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Sharpley CF, Bitsika V, Arnold WM, Shadli SM, Jesulola E, Agnew LL. Network analysis of frontal lobe alpha asymmetry confirms the neurophysiological basis of four subtypes of depressive behavior. Front Psychiatry 2023; 14:1194318. [PMID: 37448489 PMCID: PMC10336204 DOI: 10.3389/fpsyt.2023.1194318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/13/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Although depression is widespread carries a major disease burden, current treatments remain non-universally effective, arguably due to the heterogeneity of depression, and leading to the consideration of depressive "subtypes" or "depressive behavior subtypes." One such model of depressive behavior (DB) subtypes was investigated for its associations with frontal lobe asymmetry (FLA), using a different data analytic procedure than in previous research in this field. Methods 100 community volunteers (54 males, 46 females) aged between 18 yr. and 75 years (M = 32.53 yr., SD = 14.13 yr) completed the Zung Self-rating Depression Scale (SDS) and underwent 15 min of eyes closed EEG resting data collection across 10 frontal lobe sites. DB subtypes were defined on the basis of previous research using the SDS, and alpha-wave (8-13 Hz) data produced an index of FLA. Data were examined via network analysis. Results Several network analyses were conducted, producing two models of the association between DB subtypes and FLA, confirming unique neurophysiological profiles for each of the four DB subtypes. Discussion As well as providing a firm basis for using these DB subtypes in clinical settings, these findings provide a reasonable explanation for the inconsistency in previous FLA-depression research.
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Affiliation(s)
| | - Vicki Bitsika
- Brain-Behavior Research Group, University of New England, Armidale, NSW, Australia
| | - Wayne M Arnold
- Brain-Behavior Research Group, University of New England, Armidale, NSW, Australia
| | - Shabah M Shadli
- Brain-Behavior Research Group, University of New England, Armidale, NSW, Australia
| | - Emmanuel Jesulola
- Brain-Behavior Research Group, University of New England, Armidale, NSW, Australia
| | - Linda L Agnew
- Brain-Behavior Research Group, University of New England, Armidale, NSW, Australia
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Groarke A, Curtis R, Skelton J, Groarke JM. Quality of life and adjustment in men with prostate cancer: Interplay of stress, threat and resilience. PLoS One 2020; 15:e0239469. [PMID: 32941547 PMCID: PMC7498057 DOI: 10.1371/journal.pone.0239469] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/04/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Diagnosis and treatment of prostate cancer can generate many challenges which impact on adjustment, so understanding the psychosocial factors which contribute to individual vulnerability to poor adaptation warrants further investigation. This study investigates stress and masculine identity threat as predictors of quality of life and emotional adjustment in men with localized prostate cancer and the role of resilience as a potential protective psychological factor. METHODS Participants were invited to complete a survey study via online prostate cancer forums. Participants were 204 men ranging in age from 44-88 years (M = 65.24±7.51) and who were diagnosed with early localized prostate cancer within the previous five years. Measures used included the Perceived Stress Scale, Cancer-Related Masculine Threat Scale and the Conor-Davidson Resilience Scale. Using a cross-sectional online survey design, the extent to which perceived stress, masculine threat and psychological resilience are associated with quality of life, positive and negative affect and distress was assessed. RESULTS Hierarchical regression analysis demonstrated that perceived stress accounted for 26%-44% of variance on quality of life and adjustment indices, with high stress associated with low mood and poor quality of life. Low masculine threat and high resilience predicted better quality of life and emotional adjustment accounting for between 1-7% of the variance. Resilience moderated the relationship between stress and distress and mediated the association between masculine threat and distress and negative affect. CONCLUSION Perceived stress was the most powerful predictor in the model and findings suggest it contributes significantly to functional and affective status in survivors of prostate cancer. Psychological resilience is a protective factor which buffers the negative effect of stress and masculine identity threat on emotional adjustment. Findings indicate that men should be screened as part of the diagnostic and treatment process for high perceived stress and low resilience to identify those at risk for poor adjustment during survivorship.
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Affiliation(s)
- AnnMarie Groarke
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Ruth Curtis
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jean Skelton
- School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Jenny M. Groarke
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Dimensions of Depressive Symptoms and Their Association With Mortality, Hospitalization, and Quality of Life in Dialysis Patients: A Cohort Study. Psychosom Med 2019; 81:649-658. [PMID: 31232914 PMCID: PMC6727937 DOI: 10.1097/psy.0000000000000723] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE Unraveling specific dimensions of depressive symptoms may help to improve screening and treatment in dialysis patients. We aimed to identify the best-fitting factorial structure for the Beck Depression Inventory-II (BDI) in dialysis patients and to assess the relation of these structure dimensions with quality of life (QoL), hospitalization, and mortality. METHODS This prospective study included chronic dialysis patients from 10 dialysis centers in five hospitals between 2012 and 2017. Dimensions of depressive symptoms within the BDI were analyzed using confirmatory factor analysis. To investigate the clinical impact of these dimensions, the associations between symptom dimensions and QoL, hospitalization rate, and mortality were investigated using logistic, Poisson, and Cox proportional hazard regression models. Multivariable regression models included demographic, social, and clinical variables. RESULTS In total, 687 dialysis patients were included. The factor model that included a general and a somatic factor provided the best-fitting structure of the BDI-II. Only the somatic dimension scores were associated with all-cause mortality (hazard ratio of 1.7 [1.2-2.5], p < .007) in the multivariable model. All dimensions were associated with increased hospitalization rate and reduced QoL. CONCLUSIONS The somatic dimension of the BDI-II in dialysis patients was associated with all-cause mortality, increased hospitalization rate, and reduced QoL. Other dimensions were associated with hospitalization rate and decreased QoL. These findings show that symptom dimensions of depression have differential association with adverse clinical outcomes. Future studies should take symptom dimensions into account when investigating depression-related pathways, screening, and treatment effects in dialysis patients.
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Depressive Symptom Clusters and Their Relationships With Anxiety and Posttraumatic Stress Disorder Symptoms in Patients With Cancer. Cancer Nurs 2018; 42:388-395. [DOI: 10.1097/ncc.0000000000000624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rice SM, Oliffe JL, Kelly MT, Cormie P, Chambers S, Ogrodniczuk JS, Kealy D. Depression and Prostate Cancer: Examining Comorbidity and Male-Specific Symptoms. Am J Mens Health 2018; 12:1864-1872. [PMID: 29957106 PMCID: PMC6199440 DOI: 10.1177/1557988318784395] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Depression in men with prostate cancer is a significant and complex issue that can challenge clinicians’ diagnostic efforts. The objective of the current study was to evaluate prototypic and male-specific depression symptoms and suicidal ideation in men with a diagnosis of prostate cancer relative to those with and without comorbidity. The Patient Health Questionnaire-9 (PHQ-9) and Male Depression Risk Scale-22 (MDRS-22) were completed online along with demographic and background variables by 100 men with a diagnosis of prostate cancer (n = 54 prostatectomy, n = 33 receiving active treatment). Hierarchical logistic regression was used to examine recent (past 2 weeks) suicide ideation. Over one-third of the sample (38%) reported a comorbidity, and this group had significantly higher total depression scores on the PHQ-9 (Cohen’s d = 0.65), MDRS-22 emotion suppression (d = 0.35), and drug use subscales (d = 0.38) compared to respondents without comorbidity. A total of 14% reported recent suicidal ideation, of which 71.4% of cases were identified by the PHQ-9 “moderate” cut-off, and 85.7% of cases were identified by the MDRS-22 “elevated” cut-off. After control variables, MDRS-22 subscales accounted for 45.1% of variance in recent suicidal ideation. While limited by the exclusive use of self-report data, findings point to the potential benefits of evaluating male-specific symptoms as part of depression and suicide risk screening in men with prostate cancer and the need to be mindful of the heightened risk for depression among men with prostate cancer who have comorbidity.
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Affiliation(s)
- Simon M Rice
- 1 Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Australia
| | - John L Oliffe
- 3 School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Mary T Kelly
- 3 School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Prue Cormie
- 4 Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,5 Exercise Medicine Research Institute, Edith Cowan University, Perth, Australia
| | - Suzanne Chambers
- 6 Cancer Research Centre, Cancer Council Queensland, Brisbane, Queensland, Australia.,7 Prostate Cancer Foundation of Australia, Sydney, New South Wales, Australia.,8 Health & Wellness Institute, Edith Cowan University, Perth, Western Australia.,9 Institute for Resilient Regions, University of Southern Queensland, Australia.,10 Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - John S Ogrodniczuk
- 11 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - David Kealy
- 11 Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Sharpley C, Bitsika V, Christie D, Bradford R, Steigler A, Denham J. Total depression and subtypes in prostate cancer survivors 10 years after treatment. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12630] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 12/28/2022]
Affiliation(s)
- C.F. Sharpley
- Brain-Behaviour Research Group; University of New England; Armidale NSW Australia
| | - V. Bitsika
- Centre for Autism Spectrum Disorders; Bond University; Robina Qld Australia
| | - D.R.H. Christie
- Brain-Behaviour Research Group; University of New England; Armidale NSW Australia
- Genesiscare; Tugun Qld Australia
| | - R. Bradford
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
| | - A. Steigler
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
| | - J.W. Denham
- School of Medicine & Public Health; University of Newcastle; Callaghan NSW Australia
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Sharpley CF, Bitsika V, Jesulola E, Fitzpatrick K, Agnew LL. The association between aspects of psychological resilience and subtypes of depression: implications for focussed clinical treatment models. Int J Psychiatry Clin Pract 2016; 20:151-6. [PMID: 27332989 DOI: 10.1080/13651501.2016.1199810] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of this study was to explore the association between Psychological Resilience (PR) and depression at global, dichotomous and subcomponent levels. METHODS A sample of 330 participants (117 males and 213 females) was randomly recruited from an electorate in Australia and completed the Zung Self-rating Depression Scale (SDS) and Connors-Davidson Resilience Scale (CDRISC). RESULTS PR was significantly and inversely associated with total SDS score at a global level. Only one of the three CDRISC factors was significantly associated with total SDS score and also with three of four SDS depression subtypes. CONCLUSIONS Because of the different nature and treatment requirements for depression subtypes, PR may be applicable to a limited range of depressed patients, particularly those who do not exhibit Anhedonia.
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Affiliation(s)
- Christopher F Sharpley
- a Brain-Behaviour Research Group , University of New England , Armidale , Australia ;,b Centre for Autism Spectrum Disorders , Bond University , Gold Coast , Australia
| | - Vicki Bitsika
- b Centre for Autism Spectrum Disorders , Bond University , Gold Coast , Australia
| | - Emmanuel Jesulola
- a Brain-Behaviour Research Group , University of New England , Armidale , Australia
| | - Kerry Fitzpatrick
- a Brain-Behaviour Research Group , University of New England , Armidale , Australia
| | - Linda L Agnew
- a Brain-Behaviour Research Group , University of New England , Armidale , Australia
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Zhu L, Ranchor AV, van der Lee M, Garssen B, Sanderman R, Schroevers MJ. Subtypes of depression in cancer patients: an empirically driven approach. Support Care Cancer 2015; 24:1387-96. [PMID: 26341521 PMCID: PMC4729814 DOI: 10.1007/s00520-015-2919-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 08/18/2015] [Indexed: 12/03/2022]
Abstract
Purpose This study aimed to (1) identify subgroups of cancer patients with distinct subtypes of depression before the start of psychological care, (2) examine whether socio-demographic and medical characteristics distinguished these subtypes, and (3) examine whether people with distinct subtypes reported differential courses of depression during psychological care. Method This naturalistic, longitudinal study included cancer patients who sought psychological care at specialized psycho-oncology institutions in the Netherlands. Data were collected before psychological care (T1) and three (T2) and nine (T3) months thereafter. Latent class analysis was performed to identify depression subtypes in 243 patients at T1. Results Before starting psychological care, three depressive subtypes were identified, differing in severity and type of symptoms. Class 1 (47 %) with mild depression reported mostly concentration and sleep problems and fatigue. Class 2 (41 %), with slightly higher levels of depression, reported similar concentration and sleep problems and fatigue as class 1, and additionally depressed mood. Class 3 (12 %), with severe depression, reported mainly a depressed mood and, to a lesser extent but still elevated, fatigue and concentration problems. None of socio-demographic and medical characteristics significantly distinguished these subtypes. These subtypes significantly predicted the course of depression over time, with class 1 reporting moderate improvements, class 2 large improvements, and class 3 the largest improvements. Conclusions Results indicate the presence of three subtypes of depression in cancer patients before starting psychological care. Our findings suggest that psychological interventions could be tailored to respond to the specific subtype of depression experienced by each individual.
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Affiliation(s)
- Lei Zhu
- Department of Health Psychology, University Medical Centre Groningen, University of Groningen, POB 196, A. Deusinglaan 1, 9700AD, Groningen, The Netherlands
| | - Adelita V Ranchor
- Department of Health Psychology, University Medical Centre Groningen, University of Groningen, POB 196, A. Deusinglaan 1, 9700AD, Groningen, The Netherlands
| | - Marije van der Lee
- Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
| | - Bert Garssen
- Helen Dowling Institute, Centre for Psycho-Oncology, Bilthoven, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Centre Groningen, University of Groningen, POB 196, A. Deusinglaan 1, 9700AD, Groningen, The Netherlands.,Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Maya J Schroevers
- Department of Health Psychology, University Medical Centre Groningen, University of Groningen, POB 196, A. Deusinglaan 1, 9700AD, Groningen, The Netherlands.
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Assareh AA, Sharpley CF, McFarlane JR, Sachdev PS. Biological determinants of depression following bereavement. Neurosci Biobehav Rev 2014; 49:171-81. [PMID: 25541460 DOI: 10.1016/j.neubiorev.2014.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 11/13/2014] [Accepted: 12/07/2014] [Indexed: 12/28/2022]
Abstract
There is considerable variability among people in their response to bereavement. While most people adapt well to bereavement, some develop exaggerated and/or pathological responses and may meet criteria for a major depressive episode. Many studies have investigated the effect of psychosocial factors on bereavement outcome but biological factors have not received much attention, hence the focus of this paper. The biological factors studied to date in relation to bereavement outcomes include genetic polymorphisms, neuroendocrine factors, and immunologic/inflammatory markers. In addition, animal studies have shown the alterations of brain neurotransmitters as well as changes in the plasma levels of the neurotrophic growth factors under the influence of peer loss. Recent studies have also investigated the biological basis of stress resilience, and have found a few genetic polymorphisms and potential biomarkers as protective factors in the face of adversity. Longitudinal studies that include data collection prior to, and also after, bereavement and which chart both biological and psychological measures are needed to develop profiles for the prediction of response to bereavement and personalised interventions.
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Affiliation(s)
- Amelia A Assareh
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia.
| | - Christopher F Sharpley
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia; Brain-Behaviour Research Group, University of New England, Armidale, Australia
| | - James R McFarlane
- Collaborative Research Network for Mental Health and Well-being, University of New England, Armidale, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
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Sharpley CF, Bitsika V, Christie DRH, Denham JW, Duchesne GM, Couper JW. Researching Depression in Prostate Cancer Patients: Factors, Timing, and Measures. JOURNAL OF MENS HEALTH 2014. [DOI: 10.1089/jomh.2014.0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Sharpley CF, Bitsika V, Wootten AC, Christie DRH. Differences in major depressive disorder and generalised anxiety disorder symptomatology between prostate cancer patients receiving hormone therapy and those who are not. Psychooncology 2014; 23:1350-5. [PMID: 24789575 DOI: 10.1002/pon.3566] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Revised: 03/30/2014] [Accepted: 04/07/2014] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The aim of this study is to explore the associations between hormone treatment variables and depression, and the nature of depression in prostate cancer (PCa) patients by comparing the severity and symptom profile of anxiety and depression in men who were currently receiving hormone therapy (HT) versus those who were not. METHOD Self-reports of anxiety and depression on standardized scales of GAD and major depressive disorder (MDD) were collected from 156 PCa patients across two recruitment sites in Australia. Patients who were currently receiving HT were compared with patients not receiving HT for their severity and symptom profiles on GAD and MDD. RESULTS Participants receiving HT had significantly higher GAD and MDD total scores than patients who were not receiving HT. In addition, the symptom profiles of these two HT subgroups were differentiated by significantly higher scores on the key criteria for GAD and MDD plus fatigue and sleeping difficulties but not the remaining symptoms of GAD and MDD. However, there were no significant differences between HT subgroups for the degree of functional impairment experienced by these symptoms. CONCLUSION Although these data confirm the association between HT and anxiety/depression, the range of GAD and MDD symptoms influenced is relatively restricted. Moreover, functional ability does not appear to be impaired by HT. These findings clarify the ways in which HT affects PCa patients and suggests that a simple total scale score for anxiety and depression may not be as helpful in designing treatment as consideration of the symptomatic profiles of PCa patients receiving HT.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia; Centre for Autism Spectrum Disorders, Bond University, Robina, Queensland, Australia
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Differences in neurobiological pathways of four "clinical content" subtypes of depression. Behav Brain Res 2013; 256:368-76. [PMID: 23994546 DOI: 10.1016/j.bbr.2013.08.030] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/16/2013] [Accepted: 08/19/2013] [Indexed: 12/21/2022]
Abstract
Although often considered as a mental disorder, depression is best described as a behavioral-neurobiological phenomenon. In addition, although usually reported as a unitary diagnosis, major depressive episode is composed of a range of different symptoms that can occur in nearly 1500 possible combinations to fulfill the required diagnostic criterion. To investigate and describe the underlying behavioral and neurobiological substrates of these symptoms, they were clustered into "clinical content" subtypes of depression according to their predominant common behavioral characteristics. These subtypes were then found to possess different neurobiological pathways that argue for different treatment approaches.
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