Search Results (24)

Objectives: The main aim was to evaluate the origin and empirical support of the current diagnostic criteria for (hypo)manic and depressive episodes in BD focusing on their nosological (i.e., is it a real entity?) and diagnostic validity (i.e., how well do the criteria for the category portray the entity?). Methods: A narrative review of relevant textbooks/reports and articles published in peer-reviewed English-language journals (from the online databases PubMed and PsycInfo), covering the period 1900–2024 and using the terms “validity” OR “diagnosis” AND “manic-depressive”; “mania”; “hypomania”; “depression”; and “melancholia” was performed. Results: Mania appears to be a valid construct in nosological terms, although its validity in the diagnostic domain requires further research. There are scant and controversial empirical data on the nosological validity of separating hypomania from mania as different episodes. The current concept of bipolar depression combines different forms of episodes (melancholic and non-melancholic, with or without psychosis, recurrent or not) without conclusive evidence that all of them are necessarily part of the illness (i.e., limited nosological validity). Conclusions: The validity of the current definition of BD is limited and should be the focus of future research. A valid definition of BD would improve our ability to understand the pathophysiological basis of the illness and contribute to more tailored therapeutic approaches. Full article

Background: Training planning in military environments is complex due to diverse operational demands and constant exposure to stressors. When combined with high training volumes and insufficient recovery, this can result in physical and mental overload. Regular assessments are crucial to monitor the condition of personnel and adjust training accordingly, though more research is needed to effectively track performance in real operational settings. Objectives: This study aims to monitor neuromuscular and psychological performance in relation to training load in a military school, addressing the research gap in tracking performance in operational settings. Methods: Overall, 27 marines (age: 27.9 ± 4.8 years; height: 178.1 ± 6.3 cm; weight: 79.1 ± 7.8 kg) were monitored over a 13-week academic-military training period to assess neuromuscular performance and psychological fatigue. Results: Laboratory tests included the countermovement jump (p = 0.002), isometric mid-thigh pull (p = 0.001), and handgrip strength for both dominant (p = 0.947) and non-dominant hands (p = 0.665). Field tests involved maximum pull-ups (p = 0.015), push-ups (p = 0.001), and the medicine ball throw (p = 0.334). Psychological evaluation via the POMS questionnaire showed the highest negative mood scores in Tension–Anxiety, Depression–Melancholia, and Fatigue–Inertia, while Vigor–Activity was the highest positive state. RESTQ-Sport results indicated total recovery was 68.9% greater than total stress. Conclusions: Despite improvements in some field tests, no significant neuromuscular gains were observed, likely due to excessive training loads, limited recovery, and sustained stress. Full article

In her 2010 article “Aesthetic Wit(h)nessing in the Era of Trauma”, Griselda Pollock lamented the aperture between psychology, particularly that of PTSD, and esthetics in the search to bear witness to traumatic experience. This article explores the gray area that exists when the esthetic and the traumatic converge, arguing that such areas exist not only as direct representations of the difficulty of narrativizing trauma as described by such theorists as Cathy Caruth, Onno van der Hart, and Bessel van der Kolk, but also simultaneously as windows into the moments of what Dominick LaCapra calls “the sublime object of endless melancholia and impossible mourning”. Postmodernism is argued to be the organic choice of voicing traumatic retellings, and close readings of John Hersey’s proto-postmodern Hiroshima (1946), Tim O’Brien’s The Things They Carried (1992), and David Foster Wallace’s Infinite Jest (1996) work to highlight the intersections of trauma, postmodern literature, and esthetics; or, in Wallace’s case, theoretical discussions of traumatic tropes as facilitated by the postmodern tradition. In drawing attention to this tripartite convergence, this article hopes to continue in the vein of scholarship that reaffirms the need for evermore research in the field of trauma studies as well as substantiate a claim of the heightened importance of postmodern literature in the 21st century—an epoch indelibly marked by trauma, as noted by Pollock. Full article

The psychoanalytic explanation of religious sentiment is genetic, meaning that it probes the psychological processes behind the formation of such sentiment. Freud ascribed the genesis of religious sentiment to human infantile helplessness and ambivalence towards the father. This explanation encounters a dilemma when confronted with the sense of completeness and infinity in religious sentiment and fails to address components related to death, such as the transcendent and surmounting nature of the believer’s fear of death. Experience has shown that numerous religious sentiments occur through a process of emotional transformation, from a melancholic state of extreme mental anguish to a state of blissful, complete joy. This process, from a psychogenetic perspective, is essentially a defense of the self-preservation impulse. In this transformation, the ego removes chronic suffering by identifying itself with the superego. Therefore, the ego undergoes a symbolic death, through which it regains the energy of life. Full article

Melancholia is a major and severe subtype of depression, with only limited data regarding its association with neurological phenomena. To extend the current understanding of how particular aspects of melancholia are correlated with brain activity, electroencephalographic data were collected from 100 adults (44 males and 56 females, all aged 18 y or more) and investigated for the association between symptoms of melancholia and the ratios of alpha/beta activity and theta/beta activity at parietal–occipital EEG sites PO1 and PO2. The results indicate differences in these associations according to the depressive status of participants and the particular symptom of melancholia. Depressed participants exhibited meaningfully direct correlations between alpha/beta and theta/beta activity and the feeling that “Others would be better off if I was dead” at PO1, whereas non-depressed participants had significant inverse correlations between theta/beta activity and “Feeling useless and not needed” and “I find it hard to make decisions” at PO1. The results are discussed in terms of the relative levels of fast-wave (beta) versus slow-wave (alpha, theta) activity exhibited by depressed and non-depressed participants in the parietal–occipital region and the cognitive activities that are relevant to that region. Full article

The dexamethasone suppression test (DST) assesses the functionality of the HPA axis and can be regarded as the first potential biomarker in psychiatry. In 1981, a group of researchers at the University of Michigan published a groundbreaking paper regarding its use for diagnosing melancholic depression, reporting a diagnostic sensitivity of 67% and a specificity of 95%. While this study generated much enthusiasm and high expectations in the field of biological psychiatry, subsequent studies produced equivocal results, leading to the test being rejected by the American Psychiatric Association. The scientific reasons leading to the rise and fall of the DST are assessed in this review, suggestions are provided as to how the original test can be improved, and its potential applications in clinical psychiatry are discussed. An improved, standardized, and validated version of the DST would be a biologically meaningful and useful biomarker in psychiatry, providing a tool for clinicians caring for depressed patients in the areas of diagnosis, treatment, and prognosis, and predicting the risk of suicide. Additionally, such a test could be a crucial part in the generation of biologically homogenous patient cohorts, necessary for the successful development of new psychotropic medications. Full article

Recent studies have proposed valid precision models and valid Research and Diagnostic Algorithmic Rules (RADAR) for recurrent major depressive disorder (MDD). The aim of the current study was to construct precision models and RADAR scores in patients experiencing first-episode MDD and to examine whether adverse childhood experiences (ACE) and negative life events (NLE) are associated with suicidal behaviors (SB), cognitive impairment, and phenome RADAR scores. This study recruited 90 patients with major depressive disorder (MDD) in an acute phase, of whom 71 showed a first-episode MDD (FEM), and 40 controls. We constructed RADAR scores for ACE; NLE encountered in the last year; SB; and severity of depression, anxiety, chronic fatigue, and physiosomatic symptoms using the Hamilton Depression and Anxiety Rating Scales and the FibroFatigue scale. The partial least squares analysis showed that in FEM, one latent vector (labeled the phenome of FEM) could be extracted from depressive, anxiety, fatigue, physiosomatic, melancholia, and insomnia symptoms, SB, and cognitive impairments. The latter were conceptualized as a latent vector extracted from the Verbal Fluency Test, the Mini-Mental State Examination, and ratings of memory and judgement, indicating a generalized cognitive decline (G-CoDe). We found that 60.8% of the variance in the FEM phenome was explained by the cumulative effects of NLE and ACE, in particular emotional neglect and, to a lesser extent, physical abuse. In conclusion, the RADAR scores and plots constructed here should be used in research and clinical settings, rather than the binary diagnosis of MDD based on the DSM-5 or ICD. Full article

The aim of the study was to explore in depression the relationship between recent suicidal ideation and the different anhedonias taking into account the severity of depression. Recent studies have suggested that recent change of anhedonia and not state or trait anhedonia is associated with recent suicidal ideations even when the level of depression is controlled. Three samples were used (74 severe major depressives, 43 outpatients with somatic disorders presenting mild or moderate depression and 36 mild or moderate depressives hospitalized in the intensive coronary unit). Recent change of anhedonia was rated by the anhedonia subscale of the Beck Depression Inventory (BDI-II), state anhedonia by the Snaith–Hamilton Pleasure Scale (SHAPS), trait anhedonia by the TEPS (Temporal Experience of Pleasure Scale), musical anhedonia by the BMRQ (Barcelona Music Reward Questionnaire), social recent change of anhedonia by the SLIPS (Specific Loss of Interest and Pleasure Scale), the severity of depression by the BDI-II and the distinction between melancholic and non-melancholic was found using a subscale of the BDI-II. Bivariate and multivariate regression analyses were performed in each sample. In severe major depressives and, notably, in melancholia, recent suicidal ideation was associated with trait anhedonia; however, in mild or moderate depression, recent suicidal ideation was associated with recent change of anhedonia. Musical anhedonia and social recent change of anhedonia were not associated with recent suicidal ideation. Trait anhedonia could be, in severe depression, a strong predictor of recent suicidal ideation. Full article

Major depressive disorder (MDD) and bipolar disorder (BD) with melancholia and psychotic features and suicidal behaviors are accompanied by activated immune-inflammatory and oxidative pathways, which may stimulate indoleamine 2,3-dioxygenase (IDO), the first and rate-limiting enzyme of the tryptophan catabolite (TRYCAT) pathway resulting in increased tryptophan degradation and elevated tryptophan catabolites (TRYCTAs). The purpose of the current study is to systematically review and meta-analyze levels of TRP, its competing amino acids (CAAs) and TRYCATs in patients with severe affective disorders. Methods: PubMed, Google Scholar and SciFinder were searched in the present study and we recruited 35 studies to examine 4647 participants including 2332 unipolar (MDD) and bipolar (BD) depressed patients and 2315 healthy controls. Severe patients showed significant lower (p < 0.0001) TRP (standardized mean difference, SMD = −0.517, 95% confidence interval, CI: −0.735; −0.299) and TRP/CAAs (SMD = −0.617, CI: −0.957; −0.277) levels with moderate effect sizes, while no significant difference in CAAs were found. Kynurenine (KYN) levels were unaltered in severe MDD/BD phenotypes, while the KYN/TRP ratio showed a significant increase only in patients with psychotic features (SMD = 0.224, CI: 0.012; 0.436). Quinolinic acid (QA) was significantly increased (SMD = 0.358, CI: 0.015; 0.701) and kynurenic acid (KA) significantly decreased (SMD = −0.260, CI: −0.487; −0.034) in severe MDD/BD. Patients with affective disorders with melancholic and psychotic features and suicidal behaviors showed normal IDO enzyme activity but a lowered availability of plasma/serum TRP to the brain, which is probably due to other processes such as low albumin levels. Full article

The diagnostic categories in psychiatry often encompass heterogeneous symptom profiles associated with differences in the underlying etiology, pathogenesis and prognosis. Prior work demonstrated that some of this heterogeneity can be quantified though dimensional analysis of the Depression Anxiety Stress Scale (DASS), yielding unique transdiagnostic symptom subtypes. This study investigated whether classifying patients according to these symptom profiles would have prognostic value for the treatment response to therapeutic transcranial magnetic stimulation (TMS) in comorbid major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). A linear discriminant model was constructed using a simulation dataset to classify 35 participants into one of the following six pre-defined symptom profiles: Normative Mood, Tension, Anxious Arousal, Generalized Anxiety, Anhedonia and Melancholia. Clinical outcomes with TMS across MDD and PTSD were assessed. All six symptom profiles were present. After TMS, participants with anxious arousal were less likely to achieve MDD remission compared to other subtypes (FET, odds ratio 0.16, p = 0.034), exhibited poorer PTSD symptom reduction (21% vs. 46%; t (33) = 2.025, p = 0.051) and were less likely to complete TMS (FET, odds ratio 0.066, p = 0.011). These results offer preliminary evidence that classifying individuals according to these transdiagnostic symptom profiles may offer a simple method to inform TMS treatment decisions. Full article

Beat poetry, since its origination in the American milieu in the 1950s until its further maturation in the late 1960s and 1970s, has embodied ecological visions. Allen Ginsberg’s and Gary Snyder’s Buddhist poetics of the emptiness of material phenomena evoke one’s awareness ofthe true nature of material goods. This ecological awarenessenlightensanyoneto not overconsume the goods in fulfilling his/her daily necessities. In this recent era, Ginsberg’s “Plutonian Ode” and Snyder’s “Smokey the Bear Sutra” memorialize this Beat green poetics against anthropocentric materialism and its potential detrimental impacts on the natural environment. These poems view human’s material attachment as a recurring melancholia even in today’s digital technology era. Their ecological criticisms through the Buddhist poetics pave the way for anyone to cherish rather than objectify any material thing in living the biotic community. Full article

Introduction: The continuously increasing prevalence of childhood obesity is reaching epidemic proportions. Greece is among the countries with the highest childhood obesity prevalence rates. The present study aims to identify psychosocial factors associated with excess body weight of adolescents. Methods: This case-control study was conducted in Athens, Greece, and included 414 adolescents aged 11–18 years. Anthropometric measurements were recorded, and an anonymous self-completed questionnaire captured the psychosocial background, family environment, peer relations, and school environment. Results: Of the total sample of adolescents, 54.6% had normal body weight and 45.4% were overweight or obese. A multivariate logistic regression analysis showed that the factors related to the presence of overweight/obesity were adolescents’ age (OR = 0.416, p < 0.001), area of residence, presence of anxiety (OR = 4.661, p = 0.001), presence of melancholia (OR = 2.723, p = 0.016), participation in sports (OR = 0.088, p <0.001), smoking (OR = 0.185, p = 0.005), and mother’s occupation (OR = 0.065, p < 0.001). Conclusion: Psychological problems, maternal occupation, the absence of physical activity, and poor school performance were associated with adolescent overweight/obesity. It is important that screening for the presence of psychosocial issues is included in childhood obesity policies and treatment. Full article

The practice of physical medicine underwent a sea change at the turn of the 20th century, but the management of mental disorders stayed much the same as it had been since Rome. New names have been coined for disorders, and synthetic drugs are advertised as a solution to every problem, but the causes are still largely unknown and, although spontaneous remission can occur, there are no cures. This review of psychiatric diagnosis and treatment from Rome to the 21st century offers a rationale to support the classic (and still current) classification of disorders. It offers a method of distinguishing the major kinds of disorders and suggests when the prescription of psychoactive drugs may—or may not—be appropriate. Full article

The clinical picture of depressive disorders is characterized by a plethora of somatic symptoms, psychomotor retardation, and, particularly, anhedonia. The number of patients with residual symptoms or treatment resistance is high. Touch is the basic communication among humans and animals. Its application professionally in the form of, e.g., psychoactive massage therapy, has been shown in the past to reduce the somatic and mental symptoms of depression and anxiety. Here, we investigated the effects of a specially developed affect-regulating massage therapy (ARMT) vs. individual treatment with a standardized relaxation procedure, progressive muscle relaxation (PMR), in 57 outpatients with depression. Patients were given one ARMT or PMR session weekly over 4 weeks. Changes in somatic and cognitive symptoms were assessed by standard psychiatric instruments (Hamilton Depression Scale (HAMD) and the Bech–Rafaelsen–Melancholia–Scale (BRMS)) as well as a visual analogue scale. Furthermore, oral statements from all participants were obtained in semi-structured interviews. The findings show clear and statistically significant superiority of ARMT over PMR. The results might be interpreted within various models. The concept of interoception, as well as the principles of body psychotherapy and phenomenological aspects, offers cues for understanding the mechanisms involved. Within a neurobiological context, the significance of C-tactile afferents activated by special touch techniques and humoral changes such as increased oxytocin levels open additional ways of interpreting our findings. Full article