99951
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Evans K, Spiby H, Morrell JC. Non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. A systematic review and narrative synthesis of women's views on the acceptability of and satisfaction with interventions. Arch Womens Ment Health 2020; 23:11-28. [PMID: 30613846 PMCID: PMC6987064 DOI: 10.1007/s00737-018-0936-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/06/2018] [Indexed: 01/09/2023]
Abstract
To assess women's views on the acceptability of and satisfaction with non-pharmacological interventions to reduce the symptoms of anxiety in pregnant women. A systematic review and narrative synthesis (Prospero protocol number CRD42015017841). Fourteen included studies were conducted in Australia, Canada, Germany, New Zealand, UK and USA. Interventions were cognitive behavioural therapy, mindfulness, yoga, psychological assessment, supportive and educational based interventions. Studies included women from general antenatal populations and women with anxiety or depression symptoms or risk factors for anxiety or depression. The findings were limited due to the small number of studies evaluating different types of interventions using various study methods. Some studies had too little procedural reporting to allow a full quality assessment. Women's views on the acceptability of and satisfaction with interventions were overwhelmingly positive. The review highlights women's motivations for and barriers to participation as well as the benefit women perceived from peer support and individual discussions of their situation. Interventions need to be further evaluated in randomised controlled trials. The inclusion of women's views and experiences illuminates how and why intervention components contribute to outcomes. Women's initial concerns about psychological screening and the benefit derived from peer support and individual discussion should be noted by providers of maternity care.
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Affiliation(s)
- Kerry Evans
- School of Health Sciences, University of Nottingham, 12th Floor Tower Building, Nottingham, NG7 2RD, UK.
| | - Helen Spiby
- School of Health Sciences, University of Nottingham, 12th Floor Tower Building, Nottingham, NG7 2RD, UK
- School of Nursing and Midwifery, University of Queensland, Brisbane, Australia
| | - Jane C Morrell
- School of Health Sciences, University of Nottingham, 12th Floor Tower Building, Nottingham, NG7 2RD, UK
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99952
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Zhou Y, Song WM, Andhey PS, Swain A, Levy T, Miller KR, Poliani PL, Cominelli M, Grover S, Gilfillan S, Cella M, Ulland TK, Zaitsev K, Miyashita A, Ikeuchi T, Sainouchi M, Kakita A, Bennett DA, Schneider JA, Nichols MR, Beausoleil SA, Ulrich JD, Holtzman DM, Artyomov MN, Colonna M. Human and mouse single-nucleus transcriptomics reveal TREM2-dependent and TREM2-independent cellular responses in Alzheimer's disease. Nat Med 2020; 26:131-142. [PMID: 31932797 PMCID: PMC6980793 DOI: 10.1038/s41591-019-0695-9] [Citation(s) in RCA: 581] [Impact Index Per Article: 145.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 11/11/2019] [Indexed: 02/06/2023]
Abstract
Glia have been implicated in Alzheimer's disease (AD) pathogenesis. Variants of the microglia receptor triggering receptor expressed on myeloid cells 2 (TREM2) increase AD risk, and activation of disease-associated microglia (DAM) is dependent on TREM2 in mouse models of AD. We surveyed gene-expression changes associated with AD pathology and TREM2 in 5XFAD mice and in human AD by single-nucleus RNA sequencing. We confirmed the presence of Trem2-dependent DAM and identified a previously undiscovered Serpina3n+C4b+ reactive oligodendrocyte population in mice. Interestingly, remarkably different glial phenotypes were evident in human AD. Microglia signature was reminiscent of IRF8-driven reactive microglia in peripheral-nerve injury. Oligodendrocyte signatures suggested impaired axonal myelination and metabolic adaptation to neuronal degeneration. Astrocyte profiles indicated weakened metabolic coordination with neurons. Notably, the reactive phenotype of microglia was less evident in TREM2-R47H and TREM2-R62H carriers than in non-carriers, demonstrating a TREM2 requirement in both mouse and human AD, despite the marked species-specific differences.
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Affiliation(s)
- Yingyue Zhou
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Wilbur M Song
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Prabhakar S Andhey
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Amanda Swain
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Pietro L Poliani
- Pathology Unit, Molecular and Translational Medicine Department, University of Brescia, Brescia, Italy
| | - Manuela Cominelli
- Pathology Unit, Molecular and Translational Medicine Department, University of Brescia, Brescia, Italy
| | - Shikha Grover
- Department of Chemistry & Biochemistry, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Susan Gilfillan
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Marina Cella
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tyler K Ulland
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Konstantin Zaitsev
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
- Computer Technologies Department, ITMO University, Saint Petersburg, Russia
| | - Akinori Miyashita
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Makoto Sainouchi
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - Akiyoshi Kakita
- Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan
| | - David A Bennett
- Rush Alzheimer's Disease Center and Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center and Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Michael R Nichols
- Department of Chemistry & Biochemistry, University of Missouri-St. Louis, St. Louis, MO, USA
| | | | - Jason D Ulrich
- Department of Neurology, Hope Center for Neurological Disorders, Knight ADRC, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight ADRC, Washington University School of Medicine, St. Louis, MO, USA
| | - Maxim N Artyomov
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Marco Colonna
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA.
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99953
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Park SC, Kim YK. Anxiety Disorders in the DSM-5: Changes, Controversies, and Future Directions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:187-196. [PMID: 32002930 DOI: 10.1007/978-981-32-9705-0_12] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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99954
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Galván A. The Need for Sleep in the Adolescent Brain. Trends Cogn Sci 2020; 24:79-89. [DOI: 10.1016/j.tics.2019.11.002] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/04/2019] [Accepted: 11/03/2019] [Indexed: 11/29/2022]
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99955
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Bregman-Hai N, Kessler Y, Soffer-Dudek N. Who wrote that? Automaticity and reduced sense of agency in individuals prone to dissociative absorption. Conscious Cogn 2019; 78:102861. [PMID: 31887532 DOI: 10.1016/j.concog.2019.102861] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 12/08/2019] [Accepted: 12/09/2019] [Indexed: 12/29/2022]
Abstract
Dissociative absorption (DA) is a tendency to become completely immersed in a stimulus while neglecting to attend to one's surroundings. Theoretically, DA implies automatic functioning in areas that are outside the focus of attention. This study examined whether high absorbers indeed act more automatically, i.e., with decreased meta-consciousness for, and therefore poor memory of, their own actions, along with reduced sense of agency (SoA). High and low absorbers (N = 63) performed three DA-promoting tasks: choice-reaction time (CRT), Tetris, and free writing. Participants were tested on memory of task details and self-reported their state SoA. As hypothesized, trait DA was correlated with impaired autobiographical memory for self-generated writing. However, DA was not related to episodic memory disruptions in externally-generated content tasks (Tetris, CRT). In most tasks, DA was associated with decreased SoA. Absorbers' specific difficulty in identifying self-generated content suggests that their memory failures stem from reduced accessibility to self-actions and intentions.
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Affiliation(s)
- Noa Bregman-Hai
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Yoav Kessler
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Israel.
| | - Nirit Soffer-Dudek
- The Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
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99956
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Sex differences in brain structure: a twin study on restricted and repetitive behaviors in twin pairs with and without autism. Mol Autism 2019; 11:1. [PMID: 31893022 PMCID: PMC6937723 DOI: 10.1186/s13229-019-0309-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/19/2019] [Indexed: 01/01/2023] Open
Abstract
Background Females with autism spectrum disorder have been reported to exhibit fewer and less severe restricted and repetitive behaviors and interests compared to males. This difference might indicate sex-specific alterations of brain networks involved in autism symptom domains, especially within cortico-striatal and sensory integration networks. This study used a well-controlled twin design to examine sex differences in brain anatomy in relation to repetitive behaviors. Methods In 75 twin pairs (n = 150, 62 females, 88 males) enriched for autism spectrum disorder (n = 32), and other neurodevelopmental disorders (n = 32), we explored the association of restricted and repetitive behaviors and interests—operationalized by the Autism Diagnostic Interview-Revised (C domain) and the Social Responsiveness Scale-2 (Restricted Interests and Repetitive Behavior subscale)—with cortical volume, surface area and thickness of neocortical, sub-cortical, and cerebellar networks. Results Co-twin control analyses revealed within-pair associations between RRBI symptoms and increased thickness of the right intraparietal sulcus and reduced volume of the right orbital gyrus in females only, even though the mean number of RRBIs did not differ between the sexes. In a sub-sample of ASD-discordant pairs, increased thickness in association with RRBIs was found exclusively in females in the orbitofrontal regions, superior frontal gyrus, and intraparietal sulcus, while in males RRBIs tended to be associated with increased volume of the bilateral pallidum. Limitations However, due to a small sample size and the small difference in RRBI symptoms within pairs, the results of this exploratory study need to be interpreted with caution. Conclusions Our findings suggest that structural alterations of fronto-parietal networks in association with RRBIs are found mostly in females, while striatal networks are more affected in males. These results endorse the importance of investigating sex differences in the neurobiology of autism symptoms, and indicate different etiological pathways underlying restricted and repetitive behaviors and interests in females and males.
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99957
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Vallejo-Valdivielso M, de Castro-Manglano P, Díez-Suárez A, Marín-Méndez JJ, Soutullo CA. Clinical and Neuropsychological Predictors of Methylphenidate Response in Children and Adolescents with ADHD: A Naturalistic Follow-up Study in a Spanish Sample. Clin Pract Epidemiol Ment Health 2019; 15:160-171. [PMID: 32174998 PMCID: PMC7040471 DOI: 10.2174/1745017901915010160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/12/2019] [Accepted: 11/15/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Methylphenidate (MPH) is the most commonly used medication for Attention-Deficit/Hyperactivity Disorder (ADHD), but to date, there are neither consistent nor sufficient findings on conditions differentiating responsiveness to MPH response in ADHD. OBJECTIVE To develop a predictive model of MPH response, using a longitudinal and naturalistic follow-up study, in a Spanish sample of children and adolescents with ADHD. METHODS We included all children and adolescents with ADHD treated with MPH in our outpatient Clinic (2005 to 2015), evaluated with the K-SADS interview. We collected ADHD-RS-IV.es and CGI-S scores at baseline and at follow up, and neuropsychological testing (WISC-IV, Continuous Performance Test (CPT-II) & Stroop). Clinical response was defined as >30% reduction from baseline of total ADHD-RS-IV.es score and CGI-S final score of 1 or 2 maintained for the previous 3 months. RESULTS We included 518 children and adolescents with ADHD, mean (SD) age of patients was 11.4 (3.3) years old; 79% male; 51.7% had no comorbidities; and 75.31% had clinical response to a mean MPH dose of 1.2 mg/kg/day. Lower ADHD-RS-IV.es scores, absence of comorbidities (oppositional-defiant symptoms, depressive symptoms and alcohol/cannabis use), fewer altered neuropsychological tests, higher total IQ and low commission errors in CPT-II, were significantly associated with a complete clinical response to methylphenidate treatment. CONCLUSION Oppositional-defiant symptoms, depressive symptoms, and a higher number of impaired neuropsychological tests are associated with worse clinical response to methylphenidate. Other stimulants or non-stimulants treatment may be considered when these clinical and neuropsychological variables converged in the first clinical interview.
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Affiliation(s)
- María Vallejo-Valdivielso
- Child & Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, Pamplona, Navarra, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
| | - Pilar de Castro-Manglano
- Child & Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, Madrid, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
| | - Azucena Díez-Suárez
- Child & Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, Pamplona, Navarra, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
| | | | - Cesar A. Soutullo
- Child & Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, Pamplona, Navarra, Spain
- Child & Adolescent Psychiatry Unit, Department of Psychiatry & Medical Psychology, University of Navarra Clinic, Madrid, Spain
- IDISNA (Health Research Institute of Navarra - Instituto de Investigación Sanitaria de Navarra), Navarra, Spain
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99958
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Melado ASDSG, Vitorino FAC, Szpilman ARM, Poton WL. Prevalence and risk factors associated with common mental disorders among medical students. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2019. [DOI: 10.5712/rbmfc14(41)1911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective: To identify the prevalence of common mental disorders (CMD) in medical students at Vila Velha University (UVV), ES, and its associated factors. Methods: A cross-sectional study was conducted with 360 medical students from February to April 2018. A self-administered, confidential and online questionnaire was used, including sociodemographic, economic data, family support, friends’ network, physical activity and academic performance, as well as Self-Reporting Questionnaire (SRQ-20). Statistical analysis was performed using the STATA program, version 13.0. The Ethics Committee on Research with Humans approved the study, under number 2.108.290. Results: The prevalence of CMD among students was 45.6%. Risk factors were mental disorder in the family (RR 1.24, 95% CI 1.01-1.54), poor sleep quality (RR 1.49, 95% CI 1.17-1.90), fear that impaired the academic result (RR 1.33, 95% CI 1.01-1.77), feeling rejected by friends (RR 1.45, 95% CI 1.07-1.96), thinking about giving up the course (RR 1.67, 95% CI 1.29-2.17) and physical discomfort during the test (RR 1.63, 95% CI, 1.21-2.20). Conclusions: The overall prevalence of CMD among students was high, and the risk factors were significant. It is recommended that educational institutions and responsible government agencies be able to formulate and subsidize preventive actions and care for the mental health of medical students.
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99959
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Burdett H, Greenberg N. Service evaluation of a Human Givens Therapy service for veterans. Occup Med (Lond) 2019; 69:586-592. [PMID: 31120512 DOI: 10.1093/occmed/kqz045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND PTSD Resolution is a charitable provider of mental health support and treatment via Human Givens Therapy to members of the Armed Forces Community. This study utilized data from their client database to evaluate outcomes of their services. AIMS To determine whether treatment by the service resulted in improvements in mental health; to the extent possible, compare these outcomes with those of NHS IAPT (National Health Service - Improving Access to Psychological Therapies) services; and to evaluate how other factors, notable reported stress levels and prior treatment, impacted outcomes. METHODS Administratively collected data from the service provider collected between 2014 and 2016 were utilized. Clients still undergoing services were excluded. The CORE-10 (10-item Clinical Outcomes in Routine Evaluation) measure was used as the outcome measure. Demographic factors examined included age, sex, employment, accommodation, relationship status, distress at the time of presentation and prior treatment history. The effect of the factors was analysed using χ2 test as well as linear regression and Poisson regression analyses according to the nature of the variable. RESULTS PTSD Resolution clients appeared to show a similar degree of improvement as IAPT patients. Job-seekers and those who are living alone benefited less from the treatment. Despite high levels of distress and prior treatment among this client group, these factors did not seem to affect treatment outcomes. CONCLUSIONS The services of this provider appear to be an acceptable alternative for IAPT treatment, to the degree such a comparison can be made given differences in measures and client groups.
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Affiliation(s)
- H Burdett
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
| | - N Greenberg
- King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK
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99960
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Sun L, Ye R, Liang R, Xing F. Treadmill running attenuates neonatal hypoxia induced adult depressive symptoms and promoted hippocampal neural stem cell differentiation via modulating AMPK-mediated mitochondrial functions. Biochem Biophys Res Commun 2019; 523:514-521. [PMID: 31898970 DOI: 10.1016/j.bbrc.2019.12.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/06/2019] [Indexed: 12/24/2022]
Abstract
Neonatal hypoxia can induce the persisting brain dysfunctions and subsequently result in the behavioral abnormalities in adulthood. Improving mitochondrial functions were suggested as the effective strategy for brain functional recovery. In this study, we tested the effects of physical exercise, a well-established way benefits mitochondrion, for its functions to prevent hypoxia induced adult behavioral dysfunctions and the underlying molecular mechanism. Mice was induced with hypoxia and treadmill running were then administrated until the adulthood. The treadmill running resulted in the improved behavioral performance in depressive and anxiety tests together with the enhancement of hippocampal neurogenesis. We then detected treadmill running restored the mitochondrial morphology in adult neural stem cells (NSCs) as well as the ATP production in hippocampal tissue. In addition, activity of AMPK, which playing key roles in regulating mitochondrial functions, was also elevated by treadmill running. Blockage of AMPK with selective inhibitor compound C prohibited effects of treadmill running in attenuating neonatal hypoxia induced neurogenic impairment and antidepressant behavioral deficits in adulthood. In conclusion, treadmill running could prevent neonatal hypoxia induced adult antidepressant dysfunctions and neurogenic dampening via AMPK-mediated mitochondrial regulation.
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Affiliation(s)
- Lina Sun
- College of PE and Sport, Beijing Normal University, Beijing, China.
| | - Ruiqi Ye
- College of PE and Sport, Beijing Normal University, Beijing, China
| | - Rundong Liang
- College of PE and Sport, Beijing Normal University, Beijing, China
| | - Fuyan Xing
- College of PE and Sport, Beijing Normal University, Beijing, China
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99961
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Neustadter ES, Fineberg SK, Leavitt J, Carr MM, Corlett PR. Induced illusory body ownership in borderline personality disorder. Neurosci Conscious 2019; 2019:niz017. [PMID: 31908849 PMCID: PMC6938263 DOI: 10.1093/nc/niz017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/26/2019] [Accepted: 10/28/2019] [Indexed: 02/07/2023] Open
Abstract
One aspect of selfhood that may have relevance for borderline personality disorder (BPD) is variation in sense of body ownership. We employed the rubber hand illusion to manipulate sense of body ownership in BPD. We extended previous research on illusory body ownership in BPD by testing: (i) two illusion conditions: asynchronous and synchronous stimulation, (ii) relationship between illusion experience and BPD symptoms, and (iii) relationship between illusion experience and maladaptive personality traits. We measured illusion strength (questionnaire responses), proprioceptive drift (perceived shift in physical hand position), BPD symptoms (Revised Diagnostic Interview for Borderlines score), and maladaptive personality traits (Personality Inventory for DSM-5) in 24 BPD and 21 control participants. For subjective illusion strength, we found main effects of group (BPD > healthy control, F(1, 43) = 11.94, P = 0.001) and condition (synchronous > asynchronous, F(1, 43) = 22.80, P < 0.001). There was a group × condition interaction for proprioceptive drift (F(1, 43) = 6.48, P = 0.015) such that people with BPD maintained illusion susceptibility in the asynchronous condition. Borderline symptom severity correlated with illusion strength within the BPD group, and this effect was specific to affective (r = 0.45, P < 0.01) and cognitive symptoms (r = 0.46, P < 0.01). Across all participants, trait psychoticism correlated with illusion strength (r = 0.44, P < 0.01). People with BPD are more susceptible to illusory body ownership than controls. This is consistent with the clinical literature describing aberrant physical and emotional experiences of self in BPD. A predictive coding framework holds promise to develop testable mechanistic hypotheses for disrupted bodily self in BPD.
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Affiliation(s)
- Eli S Neustadter
- Yale Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511, USA.,Yale School of Medicine, Yale University, 333 Cedar St., New Haven, CT 06510, USA
| | - Sarah K Fineberg
- Yale Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511, USA
| | - Jacob Leavitt
- Department of Psychology, University of Houston, Heyne Building, #126, Houston, TX 77204, USA
| | - Meagan M Carr
- Yale Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511, USA.,Department of Psychology, Eastern Michigan State University, 341 Science Complex, Ypsilanti, MI 48197, USA
| | - Philip R Corlett
- Yale Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511, USA
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99962
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Tankus A, Fried I. Degradation of Neuronal Encoding of Speech in the Subthalamic Nucleus in Parkinson's Disease. Neurosurgery 2019; 84:378-387. [PMID: 29566177 DOI: 10.1093/neuros/nyy027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 01/23/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Most of the patients with Parkinson's disease suffer from speech disorders characterized mainly by dysarthria and hypophonia. OBJECTIVE To understand the deterioration of speech in the course of Parkinson's disease. METHODS We intraoperatively recorded single neuron activity in the subthalamic nucleus of 18 neurosurgical patients with Parkinson's disease undergoing implantation of deep brain stimulator while patients articulated 5 vowel sounds. RESULTS Here, we report that single subthalamic neurons encode individual vowel phonemes and employ 1 of 2 encoding schemes: broad or sharp tuning. Broadly tuned units respond to all examined phonemes, each with a different firing rate, whereas sharply tuned ones are specific to 1 to 2 phonemes. We then show that in comparison with patients without speech deficits, the spiking activity in patients with speech disorders was lower during speech production, overt or imagined, but not during perception. However, patients with speech disorders employed a larger percentage of the neurons for the aforementioned tasks. Whereas the lower firing rates affect mainly sharply tuned units, the extra units used a broad tuning encoding scheme. CONCLUSION Our findings suggest mechanisms of neuronal degradation due to Parkinsonian speech disorders and their possible compensation. As impairment in sharply tuned units may be compensated by broadly tuned ones, the proposed compensation model appears to be suboptimal, lending support to the persistence of speech disorders in the course of the disease.
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Affiliation(s)
- Ariel Tankus
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Itzhak Fried
- Functional Neurosurgery Unit, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Neurology and Neurosurgery, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Neurosurgery, University of California, Los Angeles, California
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99963
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Clarke T, Jamieson JD, Malone P, Rayhan RU, Washington S, VanMeter JW, Baraniuk JN. Connectivity differences between Gulf War Illness (GWI) phenotypes during a test of attention. PLoS One 2019; 14:e0226481. [PMID: 31891592 PMCID: PMC6938369 DOI: 10.1371/journal.pone.0226481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Accepted: 11/26/2019] [Indexed: 01/05/2023] Open
Abstract
One quarter of veterans returning from the 1990–1991 Persian Gulf War have developed Gulf War Illness (GWI) with chronic pain, fatigue, cognitive and gastrointestinal dysfunction. Exertion leads to characteristic, delayed onset exacerbations that are not relieved by sleep. We have modeled exertional exhaustion by comparing magnetic resonance images from before and after submaximal exercise. One third of the 27 GWI participants had brain stem atrophy and developed postural tachycardia after exercise (START: Stress Test Activated Reversible Tachycardia). The remainder activated basal ganglia and anterior insulae during a cognitive task (STOPP: Stress Test Originated Phantom Perception). Here, the role of attention in cognitive dysfunction was assessed by seed region correlations during a simple 0-back stimulus matching task (“see a letter, push a button”) performed before exercise. Analysis was analogous to resting state, but different from psychophysiological interactions (PPI). The patterns of correlations between nodes in task and default networks were significantly different for START (n = 9), STOPP (n = 18) and control (n = 8) subjects. Edges shared by the 3 groups may represent co-activation caused by the 0-back task. Controls had a task network of right dorsolateral and left ventrolateral prefrontal cortex, dorsal anterior cingulate cortex, posterior insulae and frontal eye fields (dorsal attention network). START had a large task module centered on the dorsal anterior cingulate cortex with direct links to basal ganglia, anterior insulae, and right dorsolateral prefrontal cortex nodes, and through dorsal attention network (intraparietal sulci and frontal eye fields) nodes to a default module. STOPP had 2 task submodules of basal ganglia–anterior insulae, and dorsolateral prefrontal executive control regions. Dorsal attention and posterior insulae nodes were embedded in the default module and were distant from the task networks. These three unique connectivity patterns during an attention task support the concept of Gulf War Disease with recognizable, objective patterns of cognitive dysfunction.
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Affiliation(s)
- Tomas Clarke
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - Jessie D. Jamieson
- Department of Mathematics, University of Nebraska-Lincoln, Lincoln, Nebraska, United States of America
| | - Patrick Malone
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - Rakib U. Rayhan
- Department of Physiology and Biophysics, Howard University College of Medicine, Washington, DC, United States of America
| | - Stuart Washington
- Division of Rheumatology, Immunology and Allergy, Georgetown University, Washington, DC, United States of America
| | - John W. VanMeter
- Center for Functional and Molecular Imaging, Georgetown University, Washington, DC, United States of America
| | - James N. Baraniuk
- Division of Rheumatology, Immunology and Allergy, Georgetown University, Washington, DC, United States of America
- * E-mail:
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99964
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Yang E, Kim JY, Yang SH, Lee E, Sun W, Lee HW, Kim H. Three-Dimensional Analysis of Mouse Habenula Subnuclei Reveals Reduced Volume and Gene Expression in the Lipopolysaccharide-mediated Depression Model. Exp Neurobiol 2019; 28:709-719. [PMID: 31902158 PMCID: PMC6946114 DOI: 10.5607/en.2019.28.6.709] [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] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 12/12/2022] Open
Abstract
The habenula (Hb) is small but important brain structure, anatomically and functionally links the forebrain with the midbrain to modulate various neuropsychiatric functions associated with drug addiction and emotion-associated dysfunctions. Several reports suggested that the dysfunction of Hb-related functions affected the Hb structurally and functionally. However, the technical limitation has awaited the solid conclusion of whether Hb change due to depression is likely to occur in certain subnuclei of the Hb. To probe this possibility, we developed 3-dimensional reconstruction methods for the high-resolution volumetric analysis of Hb and the mRNA levels at the given volume in normal or lipopolysaccharide (LPS)-mediated mouse model of depression. Notably, we discovered that the volume reduction was prominent in medial Hb but not in lateral Hb after LPS treatments. On the other hand, the RNA expression levels of known Hb regional markers such as Tac1 (dorsal part of medial Hb), ChAT (ventral part of medial Hb), and Tacr1 (medial and lateral Hb) were all decreased in all Hb subnuclei in LPS-injected mice. Accordingly, accurate volumetry with marker labeling was not feasible. Collectively, these established 3D analyses of mouse Hb successfully and precisely determine the volume-based changes of small brain structure, which should be applicable in a wider range of mouse models or pathological specimens.
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Affiliation(s)
- Esther Yang
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Jin Yong Kim
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Soo Hyun Yang
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Eunsoo Lee
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Woong Sun
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Hyun Woo Lee
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
| | - Hyun Kim
- Department of Anatomy, College of Medicine, Korea University, Seoul 02841, Korea
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99965
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Fernando S. Developing mental health services in the global south. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1706237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Suman Fernando
- Faculty of Social Sciences and Humanities, London Metropolitan University, London, UK
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99966
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A prospective three-year follow-up study on the clinical significance of anti-neuronal antibodies in acute psychiatric disorders. Sci Rep 2019; 10:35. [PMID: 31896766 PMCID: PMC6940359 DOI: 10.1038/s41598-019-56934-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 12/19/2019] [Indexed: 01/05/2023] Open
Abstract
The clinical significance of anti-neuronal antibodies for psychiatric disorders is controversial. We investigated if a positive anti-neuronal antibody status at admission to acute psychiatric inpatient care was associated with a more severe neuropsychiatric phenotype and more frequent abnormalities during clinical work-up three years later. Patients admitted to acute psychiatric inpatient care who tested positive for N-methyl-D-aspartate receptor (NMDAR), contactin-associated protein 2 (CASPR2) and/or glutamic acid decarboxylase 65 (GAD65) antibodies (n = 24) were age - and sex matched with antibody-negative patients (1:2) from the same cohort (n = 48). All patients were invited to follow-up including psychometric testing (e.g. Symptom Checklist-90-Revised), serum and cerebrospinal fluid (CSF) sampling, EEG and 3 T brain MRI. Twelve antibody-positive (ab+) and 26 antibody-negative (ab-) patients consented to follow-up. Ab+ patients had more severe symptoms of depression (p = 0.03), psychoticism (p = 0.04) and agitation (p = 0.001) compared to ab- patients. There were no differences in CSF analysis (n = 6 ab+/12 ab-), EEG (n = 7 ab+/19 ab-) or brain MRI (n = 7 ab+/17 ab-) between the groups. In conclusion, anti-neuronal ab+ status during index admission was associated with more severe symptoms of depression, psychoticism and agitation at three-year follow-up. This supports the hypothesis that anti-neuronal antibodies may be of clinical significance in a subgroup of psychiatric patients.
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99967
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Gıynaş Ayhan M, Köse A, Kırcı Ercan S, Yıldız Bozdoğan Ş, Yardım Özayhan H, Eren İ. Toplum ruh sağlığı merkezi hizmetlerinden yararlanan şizofreni tanılı hastaların yakınlarındaki bakım yükü: karşılaştırmalı bir çalışma. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.553434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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99968
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MacGinty R, Lesosky M, Barnett W, Nduru PM, Vanker A, Stein DJ, Zar HJ. Maternal psychosocial risk factors and lower respiratory tract infection (LRTI) during infancy in a South African birth cohort. PLoS One 2019; 14:e0226144. [PMID: 31887159 PMCID: PMC6936815 DOI: 10.1371/journal.pone.0226144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/20/2019] [Indexed: 02/04/2023] Open
Abstract
Objective To investigate the association between maternal antenatal and/or postnatal psychosocial risk factors (including depression, psychological distress, alcohol abuse and intimate partner violence (IPV) and infant lower respiratory tract infection (LRTI) in a low- and middle-income-country (LMIC). Study design Pregnant women (n = 1137) enrolled in a South African birth cohort study, the Drakenstein Child Health Study (DCHS) were longitudinally assessed for psychosocial risk factors including depression, psychological distress, alcohol abuse and/or intimate partner violence (IPV). Infants were followed from birth until one year of age for the development of LRTI by active surveillance. Two outcomes were evaluated: any LRTI, and severe and/or hospitalised LRTI. Logistic regression was used to identify associations between individual maternal psychosocial risk factors and LRTI outcomes. Analyses stratified by age were also performed to determine which age groups related to infant LRTI were linked with maternal psychosocial risk factors. Results There were 606 LRTI episodes in 369 infants in the first year (crude incidence rate = 0.53 episodes per person-year, 95%CI: 0.50; 0.56); 31% (n = 186) of episodes were severe or hospitalised events. Maternal psychosocial risk factors were associated with LRTI and severe LRTI, particularly postnatal and long-term maternal psychological distress, antenatal maternal alcohol consumption, and postnatal maternal IPV. Age stratified analyses found that antenatal maternal alcohol consumption was associated with early infant LRTI, while antenatal maternal depression was linked with infant severe LRTI between 3 and 6 months of age, and postnatal maternal IPV was associated with early LRTI and severe forms of LRTI. Conclusion The associations between maternal psychosocial risk factors and infant LRTI highlight the potential value of screening for maternal psychosocial risk factors in clinical settings and developing targeted interventions. Such interventions may not only improve maternal well-being, but also help reduce the burden of infant LRTI in LMIC settings.
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Affiliation(s)
- Rae MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
- * E-mail:
| | - Maia Lesosky
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Polite M. Nduru
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Aneesa Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, South African Medical Research Council Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - Heather J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
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99969
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99970
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Wang J, Zhou Y, Liang Y, Liu Z. A Large Sample Survey of Tibetan People on the Qinghai-Tibet Plateau: Current Situation of Depression and Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010289. [PMID: 31906177 PMCID: PMC6981986 DOI: 10.3390/ijerph17010289] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/20/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND A depressive state is a negative emotional state characterized by abnormal dejection and unpleasant mood. Long-term depressive symptoms can result in psychological disorders such as depression. However, little is known about the depression status and risk factors of the Tibetan people on the Qinghai-Tibet Plateau. OBJECTIVE This study explores the depression status of the Tibetan people to better promote ethnic minorities' physical and mental health. PARTICIPANTS AND SETTING The Center for Epidemiologic Studies Depression Scale (CES-D) was administered to 24,141 Tibetan people from Yushu Prefecture; the average age was 34.33 years (SD = 9.18, range = 18-94 years). MATERIALS AND METHODS Participants completed questionnaires collecting demographic information and evaluating symptoms of depression. RESULTS The depression prevalence was higher at high altitudes, and there may be a significant positive correlation between depression rates and altitude. Significant differences were found for each demographic variable. Participants with depressive symptoms (scores ≥8) accounted for 52.3% of the total sample, and participants with depression (scores ≥14) accounted for 28.6%. The binary logistic regression results showed that alcohol drinkers, unmarried participants, participants with high self-assessed socioeconomic status, participants with a high income level, and those with a middle-school education were more likely to be depressed. CONCLUSIONS The results provide the first evidence that the prevalence of depression in Tibetans of the Qinghai-Tibet Plateau is higher than that in the general Chinese population and that reported in Western studies, a finding that may be related to cultural differences and chronic hypoxia caused by the high altitude. This paper offers insight into the mental health status of people living in plateau areas and provides a basis for formulating pertinent mental health policy.
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Affiliation(s)
- Jiazhou Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; (J.W.); (Y.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yueyue Zhou
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; (J.W.); (Y.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yiming Liang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; (J.W.); (Y.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing 100101, China; (J.W.); (Y.Z.)
- Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
- Correspondence: ; Tel.: +86-10-6487-1358
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99971
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Li B, Hu X. Time-Varying Effects of Marital Status on Gastric Cancer: A Population-Based Study. Cancer Manag Res 2019; 11:10949-10955. [PMID: 32099458 PMCID: PMC6997217 DOI: 10.2147/cmar.s234738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 11/23/2019] [Indexed: 12/24/2022] Open
Abstract
Background Although prior studies have shown that marital status affects the prognosis of patients with gastric cancer, its time-varying effects are not well understood. We aimed to investigate the changes in marital status’ impact over a 10-year follow-up time among patients with gastric cancer (GC) in the United States. Materials and Methods All patients with gastric cancer diagnosed between 2004 and 2008 in the Surveillance, Epidemiology, and End Results (SEER) database were retrieved. Married patients and unmarried patients (single, separated, divorced or widowed) with complete survival time were selected for comparisons. A total of 14,545 patients who had clinical data and follow-up information available were enrolled. We used Kaplan–Meier analyses and time-dependent flexible parametric models to estimate time-varying hazard ratios (HRs). Results Unmarried GC patients had worse overall and cancer-specific survival compared with married patients (log-rank test: P < 0.001 and P < 0.001, respectively). The time-varying analysis found that unmarried patients had a significantly higher risk of overall mortality during the 10-year follow-up time, with the lowest adjusted hazard ratio (HR) at 12 months after diagnosis (HR at 12 months, 1.08; 95% CI, 1.03–1.15). For cancer-specific mortality, the time-varying adjusted HR of unmarried patients was significantly higher initially (HR at 12 months, 1.08; 95% CI, 1.02–1.14) but decreased to null after 20 months (HR at 24 months = 1.04; 95% CI = 0.99–1.11). Conclusion Unmarried patients had a higher risk of cancer-specific mortality during the 20 months after gastric cancer diagnosis, which may be an appropriate time frame for intervention.
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Affiliation(s)
- Bofei Li
- Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, People's Republic of China
| | - Xuechen Hu
- School of Nursing, Xi'an Medical University, Xi'an, People's Republic of China
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99972
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Jones N, Greenberg N, Phillips A, Simms A, Wessely S. British military women: combat exposure, deployment and mental health. Occup Med (Lond) 2019; 69:549-558. [PMID: 31404463 DOI: 10.1093/occmed/kqz103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Internationally, women are about to undertake combat duties alongside their male colleagues. The psychological effect of this policy change is largely unknown. AIMS To explore the mental health impact of combat exposure among military women. METHODS Self-report, between-subjects survey data were collected in Iraq and Afghanistan on four occasions between 2009 and 2014 (n = 4139). Differences in mental health, stigmatization, deployment experiences, intimate relationship impact, perception of family support levels, unit cohesion, leadership and help-seeking were compared between deployed men and women. Comparisons were repeated with the study sample stratified by level of combat exposure. Outcomes were examined using logistic regression adjusted for socio-demographic, mental health and military factors. RESULTS Overall, 4.1% of women and 4.3% of men reported post-traumatic stress disorder (PTSD) (odds ratio (OR) 1.31, 95% confidence interval (95% CI) 0.70-2.46); 22% of women and 16% of men reported symptoms of common mental disorder (CMD) (OR 1.52, 95% CI 1.11-2.08). Women were less likely to report mental health-related stigmatization (OR 0.68, 95% CI 0.53-0.87), negative relationship impact from deployment (OR 0.69, 95% CI 0.49-0.98) and subjective unit cohesion (OR 0.69, 95% CI 0.53-0.90). Help-seeking for emotional problems was similar by gender (OR 1.22, 95% CI 0.84-1.77). Overall, outcomes were minimally impacted by level of combat exposure. CONCLUSIONS Although women experienced more CMD symptoms, PTSD symptoms were similar by gender. Subject to confirmation of the study findings, women may not require enhanced mental healthcare during deployment for exposure-based conditions such as PTSD when undertaking the ground close combat role.
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Affiliation(s)
- N Jones
- Academic Department of Military Mental Health, Weston Education Centre, King's College London, London, UK
| | - N Greenberg
- Academic Department of Military Mental Health, Weston Education Centre, King's College London, London, UK
| | - A Phillips
- Academic Department of Military Mental Health, Weston Education Centre, King's College London, London, UK.,King's Centre for Military Health Research, Weston Education Centre, King's College London, London, UK
| | - A Simms
- Academic Department of Military Mental Health, Weston Education Centre, King's College London, London, UK
| | - S Wessely
- King's Centre for Military Health Research, Weston Education Centre, King's College London, London, UK
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99973
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Legesse Tesemma A, Girma Abate M, Hailemariam Abebo Z, Estifanos Madebo W. Determinants of Poor Quality of Life Among Adults Living with HIV and Enrolled in Highly Active Anti-Retroviral Therapy at Public Health Facilities of Arba Minch Town Administration in Southern Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2019; 11:387-394. [PMID: 32021481 PMCID: PMC6948197 DOI: 10.2147/hiv.s227244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/16/2019] [Indexed: 01/05/2023]
Abstract
Background The human immunodeficiency virus (HIV) continues to be a major global public health problem with more than 35 million people worldwide infected so far. Evidence shows that HIV has been compromising the quality of life of people living with HIV (PLWH) even in this era of highly active anti-retroviral therapy (HAART). There has been little research into the quality of life of PLWH receiving HAART in Ethiopia. Purpose The aim of this study was to assess the quality of life among PLWH attending anti-retroviral therapy at public health facilities of Arba Minch town, Southern Ethiopia, in 2019. Patients and methods We conducted a cross-sectional study design on 391 randomly selected PLWH who were attending HAART. We used a systematic random sampling technique to select participants in public health facilities of Arba Minch town from February 16 to April 26, 2019. The interviewers administered a structured questionnaire consisting of the WHOQOL-HIV BREF tool to measure the quality of life. Socio-demographic variables of study participants were collected, together with variables related to their clinical status extracted from their clinical records. Percentage mean scores were calculated and the mean of percentage mean scores was taken as the cutoff to categorize participants into two groups representing poor and good quality of life. Simple binary logistic regression and multivariable logistic regression analyses were used to determine significant variables. All variables with p-value ≤ 0.25 in simple binary logistic regression were considered as eligible variables for multivariable logistic regression. Variables with p-value ≤ 0.05 in multivariable logistic regression were considered as predictor variables. Results Out of the 391 enrolled adult PLWH, 184 of them (47.1%) had poor of overall quality of life status, as estimated by the WHOQOL-HIV BREF tool. Good quality of life was positively associated with recent CD4 count greater than or equal to 500 cell/mm3 (AOR=1.96, 95% CI; 1.18-3.27), absence of depression (AOR=10.59, 95% CI; 6.16-18.21), normal body mass index (AOR=2.66, 95% CI; 1.18-3.27), social support (AOR= 6.18, 95% CI; 3.56-10.75) and no perceived stigma (AOR=2.75, 95% CI; 1.62-4.67). Conclusion Nearly half of the adult PLWH receiving HAART at Arba Minch town had poor quality of life. High CD4 count, lack of social support, depression, and perceived stigma were associated with poor quality of life of PLWH. PLWH should be encouraged to be part of structured social support systems, such as associations of people living with HIV and mother support groups, in order to improve their social and psychological health. The health system should give attention to counseling on chronic care adherence and nutritional support to improve the quality of life of PLWH receiving HAART.
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Affiliation(s)
| | - Meseret Girma Abate
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Zeleke Hailemariam Abebo
- Department of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Wubshet Estifanos Madebo
- Department of Nursing, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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99974
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Mostel Z, Perl A, Marck M, Mehdi SF, Lowell B, Bathija S, Santosh R, Pavlov VA, Chavan SS, Roth J. Post-sepsis syndrome - an evolving entity that afflicts survivors of sepsis. Mol Med 2019; 26:6. [PMID: 31892321 PMCID: PMC6938630 DOI: 10.1186/s10020-019-0132-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 12/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The sequelae of sepsis were once thought to be independent of sepsis itself and assumed to be either comorbid to sick patients or complications of critical illness. Recent studies have reported consistent patterns of functional disabilities in sepsis survivors that can last from months to years after symptoms of active sepsis had resolved. BODY: Post-sepsis syndrome is an emerging pathological entity that has garnered significant interest amongst clinicians and researchers over the last two decades. It is marked by a significantly increased risk of death and a poor health-related quality of life associated with a constellation of long-term effects that persist following the patient's bout with sepsis. These include neurocognitive impairment, functional disability, psychological deficits, and worsening medical conditions. CONCLUSION This "post-sepsis syndrome" has been the subject of active preclinical and clinical research providing new mechanistic insights and approaches linked to survivor well-being. Here we review important aspects of these research efforts and goals of care for patients who survive sepsis.
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Affiliation(s)
- Zachary Mostel
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA.
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Abraham Perl
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Matthew Marck
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Syed F Mehdi
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Barbara Lowell
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Sagar Bathija
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Ramchandani Santosh
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Valentin A Pavlov
- Center for Bioelectronic Medicine and Biomedical Science, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Sangeeta S Chavan
- Center for Bioelectronic Medicine and Biomedical Science, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Jesse Roth
- Laboratory of Diabetes and Diabetes-Related Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Center for Bioelectronic Medicine and Biomedical Science, Feinstein Institute for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
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99975
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Muwonge J, Umubyeyi A, Rugema L, Krantz G. Suicidal behaviour and clinical correlates in young adults in Rwanda: a population-based, cross-sectional study. JOURNAL OF GLOBAL HEALTH REPORTS 2019. [DOI: 10.29392/joghr.3.e2019080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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99976
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Duran S, Cetinbas A, Basaran T, Kara A, Elgun B, Keklik N. The Effect of Stress and Social Media Use on the Eating Behavior in University Students. EURASIAN JOURNAL OF FAMILY MEDICINE 2019. [DOI: 10.33880/ejfm.20190800402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim: It is possible to be phisicially and mentally healthy and maintain health at every stage of life with adequate and balanced nutrition. Stress, social media, family and peer influence are also factors affecting the nutrition attitude. The aim of this study is to investigate the effects of stress and social media usage on eating behaviors in university students.
Methods: Retrospective-descriptive study data were collected by using the interview form consisted of four parts. Those four parts were “general informations” for demographic informations, “Eating Attitudes Test” for eating attitudes diagnosis, “Depression, Anxiety, Stress Scale” for diagnosis of psychological disorders and “Social Media Use”.
Results: A total of 422 people, 329 women and 93 men participated in the survey conducted at the Faculty of Health Sciences of Trakya University. There was a statistically significant difference between stress degree and eating behavior disorder and it was determined that the increase in stress severity caused abnormal eating behavior. There was a statistically significant difference between the time allocated to social media and eating behavior disorder, and it was determined that increased time allocated to social media caused eating behavior disorder.
Conclusion: In our study, it was determined that stress and social media use had significant negative effects on students' eating behaviors.
Keywords: students, stress, social media, feeding behavior
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Affiliation(s)
- Sedef Duran
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
| | - Ayca Cetinbas
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
| | - Tuba Basaran
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
| | - Ali Kara
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
| | - Binevs Elgun
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
| | - Nursel Keklik
- Beslenme ve Diyetetik Bölümü, Trakya Üniversitesi Sağlık Bilimleri Fakültesi
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99977
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The Complex Interplay of Pain, Depression, and Anxiety Symptoms in Patients With Chronic Pain. Clin J Pain 2019; 36:249-259. [DOI: 10.1097/ajp.0000000000000797] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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99978
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Oshio T. Exploring the health-relevant poverty line: a study using the data of 663,000 individuals in Japan. Int J Equity Health 2019; 18:205. [PMID: 31888635 PMCID: PMC6937975 DOI: 10.1186/s12939-019-1118-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 12/23/2019] [Indexed: 02/05/2023] Open
Abstract
Background Income poverty is known to be associated with poor health outcomes. However, the poverty line, which is used to calculate the poverty rate, is arbitrarily set without specific reference to health. This study explored the health-relevant poverty line to understand poverty in terms of population health. Methods Using repeated cross-sectional data from approximately 663,000 individuals obtained from 11 waves of nationwide population surveys conducted in Japan from 1986 to 2016, we used two methods to calculate a health-relevant poverty line: (1) We searched for a poverty line that maximized the proportion-weighted relative underperformance in health among individuals whose income was below the poverty line (Method I). (2) We searched for a poverty line that maximized the likelihood of the logistic regression model to explain poverty in terms of health using a binary variable for below-the-poverty-line income (Method II). For both methods, we considered five health outcomes: Poor/fair and poor self-rated health, subjective symptoms, problems with daily life activities, and psychological distress, along with covariates. Results Methods I and II indicated that the health-relevant poverty line should be drawn, respectively, at 72–86% and 67–69% of median income; this level is somewhat higher than the conventional 50% or 60%. Conclusions The results suggest that there is a risk that the conventionally defined poverty line may underestimate poverty in terms of population health.
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Affiliation(s)
- Takashi Oshio
- Institute of Economic Research, Hitotsubashi University, 2-1 Naka, Kunitachi, Tokyo, 186-8603, Japan.
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99979
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Zhang W, Cai S, Huang K, Lv Y, Kang Y, Wang Q, Huang L. Association between schizophrenia risk allele dosage of rs6994992 and whole-brain structural and functional characteristics. Psychiatry Res Neuroimaging 2019; 294:110956. [PMID: 31202487 DOI: 10.1016/j.pscychresns.2019.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 05/17/2019] [Accepted: 05/22/2019] [Indexed: 01/10/2023]
Abstract
The rs6994992 polymorphism has been reported as a candidate variant associated with schizophrenia (SZ). Neuroimaging studies have revealed that SZ is associated with widespread structural and functional alterations in brain. However, whether the allele dosage of rs6994992 is associated with brain structural or functional features is unclear. We aimed to investigate the association between the risk allele dosage of rs6994992 and whole-brain structural and functional characteristics and to further explore the relationship between these characteristics and cognition. Magnetic resonance images and the rs6994992 genotype were obtained from 53 healthy participants. A general linear model was used to determine the effects of risk allele dosage of rs6994992 on brain characteristics. Spearman correlation analysis was employed to calculate the correlation between altered brain characteristics and cognitive scores. Our results demonstrated that regions with significant differences in structural characteristics between groups with different dosages of rs6994992 were mainly located in the frontal and temporal lobes, hippocampus and angular gyrus. Moreover, significant regions of functional connectivity (FC) partly overlapped with the structural results. Measurements in those significant regions and FCs were correlated with the cognition scales. This association can inform our understanding of the mechanisms through which rs6994992 variants increase the risk for SZ.
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Affiliation(s)
- Wei Zhang
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Suping Cai
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Kexin Huang
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Yahui Lv
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Yafei Kang
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China
| | - Qiang Wang
- The First Affiliated Hospital, Xi 'an Jiaotong university, Shaanxi 710048, PR China
| | - Liyu Huang
- School of Life Sciences and Technology, Xidian University, Xi'an, Shaanxi 710071, PR China.
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99980
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A Prospective Study of Service Use in the Year After Birth by Women at High Risk for Antenatal Substance Use and Mental Health Disorders. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00207-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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99981
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Bates G, Van Hout MC, Teck JTW, McVeigh J. Treatments for people who use anabolic androgenic steroids: a scoping review. Harm Reduct J 2019; 16:75. [PMID: 31888665 PMCID: PMC6937954 DOI: 10.1186/s12954-019-0343-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/21/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A growing body of evidence suggests that anabolic androgenic steroids (AAS) are used globally by a diverse population with varying motivations. Evidence has increased greatly in recent years to support understanding of this form of substance use and the associated health harms, but there remains little evidence regarding interventions to support cessation and treat the consequences of use. In this scoping review, we identify and describe what is known about interventions that aim to support and achieve cessation of AAS, and treat and prevent associated health problems. METHODS A comprehensive search strategy was developed in four bibliographic databases, supported by an iterative citation searching process to identify eligible studies. Studies of any psychological or medical treatment interventions delivered in response to non-prescribed use of AAS or an associated harm in any setting were eligible. RESULTS In total, 109 eligible studies were identified, which included case reports representing a diverse range of disciplines and sources. Studies predominantly focussed on treatments for harms associated with AAS use, with scant evidence on interventions to support cessation of AAS use or responding to dependence. The types of conditions requiring treatment included psychiatric, neuroendocrine, hepatic, kidney, cardiovascular, musculoskeletal and infectious. There was limited evidence of engagement with users or delivery of psychosocial interventions as part of treatment for any condition, and of harm reduction interventions initiated alongside, or following, treatment. Findings were limited throughout by the case report study designs and limited information was provided. CONCLUSION This scoping review indicates that while a range of case reports describe treatments provided to AAS users, there is scarce evidence on treating dependence, managing withdrawal, or initiating behaviour change in users in any settings. Evidence is urgently required to support the development of effective services for users and of evidence-based guidance and interventions to respond to users in a range of healthcare settings. More consistent reporting in articles of whether engagement or assessment relating to AAS was initiated, and publication within broader health- or drug-related journals, will support development of the evidence base.
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Affiliation(s)
- Geoff Bates
- Public Health Institute, Liverpool John Moores University, Liverpool, England
| | | | | | - Jim McVeigh
- Department of Sociology, Manchester Metropolitan University, Manchester, England
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99982
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Park H, Kim JI, Min B, Oh S, Kim JH. Prevalence and correlates of suicidal ideation in Korean firefighters: a nationwide study. BMC Psychiatry 2019; 19:428. [PMID: 31888659 PMCID: PMC6937629 DOI: 10.1186/s12888-019-2388-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/04/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It is generally known that firefighters are at increased risk of suicide. However, the prevalence and correlates of suicidal ideation in firefighters have not been thoroughly described to date. The aim of this study was to measure the 1-year prevalence of suicidal ideation in firefighters and to investigate the correlates of past-year suicidal ideation among the demographic, occupational and clinical characteristics. METHOD A web-based survey was conducted using a self-reported questionnaire. A total of 45,698 Korean firefighters were included for analysis. The prevalence of suicidal ideation in the past year was calculated and its correlates were elucidated using a multivariable logistic regression analysis. RESULTS The 1-year prevalence of suicidal ideation was 10.66% in Korean firefighters. Recent traumatic experience, high levels of occupational stress from physical work environment and emotional labor, as well as current duty of officer were significant correlates of suicidal ideation in the previous year, even after controlling for the effects of PTSD and depressive symptoms. With respect to demographic factors, female gender and marital status of divorced/separated/widowed were identified to be associated with suicidal ideation in the previous year among firefighters. CONCLUSIONS The 1-year prevalence of suicidal ideation was high in Korean firefighters and was associated with various occupational factors as well as psychiatric symptoms. Early detection and management of these risk factors could reduce the risk of suicidal ideation in firefighters.
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Affiliation(s)
- Heyeon Park
- 0000 0004 0647 3378grid.412480.bDepartment of Public Health Medical Services, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 South Korea
| | - Johanna Inhyang Kim
- 0000 0004 4671 5423grid.411986.3Department of Psychiatry, Hanyang University Medical Center , 222-1, Wangsimni-ro Seongdong-gu, Seoul, South Korea
| | - Beomjun Min
- 0000 0004 0647 3378grid.412480.bDepartment of Public Health Medical Services, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 South Korea
| | - Sohee Oh
- grid.412479.dDepartment of Biostatistics, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Boramae-ro 5-gil, Dongjak-gu, Seoul, South Korea
| | - Jeong-Hyun Kim
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea. .,Mental Health and Behavioral Medicine Services for Clinical Departments, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea. .,Department of Psychiatry, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, South Korea.
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99983
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Trompetter HR, Johnston DW, Johnston M, Vollenbroek-Hutten MM, Schreurs KMG. Are Processes in Acceptance & Commitment Therapy (ACT) Related to Chronic Pain Outcomes Within Individuals Over Time? An Exploratory Study Using n-of-1 Designs. J Pers Oriented Res 2019; 5:123-136. [PMID: 33569147 PMCID: PMC7842648 DOI: 10.17505/jpor.2019.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Acceptance & Commitment Therapy (ACT) explicitly postulates experiential avoidance (EA) and values-based living (VBL) as essential treatment processes. As outcomes from between-subject studies cannot readily be generalized to within-subject processes in individuals, we explored the unfolding of, and relationship between, EA and VBL and levels of pain interference in daily life and emotional well-being within individuals experiencing chronic pain. Methods Using n-of-1 designs, three participants following a multidisciplinary treatment program filled out a 12-item daily questionnaire (87-110 days). After multiple imputation of missing data, McKnight Time-series analysis procedures were performed for each participant separately. The interrelationships of EA, VBL and pain intensity, and the relationship of EA and VBL beyond pain intensity with both chronic pain outcomes were assessed both concurrently (same day) and prospectively (consecutive days). Results Both EA and VBL were associated with at least one of five outcome variables (four domains of pain interference and emotional well-being) beyond pain intensity in two participants, but not in the third participant. These associations primarily existed for concurrent, but not consecutive, days. In contrast to VBL, EA was not associated with emotional well-being for any of the three participants. Conclusions Although the finding that ACT-processes were associated with pain outcomes on concurrent days is consistent with ACT theory, the absence of such associations on consecutive days means that alternative explanations cannot be rule out. One possibility is that pain interference fluctuates within days at a higher variability rate than was currently assessed. Future research should consider using a higher measurement frequency to be able to grasp time-lagged effects.
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Affiliation(s)
- Hester R Trompetter
- Department of Psychology, Health and Technology, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands.,Roessingh Research and Development, Telemedicine group, Postbox 310, 7500 AH, Enschede, The Netherlands
| | - Derek W Johnston
- School of Psychology, College of Life Sciences and Medicine, William Guild Building, University of Aberdeen, Aberdeen AB24 3FX, Scotland
| | - Marie Johnston
- Aberdeen Health Psychology Group, Institute of Applied Health Sciences, College of Life Sciences and Medicine, Health Sciences Building, Aberdeen AB25 2ZD, Scotland
| | - Miriam M Vollenbroek-Hutten
- Roessingh Research and Development, Telemedicine group, Postbox 310, 7500 AH, Enschede, The Netherlands.,Faculty of Engineering, Mathematics and Computer Sience, Telemedicine group, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands
| | - Karlein M G Schreurs
- Roessingh Research and Development, Telemedicine group, Postbox 310, 7500 AH, Enschede, The Netherlands
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99984
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Helle AC, Watts AL, Trull TJ, Sher KJ. Alcohol Use Disorder and Antisocial and Borderline Personality Disorders. Alcohol Res 2019; 40:arcr.v40.1.05. [PMID: 31886107 PMCID: PMC6927749 DOI: 10.35946/arcr.v40.1.05] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Alcohol use disorder (AUD) frequently co-occurs with other psychiatric disorders, including personality disorders, which are pervasive, persistent, and impairing. Personality disorders are associated with myriad serious outcomes, have a high degree of co-occurrence with substance use disorders, including AUD, and incur significant health care costs. This literature review focuses on co-occurring AUD and personality disorders characterized by impulsivity and affective dysregulation, specifically antisocial personality disorders and borderline personality disorders. Prevalence rates, potential explanations and causal models of co-occurrence, prognoses, and the status of existing treatment research are summarized. Several important future research considerations are relevant to these complex, co-occurring conditions. Research assessing mechanisms responsible for co-occurring AUD and antisocial personality disorder or borderline personality disorder will further delineate the underlying developmental processes and improve understanding of onset and courses. In addition, increased focus on the efficacy and effectiveness of treatments targeting underlying traits or common factors in these disorders will inform future prevention and treatment efforts, as interventions targeting these co-occurring conditions have relatively little empirical support.
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Affiliation(s)
- Ashley C Helle
- Ashley C. Helle, Ph.D., is a Postdoctoral fellow in the Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Ashley L Watts
- Ashley L. Watts, Ph.D., is a Postdoctoral fellow in the Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Timothy J Trull
- Timothy J. Trull, Ph.D., is a Curators' Distinguished Professor and a Byler Distinguished Professor in the Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
| | - Kenneth J Sher
- Kenneth J. Sher, Ph.D., is a Curators' Distinguished Professor in the Department of Psychological Sciences, University of Missouri-Columbia, Columbia, Missouri
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99985
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Abstract
OBJECTIVE The impact of severe mental illnesses (SMIs) is not limited to the person with the illness but extends to their family members and the community where the patient comes from. In this review, we systematically analyse the available evidence of impacts of SMI on family members, including parents, grandparents, siblings, spouses and children. DATA SOURCES PubMed, PsycINFO, Embase and Global Index Medicus were searched from the inception of each database up to 9 November 2019. We also did manual searches of grey literature. ELIGIBILITY CRITERIA We included studies that assessed the impacts of SMI on any family member. We excluded studies in admitted clinics and acute wards to rule out the acute effect of hospitalisation. DATA EXTRACTION Two reviewers extracted data independently using the Cochrane handbook guideline for systematic reviews and agreed on the final inclusion of identified studies. RISK OF BIAS The quality of the included studies was assessed using effective public health practice project quality assessment tool for quantitative studies.The review protocol was registered in the PROSPERO database. RESULTS We screened a total of 12 107 duplicate free articles and included 39 articles in the review. The multidimensional impact of SMI included physical health problems (sleeplessness, headache and extreme tiredness.), psychological difficulties (depression and other psychological problems) and socioeconomic drift (less likely to marry and higher divorce rate and greater food insecurity). Impacts on children included higher mortality, poor school performance and nutritional problems. However, the quality of one in five studies was considered weak. CONCLUSIONS Our review indicated a high level of multidimensional impact across multiple generations. The serious nature of the impact calls for interventions to address the multidimensional and multigenerational impact of SMI, particularly in low/middle-income countries. Given the relatively high number of studies rated methodologically weak, more robust studies are indicated. PROSPERO REGISTRATION NUMBER CRD42018064123.
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Affiliation(s)
- Wubalem Fekadu
- Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Psychiatry, Bahir Dar University, Bahir Dar, Ethiopia
| | - Awoke Mihiretu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tom K J Craig
- Department of Health Services and Population Research, King's College London, London, London, UK
| | - Abebaw Fekadu
- Department of Psychiatry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Center for Innovative Drug Development Therapeutic Studies for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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99986
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Espinosa A, Rudenstine S. The contribution of financial well-being, social support, and trait emotional intelligence on psychological distress. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:224-240. [PMID: 31889323 DOI: 10.1111/bjc.12242] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/28/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVES While financial deprivation, social isolation, and low emotional intelligence (EI) have been separately identified as important predictors of mental illness, no research has assessed the contribution of these factors together in understanding early markers of severe psychological distress. This information can have key implications for the development of comprehensive interventions and psychological treatment programmes. This study investigated the shared and unique contribution of financial well-being, social support, and trait EI on different types of psychological distress. DESIGN A total of 309 patients seeking psychological treatment at an outpatient mental health clinic in the United States provided consent to participate in this study. Patients responded to online questionnaires corresponding to symptomatology, demographic characteristics, and psychometric assessments. METHODS Hierarchical linear regressions identified the common and unique role of each set of variables in predicting nine different symptom clusters of psychological distress. RESULTS Financial well-being, social support, and trait EI were negatively related to the majority of symptom clusters, together explaining between 20% and 53% of the variance. Whereas financial well-being and social support uniquely captured a significant amount of the variance in all outcomes, trait EI, most notably the well-being and self-control dimensions, captured the most. CONCLUSIONS The results highlight the importance of all factors in understanding variations in mental health among help-seeking urban individuals. Furthermore, the results identify well-being and self-control as emotional facets to consider in therapeutic programmes in as much as to mitigate the risk of severe psychological distress within this population. PRACTITIONER POINTS Together, financial well-being, social support, and trait emotional intelligence (EI) can help prevent psychological distress in help-seeking urban individuals. Perceived social support and social contact differentially contributed to improved symptoms of psychological distress. Studies should examine the impact of targeting well-being and self-control in psychological treatment. The correlational nature of this study highlights the need to replicate findings via experimental or longitudinal designs.
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Affiliation(s)
- Adriana Espinosa
- Department of Psychology, City College of New York, CUNY, New York, USA
| | - Sasha Rudenstine
- Department of Psychology, City College of New York, CUNY, New York, USA.,The Graduate Center, CUNY, New York, USA
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99987
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Nagasu M, Kogi K, Yamamoto I. Association of socioeconomic and lifestyle-related risk factors with mental health conditions: a cross-sectional study. BMC Public Health 2019; 19:1759. [PMID: 31888559 PMCID: PMC6937976 DOI: 10.1186/s12889-019-8022-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/29/2019] [Indexed: 12/22/2022] Open
Abstract
Background There is rising public concern over the widening health inequalities in many countries. The aim of this study was to clarify the associations of socioeconomic status (SES)-related variables, such as levels of household disposable income and employment status, and lifestyle factors with mental health conditions among Japanese adults aged 40 to 69. Methods A cross-sectional study of 3085 participants (1527 males and 1558 females) was undertaken by using a self-administered questionnaire that included the Japanese version of the 12-item General Health Questionnaire (GHQ-12) and questions related to socioeconomic and lifestyle factors. Results The prevalence of poor mental health conditions, represented by a GHQ-12 score of 4 or more, was 33.4% among males and 40.4% among females. Males whose annual household disposable income was less than 2 million yen had significantly higher GHQ-12 scores than those with an annual household disposable income above 2 million yen. As per binary logistic regression analyses, short sleep duration and the absence of physical exercise were significantly related to poor mental health conditions among both males and females. Among females, a household disposable income of less than 2 million yen could be a risk factor for poor mental health conditions. Age and habitual drinking were inversely associated with poor mental health conditions. Conclusions Low levels of household disposable income and unhealthy lifestyle factors were significantly associated with mental health conditions. These results suggest the importance of improving unhealthy lifestyle behaviours and developing effective health promotion programmes. In addition, there is a need for social security systems for people from different socioeconomic backgrounds.
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Affiliation(s)
- Miwako Nagasu
- Faculty of Economics, Keio University, 〒108-8345 Tokyo-to, Minato-ku, Mita 2-15-45, Tokyo, Japan.
| | - Kazutaka Kogi
- The Ohara Memorial Institute for Science of Labour, Tokyo, Japan
| | - Isamu Yamamoto
- Faculty of Business and Commerce, Keio University, Tokyo, Japan
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99988
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Müller-Oehring EM, Le Berre AP, Serventi M, Kalon E, Haas AL, Padula CB, Schulte T. Brain activation to cannabis- and alcohol-related words in alcohol use disorder. Psychiatry Res Neuroimaging 2019; 294:111005. [PMID: 31715379 PMCID: PMC6886708 DOI: 10.1016/j.pscychresns.2019.111005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 12/18/2022]
Abstract
Cannabis abuse commonly co-occurs with alcohol use disorder (AUD). With increased acceptance and accessibility to cannabis in the US, it is imperative to understand the psychological and neural mechanisms of concurrent alcohol and cannabis use. We hypothesized that neural alcohol-cue conditioning may extent to other drug-related stimuli, such as cannabis, and underwrite the loss of control over reward-driven behavior. Task-activated fMRI examined the neural correlates of alcohol- and cannabis-related word cues in 21 abstinent AUD and 18 control subjects. Relative to controls, AUD showed behavioral attentional biases and frontal hypoactivation to both alcohol- and cannabis-related words. This cue-elicited prefrontal hypoactivation was related to higher lifetime alcohol consumption (pcorrected < 0.02) and modulated by past cannabis use histories (p ≦ 0.001). In particular, frontal hypoactivation to both alcohol and cannabis cues was pronounced in AUD without prior cannabis exposure. Overall, frontal control mechanisms in abstinent AUD were not sufficiently engaged to override automatic alcohol and cannabis-related intrusions, enhancing the risk for relapse and potentially for alcohol and cannabis co-use with the increased social acceptance and accessibility in the US.
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Affiliation(s)
- Eva M Müller-Oehring
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Anne-Pascale Le Berre
- Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Matthew Serventi
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States
| | - Ember Kalon
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Amie L Haas
- Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States
| | - Claudia B Padula
- Dept. of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, United States; VA Palo Alto Health Care System, Palo Alto, CA, United States
| | - Tilman Schulte
- Neuroscience Program, SRI International, Menlo Park, CA, United States; Dept. of Psychology, Palo Alto University, Palo Alto, CA, United States.
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99989
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Zengin Eroğlu M, Demirkol ME, Tamam L, Gelegen V. Kompulsif satın alma bozukluğu ve dikkat eksikliği hiperaktivite bozukluğu ilişkisi. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.559531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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99990
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Improving Cognition via Exercise (ICE): Study Protocol for a Multi-Site, Parallel-Group, Single-Blind, Randomized Clinical Trial Examining the Efficacy of Aerobic Exercise to Improve Neurocognition, Daily Functioning, and Biomarkers of Cognitive Change in Individuals with Schizophrenia. ACTA ACUST UNITED AC 2019; 4. [PMID: 31938726 DOI: 10.20900/jpbs.20190020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Individuals with schizophrenia (SZ) display cognitive deficits that have been identified as major determinants of poor functioning and disability, representing a serious public health concern and an important target for interventions. At present, available treatments offer only minimal to moderate benefits to ameliorate cognitive deficits. Thus, there remains an urgent need to identify novel interventions to improve cognition in people with SZ. Emerging evidence from animal and basic human research suggests aerobic exercise training (AE) has beneficial effects on cognition. Preliminary findings suggest that AE is efficacious in improving cognitive functioning in SZ, however the extant studies have been limited by small samples, a dearth of information on biologically-relevant covariates, and limited information on impact on daily functioning. Additionally, while AE-related cognitive benefits have been linked to Brain-Derived Neurotrophic Factor (BDNF) upregulation, this putative mechanism needs confirmation. The present report describes a study protocol designed to address these limitations-we review and summarize the current literature on treatment of cognitive deficits in SZ, state the rationale for employing AE to target these deficits, and describe the current protocol-a multi-site, single-blind, randomized clinical trial aiming to recruit 200 community-dwelling individuals with SZ. Participants are randomized to one of two 12-week interventions: AE using active-play video games (i.e., Xbox Kinect) and traditional cardiovascular exercise equipment or a stretching-and-toning (ST) control intervention. Participants undergo assessments of aerobic fitness, cognition, and daily functioning, as well as BDNF and other biomarkers of cognitive change, at baseline and after 6-and 12-weeks.
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99991
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Characterizing Body Image Distortion and Bodily Self-Plasticity in Anorexia Nervosa via Visuo-Tactile Stimulation in Virtual Reality. J Clin Med 2019; 9:jcm9010098. [PMID: 31906009 PMCID: PMC7019698 DOI: 10.3390/jcm9010098] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
We combined virtual reality and multisensory bodily illusion with the aim to characterize and reduce the perceptual (body overestimation) and the cognitive-emotional (body dissatisfaction) components of body image distortion (BID) in anorexia nervosa (AN). For each participant (20 anorexics, 20 healthy controls) we built personalized avatars that reproduced their own body size, shape, and verisimilar increases and losses of their original weight. Body overestimation and dissatisfaction were measured by asking participants to choose the avatar that best resembled their real and ideal body. Results show higher body dissatisfaction in AN, caused by the desire of a thinner body, and no body-size overestimation. Interpersonal multisensory stimulation (IMS) was then applied on the avatar reproducing participant’s perceived body, and on the two avatars which reproduced increases and losses of 15% of it, all presented with a first-person perspective (1PP). Embodiment was stronger after synchronous IMS in both groups, but did not reduce BID in participants with AN. Interestingly, anorexics reported more negative emotions after embodying the fattest avatar, which scaled with symptoms severity. Overall, our findings suggest that the cognitive-emotional, more than the perceptual component of BID is severely altered in AN and that perspective (1PP vs. 3PP) from which a body is evaluated may play a crucial role. Future research and clinical trials might take advantage of virtual reality to reduce the emotional distress related to body dissatisfaction.
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99992
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Hong W, Zhao Z, Shen Z, Sun B, Li S, Mekbib DB, Xu Y, Huang M, Xu D. Uncoupled relationship in the brain between regional homogeneity and attention function in first-episode, drug-naïve schizophrenia. Psychiatry Res Neuroimaging 2019; 294:110990. [PMID: 31706152 DOI: 10.1016/j.pscychresns.2019.110990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/15/2019] [Accepted: 10/22/2019] [Indexed: 01/04/2023]
Abstract
The relationship between the cognitive impairment and the structural and functional abnormalities in the brains of patients with schizophrenia (SZ) is not yet clear. This study aims to investigate the relationship, thereby exploring the neuromechanism underlying SZ. We collected multimodal MRI data from 68 first-episode, drug-naïve patients with SZ, and 64 well-matched healthy controls, and used regional homogeneity (ReHo) and gray matter volume (GMV) to assess the functional and structural integrity of the brains, respectively. We then evaluated in the entire brain the correlations between ReHo/GMV and the participants' neuropsychological assessment scores for each group using a partial correlation analysis controlling for age and sex. We found significant uncoupling between attention performance and mean ReHo in the left middle frontal gyrus, right superior/inferior parietal lobe (IPL), right angular gyrus (AG) and right middle/inferior temporal lobe (ITG) in SZ compared with healthy controls. Moreover, we found that the SZ group showed decreased GMV in the right IPL and AG, and a significant coupling between ReHo and GMV in the right ITG. Our findings suggest that the attention dysfunction found in SZ may be associated with the structural and functional abnormalities as well as the structure-function interrelation in several SZ-related brain regions.
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Affiliation(s)
- Wenjun Hong
- Department of Rehabilitation Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Zhiyong Zhao
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai 200062, China; Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310027, China; Columbia University & New York State Psychiatric Institute, New York 10032, USA
| | - Zhe Shen
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Bin Sun
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Shangda Li
- College of Medicine, Zhejiang University, Hangzhou 310000, China
| | - Destaw B Mekbib
- Zhejiang University Interdisciplinary Institute of Neuroscience and Technology, Hangzhou 310003, China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou 310003, China
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, The Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou 310003, China.
| | - Dongrong Xu
- Columbia University & New York State Psychiatric Institute, New York 10032, USA.
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99993
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Abstract
The conventional view on interventions as mechanistically causing interchangeable clients to get better has come under attack. Group-based and linear approaches fall short in adequately describing the idiosyncratic and dynamic nature of treatment processes. Non-linear dynamic system theories in contrast hold great potential to better conceptualize and understand the generalities and idiosyncrasies of psychotherapeutic change processes. The aim of this study was to examine whether we can detect markers of complex dynamical systems behavior in two single-case therapies. All sessions from both therapies were coded with sequential plan analysis using a 10s sampling frequency. The coding system incorporates verbal and non-verbal behaviors and allows for the representation of contextualized interactive behaviors. The high sampling frequency results in long time series, which allowed us to apply non-linear analysis techniques. We found strong support for complex behavior and the existence of a butterfly effect, i.e., a relatively short prediction horizon in which reliable predictions about the system's future behavior could be made. Further, critical fluctuations as a marker for phase-transitions were detected that were accompanied with different interactional patterns in both therapies. Finally, there was strong support for self-organized pattern formation, with a few interactional patterns dominating the interaction. Considering that we are intervening on complex dynamical systems means that we have to (1) acknowledge the principal individuality of change processes, (2) accept the fundamental limitations of the mechanistic input-output model of treatment effects and (3) appreciate the impossibility of long-term predictions of treatment responses.
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Affiliation(s)
- Guido Strunk
- Complexity-Research, Schönbrunner Str. 32 / 20, A-1050 Vienna, Austria
- Department of Entrepreneurship and Economic Education, Faculty of Business and Economics, Technical University Dortmund, Germany
- Department of Integrated Safety and Security, FH Campus Vienna, Austria
| | - Anna Lichtwarck-Aschoff
- Behavioural Science Institute, Radboud University, Montessorilaan 3, 6525 HR Nijmegen, The Netherlands
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99994
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Vaseai F, Namdar Areshtanab H, Ebrahimi H, Arshadi Bostanabad M. İranlı kadınlara yönelik aile içi şiddetin yaygınlığı ve öngörülebilirliği. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.506682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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99995
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Subjective Quality of Life and Its Associations among First Episode Psychosis Patients in Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010260. [PMID: 31905928 PMCID: PMC6981770 DOI: 10.3390/ijerph17010260] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/24/2019] [Accepted: 12/27/2019] [Indexed: 11/17/2022]
Abstract
Background—Mental disorders have been found to affect quality of life (QOL) in patients. The current study aimed to determine QOL among first episode psychosis (FEP) patients and explore its associations with sociodemographic as well as clinical factors. Methods—Data for this study were collected as a part of an Early Psychosis Intervention Program (EPIP)-Smoking and Alcohol use survey. At baseline, 280 outpatients aged 15–40 years old diagnosed with FEP, with no prior or minimal treatment, no history of medical or neurological disorder, and no history of substance abuse, were recruited. Sociodemographic details, diagnosis, length of duration of untreated psychosis (DUP), and World Health Organization Quality of Life assessment—abbreviated version (WHOQOL-BREF) scores were obtained. Results—After adjusting for all covariates, older age (p = 0.036), females, and participants diagnosed with brief psychotic disorder (p = 0.04) were associated positively, whereas separated/divorced participants, those with lower education, unemployed (p = 0.01), and longer DUP were seen to be negatively associated with different domains of QOL. Conclusion—Higher WHOQOL-BREF scores denote better QOL. Overall, female participants as compared to male participants and those diagnosed with brief psychotic disorder in this sample reported better QOL.
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99996
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Abstract
Common conclusions from traditional psychotherapy research are that we still do not know how or why even our most well-studied interventions produce change, and that there is little evidence that any form of psychotherapy is generally more effective than any other. This has led some researchers to the so-called Dodo Bird Verdict, that all forms of psychotherapy are equally effective, and to the conclusion that what is at work are "common factors" that have little to do with treatment method. An alternative explanation, however, is that the traditional research paradigm is insufficiently sensitive to provide us with the required kind of knowledge. First, the outcome in typical RCTs is averaged across individuals, and at best complemented by a search for predictors in the form of stable individual differences. This means that this research stays at a group level of analysis and is insensitive to variation and change in individual patients. Second, the independent variable in RCTs does not consist in any well-controlled psychological intervention, but in large-scale treatment packages that contain a large number of interventions over a considerable time period. In other words, this research is insensitive to the effects of specific treatment interventions. Third, traditional psychotherapy research is insensitive to the therapist and patient as individual persons, and their specific interaction. It is argued that a person-oriented approach to psychotherapy, which is idiographic, holistic and interactional, may be able to overcome some of these problems by being more sensitive to (1) the treatment course of individual patients, and patterns during that course; (2) the effects of the specific interventions that are implemented over time, and (3) the personal characteristics of patient and therapist, and nuances of their interaction.
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Affiliation(s)
- Lars-Gunnar Lundh
- Department of Psychology, Lund University, Box 213, 221 00 Lund, Sweden
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99997
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Yoshida Y, Satoh A, Yamada T, Aisu N, Matsuoka T, Koganemaru T, Kajitani R, Munechika T, Matsumoto Y, Nagano H, Komono A, Sakamoto R, Morimoto M, Arima H, Hasegawa S. The Relationship Between Evaluation Methods for Chemotherapy-Induced Peripheral Neuropathy. Sci Rep 2019; 9:20361. [PMID: 31889149 PMCID: PMC6937307 DOI: 10.1038/s41598-019-56969-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/19/2019] [Indexed: 11/12/2022] Open
Abstract
Numbness and pain are currently evaluated using subjective methods such as the visual analogue scale (VAS). PainVision (PV) is an analytical instrument that was designed to quantitatively assess sense perception and nociception in patients. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most important adverse events that renders prolonged chemotherapy difficult. To assess the features of CIPN, we aimed to compare PV methods with existing methods. A total of 73 patients received oxaliplatin for metastatic colorectal cancer. Registered patients included 37 men and 36 women in the range of 37 to 89 years (median 70). CIPN was evaluated a total of 483 times (median per patient six times). Our study examined the correlation between evaluation methods of CIPN using VAS and PV, respectively. The average VAS (hand), VAS (foot) and PV scores of CIPN were 18.4 (range: 0–100), 23.8 (range: 0–100), and 24.7 (range: 0–496), respectively. VAS (hand), VAS (foot), and FACT/GOG-NTX (NTX2, NTX4 and NTX8) were significantly correlated with PV. PV showed no correlation with a Disk-Criminator or the monofilament test used as a quantitative evaluation. The evaluation of CIPN is complex, and further improvement is required for evaluation with PV.
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Affiliation(s)
- Yoichiro Yoshida
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan.
| | - Atsushi Satoh
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Teppei Yamada
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Naoya Aisu
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Taisuke Matsuoka
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Tomoko Koganemaru
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Ryuji Kajitani
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Taro Munechika
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yoshiko Matsumoto
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Hideki Nagano
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Akira Komono
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Ryohei Sakamoto
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Mitsuaki Morimoto
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Suguru Hasegawa
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, Fukuoka, Japan
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99998
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Bright KS, Mughal MK, Wajid A, Lane-Smith M, Murray L, Roy N, Van Zanten SV, Mcneil DA, Stuart S, Kingston D. Internet-based interpersonal psychotherapy for stress, anxiety, and depression in prenatal women: study protocol for a pilot randomized controlled trial. Trials 2019; 20:814. [PMID: 31888712 PMCID: PMC6938015 DOI: 10.1186/s13063-019-3897-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Psychological distress, defined as depression, anxiety and perceived stress, during pregnancy is common, with 15-25% of women experiencing clinically significant levels of such distress. Despite the far-reaching impact of prenatal psychological distress on mothers and their children, and that women are receptive to screening, few providers routinely screen for prenatal psychological distress and less than one in five women will receive the mental health care that they require. There is a lack of certainty regarding the most effective treatments for prenatal psychological distress. No online interpersonal psychotherapy (IPT) trials have been conducted that focus on improving psychological distress in prenatal women. The purpose of this pilot randomized controlled trial is to evaluate the perspectives of pregnant women on the feasibility and acceptability of online IPT (e-IPT) delivered during pregnancy. METHODS A pilot randomized controlled trial design with repeated measures will evaluate the feasibility and acceptability of e-IPT for pregnant women compared to routine prenatal care. Qualitative interviews with 15-30 individuals in the intervention group will provide further data on the feasibility and acceptability of the intervention. Assessment of feasibility will include the ease of accessing and completing the intervention. Women will also be asked about what barriers there were to starting and completing the e-IPT. Assessment of acceptability will inquire about the perception of women regarding the intervention and its various features. A sample size of 160 consenting pregnant women aged 18 years and older will be enrolled and randomized into the experimental (e-IPT) or control (routine care) condition. The secondary outcome measures include: depression, anxiety and stress symptoms; self-efficacy; self-mastery; self-esteem; relationship quality (spouse, immediate family members); coping; and resilience. All participants will complete the aforementioned measures at baseline during pregnancy (T1), 3 months postrandomization (T2), at 8 months of pregnancy (T3), and 3 months postpartum (T4). DISCUSSION The results of this pilot randomized controlled trial will provide data on the feasibility and acceptability of the intervention and identify necessary adaptations. This study will allow for optimization of full trial processes and inform the evaluation strategy, including sample size calculations for the full randomized controlled trial. TRIAL REGISTRATION ClinicalTrials.gov, NCT01901796. Registered on 18 December 2014.
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Affiliation(s)
- Katherine S. Bright
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | - Muhammad Kashif Mughal
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | - Abdul Wajid
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | - Marie Lane-Smith
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | - Lindsay Murray
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | - Nicola Roy
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
| | | | - Deborah A. Mcneil
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
- Alberta Health Services, Scientific Director, Maternal Newborn Child and Youth Strategic Clinical Network, Southport Atrium #2237, 10101 Southport Road, S.W., Calgary, AB T2W 3N2 Canada
| | - Scott Stuart
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
- Interpersonal Psychotherapy (IPT) Institute, PO Box 5925, Coralville, Iowa 52241 USA
| | - Dawn Kingston
- Faculty of Nursing, University of Calgary, 2500 University Dr. N.W, Calgary, AB T2N 1N4 Canada
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99999
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Polis AJ, Fitzgerald PJ, Hale PJ, Watson BO. Rodent ketamine depression-related research: Finding patterns in a literature of variability. Behav Brain Res 2019; 376:112153. [PMID: 31419519 PMCID: PMC6783386 DOI: 10.1016/j.bbr.2019.112153] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/11/2019] [Accepted: 08/13/2019] [Indexed: 12/23/2022]
Abstract
Discovering that the anesthetic drug ketamine has rapidly acting antidepressant effects in many individuals with major depression is one of the most important findings in clinical psychopharmacology in recent decades. The initial report of these effects in human subjects was based on a foundation of rodent preclinical studies carried out in the 1990s, and subsequent investigation has included both further studies in individuals with depression, as well as reverse translational experiments in animal models, especially rodents. While there is general agreement in the rodent literature that ketamine has rapidly-acting, and generally sustained, antidepressant-like properties, there are also points of contention across studies, including the precise mechanism of action of this drug. In this review, we briefly summarize prominent yet variable findings regarding the mechanism of action. We also discuss a combination of similarities and variances in the rodent literature in the antidepressant-like effects of ketamine as a function of dose, species and strain, test, stressor, and presumably sex of the experimenter. We then present previously unpublished mouse strain comparison data suggesting that subanesthetic ketamine does not have robust antidepressant-like properties in unstressed animals, and may actually promote depression-like behavior, in contrast to widely reported findings. We conclude that the data best support the notion of ketamine action principally via NMDA receptor antagonism, transiently boosting glutamatergic (and possibly other) signaling in diverse brain circuits. We also suggest that future studies should address in greater detail the extent to which antidepressant-like properties of this drug are stress-sensitive, in an effort to better model major depression present in humans.
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Affiliation(s)
- Andrew J Polis
- University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109-5720, United States of America
| | - Paul J Fitzgerald
- University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109-5720, United States of America
| | - Pho J Hale
- University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109-5720, United States of America
| | - Brendon O Watson
- University of Michigan, Department of Psychiatry, Ann Arbor, MI 48109-5720, United States of America.
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100000
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Lever-van Milligen BA, Verhoeven JE, Schmaal L, van Velzen LS, Révész D, Black CN, Han LKM, Horsfall M, Batelaan NM, van Balkom AJLM, van Schaik DJF, van Oppen P, Penninx BWJH. The impact of depression and anxiety treatment on biological aging and metabolic stress: study protocol of the MOod treatment with antidepressants or running (MOTAR) study. BMC Psychiatry 2019; 19:425. [PMID: 31888565 PMCID: PMC6937704 DOI: 10.1186/s12888-019-2404-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/11/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Depressive and anxiety disorders have shown to be associated to premature or advanced biological aging and consequently to adversely impact somatic health. Treatments with antidepressant medication or running therapy are both found to be effective for many but not all patients with mood and anxiety disorders. These interventions may, however, work through different pathophysiological mechanisms and could differ in their impact on biological aging and somatic health. This study protocol describes the design of an unique intervention study that examines whether both treatments are similarly effective in reducing or reversing biological aging (primary outcome), psychiatric status, metabolic stress and neurobiological indicators (secondary outcomes). METHODS The MOod Treatment with Antidepressants or Running (MOTAR) study will recruit a total of 160 patients with a current major depressive and/or anxiety disorder in a mental health care setting. Patients will receive a 16-week treatment with either antidepressant medication or running therapy (3 times/week). Patients will undergo the treatment of their preference and a subsample will be randomized (1:1) to overcome preference bias. An additional no-disease-no-treatment group of 60 healthy controls without lifetime psychopathology, will be included as comparison group for primary and secondary outcomes at baseline. Assessments are done at week 0 for patients and controls, and at week 16 and week 52 for patients only, including written questionnaires, a psychiatric and medical examination, blood, urine and saliva collection and a cycle ergometer test, to gather information about biological aging (telomere length and telomerase activity), mental health (depression and anxiety disorder characteristics), general fitness, metabolic stress-related biomarkers (inflammation, metabolic syndrome, cortisol) and genetic determinants. In addition, neurobiological alterations in brain processes will be assessed using structural and functional Magnetic Resonance Imaging (MRI) in a subsample of at least 25 patients per treatment arm and in all controls. DISCUSSION This intervention study aims to provide a better understanding of the impact of antidepressant medication and running therapy on biological aging, metabolic stress and neurobiological indicators in patients with depressive and anxiety disorders in order to guide a more personalized medicine treatment. TRIAL REGISTRATION Trialregister.nl Number of identification: NTR3460, May 2012.
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Affiliation(s)
- Bianca A. Lever-van Milligen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Josine E. Verhoeven
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Lianne Schmaal
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura S. van Velzen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Dóra Révész
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Catherine N. Black
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Laura K. M. Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Melany Horsfall
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton J. L. M. van Balkom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Digna J. F. van Schaik
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W. J. H. Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands ,0000 0004 0546 0540grid.420193.dGGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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