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      Effects of SSRI Antidepressants on Attentional Bias toward Emotional Scenes in First-Episode Depressive Patients: Evidence from an Eye-Tracking Study

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          Abstract

          Objective

          Attentional biases toward emotional scenes may represent vulnerability and maintenance factors in depression. Antidepressant therapy may improve cognitive function and reduce depression, and is considered as the mechanism of action of antidepressants. Therefore, we conducted an eye-tracking test to examine whether selective serotonin re-uptake inhibitor (SSRI) antidepressants can reduce negative attentional biases and elicit clinical responses in depression.

          Methods

          Twenty first-episode depressive patients freely viewed three types of pictures that depicted different emotional scenes (i.e., positive-control, neutral-control, and negative-control) for 4,000 ms while their eye movements were monitored. The attentional bias to different emotional scenes was assessed before and after eight weeks of SSRI treatment using the eye-tracking method. The control group included a group of healthy individuals.

          Results

          The results revealed that first-episode depressive patients oriented their gaze more frequently to negative images and less to happy images, compared to controls. Importantly, the attentional bias in depressive patients was regulated after eight weeks of SSRI treatment. Patients showed an increased tendency to fixate on positive images and a decreased tendency to focus on negative images.

          Conclusion

          This suggests that SSRI antidepressants decrease vulnerability to negative images, while having an effect on attention in respect to positive images.

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          Most cited references46

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          A RATING SCALE FOR DEPRESSION

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            Cognitive impairment in depression: a systematic review and meta-analysis.

            This review aimed to address the question of whether cognitive impairment should be considered a core feature of depression that may be a valuable target for treatment. We conducted a systematic review and meta-analysis of cognitive function, assessed with a single neuropsychological test battery, the Cambridge Neuropsychological Test Automated Battery (CANTAB), in patients with depression during symptomatic and remitted states. Inclusion of studies comparing patients remitted from depression and controls enabled us to investigate whether cognitive impairment persists beyond episodes of low mood in depression. Our meta-analysis revealed significant moderate cognitive deficits in executive function, memory and attention in patients with depression relative to controls (Cohen's d effect sizes ranging from -0.34 to -0.65). Significant moderate deficits in executive function and attention (Cohen's d ranging from -0.52 to -0.61) and non-significant small/moderate deficits in memory (Cohen's d ranging from -0.22 to -0.54) were found to persist in patients whose depressive symptoms had remitted, indicating that cognitive impairment occurs separately from episodes of low mood in depression. Both low mood and cognitive impairment are associated with poor psychosocial functioning. Therefore, we argue that remediation of cognitive impairment and alleviation of depressive symptoms each play an important role in improving outcome for patients with depression. In conclusion, this systematic review and meta-analysis demonstrates that cognitive impairment represents a core feature of depression that cannot be considered an epiphenomenon that is entirely secondary to symptoms of low mood and that may be a valuable target for future interventions.
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              National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults

              OBJECTIVES: This study examined national trends in 12-month prevalence of major depressive episodes (MDEs) in adolescents and young adults overall and in different sociodemographic groups, as well as trends in depression treatment between 2005 and 2014. METHODS: Data were drawn from the National Surveys on Drug Use and Health for 2005 to 2014, which are annual cross-sectional surveys of the US general population. Participants included 172 495 adolescents aged 12 to 17 and 178 755 adults aged 18 to 25. Time trends in 12-month prevalence of MDEs were examined overall and in different subgroups, as were time trends in the use of treatment services. RESULTS: The 12-month prevalence of MDEs increased from 8.7% in 2005 to 11.3% in 2014 in adolescents and from 8.8% to 9.6% in young adults (both P < .001). The increase was larger and statistically significant only in the age range of 12 to 20 years. The trends remained significant after adjustment for substance use disorders and sociodemographic factors. Mental health care contacts overall did not change over time; however, the use of specialty mental health providers increased in adolescents and young adults, and the use of prescription medications and inpatient hospitalizations increased in adolescents. CONCLUSIONS: The prevalence of depression in adolescents and young adults has increased in recent years. In the context of little change in mental health treatments, trends in prevalence translate into a growing number of young people with untreated depression. The findings call for renewed efforts to expand service capacity to best meet the mental health care needs of this age group.
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                Author and article information

                Journal
                Psychiatry Investig
                Psychiatry Investig
                PI
                Psychiatry Investigation
                Korean Neuropsychiatric Association
                1738-3684
                1976-3026
                September 2020
                17 September 2020
                : 17
                : 9
                : 871-879
                Affiliations
                [1 ]Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei, China
                [2 ]Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
                [3 ]Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
                [4 ]Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Hefei, China
                [5 ]Anhui Mental Health Center, Hefei, China
                Author notes
                Correspondence: Kai Wang, PhD Department of Neurology, the First Affiliated Hospital of Anhui Medical University, No.81 Meishan Road Hefei, China Tel: +86-0551-62923704, Fax: +86-0551-62923704 E-mail: wangkai1964@ 123456126.com
                Correspondence: Chunlan Cai, MD Anhui Mental Health Center, No.316 Huangshan Road, Hefei, China Tel: +86-0551-63616116, Fax: +86-0551-63616116, E-mail: hf_ccl@ 123456126.com
                [*]

                These authors contributed equally to this work.

                Author information
                http://orcid.org/0000-0002-5458-8618
                http://orcid.org/0000-0002-6480-4740
                http://orcid.org/0000-0003-4953-337X
                http://orcid.org/0000-0002-2453-239X
                http://orcid.org/0000-0001-6590-4199
                http://orcid.org/0000-0002-7073-5534
                http://orcid.org/0000-0002-3434-2581
                http://orcid.org/0000-0002-1748-131X
                http://orcid.org/0000-0002-6197-914X
                Article
                pi-2019-0345
                10.30773/pi.2019.0345
                7538251
                32933239
                2d4d4a9a-bd4d-4e7b-8939-c7937305a2d3
                Copyright © 2020 Korean Neuropsychiatric Association

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 January 2020
                : 17 March 2020
                : 7 June 2020
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                attentional bias,depression,ssri,emotion,eye-tracking
                Clinical Psychology & Psychiatry
                attentional bias, depression, ssri, emotion, eye-tracking

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