To date, there are no biomarkers for major depressive disorder (MDD) treatment response in clinical use. Such biomarkers could allow for individualized treatment selection, reducing time spent on ineffective treatments and the burden of MDD. In search of such a biomarker, multisite pretreatment and early-treatment (1 week into treatment) structural magnetic resonance (MR) images were acquired from 184 patients with MDD randomized to an 8-week trial of the selective serotonin reuptake inhibitor (SSRI) sertraline or placebo. This study represents a large, multisite, placebo-controlled effort to examine the association between pretreatment differences or early-treatment changes in cortical thickness and treatment-specific outcomes. For standardization, a novel, robust site harmonization procedure was applied to structural measures in a priori regions (rostral and caudal anterior cingulate, lateral orbitofrontal, rostral middle frontal, and hippocampus), chosen based on previously published reports. Pretreatment cortical thickness or volume did not significantly associate with SSRI response. Thickening of the rostral anterior cingulate cortex in the first week of treatment was associated with better 8-week responses to SSRI (p = 0.010). These findings indicate that frontal lobe structural alterations in the first week of treatment may be associated with long-term treatment efficacy. While these associational findings may help to elucidate the specific neural targets of SSRIs, the predictive accuracy of pretreatment or early-treatment structural alterations in classifying treatment remitters from nonremitters was limited to 63.9%. Therefore, in this large sample of adults with MDD, structural MR imaging measures were not found to be clinically translatable biomarkers of treatment response to SSRI or placebo.

The results suggest that postpartum depression is a heterogeneous entity and that misdiagnosis of bipolar disorder in the postpartum period may be quite common. The findings have important clinical implications, which include the need for early detection of bipolarity through the use of reliable and valid assessment instruments, and implementation of appropriate prevention and treatment strategies.

Background Postpartum depression (PPD) is a neglected area of maternal health care in developing countries like Nepal; not only in the treatment aspect, but also, in the areas of research. However, it is important to identify and treat postpartum depression because it can have grave consequences for both the mother and her children.Objective To determine the screening prevalence and risk factors of postpartum depression, among women who deliver at university hospital Nepal.Method This is a cross-sectional study investigating the relationship between postpartum depression and various factors. A total of 100 postpartum women who presented to a Dhulikhel hospital for delivery were interviewed on days 2-3 after delivery. The mothers were administered Edinburgh Postnatal Depression Scale (EPDS) as well as a proforma that included questions about the known risk factors (sociodemographic and sociocultural factors, and mother-related, pregnancy-related, and child related factors).Result The overall screening prevalence of depressive symptoms in the postnatal period (defined as EPDS=>13) was 29 %( 95% CI 20.1%-37.8%). On univariate analysis (chi square test), postpartum depression was significantly associated with pregnancy complications (p<0.01), infant’s health problems (p <0.001) and vaginal delivery (p <0.05).Conclusion Postpartum depression is common among Nepalese women and can be detected early in the postpartum periods; and many psychosocial factors like pregnancy complications, infant’s health problems and vaginal delivery are associated with it. It is recommended that mothers with high risk should be routinely screened for postpartum depression.Kathmandu University Medical Journal Vol.13(1) 2015; 44-48

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In this observational study, treatment with LI, but not with ICS, appears to improve disease control, as evidenced by the reduction in the incidence of ED visits and hospitalizations in patients on LI. Savings generated by this reduction in high-cost events don't offset the increased payments for drugs in more adherence patients, except for selected high-risk patients.