THURSDAY, Feb. 4 (HealthDay News) -- For many people whose depression goes untreated, symptoms persist and worsen over time, eventually leading to a diagnosis of major depression, according to new research.

The finding stems from a study of 348 adults who had been diagnosed with mild depressive symptoms by their primary care physicians. They were not receiving treatment for depression at the time of the visit and had not received any such treatment in the previous year.

Four years later, the researchers, from Columbia University, found that 62 percent of the group was experiencing major depression. In addition, their level of social functioning was significantly worse and they were more than six times as likely as non-depressed people to have made one or more visits to a psychiatric emergency room in the preceding year.

The researchers also found that mild depression in the initial assessment predicted some type of alcohol or drug use disorder at the follow-up, as well as poor or fair emotional and physical health.

The study is in the February issue of Psychiatric Services.

"These findings come in the wake of intensive focus by the media on a study reported in January, which showed that depressed patients with mild symptoms did not do any better with medication than with placebo, suggesting that patients with mild depression don't need treatment," the study's lead author, Myrna M. Weissman, a Columbia University professor, said in a news release from the American Psychiatric Association. "Of course, patients in a clinical trail are receiving a considerable amount of attention and are not untreated."

"Our findings suggest that mildly depressed, untreated patients do not have a benign course of illness," she said.

More information

The U.S. National Institute of Mental Health has more about depression.

WEDNESDAY, Feb. 3 (HealthDay News) -- Some patients thought to be in a vegetative state actually show signs of consciousness when assessed with a brain scan.

A team of British and Belgian neuroscientists conducted functional magnetic resonance imaging (fMRI) on 54 patients who were diagnosed as being in a vegetative or a minimally conscious state because of traumatic brain injury, brain stem stroke, meningitis or other brain injury.

When the patients were asked to think about hitting a tennis ball or walking around their home or neighborhood, brain scans for five of them showed they could "willfully modulate their brain activity," or show evidence of conscious thought, said lead study author Martin Monti, a neuroscientist at the Medical Research Council Cognition and Brain Sciences Unit in Cambridge, England.

Researchers could tell the brain activity was conscious thought because the patients' brain activity was similar to that of healthy controls performing the same mental tasks, according to the study in the Feb. 2 issue of the New England Journal of Medicine.

Additional tests found three patients could follow commands or make small movements that further showed some level of awareness. Two had been considered vegetative and one minimally conscious.

In the other two, however, researchers could not find any discernible evidence that they could respond.

As a result of the testing, four patients originally diagnosed as being in a vegetative state were reclassified as being minimally conscious.

"There is no 'consciousness meter' we can put next to the brain and say if someone is conscious. We can only look at how people behave and infer if they are conscious or not," Monti said. "The problem is behavior is not always a good measure of consciousness. fMRI seems to be one way of determining if a patient who is not responsive behaviorally is, in fact, conscious."

Patients in a vegetative state appear to awaken after a coma but show no signs of awareness of self or their environment. Though their eyes are open, they have no purposeful actions, explained Dr. Allan Ropper, a neurologist at Brigham and Women's Hospital in Boston, who wrote an accompanying editorial. Their behavior is limited to reflexive behaviors, such as roving eye movements, swallowing or yawning.

The minimally conscious state is a newer term that describes patients with very limited and erratic verbal or motor responses to a spoken voice or other external stimuli.

The research raises provocative questions about the nature of consciousness and self-awareness, Ropper said.

Even if brain scans show hints of residual consciousness, "the question is, what does it mean? That is what people are going to have to grapple with," Ropper said. "It has to do with what you think life is and what is a meaningful life. Those are social, cultural and theological questions."

Ropper also cautioned against families gleaning a false sense of hope. Evidence of consciousness was found in only a small percentage of patients. And all of those were patients who had suffered traumatic brain injury, not "anoxic" brain injury caused by a lack of oxygen from, say, cardiac arrest.

The ultimate hope is that brain scans could one day enable some level of communication, said Dr. Joseph Fins, a professor of medicine and public health and chief of the division of medical ethics at Weill Cornell Medical College in New York City.

"Restoring communication is the holy grail," Fins said. "The thing that families overwhelmingly want is for their loved one to be able to express their wishes, and to know that their loved one is not in pain. These are things that could profoundly impact the decisions of families found in the difficult situation of caring for someone who is vegetative or minimally consciousness."

In the study, the patient who came closest to that was a man in his 20s who had suffered traumatic brain injury at least five years earlier in a traffic accident, Monti said. His brain scan showed he was able to correctly answer questions such as, "Is your father's name Alexander?" though he could not verbalize or show through any movement that he could respond.

"We tried very hard to communicate at the bedside, but that remained impossible," Monti said. "But it is still the case that we managed to give him, to a little extent, a voice. In a sense there was a very positive outcome. We managed to interact. This is an extremely exciting thing."

In some ways, the research raises many more questions than it answers, Monti added.

"The human brain, even though we are learning more and more about it, is extremely mysterious to us in many ways," Monti said. "We are still struggling to understand the meaning of what it means to be conscious or to have streams of thought or self- awareness."

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on traumatic brain injuries.

SUNDAY, Jan. 31 (HealthDay News) -- Though basic emotions such as amusement, anger, fear and sadness are not always expressed the same way in every culture, some are universally recognizable, a new study contends.

Specifically, the researchers investigated whether the sounds associated with basic emotions are the same in different cultures. To do this, people in England and in remote settlements in northern Namibia were told a story based on a particular emotion, which was followed by two different types of emotion-related sounds, such as laughter or crying. The British group heard sounds from Namibia, and vice versa. The participants were asked to identify which of the two sounds reflected the emotion of the story.

"People from both groups seemed to find the basic emotions -- anger, fear, disgust, amusement, sadness and surprise -- the most easily recognizable," research leader Sophie Scott, of University College London, said in a news release from the Wellcome Trust, which co-funded the study. "This suggests that these emotions -- and their vocalizations -- are similar across all human cultures."

Laughter was particularly well-recognized by listeners in both groups, who agreed that laughter represented amusement, exemplified by the feeling of being tickled, according to the study, published online Jan. 25 in the Proceedings of the National Academy of Sciences.

"Tickling makes everyone laugh -- and not just [in] humans," study co-author Disa Sauter, of University College London, said in the news release. "We see this happen in other primates, such as chimpanzees, as well as other mammals. This suggests that laughter has deep evolutionary roots, possibly originating as part of playful communication between young infants and mothers."

The finding "supports the idea that laughter is universally associated with being tickled and reflects the feeling of enjoyment of physical play," Sauter added.

More information

The American Academy of Family Physicians explains how emotions can affect health  .

SATURDAY, Jan. 30 (HealthDay News) -- Fears about losing status at work and about confidentiality are among the main reasons that many American workers are more hesitant to seek treatment for mental health issues than for physical health problems, according to a national survey released this week by the American Psychiatric Association.

More than 40 percent of the 1,129 respondents said their employer was supportive or extremely supportive of their workers seeking care for health concerns. However, the online survey also found that barriers persist for workers who said their workplace is unsupportive of employees seeking treatment, especially for mental health concerns.

Among employees, 76 percent believed their work status would be damaged by seeking treatment for drug addiction, 73 percent for alcoholism, and 62 percent for depression, compared with 55 percent who thought seeking care for diabetes would affect their work status and 54 percent for heart disease.

"It is important to support an environment that encourages employees taking care of their physical and mental health," Dr. Alan Axelson, chairman of the association's Partnership for Workplace Mental Health Advisory Council, said in an association news release. "Research supports the fact that when people receive needed care, they are healthier and more productive -- and employers realize the return on their health care investment."

The partnership offers the suggestions for employers:

• Supervisors and managers should lead by example by taking care of their physical and mental health.
• Workplaces should promote prevention, early intervention and wellness programs. This includes holding health fairs, providing healthy meals and snacks at meetings, encouraging exercise and promoting a balance between work and the rest of an employee's life.
• Employees should be discouraged from coming to work if they're ill.
• Workers should be reminded of health benefits and available programs, and efforts should be taken to make sure they know how to access care.
• Employees should be reassured about confidentiality, especially those seeking mental health treatment.

More information

Mental Health America has more about mental illness and stigma  .