This study aimed to examine the independent roles of various childhood maltreatment (CM) subtypes in the development of depression; quantify the joint mediation effect of social support and mastery in the association between subtypes of CM and depression and examine the additional contribution of mastery beyond the effect that is operating through social support to this relationship.

Data analysed were from the Zone d’Épidémiologie Psychiatrique du Sud-Ouest de Montréal, an ongoing longitudinal population-based study. In total, 1351 participants with complete information on the studied variables were included. The propensity score matching and inverse-probability weighted regression adjustment estimation methods were used to minimise the potential confounding in the relationship between CM and major depression. We then used inverse odds ratio-weighted estimation to estimate the direct effects of maltreatment and indirect effects of social support and mastery.

We found that exposures to all maltreatment subtypes increased the risk of subsequent depression. The joint mediating effect of social support and mastery explained 37.63–46.97% of the association between different maltreatment subtypes and depression. The contribution of these two mediators differed by maltreatment subtypes, with social support being the major contributor to the mediating effect.

The findings of the study not only provide scientific evidence on the importance of psychosocial attributes in the development of major depression but also suggest that prevention and invention strategies should focus on these psychosocial attributes to effectively break the vicious cycle of CM on major depression.

Early-life stressful circumstances (i.e. childhood maltreatment) coupled with stressful events later in life increase the likelihood of subsequent depression. However, very few studies have been conducted to examine the specific and cumulative effects of these stressors in the development of depression. There is also a paucity of research that simultaneously considers the role of biological factors combined with psychosocial stressors in the aetiology of depression. Guided by the biopsychosocial model proposed by Engel, the present study aims to examine to what extent the experience of stressors across the lifespan is associated with depression while taking into account the role of genetic predispositions.

Data analysed were from the Social and Psychiatric Epidemiology Catchment Area of the Southwest of Montreal (ZEPSOM), a large-scale, longitudinal community-based cohort study. A total of 1351 participants with complete information on the lifetime diagnoses of depression over a 10-year follow-up period were included in the study. Stressful events across the lifespan were operationalised as specific, cumulative and latent profiles of stressful experiences. Latent profile analysis (LPA) was used to explore the clustering of studied stressors including childhood maltreatment, poor parent–child relationship, and stressful life events. A polygenetic risk score was calculated for each participant to provide information on genetic liability. Multivariate logistic regression was used to examine the association between specific, cumulative and latent profiles of stressors and subsequent depression.

We found that different subtypes of childhood maltreatment, child–parent bonding and stressful life events predicted subsequent depression. Furthermore, a significant association between combined effects of cumulative stressful experiences and depression was found [odds ratio (OR) = 1.20, 95% confidence interval (CI): 1.12–1.28]. Three latent profiles of lifetime stressors were identified in the present study and named as ‘low-level of stress’ (75.1%), ‘moderate-level of stress’ (6.8%) and ‘high-level of stress’ (18.1%). Individuals with a ‘high-level of stress’ had a substantially higher risk of depression (OR = 1.80, 95% CI: 1.08–3.00) than the other two profiles after adjusting for genetic predispositions, socio-demographic characteristics, and health-related factors.

While controlling for genetic predispositions, the present study provides robust evidence to support the independent and cumulative as well as compositional effects of early- and later-on lifetime psychosocial stressors in the subsequent development of depression. Consequently, mental illness prevention and mental health promotion should target the occurrence of stressful events as well as build resilience in people so they can better cope with stress when it inevitably occurs.

Identifying an objective, laboratory-based diagnostic tool (e.g. changes in gene expression), when used in conjunction with disease-specific clinical assessment, could increase the accuracy of the effectiveness of a therapeutic intervention.

We assessed the association between treatment outcome and blood RNA expression before the therapeutic intervention to post-treatment (after 1 year) of five autism spectrum disorder (ASD) toddlers who underwent an intensive cognitive-behavioural intervention integrated with psychomotor and speech therapy.

We found 113 significant differentially expressed genes enriched for the nervous system, immune system, and transcription and translation-related pathways. Some of these genes, as MALAT-1, TSPO, and CFL1, appear to be promising candidates.

Our findings show that changes in peripheral gene expression could be used in conjunction with clinical scales to monitor a rehabilitation intervention’s effectiveness in toddlers affected by ASD. These results need to be validated in a larger cohort.

Antidepressant medication and interpersonal psychotherapy (IPT) are both recommended interventions in depression treatment guidelines based on literature reviews and meta-analyses. However, ‘conventional’ meta-analyses comparing their efficacy are limited by their reliance on reported study-level information and a narrow focus on depression outcome measures assessed at treatment completion. Individual participant data (IPD) meta-analysis, considered the gold standard in evidence synthesis, can improve the quality of the analyses when compared with conventional meta-analysis.

We describe the protocol for a systematic review and IPD meta-analysis comparing the efficacy of antidepressants and IPT for adult acute-phase depression across a range of outcome measures, including depressive symptom severity as well as functioning and well-being, at both post-treatment and follow-up (PROSPERO: CRD42020219891).

We will conduct a systematic literature search in PubMed, PsycINFO, Embase and the Cochrane Library to identify randomised clinical trials comparing antidepressants and IPT in the acute-phase treatment of adults with depression. We will invite the authors of these studies to share the participant-level data of their trials. One-stage IPD meta-analyses will be conducted using mixed-effects models to assess treatment effects at post-treatment and follow-up for all outcome measures that are assessed in at least two studies.

This will be the first IPD meta-analysis examining antidepressants versus IPT efficacy. This study has the potential to enhance our knowledge of depression treatment by comparing the short- and long-term effects of two widely used interventions across a range of outcome measures using state-of-the-art statistical techniques.

Results of a co-morbid insomnia and depression study of eszopiclone and fluoxetine demonstrated that co-therapy produced greater improvements in sleep and depression than fluoxetine monotherapy. To determine if changes in the HAMD17 were due to sleep, individual HAMD17 items were evaluated.

Patients met DSM-IV criteria for MDD and insomnia, with screening HAMD17 >14. All patients received fluoxetine QAM for 10 weeks, and randomly received double-blind eszopiclone 3mg or placebo QHS for 8 weeks, followed by a single-blind placebo 2-week run-out. HAMD17 was completed at Weeks 4, 8, and 10. Individual items were compared with ANCOVA using an LOCF approach.

Mean baseline HAMD17 scores were 22 for each group. At Week 4, differences were noted between treatment groups in the total score, and the individual items of insight, the three insomnia items (p<0.02 vs monotherapy), with a trend for guilt (p=0.07). At Week 8, significant differences between groups were noted in total score (p=0.0005), in the clinician-administered Bech subscale (p<0.001), in the three insomnia items (p<0.001), guilt, work/activities, and anxiety psychic (p<0.05). At Week 10, the total score, guilt, the three insomnia items, work/activities, retardation, agitation, anxiety psychic, general somatic symptoms, and hypochondriasis demonstrated significant improvements (p<0.05 vs monotherapy) despite discontinuation of eszopiclone.

Eszopiclone/fluoxetine co-therapy resulted in significant improvements in the insomnia items of the HAMD17. In addition, several items related to core depressive symptoms were also improved with co-therapy compared with monotherapy.

Support for this study provided by Sepracor Inc.

We investigated the impact of eszopiclone 3mg on next day driving ability (on-the-road brake-reaction-time, BRT) and cognitive and psychomotor performance in patients with primary insomnia.

Patients with DSM-IV primary insomnia completed this study. Treatment was administered 30min before bedtime, and next day driving ability was assessed by on-the-road BRT approximately 9.5 hours postdose. A cognitive test battery measured residual effects on information processing, divided attention, psychomotor tasks, and working memory. Overnight polysomnography was conducted to assess sleep architecture; subjective ratings of morning sedation and sleep quality were also obtained.

There were no significant differences in BRT following night time administration of eszopiclone 3mg compared with placebo (p=0.39) and there were no significant differences in objective cognitive tests of information processing, divided attention, psychomotor tasks and working memory (p values>0.15). No significant effect on subjective next day ratings of morning sedation, coordination or mood was observed (p values>0.22). There was improvement compared with placebo (p<0.0001) in subjective ease of getting to sleep and quality of sleep the morning following dosing, and no perceived impairment of behavior following awakening or early morning awakenings. Polysomnography demonstrated significant improvements in sleep onset and maintenance.

In this study, the first to assess next day on-the-road driving in primary insomniacs following hypnotic use, eszopiclone 3mg improved both objective and subjective measures of sleep onset and maintenance without residual impairments on next day driving ability or cognitive and psychomotor performance.

Support for this study provided by Sepracor Inc., Marlborough, MA.

The aim of this study is identifying the predictors of major depression and anxiety disorders and the predictors of the remission of these disorders.

A longitudinal study under the form of a community survey includes a randomly selected sample of 2,434 individuals between 15 and 65 years of age (T1); 1,815 agreed to be re-interviewed two years later (T2). Mental disorders were identified with the Composite International Diagnostic Interview, including mood disorders (major depression, and mania), and some anxiety disorders: panic disorder (PD), social phobia (SP), and agoraphobia (AG). Logistic regression was used to identify predictors (T1) of remission of mood disoders and anxiety disorders at T2 and predictor of new cases at T2.

The prevalence of mental disorders for the two waves of the research program will be presented. For major depression (MD), among the 145 subjects who had MD at T1, 69% recovered at T2 and among the 1553 that did not have MD at T1, 5.7% developed MD at T2. For anxiety disorders, among the 93 subjects who had these disorders at T1, 78.4% recovered at T2 and among the 1635 subjects who were free of an anxiety disorder at T1, 1.8% developed it at T2. Predictors identified for remission of disorders and for developing new disorders at T2 will be presented.

The predictors of new cases identified will allow to develop more effective prevention program and those associated to remissions will help to improve mental health services.