Here are half a dozen recent research papers on depression (all details & abstracts to these studies are given further down this blog posting).  Yonkers et al's publication is a very welcome one - "The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists."  At last here's a major review giving good advice on this extremely important subject.  To learn more it's worth getting hold of a copy of the complete text.  You may have access to this through your academic department.  If not, authors are usually happy to send a PDF via email when asked to - emails can be dug out via a little Google detective work.  Following the [Abstract/Full Text] link will also provide various access routes including a low-cost patient information option.  In further work looking at depression

Here are six recently published research papers.  Barnhofer and colleagues report on encouraging results using mindfulness-based cognitive therapy (MBCT) for sufferers from chronic-recurrent depression while they are still depressed.  The three major studies published already have used MBCT for recurrent depression while the sufferers are reasonably well.  The next step will clearly be a fuller randomized controlled trial.  Heeren and colleagues report on the how MBCT acts to reduce overgeneral autobiographical memoriy in formerly depressed patients. 

Archer and colleagues describe the successful development and assessment of a group-based cognitive behavioural intervention for sleep problems.  Participants' satisfaction ratings with the training were very high and there were very encouraging reductions in their sleep problems and depressive symptoms.  Morin and coworkers also report on CBT for sleep problems, this time singly or combined with sleep medication.  They concluded that "In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT."

This set of five papers documents, in part, our mixed viewpoints on depression.  Worryingly, Mehta & colleagues show deteriorating public attitudes towards mental illness in England (and to a lesser extent Scotland) between 1994 and 2003.  Meanwhile Blumner et al demonstrate a shift towards a more biological view on causes and treatment of depression in the US between 1996 and 2006.

In contrast, Miranda et al's editorial (and Grote et al's research) highlight the growing evidence showing psychotherapies for depression can be "very effective for low-income and minority populations in the United States and abroad" - extending their validity well beyond more privileged groups in developed countries.  Andersson too discusses a further way to make psychotherapies more widely available and helpful - in this case, the increasing literature documenting the widespread value of delivering cognitive behavioural therapy via the internet.     

Five of these six studies are from last month's American Journal of Psychiatry.  Kendler et al discuss the many similarities and only occasional differences between bereavement-related and other life event-related depression - an issue explored further in Maj's editorial.  Li et al show that depression in pregnancy (exacerbated further by stressful life events and obesity) increases the risk of preterm delivery.  Miklowitz reviews research on the value of adjunctive psychotherapy for bipolar disorder sufferers (already taking medication) and discusses the various ways it can be helpful.  Oquendo et al (in a freely viewable editorial) argue that suicidal behaviour should be placed on a "separate axis" in the next version of the DSM diagnostic system.  Finally Vertanen et al, in an interesting study, demonstrate that increased hospital overcrowding - measured by bed occupancy rates - is associated with increased use of antidepressants by hospital staff.

Kendler, K. S., J. Myers, et al. (2008). "Does Bereavement-Related Major Depression Differ From Major Depression Associated With Other Stressful Life Events?" Am J Psychiatry 165(11): 1449-1455.  [Abstract/Full Text]  

Here are a couple of studies on smoking, a couple on B vitamins, a couple on vitamin D, and an intriguing study on iron.  The smoking papers underline the varieties of damage this habit produces.  So the Pasco et al study shows that, for women, being a smoker is associated with double the risk of developing subsequent major depression.  The Strandberg research challenges any notion of "Eat, drink and be merry for tomorrow we die".  This study of 1658 men reports that "During the 26-year follow-up of this socioeconomically homogeneous male cohort, HRQoL (quality of life) deteriorated with an increase in daily cigarettes smoked in a dose-dependent manner.

Fish, fish oils, and n-3 fatty acids are often in the health news.  Here are seven recent papers illustrating the breadth of fish oil relevance.  The papers look at treatment of rheumatoid arthritis, the potential of flax as a dietary source of n-3 fatty acids, effects on indicators of cardiovascular disease, potential protection against dementia, reduction in mortality, and importance in pregnancy.  The papers also illustrate the patchwork, three steps forward/one step back, meandering, spreading, accretion of scientific knowledge.  As the proverb goes "One swallow doesn't make a summer".  Similarly, a single research study is usually simply one brick in the gradual building of our knowledge.  For more on fish and n-3 fatty acids, see other relevant blog posts I've written, articles in the linked Connotea database, and some recommended websites.     

Teratology is the study of the effects that drugs, medications, chemicals and other exposures may have on the unborn child during pregnancy.  Particulary when a mother is taking a medication that is helping her stay well, it can be a difficult decision whether or not to stop taking the medication because of a possible risk to the fetus ... or because of a possible risk that could be transmitted through breastfeeding.  This decision is made harder because we know that if a pregnant woman becomes unwell, for example with depression, this too risks damaging the fetus, so it's not necessarily the case that stopping medication is going to be in the unborn baby's best interest.