TY  - JOUR
AB  - BACKGROUND: Dysfunctional depressogenic cognitions are considered a key factor in the etiology and maintenance of depression. In cognitive behavioral therapy (CBT), the current gold-standard psychotherapeutic treatment for depression, cognitive restructuring techniques are employed to address dysfunctional cognitions. However, high drop-out and non-response rates suggest a need to boost the efficacy of CBT for depression. This might be achieved by enhancing the role of emotional and kinesthetic (i.e., body movement perception) features of interventions. Therefore, we aim to evaluate the efficacy of a cognitive restructuring task augmented with the performance of anti-depressive facial expressions in individuals with and without depression. Further, we aim to investigate to what extent kinesthetic markers are intrinsically associated with and, hence, allow for the detection of, depression. METHODS: In a four-arm, parallel, single-blind, randomized controlled trial (RCT), we will randomize 128 individuals with depression and 128 matched controls without depression to one of four study conditions: (1) a cognitive reappraisal training (CR); (2) CR enhanced with instructions to display anti-depressive facial expressions (CR + AFE); (3) facial muscle training focusing on anti-depressive facial expressions (AFE); and (4) a sham control condition. One week after diagnostic assessment, a single intervention of 90-120-minute duration will be administered, with a subsequent follow-up two weeks later. Depressed mood will serve as primary outcome. Secondary outcomes will include current positive mood, symptoms of depression, current suicidality, dysfunctional attitudes, automatic thoughts, emotional state, kinesthesia (i.e., facial expression, facial muscle activity, body posture), psychophysiological measures (e.g., heart rate (variability), respiration rate (variability), verbal acoustics), as well as feasibility measures (i.e., treatment integrity, compliance, usability, acceptability). Outcomes will be analyzed with multiple methods, such as hierarchical and conventional linear models and machine learning. DISCUSSION: If shown to be feasible and effective, the inclusion of kinesthesia into both psychotherapeutic diagnostics and interventions may be a pivotal step towards the more prompt, efficient, and targeted treatment of individuals with depression. TRIAL REGISTRATION: The study was preregistered in the Open Science Framework on August 12, 2022 ( https://osf.io/mswfg/ ) and retrospectively registered in the German Clinical Trials Register on November 25, 2024. CLINICAL TRIAL NUMBER: DRKS00035577.
AU  - Keinert, M.*
AU  - Schindler-Gmelch, L.*
AU  - Rupp, L.H.*
AU  - Sadeghi, M.*
AU  - Capito, K.*
AU  - Hager, M.*
AU  - Rahimi, F.*
AU  - Richer, R.*
AU  - Egger, B.*
AU  - Eskofier, B.M.
AU  - Berking, M.*
C1  - 72752
C2  - 56738
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Facing depression: Evaluating the efficacy of the EmpkinS-EKSpression reappraisal training augmented with facial expressions - protocol of a randomized controlled trial.
JO  - BMC Psychiatry
VL  - 24
IS  - 1
PB  - Bmc
PY  - 2024
SN  - 1471-244X
ER  - 

TY  - JOUR
AB  - BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9) has been proposed as a reliable and valid screening instrument for depressive symptoms with one latent factor. However, studies explicitly testing alternative model structures found support for a two-dimensional structure reflecting a somatic and a cognitive-affective dimension. We investigated the bidimensional structure of the PHQ-9, with a somatic (sleeping problems, fatigability, appetitive problems, and psychomotor retardation) and a cognitive-affective dimension (lack of interest, depressed mood, negative feelings about self, concentration problems, and suicidal ideation), and tested for sex- and regional-differences. METHODS: We have included data from the GEnder-Sensitive Analyses of mental health trajectories and implications for prevention: A multi-cohort consortium (GESA). Privacy-preserving analyses to provide information on the overall population and cohort-specific information and analyses of variance to compare depressive, somatic and cognitive-affective symptoms between sexes and cohorts were executed in DataSHIELD. In order to determine the dimensionality and measurement invariance of the PHQ-9 we tested three models (1 factor, 2 correlated factors, and bifactor) via confirmatory analyses and performed multi-group confirmatory factor analysis. RESULTS: Differences between sex and cohorts exist for PHQ-9 and for both of its dimensions. Women reported depressive symptoms in general as well as somatic and cognitive-affective symptoms more frequently. For all tested models an acceptable to excellent fit was found, consistently indicating a better model fit for the two-factor and bifactor model. Scalar measurement invariance was established between women and men, the three cohorts, and their interaction. CONCLUSIONS: The two facets of depression should be taken into account when using PHQ-9, while data also render support to a general factor. Somatic and cognitive-affective symptoms assessed by the PHQ-9 can be considered equivalent across women and men and between different German populations from different regions.
AU  - Tibubos, A.N.*
AU  - Otten, D.*
AU  - Zöller, D.*
AU  - Binder, H.*
AU  - Wild, P.S.*
AU  - Fleischer, T.*
AU  - Johar, H.
AU  - Atasoy, S.
AU  - Schulze, L.*
AU  - Ladwig, K.H.*
AU  - Schomerus, G.*
AU  - Linkohr, B.
AU  - Grabe, H.J.*
AU  - Kruse, J.*
AU  - Schmidt, C.O.*
AU  - Münzel, T.*
AU  - König, J.*
AU  - Brähler, E.*
AU  - Beutel, M.E.*
C1  - 61936
C2  - 50348
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Bidimensional structure and measurement equivalence of the Patient Health Questionnaire-9: Sex-sensitive assessment of depressive symptoms in three representative German cohort studies.
JO  - BMC Psychiatry
VL  - 21
IS  - 1
PB  - Bmc
PY  - 2021
SN  - 1471-244X
ER  - 

TY  - JOUR
AB  - BackgroundDepressive symptoms are common in patients with coronary artery disease (CAD) and are associated with an unfavourable outcome. Establishing prognostic patient profiles prior to the beginning of mental health care may facilitate higher efficacy of targeted interventions. The aim of the current study was to identify sociodemographic and somatic predictors of depression outcome among depressed patients with CAD.MethodsBased on the dataset of the multicentre SPIRR-CAD randomised controlled trial (n=570 patients with CAD and8 points on the Hospital Anxiety and Depression Scale (HADS)), 141 potential sociodemographic and somatic predictors of the change in the HADS-D depression score from baseline to 18-month-follow-up were derived in two different ways. We screened for univariable association with response, using either analysis of (co)variance or logistic regression, respectively, both adjusted for baseline HADS-D value and treatment group. To guard against overfitting, multivariable association was evaluated by a linear or binomial (generalised) linear model with lasso regularisation, a machine learning approach. Outcome measures were the change in continuous HADS-D depression scores, as well as three established binary criteria. The Charlson Comorbidity Index (CCI) was calculated to assess possible influences of comorbidities on our results and was also entered in our machine learning approach.ResultsHigher age (p=0.002), unknown previous myocardial infarction (p=0.013), and a higher heart rate variability during numeracy tests (p=.020) were univariably associated with a favourable depression outcome, whereas hyperuricemia (p0.003), higher triglycerides (p=0.014), NYHA class III (p0.028), state after resuscitation (p0.042), intake of thyroid hormones (p=0.007), antidiabetic drugs (p=0.015), analgesic drugs (p=0.027), beta blockers (p=0.035), uric acid drugs (p0.039), and anticholinergic drugs (p=0.045) were associated with an adverse effect on the HADS-D depression score. In all analyses, no significant differences between study arms could be found and physical comorbidities also had no significant influence on our results.ConclusionOur findings may contribute to identification of somatic and sociodemographic predictors of depression outcome in patients with CAD. The unexpected effects of specific medication require further clarification and further research is needed to establish a causal association between depression outcome and our predictors.Trial registrationwww.clinicaltrials.govNCT00705965 (registered 27th of June, 2008).www.isrctn.comISRCTN76240576 (registered 27th of March, 2008).
AU  - Vitinius, F.*
AU  - Escherich, S.*
AU  - Deter, H.C.*
AU  - Hellmich, M.*
AU  - Jünger, J.*
AU  - Petrowski, K.*
AU  - Ladwig, K.-H.
AU  - Lambertus, F.*
AU  - Michal, M.*
AU  - Weber, C.*
AU  - de Zwaan, M.*
AU  - Herrmann-Lingen, C.*
AU  - Ronel, J.*
AU  - Albus, C.*
C1  - 55434
C2  - 46355
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Somatic and sociodemographic predictors of depression outcome among depressed patients with coronary artery disease - a secondary analysis of the SPIRR-CAD study.
JO  - BMC Psychiatry
VL  - 19
IS  - 1
PB  - Bmc
PY  - 2019
SN  - 1471-244X
ER  - 

TY  - JOUR
AB  - Background: Suicidal ideation is common in patients suffering from panic disorder. The present study investigated rates of suicidal ideation and risk factors for suicidal ideation in a sample of primary care patients suffering from panic disorder with or without agoraphobia.Methods: A total of N = 296 patients [n = 215 (72.6%) women; age: M = 43.99, SD = 13.44] were investigated. Anxiety severity, anxiety symptoms, avoidance behavior, comorbid depression diagnosis, severity of depression, age, sex, employment status, living situation and frequency of visits at the general practitioner were considered as risk factors of suicidal ideation.Results: Suicidal ideation was experienced by 25% of the respondents. In a logistic regression analysis, depression diagnosis and depression severity emerged as significant risk factors for suicidal ideation. Anxiety measures were not associated with suicidal ideation.Conclusion: Suicidal ideation is common in primary care patients suffering from panic disorder with or without agoraphobia. Individuals with greater burden of mental illness in terms of mood disorder comorbidity and depressive symptomatology are especially likely to suffer from suicidal ideation.
AU  - Teismann, T.*
AU  - Lukaschek, K.
AU  - Hiller, T.S.*
AU  - Breitbart, J.*
AU  - Brettschneider, C.*
AU  - Schumacher, U.*
AU  - Margraf, J.*
AU  - Gensichen, J.*
C1  - 54433
C2  - 45562
CY  - Campus, 4 Crinan St, London N1 9xw, England
TI  - Suicidal ideation in primary care patients suffering from panic disorder with or without agoraphobia.
JO  - BMC Psychiatry
VL  - 18
IS  - 1
PB  - Bmc
PY  - 2018
SN  - 1471-244X
ER  - 

TY  - JOUR
AB  - BACKGROUND: Periodic catatonia is a familial subtype of schizophrenia characterized by hyperkinetic and akinetic episodes, followed by a catatonic residual syndrome. The phenotype has been evaluated in two independent genome-wide linkage scans with evidence for a major locus on chromosome 15q15, and a second independent locus on chromosome 22qtel. METHODS: In the positional and brain-expressed candidate genes KIAA0767 and KIAA1646, we searched for variants in the complete exons and adjacent splice-junctions as well as in parts of the 5'- and 3'-untranslated regions by means of a systematic mutation screening in individuals from chromosome 22q-linked pedigrees. RESULTS: The mutation scan revealed 24 single nucleotide polymorphisms, among them two rare codon variants (KIAA0767: S159I; KIAA1646: V338G). However, both were neither found segregating with the disease in the respective pedigree nor found at a significant frequency in a case-control association sample. CONCLUSION: Starting from linkage signals at chromosome22qtel in periodic catatonia, we screened two positional brain-expressed candidate genes for genetic variation. Our study excludes genetic variations in the coding and putative promoter regions of KIAA0767 and KIAA1646 as causative factors for periodic catatonia.
AU  - Stöber, G.*
AU  - Kohlmann, B.*
AU  - Iekiera, M.*
AU  - Rubie, C.*
AU  - Gawlik, M.*
AU  - Möller-Ehrlich, K.*
AU  - Meitinger, T.
AU  - Bettecken, T.
C1  - 4798
C2  - 23064
TI  - Systematic mutation analysis of KIAA0767 and KIAA I646 in chromosome 22q-linked periodic catatonia.
JO  - BMC Psychiatry
VL  - 5
PY  - 2005
SN  - 1471-244X
ER  -