Background: The concept of alexithymia is characterized by difficulties identifying and describing one’s emotions. Alexithymic individuals are impaired in the recognition of others’ emotional facial expressions. Alexithymia is quite common in patients suffering from major depressive disorder. The face-in-the-crowd task is a visual search paradigm that assesses processing of multiple facial emotions. In the present eye-tracking study, the relationship between alexithymia and visual processing of facial emotions was examined in clinical depression. Materials and Methods: Gaze behavior and manual response times of 20 alexithymic and 19 non-alexithymic depressed patients were compared in a face-in-the-crowd task. Alexithymia was empirically measured via the 20-item Toronto Alexithymia-Scale. Angry, happy, and neutral facial expressions of different individuals were shown as target and distractor stimuli. Our analyses of gaze behavior focused on latency to the target face, number of distractor faces fixated before fixating the target, number of target fixations, and number of distractor faces fixated after fixating the target. Results: Alexithymic patients exhibited in general slower decision latencies compared to non-alexithymic patients in the face-in-the-crowd task. Patient groups did not differ in latency to target, number of target fixations, and number of distractors fixated prior to target fixation. However, after having looked at the target, alexithymic patients fixated more distractors than non-alexithymic patients, regardless of expression condition. Discussion: According to our results, alexithymia goes along with impairments in visual processing of multiple facial emotions in clinical depression. Alexithymia appears to be associated with delayed manual reaction times and prolonged scanning after the first target fixation in depression, but it might have no impact on the early search phase. The observed deficits could indicate difficulties in target identification and/or decision-making when processing multiple emotional facial expressions. Impairments of alexithymic depressed patients in processing emotions in crowds of faces seem not limited to a specific affective valence. In group situations, alexithymic depressed patients might be slowed in processing interindividual differences in emotional expressions compared with non-alexithymic depressed patients. This could represent a disadvantage in understanding non-verbal communication in groups.

Genome-wide association studies (GWASs) have reported numerous associations between risk variants and major psychiatric disorders (MPDs) including schizophrenia (SCZ), bipolar disorder (BPD), major depressive disorder (MDD) and others. We reviewed all of the published GWASs, and extracted the genome-wide significant (p<10) and replicated associations between risk SNPs and MPDs. We found the associations of 6 variants located in 6 genes, including L type voltage-gated calcium channel (LTCCs) subunit alpha1 C gene (), that were genome-wide significant ( ) and replicated at single-point level across at least two GWASs. Among them, the associations between MPDs and rs1006737 within are most robust. Thus, as a next step, the expression of the replicated risk genes in human hippocampus was analyzed. We found had significant mRNA expression in human hippocampus in two independent cohorts. Finally, we tried to elucidate the roles of venlafaxine and ω-3 PUFAs in the mRNA expression regulation of the replicated risk genes in hippocampus. We used cDNA chip-based microarray profiling to explore the transcriptome-wide mRNA expression regulation by ω-3 PUFAs (0.72/kg/d) and venlafaxine (0.25/kg/d) treatment in chronic mild stress (CMS) rats. ω-3 PUFAs and venlafaxine treatment elicited significant up-regulation. We concluded that might confer the genetic vulnerability to the shared depressive symptoms across MPDs and CACNA1C might be the therapeutic target for depressive endophenotype as well.

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Environ 300 millions de personnes dans le monde souffrent de dépression et environ 30% vont développer une dépression réfractaire. Une dépression est réfractaire quand deux traitements antidépresseurs ou plus échouent à améliorer la condition d’un patient. La stimulation magnétique transcrânienne (TMS) est un traitement sécuritaire et efficace de la dépression réfractaire. Son efficacité et sa tolérabilité ont été largement prouvées grâce à des études randomisées, des méta-analyses et des revues de littérature. Toutefois, jusqu’à présent, le traitement de la dépression réfractaire avec la TMS demeure sous-étudié avec des données en pratique clinique réelle. Pour répondre à cette lacune, nous avons conduit une analyse rétrospective des dossiers médicaux de patients dépressifs réfractaires ayant suivi un traitement de TMS à l’Unité de Neuromodulation Psychiatrique (UNP) du Centre Hospitalier de l’Université de Montréal (CHUM) entre janvier 2012 et mai 2022. Nous avons examiné l’efficacité et la tolérabilité de la TMS pour ces patients. De façon secondaire, nous avons vérifié si des caractéristiques cliniques des patients avant leur traitement de TMS pouvaient être associées avec l’amélioration de leurs symptômes dépressifs à la suite du traitement de TMS. Nous avons également vérifié si nos résultats étaient semblables à ceux retrouvés dans la littérature scientifique. Cette étude offrirait aux cliniciens une perspective réaliste de l’efficacité et de la tolérabilité de la TMS à une clinique de troisième ligne. / Around 300 million people worldwide suffer from depression and around 30% will develop treatment-resistant depression (TRD). Depression is treatment-resistant when two or more antidepressant treatments fail to improve a patient’s condition. Transcranial magnetic stimulation (TMS) is a safe and effective treatment for TRD. Its efficacy and tolerability have been widely demonstrated through randomized studies, meta-analyses, and literature reviews. However, to date, the treatment of TRD with TMS remains under-studied with evidence in real-world clinical practice. To address this gap, we conducted a retrospective chart review of TRD patients who had undergone TMS therapy at the Psychiatric Neuromodulation Unit (UNP) of the University of Montreal Hospital Center (CHUM) between January 2012 and May 2022. We examined the efficacy and tolerability of TMS for these patients. As a secondary measure, we examined whether baseline clinical characteristics of patients could be associated with the improvement of their depressive symptoms following TMS treatment. We also examined whether our results were similar to those found in the scientific literature. This study would provide clinicians with a realistic perspective on the efficacy and tolerability of TMS at a third-line clinic.

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京都大学 / 新制・課程博士 / 博士(医学) / 甲第23756号 / 医博第4802号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 中山 健夫, 教授 村井 俊哉, 教授 小杉 眞司 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

<p>Thank you to all who were involved in this research including Drs. Benicio Frey,<br />Sue Becker, Margaret McKinnon, Luciano Minuzzi, and Lauren Cudney and Marg Coote. I would like to express my very great appreciation to the midwives at Community Midwives of Hamilton for enabling me to visit the clinic and recruit their pregnant clients. Finally, I would like to thank Lorenda Williams, John Williams, and Eric Johnson for their continued support.</p> / <p>Postpartum depression (PPD) is a serious disorder associated with debilitating effects on mothers and their infants. A previous history of depression appears to be the strongest risk factor for PPD. Previous studies showed that individuals with history of depression accurately recall more negative compared to positive content. The objective of this study was to compare emotional memory for negative and positive images between pregnant women with previous depressive episodes and pregnant women with no lifetime depression. This is the first study to investigate emotional memory in pregnant women with or without previous history of Major Depressive Disorder (MDD). A total of 77<br />participants between the ages of 18 - 44 (mean age: 27.3  6.2yo) completed the study (14 pregnant women with previous depressive episodes, 30 pregnant women with no lifetime depression, 13 non-pregnant women with previous depressive episodes, and 20 non-pregnant healthy). Participants took part in an emotional encoding task consisting of positive, negative, and neutral images from the International Affective Picture System (IAPS) where they were asked to rate these images based on perceived emotional intensity. Participants returned a week later for a surprise incidental recognition memory task. A multivariate general linear model revealed a significant main effect of group (F(1,71)= 8.04, p=.01). Women with history of MDD demonstrated poorer memory performance than women with no history for negative images, but the two groups did not<br />differ on memory for positive images. This suggests that having a history of depression selectively impaired the memory recognition of negative images.</p> / Master of Science (MSc)

PDSE are common (19.6%) in the local stroke population. Both premorbid factors as well as stroke-related factors contribute to the development of PRSD and PSDE. The application of different diagnostic criteria for PSDE will affect the frequency and the associated radiological characteristics. As regards the screening methods of PSDE, a more specific instrument should supplement the IQCODE or MDRS-IP in a two-stage screening procedure. / PSD is also common (16--17%) among local stroke survivors. Both psychosocial factors and the location of cerebrovascular lesions play an important role in the development of PSD. PSD in local Chinese seems to have a favorable short-term outcome in comparison with their Caucasian counterparts. With regard to the screening of PSD in Chinese, we found that both the GDS and HADS depression subscale have a satisfactory response rate and accuracy in detecting PSD. However, due to the relative low frequency of PSD in the local stroke population, a more specific instrument should supplement the GDS in a two-stage screening procedure. Finally, the familiarity of the rater with the subjects based on a preexisting therapeutic relationship did not influence the accuracy of screening for PSD in Chinese patients. / There has been a paucity of data on the frequency, clinical correlates and methods of screening of poststroke dementia (PSDE) and depression (PSD) in Chinese populations. The objective of this thesis is to examine the prevalence, diagnostic criteria and clinical correlates of PSDE and PSD in Chinese stroke patients in Hong Kong. A series of studies were all carried out; the author of the thesis had interviewed all the subjects 1--3 months after their index stroke and made the diagnosis of dementia and depression according to the DSM-IV criteria. / Tang Wai Kwong. / "July 2005." / Adviser: Gabor S. Ungvari. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0177. / Thesis (M.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-191). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / School code: 1307.

Objective. Major depressive disorder (MDD) is a common condition following treatment in the Intensive Care Unit (ICU). Long-term data on MDD in chronically critically ill (CCI) patients are scarce. Hence, the primary aim of the present study was to investigate the frequency and predictors of MDD after intensive care of CCI patients. Materials and Methods. In a prospective cohort study, patients with long-term mechanical ventilation requirements () were assessed with respect to a diagnosis of MDD, using the Structured Clinical Interview for DSM-IV, three and six months after the transfer from acute ICU to post-acute ICU. Sociodemographic, psychological, and clinical risk factors with values ≤ 0.1 were identified in a univariate logistic regression analysis and entered in a multivariable logistic regression model. A mediator analysis was run using the bootstrapping method, testing the mediating effect of perceived helplessness during the ICU stay, between the recalled traumatic experience from the ICU and a post-ICU MDD. Results. 17.6% () of the patients showed a full- or subsyndromal MDD. Perceived helplessness, recalled experiences of a traumatic event from the ICU, symptoms of acute stress disorder, and the diagnosis of posttraumatic stress disorder (PTSD) after ICU could be identified as significant predictors of MDD. In a mediator analysis, perceived helplessness could be proved as a mediator. Conclusions. Every fifth CCI patient suffers from MDD up to six months after being discharged from ICU. Particularly, perceived helplessness during the ICU stay seems to mainly affect the long-term evolvement of MDD. CCI patients with symptoms of acute stress disorder/PTSD should also be screened for MDD.