***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To look at the modification in depressive mood in postmenopausal depressed women after estrogen replacement therapy ( ERT ) .  METHOD Twelve depressed patients divided into two groups of six women each were studied . One group received conjugated equine estrogens ( CEE ) 0.625 mg/day ; the other did not receive any treatment ( control group ) . Mood was assessed in all the subjects at baseline and at 6 months with Hamilton Rating Scale score and considered as depression when it was > 15 . Differences between groups were determined by Mann-Whitney U-test , and in each group between baseline and 6-month values with Wilcoxon test . RESULTS The ERT group had a statistically significant decrease in depressive mood ( 21 vs. 13 points , P < 0.03 ) , while in the control group no significant change was found . Final Hamilton scale scores were significantly lower ( P < 0.05 ) in those under ERT , when compared with those in the control group . CONCLUSION Depressive mood decreased after 6 months with CEE , so the prescription of ERT can be useful in postmenopausal women with depressive mood Abstract 5′-Methyltetrahydrofolic acid ( 5′- MTHF ) in addition to st and ard psychotropic medication significantly improved clinical recovery in depressed patients with borderline or definite folate deficiency , and significantly reduced depressive symptoms in elderly normofolatemic patients after 3 weeks of treatment . In this equivalence study the effect of 5′- MTHF on depressive symptoms and cognitive status was compared to Trazodone ( TRZ ) in normofolatemic elderly patients with mild to moderate dementia and depression . Ninety-six patients with dementia , scoring 12–23 at the Mini Mental State Examination ( MMSE ) and ≥18 at the Hamilton Depression Rating Scale ( HDRS ) after a 2-week placebo run-in , were r and omized to receive either 5′-MTHF ( 50 mg/day p.o . ) ( 47 patients ) or TRZ ( 100 mg/day p.o . ) ( 49 patients ) in a double-blind design for 8 weeks . HDRS was assessed before , after 4 weeks and at the end of treatment ; Rey ’s Verbal Memory ( RVM ) test for immediate and delayed recall was evaluated before and after treatment . After 4 weeks of treatment HDRS score was reduced from 23±5 to 20±6 in the 5′-MTHF ( p<0.05 vs baseline ) , and from 23±3 to 21±4 in the TRZ group ( p<0.05 vs baseline ) . p]A further significant decrease to 18±6 and 19±5 respectively was obtained at the end of the treatment period ( p<0.05 vs week 4 ) with 5′-MTHF and TRZ . HDRS was administered again after a 4-week , drug-free , follow-up period : no change vs the post treatment scores was observed either in the 5′-MTHF or in the TRZ group ( 18±7 and 19±5 respectively ) . RVM test for immediate recall was significantly improved ( p<0.05 ) at week 8 vs baseline in the 5′-MTHF group whereas no significant change occurred in the TRZ group . No change in delayed recall was observed after treatment in either group . Tolerability was good for both treatments . This study shows that 5′-MTHF and TRZ are equally effective in improving depressive symptoms in patients with mild to moderate dementia and suggests that pharmacological doses of 5′-MTHF may exert psychotropic effects irrespective of folate status . ( Aging Clin . Exp . Res . 1 : 63–71 , 1993 BACKGROUND It has been hypothesized that n-3 polyunsaturated fatty acids ( PUFAs ) are involved in mood regulation , but epidemiologic evidence for such a link in the general population is lacking . OBJECTIVE This study examined whether community-dwelling elderly persons with depression have a fatty acid composition that is different from that of nondepressed persons . DESIGN We screened 3884 adults aged > or = 60 y for depressive symptoms as part of the Rotterdam Study . Subjects who screened positive had a psychiatric interview to diagnose depressive disorders . All eligible subjects had their blood drawn for measurement of plasma phospholipid concentrations . We compared percentages of n-3 and n-6 PUFAs and their ratios between 264 subjects with depressive symptoms , including 106 subjects with depressive disorders , and 461 r and omly selected reference subjects . We also investigated whether atherosclerosis or the inflammatory response as measured by C-reactive protein underlies the relation between fatty acid composition and depression . RESULTS Subjects with depressive disorders had a higher ratio of n-6 to n-3 PUFAs , but differences in individual PUFAs were mostly small . However , depressed subjects with normal CRP concentrations ( < 1.5 mg/L ) had a substantially altered fatty acid composition ; percentages of n-3 PUFAs and ratios of n-6 to n-3 PUFAs were significantly lower and higher , respectively , in subjects with depressive disorders than in control subjects [ 5.2 % compared with 5.9 % ( P = 0.02 ) and 7.2 compared with 6.6 ( P = 0.01 ) , respectively ] . This relation was not due to atherosclerosis . CONCLUSIONS In community-dwelling persons , fatty acid composition is related to depression . Because this relation was not secondary to inflammation , atherosclerosis , or possible confounders , it suggests a direct effect of fatty acid composition on mood BACKGROUND Transcranial magnetic stimulation ( TMS ) , a noninvasive technique for stimulation of the brain , has recently been suggested to be effective for the treatment of major depression . We conducted a double-blind , placebo-controlled study to assess the efficacy of slow repetitive TMS ( rTMS ) in patients with major depression . METHODS Seventy patients with major depression ( 53 women , 17 men ; mean age , 58.7 years ; SD , 17.2 years ) were r and omly assigned to receive rTMS or sham rTMS in a double-blind design . Treatment was administered in 10 daily sessions during a 2-week period . Severity of depression was blindly assessed before , during , and after completion of the treatment protocol . RESULTS All patients completed the first week of treatment and 67 completed the entire protocol . Patients who received rTMS had a significantly greater improvement in depression scores compared with those who received sham treatment . At the end of 2 weeks , 17 of 35 patients in the rTMS group , but only 8 of 32 in the sham-treated group , had an improvement of greater than 50 % in their depression ratings . CONCLUSIONS This controlled study provides evidence for the short-term efficacy of slow rTMS in patients with recurrent major depression . Additional studies will be necessary to assess the efficacy of rTMS as compared with electroconvulsive therapy as well as the long-term outcome of this treatment in major depression and possibly other psychiatric disorders Rapid transcranial magnetic stimulation ( rTMS ) applied to the left dorsal lateral frontal cortex has been shown to produce antidepressant effects . Older depressed patients , however , in one study showed a lower response rate than younger patients . The current study examined treatment response in 20 depressed , treatment-refractory patients ( mean age 60.7 + /- 9.8 years ) given five sessions of rTMS at 20 Hz for 2 seconds over 20 trains at 80 % of motor threshold or identical placebo stimulation , after patients had been withdrawn from their antidepressants . There were no significant differences in Hamilton Depression Scale scores either before or after treatment at 7 days ' follow-up . There were three responders to active treatment and three to sham treatment and responders had significantly greater frontal lobe volume than nonresponders ( p = .03 ) . These findings suggest that the stimulation parameters used in this study were probably insufficient to produce treatment response and that frontal atrophy may interfere with the effectiveness of rTMS OBJECTIVE Although there is evidence for the efficacy of antidepressants and for some individual and group psychotherapy interventions for depressed older adults , a significant number of these do not respond to treatment . Authors assessed the benefits of augmenting medication with group psychotherapy . METHODS They r and omly assigned 34 ( largely chronically ) depressed individuals age 60 and older to receive 28 weeks of antidepressant medication plus clinical management , either alone ( MED ) or with the addition of dialectical behavior therapy skills-training and scheduled telephone coaching sessions ( MED+DBT ) . RESULTS Only MED+DBT showed significant decreases on mean self-rated depression scores , and both treatment groups demonstrated significant and roughly equivalent decreases on interviewer-rated depression scores . However , on interviewer-rated depression , 71 % of MED+DBT patients were in remission at post-treatment , in contrast to 47 % of MED patients . At a 6-month follow-up , 75 % of MED+DBT patients were in remission , compared with only 31 % of MED patients , a significant difference . Only patients receiving MED+DBT showed significant improvements from pre- to post-treatment on dependency and adaptive coping that are proposed to create vulnerability to depression . CONCLUSION Results from this pilot study suggest that DBT skills training and telephone coaching may offer promise to effectively augment the effects of antidepressant medication in depressed older adults Objectives : 1 ) To compare serum vitamin B12 , C and folate concentrations in a r and omly selected sample of elderly ( age 65 years or older ) male and female Hispanics and nonHispanic whites ( NHW ) and 2 ) to examine associations between serum B12 , C and folate concentrations compared to measures of cognitive and affective ( depression ) functions . Methods : Equal numbers of male and female Hispanics and NHW were r and omly sample d from the Health Care Financing Administration ( Medicare ) registrant list for Bernalillo County , New Mexico , and asked to volunteer for a paid home interview followed by a paid comprehensive interview/examination covering health and health-related issues . In addition to serum determinations of B12 , C and folate , associations were examined between these vitamins and measures of cognitive and affective functions . Results : Males and Hispanics had lower serum vitamin B12 , C and folate concentrations than females and NHW respectively . Participants taking a multivitamin supplement ( MVI ) had higher serum vitamin concentrations than those not taking MVI . There were significant associations between serum folate concentrations and measures of cognitive function , not seen with B12 or C , nor between any of the vitamins and affective function . Conclusions : Hispanics , even after adjustments for gender , age , vitamin supplementation , vitamin content of dietary foods , education and household income , had lower serum concentrations of B12 , C and folate than NHW . The most significant associations observed were those between serum folate and various measures of cognitive function , even after adjusting for presence of depression OBJECTIVE To investigate the reported association between low vitamin E levels and depressive symptoms in a population -based study . METHODS The study is based on a cohort of 3884 adults aged 60 years and over who participated in the third survey of the Rotterdam Study , were screened for depressive symptoms with the Center of Epidemiological Studies Depression Scale and from whom blood was drawn . All screen-positive subjects had a psychiatric work-up .  Blood levels of vitamin E  were compared between 262 cases with depressive symptoms and 459 r and omly selected reference subjects . All analyses were stratified by sex , and adjusted for age , cholesterol , cognitive score , smoking , dietary supplement use , marital status , living alone , and functional disability score . RESULTS  Vitamin E levels in men with depressive symptoms were lower than in non-depressed men after adjusting for age , whereas no such difference was found in women . This association in men was substantially weakened after controlling for biological factors , and disappeared with additional adjustment for nutritional behaviour and social factors . No differences were observed when the analyses were restricted to cases with depression as defined in the Diagnostic and Statistical Manual of Mental Disorders IV . CONCLUSIONS After control for several biological and behavioural factors relating to health we found no association between low vitamin E levels and depressive symptoms or depression in the elderly Repetitive transcranial magnetic stimulation ( rTMS ) is a recent putative treatment for affective disorders . Several studies have demonstrated antidepressant effects of rTMS in younger patients ; we aim ed to assess its effect in older out patients with treatment-resistant major depression . Twenty-four out patients ( mean age=62 years , S.D.=12 ) with major depression were r and omized for sham or real stimulation and received 10 daily rTMS sessions ( 20 Hz , 2-s trains , 28-s intertrain intervals , 100 % of motor threshold ) in addition to the antidepressant medication . For sham stimulation , the coil was tilted 90 degrees . Depression severity was assessed using the Hamilton Depression Rating Scale , the Beck Depression Inventory , items from the NIMH self-rated symptom scale , and a visual analog depression scale . Mini-Mental Status Examination performance , memory , and executive and attentional functions were measured to control for cognitive side effects . Depression ratings revealed significant antidepressant effects within 2 weeks in both sham and real stimulation groups ; however , there were no between-group differences . Treatment with  rTMS  was safe ; adverse events were rare and not more prevalent in either group , and cognitive assessment did not show any deter 
    Output:
    
The treatments with the best evidence of effectiveness are antidepressants , electroconvulsive therapy , cognitive behaviour therapy , psychodynamic psychotherapy , reminiscence therapy , problem-solving therapy , bibliotherapy ( for mild to moderate depression ) and exercise .
There is limited evidence to support the effectiveness of transcranial magnetic stimulation , dialectical behaviour therapy , interpersonal therapy , light therapy ( for people in nursing homes or hospitals ) , St John 's wort and folate in reducing depressive symptoms