"It might be good politics but it's not good policy," CEO Lewis Kaplan told AAP. "It's not good for the nation's health to not focus very much more strongly on the diabetes pandemic because it's going to send the system broke." He was speaking in Sydney at the launch of a major new study of 3338 Australians living with diabetes, which highlighted illnesses linked to the disease.

Mr Kaplan said he was disappointed that Federal Health Minister Tanya had been unable to attend the launch because of a prior engagement. "We wanted to have her in the real world, not in that policy bubble called Canberra," Mr Kaplan told the launch. "Unfortunately she had a more pressing engagement."

Diabetes Australia says at least one million Australians have been diagnosed with diabetes and 700,000 are undiagnosed. Up to 275 new cases are diagnosed every day. Experts predict that by 2016 it will be the leading disease burden in the country - costing the nation billions.

Mr Kaplan said the government should have forsaken the budget surplus and pumped money into diabetes healthcare. "If we don't do something about it, in 20, 30 years' time we won't be able to afford healthcare because there will be so many people with so many complications from diabetes," he added.

The Diabetes Miles Study launched on Monday found that 35 per cent of adults who use insulin to treat type 2 diabetes experience moderate to severe depression or anxiety. Adults with type 2 diabetes are also far more likely to report complications such as heart disease, sexual dysfunction and vascular disease.

Mr Kaplan said that with over 200,000 Australians with type 2 diabetes on insulin, the study sample could mean over 70,000 people are afflicted with depression. Black Dog Institute spokesman Will Bonney said stronger mental health was key to dealing with the challenge of diabetes.

"As someone who has lived with type 1 diabetes for 31 years and encountered the black dog a number of times along the way, I am pleased that attention is being brought to the interplay of depression and diabetes," he said.

Diabetes is caused when the pancreas cannot make enough insulin to convert sugar to energy. Type 1 is unpreventable but Type 2 diabetes, which affects 85-90 per cent of all sufferers, is greatly increased by lifestyle factors such as high blood pressure, obesity and poor diet. Symptoms include blurred vision, fatigue, mood swings and headaches.

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LONDON: Women who have inherited specific genetic variants may be at increased risk for postnatal depression, according to research presented at a conference in Italy this week. If confirmed, the investigators hope that their finding will result in a blood test being developed that will allow doctors to check a woman’s risk for the condition before giving birth.

“There are studies suggesting that women with postnatal depression appear to have abnormal hormonal responses to stress, especially responses of the hypothalamic pituitary adrenal axis, possibly due to differences in sensitivity to the steroid hormones of pregnancy,” said lead investigator Dimitris Grammatopoulos from the University of Warwick, in the UK, who presented the research this week at the International and European Congress of Endocrinology in Florence, Italy.

Nature versus nurture
“Our study provided the first evidence that specific variants of genes controlling the hypothalamic pituitary adrenal axis are associated with increased risk of postnatal depression,” he said. Postnatal depression is common in Western countries affecting around 1 in 7 women.

“If left untreated, postnatal depression has profound consequences on the quality of family life and social functioning as well as on the long-term emotional and cognitive development of the baby,” said Grammatopoulos.

Similarities between depression and postnatal depression
Mutations located in genes that regulate the hypothalamic pituitary adrenal axis have previously been linked to depression, but not specifically to postnatal depression.

The most significant risk factors for the condition that have been identified to date include having a past history of depression, psychological disturbance during pregnancy, a poor marital relationship, a lack of social support, and exposure to stressful life events.

As there are certain similarities between depression and postnatal depression, Grammatopoulos and colleagues decided to test a group of 140 pregnant women for five genetic variants known as single nucleotide polymorphisms (SNPs) previously linked with increased susceptibility to depression.

The women were tested for postnatal depression before and 2–8 weeks after giving birth using a psychological test called the Edinburgh Postnatal Depression Score, and 34 of the women developed the disorder.

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New data released today at the annual meeting of the American Psychiatric Association show that patients with unipolar, non-psychotic Major Depressive Disorder (MDD) receiving transcranial magnetic stimulation (TMS) with NeuroStar TMS Therapy® achieved significant improvements in both depression symptoms and in quality of life measurements.  Overall, 58 percent of patients achieved a positive response to NeuroStar TMS therapy, with 37 percent of patients achieving remission from their depression.

After an average of five weeks of NeuroStar treatment, the percentage of patients reporting extreme problems with anxiety and depression decreased by 42.2 percent, demonstrating a reduction in depression symptomatology. For overall treatment effect, the percentage of patients reporting no problems in performing usual activities improved by 30.5 percent.  

"The improvements we observed show that non-drug therapy with NeuroStar TMS not only reduces the symptomatic suffering of patients, but lessens the disability of depression with important implications for these individuals' ability to return to functioning effectively at home, in the workplace, and in the community," said Ian A. Cook, M.D., Semel Institute for Neuroscience and Human Behavior at the University of California, Los Angeles.

In the open label study, which involved 307 patients receiving acute treatment with NeuroStar TMS, patients experienced statistically-significant improvement across physical and mental variables as measured by the Short Form 36-Item Questionnaire (SF-36).  The SF-36 is a multi-purpose, short-form health survey that evaluates functional health and well-being of disease among eight variables including physical functioning, role limitations due to physical problems, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems and mental health. After five weeks of acute TMS therapy, the most drastic improvement was seen in the mental component summary score, which more than doubled from 16.6 prior to therapy to 33.5 after therapy.

Similarly, self-reported quality of life measures significantly improved with TMS therapy compared to baseline according to the EuroQol Questionnaire (EQ-5D), a standardized instrument that was used to evaluate the effect of TMS therapy on the quality of life of patients.  At the end of acute treatment with TMS, the greatest improvements in EQ-5D dimensions were observed among patients who indicated no problems with "usual activities" (14.3 percent pre-TMS vs. 44.8 percent post-TMS), "anxiety/depression" (1.6 percent pre-TMS vs. 30.1 percent post-TMS) and "pain/discomfort" (39.4 percent pre-TMS vs. 52.8 percent post-TMS).  In other EQ-5D dimensions, 81.8 percent of patients reported no problems with "mobility" following TMS treatment vs. 68.7 percent at baseline; 87.1 percent of patients reported no problems with "self-care" following TMS treatment vs. 72.6 percent at baseline.

"These data reinforce the clinical efficacy of TMS Therapy as a viable option for patients living with major depression who have not achieved or maintained symptom improvement with oral antidepressants," said H. Brent Solvason, M.D., Stanford University Medical Center. "The most meaningful takeaway for patients is that TMS Therapy has the potential to make them feel better, in addition to potentially allowing them to experience a level of physical and social functionality they haven't had with their depression."

About Transcranial Magnetic Stimulation TMS is a non-invasive, non-systemic therapeutic device that delivers magnetic resonance imaging (MRI)-strength, pulsed, magnetic fields to induce an electronic current in a localized region of the cerebral cortex, the part of the brain that controls mood.  NeuroStar TMS Therapy is the first and only TMS therapy for major depressive disorder cleared by the U.S. Food and Drug Administration (FDA) that has been proven to achieve remission without systemic side effects in patients who have not found relief with antidepressant medication.

About Depression Depression is a serious illness that affects about 20 million Americans annually. People with depression may experience a range of physically and emotionally debilitating symptoms, including anxiousness, sadness, irritability, fatigue, changes in sleep patterns, loss of interest in previously enjoyable activities and digestive problems. It is estimated that about four million patients do not benefit from standard treatments for depression, even after repeated treatment attempts.

About the Study The clinical trial was a multi-site, naturalistic, observational study involving 307 patients receiving acute treatment with TMS therapy across 43 clinical practices.  All treatments were initiated using the NeuroStar TMS Therapy® System (Neuronetics, Inc., Malvern, PA, USA).  The study is posted on www.clinicaltrials.gov, listing number NCT 01114477.

About NeuroStar TMS Therapy® Neuronetics' NeuroStar TMS Therapy System was cleared by the FDA in October 2008 for the treatment of MDD. NeuroStar TMS Therapy is indicated for the treatment of Major Depressive Disorder in adult patients who have failed to achieve satisfactory improvement from one prior antidepressant medication at or above the minimal effective dose and duration in the current episode. NeuroStar TMS Therapy is a non-systemic (does not circulate in the bloodstream throughout the body) and non-invasive (does not involve surgery) form of neuromodulation. It stimulates nerve cells in an area of the brain that has been linked to depression by delivering highly- focused MRI-strength magnetic field pulses. The treatment is typically administered daily for 4-6 weeks.

About Neuronetics Neuronetics, Inc. is a privately-held medical device company focused on developing non-invasive therapies for psychiatric and neurological disorders using MRI-strength magnetic field pulses. Based in Malvern, PA, Neuronetics is the leader in the development of TMS Therapy, a non-invasive form of neuromodulation. Neuronetics was created as a spin-out of The Innovation Factory, a medical device incubator in Duluth, GA.

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There are few disorders which can silently destroy the beauty of our being and gifts of our creation more than the multi faceted and diverse symptoms of depression.

Depression is, without doubt, the fastest growing illness in the U.K. Approximately 1 person in every 5 will become depressed at some point in their lives and one in 20 will be clinically depressed. Statistics suggest that women are more vulnerable to depression, but men generally find it harder to admit to or talk about their experiences. We should never try to dismiss the symptoms of depression and always take them seriously, they are never an inevitable part of growing up or growing old. It is possible to overcome depression, and to prevent its return.

If we are suffering from depression it means that our brain and nervous system has reached a point where it has slowed down. In most cases it will do this because it is confronted with too much stress.  Stress or imagined stress is very often the trigger for a panic attack. This stress may be related to current issues but far more likely an event has triggered a past experience which we have pushed down deeply within ourselves and which is not in our conscious self.

Many people suffering from mental problems will be prone to panic or anxiety attacks as depression is very often intertwined with these. It is often suggested that if we suffer from one of these problems we are likely to suffer from the other. In many cases depression has its roots in our shame, our sorrow and our hope.

When we are attacked by depression it seems impossible to function and to enjoy life as we should. Hobbies and friends don't interest us as they used to, we feel exhausted all the time and just getting through the day can be massively overwhelming. Although, when we are depressed, things may feel hopeless, with help and support we can get better. Firstly we need the right tools and learning about depression, recognising the signs, symptoms and causes, is the first step to beating this enemy.

I often hear the word "depression" being used to explain feelings of sadness, but sadness is a healthy reaction to events in our life. Depression is much more than just sadness. Depression can be described as like ‘living in a black hole' and carrying a sense of impending doom. But often depressed people don't experience sadness at all and instead can simply feel lifeless, empty, and apathetic.

Irrespective of the symptoms, depression is different from normal sadness as it can totally take over our day-to-day life, damaging our ability to function effectively in any capacity. We desperately look for relief from the intense and unrelenting feelings of hopelessness, helplessness, and worthlessness.

Depression has a number of different causes which will be different from person to person and can occur through a combination of factors. With the exception of manic depression, it does not seem to be inherited through genes although some of us are more prone to depression than others. This is because of the way we're made, or how our emotional system has responded to experiences or family background. Past experiences can have a profound effect on how we feel about ourselves in the present, and if those feelings are very negative, they can be the start of a downward spiral. In many cases, the first time someone becomes depressed, it will be sparked off by an unwelcome or traumatic event, such as losing a job, going through divorce, being physically attacked or raped. It's not just the negative experience that causes the depression, but how we deal with it. If the feelings provoked are not expressed or explored at the time, they fester and contribute towards depression. It's important to acknowledge and grieve over what we have lost in order to be able to move on successfully.

There is a major characteristic about depression that we must always be aware of when turning our minds to fighting and defeating it. Depression feeds on itself. In other words, we get depressed and then we get more depressed about being depressed. Negative thoughts become automatic and are difficult for us to challenge. Being in a state of depression can then, itself, become a bigger problem than the difficulties that caused it in the first place. We need to break the hold that the depression has on us.

Depression can manifest in many different ways and we don't always realise what's going on because the problems seem to be physical, not mental. Perhaps we tell ourselves we are simply feeling tired or affected by the weather. To recognise depression in ourselves, a friend or a loved one, read through the list below which are the most common signs. Identifying with more than three of these makes depression highly likely.

* Being restless and agitated.

* Having difficulty sleeping, or feeling tired and lacking energy.

* Realising that we are doing less and less.

* Self-harming or being occupied with thoughts of suicide.

* Developing physical aches and pains with no physical cause.

* Not deriving pleasure out of things which we usually enjoy doing.

* Blaming ourselves and feelings of guilt about day to day actions.

* Loss of self-confidence and a preoccupation with negative thoughts.

* Using tobacco, alcohol or other drugs more than usual.

* Not eating properly and losing or putting on weight.

* Noticing that we have started to cry a lot.

* Being unusually irritable or impatient.

* Loss of interest in sex.

* Finding it hard to concentrate or make decisions.

* A sense of feeling numb, empty, despairing or helpless.

* Having difficulty remembering things.

* Feeling low-spirited for much of the time, every day.

* Distancing ourselves from our friends and not asking for help.

* Taking a bleak, pessimistic view of the future.

 This list or parts of it can be found anywhere on the internet.  A very commonly searched phrase on Google is "Signs of depression". Many of these sites simply recycle the same familiar information about negative self-statements, affirmations and biochemical imbalances. A few might tell us something of value, but the vast majority are fundamentally commercial sites designed to sell us something. Perhaps online therapy, or for us to click on banner advertising to generate income for the website owner.

Encouragingly, there is no isolation here, below are just a few of the famous people who have been treated for depression: Winston Churchill, Jim Carrey, Woody Allen, Agatha Christie, Charles Dickens, T.S. Eliot, Nelly Furtado, Ernest Hemingway, Margaux Hemingway, Janet Jackson, John Keats, Beyonce, Hugh Laurie, Paul Merton, Brian May, Michelangelo, Gwyneth Paltrow, Diana, Princess of Wales, Rachmaninoff, Charlotte Rampling, John D Rockefeller, Mark Rothko, Robbie Williams, J.K. Rowling, Will Self, Brooke Shields, Britney Spears, Catherine Tate, Leo Tolstoy, Mike Wallace, Evelyn Waugh, Tennessee Williams, Owen Wilson, amongst countless others.

 Aaron Beck's work in the 60's and 70s created a far greater understanding towards depression and the benefits of ‘cognitive therapy'. His two seminal works, ‘Depression: Causes and Treatments' and some years later ‘Cognitive Therapy and Emotional Disorders' in my view moved away from empirical beliefs and moved much more towards an empathetic and a person centred approach.

There is no evidence to the popular rumour that depression is caused by a lack of chemicals in our brain. An increase of certain chemicals to our brain can, however, suppress many of the symptoms of depression. I believe there are only a very few situations where medication and therapy work well together. In many cases I have had examples where the client can fall back into depression after a few months. I do wonder whether the anti-depressants can darken that shadow between the knowing and the doing. At some point I believe the most effective work will be done in the absence of these medications, although there may well be a right and wrong time for that. Treatment simply through medication does no more than, at best, paper over cracks. When we do this the cracks just become bigger. We can not solve depression with a pill.  There are no easy answers.

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IN DECEMBER, The Economist warned that without dramatic intervention the euro zone could face a new depression. Soon after, the European Central Bank sprang into action, averting an immediate financial meltdown through heavy lending to banks. The resulting calm looked like an opportunity for euro-area leaders to seize the moment and escape, once and for all, from crisis. Instead, complacency set in. The ECB's financial anaesthetic has not prevented a steady economic deterioration that now threatens to engulf—and perhaps end—the euro zone.

Across the euro area, unemployment is worsening. The unemployment rate touched a new record high in March: 10.9%, up a full percentage point from the prior year. Of course, the pain is not evenly distributed. It is low and reasonably steady in the north but high and climbing in the south. Youth unemployment rates are staggering—over 50% in Greece and Spain, 36% in Portugal and Italy, rising sharply in all four. There is worse to come. Manufacturing activity is slowing sharply across the euro area, and the core is no longer immune:

The details of these reports are most worrying. April's decline was stunning, but new order inflows tumbled at the fastest pace since December. The job decline in manufacturing is now impacting Germany and France.

The picture is distressing. It is not surprising. The euro-zone economy is large and overwhelmingly driven by domestic demand. That demand has been steadily squeezed by a broad, sustained fiscal tightening. Monetary policy is providing almost no relief. The ECB raised rates last year, and while it has since unwound the 50-basis-point increase from 2011, it shows no interest in cutting rates further below the present 1% level. Quantitative easing looks out of the question. The ECB's extraordinary lending to banks seems to have stabilised bank-financing conditions; it does not appear to have prevented a sharp slowdown in lending to the private sector. There was no way to avoid a return to recession amid such circumstances.

Ordinarily, of course, policymakers would react to this deterioration by taking steps to stabilise the economy. What is most frightening about the euro-area picture is that this is not happening. For now, austerity remains the rule. Despite the nastiness of the economic picture, the ECB is widely expected to take no action at its meeting tomorrow. The euro area is walking, eyes wide open, into depression. Led by its periphery, which is already there.

Most everyone seems to have convinced themselves that this sort of thing isn't so bad, so long as a Lehman-like financial collapse is avoided. It isn't. Nothing good will come of a euro-zone depression.

If, when all of this is said and done, the euro zone descends into a chaotic, costly break-up, many people will write that such a thing was inevitable, unavoidable. They'll be wrong. We are watching causation this very moment: institutions that know how and why to prevent things from falling apart and which nonetheless sit back and do nothing.

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Women suddenly thrust into "surgical menopause" by hysterectomy don't have more severe mood symptoms than women going through gradual, natural menopause, a new study suggests.

Researchers who followed nearly 2,000 middle-aged women for 10 years found that those who had hysterectomies, with or without ovary removal, were as likely as women who went through natural menopause to experience depression or anxiety -- and for all women, those symptoms declined steadily within a few years.

"At least among women in midlife... mood symptoms don't seem to be a worry to take into consideration when making treatment decisions around hysterectomy and oophorectomy," said the study's lead author Carolyn Gibson, a researcher in the Department of Psychology at the University of Pittsburgh.

Although past studies have shown a link between hysterectomy and risk for depression, Gibson and her fellow researchers say it's still hard to tell whether the procedure is to blame. Also unknown is whether the symptoms of surgically-induced menopause are any different from those of women who go through menopause naturally.

Gibson told Reuters Health the topic is important, because hysterectomies are very common. About 600,000 women in the United States have their uterus removed during a hysterectomy every year, according to the U.S. Centers for Disease Control and Prevention.

The researchers say between 55 percent and 80 percent of women who undergo hysterectomy also have their ovaries removed -- a procedure known as oophorectomy. Because a woman's ovaries generate estrogen, removing them induces menopause almost immediately.

Whether natural or induced, the change in a woman's hormone levels leading up to menopause, and in the years immediately afterward, often contributes to a range of symptoms, from anxiety and depression to insomnia and hot flashes.

To see whether a quick transition to menopause through surgery changes women's experience of the associated symptoms, Gibson's team turned to a database containing information on women's progression to, and through, the process. They tracked about 2,000 women who were between 42 and 52 years old in 1996 and 1997, and were followed for more than ten years.

Over that period, 1,793 of the women went through menopause naturally, 76 had an elective hysterectomy and 101 had an elective hysterectomy and their ovaries removed. All of the women were premenopausal at the beginning of the study and scored about the same on a scale that measures depression.

That scale goes from zero to 60 and, with higher scores representing more severe depression. A person with a score below 16 is not considered to be depressed. For all three groups of women, depression scores decreased from the time they entered menopause to the end of the study period, and at about the same rates.

For those going through natural menopause, scores fell from 8.6 to 7.8. Those who had a hysterectomy saw their scores fall from 9.37 to 9.08, those who also had their ovaries removed went from 10.96 to 8.91.

Overall, the study shows depression symptoms in women who had a hysterectomy "declining in a very similar way as women who had a natural menopause," said Ellen Freeman, a research professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine.

Freeman, who was not involved with the new study, told Reuters Health that it's important to know that the new study does not mean women will not be depressed after menopause -- just that the symptoms do decrease, and at about the same rate among women in each group.

Gibson and her colleagues write in the journal Obstetrics & Gynecology that this suggests symptoms of depression and anxiety improve as women enter their postmenopausal years. The authors note, however, that the results may not be applicable to the general population, such as those with a history of mood disorders.

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Researchers have found that single mothers and those with symptoms of depression are more likely to add cereal to bottles while feeding their babies, which may increase their children's risk of obesity. The researchers say efforts to prevent obesity among low-income infants should focus not only on what babies are being fed but also the reasons behind unhealthy feeding practices.

Adding cereal to bottles is one unhealthy practice that is discouraged by the American Academy of Pediatrics because it may lead to overfeeding and excess weight gain in infants. The researchers sought to determine factors associated with putting cereal in bottles among low-income, primarily Latino households in which the risk for child obesity is high.

Mothers of 254 infants were asked if they ever added cereal to bottles to help their babies sleep longer or stay full longer. The researchers also collected information on mothers' age, language, country of origin, marital status, education and income; whether the mother had symptoms of depression; and infants' age, gender and whether the infant was felt to have strong emotional reactions (a high intensity temperament).

The data were collected as part of the larger Bellevue Project for Early Language, Literacy and Education Success (BELLE Project). Funded by the National Institutes of Health/National Institute of Child Health and Human Development, the BELLE Project is following infants from birth to first grade to study issues related to parenting and child development.

Results showed that 24 percent of mothers put cereal in bottles. Those with depressive symptoms were 15 times more likely to add cereal than mothers who did not have symptoms of depression.

"Depression is very common in low-income mothers and makes it more difficult to engage in beneficial parenting practices in general," said lead author and general academic pediatrics fellow Candice Taylor Lucas, MD, MPH, who also is the Alan Mendelsohn, MD, principal investigator and associate professor of pediatrics, New York University School of Medicine and Bellevue Hospital Center.

"Our results are especially concerning because they suggest that depressed mothers may be more likely to add cereal to the bottle, which may increase their children's risk of obesity."Data also showed that mothers who were single were significantly more likely to add cereal to bottles.

"This suggests that mothers' support systems and family dynamics may influence feeding practices," said obesity researcher and fellow investigator Mary Jo Messito, MD, FAAP. Mothers who felt that their children had intense emotional reactions to daily routines were 12 times more likely to add cereal to bottles.

"Overall, these findings demonstrate that stressors prevalent in low-income households, such as depression, single parenthood and associated infant behavioral challenges, influence feeding practices likely to promote obesity," Dr. Lucas said.

"It is important to provide support for parents related to healthy feeding practices if we are to end the epidemic of childhood obesity," it concluded. The finding is being presented at the Pediatric Academic Societies (PAS) annual meeting in Boston.

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Eating too much junk food may increase risk for depression, a large study suggests.  In a cohort study of almost 9000 adults in Spain, those who consistently consumed "fast food," such as hamburgers and pizza, were 40% more likely to develop depression than the participants who consumed little to none of these types of food. In addition, investigators found that the depression risk rose steadily as more fast food was consumed.

Participants who often ate commercial baked goods, such as croissants and doughnuts, were also at significant risk of developing this disorder. "We were not surprised with the results. Several studies have analyzed the association between fast food and commercial bakery consumption and physical diseases, such as obesity or coronary heart disease," Almudena Sánchez-Villegas, PhD, from the Department of Clinical Sciences at the University of Las Palmas de Gran Canaria and the Department of Preventive Medicine and Public Health at the University of Navarra in Pamplona, Spain, told Medscape Medical News.

"With these results, a relatively new line of research is open. Limiting trans fatty acids content in several foods, avoiding the consumption of fast food and bakery, and increasing the consumption of other products such as vegetables, legumes, and fruits should be a primary goal for clinicians and public health makers," she added.

Croissants, Doughnuts, and Muffins, Oh My! According to the investigators, depression affects around 121 million people throughout the world.

Although "little is known about the role of diet in the development of depressive disorders," past studies have suggested that olive oil, B vitamins, and omega-3 fatty acids may play a preventative role, write the researchers.

As reported by Medscape Medical News, Dr. Sánchez-Villegas and colleagues published a study last year in PLoS One that linked consumption of trans unsaturated fatty acids (TFA) to a significantly increased risk for depression.

For the current study, they sought to specifically examine the role that consumption of fast food and processed food may play in the development of this disorder.

The researchers examined data on 8964 adults from the Seguimiento Universidad de Navarra (SUN) Project, an ongoing diet and lifestyle tracking study that started in 1999. None of the SUN participants had been diagnosed with depression or had taken antidepressants before the start of the study.

Exposures and outcomes were gathered through surveys mailed out biennially to the participants. A food frequency questionnaire was used to assess dietary intake. Fast food consumption was defined as total consumption of hamburgers, pizza, and hot dogs/sausages. Commercial baked goods consumption was defined as total consumption of croissants, doughnuts, and muffins.

Incident depression and/or self-reported physician-made diagnosis of depression, antidepressant use, and demographic and lifestyle data were recorded on other questionnaires.

Curb the Junk Food
Results showed that 493 of the participants were diagnosed with depression after a median follow-up of 6.2 years. Those who were found to have the highest levels of consumption of fast food showed a significantly higher risk of developing depression compared with those who had the lowest levels of consumption (adjusted hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.05 - 1.86; P = .01).

"Moreover, a significant dose-response relationship was found (P for trend = .001)," report the researchers. However, the researchers note that even small quantities of fast food were linked to a significantly higher risk for depression.

Participants who often consumed commercial baked goods were also at increased risk of developing this disorder (adjusted HR, 1.43; 95% CI, 1.06 - 1.93). The investigators also found that the study participants with the highest consumption of fast food and of commercial baked goods were more likely to be single, less active, smoke, work more than 45 hours per week, and eat less fruits, vegetables, nuts, fish, and/or olive oil.

"Although more studies are necessary, the intake of this type of food should be controlled because of its implications on both health (obesity, cardiovascular disease) and mental well-being," said Dr. Sánchez-Villegas. The researchers add that the legally permitted content of TFA in these foods "should be reviewed."

Dietary Assessment "Prudent"
"This Spanish team conducted very good, quality research and took considerable care to consider multiple possible causes of confounding, such as other factors that may explain both dietary habits and risk for depression," Felice Jacka, PhD, research fellow at Deakin University in Melbourne, Australia, told Medscape Medical News.

"For example, they take into account many variables that may be proxies of health consciousness or overall health lifestyle, such as the use of seat belts, frequency of medical and dental checkups, and drunk driving, as well as marital status, smoking, alcohol consumption, and intake of nutrient-dense foods. The study sample is also large and well described, and the prospective cohort design affords the potential for investigating cause-effect relationships," she added.

Dr. Jacka noted that the results support a previous study that she and her colleagues published recently in the American Journal of Psychiatry, which showed that women who consumed a diet higher in unhealthy and processed food were likely to be depressed. In a study published in the Australian and New Zealand Journal of Psychiatry, they reported the same results in a cohort of adolescents.

The results of the current study "are also concordant with the two prospective studies in this field, in both adults and adolescents, reporting that unhealthy diets are associated with an increased risk for mental health problems over time," she reported.

She added that although this study was rigorously conducted and is methodologically sound, "it is perhaps a shame that [it] does not have data on diagnoses of depression ascertained via clinical assessments. However, this is rare in large epidemiological studies, and the measures they have used have been shown to be valid."

Dr. Jacka noted that because diet and mental health research is relatively new, it is often uncommon for clinicians to consider diet as an intervention target in clinical care. "However, this study adds to the rapidly growing and highly consistent body of literature suggesting that depression is another common, noncommunicable illness with a significant lifestyle component," she said.

"As such, it is prudent for clinicians to assess and address the dietary as well as exercise habits of their patients, in addition to pharmacological and other established treatments."The study was supported by the Spanish Government Instituto de Salud Carlos III, Fondo de Investigaticiones Sanitarias, and the Navarra Regional Government. The study authors and Dr. Jacka have disclosed no relevant financial relationships.

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Depression is a mood disorder (mood) that cause children and adolescents to feel sad or irritable to be a long time. A young person who is depressed, no longer enjoys school, and play with friends and may be lacking in energy or have other symptoms. As adults, symptoms range from mild depression to severe and one person to another. Depression can last a long time and may have a cyclic evolution, with periods of illness followed by periods without symptoms. Chronic depression, dysthymia and mild form called, occurs when a child feels defeated most of the time period of one year or more. Both the mild form and severe form of depression can be treated with efficiency.

Until recently it was believed that only adults suffer from depression, while children and teens do not. We now know that even young children can have serious forms of depression that require treatment for healing. However, symptoms of depression in children and adolescents are difficult to recognize. Symptoms range from abdominal pain and boredom can be confused with symptoms of other diseases. Many children and teenagers with depression do not receive proper treatment for the symptoms is not known. Variations of mood and emotional changes caused by depression can go unnoticed, considered unimportant or assigned normal growth.

Children and adolescents with depression and other disorders and often have anxiety, hyperexcitability similar behavior (hyperactivity) with attention deficit disorder, eating disorders and the serious process of learning and behavior problems (disorderly conduct). These symptoms may occur before being diagnosed with depression in children.

In the past, consider that depression is "all in the mind" and that a depressed person is able to recover by itself. Today we know that depression is an illness that requires treatment and is not a flaw or weakness. Childhood and adolescence can be difficult for children with depression and family members, especially when the disease is not treated. If untreated, severe depression may last a year or more. Severe or prolonged depression can cause problems such as difficulty in making friends with others and maintaining friendships, difficulties in school, drug abuse, suicidal behavior and other problems that may extend into adulthood. Have turned to professional help if your parents found this behavior in childhood depression.

Causes
Depression is considered to be an imbalance of certain chemicals called neurotransmitters that transmit messages between brain nerve cells. Some of these chemicals, like serotonin helps regulate mood. If these chemicals that regulate mood, cause imbalance in the brain nerve cells, resulting depression or other mood disorders. Experts do not currently have set up the neurotransmitter imbalance that occurs. They believe that this change can occur as a consequence of stress or disease, but it can occur without clear cause.

Risk Factors
Depression in family members: children and adolescents who have a parent with depression are three times higher risk of depression than do those whose parents do not have depression. Experts believe that both inherited family traits (genetic) and living with a parent who has depression may increase risk to the child's depression.
Depression in children and adolescents may be due to stress, unresolved social problems and family conflicts. It may also be associated with trauma such as violence, abuse or neglect.
Children and adolescents who have serious medical conditions prolonged learning problems or behavior problems may be more easily depressed.
Some medications can trigger depression, such as steroids or narcotics for pain relief administered. Once the drugs are discontinued, symptoms usually disappear.

Factors that increase risk of depression in young
Several factors increase the risk of depression in young people:
- If a parent or an immediate family member has depression: it is the most important risk factor for depression (children or adolescents who have a parent with depression are three times more likely to be depressed)
- If they had a depressive episode, especially if the first depressive episode occurred at a young age
- If you have chronic medical conditions such as diabetes or epilepsy
- The presence of other psychiatric disorders, such as disorderly conduct or anxiety (anxiety, fear)
- Death of a family member or close friend
- Physical or sexual abuse
- Abuse of alcohol or drugs.
Other risk factors and situations that lead to depression are:
- Girls in early puberty (girls and boys before puberty have the same risk for depression but after puberty and adulthood, women are 2 times more prone to depression than men do)
- Domestic violence
- Lack of social relations with persons of the same age
- The victim of aggression or aggression.

Symptoms
Depression in childhood or adolescence is to develop gradually or suddenly. The child may seem irritable rather than sad or feeling tired or hopeless. Entourage child in the child with apparent slowness in movements depression, insomnia or agitation. The child may be self-critical or have a feeling that others are too critical of him.

The symptoms of depression are often subtle at first. At this stage it is difficult symptoms associated with depression and it's hard to believe that it is depression in children.

Children with depression may have these symptoms:
- Irritability
- Violent temper
- Unexplained pain such as headaches or stomach
- Difficulty in thinking and decision making
- Drowsiness sauinsomnie
- Changes in eating habits that can lead to growth, absence of weight loss or weight gain, expected to increase child
- Loss of self-esteem (low self confidence)
- Feelings of guilt or hopelessness
- Lack of energy or constant fatigue
- Withdrawal from social life, such as lack of interest in friends
- The thought of death and suicidal thoughts.

Untreated depression can lead to suicide. Carefully for signs of suicide change with age. Signs of attention to child and adolescent suicide include preoccupation with death or suicide or the recent termination of the relations of friendship.

Many children with depression have symptoms of anxiety (anxiety) such as permanent and unfounded concerns and fears of separation from a parent. Sometimes these symptoms appear before depression is diagnosed.

Other less common symptoms can occur in children with severe depression and hearing voices that are not there (auditory hallucinations) or blind belief in a false idea (illusion, anger). Hallucinations are common in childhood, while delusions are more common in adolescence.

Differentiate between various normal mood and symptoms of depression is often difficult. Occasional feelings of sadness or irritability are normal. They allow the child to understand the grief and cope with obstacles in life. For example, deep sorrow (heavy loss) is a normal response to a loss such as death of family pet, the loss of a friend or divorce of parents. After a tough loss, the child may stay sad for a long time. However, if these emotions do not disappear after a while and begin to interfere with the private life of the young child can develop symptoms of mood disorder like depression or dysthymic disorder (depression during long nonsevere) requiring treatment.

Approximately 15% of children and adolescents diagnosed with depression develop bipolar disorder (this contradictory symptoms: alternating between depression and mood exaggerated). Children and adolescents with bipolar disorder have extreme events which alternates between bouts of manic depression (children are energetic, restless or irritable). The common symptoms of depression may be common to other diseases.

It is sometimes difficult to differentiate bipolar disorder from depression. It is common for a child diagnosed with bipolar disorder to be diagnosed with depression for the first time that after his first manic episode is diagnosed with bipolar disorder. Although depression is part of bipolar disorder, they require different treatment from that of depression. Like depression, bipolar disorder may be familial, hence the need to inform the family doctor about a family that there are other cases of bipolar disorders .

Patofisiologiese meganisme
Depression in childhood and adolescence may be manifested first by irritability, sadness by crying or sudden unexplained. Children may lose interest in activities that they once used to enjoy, can not feel loved or they may feel hopeless. They may have problems at school, may become careless or rude.
Often children may have depression and other disorders associated with depression and other manifestations of anxiety (anxiety), behavioral disorders similar to hyperexcitability (hyperactivity) with attention deficit disorder, eating disorders and the process of learning, and serious behavior problems (conduct disordered). These disorders can occur before a young person to become depressed. Some children with depression develop serious behavior problems (disorderly conduct), usually after they became depressed. If your child has this disorder should be instituted when necessary treatment for depression.

The child or teen with depression is more prone to drug abuse, alcohol, smoking than those who do not have depression. About 30% of young people with depression will have problems with alcohol or drugs. They are much more difficult to treat depression, increase the treatment time required to become efficient and increase the risk of suicide. An early diagnosis and treatment accompanied by good communication with your child can help prevent substance abuse.

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“Going for a brisk stroll could play an important role in fighting depression,” BBC News has reported. Current evidence suggests that physical activity can be useful for reducing the symptoms of depression, but previous examinations of research have not specifically looked at the benefits of walking for depression. In order to improve our understanding of the issue, Scottish researchers conducted a systematic search for all relevant medical trials on the subject, combining their results into a single analysis.

The researchers found eight relevant studies featuring a total of 341 people. Overall, the combined results of these trials suggested that walking reduced the symptoms of depression. However, the trials were small, and they varied in the types of people they included, the walking programmes they used and what they compared walking to. This limits the strength of the conclusions that can be drawn about the effects of walking in specific groups of people with depression.

However, this is not the first research to have suggested that physical activity is beneficial for depressive symptoms. The National Institute for Health and Clinical Excellence (NICE) currently recommends considering structured group physical activity programmes as a treatment option for some forms of depression.

As the authors of the review note, walking is a form of physical activity that most people can take part in safely and at minimal cost. More research is now needed to determine exactly what duration and frequency of walking is most effective for depressive symptoms.

Where did the story come from?
The study was carried out by researchers from the Universities of Stirling and Edinburgh. Sources of funding were not reported. The study was published in the peer-reviewed journal Mental Health and Physical Activity. The study was reported appropriately by the BBC.

What kind of research was this?
Physical activity has been found to reduce depressive symptoms, but the researchers behind this study say that it is not known whether walking specifically has the same effect. They say, however, that walking can be easily undertaken by most people, fits into our daily schedules, is low-cost and comes with little risk of adverse effects. The researchers set out to conduct a systematic review of the evidence on the effects of walking on depression. They also set out to perform a meta-analysis, which is a pooling of the results of the individual studies.

A systematic review is the best way to summarise all of the existing research on the question of interest, as, during a systematic review, researchers should rigorously search for and analyse all relevant high-quality studies available on a subject. Systematic reviews include relevant studies regardless of their results, rather than just focusing on those that support or contradict a particular theory. The results of the studies in a systematic review may be statistically pooled if the studies are similar enough in method to produce meaningful results. Pooling very different types of studies (for example those with very different study populations) will produce results that don’t improve the researchers’ understanding of the effect of an intervention.

What did the research involve?
The researchers searched 11 literature databases to identify randomised controlled trials of walking as a treatment for depression. They then statistically pooled the results of eligible studies to assess whether walking reduced depressive symptoms compared with a control treatment that did not involve walking.

The researchers included any studies in adults with any form of depression, excluding those in which depression was being examined as part of bipolar disorder or where all the participants were recruited because they had a specific medical condition, such as cancer. Studies of any kind of structured or semi-structured walking programmes were included. Studies where other types of exercise were also part of the activity programme were excluded. Stretching to warm up or cool down before walking was permitted. The comparison group in eligible trials could be those receiving no treatment, usual depression care or a treatment that was also given to the walking group (for example, cognitive behavioural therapy). Depressive symptoms could be assessed using any symptom scale.

Information on the study characteristics and results was extracted from eligible studies, and the quality of the trials was assessed. Results were pooled using standard methods. The researchers looked at the effect of walking overall, and also at indoor and outdoor walking and group walking specifically.

What were the basic results?
The researchers identified seven trials that fully matched their inclusion criteria. They also included an additional trial that included people who either had moderate depression or who had a high body mass index (BMI). They did this as the trial was relatively large, and included a considerable number of people with depression. The trials were generally quite small, with between 11 and 127 people in each trial. The trials included 341 people in total. They varied in their quality, with only one trial reporting on, and meeting, all four of the quality indicators used by the reviewers.

There was a lot of variability between these trials, including differences in the types of people that were recruited, the settings in which they were treated, how severe their depression was and how it was diagnosed. The trials also varied in the types of walking programmes they used: whether they were supervised; indoor (for example, on a treadmill) or outdoor; whether they were group walks; and the duration and frequency of the walks performed. The walks ranged from 20 to 50 minutes, and the programmes lasted up to six months. The control groups were assigned therapies including usual care, stretching and relaxation exercises, social contact or other kinds of support (talking to a researcher or a support group).

Pooling the results of these studies showed that, overall, walking did significantly reduce depressive symptoms. There was a high level of variability across the results of the studies, however, with one finding a better outcome with the control treatment, one finding no significant benefit of walking, and the other studies finding varying levels of benefit. The researchers then conducted a further two separate analyses – one including only the four best trials and one excluding the study that had recruited people with high BMIs. Both of these still found that walking significantly reduced depressive symptoms.

The researchers also found that walking had a significant effect in trials of indoor walking, outdoor walking and group walking if these were looked at separately. The researchers noted that the variability in the designs of these studies meant that the pooled results may not be directly applicable to specific groups of people.

How did the researchers interpret the results?
The researchers concluded that walking significantly reduced the symptoms of depression in some populations. However, they say that there are limitations to the existing studies and suggest that further research is needed to determine exactly what type of walking programmes (frequency, intensity, duration) would be best for people with depression being treated in primary care, such as by a GP.

Conclusion
Physical activity is already thought to have a beneficial effect on depressive symptoms, and the UK’s National Institute for Health and Clinical Excellence (NICE) currently recommends considering a structured group physical activity programme as a treatment option for people with mild-to-moderate depression and persistent ‘subthreshold’ depressive symptoms:

subthreshold depression is defined as a person meeting fewer than five symptoms on an accepted set of diagnostic criteria for identifying depression mild depression is defined as having five of the symptoms (or a few more) required to make a diagnosis, but only minor functional impairment moderate depression is when symptoms or functional impairment are between mild and severe NICE recommends that structured group physical activity is delivered in groups that are supported by a competent practitioner, and that it should typically consist of three sessions per week (lasting 45 minutes to 1 hour) over 10–14 weeks.

This new study suggests that walking is an activity that can help to reduce the symptoms of depression. It is a systematic review, the form of study considered to be the best way to determine what all the relevant research available says about a particular question. However, there are some limitations to this review, because the available studies are small and vary in their methods and results. This means that it is difficult to be certain exactly what level of benefit certain types of people with depression will get from walking. As the authors of the review state, more research is needed to determine which type of walking programme is best for people with depression being treated in primary care.

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