contributing uniquely to the development and persistence of the condition. Understanding these factors provides critical insight into the multifaceted nature of depression.
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Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
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Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
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Long-term depression, or LTD, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTD is the process of synaptic weakening that occurs over time between pre and postsynaptic neuronal connections. The synaptic weakening of LTD works in opposition to synaptic strengthening by long-term potentiation (LTP) and together are the main mechanisms that underlie learning and memory.
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Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Heterogeneous depression trajectories in multiple sclerosis patients.

Douglas D Gunzler1, Nathan Morris2, Adam Perzynski1

  • 1Case Western Reserve University, Center for Health Care Research & Policy, MetroHealth Medical Center, Cleveland, OH, USA.

Multiple Sclerosis and Related Disorders
|September 21, 2016
PubMed
Summary

Depression in Multiple Sclerosis (MS) patients shows varied trajectories, with distinct subgroups identified. Understanding these patterns aids clinicians in tailoring care for MS patients experiencing different depression levels.

Keywords:
DepressionElectronic health recordsHeterogeneityLatent class growth analysisPatient reported outcomes

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Area of Science:

  • Neurology
  • Psychiatry
  • Health Informatics

Background:

  • Depression presents heterogeneous trajectories in Multiple Sclerosis (MS) patients.
  • Understanding these patterns is crucial for effective patient care and management.
  • Identifying distinct depression courses can inform clinical decision-making.

Purpose of the Study:

  • To identify and characterize distinct depression trajectories in a large cohort of MS patients.
  • To explore the relationship between identified depression trajectories and baseline clinical characteristics.
  • To provide a framework for utilizing electronic health record (EHR) data to understand depression heterogeneity in MS.

Main Methods:

  • Latent class growth analysis (LCGA) applied to a large dataset of 3507 MS patients.
  • Utilized electronic health records (EHR) data, including Patient Health Questionnaire-9 (PHQ-9) for depression screening.
  • Compared latent trajectory classes based on baseline clinical characteristics.

Main Results:

  • Identified three distinct depression trajectories: high (10.0%), moderate/wavering (26.2%), and low/variable (63.8%).
  • These trajectories correlated with baseline MS disability levels (high, moderate, and low, respectively).
  • The overall average trajectory showed a slight decline, remaining below the moderate depression threshold.

Conclusions:

  • The LCGA approach using EHR data effectively reveals heterogeneous depression trajectories in MS.
  • This methodology offers a template for enhanced use of EHR data in clinical research.
  • Clinicians can leverage this understanding for targeted monitoring of MS patients with high or unstable depression levels.