Background Reduced reward learning might contribute to the onset and maintenance of major depressive disorder (MDD). In particular, the inability to utilize rewards to guide behavior is hypothesized to be associated with anhedonia, a core feature and potential trait marker of MDD. Few studies have investigated whether reduced reward learning normalizes with treatment and/or reward learning predicts clinical outcome. Our goal was to test that MDD is characterized by reduced reward learning, especially in the presence of anhedonic symptoms, and to investigate the relationship between reward learning and MDD diagnosis after 8 weeks of treatment. Methods Seventy-nine inpatients and 63 healthy controls performed a probabilistic reward task yielding an objective measure of participants’ ability to modulate behaviour as a function of reward. We compared reward responsiveness between depressed patients and controls, as well as high vs. low anhedonic MDD patients. Further, we evaluated whether reward learning deficits predicted persistence of MDD after 8 weeks of treatment. Results Relative to controls, MDD patients showed reduced reward learning. Moreover, patients with high anhedonia showed diminished reward learning compared to patients with low anhedonia. Reduced reward learning at study entry increased the odds of a persisting diagnosis of MDD after 8 weeks of treatment (OR: 7.84). Conclusions Our findings indicate that depressed patients, especially those with anhedonic features, are characterized by an impaired ability to modulate behaviour as a function of reward. Moreover, reduced reward learning increased the odds for the diagnosis of MDD to persist after 8 weeks of treatment.

Increased prevalence of depressive symptoms and anxiety among pregnant women and women in the early postpartum period was observed during the lockdown in Belgium. Obstetricians must take actions to safeguard perinatal mental health.

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Introduction Evidence on perinatal mental health during the coronavirus disease 2019 (COVID‐19) pandemic and its potential determinants is limited. Therefore, this multinational study aimed to assess the mental health status of pregnant and breastfeeding women during the pandemic, and to explore potential associations between depressive symptoms, anxiety, and stress and women's sociodemographic, health, and reproductive characteristics. Material and methods A cross‐sectional, web‐based study was performed in Ireland, Norway, Switzerland, the Netherlands, and the UK between 16 June and 14 July 2020. Pregnant and breastfeeding women up to 3 months postpartum who were older than 18 years of age were eligible. The online, anonymous survey was promoted through social media and hospital websites. The Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder seven‐item scale (GAD‐7), and the Perceived Stress Scale (PSS) were used to assess mental health status. Regression model analysis was used to identify factors associated with poor mental health status. Results In total, 9041 women participated (including 3907 pregnant and 5134 breastfeeding women). The prevalence of major depressive symptoms (EDS ≥ 13) was 15% in the pregnancy cohort and and 13% the breastfeeding cohort. Moderate to severe generalized anxiety symptoms (GAD ≥ 10) were found among 11% and 10% of the pregnant and breastfeeding women. The mean (±SD) PSS scores for pregnant and breastfeeding women were 14.1 ± 6.6 and 13.7 ± 6.6, respectively. Risk factors associated with poor mental health included having a chronic mental illness, a chronic somatic illness in the postpartum period, smoking, having an unplanned pregnancy, professional status, and living in the UK or Ireland. Conclusions This multinational study found high levels of depressive symptoms and generalized anxiety among pregnant and breastfeeding women during the COVID‐19 outbreak. The study findings underline the importance of monitoring perinatal mental health during pandemics and other societal crises to safeguard maternal and infant mental health.

Involvement of the type 1 cannabinoid receptor (CB 1 R) in the effects of alcohol on the brain is supported by animal experiments, but how in vivo CB 1 R levels are altered in alcoholic patients is still unclear. To assess the short-time effects of a binge drinking episode on CB 1 R availability, 20 healthy social drinkers underwent [18 F]MK-9470-positron emission tomography (PET) at baseline and after intravenous ethanol administration (ALC ACU). Moreover, 26 alcoholic patients underwent sequential CB 1 R PET after chronic heavy drinking (ALC CHR) and after 1 month of abstinence (ALC ABST). Seventeen healthy subjects served as controls.Compared with baseline, ALC ACU resulted in a global increase of CB 1 R availability (ϩ15.8%). In contrast, a global decreased CB 1 R availability was found in ALC CHR patients (Ϫ16.1%) compared with controls, which remained unaltered after abstinence (Ϫ17.0%). Voxel-based analysis showed that ALC CHR patients had reduced CB 1 R availability, especially in the cerebellum and parieto-occipital cortex. After abstinence, reduced CB 1 R availability extended also to other areas such as the ventral striatum and mesotemporal lobe.In conclusion, whereas the acute alcohol effect is an increase in CB 1 R availability, chronic heavy drinking leads to reduced CB 1 R availability that is not reversible after 1 month of abstinence. Longer follow-up is required to differentiate whether this is a compensatory effect of repeated endocannabinoid overstimulation or an enduring trait-like feature. An enhanced CB 1 R signaling may offer a new therapeutic direction for treatment of the negative affective state produced by alcohol withdrawal and abstinence, which is critical for the maintenance of alcohol addiction.

Background: Major Depressive Disorder (MDD) is a heterogeneous disease. More homogeneous psycho(patho)logical dimensions would facilitate MDD research as well as clinical practice. The first aim of this study was to find potential dimensions within a broad psychopathological assessment in depressed patients. Secondly, we aimed at examining how these dimensions predicted course in MDD. Methods: Ten psychopathological variables were assessed in 75 MDD inpatients. Factor and regression analyses assessed putative relations between psychopathological factors and depression severity and outcome after 8 weeks of treatment. Results: A 3 factor model (eigenvalue: 54.4%) was found, representing a psychomotor change, anhedonia and negative affect factor. Anhedonia and negative affect predicted depression severity (R2=0.37, F=20.86, p<0.0001). Anhedonia predicted non-response (OR 6.00, CI 1.46–24.59) and both negative affect (OR 5.69, CI 1.19–27.20) and anhedonia predicted non-remission (OR 9.28, CI 1.85–46.51). Limitations: The sample size of the study was relatively modest, limiting the number of variables included in the analysis. Conclusions: Results confirm that psychomotor change, anhedonia and negative affect are key MDD dimensions, two of which are related to treatment outcome.

We found evidence of NR3C1 promoter hypomethylation in female patients with CFS and the functional relevance of these differences was consistent with the hypothalamic-pituitary-adrenalaxis hypofunction hypothesis (GR hypersuppression). However, we found no evidence of an additional effect of childhood trauma on CFS via alterations in NR3C1 methylation.

Background: This exploratory study investigates the influence of maternal cortisol and emotional state during pregnancy on fetal intrauterine growth (IUG). We expected higher basal cortisol levels, or more depressive and anxious complaints during pregnancy, to be associated with slower IUG and lower birth weight. Methods: a total of 91 pregnant women were recruited from the antenatal clinic and were seen once each trimester. In addition to psychological assessments, a diurnal cortisol profile was derived from saliva samples. IUG was evaluated using ultrasound. results: In mid-pregnancy (trimester (T)2), basal cortisol levels significantly predicted the variance of weight (proportion of variance in growth variable explained (PVe) = 11.6%) and body mass index (BMI) at birth (PVe = 6.8%). In late pregnancy (T3) emotional state, particularly depressive symptoms (BMI at birth: PVe = 6.9%; ponderal index (PI) at birth: PVe = 8.2%; head circumference at T3: PVe = 10.3%; head circumference at birth PVe = 9.1%) and attachment (BMI at birth: PVe = 6.9%; PI at birth: PVe = 7.2%) had an influence on growth. analysis of growth between T2 and T3 showed that attachment and cortisol in T3 had an influence on the variation in increase in estimated fetal weight (PVe = 12.5-8.6%).