The association between levels of cortisol secretion and fear perception in patients with remitted depression predicts recurrence.

This study examines the association between cortisol secretion and fear perception in remitted patients to identify mechanisms underlying risk for recurrence of depression. We hypothesized that the stronger the association between cortisol secretion and fear perception in persons with remitted depression, the more recurrence would be experienced. We also investigated whether high levels of cortisol and fear perception per se predict more recurrence.

Stressful life events as a link between problems in nonverbal communication and recurrence of depression.

Background: Interpersonal difficulties and stressful life events are important etiological factors in (recurrence of) depression. This study examines whether stressful life events mediate the influence of problems in nonverbal communication on recurrence of depression.

Methods: We registered nonverbal expressions of involvement from videotaped behavior of 101 remitted outpatients and their interviewers.

Lack of association between conversation partners' nonverbal behavior predicts recurrence of depression, independently of personality.

High neuroticism and low extraversion are related to depression and its recurrence. We investigated whether nonverbal involvement behavior during social interaction is one of the factors via which these relations are effectuated. We measured nonverbal expressions of involvement from videotaped behavior of remitted depressed outpatients (n=101) and their conversation partners, and assessed self-reported neuroticism and extraversion scores.

Cognitive, physiological, and personality correlates of recurrence of depression.

Background: The risk of recurrence in depressive disorder is high and increases with the number of episodes. We investigated whether individuals with a history of recurrent depression deviate from individuals with a single episode, as regards risk-related variables in 3 different domains of depression research.

Methods: Participants were 102 outpatients with major depressive disorder remitted from an episode (60 recurrent, 42 nonrecurrent).

Potential psychosocial mechanisms linking depression to immune function in elderly subjects.

Although depression and immune changes in elderly subjects constitute a considerable health risk, mechanisms underlying the association between depression and immune function are unclear. The question of whether personality and social support can explain the variation in immune function during depression was addressed in 21 elderly depressive and 23 control subjects. The following variables were studied: neuroticism, extraversion, received social support, depression-related immune parameters [i.

The reliability and validity of the Seasonal Pattern Assessment Questionnaire: a comparison between patient groups.

Background: The Seasonal Pattern Assessment Questionnaire (SPAQ) is a frequently used screening instrument in the research on Seasonal Affective Disorder (SAD). Nevertheless, studies on its reliability and validity are relatively scarce. In the present study the reliability and the contrast validity of the SPAQ are investigated.

Do depressive episodes lead to accumulation of vulnerability in the elderly?

The vulnerability-accumulation (or scarring) hypothesis postulates that the experience of depression induces a lasting increase in vulnerability, and through this raises the risk of recurrence. We examined the validity of the vulnerability-accumulation model for depressive episodes in later life. The sample comprised 26 elderly persons who had remitted from a depressive episode and 96 control respondents who were all selected from the participants of a large community survey among persons aged 57 years or more.

Non-verbal interaction involvement as an indicator of prognosis in remitted depressed subjects.

Fifty-one remitted depressed inpatients and their interviewers were observed during a conversation. We investigated whether non-verbal behavioral elements indicative of involvement displayed by the remitted patients and/or their interviewers were predictive of depressive symptoms 6 months later. Involvement behavior of the patients appeared to be related to future complaints; the lower the level of involvement displayed, the more unfavorable the outcome.

Urinary free cortisol excretion in elderly persons with minor and major depression.

Several studies have found that cortisol hypersecretion may occur in severely depressed patients, characterized by melancholic features. On the other hand, illness chronicity seems to be related to low, rather than high, cortisol levels. This study aims to trace factors associated with 24-h urinary free cortisol levels in a sample of 23 elderly persons with major or minor depression and 21 non-depressed control subjects.

Functional disability and neuroticism as predictors of late-life depression.

The authors investigated the association of premorbidly-assessed disability and neuroticism with the onset of late-life depression in 86 depressed and 72 randomly selected control persons, originating from a 1993 Dutch community study of elderly people. Compared with elderly people with average levels of disability and neuroticism, people with low levels were significantly less likely to develop a depressive disorder. High scorers, on the other hand, did not differ significantly from the average group.

Depression in later life: three etiologically different subgroups.

Background: Various studies support the notion that early onset depression and late onset depression have different etiological pathways. Late onset depression has been found to be a heterogeneous group. This study attempts to divide the late onset group in two subgroups with different aetiology and find evidence for the vascular depression hypothesis.

Increase of NK-T cells in aged depressed patients not treated with antidepressive drugs.

Background: A change in number and/or activity of natural killer cells has repeatedly been reported in depressive illness. Much less attention has yet been given to the subgroup of natural killer cells that are positive for the T-cell marker CD3 (NK-T cells). These cells possibly have important immunoregulatory properties.

Correlates of symptomatic, minor and major depression in the elderly.

Background: Associations between different types of depression with clinical characteristics and putative vulnerability factors from several domains (health, disability, personality, familial psychopathology) were studied in a sample of elderly subjects, in order to find arguments that support or discard the notion of discontinuity in correlates of depression.

Methods: Subjects were 183 depressed elderly persons from the general population, general practitioners and mental health care outpatient clinics, and a random elderly control group (n=74). Depression was subdivided into symptomatic (n=45), DSM-IV minor (n=73), and DSM-IV major (n=65) depression.

Lack of coordination of nonverbal behaviour between patients and interviewers as a potential risk factor to depression recurrence: vulnerability accumulation in depression.

Background: Coordination of nonverbal behaviour during interactions is a prerequisite for satisfactory relationships. Lack of coordination may form a risk factor for depression. The 'vulnerability-accumulation hypothesis' assumes that vulnerability to recurrence of depression will increase with increasing experience of depressive episodes.

Depressed patients' perceptions of facial emotions in depressed and remitted states are associated with relapse: a longitudinal study.

Within the framework of interpersonal and cognitive theories of depression, we investigated whether the perception of facial emotions was associated with subsequent relapse into depression. The 23 inpatients with major depression who remitted (65 admitted patients) were studied at admission (T0), at discharge (T1), and 6 months thereafter to assess relapse. They judged schematic faces with respect to the expression of positive and negative emotions.

Prophylactic treatment of seasonal affective disorder (SAD) by using light visors: bright white or infrared light?

Background: Thirty-eight patients with SAD participated in a light visor study addressing two questions. 1. Can the development of a depressive episode be prevented by daily exposure to bright light started before symptom onset in early fall and continued throughout the winter? 2.

The prevalence of seasonal affective disorder in The Netherlands: a prospective and retrospective study of seasonal mood variation in the general population.

Background: The aim of the present study was to assess the prevalence of seasonal affective disorder (SAD) in The Netherlands.

Methods: The subjects (n = 5356), randomly selected from community registers, were given the Seasonal Pattern Assessment Questionnaire and the Centre for Epidemiological Studies Depression Scale over a period of 13 months. The response rate was 52.

Seasonal affective disorder and latitude: a review of the literature.

Background: The aim of the study is to investigate the relationship between the prevalence of SAD and latitude.

Methods: An overview of the epidemiological literature on the prevalence of SAD is given and studies relevant for the latitudinal dependency of prevalence will be analyzed and discussed.

Results: The mean prevalence of SAD is two times higher in North America compared to Europe.

Gender-specific mechanisms associated with outcome of depression: perception of emotions, coping and interpersonal functioning.

We proposed that a negative bias in the perception of facial expressions would affect the way in which deficient coping and interpersonal functioning influenced the risk of persistent depression. Furthermore, we hypothesised that cognitions, coping strategies, and interpersonal functioning would be more likely to contribute to the prediction of outcome of depression among women than among men. At admission, 60 in-patients with major depression judged 12 schematic faces with respect to the emotions that they expressed (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation).

The judgement of facial expressions by depressed patients, their partners and controls.

Background: Research has shown that cognitive and interpersonal processes play significant roles in depression development and maintenance. Depressed patients judgments of emotions displayed in facial expressions, as well as those of their partners, allow for better understanding of these processes.

Methods: In this study, twenty major depression outpatients, their partners and control persons (matched on the sex and age of the partner) judged facial expressions as to the emotions they felt were portrayed, at the patients outpatient admission.

Non-verbal behavioral interactions of depressed patients with partners and strangers: the role of behavioral social support and involvement in depression persistence.

Excessive support seeking and lack of receiving social support have been associated with depression onset and unfavorable course of depression. It has been assumed that social support is effected by observable behaviors that express involvement. Twenty-five patients with major depression were studied during a social interaction with their partner and a similar interaction, with a stranger, matched on the sex and age of the partner.

Relationship between perception of facial emotions and anxiety in clinical depression: does anxiety-related perception predict persistence of depression?

Within the framework of interpersonal theories on depression, it was postulated 1) that an anxiety-related mood-congruent bias with respect to the perception of facial expressions could be demonstrated in clinically depressed patients: 2) that the perception of negative facial emotions would be associated with co-occurring anxiety levels rather than with depression, and 3) that the putative anxiety-related bias would predict the subsequent course of depression. Such relationships would support the possible causal role of negative biases for the persistence of depression. Thirty-nine depressed patients (thirty-six patients met the criteria for major depression, two had a dysthymic disorder and one patient suffered from a cyclothymic disorder) were studied.

Depression relapse and ethological measures.

Within the framework of interactional theories on depression, the question is raised whether depression relapse can be predicted by observable behavior of remitted patients and their interviewer during an interaction (i.e. discharge interview).

Prediction of acute and late responses to light therapy from vocal (pitch) and self-rated activation in seasonal affective disorder.

It was hypothesized that pre-treatment activation plays a role in the response to light therapy in Seasonal Affective Disorder (SAD). In 55 SAD patients (DSMIII-R) energetic and tense activation was assessed before light therapy via self-rating (AD-ACL) and voice sound characteristics (mean pitch and variation in pitch). These variables were studied in relation to the "acute" response to 4 days of light therapy (30 min, 10000 lux) and to a "late" response (11 (10) days after light therapy had stopped).

Nonverbal support giving induces nonverbal support seeking in depressed patients.

Nonverbal support seeking behavior of 11 mildly depressed patients was studied in relation to the nonverbal support giving behavior of a female interviewer. The patients were interviewed for 20 minutes during which the interviewer gave high and low nonverbal support for 10 minutes in a cross-over design. Different behavioral elements of the patients and of the interviewer were pooled into behavioral factors.