Food anthocyanins decrease concentrations of TNF-α in older adults with mild cognitive impairment: A randomized, controlled, double blind clinical trial.

Background & Aims: Vascular function, blood pressure and inflammation are involved in the pathogenesis of major chronic diseases, including both cardiovascular disease (CVD) and mild cognitive impairment (MCI). This study investigated the effects of food anthocyanins on microvascular function, 24-h ambulatory blood pressure (ABP) and inflammatory biomarkers in older adults with MCI.

Methods And Results: Thirty-one participants with MCI [19 female, 12 male, mean age 75.

Suprasensory phenomena in those with a bipolar disorder.

Objectives: To increase awareness of the sensory changes experienced during hypo/manic and depressive states by those with a bipolar disorder and determine if the prevalence of such features is similar across differing bipolar sub-types.

Methods: We interviewed 66 patients who acknowledged sensory changes during hypo/manic states. They were allocated to bipolar I, bipolar II and soft bipolar diagnostic categories and the prevalence of 10 differing sensory changes was quantified during hypo/manic and depressive phases.

Lithium and cognition in those with bipolar disorder.

Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, working memory, intellectual functioning, verbal memory, visual memory, and executive functioning by reviewing the published empirical literature.

Anhedonia in melancholic and non-melancholic depressive disorders.

Background: Anhedonia represents a core symptom of major depression and may be a potential marker for melancholia. However, current understanding of this construct in depressive sub-types is limited.

Method: Participants were recruited from the Black Dog Institute (Sydney) and Massachusetts General Hospital (Boston).

Clinical features distinguishing grief from depressive episodes: A qualitative analysis.

Background: The independence or interdependence of grief and major depression has been keenly argued in relation to recent DSM definitions and encouraged the current study.

Methods: We report a phenomenological study seeking to identify the experiential and phenomenological differences between depression and grief as judged qualitatively by those who had experienced clinical (n=125) or non-clinical depressive states (n=28).

Results: Analyses involving the whole sample indicated that, in contrast to grief, depression involved feelings of hopelessness and helplessness, being endless and was associated with a lack of control, having an internal self-focus impacting on self-esteem, being more severe and stressful, being marked by physical symptoms and often lacking a justifiable cause.

Emotional response patterns of depression, grief, sadness and stress to differing life events: a quantitative analysis.

Background: In clarifying the clinical definition of an episode of major depression, DSM-5 equates bereavement with a number of other loss-related stressors (e.g. financial ruin, serious medical problems) and infers differences between such loss-related and non-loss-related responses.

Construct validity of the Experiences of Therapy Questionnaire (ETQ).

Background: The Experiences of Therapy Questionnaire (ETQ) is a reliable measure of adverse effects associated with psychotherapy. The measure has not been subject to validity analyses. This study sought to examine the validity of the ETQ by comparison against a measure of therapist satisfaction.

Predictors of post-natal depression are shaped distinctly by the measure of 'depression'.

Background: Many variables have been proposed as predictive of post-natal depression (PND).

Aims: To investigate and refine PND risk variables.

Method: We recruited a large sample and employed two measures of PND (the dimensional Edinburgh Postnatal Depression Scale or EPDS, and DSM-defined major depression).

Melancholia and catatonia: disorders or specifiers?

The fifth version of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 defines mental disorders as syndromes and also introduced disorder "specifiers" with the aim of providing increased diagnostic specificity by defining more homogeneous subgroups of those with the disorder and who share certain features. While the majority of specifiers in DSM-5 define a specific aspect of the disorder such as age at onset or severity, some define syndromes that appear to meet the DSM-5 definition of a mental disorder. Specifically, melancholia is positioned in DSM-5 as a major depressive disorder (non-coded) specifier, while catatonia is listed as both a disorder secondary to a medical condition and as a specifier associated with other mental disorders such as schizophrenia, major depressive disorder, and bipolar disorder.

Gender differences in depression severity and symptoms across depressive sub-types.

Background: Lifetime rates of depression are distinctly higher in women reflecting both real and artefactual influences. Most prevalence studies quantifying a female preponderance have examined severity-based diagnostic groups such as major depression or dysthymia. We examined gender differences across three depressive sub-type conditions using four differing measures to determine whether any gender differences emerge more from severity or symptom prevalence, reflect nuances of the particular measure, or whether depressive sub-type is influential.

Emotion regulation strategies in bipolar II disorder and borderline personality disorder: differences and relationships with perceived parental style.

Background: Bipolar II disorder (BP II) and Borderline Personality Disorder (BPD) share common features and can be difficult to differentiate, contributing to misdiagnosis and inappropriate treatment. Research contrasting phenomenological features of both conditions is limited. The current study sought to identify differences in emotion regulation strategies in BP II and BPD in addition to examining relationships with perceived parental style.

Is cognitive behaviour therapy of benefit for melancholic depression?

Objective: This paper seeks to determine the relevance and likely salience of cognitive behaviour therapy (CBT) as a treatment for melancholic depression.

Methods: The findings of a randomised trial comparing 12-week outcome of 18 patients with melancholic depression receiving antidepressant medication and 11 receiving CBT were evaluated, and qualitative explanations for the outcomes were provided principally by the treating CBT practitioners.

Results: In the trial, CBT showed no improvement in depression severity in the first four weeks and then some level of improvement over the subsequent eight weeks.

Melancholia: definition and management.

Purpose Of Review: To overview historical ascriptions and the current nosological status of melancholia, before reporting diagnostic strategy, biological marker and treatment studies.

Recent Findings: As melancholia has never been satisfactorily differentiated by reliance on symptoms, strategies that adopt a more prototypic approach and incorporate illness correlates in conjunction with symptoms appear to provide greater precision in differentiating melancholic and nonmelancholic depression. An early indicative biological marker--hyperactive Hypothalamic-Pituitary-Adrenal axis functioning--remains supported, whereas a number of other recently proposed candidate markers require clarification.

Paradigms lost and gained: has psychiatry in Australasia lost its voice?

Objective: The evolution of views about causes and management models in psychiatry is of keen interest to those who respect the field's history. The objective of this study was to identify international paradigm shifts since 1950 in psychiatric theorising and management models.

Method: Multiple methods were used, including citation analysis, qualitative judgments by highly cited researchers and obtaining the views of historians of psychiatry.

High-risk behaviour in hypomanic states.

Background: Risk-taking behaviours during hypomanic states are recognised, however the high-risk nature of some behaviours-including the potential for harm to both the individual and others-has not been detailed in the research literature. The current study examines risk-taking behaviours and their consequences (including their potential for impairment) in those with a bipolar II condition.

Method: Participants were recruited from the Sydney-based Black Dog Institute Depression Clinic.

The Mood Assessment Program is now on the Australian map.

Objective: To report on the wide uptake and utility of the freely available Mood Assessment Program (MAP) since its introduction as a tool to assist diagnosis and management of mood disorders.

Method: By mid-2012, some 16,000 patients had completed the MAP. We analyse data derived from such a sample.

Beyond the baby blues: perspectives of women diagnosed with a mood disorder on children, pregnancy and medication.

Objective: The aim of this study was to explore the views of women diagnosed with a mood disorder about children, medication and pregnancy.

Method: Female patients from the Black Dog Institute were invited to complete a questionnaire regarding their views about pregnancy, children and medication during pregnancy. Diagnostic groupings were derived by assessing DSM-IV criteria for mood disorders.

Development of a measure quantifying adverse psychotherapeutic ingredients: the Experiences of Therapy Questionnaire (ETQ).

While psychotherapies are of established value, they may, as active treatments, risk adverse outcomes. As there is no validated measure of potentially negative psychotherapeutic ingredients, we sought to develop such a measure for use in psychotherapy evaluation studies. Based on a review of the literature, a 103-item experiential measure was derived.

Suggested early onset of true action of antidepressant drugs may be artefactual: a heuristic study.

In recent decades, there have been many studies reporting that antidepressants have a rapid onset of action, with improvement occurring in the first week. The current pilot study questions whether such findings reflect an artefact emerging from high rates of 'nonspecific' improvement and evaluates the phenomenon in a small sample of melancholic patients seemingly lacking nonspecific improvement propensities. Twenty-nine patients with a well-defined melancholic depression completed a 12-week treatment study comparing drug therapy versus cognitive behaviour therapy.

Do practitioners managing mood disorders work to a sub-typing or a 'one size fits all' model?

Objective: To assess whether psychiatrists in the community operate to a sub-typing model of mood disorders when choosing psychotropic medications.

Method: Patients assessed through the Black Dog Institute depression clinic provided information on their previously prescribed and current medications, on how effective they found them and whether they had to be ceased due to side-effects. The prevalence of each medication trialled was analysed according to diagnosis (bipolar I, bipolar II, unipolar melancholic depression or unipolar non-melancholic depression).

Out of the darkness: the impact of a mood disorder over time.

Objective: Being diagnosed with depression or bipolar disorder has a significant impact on an individual's life. This paper reports data examining how patients view having had such a condition.

Method: Patients attending the Black Dog Institute Depression Clinic were asked to complete questionnaires examining the impact of being diagnosed with a mood disorder and dealing with that condition over time.

The 'magic button question' for those with a mood disorder--would they wish to re-live their condition?

Background: To determine any positive aspects of living with a clinical mood disorder, and indirectly address the question--"If you could live your life again, would you press the 'magic button' to experience life without a mood disorder?"

Method: Patients referred to a tertiary mood disorder facility were asked to complete a series of questionnaires pursuing detailed historical information about their mood disorder, including its 'best' and 'worst' aspects.

Results: Of the 884 patients surveyed, 335 (38%) returned data on their mood disorder's advantages and/or disadvantages. Of these, 62.