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Solelhac G, Imler T, Strippoli MPF, Marchi NA, Berger M, Haba-Rubio J, Raffray T, Bayon V, Lombardi AS, Ranjbar S, Siclari F, Vollenweider P, Marques-Vidal P, Geoffroy PA, Léger D, Stephan A, Preisig M, Heinzer R. Sleep disturbances and incident risk of major depressive disorder in a population-based cohort. Psychiatry Res 2024; 338:115934. [PMID: 38833937 DOI: 10.1016/j.psychres.2024.115934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 06/06/2024]
Abstract
Sleep disturbances are well-known symptoms of major depressive disorder (MDD). However, the prospective risk of MDD in the presence of sleep disturbances in a general population-based cohort is not well known. This study investigated associations between both polysomnography (PSG)-based or subjective sleep features and incident MDD. Participants representative of the general population who had never had MDD completed sleep questionnaires (n = 2000) and/or underwent PSG (n = 717). Over 8 years' follow-up, participants completed psychiatric interviews enabling the diagnosis of MDD. Survival Cox models were used to analyze associations between sleep features and MDD incidence. A higher Epworth Sleepiness Scale and presence of insomnia symptoms were significantly associated with a higher incidence of MDD (hazard ratio [HR] [95 % confidence interval (CI)]: 1.062 [1.022-1.103], p = 0.002 and 1.437 [1.064-1.940], p = 0.018, respectively). Higher density of rapid eye movements in rapid eye movement (REM) sleep was associated with a higher incidence of MDD in men (HR 1.270 [95 % CI 1.064-1.516], p = 0.008). In women, higher delta power spectral density was associated with a lower MDD incidence (HR 0.674 [95 % CI 0.463-0.981], p = 0.039). This study confirmed the associations between subjective and objective sleep features and the incidence of MDD in a large community dwelling cohort.
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Affiliation(s)
- Geoffroy Solelhac
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Théo Imler
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Marie-Pierre F Strippoli
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Nicola Andrea Marchi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Mathieu Berger
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Jose Haba-Rubio
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland
| | - Tifenn Raffray
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Florimont Sleep Center, Lausanne, Switzerland
| | - Virginie Bayon
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Anne Sophie Lombardi
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Setareh Ranjbar
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Francesca Siclari
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland; Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pierre-Alexis Geoffroy
- GHU Paris - Psychiatry & Neurosciences, Paris, France; Université de Paris, NeuroDiderot, Inserm, Paris, France; Département de Psychiatrie et d'Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat - Claude Bernard, Paris, France
| | - Damien Léger
- Université Paris Cité, VIFASOM, AP-HP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Aurélie Stephan
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Center for research in Psychiatric Epidemiology and Psychopathology (CEPP), Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Raphaël Heinzer
- Center for Investigation and Research in Sleep (CIRS), Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Zuloaga DG, Lafrican JJ, Zuloaga KL. Androgen regulation of behavioral stress responses and the hypothalamic-pituitary-adrenal axis. Horm Behav 2024; 162:105528. [PMID: 38503191 PMCID: PMC11144109 DOI: 10.1016/j.yhbeh.2024.105528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/02/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
Testosterone is a powerful steroid hormone that can impact the brain and behavior in various ways, including regulating behavioral and neuroendocrine (hypothalamic-pituitary-adrenal (HPA) axis) stress responses. Early in life androgens can act to alter development of brain regions associated with stress regulation, which ultimately impacts the display of stress responses later in life. Adult circulating androgens can also influence the expression of distinct genes and proteins that regulate stress responses. These changes in the brain are hypothesized to underlie the potent effects of androgens in regulating behaviors related to stress and stress-induced activation of the HPA axis. Androgens can induce alterations in these functions through direct binding to the androgen receptor (AR) or following conversion to estrogens and subsequent binding to estrogen receptors including estrogen receptor alpha (ERα), beta (ERβ), and G protein-coupled estrogen receptor 1 (GPER1). In this review, we focus on the role of androgens in regulating behavioral and neuroendocrine stress responses at different stages of the lifespan and the sex hormone receptors involved in regulating these effects. We also review the specific brain regions and cell phenotypes upon which androgens are proposed to act to regulate stress responses with an emphasis on hypothalamic and extended amygdala subregions. This knowledge of androgen effects on these neural systems is critical for understanding how sex hormones regulate stress responses.
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Affiliation(s)
- Damian G Zuloaga
- Department of Psychology, University at Albany, Albany, NY, USA.
| | | | - Kristen L Zuloaga
- Department of Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA
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Berardelli I, Aguglia A, Amerio A, Sarubbi S, Rogante E, Trocchia MA, Zelletta D, Longhini L, Erbuto D, Pastorino F, Lamis DA, Innamorati M, Serafini G, Pompili M. Characterization of Psychiatric Inpatients: The Role of Gender Differences in Clinical and Pharmacological Patterns. J Psychiatr Pract 2024; 30:2-12. [PMID: 38227722 DOI: 10.1097/pra.0000000000000756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND Severe mental disorders that require hospitalization are disabling conditions that contribute to the burden of mental diseases. They pose increased clinical challenges and highlight the need to thoroughly explore variables emerging from daily clinical practice. In this study, we assessed to what extent gender differences may characterize a large population of psychiatric inpatients. METHODS We conducted a cross-sectional study in 2 Italian teaching medical centers, which included 2358 patients who were consecutively admitted to the psychiatric emergency units. We explored and characterized gender differences for variables such as prevalence of psychiatric diagnosis, presence of suicidal ideation, suicide attempts, age at onset of psychiatric illness, presence of substance or alcohol abuse, length of stay, number of hospitalizations, presence of involuntary admission, type of discharge from the hospital, and pharmacological treatment at discharge. RESULTS Female patients were primarily diagnosed with bipolar disorder or personality disorders. Female patients had a significantly higher prevalence of lifetime suicide attempts (23.1% vs. 16.5%, P<0.001) and a longer length of hospitalization (11.43±10.73 d vs. 10.52±10.37 d, t=-2.099, gl=2356, P=0.036) compared with male patients. Male patients had more involuntary admissions (25.1% vs. 19.7%, χ2=9.616, gl=1, P=0.002), more use of illicit substances (34.1% vs. 20.9%, χ2=51.084, gl=1, P<0.001), and higher rates of alcohol abuse (21.3% vs. 14.7%, χ2=17.182, gl=1, P<0.001) compared with female patients. Finally, antidepressants and lithium were prescribed more frequently to the female patients, whereas other mood stabilizers were more often prescribed to the male patients. CONCLUSIONS Our real-world results highlighted gender differences among patients with severe mental disorders admitted to psychiatric units, and suggest further investigations that may help in understanding trajectories accompanying disabling clinical conditions.
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Gersamia AG, Pochigaeva KI, Less YE, Akzhigitov RG, Guekht AB, Gulyaeva NV. [Gender characteristics of depressive disorders: clinical, psychological, neurobiological and translational aspects]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:7-16. [PMID: 38529858 DOI: 10.17116/jnevro20241240317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Various studies have indicated that the prevalence of depression is almost twice as high among women as among men. A major factor associated with the development of depression and other affective disorders are adverse and psychologically traumatic life events that contribute to changes in the neuroendocrine system, altering the capacity to adapt to stress. These changes are involved in the pathogenesis of mental disorders, along with genetic and other factors, and are to a significant degree regulated by gender dependent mechanisms. While women have a high prevalence of depressive disorders, men show a higher rate of alcohol and substance abuse. These differences in the epidemiology are most likely explained by different predisposition to mental disorders in men and women and a diversity of biological consequences to adverse life events. Taking this into account, there is a need for a critical review of currently used approaches to modeling depressive disorders in preclinical studies, including the use of animals of both sexes. Adaptation of experimental models and protocols taking into account gender characteristics of neuroendocrine changes in response to stress, as well as structural-morphological, electrophysiological, molecular, genetic and epigenetic features, will significantly increase the translational validity of experimental work.
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Affiliation(s)
- A G Gersamia
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - K I Pochigaeva
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Yu E Less
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - R G Akzhigitov
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - A B Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - N V Gulyaeva
- Institute of Higher Nervous Activity and Neurophysiology of RAS, Moscow, Russia
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Tian F, Zhu L, Shi Q, Wang R, Zhang L, Dong Q, Qian K, Zhao Q, Hu B. The Three-Lead EEG Sensor: Introducing an EEG-Assisted Depression Diagnosis System Based on Ant Lion Optimization. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2023; 17:1305-1318. [PMID: 37402182 DOI: 10.1109/tbcas.2023.3292237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
For depression diagnosis, traditional methods such as interviews and clinical scales have been widely leveraged in the past few decades, but they are subjective, time-consuming, and labor-consuming. With the development of affective computing and Artificial Intelligence (AI) technologies, Electroencephalogram (EEG)-based depression detection methods have emerged. However, previous research has virtually neglected practical application scenarios, as most studies have focused on analyzing and modeling EEG data. Furthermore, EEG data is typically obtained from specialized devices that are large, complex to operate, and poorly ubiquitous. To address these challenges, a wearable three-lead EEG sensor with flexible electrodes was developed to obtain prefrontal-lobe EEG data. Experimental measurements show that the EEG sensor achieves promising performance (background noise of no more than 0.91 μVpp, Signal-to-Noise Ratio (SNR) of 26--48 dB, and electrode-skin contact impedance of less than 1 K Ω). In addition, EEG data from 70 depressed patients and 108 healthy controls were collected using the EEG sensor, and the linear and nonlinear features were extracted. The features were then weighted and selected using the Ant Lion Optimization (ALO) algorithm to improve classification performance. The experimental results show that the k-NN classifier achieves a classification accuracy of 90.70%, specificity of 96.53%, and sensitivity of 81.79%, indicating the promising potential of the three-lead EEG sensor combined with the ALO algorithm and the k-NN classifier for EEG-assisted depression diagnosis.
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Wang X, Xia Y, Yan R, Sun H, Huang Y, Zou H, Du Y, Hua L, Tang H, Zhou H, Yao Z, Lu Q. The sex differences in anhedonia in major depressive disorder: A resting-state fMRI study. J Affect Disord 2023; 340:555-566. [PMID: 37591350 DOI: 10.1016/j.jad.2023.08.083] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 07/23/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE The external behavioural manifestations and internal neural mechanisms of anhedonia are sexually dimorphic. This study aimed to explore the sex differences in the regional brain neuroimaging features of anhedonia in the context of major depressive disorder (MDD). METHOD The resting-fMRI by applying amplitude of low-frequency fluctuation (ALFF) method was estimated in 414 patients with MDD (281 high anhedonia [HA], 133 low anhedonia [LA]) and 213 healthy controls (HC). The effects of two factors in patients with MDD were analysed using a 2 (sex: male, female) × 2 (group: HA, LA) ANOVA concerning the brain regions in which statistical differences were identified between patients with MDD and HC. We followed up with patients with HA at baseline, and 43 patients completed a second fMRI scan in remission. Paired t-test was performed to compare the ALFF values of anhedonia-related brain regions between the baseline and remission periods. RESULTS For the sex-by-group interaction, the bilateral insula, right hippocampus, right post cingulum cortex, and left putamen showed significant differences. Furthermore, the abnormally elevated ALFF values in anhedonia-related brain regions at baseline decreased in remission. CONCLUSION Our findings point to the fact that the females showed unique patterns of anhedonia-related brain activity compared to males, which may have clinical implications for interfering with the anhedonia symptoms in MDD. Using task fMRI, we can further examine the distinct characteristics between consumption anhedonia and anticipation anhedonia in MDD.
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Affiliation(s)
- Xiaoqin Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Yi Xia
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Rui Yan
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Hao Sun
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, China
| | - Yinghong Huang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, China
| | - Haowen Zou
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, China
| | - Yishan Du
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Lingling Hua
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Hao Tang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Hongliang Zhou
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Zhijian Yao
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China; Nanjing Brain Hospital, Medical School of Nanjing University, 22 Hankou Road, Nanjing 210093, China; School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China.
| | - Qing Lu
- School of Biological Sciences and Medical Engineering, Southeast University, 2 sipailou, Nanjing 210096, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Nanjing 210096, China.
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Nieves GM, Bravo M, Bath KG. Early life adversity ablates sex differences in active versus passive threat responding in mice. Stress 2023; 26:2244598. [PMID: 37624104 PMCID: PMC10529224 DOI: 10.1080/10253890.2023.2244598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023] Open
Abstract
Early life adversity (ELA) heightens the risk for anxiety disorders (which are characterized by heightened fear and avoidance behaviors), with females being twice as likely as males to develop pathology. Pavlovian fear conditioning tasks have been used to study possible mechanisms supporting endophenotypes of pathology. Identification of sex and ELA selective effects on the nature of behavioral responding in these paradigms may provide a unique window into coping strategies in response to learned fear to guide more mechanistic studies. The goals of this study were two-fold; First, to test if male and female mice employed different coping strategies in response to threat learning using different conditioning parameters (low, medium, and high intensity foot shocks). Second, to test if ELA in the form of limited bedding and nesting (LBN) altered the behavioral response of mice to conditioning. Mice received 6 tone/foot-shock pairings at one of three different foot-shock intensities (0.35 mA; 0.57 mA; 0.7 mA). Freezing, darting, and foot-shock reactivity were measured across trials. During conditioning, control-reared female mice exhibited significantly higher rates of darting behavior compared to control males at nearly all shock intensities tested. LBN rearing decreased the proportion of darting females to levels observed in males. Thus, ELA in the form of LBN significantly diminished the recruitment of active versus passive coping strategies in female mice but did not generally change male responding. Additional work will be required to understand the neural basis of these behavioral effects. Findings extending from this work have the potential to shed light on how ELA impacts trajectories of regional brain development with implications for sex-selective risk for behavioral endophenotypes associated with pathology and possibly symptom presentation.
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Affiliation(s)
- Gabriela Manzano Nieves
- Department of Psychiatry, Sackler Institute for Developmental Psychobiology, and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York 10021
| | - Marilyn Bravo
- David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, 90095
| | - Kevin G. Bath
- Division of Developmental Neuroscience, New York State Psychiatric Institute/Research Foundation for Mental Hygiene, 1051 Riverside Drive, New York, NY, 10032
- Department of Psychiatry, Columbia University Medical College, New York, NY 1003
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8
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Eo YS. The prevalence of depression and its association with sociodemographic factors in menopausal women in South Korea. J Women Aging 2023; 35:417-427. [PMID: 35895808 DOI: 10.1080/08952841.2022.2104570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
This study examined factors that may be associated with depression among middle-aged women in South Korea using data from the 2018 (7th) wave of the Korean Longitudinal Survey of Women and Families. A sample of 6,399 women aged 35-64 years was included. Multivariate logistic regression was performed to identify factors associated with depressive symptoms, as measured by the CES-D-10 scale (Center for Epidemiological Studies Depression), in pre- and post-menopausal women. Results indicated that being single, having poorer self-rated health, and having a lower economic background were associated with an increased risk of depression in both groups. Being unemployed also increased the risk of depressed mood in pre-menopausal women, while factors significantly associated with an increased risk of depressive symptoms in post-menopausal women included having a lower level of education, musculoskeletal pain, and having pain or discomfort. Thus, these factors should be considered when developing interventions to improve the mood and quality of life of middle-aged women. Interventions in the local community may include health services (hormone therapy), educational learning programs, counselling, and improved access to leisure activities.
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Affiliation(s)
- Yong-Sook Eo
- Department of Nursing, Dongguk University, Gyeongju-si, South Korea
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9
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Collins B, Biddle M, Wood DR, Boyapati S, Barth M, Jeun C, Knox D. The role of avoidance in modulating single prolonged stress effects on emotional memory in male and female rats. Behav Brain Res 2023; 452:114579. [PMID: 37451551 PMCID: PMC10530017 DOI: 10.1016/j.bbr.2023.114579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
The incidence of post traumatic stress disorder (PTSD) is greater in women than men, but mechanisms via which this difference manifests remain under explored. The single prolonged stress (SPS) rodent model of traumatic stress has been used to identify mechanisms through which traumatic stress leads to deficits in retaining extinction (a core PTSD symptom), but has been mostly utilized in male model systems. Recent studies have observed that SPS leads to changes in persistent fear memory in female rats, though these results are variable. This variability could be driven by changes in behavioral strategy in females during extinction, but this possibility has not been sufficiently explored. To address this, we examined the impact of SPS on freezing and avoidance (a core PTSD symptom) during extinction in male and female rats. In male rats, SPS enhanced acquisition of conditioned freezing, but did not enhance freezing during extinction training or testing. SPS also decreased avoidance during extinction training, but not extinction testing. In female rats, SPS had no impact on conditioned freezing. Avoidance was not observed in control rats, but emerged in SPS/female rats during extinction testing. Furthermore, avoidance was negatively correlated with freezing in female rats (high avoidance associated with lower freezing), but this relationship was disrupted with SPS. The results suggest that introducing avoidance during extinction negates SPS effects on extinction retention in male and female rats, control/female rats engage in avoidance to regulate fear expression, and this relationship is disrupted with SPS.
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Affiliation(s)
- Bailey Collins
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Matthew Biddle
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Donna R Wood
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Sushma Boyapati
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Michelle Barth
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Celine Jeun
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA
| | - Dayan Knox
- Department of Psychological and Brain Science, University of Delaware, Newark, DE, USA.
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Wright CJ, Milosavljevic S, Pocivavsek A. The stress of losing sleep: Sex-specific neurobiological outcomes. Neurobiol Stress 2023; 24:100543. [PMID: 37252645 PMCID: PMC10209346 DOI: 10.1016/j.ynstr.2023.100543] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/20/2023] [Accepted: 05/06/2023] [Indexed: 05/31/2023] Open
Abstract
Sleep is a vital and evolutionarily conserved process, critical to daily functioning and homeostatic balance. Losing sleep is inherently stressful and leads to numerous detrimental physiological outcomes. Despite sleep disturbances affecting everyone, women and female rodents are often excluded or underrepresented in clinical and pre-clinical studies. Advancing our understanding of the role of biological sex in the responses to sleep loss stands to greatly improve our ability to understand and treat health consequences of insufficient sleep. As such, this review discusses sex differences in response to sleep deprivation, with a focus on the sympathetic nervous system stress response and activation of the hypothalamic-pituitary-adrenal (HPA) axis. We review sex differences in several stress-related consequences of sleep loss, including inflammation, learning and memory deficits, and mood related changes. Focusing on women's health, we discuss the effects of sleep deprivation during the peripartum period. In closing, we present neurobiological mechanisms, including the contribution of sex hormones, orexins, circadian timing systems, and astrocytic neuromodulation, that may underlie potential sex differences in sleep deprivation responses.
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Affiliation(s)
| | | | - Ana Pocivavsek
- Corresponding author. Pharmacology, Physiology, and Neuroscience, USC School of Medicine, Columbia, SC, 29208, USA.
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11
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The role of estrogen receptor manipulation during traumatic stress on changes in emotional memory induced by traumatic stress. Psychopharmacology (Berl) 2023; 240:1049-1061. [PMID: 36879072 DOI: 10.1007/s00213-023-06342-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/13/2023] [Indexed: 03/08/2023]
Abstract
RATIONALE Traumatic stress leads to persistent fear, which is a core feature of post-traumatic stress disorder (PTSD). Women are more likely than men to develop PTSD after trauma exposure, which suggests women are differentially sensitive to traumatic stress. However, it is unclear how this differential sensitivity manifests. Cyclical changes in vascular estrogen release could be a contributing factor where levels of vascular estrogens (and activation of estrogen receptors) at the time of traumatic stress alter the impact of traumatic stress. METHODS To examine this, we manipulated estrogen receptors at the time of stress and observed the effect this had on fear and extinction memory (within the single prolonged stress (SPS) paradigm) in female rats. In all experiments, freezing and darting were used to measure fear and extinction memory. RESULTS In Experiment 1, SPS enhanced freezing during extinction testing, and this effect was blocked by nuclear estrogen receptor antagonism prior to SPS. In Experiment 2, SPS decreased conditioned freezing during the acquisition and testing of extinction. Administration of 17β-estradiol altered freezing in control and SPS animals during the acquisition of extinction, but this treatment had no effect on freezing during the testing of extinction memory. In all experiments, darting was only observed to footshock onset during fear conditioning. CONCLUSION The results suggest multiple behaviors (or different behavioral paradigms) are needed to characterize the nature of traumatic stress effects on emotional memory in female rats and that nuclear estrogen receptor antagonism prior to SPS blocks SPS effects on emotional memory in female rats.
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Bates MLS, Arner JR, Curtis AL, Valentino R, Bhatnagar S. Sex-specific alterations in corticotropin-releasing factor regulation of coerulear-cortical network activity. Neuropharmacology 2023; 223:109317. [PMID: 36334761 DOI: 10.1016/j.neuropharm.2022.109317] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 10/20/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
The locus coeruleus (LC)-norepinephrine system is a stress responsive system that regulates arousal and cognitive functions through extensive projections, including to the prefrontal cortex. LC-cortical circuits are activated by stressors, and this activation is thought to contribute to stress-induced impairments in executive function. Because corticotropin-releasing factor (CRF) is a mediator of stress-induced LC activation, we examined the effects of CRF administered into the LC of male and female rats on network activity of two functionally distinct regions of the PFC, the medial PFC (mPFC) and the orbitofrontal cortex (OFC). Network activity, measured as local field potentials, was recorded in awake animals before and after intra-LC infusion of aCSF or CRF (2 or 20 ng). CRF had qualitatively distinct effects on network activity in males and females with respect to dose, region and timecourse. CRF (20 ng) produced a prominent theta oscillation (7-9 Hz) selectively in female rats shortly after LC infusion and 20 min later. In contrast, in male rats, CRF (2 and 20 ng) decreased the amplitude of power in the 4-6 Hz range in the mPFC 10 min after injection. Lastly, CRF (20 ng) increased mPFC-OFC coherence in females and decreased mPFC-OFC coherence in males. In sum, these results show sex differences in CRF modulation of the LC-norepinephrine system that regulates prefrontal cortical networks, which may underlie sex differences in cognitive and behavioral responses to stress.
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Affiliation(s)
- M L Shawn Bates
- Department of Psychology, California State University, Chico, 400 W. First St, Chico, CA, 95929, USA
| | - Jay R Arner
- Division of Stress Neurobiology, Department of Anesthesiology and Critical Care, Abramson Research Center, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Andre L Curtis
- Division of Stress Neurobiology, Department of Anesthesiology and Critical Care, Abramson Research Center, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Rita Valentino
- Division of Stress Neurobiology, Department of Anesthesiology and Critical Care, Abramson Research Center, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA; The Perelman School of Medicine, University of Pennsylvania, USA
| | - Seema Bhatnagar
- Division of Stress Neurobiology, Department of Anesthesiology and Critical Care, Abramson Research Center, The Children's Hospital of Philadelphia, 3615 Civic Center Blvd, Philadelphia, PA, 19104, USA; The Perelman School of Medicine, University of Pennsylvania, USA.
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13
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Serio B, Kohler R, Ye F, Lichenstein SD, Yip SW. A multidimensional approach to understanding the emergence of sex differences in internalizing symptoms in adolescence. Dev Cogn Neurosci 2022; 58:101182. [PMID: 36495789 PMCID: PMC9730154 DOI: 10.1016/j.dcn.2022.101182] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 11/06/2022] [Accepted: 11/27/2022] [Indexed: 11/29/2022] Open
Abstract
Women are more vulnerable to internalizing disorders (e.g., depression and anxiety). This study took an integrative developmental approach to investigate multidimensional factors associated with the emergence of sex differences in internalizing symptoms, using data from the Adolescent Brain Cognitive Development (ABCD) study. Indices of sex hormone levels (dehydroepiandrosterone, testosterone, and estradiol), physical pubertal development, task-based functional brain activity, family conflict, and internalizing symptoms were drawn from the ABCD study's baseline sample (9- to 10-year-old; N = 11,844). Principal component analysis served as a data-driven dimensionality reduction technique on the internalizing subscales to yield a single robust measure of internalizing symptoms. Moderated mediation analyses assessed whether associations between known risk factors and internalizing symptoms vary by sex. Results revealed direct and indirect effects of physical pubertal development on internalizing symptoms through family conflict across sexes. No effects were found of sex hormone levels or amygdala response to fearful faces on internalizing symptoms. Females did not report overall greater internalizing symptoms relative to males, suggesting that internalizing symptoms have not yet begun to increase in females at this age. Findings provide an essential baseline for future longitudinal research on the endocrine, neurocognitive, and psychosocial factors associated with sex differences in internalizing symptoms.
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Affiliation(s)
- Bianca Serio
- Department of Psychiatry, Yale School of Medicine, New Haven, USA; Child Study Center, Yale School of Medicine, New Haven, USA; Division of Psychology and Language Sciences, University College London, London, UK; Max Planck School of Cognition, Leipzig, Germany.
| | - Robert Kohler
- Department of Psychiatry, Yale School of Medicine, New Haven, USA
| | - Fengdan Ye
- Department of Psychiatry, Yale School of Medicine, New Haven, USA
| | | | - Sarah W Yip
- Department of Psychiatry, Yale School of Medicine, New Haven, USA; Child Study Center, Yale School of Medicine, New Haven, USA
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14
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Alachkar A, Lee J, Asthana K, Vakil Monfared R, Chen J, Alhassen S, Samad M, Wood M, Mayer EA, Baldi P. The hidden link between circadian entropy and mental health disorders. Transl Psychiatry 2022; 12:281. [PMID: 35835742 PMCID: PMC9283542 DOI: 10.1038/s41398-022-02028-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 12/22/2022] Open
Abstract
The high overlapping nature of various features across multiple mental health disorders suggests the existence of common psychopathology factor(s) (p-factors) that mediate similar phenotypic presentations across distinct but relatable disorders. In this perspective, we argue that circadian rhythm disruption (CRD) is a common underlying p-factor that bridges across mental health disorders within their age and sex contexts. We present and analyze evidence from the literature for the critical roles circadian rhythmicity plays in regulating mental, emotional, and behavioral functions throughout the lifespan. A review of the literature shows that coarse CRD, such as sleep disruption, is prevalent in all mental health disorders at the level of etiological and pathophysiological mechanisms and clinical phenotypical manifestations. Finally, we discuss the subtle interplay of CRD with sex in relation to these disorders across different stages of life. Our perspective highlights the need to shift investigations towards molecular levels, for instance, by using spatiotemporal circadian "omic" studies in animal models to identify the complex and causal relationships between CRD and mental health disorders.
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Affiliation(s)
- Amal Alachkar
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA, USA. .,Institute for Genomics and Bioinformatics, University of California, Irvine, CA, USA. .,Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
| | - Justine Lee
- grid.266093.80000 0001 0668 7243Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA USA
| | - Kalyani Asthana
- grid.266093.80000 0001 0668 7243Department of Computer Science, School of Information and Computer Sciences, University of California, Irvine, CA USA
| | - Roudabeh Vakil Monfared
- grid.266093.80000 0001 0668 7243Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA USA
| | - Jiaqi Chen
- grid.266093.80000 0001 0668 7243Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA USA
| | - Sammy Alhassen
- grid.266093.80000 0001 0668 7243Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University of California, Irvine, CA USA
| | - Muntaha Samad
- grid.266093.80000 0001 0668 7243Institute for Genomics and Bioinformatics, University of California, Irvine, CA USA ,grid.266093.80000 0001 0668 7243Department of Computer Science, School of Information and Computer Sciences, University of California, Irvine, CA USA
| | - Marcelo Wood
- grid.266093.80000 0001 0668 7243Institute for Genomics and Bioinformatics, University of California, Irvine, CA USA ,grid.266093.80000 0001 0668 7243Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA USA ,grid.266093.80000 0001 0668 7243Department of Neurobiology and Behavior, School of Biological Sciences, University of California, Irvine, CA USA
| | - Emeran A. Mayer
- grid.266093.80000 0001 0668 7243Institute for Genomics and Bioinformatics, University of California, Irvine, CA USA ,grid.19006.3e0000 0000 9632 6718G. Oppenheimer Center of Neurobiology of Stress & Resilience and Goldman Luskin Microbiome Center, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California, Los Angeles, CA USA
| | - Pierre Baldi
- Institute for Genomics and Bioinformatics, University of California, Irvine, CA, USA. .,Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA. .,Department of Computer Science, School of Information and Computer Sciences, University of California, Irvine, CA, USA.
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15
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Touchant M, Labonté B. Sex-Specific Brain Transcriptional Signatures in Human MDD and Their Correlates in Mouse Models of Depression. Front Behav Neurosci 2022; 16:845491. [PMID: 35592639 PMCID: PMC9110970 DOI: 10.3389/fnbeh.2022.845491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/05/2022] [Indexed: 01/13/2023] Open
Abstract
Major depressive disorder (MDD) is amongst the most devastating psychiatric conditions affecting several millions of people worldwide every year. Despite the importance of this disease and its impact on modern societies, still very little is known about the etiological mechanisms. Treatment strategies have stagnated over the last decades and very little progress has been made to improve the efficiency of current therapeutic approaches. In order to better understand the disease, it is necessary for researchers to use appropriate animal models that reproduce specific aspects of the complex clinical manifestations at the behavioral and molecular levels. Here, we review the current literature describing the use of mouse models to reproduce specific aspects of MDD and anxiety in males and females. We first describe some of the most commonly used mouse models and their capacity to display unique but also shared features relevant to MDD. We then transition toward an integral description, combined with genome-wide transcriptional strategies. The use of these models reveals crucial insights into the molecular programs underlying the expression of stress susceptibility and resilience in a sex-specific fashion. These studies performed on human and mouse tissues establish correlates into the mechanisms mediating the impact of stress and the extent to which different mouse models of chronic stress recapitulate the molecular changes observed in depressed humans. The focus of this review is specifically to highlight the sex differences revealed from different stress paradigms and transcriptional analyses both in human and animal models.
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Affiliation(s)
- Maureen Touchant
- CERVO Brain Research Centre, Québec, QC, Canada
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec, QC, Canada
| | - Benoit Labonté
- CERVO Brain Research Centre, Québec, QC, Canada
- Department of Psychiatry and Neuroscience, Faculty of Medicine, Université Laval, Québec, QC, Canada
- *Correspondence: Benoit Labonté
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16
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Rybka KA, Sturm KL, De Guzman RM, Bah S, Jacobskind JS, Rosinger ZJ, Taroc EZM, Forni PE, Zuloaga DG. Androgen regulation of corticotropin releasing factor receptor 1 in the mouse brain. Neuroscience 2022; 491:185-199. [DOI: 10.1016/j.neuroscience.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 12/19/2022]
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17
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The Problem of Malnutrition Associated with Major Depressive Disorder from a Sex-Gender Perspective. Nutrients 2022; 14:nu14051107. [PMID: 35268082 PMCID: PMC8912662 DOI: 10.3390/nu14051107] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 02/03/2023] Open
Abstract
Major depressive disorder (MDD) is an incapacitating condition characterized by loss of interest, anhedonia and low mood, which affects almost 4% of people worldwide. With rising prevalence, it is considered a public health issue that affects economic productivity and heavily increases health costs alone or as a comorbidity for other pandemic non-communicable diseases (such as obesity, cardiovascular disease, diabetes, inflammatory bowel diseases, etc.). What is even more noteworthy is the double number of women suffering from MDD compared to men. In fact, this sex-related ratio has been contemplated since men and women have different sexual hormone oscillations, where women meet significant changes depending on the age range and moment of life (menstruation, premenstruation, pregnancy, postpartum, menopause…), which seem to be associated with susceptibility to depressive symptoms. For instance, a decreased estrogen level promotes decreased activation of serotonin transporters. Nevertheless, sexual hormones are not the only triggers that alter neurotransmission of monoamines and other neuropeptides. Actually, different dietary habits and/or nutritional requirements for specific moments of life severely affect MDD pathophysiology in women. In this context, the present review aims to descriptively collect information regarding the role of malnutrition in MDD onset and course, focusing on female patient and especially macro- and micronutrient deficiencies (amino acids, ω3 polyunsaturated fatty acids (ω3 PUFAs), folate, vitamin B12, vitamin D, minerals…), besides providing evidence for future nutritional intervention programs with a sex-gender perspective that hopefully improves mental health and quality of life in women.
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18
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Family Structure and Maternal Depressive Symptoms: A Cross-National Comparison of Australia, the United Kingdom, and the United States. SOCIAL SCIENCES 2022. [DOI: 10.3390/socsci11020078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to understand the relationship between family structure and maternal depressive symptoms (MDS) in Australia, the United Kingdom, and the United States. Family structures that involve transitions across life’s course, such as divorce, can alter access to resources and introduce new stressors into family systems. Using the stress process model, we examine the links between family structure, stress, resources, and MDS. Using nationally representative data from Australia, the United Kingdom, and the United States and cross-sectional models for each country, we find that family structure may influence MDS differently in the UK than it does in Australia or, especially, the US. Specifically, mothers in the UK who either enter or leave a marriage after the birth of their child experience increased levels of MDS compared with mothers who do not experience a similar transition. These findings demonstrate that the effects of family structure transitions across life’s course may vary according to the country context as well as to the mother’s access to resources and exposure to stress. Considering that the effects of family structure transitions are not universal, this indicates that greater attention should be paid to the country contexts families exist in and the effects that public policies and social safety nets can have on MDS.
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19
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Sheng JA, Tan SML, Hale TM, Handa RJ. Androgens and Their Role in Regulating Sex Differences in the Hypothalamic/Pituitary/Adrenal Axis Stress Response and Stress-Related Behaviors. ANDROGENS: CLINICAL RESEARCH AND THERAPEUTICS 2022; 2:261-274. [PMID: 35024695 PMCID: PMC8744007 DOI: 10.1089/andro.2021.0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 02/06/2023]
Abstract
Androgens play a pivotal role during development. These gonadal hormones and their receptors exert organizational actions that shape brain morphology in regions controlling the stress regulatory systems in a male-specific manner. Specifically, androgens drive sex differences in the hypothalamic/pituitary/adrenal (HPA) axis and corresponding hypothalamic neuropeptides. While studies have examined the role of estradiol and its receptors in sex differences in the HPA axis and associated behaviors, the role of androgens remains far less studied. Androgens are generally thought to modulate the HPA axis through the activation of androgen receptors (ARs). They can also impact the HPA axis through reduction to estrogenic metabolites that can bind estrogen receptors in the brain and periphery. Such regulation of the HPA axis stress response by androgens can often result in sex-biased risk factors for stress-related disorders, such as anxiety and depression. This review focuses on the biosynthesis pathways and molecular actions of androgens and their nuclear receptors. The impact of androgens on hypothalamic neuropeptide systems (corticotropin-releasing hormone, arginine vasopressin, oxytocin, dopamine, and serotonin) that control the stress response and stress-related disorders is discussed. Finally, this review discusses potential therapeutics involving androgens (androgen replacement therapies, selective AR modulator therapies) and ongoing clinical trials.
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Affiliation(s)
- Julietta A Sheng
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Sarah M L Tan
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Taben M Hale
- Department of Basic Medical Science, University of Arizona College of Medicine - Phoenix, Arizona, USA
| | - Robert J Handa
- Department of Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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20
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Oh H, Newton D, Lewis D, Sibille E. Lower Levels of GABAergic Function Markers in Corticotropin-Releasing Hormone-Expressing Neurons in the sgACC of Human Subjects With Depression. Front Psychiatry 2022; 13:827972. [PMID: 35280164 PMCID: PMC8913899 DOI: 10.3389/fpsyt.2022.827972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/21/2022] [Indexed: 11/13/2022] Open
Abstract
RATIONALE A previous transcriptome meta-analysis revealed significantly lower levels of corticotropin-releasing hormone (CRH) mRNA in corticolimbic brain regions in major depressive disorder (MDD) subjects, suggesting that cortical CRH-expressing (CRH+) cells are affected in MDD. Rodent studies show that cortical CRH is mostly expressed in GABAergic interneurons; however, the characteristic features of CRH+ cells in human brain cortex and their association with MDD are largely unknown. METHODS Subgenual anterior cingulate cortex (sgACC) of human subjects without brain disorders were labeled using fluorescent in situ hybridization (FISH) for CRH and markers of excitatory (SLC17A7), inhibitory (GAD1) neurons, as well as markers of other interneuron subpopulations (PVALB, SST, VIP). MDD-associated changes in CRH+ cell density and cellular CRH expression (n = 6/group) were analyzed. RNA-sequencing was performed on sgACC CRH+ interneurons from comparison and MDD subjects (n = 6/group), and analyzed for group differences. The effect of reduced BDNF on CRH expression was tested in mice with blocked TrkB function. RESULTS About 80% of CRH+ cells were GABAergic and 17.5% were glutamatergic. CRH+ GABAergic interneurons co-expressed VIP (52%), SST (7%), or PVALB (7%). MDD subjects displayed lower CRH mRNA levels in GABAergic interneurons relative to comparison subjects without changes in cell density. CRH+ interneurons show transcriptomic profile suggesting lower excitability and less GABA release and reuptake. Further analyses suggested that these molecular changes are not mediated by altered glucocorticoid feedback and potentially occur downstream for a common modulator of neurotrophic function. SUMMARY CRH+ cells in human sgACC are a heterogeneous population of GABAergic interneurons, although largely co-expressing VIP. Our data suggest that MDD is associated with reduced markers of inhibitory function in sgACC CRH+ interneurons, and provide further evidence for impaired GABAergic function in the cortex in MDD.
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Affiliation(s)
- Hyunjung Oh
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada
| | - Dwight Newton
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada.,Departments of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - David Lewis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Etienne Sibille
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON, Canada.,Departments of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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21
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Sialino LD, van Oostrom SH, Wijnhoven HAH, Picavet S, Verschuren WMM, Visser M, Schaap LA. Sex differences in mental health among older adults: investigating time trends and possible risk groups with regard to age, educational level and ethnicity. Aging Ment Health 2021; 25:2355-2364. [PMID: 33222516 DOI: 10.1080/13607863.2020.1847248] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Older women report lower mental health compared to men, yet little is known about the nature of this sex difference. Therefore, this study investigates time trends and possible risk groups. METHOD Data from the Doetinchem Cohort Study (DCS) and the Longitudinal Aging Study Amsterdam (LASA) were used. General mental health was assessed every 5 years, from 1995 to 1998 onwards (DCS, n = 1412, 20-year follow-up, baseline age 55-64 years). Depressive and anxiety symptoms were assessed for two birth cohorts, from 1992/1993 onwards (LASA cohort 1, n = 967, 24-year follow-up, age 55-65 years,) and 2002/2003 onwards (LASA cohort 2, n = 1002, 12-year follow-up, age 55-65 years) with follow-up measurements every 3-4 years. RESULTS Mixed model analyses showed that older women had a worse general mental health (-6.95; -8.36 to 5.53; range 0-100, ∼10% lower), more depressive symptoms (2.09; 1.53-2.63; range 0-60, ∼30% more) and more anxiety symptoms (0.86; 0.54-1.18; range 0-11, ∼30% more) compared to men. These sex differences remained stable until the age of 75 years, where after they decreased due to an accelerated decline in mental health for men compared to women. Sex differences and their course by age were consistent over successive birth cohorts, educational levels and ethnic groups (Caucasian vs. Turkish/Moroccan). CONCLUSION There is a consistent female disadvantage in mental health across different sociodemographic groups and over decennia (1992 vs. 2002) with no specific risk groups.
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Affiliation(s)
- Lena D Sialino
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Hanneke A H Wijnhoven
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Susan Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Julius Center for Health Services and Primary Care, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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22
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Gargiulo AT, Peterson LM, Grafe LA. Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults. Brain Behav 2021; 11:e2384. [PMID: 34661981 PMCID: PMC8613418 DOI: 10.1002/brb3.2384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic. METHODS Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393). RESULTS Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience. CONCLUSIONS Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.
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Affiliation(s)
- Andrew T. Gargiulo
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laurel M. Peterson
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
| | - Laura A. Grafe
- Department of PsychologyBryn Mawr College Bryn MawrBryn MawrPennsylvaniaUSA
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23
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Kantrowitz JT, Dong Z, Milak MS, Rashid R, Kegeles LS, Javitt DC, Lieberman JA, John Mann J. Ventromedial prefrontal cortex/anterior cingulate cortex Glx, glutamate, and GABA levels in medication-free major depressive disorder. Transl Psychiatry 2021; 11:419. [PMID: 34354048 PMCID: PMC8342485 DOI: 10.1038/s41398-021-01541-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/12/2021] [Accepted: 07/23/2021] [Indexed: 02/07/2023] Open
Abstract
Glutamate (Glu) and gamma-aminobutyric acid (GABA) are implicated in the pathophysiology of major depressive disorder (MDD). GABA levels or GABAergic interneuron numbers are generally low in MDD, potentially disinhibiting Glu release. It is unclear whether Glu release or turnover is increased in depression. Conversely, a meta-analysis of prefrontal proton magnetic resonance spectroscopy (1H MRS) studies in MDD finds low Glx (combination of glutamate and glutamine) in medicated MDD. We hypothesize that elevated Glx or Glu may be a marker of more severe, untreated MDD. We examined ventromedial prefrontal cortex/anterior cingulate cortex (vmPFC/ACC) Glx and glutamate levels using 1H MRS in 34 medication-free, symptomatic, chronically ill MDD patients and 32 healthy volunteers, and GABA levels in a subsample. Elevated Glx and Glu were observed in MDD compared with healthy volunteers, with the highest levels seen in males with MDD. vmPFC/ACC GABA was low in MDD. Higher Glx levels correlated with more severe depression and lower GABA. MDD severity and diagnosis were both linked to higher Glx in vmPFC/ACC. Low GABA in a subset of these patients is consistent with our hypothesized model of low GABA leading to glutamate disinhibition in MDD. This finding and model are consistent with our previously reported findings that the NMDAR-antagonist antidepressant effect is proportional to the reduction of vmPFC/ACC Glx or Glu levels.
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Affiliation(s)
- Joshua T. Kantrowitz
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY USA
| | - Zhengchao Dong
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - Matthew S. Milak
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - Rain Rashid
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - Lawrence S. Kegeles
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Radiology, Columbia University, College of Physicians and Surgeons, New York, NY USA
| | - Daniel C. Javitt
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.250263.00000 0001 2189 4777Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY USA
| | - Jeffrey A. Lieberman
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA
| | - J. John Mann
- grid.21729.3f0000000419368729Department of Psychiatry, Columbia University, College of Physicians and Surgeons, New York, NY USA ,grid.413734.60000 0000 8499 1112New York State Psychiatric Institute, New York, NY USA ,grid.21729.3f0000000419368729Department of Radiology, Columbia University, College of Physicians and Surgeons, New York, NY USA
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Sex differences in the association between symptom profiles and cognitive functioning in patients with depressive disorder. J Affect Disord 2021; 287:1-7. [PMID: 33761324 DOI: 10.1016/j.jad.2021.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Depressive disorder (DD) is a heterogeneous disease with sex differences in symptom profiles and cognitive performance. However, sex differences in cognitive dysfunction associated with different symptom profiles have received little systematic study. This study aimed to explore the association between clinical symptoms and cognitive deficits in patients with DD. METHODS A cohort of 222 hospitalized patients with DD (males/females = 114/108) and 173 healthy controls (males/females = 80/93) were enrolled. Cognitive function was measured using a comprehensive neuropsychological battery. Depression was assessed using the 17-item Hamilton Rating Scale for Depression (HAMD-17). According to different genders, the relationship between symptom profiles and cognitive deficits was identified using partial correlation analysis and multiple regression analysis. RESULTS Patients with DD performed significantly worse than healthy controls in all cognitive domains investigated (all p < 0.05). Remarkably, female patients scored better than male patients on information processing speed (p < 0.05). Multivariate regression analyses showed that the retardation factor score was independently associated with attention and cognitive flexibility, and the sleep disturbance factor score was independently associated with information processing speed in male patients. Furthermore, the anxiety/somatization factor score was independently associated with working memory in female patients. CONCLUSION In the present study, we showed that significant sex differences in the association between symptom profiles and cognitive impairment are present in DD patients. Understanding how DD patients' clinical features and cognitive performance are linked from a sex perspective may have clinical implications for predicting and interfering with the outcome of depression.
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Guajardo HM, Valentino RJ. Sex differences in μ-opioid regulation of coerulear-cortical transmission. Neurosci Lett 2021; 746:135651. [PMID: 33482313 DOI: 10.1016/j.neulet.2021.135651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/26/2022]
Abstract
Stress-induced activation of locus coeruleus (LC)-norepinephrine (NE) projections to the prefrontal cortex are thought to promote cognitive responses to stressors. LC activation by stressors is modulated by endogenous opioids that restrain LC activation and facilitate a return to baseline activity upon stress termination. Sex differences in this opioid influence could be a basis for sex differences in stress vulnerability. Consistent with this, we recently demonstrated that μ-opioid receptor (MOR) expression is decreased in the female rat LC compared to the male LC, and this was associated with sexually distinct consequences of activating MOR in the LC on cognitive flexibility. Given that the LC-NE system affects cognitive flexibility through its projections to the medial prefrontal cortex (mPFC), the present study quantified and compared the effects of LC-MOR activation on mPFC neural activity in male and female rats. Local field potential (LFPs) were recorded from the mPFC of freely behaving male and female rats before and following local LC microinjection of the MOR agonist, DAMGO, or vehicle. Intra-LC DAMGO altered the LFP power spectrum selectively in male but not female rats, resulting in a time-dependent increase in the power in delta and alpha frequency bands. LC microinfusion of ACSF had no effect on either sex. Together, the results are consistent with previous evidence for decreased MOR function in the female rat LC and demonstrate that this translates to a diminished effect on cortical activity that can account for sex differences in cognitive consequences. Decreased LC-MOR function in females could contribute to greater stress-induced activation of the LC and increased vulnerability of females to hyperarousal symptoms of stress-related neuropsychiatric pathologies.
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Affiliation(s)
- Herminio M Guajardo
- Neuroscience Graduate Group, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
| | - Rita J Valentino
- Neuroscience Graduate Group, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
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Platt JM, Bates L, Jager J, McLaughlin KA, Keyes KM. Is the US Gender Gap in Depression Changing Over Time? A Meta-Regression. Am J Epidemiol 2021; 190:1190-1206. [PMID: 33423055 PMCID: PMC8484777 DOI: 10.1093/aje/kwab002] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 09/28/2020] [Accepted: 10/06/2020] [Indexed: 01/19/2023] Open
Abstract
The depression gap refers to higher rates of depression among women than men. Change in the depression gap over time might elucidate social causes of this disparity-such as unequal college attendance or employment status. We conducted a meta-regression analysis to estimate variation in the depression gap over time by age, accounting for potential sources of variation between studies. Electronic databases and bibliographies were searched for English-language studies from January 1980 through October 2019; 144 independent estimates from US-representative samples met selection criteria (n = 813,189). The depression gap was summarized as prevalence ratios among studies using diagnostic instruments and as standardized mean differences among symptom-based studies. Primary study measures were baseline study year (range, 1982-2017) and age (age groups ranging, in years, from 10-59 and 60 or older). Compared with respondents aged ≥60 years, depression prevalence was greater among respondents aged 10-19 (prevalence ratio = 1.26, 95% confidence interval: 1.02, 1.56). Over time, the depression gap did not change among adults, but it increased among adolescents (age-by-time interaction prevalence ratio = 1.05, 95% confidence interval: 1.01, 1.08). Results were similar for symptom-based studies. The present study finds no evidence of a change in the depression gender gap for US adults; however, the gap increased among adolescents. Greater attention to factors driving this widening disparity in adolescent depression is needed.
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Affiliation(s)
- Jonathan M Platt
- Correspondence to Dr. Jonathan M. Platt, Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th Street, New York, NY 10032 (e-mail: )
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Maita I, Bazer A, Blackford JU, Samuels BA. Functional anatomy of the bed nucleus of the stria terminalis-hypothalamus neural circuitry: Implications for valence surveillance, addiction, feeding, and social behaviors. HANDBOOK OF CLINICAL NEUROLOGY 2021; 179:403-418. [PMID: 34225978 DOI: 10.1016/b978-0-12-819975-6.00026-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The bed nucleus of the stria terminalis (BNST) is a medial basal forebrain structure that modulates the hypothalamo-pituitary-adrenal (HPA) axis. The heterogeneous subnuclei of the BNST integrate inputs from mood and reward-related areas and send direct inhibitory projections to the hypothalamus. The connections between the BNST and hypothalamus are conserved across species, promote activation of the HPA axis, and can increase avoidance of aversive environments, which is historically associated with anxiety behaviors. However, BNST-hypothalamus circuitry is also implicated in motivated behaviors, drug seeking, feeding, and sexual behavior. These complex and diverse roles, as well its sexual dimorphism, indicate that the BNST-hypothalamus circuitry is an essential component of the neural circuitry that may underlie various psychiatric diseases, ranging from anorexia to anxiety to addiction. The following review is a cross-species exploration of BNST-hypothalamus circuitry. First, we describe the BNST subnuclei, microcircuitry and complex reciprocal connections with the hypothalamus. We will then discuss the behavioral functions of BNST-hypothalamus circuitry, including valence surveillance, addiction, feeding, and social behavior. Finally, we will address sex differences in morphology and function of the BNST and hypothalamus.
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Affiliation(s)
- Isabella Maita
- Department of Psychology, Rutgers University, Piscataway, NJ, United States
| | - Allyson Bazer
- Department of Psychology, Rutgers University, Piscataway, NJ, United States
| | - Jennifer Urbano Blackford
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Research Health Scientist, Tennessee Valley HealthCare System, US Department of Veterans Affairs, Nashville, TN, United States
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Depressive Symptoms among Middle-Aged Women-Understanding the Cause. Brain Sci 2020; 11:brainsci11010026. [PMID: 33379297 PMCID: PMC7824332 DOI: 10.3390/brainsci11010026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 12/20/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022] Open
Abstract
Menopause is an important event in a woman’s life associated with hormonal changes that play a substantial role in the functioning of her body. A decline in the level of estrogens contributes to depressive symptoms and mood disorders during this period. The severity of depressive symptoms experienced by middle-aged women depends on many factors, including sociodemographic data (e.g., menopause, employment status, and marital status) and genetic variables (MAO-A and 5-HTT gene polymorphisms). In order to assess their influence on the development of depression in females, we analyzed 1453 healthy Polish women in different stages of menopause. Based on the results, we found that the l/l + l/s inheritance model for the 5-HTT gene polymorphism was more common in women without and with moderate depressive symptoms according to the Beck Depression Inventory (BDI), while the l/s model was more often observed in women with mild depression. Moreover, the overdominant 3/3 + 4/4 genotype of the MAO-A gene polymorphism was more often found in respondents without depressive symptoms, while women with depressive symptoms had more often the overdominant 3/4 genotype.
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Ko YH, Kim SK, Lee SY, Jang CG. Flavonoids as therapeutic candidates for emotional disorders such as anxiety and depression. Arch Pharm Res 2020; 43:1128-1143. [DOI: 10.1007/s12272-020-01292-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023]
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Gender differences in adolescent sleep neurophysiology: a high-density sleep EEG study. Sci Rep 2020; 10:15935. [PMID: 32985555 PMCID: PMC7522718 DOI: 10.1038/s41598-020-72802-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/27/2020] [Indexed: 12/21/2022] Open
Abstract
During adolescence, differences between males and females in physiology, behavior and risk for psychopathology are accentuated. The goal of the current study was to examine gender differences in sleep neurophysiology using high-density sleep EEG in early adolescence. We examined gender differences in sleep EEG power and coherence across frequency bands for both NREM and REM sleep in a sample of 61 adolescents (31 girls and 30 boys; mean age = 12.48; SD = 1.34). In addition, sleep spindles were individually detected and characterized. Compared to boys, girls had significantly greater spindle activity, as reflected in higher NREM sigma power, spindle amplitude, spindle frequency and spindle density over widespread regions. Furthermore, power in higher frequency bands (16.2–44 Hz) was larger in girls than boys in a state independent manner. Oscillatory activity across frequency bands and sleep states was generally more coherent in females as compared to males, suggesting greater connectivity in females. An exception to this finding was the alpha band during NREM and REM sleep, where coherence was higher (NREM) or not different (REM) in boys compared to girls. Sleep spindles are generated through thalamocortical circuits, and thus, the greater spindle activity across regions in females may represent a stronger thalamocortical circuit in adolescent females as compared to males. Moreover, greater global connectivity in females may reflect functional brain differences with implications for cognition and mental health. Given the pronounced gender differences, our study highlights the importance of taking gender into account when designing and interpreting studies of sleep neurophysiology.
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Platt JM, Bates LM, Jager J, McLaughlin KA, Keyes KM. Changes in the depression gender gap from 1992 to 2014: Cohort effects and mediation by gendered social position. Soc Sci Med 2020; 258:113088. [PMID: 32540513 PMCID: PMC7377349 DOI: 10.1016/j.socscimed.2020.113088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
The depression gap (i.e., higher rates of depression among women than men) represents an important mental health disparity in the US. Differences in gendered social position (i.e., the roles, responsibilities, and opportunities available to women and men), which have been changing since the mid-20th Century may contribute to this gender gap. The present study examined the evidence for a changing depression gap across birth cohorts and tested the extent to which any changes over time were mediated by changes in relative social position between women and men. Data were from the National Longitudinal Surveys. The depression gap was defined as differences in mean CESD scores for women vs. men. The analytic sample included 13,666 respondents interviewed from 1992 to 2014. Hierarchical mixed models estimated the magnitude of the gender depression gap over time, its association with 10-year birth cohort (range: 1957-1994), and whether any variation was mediated by ratios among women relative to men of obtaining a college degree, being employed full-time, and the average number of hours spent doing housework per week, three indicators of gendered social position. There was a linear decrease in the depression gap by 0.18 points across birth cohort (95% CI = -0.26, -0.10). The results of the mediation analysis estimated that an increasing ratio of college degree attainment mediated 39% of the gender depression gap across cohorts (95% CI = 0.18, 0.78). There was no evidence of mediation due to changing employment or housework ratios. These findings partially support the hypothesis that the depression gap is changing over time and is meaningfully related to the social environment. Understanding the social causes of the depression gap can illuminate the fundamental processes through which depression disparities may be perpetuated or attenuated over time and may aid in the identification of strategies to reduce them.
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Affiliation(s)
- Jonathan M Platt
- Department of Epidemiology, Columbia University, New York, NY, USA.
| | - Lisa M Bates
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Justin Jager
- Department of Psychology Arizona State University, Tempe, AZ, USA
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Zuloaga DG, Heck AL, De Guzman RM, Handa RJ. Roles for androgens in mediating the sex differences of neuroendocrine and behavioral stress responses. Biol Sex Differ 2020; 11:44. [PMID: 32727567 PMCID: PMC7388454 DOI: 10.1186/s13293-020-00319-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 07/09/2020] [Indexed: 12/17/2022] Open
Abstract
Estradiol and testosterone are powerful steroid hormones that impact brain function in numerous ways. During development, these hormones can act to program the adult brain in a male or female direction. During adulthood, gonadal steroid hormones can activate or inhibit brain regions to modulate adult functions. Sex differences in behavioral and neuroendocrine (i.e., hypothalamic pituitary adrenal (HPA) axis) responses to stress arise as a result of these organizational and activational actions. The sex differences that are present in the HPA and behavioral responses to stress are particularly important considering their role in maintaining homeostasis. Furthermore, dysregulation of these systems can underlie the sex biases in risk for complex, stress-related diseases that are found in humans. Although many studies have explored the role of estrogen and estrogen receptors in mediating sex differences in stress-related behaviors and HPA function, much less consideration has been given to the role of androgens. While circulating androgens can act by binding and activating androgen receptors, they can also act by metabolism to estrogenic molecules to impact estrogen signaling in the brain and periphery. This review focuses on androgens as an important hormone for modulating the HPA axis and behaviors throughout life and for setting up sex differences in key stress regulatory systems that could impact risk for disease in adulthood. In particular, impacts of androgens on neuropeptide systems known to play key roles in HPA and behavioral responses to stress (corticotropin-releasing factor, vasopressin, and oxytocin) are discussed. A greater knowledge of androgen action in the brain is key to understanding the neurobiology of stress in both sexes.
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Affiliation(s)
| | - Ashley L Heck
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | | | - Robert J Handa
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
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Pulopulos M, Allaert J, Vanderhasselt MA, Sanchez-Lopez A, De Witte S, Baeken C, De Raedt R. Effects of HF-rTMS over the left and right DLPFC on proactive and reactive cognitive control. Soc Cogn Affect Neurosci 2020; 17:109-119. [PMID: 32613224 PMCID: PMC8824550 DOI: 10.1093/scan/nsaa082] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/24/2020] [Accepted: 06/15/2020] [Indexed: 01/02/2023] Open
Abstract
Previous research supports the distinction between proactive and reactive control. Although the dorsolateral prefrontal cortex (DLPFC) has been consistently related to these processes, lateralization of proactive and reactive control is still under debate. We manipulated brain activity to investigate the role of the left and right DLPFC in proactive and reactive cognitive control. Using a single-blind, sham-controlled crossover within-subjects design, 25 young healthy females performed the 'AX' Continuous Performance Task after receiving sham versus active High-Frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS) to increase left and right DLPFC activity. RTs and pupillometry were used to assess patterns of proactive and reactive cognitive control and task-related resource allocation respectively. We observed that, compared to sham, HF-rTMS over the left DLPFC increased proactive control. After right DLPFC HF-rTMS, participants showed slower RTs on AX trials, suggesting more reactive control. However, this latter result was not supported by RTs on BX trials (i.e. the trial that specifically assess reactive control). Pupil measures showed a sustained increase in resource allocation after both active left and right HF-rTMS. Our results with RT data provide evidence on the role of the left DLPFC in proactive control and suggest that the right DLPFC is implicated in reactive control.
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Affiliation(s)
- Matias Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Jens Allaert
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.,Department of Head and Skin, Ghent University, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.,Department of Head and Skin, Ghent University, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Belgium
| | - Alvaro Sanchez-Lopez
- Department of Personality, Evaluation and Psychological Treatment, Complutense University of Madrid, Spain
| | - Sara De Witte
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.,Department of Head and Skin, Ghent University, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Belgium
| | - Chris Baeken
- Department of Head and Skin, Ghent University, Belgium.,Ghent Experimental Psychiatry (GHEP) Lab, Belgium.,Department of Psychiatry, University Hospital Brussels (UZBrussel), Belgium
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
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Fernández-Pérez D, Ros L, Escribano F, Serrano JP. Reminiscence, personality, coping and mood state in institutionalised older adults: a cross-sectional study. Psychogeriatrics 2020; 20:310-320. [PMID: 31881114 DOI: 10.1111/psyg.12500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/22/2019] [Accepted: 12/09/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Reminiscence functions in older adults have been associated with variables related to mental health such as depressive symptoms. Additionally, the way in which older adults cope with stress or their personality traits could influence their use of reminiscence. This study examined the relation between gender, coping styles, personality traits and reminiscence functions and how these variables predict depressive symptoms in institutionalised older adults. METHODS The participants were 117 institutionalised older adults (range 62-98 years). They completed measures of reminiscence functions, depressive symptoms, coping styles and personality traits. RESULTS Neuroticism and avoidance coping styles were related to a maladaptive use of reminiscence functions. The results showed that institutionalised older adults with high neuroticism and who usually use emotional discharge and logical analysis as avoidance coping styles and bitterness revival as a reminiscence function may be more likely to present depressive symptoms. CONCLUSION The findings may help enhance the efficacy of interventions using reminiscence.
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Affiliation(s)
| | - Laura Ros
- Department of Psychology, University of Castilla La Mancha, Ciudad Real, Spain
| | - Flor Escribano
- Department of Psychology, University of Castilla La Mancha, Ciudad Real, Spain
| | - Juan Pedro Serrano
- Department of Psychology, University of Castilla La Mancha, Ciudad Real, Spain
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Abstract
Major depressive disorder (MDD) is a serious public health problem that has, at best, modest treatment response—potentially due to its heterogeneous clinical presentation. One way to parse the heterogeneity is to investigate the role of particular features of MDD, an endeavor that can also help identify novel and focal targets for treatment and prevention efforts. Our R01 focuses on the feature of psychomotor disturbance (e.g., psychomotor agitation (PmA) and retardation (PmR)), a particularly pernicious feature of MDD, that has not been examined extensively in MDD. Aim 1 is comparing three groups of individuals—those with current MDD (n = 100), remitted MDD (n = 100), and controls (n = 50)—on multiple measures of PmR and PmA (assessed both in the lab and in the subjects’ natural environment). Aim 2 is examining the structural (diffusion MRI) and functional (resting state fMRI) connectivity of motor circuitry of the three groups as well as the relation between motor circuitry and the proposed indicators of PmR and PmA. Aim 3 is following up with subjects three times over 18 months to evaluate whether motor symptoms change in tandem with overall depressive symptoms and functioning over time and/or whether baseline PmR/PmA predicts course of depression and functioning. Aim 3 is particularly clinically significant. Finding that motor functioning and overall depression severity co-vary over time, or that motor variables predict subsequent change in overall depression severity, would support the potential clinical utility of these novel, reliable, and easily administered motor assessments.
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Heun R, Hein S. Risk factors of major depression in the elderly. Eur Psychiatry 2020; 20:199-204. [PMID: 15935417 DOI: 10.1016/j.eurpsy.2004.09.036] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2004] [Accepted: 09/24/2004] [Indexed: 11/25/2022] Open
Abstract
AbstractBackgroundSeveral risk factors of depression have been identified in retrospective as well as some prospective studies in the elderly. Confirmation in independent samples is needed. The present follow-up study prospectively investigated risk factors of depression in an elderly German sample.MethodsOne thousand four hundred and thirty-one subjects from a family study were re-investigated after 4.7 ± 2.5 years. Bivariate and multivariate forward logistic regression analyses were used to identify risk factors of the development of new depression in the elderly.ResultsRisk factors of a new depressive episode in 1408 elderly without current depression were age, female gender, a previous depression, subjective memory impairment, previous anxiety and somatoform disorders. The presence of dementia or mild cognitive impairment were significant risk factors in bivariate, but not multivariate analysis controlling for possible confounding. Risk factors of a first geriatric depressive episode were age, gender and subjective memory impairment; age remained the only significant risk factor in multivariate analysis.ConclusionsThis investigation confirms previous studies from other countries concerning the relevance of risk factors for depression in the elderly. The knowledge of risk factors might help identify subjects at increased risk of depression for early intervention approaches. Elderly with a history of previous depression carry the highest risk.
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Affiliation(s)
- Reinhard Heun
- Department of Psychiatry, University of Bonn, Venusberg, 53105 Bonn, Germany.
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Pulopulos MM, Baeken C, De Raedt R. Cortisol response to stress: The role of expectancy and anticipatory stress regulation. Horm Behav 2020; 117:104587. [PMID: 31639385 DOI: 10.1016/j.yhbeh.2019.104587] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 09/02/2019] [Accepted: 09/11/2019] [Indexed: 11/22/2022]
Abstract
An exacerbated physiological response to stress is associated with the development of stress-related disorders (e.g., depression and anxiety disorders). Recently, it has been proposed that individuals with high expectancies of being able to deal with stressful situations will activate regulatory mechanisms during the anticipation of the stressful event that would improve stress regulation. To test this hypothesis, 52 women in young adulthood (M = 21.06; SD = 2.58) anticipated and performed a laboratory-based stress task after receiving positive or negative bogus feedback on their abilities to deal with stressful events. Heart rate variability and salivary cortisol were assessed throughout the experimental protocol. Participants receiving positive bogus feedback (i.e., High Expectancy group) showed a more positive anticipatory cognitive stress appraisal (i.e., they anticipated the stress task as less threatening/challenging, and they perceived that they were more able to deal with it), and they showed a lower cortisol response to stress. Moreover, a more positive anticipatory cognitive stress appraisal was associated with better anticipatory stress regulation (indexed as less decrease in heart rate variability), leading to a lower cortisol response. Our results indicate that people with positive expectancy initiate mechanisms of anticipatory stress regulation that enhance the regulation of the physiological stress response. Expectancy and anticipatory stress regulation may be key mechanisms in the development and treatment of stress-related disorders.
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Affiliation(s)
- Matias M Pulopulos
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Psychiatry, University Hospital (UZBrussel), Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, The Netherlands
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Vega JN, Taylor WD, Gandelman JA, Boyd BD, Newhouse PA, Shokouhi S, Albert KM. Persistent Intrinsic Functional Network Connectivity Alterations in Middle-Aged and Older Women With Remitted Depression. Front Psychiatry 2020; 11:62. [PMID: 32153440 PMCID: PMC7047962 DOI: 10.3389/fpsyt.2020.00062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 01/24/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In younger adults, residual alterations in functional neural networks persist during remitted depression. However, there are fewer data for midlife and older adults at risk of recurrence. Such residual network alterations may contribute to vulnerability to recurrence. This study examined intrinsic network functional connectivity in midlife and older women with remitted depression. METHODS A total of 69 women (24 with a history of depression, 45 with no psychiatric history) over 50 years of age completed 3T fMRI with resting-state acquisition. Participants with remitted depression met DSM-IV-TR criteria for an episode in the last 10 years but not the prior year. Whole-brain seed-to-voxel resting-state functional connectivity analyses examined the default mode network (DMN), executive control network (ECN), and salience network (SN), plus bilateral hippocampal seeds. All analyses were adjusted for age and used cluster-level correction for multiple comparisons with FDR < 0.05 and a height threshold of p < 0.001, uncorrected. RESULTS Women with a history of depression exhibited decreased functional connectivity between the SN (right insula seed) and ECN regions, specifically the left superior frontal gyrus. They also exhibited increased functional connectivity between the left hippocampus and the left postcentral gyrus. We did not observe any group differences in functional connectivity for DMN or ECN seeds. CONCLUSIONS Remitted depression in women is associated with connectivity differences between the SN and ECN and between the hippocampus and the postcentral gyrus, a region involved in interoception. Further work is needed to determine whether these findings are related to functional alterations or are predictive of recurrence.
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Affiliation(s)
- Jennifer N Vega
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Warren D Taylor
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, United States
| | - Jason A Gandelman
- Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Brian D Boyd
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Paul A Newhouse
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Tennessee Valley Health System, Nashville, TN, United States
| | - Sepideh Shokouhi
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Kimberly M Albert
- Center for Cognitive Medicine, Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Hamidovic A, Karapetyan K, Serdarevic F, Choi SH, Eisenlohr-Moul T, Pinna G. Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis. Front Endocrinol (Lausanne) 2020; 11:311. [PMID: 32582024 PMCID: PMC7280552 DOI: 10.3389/fendo.2020.00311] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/24/2020] [Indexed: 01/27/2023] Open
Abstract
Although results of animal research show that interactions between stress and sex hormones are implicated in the development of affective disorders in women, translation of these findings to patients has been scarce. As a basic step toward advancing this field of research, we analyzed findings of studies which reported circulating cortisol levels in healthy women in the follicular vs. luteal phase of the menstrual cycle. We deemed this analysis critical not only to advance our understanding of basic physiology, but also as an important contrast to the findings of future studies evaluating stress and sex hormones in women with affective disorders. We hypothesized that cortisol levels would be lower in the follicular phase based on the proposition that changes in levels of potent GABAergic neurosteroids, including allopregnanolone, during the menstrual cycle dynamically change in the opposite direction relative to cortisol levels. Implementing strict inclusion criteria, we compiled results of high-quality studies involving 778 study participants to derive a standardized mean difference between circulating cortisol levels in the follicular vs. luteal phase of the menstrual cycle. In line with our hypothesis, our meta-analysis found that women in the follicular phase had higher cortisol levels than women in the luteal phase, with an overall Hedges' g of 0.13 (p < 0.01) for the random effects model. No significant between-study difference was detected, with the level of heterogeneity in the small range. Furthermore, there was no evidence of publication bias. As cortisol regulation is a delicate process, we review some of the basic mechanisms by which progesterone, its potent metabolites, and estradiol regulate cortisol output and circulation to contribute to the net effect of higher cortisol in the follicular phase.
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Affiliation(s)
- Ajna Hamidovic
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
- *Correspondence: Ajna Hamidovic
| | - Kristina Karapetyan
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Fadila Serdarevic
- Department of Epidemiology, Erasmus Medical Centre Rotterdam, Rotterdam, Netherlands
| | - So Hee Choi
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, United States
| | - Tory Eisenlohr-Moul
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Graziano Pinna
- The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
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Elamragy AA, Abdelhalim AA, Arafa ME, Baghdady YM. Anxiety and depression relationship with coronary slow flow. PLoS One 2019; 14:e0221918. [PMID: 31487310 PMCID: PMC6728014 DOI: 10.1371/journal.pone.0221918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 08/19/2019] [Indexed: 11/18/2022] Open
Abstract
Background Psychiatric disorders (depression / anxiety) are linked to coronary artery disease (CAD). Coronary slow flow (CSF) is a relatively common form of CAD with the same underlying mechanisms that are attributed to many anatomic and pathophysiologic factors. However, the relationship between psychiatric disorders and CSF is less well-established; and this is the aim of this study. Methods This cross-sectional observational study was conducted on the first 50 consecutive patients diagnosed with CSF by elective coronary angiography (CAG). They were compared with another 50 consecutive patients showing normal coronaries by CAG. Beck Anxiety Inventory and Beck Depression Inventory were used for assessment. CSF was diagnosed by coronary angiography “Thrombolysis In Myocardial Infarction” frame count. Lipid profile was obtained for all patients. Results Traditional risk factors (male gender, smoking, total cholesterol, low-density lipoproteins and triglycerides) were higher in the CSF group. Depression and anxiety scores were also higher in the CSF group. On multivariate analysis, male gender, depression and high triglycerides were the only significant independent predictors of CSF. A significant correlation existed between CSF and both anxiety and depression scores. Both scores were also significantly higher in multivessel vs single vessel affection. Conclusion Psychiatric depression, male gender and high triglycerides are highly associated with CSF in patients undergoing elective CAG. There is a significant correlation between CSF severity and the severity of both anxiety and depression. Further studies are warranted to explore the impact of psychological intervention on CSF and its long-term outcome.
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Michl-Petzing LC, Handley ED, Sturge-Apple M, Cicchetti D, Toth SL. Re-examining the "cycle of abuse": Parenting determinants among previously maltreated, low-income mothers. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2019; 33:742-752. [PMID: 31033305 PMCID: PMC6706323 DOI: 10.1037/fam0000534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Multidomain approaches toward understanding the transmission of harsh caregiving across generations have been largely overlooked in the literature. To address this, the current study examined how maternal and child factors may operate as mediating mechanisms in the association between maternal history of child maltreatment and maternal caregiving behaviors. In particular, we tested the relative roles of maternal depression, maternal efficacy beliefs, and child behavioral difficulties as explanatory variables in these associations. Participants (N = 127) were drawn from a community sample of mother-child dyads from socioeconomically disadvantaged, ethnically diverse backgrounds. Mother-child dyads were assessed at baseline, when the children were approximately 12 months old, with follow-up visits occurring when children were 26 and 37 months of age. Findings did not support a significant direct effect of childhood maltreatment on mothers' subsequent harsh or responsive parenting behavior. However, analyses demonstrated a significant indirect effect of childhood maltreatment history on later responsive parenting behaviors via maternal depression. Results also supported a significant indirect effect of childhood maltreatment history on later harsh parenting behavior through child behavior problems. Although mothers' childhood maltreatment history significantly predicted lower levels of maternal efficacy, results did not support a mediating role of maternal efficacy beliefs in the association between maltreatment history and subsequent parenting behaviors. Identifying specific factors that potentially disrupt the intergenerational pattern of maladaptive parenting can serve to guide prevention and intervention efforts aimed at facilitating more positive, responsive parenting strategies within high-risk families. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Depression, cardiovascular disease, and related pathophysiologic mechanisms in women. COR ET VASA 2019. [DOI: 10.33678/cor.2019.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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43
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Leeners B, Krüger THC, Geraedts K, Tronci E, Mancini T, Egli M, Röblitz S, Saleh L, Spanaus K, Schippert C, Zhang Y, Ille F. Associations Between Natural Physiological and Supraphysiological Estradiol Levels and Stress Perception. Front Psychol 2019; 10:1296. [PMID: 31244718 PMCID: PMC6579809 DOI: 10.3389/fpsyg.2019.01296] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 05/16/2019] [Indexed: 11/13/2022] Open
Abstract
Stress is a risk factor for impaired general, mental, and reproductive health. The role of physiological and supraphysiological estradiol concentrations in stress perception and stress processing is less well understood. We, therefore, conducted a prospective observational study to investigate the association between estradiol, stress perception, and stress-related cognitive performance within serial measurements either during the natural menstrual cycle or during fertility treatment, where estradiol levels are strongly above the physiological level of a natural cycle, and consequently, represent a good model to study dose-dependent effects of estradiol. Data from 44 women receiving in vitro fertilization (IVF) at the Department of Reproductive Endocrinology in Zurich, Switzerland was compared to data from 88 women with measurements during their natural menstrual cycle. The German version of the Perceived Stress Questionnaire (PSQ) and the Cognitive Bias Test (CBT), in which cognitive performance is tested under time stress were used to evaluate subjective and functional aspects of stress. Estradiol levels were investigated at four different time points during the menstrual cycle and at two different time points during a fertility treatment. Cycle phases were associated with PSQ worry and cognitive bias in normally cycling women, but different phases of fertility treatment were not associated with subjectively perceived stress and stress-related cognitive bias. PSQ lack of joy and PSQ demands related to CBT in women receiving fertility treatment but not in women with a normal menstrual cycle. Only strong changes of the estradiol level during fertility treatment were weakly associated with CBT, but not with subjectively experienced stress. Our research emphasizes the multidimensional character of stress and the necessity to adjust stress research to the complex nature of stress perception and processing. Infertility is associated with an increased psychological burden in patients. However, not all phases of the process to overcome infertility do significantly increase patient stress levels. Also, research on the psychological burden of infertility should consider that stress may vary during the different phases of fertility treatment. Clinical trial registration: ClinicalTrials.gov # NCT02098668.
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Affiliation(s)
- Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Tillmann H C Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Kirsten Geraedts
- Department of Reproductive Endocrinology, University Hospital Zurich, Zurich, Switzerland
| | - Enrico Tronci
- Department of Computer Science, University of Rome "La Sapienza", Rome, Italy
| | - Toni Mancini
- Department of Computer Science, University of Rome "La Sapienza", Rome, Italy
| | - Marcel Egli
- Centre of Competence in Aerospace Biomedical Science & Technology, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
| | - Susanna Röblitz
- Computational Biology Unit, Department of Informatics, University of Bergen, Bergen, Norway
| | - Lanja Saleh
- Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
| | - Katharina Spanaus
- Institute of Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland
| | - Cordula Schippert
- Department of Gynaecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Yuanyuan Zhang
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Medical School Hannover, Hannover, Germany
| | - Fabian Ille
- Centre of Competence in Aerospace Biomedical Science & Technology, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
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Musliner KL, Liu X, Gasse C, Christensen KS, Wimberley T, Munk-Olsen T. Incidence of medically treated depression in Denmark among individuals 15-44 years old: a comprehensive overview based on population registers. Acta Psychiatr Scand 2019; 139:548-557. [PMID: 30908590 DOI: 10.1111/acps.13028] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2019] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Examine the overall incidence of medically treated depression in Denmark among individuals 15-44 years old, and estimate the 5-year cumulative incidence of psychiatric hospital care among individuals treated first in non-hospital-based care. METHODS We followed all individuals born in Denmark between 1969 and 1998 from age 15 or 2006 (whichever came first) until first depression treatment; death; emigration; or December 31, 2013. Incidence rates were estimated using Poisson regression. Cumulative incidence of hospital care following treatment in non-hospital care was estimated using Kaplan-Meier curves. RESULTS In this sample of 2 014 760 individuals, incidence rates of depression in non-hospital and hospital-based care in 2012-2013 were 6.6 (95% Confidence Interval: 6.5-6.7) per 1000 person-years and 1.5 (95% CI: 1.5-1.6) per 1000 person-years, respectively. Overall, 85-90% of first medical treatment for depression took place outside of psychiatric hospitals, but a quarter (26.3%) of individuals treated for depression received hospital care initially or within 5 years. Incidence of hospital care was higher in women and younger individuals. CONCLUSIONS Most medical treatment for depression in Denmark takes place in non-hospital settings. Women and younger individuals are more likely to receive hospital care both initially and within 5 years after first antidepressant treatment.
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Affiliation(s)
- K L Musliner
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - X Liu
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - C Gasse
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark.,Department of Depression and Anxiety, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - K S Christensen
- Research Unit for General Practice, Section for General Medicine, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - T Wimberley
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - T Munk-Olsen
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,CIRRAU - Center for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
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Rydberg Sterner T, Gudmundsson P, Sigström R, Ahlner F, Seidu N, Zettergren A, Kern S, Östling S, Waern M, Skoog I. Depression and neuroticism decrease among women but not among men between 1976 and 2016 in Swedish septuagenarians. Acta Psychiatr Scand 2019; 139:381-394. [PMID: 30697686 DOI: 10.1111/acps.13005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES We evaluated birth-cohort differences in depressive symptom burden, prevalence of depression diagnoses, and neuroticism, among Swedish 70-year-olds examined between 1976 and 2016. METHODS We used a repeated cross-sectional design examining four representative population samples of Swedish 70-year-olds (total n = 2279) with identical methods in 1976-77 (n = 392), 1992-93 (n = 226), 2000-02 (n = 487), and 2014-16 (n = 1166). Depressive symptom burden was rated with the Montgomery Åsberg Depression Rating Scale. Major depression was diagnosed according to DSM-5, and minor depression according to DSM-IV-TR research criteria. Neuroticism was rated with the Eysenck Personality Inventory. RESULTS For women in 2014-16, MADRS score (4.4 vs. 6.1 vs. 5.8; P < 0.05) and neuroticism (6.6 vs. 7.7 vs. 9.2; P < 0.05) were lower compared with 1992-93 and 1976-77, and the prevalence of any depression was lower compared with 2000-02 and 1992-93 (10.9% vs. 16.9% vs. 18.1%; P < 0.05). For men, we observed no birth-cohort differences in depression, while neuroticism was found to be lower in 2014-16 compared with 1976-77 among men without depression (5.1 vs. 5.9; P < 0.01). The sex difference for MADRS and neuroticism declined between 1976-77 and 2014-16 (cohort*sex P < 0.05). CONCLUSIONS Depressive burden and neuroticism decreased in 70-year-old women between 1976 and 2016.
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Affiliation(s)
- T Rydberg Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - P Gudmundsson
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - R Sigström
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - F Ahlner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - N Seidu
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - A Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - S Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - S Östling
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - M Waern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - I Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
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Chen H, Wang X, Huang Y, Li G, Liu Z, Li Y, Geng H. Prevalence, risk factors and multi-group latent class analysis of lifetime anxiety disorders comorbid depressive symptoms. J Affect Disord 2019; 243:360-365. [PMID: 30266027 DOI: 10.1016/j.jad.2018.09.053] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/06/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Previous studies about comorbidity have primarily focused on disorders based on diagnostic criteria instead of symptoms. This study aimed to describe the prevalence and risk factors of anxiety comorbid depression based on a population-based sample in Chifeng City Inner Mongolia and explored the gender differences of depressive subtypes in anxiety patients. METHODS This study was a cross-sectional study conducted among 6376 community residents. Logistics analysis and multiple-group latent class analysis was used in exploring the risk factors and subtypes of anxiety comorbid depressive symptoms. RESULTS A total of 4528 respondents were interviewed in this study. The lifetime prevalence estimates for anxiety in the total sample was 5.70%. Among residents who had ever had anxiety, most of them reported having depressive symptoms while 15.79% of them met the criteria of MDD. Logistics analysis showed childhood adversities were associated with anxiety comorbid depressive symptoms. The results of multiple-group latent class analysis showed that the latent class probabilities were different between males and females. CONCLUSION The prevalence rates of comorbidity were similar to the reports of previous regional surveys in China with statistically significant differences of comorbidity occurring between males and females. Precision prevention should therefore be targeted towards different kinds of populations.
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Affiliation(s)
- Hongguang Chen
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China.
| | - Xiao Wang
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Yueqin Huang
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China.
| | - Guohua Li
- Chifeng Anding Hospital, Chifeng, Inner Mongolia, 024000, China.
| | - Zhaorui Liu
- Peking University Sixth Hospital (Institute of Mental Health), National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing 100191, China
| | - Yanxiang Li
- Chifeng Anding Hospital, Chifeng, Inner Mongolia, 024000, China
| | - Hongchun Geng
- Chifeng Anding Hospital, Chifeng, Inner Mongolia, 024000, China
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Sex differences and the neurobiology of affective disorders. Neuropsychopharmacology 2019; 44:111-128. [PMID: 30061743 PMCID: PMC6235863 DOI: 10.1038/s41386-018-0148-z] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/14/2018] [Accepted: 06/25/2018] [Indexed: 12/11/2022]
Abstract
Observations of the disproportionate incidence of depression in women compared with men have long preceded the recent explosion of interest in sex differences. Nonetheless, the source and implications of this epidemiologic sex difference remain unclear, as does the practical significance of the multitude of sex differences that have been reported in brain structure and function. In this article, we attempt to provide a framework for thinking about how sex and reproductive hormones (particularly estradiol as an example) might contribute to affective illness. After briefly reviewing some observed sex differences in depression, we discuss how sex might alter brain function through hormonal effects (both organizational (programmed) and activational (acute)), sex chromosome effects, and the interaction of sex with the environment. We next review sex differences in the brain at the structural, cellular, and network levels. We then focus on how sex and reproductive hormones regulate systems implicated in the pathophysiology of depression, including neuroplasticity, genetic and neural networks, the stress axis, and immune function. Finally, we suggest several models that might explain a sex-dependent differential regulation of affect and susceptibility to affective illness. As a disclaimer, the studies cited in this review are not intended to be comprehensive but rather serve as examples of the multitude of levels at which sex and reproductive hormones regulate brain structure and function. As such and despite our current ignorance regarding both the ontogeny of affective illness and the impact of sex on that ontogeny, sex differences may provide a lens through which we may better view the mechanisms underlying affective regulation and dysfunction.
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48
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Green T, Flash S, Reiss AL. Sex differences in psychiatric disorders: what we can learn from sex chromosome aneuploidies. Neuropsychopharmacology 2019; 44:9-21. [PMID: 30127341 PMCID: PMC6235860 DOI: 10.1038/s41386-018-0153-2] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Revised: 06/01/2018] [Accepted: 06/21/2018] [Indexed: 12/17/2022]
Abstract
The study of sexual dimorphism in psychiatric and neurodevelopmental disorders is challenging due to the complex interplay of diverse biological, psychological, and social factors. Males are more susceptible to neurodevelopmental disorders including intellectual disability, autism spectrum disorder, and attention-deficit activity disorder. Conversely, after puberty, females are more prone to major depressive disorder and anxiety disorders compared to males. One major biological factor contributing to sex differences is the sex chromosomes. First, the X and Y chromosomes have unique and specific genetic effects as well as downstream gonadal effects. Second, males have one X chromosome and one Y chromosome, while females have two X chromosomes. Thus, sex chromosome constitution also differs between the sexes. Due to this complexity, determining genetic and downstream biological influences on sexual dimorphism in humans is challenging. Sex chromosome aneuploidies, such as Turner syndrome (X0) and Klinefelter syndrome (XXY), are common genetic conditions in humans. The study of individuals with sex chromosome aneuploidies provides a promising framework for studying sexual dimorphism in neurodevelopmental and psychiatric disorders. Here we will review and contrast four syndromes caused by variation in the number of sex chromosomes: Turner syndrome, Klinefelter syndrome, XYY syndrome, and XXX syndrome. Overall we describe an increased rate of attention-deficit hyperactivity disorder and autism spectrum disorder, along with the increased rates of major depressive disorder and anxiety disorders in one or more of these conditions. In addition to contributing unique insights about sexual dimorphism in neuropsychiatric disorders, awareness of the increased risk of neurodevelopmental and psychiatric disorders in sex chromosome aneuploidies can inform appropriate management of these common genetic disorders.
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Affiliation(s)
- Tamar Green
- Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, CA, 94305, USA.
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
| | - Shira Flash
- Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, CA, 94305, USA
| | - Allan L Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University, Stanford, CA, 94305, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
- Department of Radiology, Stanford University, Stanford, CA, 94305, USA
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49
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Gender-related patterns of psychiatric disorder clustering among bariatric surgery candidates: A latent class analysis. J Affect Disord 2018; 240:72-78. [PMID: 30056172 DOI: 10.1016/j.jad.2018.07.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/31/2018] [Accepted: 07/14/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND Psychiatric disorders tend to distribute unevenly in women and men with severe obesity. The current research aimed to identify homogeneous clusters of concurrent psychiatric disorders among patients seeking bariatric surgery, by gender. METHODS We recruited a consecutive sample of 393 candidates with obesity (311 women and 82 men) in a university-based bariatric center. Trained clinicians assessed psychiatric disorders through the Structured Clinical Interview for DSM-IV (SCID). Latent class analysis categorized pre-surgical patients into uniform clusters of co-occurring psychiatric disorders. RESULTS For both genders, the 3-class psychopathological clustering was the best-fitting solution. Among women, the latent classes were: (1) "oligosymptomatic", wherein 42% of patients showed low probability of psychiatric disorders; (2) "bipolar with comorbidities", in 33%; and (3) "anxiety/depression", in 25%. Among men, (1) "bipolar with comorbidities" was found in 47% of patients; (2) "oligosymptomatic", in 40%; and (3) "anxiety/depression", in 13%. For both genders, the probability of presenting eating disorders was higher in both "bipolar" and "anxiety/depression" classes. Substance use disorders was prominent among "bipolar" men. In comparison with "oligosymptomatic" class, the likelihood of higher BMI was observed among "bipolar" men and poorer work attainment among men with "anxiety/depression". LIMITATION Participants was cross-sectionally drawn from a single bariatric center. CONCLUSIONS Pre-surgical men and women with severe obesity were distributed in three comorbidity profiles and revealed analogous psychopathological patterns. The class of "bipolar disorders" most likely presented comorbidity with eating and substance use disorder. This natural clustering of psychiatric disorders among bariatric patients suggests gender-related therapeutic approaches and surgical outcomes.
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Sassi S, Hakko H, Räty E, Riipinen P. Light motor vehicle collisions with heavy vehicles — Psychosocial and health related risk factors of drivers being at-fault for collisions. Forensic Sci Int 2018; 291:245-252. [DOI: 10.1016/j.forsciint.2018.08.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/03/2018] [Accepted: 08/25/2018] [Indexed: 10/28/2022]
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