Linkapalooza

All links, no editorializing.
Well, not much editorializing.


1) Some cases of mood disorders, including depression, are linked to severe infections and autoimmune disease..

Any contact with a hospital for autoimmune disease was associated with an independent and significant 45% higher risk of a subsequent mood disorder diagnosis, Michael Eriksen Benros, MD, of Denmark's Aarhus University, and colleagues reported online in JAMA Psychiatry.

Hospitalization for any infection was associated with a significant 62% elevated risk of later mood disorders.

If that association was causal and could be eliminated, 12% of all mood disorders could be avoided, the researchers estimated.

The results make sense in light of previous investigations that have found links between immunological responses to stress and depression.

2) Interesting results from the ongoing attempts to distinguish different types of depressions and identify them with biomarkers so that we might respond to each with suitable treatment:  Brain scan predicts best therapy for depression.

Researchers used brain scans to measure glucose metabolism in untreated depressed patients. The patients were then randomly assigned to one of two treatments: either escitalopram (a widely prescribed SSRI) or cognitive behavioral therapy.

. . .the level of glucose metabolism in a brain region called the right anterior insula — which is associated with depression-relevant behaviours such as emotional self-awareness and decision-making — predicted who would benefit from which therapy. Patients who responded positively to the drug but poorly to cognitive therapy had insula glucose-metabolism levels above the mean level for the whole brain. Those who responded in the opposite way had below-average insula metabolism levels.

Developments like this are crucial: we don't really know what depression is, much less how one type of depression might differ from others. Making these distinctions, and testing treatments for each type of depression, is the only way past the status quo. And that status quo is, from a patient's point of view, completely unacceptable.  Which treatment you receive is not a function of what sort of depression you have: it is a function of: which therapist you see; that therapist's theoretical preferences; which pharmaceutical company has spent the most $$ of late buying off researchers; or which advertisement for which antidepressant the patient recently saw on late-night TV; and perhaps even which pharmaceutical salesman has showered your therapist with the most bling. In other words, the whole thing is a crapshoot. Though your clinician may prefer to call it "trial and error."

3) A good editorial from Nature on the search for biomarkers and how the stigma of mental illness slows research.

4) More on the neurochemistry of stress and depression. That one gets a bit sciencey!