Daniela Victor

Hippocampal volume and 2-year outcome in depression

Although the hippocampus has been found to be smaller in people with depression, the clinical relevance of this is unclear. We investigated hippocampal volume (using high-resolution magnetic resonance imaging) and 2-year outcome in 57 patients with major depression. The left and right hippocampal volumes of patients with a depression relapse were significantly smaller than those of healthy controls. Our results support the hypothesis that the hippocampus is crucial in the outcome of depression.

Hippocampal volume in first episode and recurrent depression

Abnormalities in limbic-thalamic-cortical networks are hypothesized to modulate human mood states. In the present study differences in hippocampal volumes of patients with a first episode of depression, recurrent major depression and healthy control subjects were examined with high-resolution magnetic resonance imaging (MRI). Male patients with a first episode of major depression had a significantly smaller left hippocampal volume than male control subjects. Also, these patients had a significant left-right asymmetry in hippocampal volume. Female patients showed no significant alterations in hippocampal volumes. The results support the hypothesis that the hippocampus plays an important role in the pathophysiology of the early phase of major depression, especially for male patients. Implications for the neurodevelopmental and the neurodegenerative model of hippocampal change are discussed.

Contrasting chronic with episodic depression: An analysis of distorted socio-emotional information processing in chronic depression

BACKGROUND The specific features that differentiate chronic and episodic depression are widely unknown. This study compares the chronic and episodic form of depression with regard to two domains of socio-emotional information processing: Decoding of other peoples emotional states (Theory of Mind) and the perception of own emotions (alexithymia). METHOD This study compares 30 chronically and 29 episodically depressed patients by tapping into Theory of Mind deficits with a multi-method approach and by assessing alexithymic deficits. Furthermore, a retrospective assessment of adverse relational childhood experiences is administered. RESULTS The observed results reveal distorted information processing in only one of the two domains: Chronically depressed patients scored higher in alexithymia than episodically depressed patients, while no group differences in the domain of Theory of Mind were found. Moreover, alexithymia was found to mediate the influence of adverse relational childhood experiences on depression type (chronic vs. episodic). LIMITATIONS Due to the reliance on retrospective and self-report data, results should be interpreted with due caution. In addition, the cross-sectional design limits causal conclusions. CONCLUSIONS These results suggest a potentially central role of the deficient perception of own emotions in causing or maintaining chronic depression. Derived practical implications include a focus on the perception of own emotions in the psychotherapy of chronic depression. If future research continues to uncover systematic differences in the psychopathology of chronic and episodic depression, chronicity should be more strongly considered when classifying unipolar depressive disorders.

Life events and hippocampal volume in first-episode major depression

BACKGROUND There are many studies on life events in depression and also several studies examining brain structural changes in the hippocampus of depressed patients. However, only few studies have focused on the association of life events and hippocampal volume in depression. The hypothesis of a significant negative association between life events and hippocampal volumes in first episode depression was examined. METHODS 28 in-patients with a first episode of major depression were examined with high-resolution magnetic resonance imaging measuring hippocampal volumes. The precourse of depression was assessed with the Interview for the Retrospective Assessment of the Onset and Course of Schizophrenia and Other Psychoses (IRAOS) and life events by using the Munich Interview for the Assessment of Life Events and Conditions (MEL). RESULTS A significant negative correlation between major life events three month before the onset of depression and the left hippocampal volume was found for male patients. In female patients no significant association between major life events and hippocampal volumes could be found. CONCLUSIONS The results support the hypothesis that the hippocampus plays a crucial role in the pathogenesis of major depression in the early phase of the disorder particularly for male patients.

Expressed emotion, perceived criticism and 10-year outcome of depression.

Outcome studies of patients suffering from depression indicate a high relapse rate and a tendency towards chronicity. A family atmosphere characterised by expressed emotion (EE) and perceived criticism (PC) was reported to be a robust predictor of outcome in affective disorders. The aim of the study was to analyze the association between EE, PC and long-term outcome of depression. Fifty inpatients with major depression were followed up 1, 2 and 10 years after discharge from the hospital. After 10 years, 26 patients (56.5%) had at least one recurrence. Spousal EE, assessed with the Five-Minute Speech Sample (FMSS), and the Perceived Criticism Index (PCI) were not significant prognostic factors for depression outcome. The significance of EE and PC for the long-term course of depression has to be questioned. The findings indicate a need to examine factors that may partly mediate the effect of EE and PC on the outcome of depression.

Die therapeutische Beziehung in der Kinder- und Jugendlichen-Psychotherapie:

Zusammenfassung. Theoretischer Hintergrund: Die therapeutische Beziehung stellt innerhalb der Psychotherapieforschung bei Kindern und Jugendlichen ein weitgehend unerforschtes Gebiet dar. Eine Ursache dieses Forschungsdefizits liegt im Mangel an psychometrisch evaluierten Messinstrumenten. Fragestellung und Methode: In der vorliegenden Untersuchung wurde die ins Deutsche ubersetzte Version der Therapeutic Alliance Scales for Children (Shirk & Saiz, 1992) an einer Stichprobe von N = 80 ambulant pychotherapeutisch behandelten Kindern und Jugendlichen und ihrer Therapeuten evaluiert. Ergebnisse: Die Drei-Faktoren-Losung der amerikanischen Originalversion der Fragebogen konnte repliziert werden. Fur die Skalen Arbeitsbeziehung und positive und negative Aspekte der emotionalen Beziehung ergaben sich gute Reliabilitatskennwerte. Der Zusammenhang zwischen Therapeuten- und Patienteneinschatzungen lag vergleichbar dem bei Erwachsenen im mittleren Bereich. Schlussfolgerungen: Der Fragebogen zur Therapeutischen Bezi...

Attachment Status Affects Heart Rate Responses to Experimental Ostracism in Inpatients with Depression.

Depression is assumed to be both a risk factor for rejection and a result of it, and as such constitutes an important factor in rejection research. Attachment theory has been applied to understand psychological disorders, such as depression, and can explain individual differences in responses to rejection. Research on autonomic nervous system activity to rejection experiences has been contradictory, with opposing strings of argumentation (activating vs. numbing). We investigated autonomic nervous system-mediated peripheral physiological responses (heart rate) to experimentally manipulated ostracism (Cyberball) in 97 depressed patients with organized (n = 52) and disorganized attachment status (n = 45). Controlling for baseline mean heart rate levels, depressed patients with disorganized attachment status responded to ostracism with significantly higher increases in heart rate than depressed patients with organized attachment status (p = .029; ηp2 = .051). These results suggest that attachment status may be a useful indicator of autonomic responses to perceived social threat, which in turn may affect the therapeutic process and the patient-therapist relationship.