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Zhang ZX, Li E, Yan JP, Fu W, Shen P, Tian SW, You Y. Apelin attenuates depressive-like behavior and neuroinflammation in rats co-treated with chronic stress and lipopolysaccharide. Neuropeptides 2019; 77:101959. [PMID: 31445676 DOI: 10.1016/j.npep.2019.101959] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 07/07/2019] [Accepted: 08/07/2019] [Indexed: 12/11/2022]
Abstract
Several experimental studies have proved that activation of neuroinflammation pathways may contribute to the development of depression, a neuropsychiatric disorder disease. Our previous studies have shown the antidepressant properties of apelin, but the mechanism was unkown. This study was performed to verify whether the antidepressant effect of apelin was related to its anti-inflammation effect in the central nervous system. To achieve our aim, we selected the co-treatment of chronic stress and LPS to induced an inflammatory process in rats. The effect of this co-treatment was evaluated through the expression of inflammatory markers and glial cell activation. LPS injection co-treated with unpredictable chronic mild stress resulted in the activation of microglial cell and astrocyte, expression of inflammatory markers and depressive behaviors. Treatment with apelin significantly attenuates the deleterious effects in these rats. Our results showed that apelin improved depressive phenotype and decreased the activation of glial cells in stress co-treatment group. The down-regulations of p-NF-κB and p-IKKβ suggested that the effects are possibly mediated by inhibition of the NF-κB-mediated inflammatory response. These findings speculated that intracerebroventricular injection of apelin could be a therapeutic approach for the treatment of depression, and the antidepressant function of apelin may closely associated with its alleviation in neuroinflammation.
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Affiliation(s)
- Zi-Xuan Zhang
- Department of Neurology, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan 571199, PR China; Department of Neurology, XiangTan Central Hospital, Xiangtan, Hunan 411100, PR China
| | - E Li
- Institute of Neuroscience, Chinese Academy of Sciences, CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, PR China
| | - Jian-Ping Yan
- Department of Neurology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, PR China
| | - Wan Fu
- Department of Neurology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, PR China
| | - Pei Shen
- Department of Neurology, The First Affiliated Hospital, University of South China, Hengyang, Hunan 421001, PR China
| | - Shao-Wen Tian
- Department of Physiology, Hengyang Medical College, University of South China, Hengyang, Hunan 421001, PR China.
| | - Yong You
- Department of Neurology, The Second Affiliated Hospital, Hainan Medical University, Haikou, Hainan 571199, PR China.
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Yang SJ, Song ZJ, Wang XC, Zhang ZR, Wu SB, Zhu GQ. Curculigoside facilitates fear extinction and prevents depression-like behaviors in a mouse learned helplessness model through increasing hippocampal BDNF. Acta Pharmacol Sin 2019; 40:1269-1278. [PMID: 31028292 PMCID: PMC6786307 DOI: 10.1038/s41401-019-0238-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 04/11/2019] [Indexed: 12/11/2022] Open
Abstract
Curculigoside (CUR) is the main active component of traditional Chinese medicine Curculigoorchioides Gaertn (Xianmao in Chinese), which exhibits a variety of pharmacological activities. In this study we investigated the effects of CUR on fear extinction and related depression-like behaviors in mice. In fear conditioning task, we found that administration of CUR (1.6, 8, 40 mg·kg-1·d-1, ip, for 7 days) did not affect memory consolidation, but CUR at higher doses (8, 40 mg·kg-1·d-1) significantly facilitated fear extinction, especially on D3 and D4. Moreover, CUR administration significantly ameliorated the fear conditioning-induced depression-like behaviors, likely through promoting fear extinction. We showed that CUR increased the expression of brain-derived neurotrophic factor (BDNF) and phosphorylation of tropomyosin receptor kinase B (TrkB) in the hippocampus, and activated protein kinase B (Akt)-mammalian target of the rapamycin (mTOR) signaling pathway. Administration of the selective TrkB agonist 7,8-dihydroxyflavone (7,8-DHF, 5 mg·kg-1·d-1, ip) also facilitated fear extinction, ameliorated depression-like behaviors. We established a mouse learned helplessness (LH) model to evaluate the antidepressant activity of CUR. The spatial memory was assessed in Morris water maze. We showed that LH-induced depression-like behaviors, including prolonged immobility times in forced swim and tail suspension tests as well as spatial memory impairments; LH also downregulated BDNF expression and the Akt-mTOR signaling pathway in the hippocampus. Administration of CUR (1.6, 8, 40 mg·kg-1·d-1, ip, for 14 days) or 7,8-DHF (5 mg·kg-1·d-1, ip, for 3 days) prevented LH-induced depression-like behaviors and promoted BDNF expression and the Akt-mTOR signaling pathway. In conclusion, CUR can accelerate the fear memory extinction and ameliorate depression-like behaviors in mice via promoting BDNF expression and activating the Akt-mTOR signaling pathway in the hippocampus.
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Affiliation(s)
- San-Juan Yang
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Zhu-Jin Song
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Xun-Cui Wang
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Zheng-Rong Zhang
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China
| | - Sheng-Bing Wu
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China
- Anhui Academy of Chinese Medicine, Hefei, 230038, China
| | - Guo-Qi Zhu
- Key Laboratory of Xin'an Medicine, Ministry of Education, Anhui University of Chinese Medicine, Hefei, 230038, China.
- Anhui Academy of Chinese Medicine, Hefei, 230038, China.
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53
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Jaffe DH, Rive B, Denee TR. The burden of suicidal ideation across Europe: a cross-sectional survey in five countries. Neuropsychiatr Dis Treat 2019; 15:2257-2271. [PMID: 31496708 PMCID: PMC6689539 DOI: 10.2147/ndt.s204265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Suicidal ideation (SI) is an associated risk of depression, affecting 30-40% of the depressed population. However, there is a paucity of studies investigating the impact of SI in Europe. This retrospective observational study examined the burden of SI among adults with major depressive disorder (MDD) in the 2017 National Health and Wellness Survey in five European countries: France, Germany, Italy, Spain, and the UK. METHODS Bivariate analyses evaluated group differences between respondents with MDD with and without SI according to demographic characteristics, self-reported health-related quality of life, work productivity and activity impairment (WPAI), and healthcare resource utilization (HRU). Generalized linear models examined group differences country-wise, after controlling for relevant confounders. RESULTS Among 52,060 respondents, 3,308 individuals were diagnosed with MDD, comprising SI (n=905) and non-SI (nSI) (n=2403) patients. Adjusted differences (ADs), compared to the general population, were observed using the Medical Outcomes Study Short Form Survey (SF-12v2) mental component summary scores (AD: SI=-20.02, nSI=-10.77), physical component summary scores (AD: SI=-4.49, nSI=-2.50), and EuroQoL-5 Dimensions (AD: SI=-0.34, nSI=-0.15) (for all, p<0.001). Significantly greater WPAI and higher HRU were associated with SI compared to nSI. CONCLUSION The results illustrate the unique impact of SI within the MDD population and the need to reduce the burden.
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Affiliation(s)
| | - Benoit Rive
- Janssen-Cilag S.A., Health Economics Market Access and Reimbursement Statistics
, Paris, France
| | - Tom R Denee
- Janssen-Cilag Limited, Health Economics Market Access and Reimbursement
, High Wycombe, UK
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54
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Recent Suicidal Ideation and Behavior in the General Population: The Role of Depression, Posttraumatic Stress, and Reactive Avoidance. J Nerv Ment Dis 2019; 207:320-325. [PMID: 30958420 DOI: 10.1097/nmd.0000000000000976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The multivariate relationship between suicidality and three potential etiologic variables (depression, posttraumatic stress, and reactive avoidance) was examined in a stratified sample of 679 individuals from the general population. Lifetime exposure to a trauma or another very upsetting event was prevalent among those reporting suicidal behavior in the previous 6 months (58%) and those reporting recent suicidal ideation alone (40%), relative to those with no recent suicidal thoughts or behaviors (26%). Canonical correlation analysis indicated two independent sources of variance: the first loading on both suicidal ideation and behavior, predicted by depression, posttraumatic stress, and reactive avoidance, and the second indicating a unique relationship between suicidal behavior and reactive avoidance alone. Results indicate that the etiology of suicidality is likely multidimensional, and point to a significant variant of suicidal behavior that is unrelated to depression or posttraumatic stress, but may reflect emotional dysregulation and subsequent distress reduction behaviors.
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55
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Meng G, Wang L, Wang X, Chi VTQ, Zhang Q, Liu L, Yao Z, Wu H, Bao X, Gu Y, Zhang S, Sun S, Zhou M, Jia Q, Song K, Sun Z, Wu Y, Niu K. Association between neutrophil to lymphocyte ratio and depressive symptoms among Chinese adults: A population study from the TCLSIH cohort study. Psychoneuroendocrinology 2019; 103:76-82. [PMID: 30658341 DOI: 10.1016/j.psyneuen.2019.01.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/04/2019] [Accepted: 01/08/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The prevalence of depression in the general population has risen sharply over the past few decades and has become a major health problem throughout the world. Increasing evidence suggests that inflammation plays an important role in the pathogenesis of depression. To better understand the role of inflammation in the pathogenesis of depression we can use the neutrophil-to-lymphocyte ratio (NLR) because it is a simple and effective marker of inflammation and immunity. METHODS This cross-sectional study was conducted among adults from the healthy general population in Tianjin, China. NLR was measured according to the complete blood count. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS), and a cutoff score of 45 was used to indicate the presence of depressive symptoms in the study participants. The relationship between NLR and the prevalence of depressive symptoms was evaluated separately for men and women using the multiple logistic regression analysis. RESULTS In the present study, the overall prevalence of depressive symptoms was 17.0% among all participants. In women, the multivariable-adjusted OR of having depressive symptoms was 1.28 (95% CI 1.10, 1.49; p for trend <0.01) for the fifth compared with the first quintile of NLR, and was 1.22 (95% CI 1.07,1.39; p < 0.01) per unit increase of NLR. However, no significant association was found between NLR and depressive symptoms in men. CONCLUSION This study suggests that increased NLR levels are independently related to depressive symptoms in women, but not in men. Further research is required to investigate this relationship with longitudinal data to establish the temporal ordering between these variables.
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Affiliation(s)
- Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Liu Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xiaona Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Vu Thi Quynh Chi
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhanxin Yao
- Tianjin Institute of Health and Environmental Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xue Bao
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Ming Zhou
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhong Sun
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yuntang Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China; Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
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56
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Glaus J, Cui L, Hommer R, Merikangas KR. Association between mood disorders and BMI/overweight using a family study approach. J Affect Disord 2019; 248:131-138. [PMID: 30731280 DOI: 10.1016/j.jad.2019.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/19/2018] [Accepted: 01/12/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND We previously demonstrated the specificity of familial transmission of the atypical subtype of depression, primarily characterized by overeating and oversleeping. However, the specific components of this subtype that are familial have not been established. The aim of this paper is to examine whether the familial specificity of atypical depression can be attributed to the association between Body Mass Index (BMI) and overweight/obesity with mood disorders. METHODS The sample included 293 probands recruited from the community and their 544 adult first-degree relatives. Diagnostic assignment was based on a direct semi-structured interview. Mixed effect models were employed to test the familial aggregation and the familial cross-aggregation of mood disorders and BMI/overweight. RESULTS There were significant within-individual associations between overweight and the atypical subtype of depression (p-value = 0.003). There was also an association for BMI/overweight between probands and relatives (β = 0.23, p-value < 0.001; odds ratio [OR] = 1.57, 95% confidence interval [CI] = 1.02-2.43, respectively). Atypical depression in probands was significantly associated with BMI and overweight in relatives (β = 0.001, p-value = 0.040; OR = 2.79, 95%CI = 1.20-6.49, respectively). LIMITATIONS The cross-sectional design impedes our ability to evaluate the direction of these associations. Other potential risk factors, such as diabetes, physical activity and unhealthy diet were not considered. CONCLUSIONS These findings imply that overweight may be either a precursor or consequence of atypical depression rather than a manifestation of a common diathesis underlying depression in families. Clinicians should pay particular attention to this subtype that could be at increased risk for the development of cardiovascular risk factors and diseases.
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Affiliation(s)
- Jennifer Glaus
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA.
| | - Lihong Cui
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Rebecca Hommer
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive, MSC 3720, Bldg 35A, Room 2E422A, Bethesda, MD, USA
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57
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Maes M, Moraes JB, Congio A, Bonifacio KL, Barbosa DS, Vargas HO, Michelin AP, Carvalho AF, Nunes SOV. Development of a Novel Staging Model for Affective Disorders Using Partial Least Squares Bootstrapping: Effects of Lipid-Associated Antioxidant Defenses and Neuro-Oxidative Stress. Mol Neurobiol 2019; 56:6626-6644. [PMID: 30911933 DOI: 10.1007/s12035-019-1552-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 03/13/2019] [Indexed: 12/14/2022]
Abstract
Although, staging models gained momentum to stage define affective disorders, no attempts were made to construct mathematical staging models using clinical and biomarker data in patients with major depression and bipolar disorder. The aims of this study were to use clinical and biomarker data to construct statistically derived staging models, which are associated with early lifetime traumata (ELTs), affective phenomenology, and biomarkers. In the current study, 172 subjects participated, 105 with affective disorders (both bipolar and unipolar) and 67 controls. Staging scores were computed by extracting latent vectors (LVs) from clinical data including ELTs, recurring flare ups and suicidal behaviors, outcome data such as disabilities and health-related quality of life (HR-QoL), and paraoxonase (PON)1 actvities and nitro-oxidative stress biomarkers. Recurrence of episodes and suicidal behaviors could reliably be combined into a LV with adequate composite reliability (the "recurrence LV"), which was associated with female sex, the combined effects of multiple ELTs, disabilities, HR-QoL, and impairments in cognitive tests. All those factors could be combined into a reliable "ELT-staging LV" which was significantly associated with nitro-oxidative stress biomarkers. A reliable LV could be extracted from serum PON1 activities, recurrent flare ups, disabilities, and HR-QoL. Our ELT-staging index scores the severity of a relevant affective dimension, shared by both major depression and bipolar disorder, namely the trajectory from ELTs, a relapsing course, and suicidal behaviors to progressive disabilities. Patients were classified into three stages, namely an early stage, a relapse-regression stage, and a suicidal-regression stage. Lowered lipid-associated antioxidant defenses may be a drug target to prevent the transition from the early to the later regression stages.
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Affiliation(s)
- Michael Maes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil. .,Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand. .,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria. .,IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia.
| | - Juliana Brum Moraes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Ana Congio
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Kamila Landucci Bonifacio
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Decio Sabbatini Barbosa
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Heber Odebrecht Vargas
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Ana Paula Michelin
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| | - Sandra Odebrecht Vargas Nunes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch, Londrina, PR, 60 86035-380, Brazil
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Smith KL, Cunningham JI, Eyerman DJ, Dean RL, Deaver DR, Sanchez C. Opioid system modulators buprenorphine and samidorphan alter behavior and extracellular neurotransmitter concentrations in the Wistar Kyoto rat. Neuropharmacology 2019; 146:316-326. [DOI: 10.1016/j.neuropharm.2018.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 10/26/2018] [Accepted: 11/10/2018] [Indexed: 01/04/2023]
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Bergmans RS, Kelly KM, Mezuk B. Inflammation as a unique marker of suicide ideation distinct from depression syndrome among U.S. adults. J Affect Disord 2019; 245:1052-1060. [PMID: 30699847 PMCID: PMC6448785 DOI: 10.1016/j.jad.2018.11.046] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 09/19/2018] [Accepted: 11/03/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Recent evidence suggests that pro-inflammatory states may be independently associated with the risk of suicidality, above and beyond depression. This study assesses whether four indicators of inflammation, circulating levels of C-reactive protein (CRP), white blood cell (WBC) count and immunoglobulin E (IgE), and dietary inflammatory potential, measured using the Dietary Inflammatory Index® (DII), distinguish suicidal ideation (SI) from major depression (MD). METHODS Data come from multiple cycles of the US National Health and Nutrition Examination Survey (NCRP&WBC = 13,912; NDII = 17,076; NIgE = 4,060). MD was measured using the Patient Health Questionnaire-9 (PHQ-9); SI was indicated by the last item of the PHQ-9. To assess SI independent from MD, participants were classified into four categories: SI with MD, SI without MD, MD without SI, and neither MD nor SI. Regression models were used to assess the relationship between indicators of inflammation and SI with and without MD. RESULTS None of the inflammatory indicators were able to distinguish SI status among MD cases. DII was associated with SI among individuals without MD. CRP, DII, and WBC were associated with MD. No associations were found for IgE. LIMITATIONS Cross-section data prevent drawing causal conclusions. Underreporting of MD and suicidal ideation and measurement of habitual diet using 24 h dietary recalls are also weaknesses. CONCLUSION Dietary inflammatory potential was associated with suicide ideation among US adults with and without depression. Diet may play a role in suicide ideation and more empirical evidence is needed to determine whether nutritional protocols could aid in the treatment of suicidal behaviors. Findings did not support inflammatory factors having a relationship with suicide ideation distinct from depression.
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Affiliation(s)
- Rachel S Bergmans
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Kristen M Kelly
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Briana Mezuk
- UM SPH Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
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Twelve-Month Incidence of Depressive Symptoms in Suburb-Dwelling Chinese Older Adults: Role of Sarcopenia. J Am Med Dir Assoc 2019; 20:64-69. [DOI: 10.1016/j.jamda.2018.07.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 07/16/2018] [Accepted: 07/23/2018] [Indexed: 12/14/2022]
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61
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Maes M, Congio A, Moraes JB, Bonifacio KL, Barbosa DS, Vargas HO, Morris G, Puri BK, Michelin AP, Nunes SOV. Early Life Trauma Predicts Affective Phenomenology and the Effects are Partly Mediated by Staging Coupled with Lowered Lipid-Associated Antioxidant Defences. Biomol Concepts 2018; 9:115-130. [PMID: 30471214 DOI: 10.1515/bmc-2018-0010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 11/01/2018] [Indexed: 12/26/2022] Open
Abstract
Background Early life trauma (ELT) may drive mood disorder phenomenology, nitro-oxidative pathways and impairments in semantic memory. There are no data regarding the impact of ELT on affective phenomenology and whether these pathways are mediated by staging or lowered lipid-associated antioxidant defences. Methods This study examined healthy controls (n=54) and patients with affective disorders including major depression, bipolar disorder and anxiety disorders (n=118). ELT was assessed using the Child Trauma Questionnaire. In addition, we measured affective phenomenology and assayed advanced oxidation protein products; malondialdehyde, paraoxonase 1 (CMPAase) activity, high-sensitivity C-reactive protein (hsCRP), and high-density lipoprotein (HDL) cholesterol. Results ELT was associated into with increased risk for mood and comorbid anxiety disorders and a more severe phenomenology, including staging characteristics, depression and anxiety severity, suicidal behaviours, type of treatments, disabilities, body mass index, smoking behaviour and hsCRP, as well as lowered health-related quality of life, antioxidant defences and semantic memory. The number of mood episodes and CMPAase/HDL-cholesterol levels could be reliably combined into a new vulnerability staging-biomarker index, which mediates in part the effects of ELT on affective phenomenology and oxidative stress. Moreover, the effects of female sex on mood disorders and affective phenomenology are mediated by ELT. Discussion The cumulative effects of different ELT drive many aspects of affective phenomenology either directly or indirectly through effects of staging and/or lipid-associated antioxidant defences. The results show that children, especially girls, with ELT are at great risk to develop mood disorders and more severe phenotypes of affective disorders.
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Affiliation(s)
- Michael Maes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil.,Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand.,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.,IMPACT Strategic Research Centre, Deakin University, Geelong, Vic, Australia
| | - Ana Congio
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Juliana Brum Moraes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Kamila Landucci Bonifacio
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Decio Sabbatini Barbosa
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Heber Odebrecht Vargas
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Gerwyn Morris
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic, Australia
| | - Basant K Puri
- Department of Medicine, Imperial College London, London, UK
| | - Ana Paula Michelin
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
| | - Sandra Odebrecht Vargas Nunes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60; 86035-380, Londrina, PR, Brazil
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Zhao T, Markevych I, Romanos M, Nowak D, Heinrich J. Ambient ozone exposure and mental health: A systematic review of epidemiological studies. ENVIRONMENTAL RESEARCH 2018; 165:459-472. [PMID: 29728258 DOI: 10.1016/j.envres.2018.04.015] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/09/2018] [Accepted: 04/17/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND An increasing number of studies have suggested adverse effects of air pollution on mental health. Given the potentially negative impacts of ozone exposure on the immune and nervous system driven from animal experiments, ozone might also affect mental health. However, no systematic synthesis of the relevant literature has been conducted yet. This paper reviews the studies that assessed the link between ozone exposure and mental health thus far. METHODS We followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). PubMed, Web of Science, and EMBASE were systematically searched for epidemiological studies on ambient ozone exposure and mental or behavioral disorders according to the International Classification of Disease. The period was from January 1st, 1960 to December 14st, 2017. We evaluated the risk of bias by the Office of Health Assessment and Translation (OHAT) Approach and Navigation Guide for each included study. RESULTS The keyword search yielded 567 results. 31 papers met the selection criteria and were included in the review. We found only inconclusive evidence that ozone affects autism spectrum disorders, impairment of cognitive functions and dementia, depression, and suicide. The large heterogeneity of study designs, outcome definitions and study quality in general prevented us from conducting meta-analyses. CONCLUSIONS Current evidence for an association between ambient ozone exposure and mental health outcomes is inconclusive and further high quality studies are needed to assess any potential links given the strong biologic plausibility.
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Affiliation(s)
- Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Marcel Romanos
- Centre of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
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Moraes JB, Maes M, Roomruangwong C, Bonifacio KL, Barbosa DS, Vargas HO, Anderson G, Kubera M, Carvalho AF, Nunes SOV. In major affective disorders, early life trauma predict increased nitro-oxidative stress, lipid peroxidation and protein oxidation and recurrence of major affective disorders, suicidal behaviors and a lowered quality of life. Metab Brain Dis 2018. [PMID: 29542039 DOI: 10.1007/s11011-018-0209-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Early life trauma (ELT) may increase the risk towards bipolar disorder (BD) and major depression (MDD), disorders associated with activated neuro-oxidative and neuro-nitrosative stress (O&NS) pathways. It has remained elusive whether ELTs are associated with O&NS and which ELTs are associated with distinct affective disorder phenotypes. This case-control study examined patients with BD (n = 68) and MDD (n = 37) and healthy controls (n = 66). The Child Trauma Questionnaire (CTQ) was used to assess specific ELT. We measured malondialdehyde (MDA), lipid hydroperoxides (LOOH), superoxide dismutase (SOD), catalase, advanced oxidation protein products (AOPP); NO metabolites (NOx), paraoxonase 1 activity, zinc, albumin, high density lipoprotein cholesterol and -SH groups and computed z-unit weighted composite scores. Physical neglect significantly predicts higher z-unit weighted composite scores of LOOH+SOD, LOOH+SOD+NOx, LOOH+SOD+NOx + MDA and LOOH+SOD+NOx + AOPP. Sexual abuse was associated with a significantly lower composite score of zinc+albumin+SH. Emotional abuse was associated with severity of depression and anxiety, number of depressive and manic episodes, alcohol and hypnotics use, lifetime suicidal behavior and lowered quality of life. Sexual abuse was associated with an increased risk towards BD, but not MDD. ELT, especially physical neglect, may drive increased (nitro-)oxidative stress coupled with lipid and protein oxidation, which - together with emotional abuse - may play a role in severity of illness, lowered quality of life and MDD. ELTs are also associated with the onset of BD, but this link did not appear to be related to activated O&NS pathways. These novel findings deserve confirmation in prospective studies.
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Affiliation(s)
- Juliana Brum Moraes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil
| | - Michael Maes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil.
- Department of Psychiatry, Chulalongkorn University, Bangkok, Thailand.
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria.
- Revitalis, Waalre, The Netherlands.
- IMPACT Strategic Research Centre, Deakin University, Geelong, Vic, Australia.
- IMPACT Strategic Research Centre, School of Medicine, Deakin University, PO Box 281, Geelong, 3220, Australia.
| | | | - Kamila Landucci Bonifacio
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil
| | - Decio Sabbatini Barbosa
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil
| | - Heber Odebrecht Vargas
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil
| | | | - Marta Kubera
- Department of Experimental Neuroendocrinology, Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Andre F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Fortaleza, CE, Brazil
| | - Sandra Odebrecht Vargas Nunes
- Health Sciences Graduate Program, Health Sciences Center, State University of Londrina, Av. Robert Koch 60, Londrina, PR, 86035-380, Brazil
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Fornaro M, Grunebaum MF, Burke AK, Mann JJ, Oquendo MA. Comparison of familial and non-familial suicidal behaviors among people with major depressive disorder: Testing the discriminative predicting role of high-yield clinical variables. J Psychiatr Res 2018; 102:118-122. [PMID: 29635115 DOI: 10.1016/j.jpsychires.2018.02.021] [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: 02/20/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Suicidal behavior in first-degree relatives of people diagnosed with major depressive disorder (MDD) increases the risk of suicidal behavior. Such an effect may be the result of genetic risk factors or environmental ones, including imitation, or both. Surprisingly few studies have examined this question and thus, there still is little known about the effect of first-degree family history of suicidal behavior on the type of suicidal behavior and profile of risk factors related to the diathesis for suicidal behavior. Even less is known about intra-familial risk transmission. METHODS Patients with MDD (n = 252) experiencing a current major depressive episode and who had a previous suicide attempt were studied. Those with and without a family history of first-degree relatives who had made a suicide attempt or died by suicide were compared across clinical and suicide-related characteristics. RESULTS Suicide attempters with (FDR+, n = 59) and without a first-degree relative with suicide attempt or suicide (FDR-, n = 193) were similar in terms of type or frequency of suicide attempts, level of lifetime aggression and impulsivity, age of onset of depression and age at first suicide attempt. LIMITATIONS Cross-Sectional study. Lack of additional external validators. CONCLUSIONS Contrary to our hypothesis and the concept of "genetic anticipation", a first-degree family history of suicide attempt or suicide in currently depressed attempters with MDD was not associated with a range of clinical and suicide-related characteristics. Longitudinal studies incorporating external validators and potential biological markers may advance this area of research.
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Affiliation(s)
- Michele Fornaro
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | | | - Ainsley K Burke
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | - J John Mann
- New York State Psychiatric Institute, Columbia University, NY, USA.
| | - Maria A Oquendo
- New York State Psychiatric Institute, Columbia University, NY, USA.
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Behr Gomes Jardim G, Novelo M, Spanemberg L, von Gunten A, Engroff P, Nogueira EL, Cataldo Neto A. Influence of childhood abuse and neglect subtypes on late-life suicide risk beyond depression. CHILD ABUSE & NEGLECT 2018; 80:249-256. [PMID: 29631256 DOI: 10.1016/j.chiabu.2018.03.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 03/22/2018] [Accepted: 03/27/2018] [Indexed: 05/25/2023]
Abstract
The association of childhood maltreatment and suicide has been extensively examined within the population. Depression figures as a main cause for the elevated suicide rate in advanced ages and is often related to childhood maltreatment. The purpose of the present study was to examine the relationship between childhood maltreatment subtypes and suicide risk, testing geriatric depression as a moderator. This is a cross-sectional study looking at a sample of 449 individuals 60 year s old or older from the Multidimensional Study of the Elderly of Porto Alegre Family Health Strategy, Brazil (EMI-SUS/POA). Childhood maltreatment (Childhood Trauma Questionnaire), geriatric depressive symptoms (Geriatric Depression Scale), and suicide risk (Mini International Neuropsychiatric Interview) were assessed. The subtypes of childhood abuse and neglect were significantly associated with suicide risk. In the multivariate analysis, controlling for age, gender, income, marital status, ethnicity, smoking, and geriatric depression symptoms, all trauma subtypes remained associated with suicide risk with the exception of physical neglect (EA = 3.65; PA = 3.16; SA = 5.1; EN = 2.43; PN = 1.76). The present study showed that childhood maltreatment subtypes predicted suicide risk, and geriatric depression does not directly mediate this relation.
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Affiliation(s)
- Gabriel Behr Gomes Jardim
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Brazil.
| | - Marta Novelo
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Brazil.
| | - Lucas Spanemberg
- Nucleo Especifico de Formacao em Psiquiatria, Escola de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Brazil; Departamento de Psiquiatria, Universidade Federal do Rio Grande do Sul - UFRGS, Brazil.
| | - Armin von Gunten
- Service Universitaire de Psychiatrie de l'Age Avance - SUPAA, University of Lausanne - UNIL, Switzerland.
| | - Paula Engroff
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Brazil.
| | - Eduardo Lopes Nogueira
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Brazil; Nucleo Especifico de Formacao em Psiquiatria, Escola de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Brazil.
| | - Alfredo Cataldo Neto
- Instituto de Geriatria e Gerontologia - IGG, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS, Brazil; Nucleo Especifico de Formacao em Psiquiatria, Escola de Medicina da Pontifícia Universidade Católica do Rio Grande do Sul, Brazil.
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Liang S, Wu X, Hu X, Wang T, Jin F. Recognizing Depression from the Microbiota⁻Gut⁻Brain Axis. Int J Mol Sci 2018; 19:ijms19061592. [PMID: 29843470 PMCID: PMC6032096 DOI: 10.3390/ijms19061592] [Citation(s) in RCA: 166] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 04/19/2018] [Accepted: 05/02/2018] [Indexed: 12/12/2022] Open
Abstract
Major depression is one of the leading causes of disability, morbidity, and mortality worldwide. The brain⁻gut axis functions are disturbed, revealed by a dysfunction of the brain, immune system, endocrine system, and gut. Traditional depression treatments all target the brain, with different drugs and/or psychotherapy. Unfortunately, most of the patients have never received any treatment. Studies indicate that gut microbiota could be a direct cause for the disorder. Abnormal microbiota and the microbiota⁻gut⁻brain dysfunction may cause mental disorders, while correcting these disturbance could alleviate depression. Nowadays, the gut microbiota modulation has become a hot topic in treatment research of mental disorders. Depression is closely related with the health condition of the brain⁻gut axis, and maintaining/restoring the normal condition of gut microbiota helps in the prevention/therapy of mental disorders.
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Affiliation(s)
- Shan Liang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Xiaoli Wu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Xu Hu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Tao Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Feng Jin
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China.
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Shefa U, Kim D, Kim MS, Jeong NY, Jung J. Roles of Gasotransmitters in Synaptic Plasticity and Neuropsychiatric Conditions. Neural Plast 2018; 2018:1824713. [PMID: 29853837 PMCID: PMC5960547 DOI: 10.1155/2018/1824713] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/25/2018] [Accepted: 03/11/2018] [Indexed: 12/22/2022] Open
Abstract
Synaptic plasticity is important for maintaining normal neuronal activity and proper neuronal functioning in the nervous system. It is crucial for regulating synaptic transmission or electrical signal transduction to neuronal networks, for sharing essential information among neurons, and for maintaining homeostasis in the body. Moreover, changes in synaptic or neural plasticity are associated with many neuropsychiatric conditions, such as schizophrenia (SCZ), bipolar disorder (BP), major depressive disorder (MDD), and Alzheimer's disease (AD). The improper maintenance of neural plasticity causes incorrect neurotransmitter transmission, which can also cause neuropsychiatric conditions. Gas neurotransmitters (gasotransmitters), such as hydrogen sulfide (H2S), nitric oxide (NO), and carbon monoxide (CO), play roles in maintaining synaptic plasticity and in helping to restore such plasticity in the neuronal architecture in the central nervous system (CNS). Indeed, the upregulation or downregulation of these gasotransmitters may cause neuropsychiatric conditions, and their amelioration may restore synaptic plasticity and proper neuronal functioning and thereby improve such conditions. Understanding the specific molecular mechanisms underpinning these effects can help identify ways to treat these neuropsychiatric conditions.
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Affiliation(s)
- Ulfuara Shefa
- Department of Biomedical Science, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Dokyoung Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
| | - Min-Sik Kim
- Department of Applied Chemistry, College of Applied Science, Kyung Hee University, Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Na Young Jeong
- Department of Anatomy and Cell Biology, College of Medicine, Dong-A University, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Republic of Korea
| | - Junyang Jung
- Department of Biomedical Science, Graduate School, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
- Department of Anatomy and Neurobiology, College of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Republic of Korea
- East-West Medical Research Institute, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, 13 Seoul 02447, Republic of Korea
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Psychiatric Comorbidities in Patients Undergoing Total Pancreatectomy With Islet Cell Autotransplantation and Associated Mortality. Pancreas 2018; 47. [PMID: 29521946 PMCID: PMC9648619 DOI: 10.1097/mpa.0000000000001010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Trained lay health workers reduce common mental disorder symptoms of adults with suicidal ideation in Zimbabwe: a cohort study. BMC Public Health 2018; 18:227. [PMID: 29422023 PMCID: PMC5806479 DOI: 10.1186/s12889-018-5117-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 01/24/2018] [Indexed: 12/28/2022] Open
Abstract
Background Suicidal ideation may lead to deliberate self-harm which increases the risk of death by suicide. Globally, the main cause of deliberate self-harm is depression. The aim of this study was to explore prevalence of, and risk factors for, suicidal ideation among men and women with common mental disorder (CMD) symptoms attending public clinics in Zimbabwe, and to determine whether problem solving therapy delivered by lay health workers can reduce common mental disorder symptoms among people with suicidal ideation, using secondary analysis of a randomised controlled trial. Methods At trial enrolment, the Shona Symptom Questionnaire (SSQ) was used to screen for CMD symptoms. In the intervention arm, participants received six problem-solving therapy sessions conducted by trained and supervised lay health workers, while those in the control arm received enhanced usual care. We used multivariate logistic regression to identify risk factors for suicidal ideation at enrolment, and cluster-level logistic regression to compare SSQ scores at endline (6 months follow-up) between trial arms, stratified by suicidal ideation at enrolment. Results There were 573 participants who screened positive for CMD symptoms and 75 (13.1%) reported suicidal ideation at baseline. At baseline, after adjusting for confounders, suicidal ideation was independently associated with being aged over 24, lack of household income (household income yes/no; adjusted odds ratio 0.52 (95% CI 0.29, 0.95); p = 0.03) and with having recently skipped a meal due to lack of food (adjusted odds ratio 3.06 (95% CI 1.81, 5.18); p < 0.001). Participants who reported suicidal ideation at enrolment experienced similar benefit to CMD symptoms from the Friendship Bench intervention (adjusted mean difference − 5.38, 95% CI −7.85, − 2.90; p < 0.001) compared to those who had common mental disorder symptoms but no suicidal ideation (adjusted mean difference − 4.86, 95% CI −5.68, − 4.04; p < 0.001). Conclusions Problem-solving therapy delivered by trained and supervised lay health workers reduced common mental disorder symptoms among participants with suicidal thoughts who attended primary care facilities in Zimbabwe. Trial registration pactr.org ldentifier: PACTR201410000876178
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Coppens E, Van Audenhove C, Gusmão R, Purebl G, Székely A, Maxwell M, Koburger N, Arensman E, Hegerl U. Effectiveness of General Practitioner training to improve suicide awareness and knowledge and skills towards depression. J Affect Disord 2018; 227:17-23. [PMID: 29049931 DOI: 10.1016/j.jad.2017.09.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 07/14/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND General Practitioners (GPs) are well placed as gatekeepers for managing depression and suicidal ideation but not always well prepared. Capacity building has therefore been recommended as a useful strategy for suicide prevention. This study aimed to examine whether GPs' knowledge and attitudes towards and confidence to deal with depression and suicide improve after following a training program. METHODS As part of the OSPI-Europe multilevel intervention, a standardized training on depression and suicide was provided to 208 GPs in three European countries. Core outcomes were assessed using the Depression Attitude Questionnaire, the Attitude towards Suicide Prevention Scale, and the Morriss Confidence Scale. Data were collected before and after training, and at three to six months follow-up. RESULTS At baseline, GPs demonstrated various stigmatizing attitudes towards depression and low optimism about the therapeutic treatment of depression. They showed moderately positive attitudes towards suicide prevention but felt little confident in dealing with depression and suicide in daily practice. The training resulted in improved knowledge, attitudes and confidence regarding depression and suicide and their prevention and treatment. At follow-up, only the increase in confidence to deal with depression and suicide was sustained. LIMITATIONS The Depression Attitude Questionnaire has rather weak psychometric properties. Other external factors may have contributed to the observed training effects as the study included no control group. CONCLUSIONS The OSPI-Europe training program was able to improve the GPs' attitudes towards suicide prevention, several attitudes towards depression and its treatment as well as the GPs' confidence to deal with depression and suicide in everyday practice. At follow, only the GPs' confidence to deal with depression and suicide was preserved.
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Affiliation(s)
- Evelien Coppens
- LUCAS, Centre for Care Research and Consultancy, University of Leuven, Belgium
| | | | - Ricardo Gusmão
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Portugal
| | - György Purebl
- Institute of Behavioural Sciences, Semmelweis University Budapest, Hungary
| | - András Székely
- Institute of Behavioural Sciences, Semmelweis University Budapest, Hungary
| | - Margaret Maxwell
- Nursing, Midwifery and Allied Health Professions Research Unit, Faculty of Health Sciences and Sport, University of Stirling, United Kingdom
| | - Nicole Koburger
- Depression Research Centre, German Depression Foundation, Leipzig, Germany
| | - Ella Arensman
- National Suicide Research Foundation & Department of Epidemiology and Public Health, University College Cork, Ireland
| | - Ulrich Hegerl
- Depression Research Centre, German Depression Foundation, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig, Germany
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Thylstrup B, Bloomfield K, Hesse M. Incremental predictive validity of the Addiction Severity Index psychiatric composite score in a consecutive cohort of patients in residential treatment for drug use disorders. Addict Behav 2018; 76:201-207. [PMID: 28846941 DOI: 10.1016/j.addbeh.2017.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/10/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The Addiction Severity Index (ASI) is a widely used assessment instrument for substance abuse treatment that includes scales reflecting current status in seven potential problem areas, including psychiatric severity. The aim of this study was to assess the ability of the psychiatric composite score to predict suicide and psychiatric care after residential treatment for drug use disorders after adjusting for history of psychiatric care. METHODS All patients treated for drug use disorders in residential treatment centers in Denmark during the years 2000-2010 with complete ASI data were followed through national registers of psychiatric care and causes of death (N=5825). Competing risks regression analyses were used to assess the incremental predictive validity of the psychiatric composite score, controlling for previous psychiatric care, length of intake, and other ASI composite scores, up to 12years after discharge. RESULTS A total of 1769 patients received psychiatric care after being discharged from residential treatment (30.3%), and 27 (0.5%) committed suicide. After adjusting for all covariates, psychiatric composite score was associated with a higher risk of receiving psychiatric care after residential treatment (subhazard ratio [SHR]=3.44, p<0.001), and of committing suicide (SHR=11.45, p<0.001). CONCLUSIONS The ASI psychiatric composite score has significant predictive validity and promises to be useful in identifying patients with drug use disorders who could benefit from additional mental health treatment.
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An Investigation into Suicides Among Bhutanese Refugees Resettled in the United States Between 2008 and 2011. J Immigr Minor Health 2017; 18:819-827. [PMID: 26758579 DOI: 10.1007/s10903-015-0326-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
An increase of Bhutanese refugee suicides were reported in the US between 2009 and 2012. This investigation examined these reported suicides in depth to gain a better understanding of factors associated with suicide within this population. The study employed 14 psychological autopsies to elicit underlying motivations and circumstances for self-inflicted death and to identify potential future avenues for prevention and intervention among refugee communities. Disappointment with current (un)employment, lack of resettlement services and social support, and frustrations with separation from family were believed to contribute to suicidal acts. Suicide within refugee populations may be connected with experiences of family withdrawal, integration difficulties, and perceived lack of care. It is important to assess the effectiveness of improving refugee services on the mental health of migrants. More research is needed in order to better understand, and respond to, suicide in resettled populations.
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Afzali MH, Sunderland M, Batterham PJ, Carragher N, Slade T. Trauma characteristics, post-traumatic symptoms, psychiatric disorders and suicidal behaviours: Results from the 2007 Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry 2017; 51:1142-1151. [PMID: 29087229 DOI: 10.1177/0004867416683815] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The current study examined whether trauma characteristics such as the type and number of traumatic events were associated with three suicidal behaviours (i.e. ideation, plan and attempt) after adjusting for sociodemographic factors, post-traumatic symptoms and history of psychiatric disorders. METHOD Data came from the 2007 Australian National Survey of Mental Health and Wellbeing ( N = 8841). Respondents were asked about exposure to 28 traumatic events that occurred during their lifetime. Suicidal behaviours were measured using three statements about whether the person ever seriously thought about or planned or attempted suicide. RESULTS Sexual violence and exposure to multiple traumatic events were particularly associated with suicidal behaviours. The presence of the emotional numbing symptom cluster and co-occurrence of three psychiatric disorders (major depressive disorder, alcohol use disorder and substance use disorder) also increased the odds of suicidal behaviours. Analysis of age of onset revealed that the mean age of traumatic exposure was earlier than the age at which suicidal behaviours emerged. CONCLUSIONS The current study is the first to demonstrate that sexual violence and exposure to multiple traumatic events are associated with suicidal behaviours in a representative sample of Australian adults. The results underline the potential benefits of thorough assessment of trauma history, post-traumatic symptoms and history of psychiatric disorders and their additive contribution in suicide risk among trauma victims. These findings can be used by clinicians and researchers for early intervention programmes.
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Affiliation(s)
- Mohammad H Afzali
- 1 NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
| | - Matthew Sunderland
- 1 NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
| | - Philip J Batterham
- 2 National Institute for Mental Health Research, Australian National University, Canberra, ACT, Australia
| | - Natacha Carragher
- 3 Medical Education and Student Office, Faculty of Medicine, UNSW Australia, Sydney, NSW, Australia
| | - Tim Slade
- 1 NHMRC Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
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Chum J, Kim MS, Zielinski L, Bhatt M, Chung D, Yeung S, Litke K, McCabe K, Whattam J, Garrick L, O’Neill L, Goyert S, Merrifield C, Patel Y, Samaan Z. Acceptability of the Fitbit in behavioural activation therapy for depression: a qualitative study. EVIDENCE-BASED MENTAL HEALTH 2017; 20:128-133. [PMID: 29056608 PMCID: PMC5750411 DOI: 10.1136/eb-2017-102763] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Major depressive disorder is characterised by low mood and poor motivation. Literature suggests that increased physical activity has positive effects on alleviating depression. Fitness-tracking devices may complement behavioural activation (BA) therapy to improve physical activity and mental health in patients with depression. OBJECTIVES To understand patients' perceived benefit from the Fitbit and explore themes associated with patient experiences. To compare perceived benefit, patient factors, Fitbit usage and Beck's Depression Inventory (BDI) scores. METHODS Semistructured interviews were conducted with patients (n=36) who completed a 28-week BA group programme in a mood disorders outpatient clinic. All patients were asked to carry a Fitbit One device. We conducted thematic analyses on the interviews and exploratory quantitative analyses on patient characteristics, Fitbit usage, steps recorded, perceived benefit and BDI scores. FINDINGS Twenty-three patients found the Fitbit helpful for their physical activity. Themes of positive experiences included self-awareness, peer motivation and goal-setting opportunities. Negative themes included inconvenience, inaccuracies and disinterest. Age, baseline and change in BDI scores, prior physical activity goals and familiarity with technology were not associated with perceived benefit from the Fitbit or usage. Perceived benefit was significantly (p<0.01) associated with usage. CONCLUSIONS Overall, the Fitbit is an acceptable tool to complement BA therapy for patients with depression. Many positive themes were concordant with current literature; however, patients also reported negative aspects that may affect use. CLINICAL IMPLICATIONS Clinicians and researchers should consider both strengths and limitations of activity trackers when implementing them to motivate patients with depression. TRIAL REGISTRATION NUMBER NCT02045771; Pre-results.
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Affiliation(s)
- Jenny Chum
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Min Suk Kim
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Zielinski
- MiNDS Neuroscience Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Meha Bhatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Douglas Chung
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sharon Yeung
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Kathryn Litke
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Kathleen McCabe
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jeff Whattam
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Laura Garrick
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Laura O’Neill
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Stefanie Goyert
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Colleen Merrifield
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Yogita Patel
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - Zainab Samaan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Mood Disorders Research Unit, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychiatry and Behavioral Neurosciences, Peter Boris Centre for Addictions Research, St. Joseph’s Healthcare, Hamilton, Ontario, Canada
- Department of Populations Genomics Program, Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
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Hou XY, Hu ZL, Zhang DZ, Lu W, Zhou J, Wu PF, Guan XL, Han QQ, Deng SL, Zhang H, Chen JG, Wang F. Rapid Antidepressant Effect of Hydrogen Sulfide: Evidence for Activation of mTORC1-TrkB-AMPA Receptor Pathways. Antioxid Redox Signal 2017; 27:472-488. [PMID: 28158955 DOI: 10.1089/ars.2016.6737] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
AIMS We asked whether hydrogen sulfide (H2S), as the third gaseous mediator, provided fast antidepressant effect on major depressive disorders and underlying mechanisms. RESULTS The decreased level of H2S was detected in the hippocampus of chronic unpredictable mild stress (CUMS)-treated rats. Acute administration of H2S either by H2S inhalation or by the donor NaHS produced a rapid antidepressant-like behavioral effect. Further investigation demonstrated that this effect of H2S was mediated by reversing the CUMS-induced decrease in dendritic spine density and required the activation of mammalian target of rapamycin (mTOR)C1 and neurotrophic TrkB receptors, which proceeded to increase synaptic protein expression, including postsynaptic density protein 95, synaptophysin, and α-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid receptor GluR1/2 subunit. INNOVATION This study provides the first direct evidence for detecting the decreased H2S in hippocampus of CUMS rats and the biological significance of H2S in treating major depression. CONCLUSION Our data demonstrate that H2S activates mTORC1 signaling cascades and thereby produces fast-onset antidepressant effect. The study provides a profound insight into H2S or its donors as potent preventive and therapeutic agents for intervention of depression. Antioxid. Redox Signal. 27, 472-488.
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Affiliation(s)
- Xiao-Yi Hou
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Zhuang-Li Hu
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation (Huazhong University of Science and Technology) , Wuhan, China .,3 Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology , Wuhan, China .,4 Key Laboratory of Neurological Diseases (HUST), Ministry of Education of China , Wuhan, China
| | - Deng-Zheng Zhang
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Wei Lu
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Jun Zhou
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Peng-Fei Wu
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation (Huazhong University of Science and Technology) , Wuhan, China .,3 Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology , Wuhan, China .,4 Key Laboratory of Neurological Diseases (HUST), Ministry of Education of China , Wuhan, China
| | - Xin-Lei Guan
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Qian-Qian Han
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Si-Long Deng
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China
| | - Hai Zhang
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,4 Key Laboratory of Neurological Diseases (HUST), Ministry of Education of China , Wuhan, China .,5 Collaborative Innovation Center for Brain Science , Wuhan, China
| | - Jian-Guo Chen
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation (Huazhong University of Science and Technology) , Wuhan, China .,3 Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology , Wuhan, China .,4 Key Laboratory of Neurological Diseases (HUST), Ministry of Education of China , Wuhan, China .,5 Collaborative Innovation Center for Brain Science , Wuhan, China
| | - Fang Wang
- 1 Department of Pharmacology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, China .,2 Hubei Key Laboratory of Drug Target Research and Pharmacodynamic Evaluation (Huazhong University of Science and Technology) , Wuhan, China .,3 Laboratory of Neuropsychiatric Diseases, The Institute of Brain Research, Huazhong University of Science and Technology , Wuhan, China .,4 Key Laboratory of Neurological Diseases (HUST), Ministry of Education of China , Wuhan, China .,5 Collaborative Innovation Center for Brain Science , Wuhan, China
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Park CHK, Lee JW, Lee SY, Moon J, Shim SH, Paik JW, Kim SG, Cho SJ, Kim MH, Kim S, Park JH, You S, Jeon HJ, Ahn YM. Comparison of Baseline Characteristics between Community-based and Hospital-based Suicidal Ideators and Its Implications for Tailoring Strategies for Suicide Prevention: Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior. J Korean Med Sci 2017; 32:1522-1533. [PMID: 28776350 PMCID: PMC5546974 DOI: 10.3346/jkms.2017.32.9.1522] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 06/17/2017] [Indexed: 11/20/2022] Open
Abstract
In this cross-sectional study, we aimed to identify distinguishing factors between populations with suicidal ideation recruited from hospitals and communities to make an efficient allocation of limited anti-suicidal resources according to group differences. We analyzed the baseline data from 120 individuals in a community-based cohort (CC) and 137 individuals in a hospital-based cohort (HC) with suicidal ideation obtained from the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior (K-COMPASS) study. First, their sociodemographic factors, histories of medical and psychiatric illnesses, and suicidal behaviors were compared. Second, diagnosis by the Korean version of the Mini International Neuropsychiatric Interview, scores of psychometric scales were used to assess differences in clinical severity between the groups. The results revealed that the HC had more severe clinical features: more psychiatric diagnosis including current and recurrent major depressive episodes (odds ratio [OR], 4.054; P < 0.001 and OR, 11.432; P < 0.001, respectively), current suicide risk (OR, 4.817; P < 0.001), past manic episodes (OR, 9.500; P < 0.001), past hypomanic episodes (OR, 4.108; P = 0.008), current alcohol abuse (OR, 3.566; P = 0.020), and current mood disorder with psychotic features (OR, 20.342; P < 0.001) besides significantly higher scores in depression, anxiety, alcohol problems, impulsivity, and stress. By comparison, old age, single households, and low socioeconomic status were significantly associated with the CC. These findings indicate the necessity of more clinically oriented support for hospital visitors and more socioeconomic aid for community-dwellers with suicidality.
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Affiliation(s)
- C Hyung Keun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Won Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Yeol Lee
- Department of Psychiatry, School of Medicine, Wonkwang University, Iksan, Korea
| | - Jungjoon Moon
- Department of Psychiatry, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Se Hoon Shim
- Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea
| | - Jong Woo Paik
- Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Seong Jin Cho
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Min Hyuk Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seokho Kim
- Deparmtent of Sociology, Seoul National University College of Social Sciences, Seoul, Korea
| | - Jae Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University College of Medicine, Suwon, Korea
| | - Sungeun You
- Department of Psychology, Chungbuk National University College of Social Sciences, Cheongju, Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yong Min Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea.
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77
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Moradinazar M, Najafi F, Baneshi MR, Haghdoost AA. Estimation of the rate and number of underreported deliberate self-poisoning attempts in western Iran in 2015. Epidemiol Health 2017; 39:e2017023. [PMID: 28728353 PMCID: PMC5668665 DOI: 10.4178/epih.e2017023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 06/15/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level. RESULTS The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population. CONCLUSIONS Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
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Affiliation(s)
- Mehdi Moradinazar
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Modeling in Health Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Dell'Osso B, Camuri G, Cremaschi L, Dobrea C, Buoli M, Ketter TA, Altamura AC. Lifetime presence of psychotic symptoms in bipolar disorder is associated with less favorable socio-demographic and certain clinical features. Compr Psychiatry 2017; 76:169-176. [PMID: 28531646 DOI: 10.1016/j.comppsych.2017.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 03/14/2017] [Accepted: 04/17/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The presence of psychotic symptoms in bipolar disorder (BD) is considered a feature of higher severity of illness and, in particular, of manic episodes in bipolar I disorder (BD I). However, the possibility to apply the "with psychotic features" specifier to major depressive episodes in either bipolar II disorder (BD II) or BD I highlights the need for additional research in this area. METHODS The present study assessed the lifetime presence of psychotic symptoms and related socio-demographic and clinical features in a large sample of BD patients (N=360), with (BDPs, N=207) and without a lifetime history of psychosis (BDNPs, N=153). RESULTS An overall less favorable socio-demographic profile was observed in BDPs vs BDNPs. In terms of clinical variables, BDPs vs BDNPs had: earlier age at onset (27.7±10.5 vs 30.1±12.3years; p=0.02), higher rates of BD I diagnosis (95.7% vs 45.8%; p<0.001), more elevated (manic/hypomanic/mixed) polarity of first (55.2% vs 24.4%; p<0.001) and most recent episode (69.8% vs 35.6%; p<0.001), more comorbid alcohol/substance use disorder (38.1% vs 21.9%; p=0.002), more lifetime hospitalizations (3.8±6.1 vs 2±3; p=0.002) and involuntary commitments (1±1.9 vs 0.1±0.4; p<0.001), more history of psychosocial rehabilitation (17.9% vs 5.7%; p=0.001), more current antipsychotic use (90.1% vs 70.9%; p<0.001), and lower GAF (62.3±14.2 vs 69.3±12.5; p<0.001), but shorter duration of most recent episode (34.1±45.4 vs 50.3±65.7days; p=0.04), lower rates of comorbid anxiety disorders (23.9% vs 38.2%; p=0.005), and antidepressant use (19.4% vs 56.6%; p<0.001). CONCLUSIONS The present findings indicate an overall worse profile of socio-demographic and certain clinical characteristics associated with the lifetime presence of psychotic symptoms in bipolar patients.
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Affiliation(s)
- Bernardo Dell'Osso
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy; Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA.
| | - Giulia Camuri
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Cremaschi
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Dobrea
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Terence A Ketter
- Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, CA, USA
| | - A Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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Baneshi MR, Haghdoost AA, Zolala F, Nakhaee N, Jalali M, Tabrizi R, Akbari M. Can Religious Beliefs be a Protective Factor for Suicidal Behavior? A Decision Tree Analysis in a Mid-Sized City in Iran, 2013. JOURNAL OF RELIGION AND HEALTH 2017; 56:428-436. [PMID: 26923839 DOI: 10.1007/s10943-016-0215-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study aimed to assess using tree-based models the impact of different dimensions of religion and other risk factors on suicide attempts in the Islamic Republic of Iran. Three hundred patients who attempted suicide and 300 age- and sex-matched patient attendants with other types of disease who referred to Kerman Afzalipour Hospital were recruited for this study following a convenience sampling. Religiosity was assessed by the Duke University Religion Index. A tree-based model was constructed using the Gini Index as the homogeneity criterion. A complementary discrimination analysis was also applied. Variables contributing to the construction of the tree were stressful life events, mental disorder, family support, and religious belief. Strong religious belief was a protective factor for those with a low number of stressful life events and those with a high mental disorder score; 72 % of those who formed these two groups had not attempted suicide. Moreover, 63 % of those with a high number of stressful life events, strong family support, strong problem-solving skills, and a low mental disorder score were less likely to attempt suicide. The significance of four other variables, GHQ, problem-coping skills, friend support, and neuroticism, was revealed in the discrimination analysis. Religious beliefs seem to be an independent factor that can predict risk for suicidal behavior. Based on the decision tree, religious beliefs among people with a high number of stressful life events might not be a dissuading factor. Such subjects need more family support and problem-solving skills.
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Affiliation(s)
- Mohammad Reza Baneshi
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzaneh Zolala
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nouzar Nakhaee
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Jalali
- Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Tabrizi
- Health Policy Research Center (HPRC), School of Medicine, Shiraz University of Medical Science, Building No 2, Eighth Floor, Zand Avenue, Shiraz, 71348-53185, Iran
| | - Maryam Akbari
- Health Policy Research Center (HPRC), School of Medicine, Shiraz University of Medical Science, Building No 2, Eighth Floor, Zand Avenue, Shiraz, 71348-53185, Iran.
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Ovalle-Peña O, Alejo-Riveros A, Tarquino-Bulla LC, Prado-Guzmán K. Relación entre depresión y rasgos de personalidad en jóvenes y adultos con conducta intencional suicida de Ibagué, Colombia. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n2.59004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. La conducta intencional suicida es una de las condiciones médicas más preocupantes y peligrosas en el mundo. Se presume que por cada muerte autoinfligida, se presentan alrededor de 20 intentos de suicidio.Objetivo. Identificar la relación entre depresión y rasgos de personalidad en personas con intento de suicidio.Materiales y métodos. Estudio correlacional de corte transversal en el que participaron 25 personas entre 18 y 40 años de edad, quienes intentaron suicidarse durante el 2014 y 2015 en Ibagué, Colombia. Se empleó una ficha de datos sociodemográficos, el cuestionario “Big Five” y el Inventario de depresión Estado-Rasgo.Resultados. Se evidencia que en los participantes existen correlaciones significativas de carácter negativo, por un lado, entre la subdimensión de la personalidad, el control de emociones y la depresión como estado y, por el otro, entre esta misma subdimensión y la distimia como estado. Esto sugiere que a mayor depresión como estado o como rasgo, menor estabilidad emocional. Otras correlaciones identificadas aluden a una relación moderada entre la dimensión de la personalidad, la estabilidad emocional y la depresión.Conclusión. Las variables empleadas (depresión y estabilidad emocional) cobran gran importancia al momento de diseñar acciones preventivas en salud.
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Pignon B, Geoffroy PA, Thomas P, Roelandt JL, Rolland B, Morgan C, Vaiva G, Amad A. Prevalence and clinical severity of mood disorders among first-, second- and third-generation migrants. J Affect Disord 2017; 210:174-180. [PMID: 28049102 DOI: 10.1016/j.jad.2016.12.039] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/27/2016] [Accepted: 12/17/2016] [Indexed: 12/26/2022]
Abstract
BACKGROUND The role of migration as a risk factor remains unknown for mood disorders because of poor data. We sought to examine the prevalence and severity of mood disorders (bipolar disorder (BD), unipolar depressive disorder (UDD) and dysthymia) in first, second, and third generation migrants in France. METHODS The Mental Health in the General Population survey interviewed 38,694 individuals. The prevalence of lifetime mood disorders, comorbidities, and clinical features was compared between migrants and non-migrants and by generation. All analyses were adjusted for age, sex and level of education. RESULTS The prevalence of any lifetime mood disorder was higher in migrants compared with non-migrants (OR = 1.36, 95% CI [1.27 - 1.45]). This increased prevalence was significant for UDD (OR = 1.44, 95% CI [1.34 - 1.54]), but not for BD (OR = 1.15, 95% CI [0.96 - 1.36]) or dysthymia (OR = 1.09, 95% CI [0.94 - 1.27]), although the prevalence of BD was increased in the third generation (OR = 1.27, 95% CI [1.01 - 1.60]). Migrants with BD or UDD were more likely to display a comorbid psychotic disorder compared to non-migrants with BD or UDD. Cannabis-use disorders were more common in migrant groups for the 3 mood disorders, whereas alcohol-use disorders were higher in migrants with UDD. Posttraumatic stress disorder was more frequent among migrants with UDD. LIMITATIONS The study used cross-sectional prevalence data and could be biased by differences in the course of disease according to migrant status. Moreover, this design does not allow causality conclusion or generalization of the main findings. CONCLUSION Mood disorders are more common among migrants, especially UDD. Moreover, migrants with mood disorders presented with a more severe profile, with increased rates of psychotic and substance-use disorders.
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Affiliation(s)
- Baptiste Pignon
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France.
| | - Pierre Alexis Geoffroy
- Inserm, U1144, Paris F-75006, France; Paris Descartes University, UMR-S 1144, Paris F-75006, France; Paris Diderot University, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Psychiatry and Addiction Medicine Department, 75475 Paris Cedex 10, France
| | - Pierre Thomas
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Federation of Mental Health Research, Lille, France; INSERM 1123, Equipe ECEVE, Paris, France
| | - Jean-Luc Roelandt
- World Health Organization Collaborative Centre (WHO-CC), EPSM Lille-Metropole, Lille, France; INSERM 1123, Equipe ECEVE, Paris, France
| | - Benjamin Rolland
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Univ. Lille, INSERM, CHU LILLE, U1171, Department of Addiction Medicine - Addiction Consultation Liaison Unit, Pôle de Psychiatrie, F-59000 Lille, France
| | - Craig Morgan
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Guillaume Vaiva
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; Federation of Mental Health Research, Lille, France
| | - Ali Amad
- Univ. Lille, CNRS, CHU LILLE, UMR9193-PsychiC-SCALab, UMR9193-PsychiC-SCALab, Psychiatry Department, F-59000 Lille, France; King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Abstract
AIMS Whether the public stigma associated with mental illness negatively affects an individual, largely depends on whether the person has been labelled 'mentally ill'. For labelled individuals concealing mental illness is a common strategy to cope with mental illness stigma, despite secrecy's potential negative consequences. In addition, initial evidence points to a link between stigma and suicidality, but quantitative data from community samples are lacking. METHODS Based on previous literature about mental illness stigma and suicidality, as well as about the potential influence of labelling processes and secrecy, a theory-driven model linking perceived mental illness stigma and suicidal ideation by a mediation of secrecy and hopelessness was established. This model was tested separately among labelled and unlabelled persons using data derived from a Swiss cross-sectional population-based study. A large community sample of people with elevated psychiatric symptoms was examined by interviews and self-report, collecting information on perceived stigma, secrecy, hopelessness and suicidal ideation. Participants who had ever used mental health services were considered as labelled 'mentally ill'. A descriptive analysis, stratified logistic regression models and a path analysis testing a three-path mediation effect were conducted. RESULTS While no significant differences between labelled and unlabelled participants were observed regarding perceived stigma and secrecy, labelled individuals reported significantly higher frequencies of suicidal ideation and feelings of hopelessness. More perceived stigma was associated with suicidal ideation among labelled, but not among unlabelled individuals. In the path analysis, this link was mediated by increased secrecy and hopelessness. CONCLUSIONS Results from this study indicate that among persons labelled 'mentally ill', mental illness stigma is a contributor to suicidal ideation. One explanation for this association is the relation perceived stigma has with secrecy, which introduces negative emotional consequences. If our findings are replicated, they would suggest that programmes empowering people in treatment for mental illness to cope with anticipated and experienced discrimination as well as interventions to reduce public stigma within society could improve suicide prevention.
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83
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Doblyte S, Jiménez-Mejías E. Understanding Help-Seeking Behavior in Depression: A Qualitative Synthesis of Patients' Experiences. QUALITATIVE HEALTH RESEARCH 2017; 27:100-113. [PMID: 27956660 DOI: 10.1177/1049732316681282] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Despite decades of evidence-based interventions, depression remains a great challenge for public health due to enormous treatment gap and lag which, at least partially, result from low professional help-seeking by people suffering from depressive symptoms. In this article, we aim to gain a better understanding of help-seeking behavior in depression, and how to intervene effectively decreasing treatment gap and delay by using a meta-ethnography approach-an interpretive technique to systematically synthesize qualitative data. It integrates views and experiences of 474 individuals with depression across 20 papers. Findings suggest several interrelated major concepts-help-seeking as a threat to identity, social networks as a conflict or support, and alternative coping strategies as the main factor for treatment delay-as well as multiple relational, structural, attitudinal, cognitive, culture-specific, or gender-specific barriers. A model of help-seeking as a threat to identity is developed and discussed in the context of existing research.
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84
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Zhou X, Liu L, Zhang Y, Pu J, Yang L, Zhou C, Yuan S, Zhang H, Xie P. Metabolomics identifies perturbations in amino acid metabolism in the prefrontal cortex of the learned helplessness rat model of depression. Neuroscience 2016; 343:1-9. [PMID: 27919695 DOI: 10.1016/j.neuroscience.2016.11.038] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 12/31/2022]
Abstract
Major depressive disorder is a serious psychiatric condition associated with high rates of suicide and is a leading cause of health burden worldwide. However, the underlying molecular mechanisms of major depression are still essentially unclear. In our study, a non-targeted gas chromatography-mass spectrometry-based metabolomics approach was used to investigate metabolic changes in the prefrontal cortex of the learned helplessness (LH) rat model of depression. Body-weight measurements and behavioral tests including the active escape test, sucrose preference test, forced swimming test, elevated plus-maze and open field test were used to assess changes in the behavioral spectrum after inescapable footshock stress. Rats in the stress group exhibited significant learned helpless and depression-like behaviors, while without any significant change in anxiety-like behaviors. Using multivariate and univariate statistical analysis, a total of 18 differential metabolites were identified after the footshock stress protocol. Ingenuity Pathways Analysis and MetaboAnalyst were applied for predicted pathways and biological functions analysis. "Amino Acid Metabolism, Molecule Transport, Small Molecule Biochemistry" was the most significantly altered network in the LH model. Amino acid metabolism, particularly glutamate metabolism, cysteine and methionine metabolism, arginine and proline metabolism, was significantly perturbed in the prefrontal cortex of LH rats.
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Affiliation(s)
- Xinyu Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lanxiang Liu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Yuqing Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Juncai Pu
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Lining Yang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Chanjuan Zhou
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Shuai Yuan
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Hanping Zhang
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology and Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China; Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China.
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85
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Shao Y, Zhu C, Zhang Y, Yu H, Peng H, Jin Y, Shi G, Wang N, Chen Z, Chen Y, Jiang Q. Epidemiology and temporal trend of suicide mortality in the elderly in Jiading, Shanghai, 2003-2013: a descriptive, observational study. BMJ Open 2016; 6:e012227. [PMID: 27543591 PMCID: PMC5013362 DOI: 10.1136/bmjopen-2016-012227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To investigate and describe the epidemiological characteristics of suicide in the elderly in Jiading, Shanghai, for the period 2003-2013. DESIGN Retrospective, observational, epidemiological study using routinely collected data. SETTING Jiading District, Shanghai. METHODS Suicide data were retrieved from the Shanghai Vital Registry database for the period 2003-2013. Crude and age-standardised mortality rates were calculated for various groups according to sex and age. Joinpoint regression was performed to estimate the percentage change (PC) and annual percentage change (APC) for suicide mortality. RESULT A total of 956 deaths due to suicide occurred among people aged ≥65 years during the study period, accounting for 76.7% (956/1247) of all suicide decedents. Among the 956 people with suicide deaths, 88.7% (848/956) had a history of a psychiatric condition. The age-standardised mortality rates for suicide without and with a psychotic history in people aged ≥65 years were much higher than those for people aged <65 years in both genders. Suicide mortality in the elderly showed a declining trend, with a PC of -51.5% for men and -47.5% for women. The APC was -29.1 in 2003-2005, 4.6 in 2005-2008 and -9.7 in 2008-2013 for aged men, and -12.2 in 2003-2006 and -5.2 in 2006-2013 for aged women, respectively. Women living in Jiading had a higher risk of suicide death than men, especially among the elderly. The mortality rate for suicide increased with age in the elderly, and was more marked for those with a psychiatric history than for those without. CONCLUSIONS Suicide mortality declined in Jiading during the study period 2003-2013 overall, but remained high in the elderly, especially those with a psychiatric history.
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Affiliation(s)
- Yueqin Shao
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Chenghua Zhu
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Yiying Zhang
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hongjie Yu
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Hui Peng
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yaqing Jin
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Guozheng Shi
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Na Wang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
| | - Zheng Chen
- Jiading District Center for Disease Control and Prevention, Shanghai, China
| | - Yue Chen
- Faculty of Medicine, School of Epidemiology, Public Health, and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Qingwu Jiang
- Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai, China
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86
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Iorfino F, Hickie IB, Lee RSC, Lagopoulos J, Hermens DF. The underlying neurobiology of key functional domains in young people with mood and anxiety disorders: a systematic review. BMC Psychiatry 2016; 16:156. [PMID: 27215830 PMCID: PMC4878058 DOI: 10.1186/s12888-016-0852-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/08/2016] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Mood and anxiety disorders are leading causes of disability and mortality, due largely to their onset during adolescence and young adulthood and broader impact on functioning. Key factors that are associated with disability and these disorders in young people are social and economic participation (e.g. education, employment), physical health, suicide and self-harm behaviours, and alcohol and substance use. A better understanding of the objective markers (i.e. neurobiological parameters) associated with these factors is important for the development of effective early interventions that reduce the impact of disability and illness persistence. METHODS We systematically reviewed the literature for neurobiological parameters (i.e. neuropsychology, neuroimaging, sleep-wake and circadian biology, neurophysiology and metabolic measures) associated with functional domains in young people (12 to 30 years) with mood and/or anxiety disorders. RESULTS Of the one hundred and thirty-four studies selected, 7.6 % investigated social and economic participation, 2.1 % physical health, 15.3 % suicide and self-harm behaviours, 6.9 % alcohol and substance use, whereas the majority (68.1 %) focussed on clinical syndrome. CONCLUSIONS Despite the predominance of studies that solely examine the clinical syndrome of young people the literature also provides evidence of distinct associations among objective measures (indexing various aspects of brain circuitry) and other functional domains. We suggest that a shift in focus towards characterising the mechanisms that underlie and/or mediate multiple functional domains will optimise personalised interventions and improve illness trajectories.
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Affiliation(s)
- Frank Iorfino
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Ian B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Rico S C Lee
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Jim Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia
| | - Daniel F Hermens
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, 94 Mallet Street, Camperdown, NSW, 2050, Australia.
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87
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Moreno-Küstner B, Jones R, Švab I, Maaroos H, Xavier M, Geerlings M, Torres-González F, Nazareth I, Motrico-Martínez E, Montón-Franco C, Gil-de-Gómez MJ, Sánchez-Celaya M, Díaz-Barreiros MÁ, Vicens-Caldentey C, King M. Suicidality in primary care patients who present with sadness and anhedonia: a prospective European study. BMC Psychiatry 2016; 16:94. [PMID: 27053286 PMCID: PMC4823872 DOI: 10.1186/s12888-016-0775-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 03/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sadness and anhedonia (loss of interest in activities) are central symptoms of major depression. However, not all people with these symptoms meet diagnostic criteria for major depression. We aimed to assess the importance of suicidality in the outcomes for primary care patients who present with sadness and anhedonia. METHOD Cohort study of 2,599 unselected primary care attenders in six European countries followed up at 6 and 12 months. RESULTS 1) In patients with sadness and/or anhedonia who were not depressed at entry to the study, suicide plans (OR = 3.05; 95 % CI = 1.50-6.24; p = 0.0022) and suicide attempts (OR = 9.08; 95 % CI = 2.57-32.03; p = 0.0006) were significant predictors of developing new onset depression at 6 or 12 months. 2) In patients with sadness and/or anhedonia who met CIDI criteria for major depression at entry, suicidal ideation (OR = 2.93; 95 % CI = 1.70-5.07; p = 0.0001), suicide plans (OR = 3.70; 95 % CI = 2.08-6.57; p < 0.0001), and suicide attempts (OR = 3.33; 95 % CI = 1.47-7.54; p = 0.0040) were significant predictors of persistent depression at 6 or 12 months. CONCLUSIONS Three questions on suicidality could help primary care professionals to assess such patients more closely without necessarily establishing whether they meet criteria for major depression.
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Affiliation(s)
- Berta Moreno-Küstner
- Department of Personality, Assessment and Psychological Treatment, University of Malaga (Maristan Network), Malaga, Spain
| | | | - Igor Švab
- Department of Family Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Heidi Maaroos
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | | | | | | | - Irwin Nazareth
- Department of Primary Care and Population Health, University College London Medical School and Medical, Research Council General Practice Research Framework, London, UK
| | | | - Carmen Montón-Franco
- Centro de Salud Casablanca. (redIAPP, grupo Aragón) Departamento de Medicina y Psiquiatría, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Marta Sánchez-Celaya
- Unidad Docente de Medicina Familiar y Comunitaria de Madrid, Coordinadora de Coordinadora de Direcciones de Continuidad Asistencial, Servicio Madrileño de Salud, Madrid, Spain
| | | | - Catalina Vicens-Caldentey
- Centro de Salud Son Serra, Unidad de Investigación de Atención Primaria de Baleares (redIAPP, grupo Baleares), Mallorca, Spain
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88
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Jiménez E, Arias B, Mitjans M, Goikolea JM, Ruíz V, Brat M, Sáiz PA, García-Portilla MP, Burón P, Bobes J, Oquendo MA, Vieta E, Benabarre A. Clinical features, impulsivity, temperament and functioning and their role in suicidality in patients with bipolar disorder. Acta Psychiatr Scand 2016; 133:266-76. [PMID: 26726104 DOI: 10.1111/acps.12548] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our aim was to analyse sociodemographic and clinical differences between non-suicidal (NS) bipolar patients (BP), BP reporting only suicidal ideation (SI) and BP suicide attempters according to Columbia-Suicide Severity Rating Scale (C-SRSS) criteria. Secondarily, we also investigated whether the C-SRSS Intensity Scale was associated with emergence of suicidal behaviour (SB). METHOD A total of 215 euthymic bipolar out-patients were recruited. Semistructured interviews including the C-SRSS were used to assess sociodemographic and clinical data. Patients were grouped according to C-SRSS criteria: patients who scored ≤1 on the Severity Scale were classified as NS. The remaining patients were grouped into two groups: 'patients with history of SI' and 'patients with history of SI and SB' according to whether they did or did not have a past actual suicide attempt respectively. RESULTS Patients from the three groups differed in illness onset, diagnosis, number of episodes and admissions, family history, comorbidities, rapid cycling and medication, as well as level of education, functioning, impulsivity and temperamental profile. CONCLUSION Our results suggest that increased impulsivity, higher rates of psychiatric admissions and a reported poor controllability of SI significantly increased the risk for suicidal acts among patients presenting SI.
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Affiliation(s)
- E Jiménez
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - B Arias
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain
| | - M Mitjans
- Anthropology Section, Department of Animal Biology, Faculty of Biology, University of Barcelona, IBUB, CIBERSAM, Instituto de Salud Carlos III, Barcelona, Catalonia, Spain.,Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - J M Goikolea
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - V Ruíz
- Institut Clinic de Neurociencies, Hospital Clinic, Barcelona, Catalonia, Spain
| | - M Brat
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - P A Sáiz
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M P García-Portilla
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - P Burón
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain
| | - J Bobes
- Department of Psychiatry, School of Medicine, University of Oviedo, CIBERSAM, Instituto de Neurociencias del Principado de Asturias, INEUROPA, Oviedo, Spain.,Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - M A Oquendo
- Department of Psychiatry, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - E Vieta
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - A Benabarre
- Bipolar Disorder Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
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89
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Torterolo P, Scorza C, Lagos P, Urbanavicius J, Benedetto L, Pascovich C, López-Hill X, Chase MH, Monti JM. Melanin-Concentrating Hormone (MCH): Role in REM Sleep and Depression. Front Neurosci 2015; 9:475. [PMID: 26733789 PMCID: PMC4681773 DOI: 10.3389/fnins.2015.00475] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 11/26/2015] [Indexed: 12/05/2022] Open
Abstract
The melanin-concentrating hormone (MCH) is a peptidergic neuromodulator synthesized by neurons of the lateral sector of the posterior hypothalamus and zona incerta. MCHergic neurons project throughout the central nervous system, including areas such as the dorsal (DR) and median (MR) raphe nuclei, which are involved in the control of sleep and mood. Major Depression (MD) is a prevalent psychiatric disease diagnosed on the basis of symptomatic criteria such as sadness or melancholia, guilt, irritability, and anhedonia. A short REM sleep latency (i.e., the interval between sleep onset and the first REM sleep period), as well as an increase in the duration of REM sleep and the density of rapid-eye movements during this state, are considered important biological markers of depression. The fact that the greatest firing rate of MCHergic neurons occurs during REM sleep and that optogenetic stimulation of these neurons induces sleep, tends to indicate that MCH plays a critical role in the generation and maintenance of sleep, especially REM sleep. In addition, the acute microinjection of MCH into the DR promotes REM sleep, while immunoneutralization of this peptide within the DR decreases the time spent in this state. Moreover, microinjections of MCH into either the DR or MR promote a depressive-like behavior. In the DR, this effect is prevented by the systemic administration of antidepressant drugs (either fluoxetine or nortriptyline) and blocked by the intra-DR microinjection of a specific MCH receptor antagonist. Using electrophysiological and microdialysis techniques we demonstrated also that MCH decreases the activity of serotonergic DR neurons. Therefore, there are substantive experimental data suggesting that the MCHergic system plays a role in the control of REM sleep and, in addition, in the pathophysiology of depression. Consequently, in the present report, we summarize and evaluate the current data and hypotheses related to the role of MCH in REM sleep and MD.
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Affiliation(s)
- Pablo Torterolo
- Department of Physiology, School of Medicine, Universidad de la República Montevideo, Uruguay
| | - Cecilia Scorza
- Department of Experimental Neuropharmacology, Instituto de Investigaciones Biológicas Clemente Estable Montevideo, Uruguay
| | - Patricia Lagos
- Department of Physiology, School of Medicine, Universidad de la República Montevideo, Uruguay
| | - Jessika Urbanavicius
- Department of Experimental Neuropharmacology, Instituto de Investigaciones Biológicas Clemente Estable Montevideo, Uruguay
| | - Luciana Benedetto
- Department of Physiology, School of Medicine, Universidad de la República Montevideo, Uruguay
| | - Claudia Pascovich
- Department of Physiology, School of Medicine, Universidad de la República Montevideo, Uruguay
| | - Ximena López-Hill
- Department of Experimental Neuropharmacology, Instituto de Investigaciones Biológicas Clemente Estable Montevideo, Uruguay
| | - Michael H Chase
- WebSciences International and University of California, Los Angeles School of Medicine Los Angeles, CA, USA
| | - Jaime M Monti
- Department of Pharmacology and Therapeutics, School of Medicine, Hospital de Clínicas, Universidad de la República Montevideo, Uruguay
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90
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Lenz AS, Hall J, Bailey Smith L. Meta-Analysis of Group Mindfulness-Based Cognitive Therapy for Decreasing Symptoms of Acute Depression. JOURNAL FOR SPECIALISTS IN GROUP WORK 2015. [DOI: 10.1080/01933922.2015.1111488] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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91
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Popovic D, Vieta E, Azorin JM, Angst J, Bowden CL, Mosolov S, Young AH, Perugi G. Suicide attempts in major depressive episode: evidence from the BRIDGE-II-Mix study. Bipolar Disord 2015; 17:795-803. [PMID: 26415692 DOI: 10.1111/bdi.12338] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 08/21/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The Bipolar Disorders: Improving Diagnosis, Guidance, and Education (BRIDGE-II-Mix) study aimed to estimate the frequency of mixed states in patients with a major depressive episode (MDE) according to different definitions and to compare their clinical validity, looking into specific features such as suicidality. METHODS A total of 2,811 subjects were enrolled in this multicenter cross-sectional study. Psychiatric symptoms, and sociodemographic and clinical variables were collected. The analysis compared the characteristics of patients with MDE with (MDE-SA group) and without (MDE-NSA) a history of suicide attempts. RESULTS The history of suicide attempts was registered in 628 patients (22.34%). In the MDE-SA group, women (72.5%, p = 0.028), (hypo)mania in first-degree relatives (20.5%, p < 0.0001), psychotic features (15.1%, p < 0.0001), and atypical features (9.2%, p = 0.009) were more prevalent. MDE-SA patients' previous responses to treatment with antidepressants included more (hypo)manic switches [odds ratio (OR) = 1.97, 95% confidence interval (CI): 1.58-2.44, p < 0.0001], treatment resistance (OR = 2.07, 95% CI: 1.72-2.49, p < 0.0001), mood lability (OR = 1.98, 95% CI: 1.65-2.39, p < 0.0001), and irritability (OR = 1.80, 95% CI: 1.48-2.17, p < 0.0001). Multivariate analysis evidenced that risky behavior, psychomotor agitation and impulsivity, and borderline personality and substance use disorders were the variables most frequently associated with previous suicide attempts. In the MDE-SA group, 75 patients (11.9%) fulfilled Diagnostic and Statistical Manual (DSM)-5 criteria for MDE with mixed features, and 250 patients (39.8%) fulfilled research-based diagnostic criteria for a mixed depressive episode. CONCLUSIONS Important differences between MDE-SA and MDE-NSA patients have emerged. Early identification of symptoms such as risky behavior, psychomotor agitation, and impulsivity in patients with MDE, and treatment of mixed depressive states could represent a major step in suicide prevention.
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Affiliation(s)
- Dina Popovic
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Barcelona Bipolar Disorders Program, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | | | - Jules Angst
- Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | | | | | | | - Giulio Perugi
- Dipartmento di Medicina Sperimentale, Clinica Psichiatrica, University of Pisa, Pisa, Italy
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Fond G, Gaman A, Brunel L, Haffen E, Llorca PM. Google Trends: Ready for real-time suicide prevention or just a Zeta-Jones effect? An exploratory study. Psychiatry Res 2015; 228:913-7. [PMID: 26003510 DOI: 10.1016/j.psychres.2015.04.022] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 04/13/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022]
Abstract
Two studies have shown that increasing the consultation of the word "suicide" in the Google search engine was associated with a subsequent increase in the prevalence of suicide attempts. The main goal of this article was to explore the trends generated by a key-word search associated with suicide, depression and bipolarity in an attempt to identify general trends (disorders epidemics in the population/"real events" vs newsworthy advertisement/"media event"). Based on previous studies, the frequency of the search words "how to suicide" and "commit suicide" were analyzed for suicide, as well as "depression" (for depressive disorders) and "bipolar disorder". Together, these analyses suggest that the search for the words "how to suicide" or "commit suicide" on the Google search engine may be a good indicator for suicide prevention policies. However, the tool is not developed enough to date to be used as a real time dynamic indicator of suicide epidemics. The frequency of the search for the word "suicide" was associated with those for "depression" but not for "bipolar disorder", but searches for psychiatric conditions seem to be influenced by media events more than by real events in the general population.
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Affiliation(s)
- Guillaume Fond
- INSERM U955, Translational Psychiatry team, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Fondation Fondamental, Fondation de Cooperation en Santé Mentale, France; Network of Expert centres for Schizophrenia, Créteil 94000, France.
| | - Alexandru Gaman
- Fondation Fondamental, Fondation de Cooperation en Santé Mentale, France
| | - Lore Brunel
- INSERM U955, Translational Psychiatry team, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France; Fondation Fondamental, Fondation de Cooperation en Santé Mentale, France; Network of Expert centres for Schizophrenia, Créteil 94000, France
| | - Emmanuel Haffen
- Fondation Fondamental, Fondation de Cooperation en Santé Mentale, France; Department of Clinical Psychiatry, CIC-1431, University Hospital of Besançon, EA Neurosciences 481, University of Franche-Comté, Besançon, France
| | - Pierre-Michel Llorca
- Fondation Fondamental, Fondation de Cooperation en Santé Mentale, France; CHU Clermont Ferrand, France; Network of Expert centres for Schizophrenia, Créteil 94000, France
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93
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Palma-Gudiel H, Córdova-Palomera A, Leza JC, Fañanás L. Glucocorticoid receptor gene (NR3C1) methylation processes as mediators of early adversity in stress-related disorders causality: A critical review. Neurosci Biobehav Rev 2015; 55:520-35. [PMID: 26073068 DOI: 10.1016/j.neubiorev.2015.05.016] [Citation(s) in RCA: 222] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 05/19/2015] [Accepted: 05/25/2015] [Indexed: 01/04/2023]
Abstract
Early life stress (ELS) is a known risk factor for suffering psychopathology in adulthood. The hypothalamic-pituitary-adrenal (HPA) axis has been described to be deregulated in both individuals who experienced early psychosocial stress and in patients with a wide range of psychiatric disorders. The NR3C1 gene codes for the glucocorticoid receptor, a key element involved in several steps of HPA axis modulation. In this review, we gather existing evidence linking NR3C1 methylation pattern with either ELS or psychopathology. We summarize that several types of ELS have been frequently associated with NR3C1 hypermethylation whereas hypomethylation has been continuously found to be associated with post-traumatic stress disorder. In light of the reported findings, the main concerns of ongoing research in this field are the lack of methodological consensus and selection of CpG sites. Further studies should target individual CpG site methylation assessment focusing in biologically relevant areas such as transcription factor binding regions whereas widening the examined sequence in order to include all non-coding first exons of the NR3C1 gene in the analysis.
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Affiliation(s)
- Helena Palma-Gudiel
- Unity of Anthropology, Departament of Animal Biology, Faculty of Biology, Instituto de Biomedicina (IBUB), Universidad de Barcelona (UB), Av. Diagonal, 643, 08028 Barcelona, Spain
| | - Aldo Córdova-Palomera
- Unity of Anthropology, Departament of Animal Biology, Faculty of Biology, Instituto de Biomedicina (IBUB), Universidad de Barcelona (UB), Av. Diagonal, 643, 08028 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/ Doctor Esquerdo, 46, 28007 Madrid, Spain
| | - Juan Carlos Leza
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/ Doctor Esquerdo, 46, 28007 Madrid, Spain; Department of Pharmacology, Faculty of Medicine, Universidad Complutense, Madrid, Spain
| | - Lourdes Fañanás
- Unity of Anthropology, Departament of Animal Biology, Faculty of Biology, Instituto de Biomedicina (IBUB), Universidad de Barcelona (UB), Av. Diagonal, 643, 08028 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), C/ Doctor Esquerdo, 46, 28007 Madrid, Spain.
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94
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Vollmer LL, Schmeltzer SN, Ahlbrand R, Sah R. A potential role for the acid-sensing T cell death associated gene-8 (TDAG8) receptor in depression-like behavior. Physiol Behav 2015; 150:78-82. [PMID: 25770699 DOI: 10.1016/j.physbeh.2015.03.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/17/2015] [Accepted: 03/09/2015] [Indexed: 01/13/2023]
Abstract
Inflammation has been suggested to contribute to the pathophysiology of depression. The T cell death associated gene-8 (TDAG8) receptor is a proton-sensing G-protein-coupled receptor (GPCR) expressed on immune cells in both the CNS and periphery. Previous work has shown modulation of inflammation by the TDAG8 receptor, with pro-inflammatory responses reported in the central nervous system (CNS). Given the link between depression and inflammation, the aim of the present study was to investigate the role of TDAG8 in depression relevant behaviors. Mice deficient in TDAG8 (TDAG8(-/-)) were tested in the forced swim test (FST) and sucrose preference paradigm. TDAG8 deficiency resulted in significant attenuation of immobility in the FST as compared to wild type TDAG8 (TDAG8(+/+)) mice. These differences were not due to alterations in motor activity evoked by TDAG8 deficiency as TDAG8(+/+) and TDAG8(-/-) mice displayed similar activity in the home cage or in a novel context. TDAG8(-/-) mice showed significantly higher consumption of sucrose compared to wild type mice although sucrose preference was not significantly different between genotypes. Collectively, our results support the involvement of the TDAG8 receptor in behavioral response relevant to depression. Further investigation is required to validate TDAG8 as a novel target linking inflammation and depression.
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Affiliation(s)
- Lauren Larke Vollmer
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45219, United States.
| | - Sarah N Schmeltzer
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45219, United States
| | - Rebecca Ahlbrand
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45219, United States
| | - Renu Sah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, College of Medicine, Cincinnati, OH 45219, United States; VA Medical Centre, Cincinnati, OH 45237, United States
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95
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Is cognitive impairment associated with suicidality? A population-based study. Eur Neuropsychopharmacol 2015; 25:203-13. [PMID: 25190638 DOI: 10.1016/j.euroneuro.2014.08.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 07/23/2014] [Accepted: 08/10/2014] [Indexed: 11/20/2022]
Abstract
Suicide is one of the main causes of mortality in young people and in individuals with depression. The impact of impaired cognitive function on suicidal ideation is largely unknown. The aim of this study was to examine how cognitive functioning may influence suicidal thoughts, both in the general population and in a subgroup of individuals with depression. A total of 4583 participants (aged 18 years and older) were interviewed in a cross-sectional study of a representative sample of the non-institutionalized Spanish population. Cognitive functioning was evaluated using five cognitive tests. Participants were also asked to provide information about mental health symptoms and conditions through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Logistic regression analysis was performed overall and by age group. Lifetime prevalence of suicidal ideation was 3.7%, whereas prevalence of suicidal ideation in the previous 12 months was 0.9%. Depression was the strongest risk factor for suicidal ideation. Compared with people without suicidal ideation, people with suicidal ideas performed significantly worse on cognitive functioning after adjusting for age, years of education, gender, and the presence of depression. In the age-subgroup analyses, only the youngest group (18-49 years) showed a significant association between cognitive functioning and suicidal ideation. Worse cognitive functioning was also associated with more frequent suicidal ideas in those individuals with depression even when depression severity was taken into account. In conclusion, both cognitive functioning and diagnosis of depression are associated with higher risk of suicide in the Spanish general population, especially in young individuals.
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96
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Bauer M, Severus E, Köhler S, Whybrow PC, Angst J, Möller HJ. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of unipolar depressive disorders. part 2: maintenance treatment of major depressive disorder-update 2015. World J Biol Psychiatry 2015; 16:76-95. [PMID: 25677972 DOI: 10.3109/15622975.2014.1001786] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
These guidelines for the treatment of unipolar depressive disorders systematically review available evidence pertaining to the biological treatment of patients with major depression and produce a series of practice recommendations that are clinically and scientifically meaningful based on the available evidence. These guidelines are intended for use by all physicians assessing and treating patients with these conditions. The relevant data have been extracted primarily from various treatment guidelines and panels for depressive disorders, as well as from meta-analyses/reviews on the efficacy of antidepressant medications and other biological treatment interventions identified by a search of the MEDLINE database and Cochrane Library. The identified literature was evaluated with respect to the strength of evidence for its efficacy and was then categorized into five levels of evidence (CE A-F) and five levels of recommendation grades (RG 1-5). This second part of the WFSBP guidelines on depressive disorders covers the management of the maintenance phase treatment, and is primarily concerned with the biological treatment (including pharmacological and hormonal medications, electroconvulsive therapy and other brain stimulation treatments) of adults and also, albeit to a lesser extent, children, adolescents and older adults.
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Affiliation(s)
- Michael Bauer
- Department of Psychiatry and Psychotherapy , TU Dresden , Germany
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97
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Tang XW, Wang J, Zou YF. No association between wolframin gene H611R polymorphism and mood disorders: evidence from 2,570 subjects. Nord J Psychiatry 2015; 69:132-7. [PMID: 25074416 DOI: 10.3109/08039488.2014.936503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In the past few decades, a number of studies have investigated the association of the wolframin (WFS1) gene H611R polymorphism with mood disorders, but the findings are not always consistent. AIMS The objective of the present study is to assess the association between WFS1 gene H611R polymorphism and mood disorders by using a meta-analysis. METHODS A comprehensive literature search of PubMed, Excerpta Medica Database, Elsevier Science Direct and China National Knowledge Infrastructure databases was conducted to identify relevant articles, with the last report up to April 15, 2014. Pooled odds ratio (OR) with 95% confidence interval (CI) was estimated. RESULTS Seven studies including 1318 cases and 1252 controls were selected from potentially relevant articles. This meta-analysis showed that there was no significant association between WFS1 gene H611R polymorphism and mood disorders (R vs. H: OR = 0.93, 95% CI = 0.82-1.05, P = 0.22; HR+ RR vs. HH: OR = 0.98, 95% CI = 0.82-1.17, P = 0.80; RR vs. HH+ HR: OR = 0.84, 95% CI = 0.67-1.04, P = 0.11; RR vs. HH: OR = 0.86, 95% CI = 0.67-1.10, P = 0.24; HR vs. HH: OR = 1.03, 95% CI = 0.78-1.36, P = 0.83). In subgroup analyses by ethnicity, we did not detect any significant association of this polymorphism with mood disorders in Caucasian and Asian populations (P > 0.05). In subgroup analyses by types of mood disorders, we also did not detect any significant association of this polymorphism with bipolar disorder or major depressive disorder (P > 0.05). CONCLUSIONS The results of this meta-analysis suggest that there is no association between WFS1 gene H611R polymorphism and mood disorders.
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Affiliation(s)
- Xiao-Wu Tang
- Xiao-Wu Tang, Department of Medicine, HeFei Vocational and Technical College , ChaoHu 238000, Anhui , China
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98
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Peng GJ, Tian JS, Gao XX, Zhou YZ, Qin XM. Research on the Pathological Mechanism and Drug Treatment Mechanism of Depression. Curr Neuropharmacol 2015; 13:514-23. [PMID: 26412071 PMCID: PMC4790409 DOI: 10.2174/1570159x1304150831120428] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 01/19/2015] [Accepted: 01/25/2015] [Indexed: 11/25/2022] Open
Abstract
Depression is one of the prevalent and persistent psychiatric illnesses. It brings heavy socioeconomic burden such as healthcare expenditures and even higher suicide rates. Despite many hypotheses about its mechanism have been put forward, so far it is still unclear, not to mention the precise and effective diagnostic or therapeutic methods. In this paper, the current conditions of pathological and pharmacological mechanism of depression were reviewed systematically. Firstly, the most recent hypotheses and metabolomics based research including hereditary, neurotransmitter systems, brain derived neurotrophic factor (BDNF), hyperactivity of the hypothalamic pituitary adrenal (HPA) axis and inflammatory as well as metabolomics were summarized. Secondly, the present situation and development on antidepressant drugs at home and abroad were reviewed. Finally, a conclusion and prospect on the pathological and pharmacological mechanism of depression were provided primarily.
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Affiliation(s)
- Guo-jiang Peng
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
- College of Chemistry and Chemical Engineering of Shanxi University, Taiyuan 030006,
PR China
| | - Jun-sheng Tian
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
| | - Xiao-xia Gao
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
| | - Yu-zhi Zhou
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
| | - Xue-mei Qin
- Modern Research Center for Traditional Chinese Medicine of Shanxi University, Taiyuan 030006, PR China
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99
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Skundberg-Kletthagen H, Hedelin B, Wangensteen S, Hall-Lord ML. Burden, Health and Sense of Coherence among Relatives of Depressed Inpatients. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojn.2015.53020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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100
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Roman A, Kreiner G, Nalepa I. Macrophages and depression - a misalliance or well-arranged marriage? Pharmacol Rep 2014; 65:1663-72. [PMID: 24553015 DOI: 10.1016/s1734-1140(13)71528-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 08/30/2013] [Indexed: 12/29/2022]
Abstract
Depression is a severe medical condition with multiple manifestations and diverse, largely unknown etiologies. The immune system, particularly macrophages, plays an important role in the pathology of the illness. Macrophages represent a heterogeneous population of immune cells that is dispersed throughout the body. The central nervous system is populated by several types of macrophages, including microglia, perivascular cells, meningeal and choroid plexus macrophages and pericytes. These cells occupy different brain compartments and have various functions. Under basal conditions, brain macrophages support the proper function of neural cells, organize and preserve the neuronal network and maintain homeostasis. As cells of the innate immune system, they recognize and react to any disturbances in homeostasis, eliminating pathogens or damaged cells, terminating inflammation and proceeding to initiate tissue reconstruction. Disturbances in these processes result in diverse pathologies. In particular, tissue stress or malfunction, both in the brain and in the periphery, produce sustained inflammatory states, which may cause depression. Excessive release of proinflammatory mediators is responsible for alterations of neurotransmitter systems and the occurrence of depressive symptoms. Almost all antidepressive drugs target monoamine or serotonin neurotransmission and also have anti-inflammatory or immunosuppressive properties. In addition, non-pharmacological treatments, such as electroconvulsive shock, can also exert anti-inflammatory effects. Recent studies have shown that antidepressive therapies can affect the functional properties of peripheral and brain macrophages and skew them toward the anti-inflammatory M2 phenotype. Because macrophages can affect outcome of inflammatory diseases, alleviate sickness behavior and improve cognitive function, it is possible that the effects of antidepressive treatments may be, at least in part, mediated by changes in macrophage activity.
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Affiliation(s)
- Adam Roman
- Department of Brain Biochemistry, Institute of Pharmacology, Polish Academy of Sciences, Smętna 12, PL 31-343 Kraków, Poland.
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