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Hoepner CT, McIntyre RS, Papakostas GI. Impact of Supplementation and Nutritional Interventions on Pathogenic Processes of Mood Disorders: A Review of the Evidence. Nutrients 2021; 13:nu13030767. [PMID: 33652997 PMCID: PMC7996954 DOI: 10.3390/nu13030767] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/10/2021] [Accepted: 02/20/2021] [Indexed: 02/06/2023] Open
Abstract
This narrative review was conducted using searches of the PubMed/Medline and Google Scholar databases from inception to November 2019. Clinical trials and relevant articles were identified by cross-referencing major depressive disorder (and/or variants) with the following terms: folate, homocysteine, S-adenosylmethionine (SAMe), L-acetylcarnitine, alpha-lipoic acid, N-acetylcysteine, L-tryptophan, zinc, magnesium, vitamin D, omega-3 fatty acids, coenzyme Q10, and inositol. Manual reviews of references were also performed using article reference lists. Abnormal levels of folate, homocysteine, and SAMe have been shown to be associated with a higher risk of depression. Numerous studies have demonstrated antidepressant activity with L-methylfolate and SAMe supplementation in individuals with depression. Additionally, the amino acids L-acetylcarnitine, alpha-lipoic acid, N-acetylcysteine, and L-tryptophan have been implicated in the development of depression and shown to exert antidepressant effects. Other agents with evidence for improving depressive symptoms include zinc, magnesium, omega-3 fatty acids, and coenzyme Q10. Potential biases and differences in study designs within and amongst the studies and reviews selected may confound results. Augmentation of antidepressant medications with various supplements targeting nutritional and physiological factors can potentiate antidepressant effects. Medical foods, particularly L-methylfolate, and other supplements may play a role in managing depression in patients with inadequate response to antidepressant therapies.
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Affiliation(s)
- Cara T. Hoepner
- Bay Area Psychiatric, A Nursing Corporation, San Francisco, CA 94111, USA
- Correspondence:
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, ON M5T 2S8, Canada;
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252
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Suneson K, Lindahl J, Chamli Hårsmar S, Söderberg G, Lindqvist D. Inflammatory Depression-Mechanisms and Non-Pharmacological Interventions. Int J Mol Sci 2021; 22:1640. [PMID: 33561973 PMCID: PMC7915869 DOI: 10.3390/ijms22041640] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 02/08/2023] Open
Abstract
Treatment of depression is hampered by the failure to identify distinct symptom profiles with distinct pathophysiologies that differentially respond to distinct treatments. We posit that inflammatory depression is a meaningful depression subtype associated with specific symptoms and biological abnormalities. We review several upstream, potentially causative, mechanisms driving low-grade inflammation in this subtype of depression. We also discuss downstream mechanisms mediating the link between inflammation and symptoms of depression, including alterations in dopaminergic neurotransmission and tryptophan metabolism. Finally, we review evidence for several non-pharmacological interventions for inflammatory depression, including probiotics, omega-3 fatty acids, and physical exercise interventions. While some evidence suggests that these interventions may be efficacious in inflammatory depression, future clinical trials should consider enriching patient populations for inflammatory markers, or stratify patients by inflammatory status, to confirm or refute this hypothesis.
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Affiliation(s)
- Klara Suneson
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatric Clinic Helsingborg, Region Skåne, 252 23 Helsingborg, Sweden
| | - Jesper Lindahl
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden;
| | - Simon Chamli Hårsmar
- Office for Psychiatry and Habilitation, Psychiatric Clinic Lund, Region Skåne, 221 85 Lund, Sweden;
| | - Gustav Söderberg
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
| | - Daniel Lindqvist
- Department of Clinical Sciences Lund, Psychiatry, Faculty of Medicine, Lund University, 221 85 Lund, Sweden; (J.L.); (G.S.); (D.L.)
- Office for Psychiatry and Habilitation, Psychiatry Research Skåne, Region Skåne, 221 85 Lund, Sweden
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253
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Wardecker BM, Graham-Engeland JE, Almeida DM. Perceived discrimination predicts elevated biological markers of inflammation among sexual minority adults. J Behav Med 2021; 44:53-65. [PMID: 32930919 PMCID: PMC7855007 DOI: 10.1007/s10865-020-00180-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 09/05/2020] [Indexed: 01/24/2023]
Abstract
Sexual minority (SM) adults (those who are lesbian, gay, or bisexual) consistently report more health problems compared to heterosexuals, and they tend to experience excess social stress. Although numerous studies have established links between social stress and clinical outcomes in SM adults, few studies have examined biological factors that may help explain how social stress leads to health disparities among SM adults. We used data from the Midlife in the United States Study (MIDUS) to examine whether two inflammatory markers that have been commonly associated with social stress-C-reactive protein (CRP) and interleukin-6 (IL-6)-differed by sexual orientation and whether any differences were explained by perceptions of discrimination. Participants self-identified as heterosexual (n = 1956) or lesbian, gay, or bisexual (n = 81). After controlling for age, gender, race, and education, SM individuals had higher CRP and IL-6 than heterosexuals on average and these differences were partially explained by perceptions of discrimination. Implications for inflammatory pathways as mechanisms related to SM health disparities and discrimination are discussed.
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Affiliation(s)
- Britney M Wardecker
- College of Nursing, The Pennsylvania State University, University Park, PA, USA.
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA.
| | - Jennifer E Graham-Engeland
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - David M Almeida
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
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254
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Bujtor M, Turner AI, Torres SJ, Esteban-Gonzalo L, Pariante CM, Borsini A. Associations of Dietary Intake on Biological Markers of Inflammation in Children and Adolescents: A Systematic Review. Nutrients 2021; 13:356. [PMID: 33503979 PMCID: PMC7911843 DOI: 10.3390/nu13020356] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND In children and adolescents, chronic low-grade inflammation has been implicated in the pathogenesis of co- and multi-morbid conditions to mental health disorders. Diet quality is a potential mechanism of action that can exacerbate or ameliorate low-grade inflammation; however, the exact way dietary intake can regulate the immune response in children and adolescents is still to be fully understood. METHODS Studies that measured dietary intake (patterns of diet, indices, food groups, nutrients) and any inflammatory biomarkers in children and adolescents aged 2 to19 years and published until November 2020 were included in this systematic review, and were selected in line with PRISMA guidelines through the following databases: Academic Search Complete, CINAHL, Global Health, Medline COMPLETE and Web of Science-Core Collection. A total of 53 articles were identified. RESULTS Results show that adequate adherence to healthful dietary patterns such as the Mediterranean diet, or food groups such as vegetables and fruit, or macro/micro nutrients such as fibre or vitamin C and E, are associated with decreased levels of pro-inflammatory biomarkers, mainly c-reactive protein (CRP), interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), whereas adherence to a Western dietary pattern, as well as intake of food groups such as added sugars, macro-nutrients such as saturated fatty acids or ultra-processed foods, is associated with higher levels of the same pro-inflammatory biomarkers. CONCLUSIONS This is the first systematic review examining dietary intake and biological markers of inflammation in both children and adolescents. A good quality diet, high in vegetable and fruit intake, wholegrains, fibre and healthy fats ameliorates low-grade inflammation, and therefore represents a promising therapeutic approach, as well as an important element for disease prevention in both children and adolescents.
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Affiliation(s)
- Melissa Bujtor
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Anne I. Turner
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Susan J. Torres
- Institute for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC 3125, Australia; (M.B.); (A.I.T.); (S.J.T.)
| | - Laura Esteban-Gonzalo
- Nursing Department, Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain;
| | - Carmine M. Pariante
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London SE5 9RT, UK;
| | - Alessandra Borsini
- Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London SE5 9RT, UK;
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255
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Ex vivo glucocorticoid receptor-mediated IL-10 response predicts the course of depression severity. J Neural Transm (Vienna) 2021; 128:95-104. [PMID: 33447872 PMCID: PMC7815576 DOI: 10.1007/s00702-020-02288-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/10/2020] [Indexed: 12/28/2022]
Abstract
Directly measuring hypothalamic pituitary adrenal (HPA) axis function, an important player in affective disorders, is intensive and invasive. A crucial component of this system, the activity of the glucocorticoid receptor (GR), can be assessed ex vivo instead. Here, we investigated GR sensitivity in patients with major depressive disorder (MDD) to determine its predictive potential. Psychometric data and blood samples were collected from patients experiencing a major depressive episode (MDE, n = 87), healthy control subjects (n = 49), and patients with remitted MDD (n = 31) at baseline and (for patients) after median 20 days of follow-up after treatment as usual. Blood cells were stimulated ex vivo with lipopolysaccharide and the effect was suppressed by increasing dexamethasone (DEX) concentrations. The resultant cytokine secretion profile (for IL-6, IL-10, and TNF-α) was considered indicative of GR activity. Higher baseline scores of the Montgomery–Åsberg Depression Rating Scale (MADRS) were associated with a stronger decrease of logIC IL-6 (indicating an increase of GR sensitivity). Higher baseline logEC IL-10 (indicating a lower GR sensitivity) and a stronger reduction of logEC IL-10 (indicating a stronger increase in GR sensitivity) were associated with a stronger decrease in the MADRS score. Patients with remitted MDD showed higher logIC TNF-α values (indicating lower GR sensitivity) in comparison to patients with a current MDD at baseline and follow-up. Initially low GR sensitivity measured ex vivo in peripheral blood cells that increases over the course of treatment could serve as a predictive marker for stronger improvement in depression severity.
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256
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Banin RM, Machado MMF, de Andrade IS, Carvalho LOT, Hirata BKS, de Andrade HM, Júlio VDS, Ribeiro JDSFB, Cerutti SM, Oyama LM, Ribeiro EB, Telles MM. Ginkgo biloba extract (GbE) attenuates obesity and anxious/depressive-like behaviours induced by ovariectomy. Sci Rep 2021; 11:44. [PMID: 33420094 PMCID: PMC7794418 DOI: 10.1038/s41598-020-78528-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022] Open
Abstract
While several pieces of evidence link obesity and mood disorders in menopause, the mechanisms involved are not yet fully understood. We have previously demonstrated that Ginkgo biloba extract (GbE) both attenuated diet-induced obesity of male rats and restored serotonin-induced hypophagia in ovariectomized female rats. The present study aimed at exploring whether GbE treatment ameliorates ovariectomy-related obesity and anxious/depressive-like behaviours. Wistar female rats were either ovariectomized (OVX) or sham-operated (Sham). After 2 months, either 500 mg/kg of GbE or vehicle were administered daily by gavage for 14 days. Anxious/depressive-like behaviours were assessed by the Elevated Plus Maze and the Forced Swim Tests, respectively. Ovariectomy caused high visceral adiposity, hyperleptinemia, and hypercholesterolemia, and increased the anxiety index (p = 0.048 vs. Sham + GbE) while it decreased the latency to immobility (p = 0.004 vs. Sham). GbE treatment in OVX rats improved body composition, adiponectin levels and blood lipid profile. It also reduced the anxiety index (p = 0.004) and increased the latency to immobility (p = 0.003) of OVX rats. Linear regression analysis demonstrated that leptin (p = 0.047) and total cholesterol levels (p = 0.022) were associated with anxious-like behaviours while body adiposity (p = 0.00005) was strongly associated with depressive-like behaviours. The results showed that GbE therapy was effective in attenuating the deleterious effects of ovariectomy on body composition, lipid profile, and anxious/depressive-like behaviours. Further studies are warranted to better understand the therapeutic potential of GbE in menopause.
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Affiliation(s)
- Renata Mancini Banin
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil
| | - Meira Maria Forcelini Machado
- Setor de Fisiologia e Farmacologia, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Iracema Senna de Andrade
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil
| | - Lorenza Oliveira Testa Carvalho
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil
| | - Bruna Kelly Sousa Hirata
- Setor de Fisiologia e Farmacologia, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Heider Mendonça de Andrade
- Setor de Fisiologia e Farmacologia, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Viviane da Silva Júlio
- Setor de Fisiologia e Farmacologia, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | | | - Suzete Maria Cerutti
- Setor de Fisiologia e Farmacologia, Departamento de Ciências Biológicas, Universidade Federal de São Paulo, Diadema, SP, Brasil
| | - Lila Missae Oyama
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil
| | - Eliane Beraldi Ribeiro
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil.
| | - Mônica Marques Telles
- Disciplina de Fisiologia da Nutrição, Departamento de Fisiologia, Universidade Federal de São Paulo, Rua Botucatu, 862, Edifício de Ciências Biomédicas, 2º andar, Vila Clementino, São Paulo, SP, CEP: 04023-062, Brasil
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257
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Kalungi A, Kinyanda E, Womersley JS, Joloba ML, Ssembajjwe W, Nsubuga RN, Kaleebu P, Levin J, Kidd M, Seedat S, Hemmings SMJ. TERT rs2736100 and TERC rs16847897 genotypes moderate the association between internalizing mental disorders and accelerated telomere length attrition among HIV+ children and adolescents in Uganda. BMC Med Genomics 2021; 14:15. [PMID: 33407441 PMCID: PMC7789327 DOI: 10.1186/s12920-020-00857-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 12/14/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Internalizing mental disorders (IMDs) (depression, anxiety and post-traumatic stress disorder) have been associated with accelerated telomere length (TL) attrition; however, this association has not been investigated in the context of genetic variation that has been found to influence TL. We have previously reported an association between IMDs and accelerated TL attrition among Ugandan HIV+ children and adolescents. This study investigated the moderating effects of selected single nucleotide polymorphisms in the telomerase reverse transcriptase gene (TERT) (rs2736100, rs7726159, rs10069690 and rs2853669) and the telomerase RNA component gene (TERC) (rs12696304, rs16847897 and rs10936599) on the association between IMDs and TL, among Ugandan HIV+ children (aged 5-11 years) and adolescents (aged 12-17 years). RESULTS We found no significant interaction between IMDs as a group and any of the selected SNPs on TL at baseline. We observed significant interactions of IMDs with TERT rs2736100 (p = 0.007) and TERC rs16847897 (p = 0.012), respectively, on TL at 12 months. CONCLUSIONS TERT rs2736100 and TERC rs16847897 moderate the association between IMDs and TL among Ugandan HIV+ children and adolescents at 12 months. Understanding the nature of this association may shed light on the pathophysiological mechanisms underlying advanced cellular aging in IMDs.
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Affiliation(s)
- Allan Kalungi
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda.
- Department of Medical Microbiology, Makerere University, Kampala, Uganda.
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Eugene Kinyanda
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jacqueline S Womersley
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Moses L Joloba
- Department of Medical Microbiology, Makerere University, Kampala, Uganda
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Wilber Ssembajjwe
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rebecca N Nsubuga
- Statistics and Data Science Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | - Jonathan Levin
- School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Martin Kidd
- Centre for Statistical Consultation, Department of Statistics and Actuarial Sciences, University of Stellenbosch, Cape Town, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sian M J Hemmings
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council/Stellenbosch University Genomics of Brain Disorders Research Unit, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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258
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Tait JL, Bulmer S, Drain JR, Main LC. Associations between inflammatory markers and well-being during 12 weeks of basic military training. Eur J Appl Physiol 2021; 121:849-860. [PMID: 33389139 DOI: 10.1007/s00421-020-04554-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 11/07/2020] [Indexed: 01/05/2023]
Abstract
PURPOSE Stress, anxiety and physical exertion are all closely linked to well-being, and each can alter immune function. Diminished well-being has been observed during military training, however there is mixed evidence regarding whether concomitant changes in inflammatory markers occur, with these phenomena indicating potential maladaptive responses to imposed training loads. The aims of this project were (1) assess changes in inflammation and subjective well-being across a 12-week basic military training (BMT) program, and (2) evaluate relationships between circulating inflammatory markers and well-being. METHODS A total of 37 men and women undergoing 12 weeks of BMT in Australia were recruited. Well-being was assessed via questionnaire (DASS-21), and plasma samples were collected for the analysis of inflammatory cytokines [interleukin (IL)-4, IL-6, IL-1β, IL-8, IL-10, and tumor necrosis factor (TNF)-α] at weeks 1, 4, 8 and 12. Data were analysed using general linear mixed models. RESULTS Depression, anxiety and stress subscale scores all significantly improved (all P ≤ 0.001), and TNF-α decreased (P = 0.031) across time. Compared to baseline (week 1), significant decreases in associations between depression and IL-10, anxiety and IL-10, and stress and IL-10, IL-4 IL-6 and TNF-α (all P < 0.05), were detected across BMT. CONCLUSION The BMT program appears to support improved well-being over the 12 weeks, with minimal perturbation to inflammatory markers. Biomarkers and well-being displayed consistent associations and may have utility as psychophysiological indicators of health status in military research, however for now, subjective measures may represent more cost-effective proxies for ongoing monitoring of military personnel.
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Affiliation(s)
- Jamie L Tait
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Sean Bulmer
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Jace R Drain
- Defence Science and Technology Group, Fishermans Bend, Australia
| | - Luana C Main
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
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259
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Yoshimura R, Okamoto N, Konishi Y, Ikenouchi A. Associations between plasma levels of C-reactive protein and catecholamine metabolites in patients with major depression. Ther Adv Psychopharmacol 2021; 11:20451253211015837. [PMID: 34035894 PMCID: PMC8132088 DOI: 10.1177/20451253211015837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka 8078555, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Yuki Konishi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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260
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McFarland DC, Saracino RM, Miller AH, Breitbart W, Rosenfeld B, Nelson C. Prognostic implications of depression and inflammation in patients with metastatic lung cancer. Future Oncol 2021; 17:183-196. [PMID: 33305608 PMCID: PMC7857340 DOI: 10.2217/fon-2020-0632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/29/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression and inflammation. Kaplan-Meier plots and Cox proportional hazard models provided survival estimations. Results: Estimated survival was 515 days for the cohort and 323 days for patients with depression (hazard ratio: 1.12; 95% CI: 1.05-1.179), 356 days for patients with elevated inflammation (hazard ratio: 2.85, 95% CI: 1.856-4.388), and 307 days with both (χ2 = 12.546; p < 0.001]). Conclusion: Depression and inflammation are independently associated with inferior survival. Survival worsened by inflammation is mediated by depression-a treatable risk factor.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Rebecca M. Saracino
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Andrew H. Miller
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - William Breitbart
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, Bronx, NY 10458, USA
| | - Christian Nelson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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261
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Zhu W, Xu D, Li H, Xu G, Tian J, Lyu L, Wan N, Wei L, Rong W, Liu C, Wu B, Bian X, Lyu A. Impact of Long-Term Home Quarantine on Mental Health and Physical Activity of People in Shanghai During the COVID-19 Pandemic. Front Psychiatry 2021; 12:782753. [PMID: 35153854 PMCID: PMC8829462 DOI: 10.3389/fpsyt.2021.782753] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 12/23/2021] [Indexed: 01/01/2023] Open
Abstract
This study aimed to investigate the effects of long-term home quarantine on the mental health of people during the COVID-19 epidemic in Shanghai. We conducted an online questionnaire survey on March 26 2020 and collected data on demographics, level of physical activity (PA), and mental health status of the participants. We assessed the mental health status using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Scale (GAD-7), whereas PA was assessed using International Physical Activity Questionnaire Short Form (IPAQ-SF). Of all 2,409 valid samples, participants reported performing a total of 2015.20 metabolic equivalent of task (MET)-minutes/week of total PA before the outbreak period and 1720.29 MET-minutes/week of total PA during the outbreak period (p < 0.001). Participants who spent a longer time at home reported to have a better performance on the PHQ-9 (p = 0.087) and GAD-7 (p < 0.001). A high level of PA was considered an protective factor against depression (OR = 0.755, 95% CI 0.603-0.944, p < 0.001). Additionally, a high level of PA had a preventative effect on anxiety (OR = 0.741, 95% CI 0.568-0.967, p < 0.001), and a longer working period during the outbreak was shown to be a risk factor for anxiety (11-29 days, OR 1.455, 95% CI 1.110-1.909; 30-60 days OR 1.619, 95% CI 1.227-2.316). Home confinement during the pandemic might not have a negative effect on mental health provided that people engage in more PA indoors. This study encourages interventions for mental health problems through physical exercise.
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Affiliation(s)
- Wentong Zhu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Doudou Xu
- Department of Nursing, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Li
- Department of Pharmacy, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Gang Xu
- School of Public Health, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luheng Lyu
- Department of Biochemistry and Molecular Biology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Naifu Wan
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijiang Wei
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wuwei Rong
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chenchen Liu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Beiwen Wu
- Department of Nursing, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaolan Bian
- Department of Pharmacy, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ankang Lyu
- Department of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Lai WT, Deng WF, Xu SX, Zhao J, Xu D, Liu YH, Guo YY, Wang MB, He FS, Ye SW, Yang QF, Liu TB, Zhang YL, Wang S, Li MZ, Yang YJ, Xie XH, Rong H. Shotgun metagenomics reveals both taxonomic and tryptophan pathway differences of gut microbiota in major depressive disorder patients. Psychol Med 2021; 51:90-101. [PMID: 31685046 DOI: 10.1017/s0033291719003027] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The microbiota-gut-brain axis, especially the microbial tryptophan (Trp) biosynthesis and metabolism pathway (MiTBamp), may play a critical role in the pathogenesis of major depressive disorder (MDD). However, studies on the MiTBamp in MDD are lacking. The aim of the present study was to analyze the gut microbiota composition and the MiTBamp in MDD patients. METHODS We performed shotgun metagenomic sequencing of stool samples from 26 MDD patients and 29 healthy controls (HCs). In addition to the microbiota community and the MiTBamp analyses, we also built a classification based on the Random Forests (RF) and Boruta algorithm to identify the gut microbiota as biomarkers for MDD. RESULTS The Bacteroidetes abundance was strongly reduced whereas that of Actinobacteria was significantly increased in the MDD patients compared with the abundance in the HCs. Most noteworthy, the MDD patients had increased levels of Bifidobacterium, which is commonly used as a probiotic. Four Kyoto Encyclopedia of Genes and Genomes (KEGG) orthologies (KOs) (K01817, K11358, K01626, K01667) abundances in the MiTBamp were significantly lower in the MDD group. Furthermore, we found a negative correlation between the K01626 abundance and the HAMD scores in the MDD group. Finally, RF classification at the genus level can achieve an area under the receiver operating characteristic curve of 0.890. CONCLUSIONS The present findings enabled a better understanding of the changes in gut microbiota and the related Trp pathway in MDD. Alterations of the gut microbiota may have the potential as biomarkers for distinguishing MDD patients form HCs.
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Affiliation(s)
- Wen-Tao Lai
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Wen-Feng Deng
- Laboratory of Brain Stimulation and Biological Psychiatry, Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Shu-Xian Xu
- Laboratory of Brain Stimulation and Biological Psychiatry, Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Jie Zhao
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Dan Xu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Yang-Hui Liu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Yuan-Yuan Guo
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Ming-Bang Wang
- Xiamen Branch, Shanghai Key Laboratory of Birth Defects, Division of Neonatology, Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | | | - Shu-Wei Ye
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Qi-Fan Yang
- Laboratory of Brain Stimulation and Biological Psychiatry, Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Tie-Bang Liu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Ying-Li Zhang
- Department of Depression, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Sheng Wang
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Min-Zhi Li
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Ying-Jia Yang
- Department of Depression, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Xin-Hui Xie
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
- Laboratory of Brain Stimulation and Biological Psychiatry, Brain Function and Psychosomatic Medicine Institute, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
- Center of Acute Psychiatry Service, Second People's Hospital of Huizhou, Huizhou, Guangdong, China
| | - Han Rong
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, Guangdong, China
- Affiliated Shenzhen Clinical College of Psychiatry, Jining Medical University, Jining, Shandong, China
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Arakaki FH, Xerfan EMS, Galduróz JCF, Tufik S, Andersen ML. Could PCSO-524® be a potential adjuvant treatment to sleep therapy in the management of depression? Psychiatry Res 2021; 295:113590. [PMID: 33276268 DOI: 10.1016/j.psychres.2020.113590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/21/2020] [Indexed: 11/30/2022]
Abstract
Sleep is essential in neural system homeostasis due to its regulation of the immunological system and inflammatory cytokines. Poor sleep quality can induce a pro-inflammatory state and aggravate depressive symptoms. Depression has been linked with high levels of peripheral and central pro-inflammatory markers. In this context, we highlight a possible role for PCSO-524®, a nutritional supplement extracted from the New Zealand green lipped mussel that has already been shown to have anti-inflammatory effects, as an adjuvant treatment for depression alongside sleep therapy. Although there are not as yet any studies on its use in treating depression, it has been demonstrated to be a promising treatment in another condition that has been linked with inflammation, attention deficit/hyperactivity disorder, and in some other neurodegenerative disorders. Therefore, PCSO-524®, associated with good sleep quality, could be an option to reinforce depression management.
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Affiliation(s)
- Felipe H Arakaki
- Departamento de Psicobiologia - Universidade Federal de Sao Paulo (UNIFESP), Brazil
| | - Ellen M S Xerfan
- Programa de Pós-Graduação em Medicina Translacional - Universidade Federal de Sao Paulo (UNIFESP), Brazil
| | | | - Sergio Tufik
- Departamento de Psicobiologia - Universidade Federal de Sao Paulo (UNIFESP), Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia - Universidade Federal de Sao Paulo (UNIFESP), Brazil.
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O’Donovan A, Bahorik A, Sidney S, Launer LJ, Yaffe K. Relationships of inflammation trajectories with white matter volume and integrity in midlife. Brain Behav Immun 2021; 91:81-88. [PMID: 32966872 PMCID: PMC7749816 DOI: 10.1016/j.bbi.2020.09.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Elevated inflammation is associated with worse late-life cognitive functioning and brain health. Our goal was to examine the relationship between inflammation trajectories and white matter integrity in midlife. METHODS Participants were 508 adults from the Coronary Artery Risk Development in Young Adults Study (CARDIA; 51% female). Latent class analysis was used to identify inflammation trajectories based on repeated measures of the inflammatory marker C-reactive protein (CRP) over the 18 years before brain magnetic resonance imaging (MRI). Outcomes were brain MRI measures of total and region-specific white matter volume and integrity at a mean age of 50.6 ± 3.4 years. Linear regression was used to examine if inflammation trajectories were associated with brain MRI outcomes, adjusting for potential confounds in all models and for disease and health behaviors in follow-up models. RESULTS Lower-stable (38%), moderate-increasing (7%), and consistently-higher (54%), trajectories emerged. Compared to the lower-stable group, the moderate-increasing group showed lower white matter volume (β = -0.18, 95% CI -0.29, -0.06) and worse white matter integrity as indexed by lower fractional anisotropy (FA; β = -0.37, 95% CI -0.70, -0.04) and higher mean diffusivity (β = 0.44, 95% CI 0.11, 0.78) in the whole brain. The consistently-higher group showed lower whole-brain FA (β = -0.20, -0.38, -0.03). In exploratory analyses, the moderate-increasing group showed lower white matter volume, lower FA and higher MD in the frontal, temporal, and parietal lobes compared to the lower-stable group. The consistently-higher group showed lower white matter volume in the parietal lobe and lower FA in the frontal, temporal, and parietal lobes, but similar MD, compared to the lower-stable group. Findings for the moderate-increasing, but not the consistently-higher, group were robust to adjustment for disease and lifestyle factors. CONCLUSION Increasing or high inflammation trajectories from early to mid adulthood are associated with worse brain health, as indexed by lower white matter volume and/or worse white matter integrity.
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Affiliation(s)
- Aoife O’Donovan
- University of California, San Francisco, CA,Corresponding Author: Aoife O’Donovan, PhD, Department of Psychiatry, University of California, San Francisco, 4150 Clement Street, San Francisco, CA 94121, Phone: +01 (415) 221-4810 X24959,
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Lewis NA, Yoneda T. Within-Couple Personality Concordance Over Time: The Importance of Personality Synchrony for Perceived Spousal Support. J Gerontol B Psychol Sci Soc Sci 2021; 76:31-43. [PMID: 32931566 PMCID: PMC7756696 DOI: 10.1093/geronb/gbaa163] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Within-couple similarities in personality traits tend to be positively associated with relationship well-being. However, research in this area is typically based on cross-sectional designs, thereby limiting examination of longitudinal personality concordance. Given that life experiences shape within-person change in personality, and that partners within a couple often experience similar life events, investigation of within-couple personality synchrony and associations with marital outcomes is warranted. METHODS Using data from 3,988 couples (mean age at baseline = 67.0 years, SD = 9.6), multilevel dyadic growth models estimated within-couple similarity in baseline levels, change, and occasion-to-occasion variability for each of the Big Five personality traits over an 8-year follow-up. Bivariate growth models examined the effect of within-couple similarity on perceived spousal support, accounting for dependency within couples. RESULTS Adjusting for baseline age, education, functional ability, and relationship length, analyses revealed within-couple concordance between baseline levels of all 5 personality traits, as well as correlated within-couple fluctuations in neuroticism, extraversion, and openness over time. Similarity in openness, agreeableness, and neuroticism trajectories predicted spousal support. Couples were most similar in openness, showing correlated intercepts, change, and variability, and this longitudinal synchrony was particularly important for perceived spousal support in women. DISCUSSION These findings provide evidence for longitudinal personality synchrony over time within older adult couples. Further, concordance in neuroticism, extraversion, and openness predicted perceived spousal support, though there may be some gender differences in personality dynamics and relationship well-being. Effects of similarity were relatively small compared to actor and partner effects of these traits.
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Affiliation(s)
- Nathan A Lewis
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Tomiko Yoneda
- Department of Psychology, University of Victoria, British Columbia, Canada
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266
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Disease trajectories and mortality among individuals diagnosed with depression: a community-based cohort study in UK Biobank. Mol Psychiatry 2021; 26:6736-6746. [PMID: 34035478 PMCID: PMC8145187 DOI: 10.1038/s41380-021-01170-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 02/05/2023]
Abstract
Patients with depression are at increased risk for a range of comorbid diseases, with, however, unclear explanations. In this large community-based cohort study of the UK Biobank, 24,130 patients diagnosed with depression were compared to 120,366 matched individuals without such a diagnosis. Follow-up was conducted from 6 months after the index date until death or the end of 2019, for the occurrence of 470 medical conditions and 16 specific causes of death. The median age at the time of the depression diagnosis was 62.0 years, and most of the patients were female (63.63%). During a median follow-up of 4.94 years, 129 medical conditions were found to be significantly associated with a prior diagnosis of depression, based on adjusted Cox regression models. Using disease trajectory network analysis to visualize the magnitude of disease-disease associations and the temporal order of the associated medical conditions, we identified three main affected disease clusters after depression (i.e., cardiometabolic diseases, chronic inflammatory diseases, and diseases related to tobacco abuse), which were further linked to a wider range of other conditions. In addition, we also identified three depression-mortality trajectories leading to death due to cardiovascular disease, respiratory system disease and malignant neoplasm. In conclusion, an inpatient diagnosis of depression in later life is associated with three distinct network-based clusters of medical conditions, indicating alterations in the cardiometabolic system, chronic status of inflammation, and tobacco abuse as key pathways to a wide range of other conditions downstream. If replicated, these pathways may constitute promising targets for the health promotion among depression patients.
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267
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Pilozzi A, Carro C, Huang X. Roles of β-Endorphin in Stress, Behavior, Neuroinflammation, and Brain Energy Metabolism. Int J Mol Sci 2020; 22:E338. [PMID: 33396962 PMCID: PMC7796446 DOI: 10.3390/ijms22010338] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 12/23/2020] [Accepted: 12/26/2020] [Indexed: 12/25/2022] Open
Abstract
β-Endorphins are peptides that exert a wide variety of effects throughout the body. Produced through the cleavage pro-opiomelanocortin (POMC), β-endorphins are the primarily agonist of mu opioid receptors, which can be found throughout the body, brain, and cells of the immune system that regulate a diverse set of systems. As an agonist of the body's opioid receptors, β-endorphins are most noted for their potent analgesic effects, but they also have their involvement in reward-centric and homeostasis-restoring behaviors, among other effects. These effects have implicated the peptide in psychiatric and neurodegenerative disorders, making it a research target of interest. This review briefly summarizes the basics of endorphin function, goes over the behaviors and regulatory pathways it governs, and examines the variability of β-endorphin levels observed between normal and disease/disorder affected individuals.
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Affiliation(s)
| | | | - Xudong Huang
- Neurochemistry Laboratory, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA; (A.P.); (C.C.)
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Abstract
Depression is among the most prevalent mental disorders worldwide, and a substantial proportion of patients do not respond adequately to standard antidepressants. Our understanding of the pathophysiology of depression is no longer limited to the chemical imbalance of neurotransmitters, but also involves the interplay of proinflammatory modulators in the central nervous system, as well as folate metabolism. Additional factors such as stress and metabolic disorders also may contribute. Multiple inflammatory, metabolic, and genetic markers have been identified and may provide critical information to help clinicians individualize treatments for patients to achieve optimal outcomes. Recent advancements in research have clarified underlying causes of depression and have led to possible new avenues for adjunctive treatment. Among these is L-methylfolate, a medical food that is thought to enhance synthesis of monoamines (serotonin, norepinephrine, and dopamine), suppress inflammation, and promote neural health. Clinical studies that assessed supplemental use of L-methylfolate in patients with usual care-resistant depression found that it resulted in improved outcomes. Patients with selective serotonin reuptake inhibitor-resistant depression, and particularly subgroups with biomarkers of inflammation or metabolic disorders or folate metabolism-related genetic polymorphisms (or ≥2 of these factors), had the best responses. Considering this, the goals of this review are to 1) highlight recent advances in the pathophysiology of major depressive disorder as it pertains to folate and associated biomarkers and 2) establish the profiles of patients with depression who could benefit most from supplemental use of L-methylfolate.
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269
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Madison AA, Andridge R, Padin AC, Wilson S, Bailey MT, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Carson WE, Malarkey WB, Kiecolt-Glaser JK. Endotoxemia coupled with heightened inflammation predicts future depressive symptoms. Psychoneuroendocrinology 2020; 122:104864. [PMID: 33166799 PMCID: PMC7721058 DOI: 10.1016/j.psyneuen.2020.104864] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/27/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Cross-sectional data have linked gut barrier abnormalities and endotoxemia with depression, even among those without gastrointestinal symptoms. This study examined longitudinal associations between endotoxemia markers and depressive symptoms, as well as the role of inflammation in this relationship. DESIGN At three annual visits, 315 women (n=209 breast cancer survivors, n = 106 non-cancer patient controls, M=55 years old) completed the Center for Epidemiological Studies Depression questionnaire (CES-D) and provided blood samples to assess inflammatory markers - interleukin-6, tumor necrosis factor-alpha, and C-reactive protein - and endotoxemia markers - lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14), and their ratio. RESULTS Adjusting for key demographic variables, health behaviors, visit 1 depressive symptoms, and cancer status and treatment, women with higher visit 1 LBP and LBP/sCD14 had more depressive symptoms at the two subsequent annual visits. Illustrating the notable impact, a woman at the 75th percentile for LBP or LBP/sCD14 at visit 1 was 18 % more likely to report clinically significant depressive symptoms (CES-D ≥16) at follow-up than a woman in the lowest quartile. Cancer status and treatment type did not modulate this relationship. In contrast, visit 1 depressive symptoms did not predict endotoxemia at follow-up. A significant interaction between LBP/sCD14 and inflammatory burden suggested that visit 1 endotoxemia fueled depressive symptoms only in the context of elevated inflammation. CONCLUSION These results suggest that endotoxemia, combined with systemic inflammation, can drive depressive symptoms. These findings may implicate bacterial endotoxin translocation from the gut to the bloodstream in depression etiology. Interventions that reduce endotoxemia and inflammation may lessen the risk of depression.
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Affiliation(s)
- Annelise A. Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,Department of Psychology, The Ohio State University
| | - Rebecca Andridge
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,College of Public Health, The Ohio State University
| | - Avelina C. Padin
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,Department of Psychology, The Ohio State University
| | | | - Michael T. Bailey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,Department of Pediatrics, The Ohio State University College of Medicine,,Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children’s Hospital
| | | | | | | | | | | | - William B. Malarkey
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,Department of Internal Medicine, The Ohio State University College of Medicine
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine,,Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine
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Ali AM. COVID-19: A pandemic that threatens physical and mental health by promoting physical inactivity. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:221-223. [PMID: 34189487 PMCID: PMC7685939 DOI: 10.1016/j.smhs.2020.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/22/2020] [Accepted: 11/22/2020] [Indexed: 12/18/2022] Open
Abstract
Ever since the outbreak of Coronavirus disease 2019 (COVID-19) in late 2019, it has killed millions of people worldwide. Even people not stricken by this disease are not spared from its negative economic, social, and health-related drawbacks. This commentary provides insight into the potential mechanisms involved in the development of depression and emotional negativity escalating during the current pandemic. In particular, preventive measures of COVID-19, such as staying at home, are sedentarism measures that decrease physical activity. Physical inactivity alters gut microbiome structure in a fashion that promotes gut dysbiosis and flaring of systemic inflammation, leading to the buildup of body fat. Obesity, which contributes to a trail of health-depleting disorders, furthers gut microbial disintegration while fat tissue stimulates the release of cytokines, promotes metabolic resistance, and alters signaling involved in the production of antioxidants. As a result, the body gets flooded by toxic molecules such pro-inflammatory mediators, free radicals, and advanced glycation end products. These toxic molecules alter cellular function in all body tissues, including those of the brain. Neuroinflammation is associated with progressive declines in cognitive and motor functions along with dysregulation in emotions. Counteracting the sedentarism enforced by the COVID-19 pandemic through the participation in suitable indoors activities and the intake of healthy food is likely to protect against or revert physiological impairments that may affect people retreating to their homes during the current crisis, eventually restoring physical and mental health.
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Affiliation(s)
- Amira Mohammed Ali
- Corresponding author. National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, 187-8502, Japan.
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271
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Harris KM, Jacoby DL, Lampert R, Soucier RJ, Burg MM. Psychological stress in heart failure: a potentially actionable disease modifier. Heart Fail Rev 2020; 26:561-575. [PMID: 33215323 DOI: 10.1007/s10741-020-10056-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 10/24/2022]
Abstract
Psychological stress is common in patients with heart failure, due in part to the complexities of effective disease self-management and progressively worsening functional limitations, including frequent symptom exacerbations and hospitalizations. Emerging evidence suggests that heart failure patients who experience higher levels of stress may have a more burdensome disease course, with diminished quality of life and increased risk for adverse events, and that multiple behavioral and pathophysiological pathways are involved. Furthermore, the reduced quality of life associated with heart failure can serve as a life stressor for many patients. The purpose of this review is to summarize the current state of the science concerning psychological stress in patients with heart failure and to discuss potential pathways responsible for the observed effects. Key knowledge gaps are also outlined, including the need to understand patterns of exposure to various heart failure-related and daily life stressors and their associated effects on heart failure symptoms and pathophysiology, to identify patient subgroups at increased risk for stress exposure and disease-related consequences, and the effect of stress specifically for patients who have heart failure with preserved ejection fraction. Stress is a potentially modifiable factor, and addressing these gaps and advancing the science of stress in heart failure is likely to yield important insights about actionable pathways for improving patient quality of life and outcomes.
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Affiliation(s)
- Kristie M Harris
- Yale School of Medicine, Department of Internal Medicine, Section of Cardiovascular Medicine, New Haven, CT, USA. .,VA Connecticut Healthcare System, Department of Cardiology, West Haven, CT, USA.
| | - Daniel L Jacoby
- Yale School of Medicine, Department of Internal Medicine, Section of Cardiovascular Medicine, New Haven, CT, USA
| | - Rachel Lampert
- Yale School of Medicine, Department of Internal Medicine, Section of Cardiovascular Medicine, New Haven, CT, USA
| | - Richard J Soucier
- Saint Francis Hospital and Medical Center, Trinity Health of New England, Hartford, CT, USA
| | - Matthew M Burg
- Yale School of Medicine, Department of Internal Medicine, Section of Cardiovascular Medicine, New Haven, CT, USA.,VA Connecticut Healthcare System, Department of Cardiology, West Haven, CT, USA.,Yale School of Medicine, Department of Anesthesiology, New Haven, CT, USA
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Huckvale S, Reyes S, Kulikova A, Rohatgi A, Riggs KA, Brown ES. An Association Between the Inflammatory Biomarker GlycA and Depressive Symptom Severity. J Clin Psychiatry 2020; 82:20m13245. [PMID: 33211910 PMCID: PMC7932005 DOI: 10.4088/jcp.20m13245] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The underlying mechanisms of depression remain unclear; however, current literature suggests a relationship between inflammation and depression. The association between the inflammatory biomarker high-sensitivity C-reactive protein (hs-CRP) and depression has been previously investigated, but the relationship between GlycA, a novel spectroscopic inflammatory biomarker, and depression does not appear to have been examined. METHODS Data were obtained from The Dallas Heart Study (DHS, conducted between 2000 and 2002), which consisted of a large community-based sample of Dallas County residents (N = 3,033). Depressive symptom severity was assessed with the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR). It was hypothesized that the serum GlycA level would be a statistically significant predictor of QIDS-SR scores after control for demographic covariates. Multiple linear regression was used to assess the relationship between GlycA level and QIDS-SR scores. The role of hs-CRP in predicting QIDS-SR scores was also explored. RESULTS GlycA level was a statistically significant positive predictor of QIDS-SR score (β = .053, P = .038) with control for sex, age, antidepressant use, ethnicity, smoking status, drinking status, body mass index, and years of education. In a subset of adults with moderate-to-severe depression, GlycA level was not associated with QIDS-SR scores. Additionally, hs-CRP level was not a statistically significant predictor of QIDS-SR scores. CONCLUSIONS This study found a positive association between the inflammatory biomarker GlycA, but not hs-CRP, and depressive symptom severity in a large multiethnic and multiracial community-based sample. Thus, these results provide the first indication that GlycA may be a potentially useful novel biomarker of depression.
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Affiliation(s)
- Samara Huckvale
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephanie Reyes
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Alexandra Kulikova
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Anand Rohatgi
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kayla A. Riggs
- Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas
| | - E. Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas,Corresponding author: E. Sherwood Brown, MD, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC 8849, Dallas, TX 75390-8849 ()
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273
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Abstract
OBJECTIVE : An exaggerated exercise SBP, which is potentially modifiable, may be associated with incident depressive symptoms via an increased pulsatile pressure load on the brain. However, the association between exaggerated exercise SBP and incident depressive symptoms is unknown. Therefore, we examined whether exaggerated exercise SBP is associated with a higher risk of depressive symptoms over time. METHODS : We used longitudinal data from the population-based Maastricht Study, with only individuals free of depressive symptoms at baseline included (n = 2121; 51.3% men; age 59.5 ± 8.5 years). Exercise SBP was measured at baseline with a submaximal exercise cycle test. We calculated a composite score of exercise SBP based on four standardized exercise SBP measures: SBP at moderate workload, SBP at peak exercise, SBP change per minute during exercise and SBP 4 min after exercise. Clinically relevant depressive symptoms were determined annually at follow-up and defined as a Patient Health Questionnaire score of at least 10. RESULTS : After a mean follow-up of 3.9 years, 175 participants (8.3%) had incident clinically relevant depressive symptoms. A 1 SD higher exercise SBP composite score was associated with a higher incidence of clinically relevant depressive symptoms [hazard ratio: 1.27 (95% confidence interval: 1.04-1.54)]. Results were adjusted for age, sex, education level, glucose metabolism status, lifestyle, cardiovascular risk factors, resting SBP and cardiorespiratory fitness. CONCLUSION : A higher exercise SBP response is associated with a higher incidence of clinically relevant depressive symptoms.
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274
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Renna ME, Shrout MR, Madison AA, Alfano CM, Povoski SP, Lipari AM, Agnese DM, Carson WE, Kiecolt-Glaser JK. Within-person changes in cancer-related distress predict breast cancer survivors' inflammation across treatment. Psychoneuroendocrinology 2020; 121:104866. [PMID: 32947247 PMCID: PMC7572735 DOI: 10.1016/j.psyneuen.2020.104866] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Among breast cancer survivors, elevated inflammation has been linked to greater recurrence risk. Psychological processes, such as cancer-related distress, can pose threats to a survivor's longevity and wellbeing. Although distress can heighten inflammation, little is known about how fluctuations in distress during and after treatment impact a woman's own inflammation - the primary question of this study. METHODS Breast cancer survivors (n = 165, stages 0-III) completed a baseline visit before treatment and two follow-up visits 6 and 18 months after. At each visit, women completed the Impact of Events Scale to assess cancer-related distress, and a blood sample was collected to measure proinflammatory cytokines IL-6, TNF-α, IL-1β, and IL-8. This longitudinal study related fluctuations in survivor's own cancer-related distress (i.e., within-person effects), as well as average effects of cancer-related distress between survivors (i.e., between-person effects) to inflammatory changes across visits. RESULTS Women had elevated inflammation at visits where they expressed more cancer-related distress than what was typical. In contrast, the average cancer-related distress was not associated with inflammation. CONCLUSION Larger increases in a women's cancer-related distress was linked with higher inflammation across visits. Comparing a survivor's own cancer-related distress to her average levels may prove useful in identifying links between distress and inflammation.
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Affiliation(s)
- Megan E. Renna
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Corresponding author at: Institute of Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, 43210, United States. (M.E. Renna)
| | - M. Rosie Shrout
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Annelise A. Madison
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Psychology, The Ohio State University, Columbus, OH, USA
| | | | - Stephen P. Povoski
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Adele M. Lipari
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Doreen M. Agnese
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - William E. Carson
- Comprehensive Cancer Center, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Janice K. Kiecolt-Glaser
- Institute for Behavioral Medicine Research, The Ohio State University College of Medicine, Columbus, OH, USA,Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine, Columbus, OH, USA
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275
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Coe CL, Miyamoto Y, Love GD, Karasawa M, Kawakami N, Kitayama S, Ryff CD. Cultural and life style practices associated with low inflammatory physiology in Japanese adults. Brain Behav Immun 2020; 90:385-392. [PMID: 32805392 PMCID: PMC7544652 DOI: 10.1016/j.bbi.2020.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 07/20/2020] [Accepted: 08/08/2020] [Indexed: 02/05/2023] Open
Abstract
Japan is an exceptionally healthy East Asian country with extended longevity. In addition, the typical levels of several proinflammatory proteins, including both C-reactive protein (CRP) and interleukin-6 (IL-6), are often reported to be low when compared to American and European populations. This analysis determined if blood levels of CRP and IL-6 were associated with 4 cultural practices reflective of Japanese behavior and customs -- drinking tea, eating seafood, consuming vegetables, and partaking in relaxing baths regularly - among 382 adults living in Tokyo. Regression models controlled for demographic factors, adiposity (BMI), physical exercise, smoking, alcohol use, and chronic illness (e.g., diabetes). Consuming a Japanese diet was associated with significantly lower CRP and IL-6 levels. More frequent bathing was associated with lower IL-6, but not specifically predictive of low CRP. This study has confirmed prior evidence for low inflammatory activity in Japanese adults and its association with several behavioral practices common in Japan.
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Affiliation(s)
- Christopher L Coe
- Harlow Center for Biological Psychology, University of Wisconsin, Madison, WI, United States.
| | - Yuri Miyamoto
- Department of Psychology, University of Wisconsin, Madison, WI, United States
| | - Gayle D Love
- Institute on Aging, University of Wisconsin, Madison, WI, United States
| | - Mayumi Karasawa
- Department of Comparative Psychology, Tokyo Woman's Christian University, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, University of Tokyo, Tokyo, Japan
| | - Shinobu Kitayama
- Department of Psychology, University of Michigan, Ann Arbor, MI, United States
| | - Carol D Ryff
- Department of Psychology, University of Wisconsin, Madison, WI, United States; Institute on Aging, University of Wisconsin, Madison, WI, United States
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276
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Syndemic burden and systemic inflammation, HIV health status, and blood pressure among women with unsuppressed HIV viral loads among women living with HIV. AIDS 2020; 34:1959-1963. [PMID: 32694420 DOI: 10.1097/qad.0000000000002617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Smoking, low education, obesity, and depressive symptoms are all associated with HIV health status, increased blood pressure, and inflammation, and constitute a syndemic burden that may contribute to poor health outcomes. The current study examined syndemic burden and health outcomes among women living with HIV. METHODS Women were participants enrolled in the Women's Interagency HIV Study. Outcomes included blood pressure, HIV health status (HIV-1 RNA viral load and CD4 T-cell counts), and IL-6. Syndemic burden was defined as a count variable of low education, obesity, cigarette use, and depressive symptoms. RESULTS Women (N = 131) were an average of 60.54 years of age (SD = 8.86), and 49% were non-Hispanic Black. In multivariable analyses, syndemic burden was not significantly associated with SBP (P = 0.342) or DBP (P = 0.763), IL-6 (P = 0.168), or CD4 cell count (P = 0.846). However, syndemic burden was associated with increased viral load (age adjusted β = 0.35, P < 0.001). Comparing women with high versus low syndemic burden, also controlling for women's age, women with high syndemic burden had higher DBP and HIV viral load. DISCUSSION Syndemic burden appeared to play an important role in HIV health status and could potentially increase the risk of HIV transmission. High syndemic burden, defined as at least two syndemic conditions, had the greatest effects of HIV viral load and DBP. Targeted interventions to address syndemic burden may help improve health outcomes in women living with HIV as well as reduce the risk of hypertension and HIV transmission.
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277
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Hawkins MAW, Clawson AH, Smith CE, Stout ME, Keirns NG, Ruppe NM. Psychological distress and substance use among young adults with comorbid asthma and obesity. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:914-921. [PMID: 31373892 DOI: 10.1080/07448481.2019.1643353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/31/2018] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
This study examined psychosocial distress and substance use in young adults with asthma (A), obesity (O), comorbid asthma and obesity (AO), or neither (controls). Participants: Eight hundred eighty-one young adults were included in the A, O, AO, or control group. Methods: ANCOVA and logistic regression analyses were performed to compare responses to screeners for psychological distress and substance use among the four groups. Results: Levels of depressive symptoms, worry, nonsuicidal self-injury, emotion dysregulation, and chronic pain symptoms differed across groups, with the A and AO groups showing greater psychological distress than the O and control groups. The AO group exhibited the highest levels of cigarette and smokeless tobacco use, while the O group exhibited the least frequent binge drinking behaviors. Conclusions: Individuals with asthma or comorbid asthma and obesity appear to experience the poorest psychosocial functioning and highest use of tobacco products. Potential mechanisms and implications of these relationships are discussed.
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Affiliation(s)
- Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ashley H Clawson
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Caitlin E Smith
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Madison E Stout
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Natalie G Keirns
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Nicole M Ruppe
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
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278
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Alessi MG, Bennett JM. Mental health is the health of the whole body: How psychoneuroimmunology & health psychology can inform & improve treatment. J Eval Clin Pract 2020; 26:1539-1547. [PMID: 32171052 DOI: 10.1111/jep.13386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/12/2020] [Accepted: 02/20/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Converging and accumulating evidence for the cross-communication among the nervous, immune, and endocrine systems, a field of study known as psychoneuroimmunology, implicates immunological dysfunction as a shared and common mechanism of both mental and physical illness. For example, psychiatric disorders like schizophrenia, bipolar disorder, major depression, and anxiety disorders have higher prevalence rates across a spectrum of autoimmune conditions compared to the general population. Additionally, subclinical immunological abnormalities are observed in a variety of psychiatric conditions, with chronic inflammation most extensively studied in the pathophysiology of depression. These observations blur the historical distinctions between mental and physical illness, yet clinical practice remains fragmented and primarily focused on differentially treating individual symptoms. PROPOSED THESIS Therapeutically targeting inflammation offers translational opportunities for integrating mental and physical healthcare, a key niche of the interdisciplinary field of health psychology. CONCLUSION Utilizing a psychoneuroimmunological lens, health psychologists and clinicians can reconceptualize healthcare through integrative treatment approaches and advocacy for comprehensive policy-level reform at both the individual-level of care as well as community-wide prevention approaches.
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Affiliation(s)
- Maria G Alessi
- Health Psychology PhD Program, UNC Charlotte, Charlotte, North Carolina, USA
| | - Jeanette M Bennett
- Health Psychology PhD Program, UNC Charlotte, Charlotte, North Carolina, USA.,Department of Psychological Science, UNC Charlotte, Charlotte, North Carolina, USA
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279
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Repeated administration of LPS exaggerates amphetamine-induced locomotor response and causes learning deficits in mice. J Neuroimmunol 2020; 349:577401. [PMID: 33002724 DOI: 10.1016/j.jneuroim.2020.577401] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 09/03/2020] [Accepted: 09/18/2020] [Indexed: 12/12/2022]
Abstract
Immune activation contributes to the pathophysiology of psychiatric disorders. Administration of a single dose of lipopolysaccharides (LPS) has been shown to induce depressive- and anxiety-like behaviors in rodents through activation of the kynurenine pathway, increasing levels of the N-methyl-d-aspartate (NMDA) receptor agonist quinolinic acid. Conversely, repeated administration of LPS produces increased levels of the NMDA receptor antagonist kynurenic acid. Here we show that repeated LPS administration increases sensitivity to D-amphetamine and produces cognitive deficits and anxiety-like behavior. Together, our behavioral data suggests that repeated LPS administration may be useful to study the contribution of inflammation to psychiatric disorders such as schizophrenia.
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280
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Braun A, Evdokimov D, Frank J, Sommer C, Üçeyler N. MiR103a-3p and miR107 are related to adaptive coping in a cluster of fibromyalgia patients. PLoS One 2020; 15:e0239286. [PMID: 32941517 PMCID: PMC7498021 DOI: 10.1371/journal.pone.0239286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 09/03/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND MicroRNA (miRNA) mainly inhibit post-transcriptional gene expression of specific targets and may modulate disease severity. OBJECTIVE We aimed to identify miRNA signatures distinguishing patient clusters with fibromyalgia syndrome (FMS). SUBJECTS AND METHODS We previously determined four FMS patient clusters labelled "maladaptive", "adaptive", "vulnerable", and "resilient". Here, we cluster-wise assessed relative gene expression of miR103a-3p, miR107, miR130a-3p, and miR125a-5p in white blood cell (WBC) RNA of 31 FMS patients and 16 healthy controls. Sum scores of pain-, stress-, and resilience-related questionnaires were correlated with miRNA relative gene expression. A cluster-specific speculative model of a miRNA-mediated regulatory cycle was proposed, and its potential targets verified by the online tool "target scan human". RESULTS One-way ANOVA revealed lower gene expression of miR103a-3p, miR107, and miR130a-3p in FMS patients compared to controls (p < 0.05). Follow-up post-hoc tests indicated the highest peak of gene expression of miR103a-3p for the adaptive cluster (p < 0.05), i.e. in patients with low disability in all symptom categories. Gene expression of miR103a-3p correlated with FMS related disability and miR107 with the score "physical abuse" of the trauma questionnaire (p < 0.05). Target scan identified sucrose non-fermentable serine/threonine protein kinase, nuclear factor kappa-b, cyclin dependent kinase, and toll-like receptor 4 as genetic targets of the miR103a/107 miRNA family. CONCLUSION We show an association between upregulated gene expression of miR103a, tendentially of miR107, and adaptive coping in FMS patients. Validation of this pair of miRNA may enable to identify a somatic resilience factor in FMS.
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Affiliation(s)
- Alexandra Braun
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Johanna Frank
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Claudia Sommer
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Nurcan Üçeyler
- Department of Neurology, University of Würzburg, Würzburg, Germany
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281
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Duvetorp A, Mrowietz U, Nilsson M, Seifert O. Sex and Age Influence the Associated Risk of Depression in Patients with Psoriasis: A Retrospective Population Study Based on Diagnosis and Drug-Use. Dermatology 2020; 237:595-602. [PMID: 32927456 DOI: 10.1159/000509732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/08/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The reported prevalence of depression among individuals with psoriasis varies substantially, and the effect of gender on depression distribution has revealed conflicting results. In addition, using medication to identify cases is uncommon. OBJECTIVE To study the prevalence of pharmacologically treated depression among individuals with and without psoriasis in a Swedish population using ICD-10 codes and data from the Swedish Prescribed Drug Register. METHODS A retrospective case-control population-based study was performed including all living individuals (age ≥18 years) in Region Jönköping, southern Sweden (n = 273,536). ICD-10 codes for the diagnosis of psoriasis (L40.*) and depression (F32.* and F33.*), and data on pharmacological treatment from the Swedish Prescribed Drug Register, were extracted from electronic medical records between April 9, 2008 and January 1, 2016. The extraction date was January 1, 2016. RESULTS The risk of pharmacologically treated depression was increased in individuals with psoriasis (age- and sex-adjusted OR 1.55; CI 1.43-1.68); 21.1% of women with psoriasis received pharmacological treatment for depression during the study period compared to 14.2% in the control population. Prevalence figures for depression were significantly higher in women with psoriasis compared to men. The risk of suffering from depression was highest among male and female patients with psoriasis under the age of 31 years. CONCLUSIONS Depression is common among patients with psoriasis. The results of the current study underline the need for dermatologists to adopt a holistic approach, looking beyond the skin, when handling patients with psoriasis in every-day clinical practice.
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Affiliation(s)
- Albert Duvetorp
- Department of Dermatology and Venereology, Skåne University Hospital, Malmö, Sweden.,Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Ulrich Mrowietz
- Psoriasis-Center at the Department of Dermatology, University Medical Centre Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mats Nilsson
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.,Futurum - Academy for Health and Care, Region Jönköping County, Jönköping, Sweden
| | - Oliver Seifert
- Department of Clinical and Experimental Medicine, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden, .,Department of Dermatology and Venereology, Ryhov Hospital, Jönköping, Sweden,
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282
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Kiecolt-Glaser JK, Renna ME, Shrout MR, Madison AA. Stress Reactivity: What Pushes Us Higher, Faster, and Longer - and Why It Matters. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2020; 29:492-498. [PMID: 33758478 DOI: 10.1177/0963721420949521] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Brief everyday stressors can provoke cardiovascular, hormonal, and immune changes, with considerable variation in the magnitude and duration of these responses. Acute responses to daily stressors can vary widely among individuals experiencing the same stressor, and these physiological responses may not align with stress appraisals. This review highlights individual and dyadic factors that may heighten and prolong stress reactivity, and their implications for health. We discuss depression, rumination, early life adversity, and social evaluation as individual level factors, and interpersonal stress processes and relationship quality as dyadic level factors that may influence physiological stress responses. Heightened and prolonged stress reactivity can provide a gateway to the physiological dysregulation that underlies depression and chronic disease, which themselves alter stress reactivity - a vicious cycle. Interventions that may dampen physiological stress reactivity include yoga, meditation, health behaviors (diet, exercise, and sleep), and cognitive behavioral therapy.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine.,Department of Psychiatry and Behavioral Health, The Ohio State University College of Medicine
| | - Megan E Renna
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine.,The Comprehensive Cancer Center, The Ohio State University College of Medicine
| | - M Rosie Shrout
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine
| | - Annelise A Madison
- The Institute for Behavioral Medicine Research, The Ohio State University College of Medicine.,Department of Psychology, The Ohio State University
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283
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Ellul P, Gasnier M, Trebossen V, Gaillard R. Immune Activation and Deficit in Neurotransmitters Synthesis in Treatment Resistant Depression: About a Case of Hashimoto Encephalopathy. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2020; 18:463-466. [PMID: 32702227 PMCID: PMC7383012 DOI: 10.9758/cpn.2020.18.3.463] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 06/05/2019] [Accepted: 06/10/2019] [Indexed: 12/31/2022]
Abstract
We report a case of Hashimoto encephalopathy initially presented as a drug-resistant depression with predominant apathy and asthenia, successfully treated with cyclophosphamide. We suspected that the psychiatric symptoms were due to a deficit in neurotransmitter synthesis related to immune activation. We hypothesized that the immunomodulatory treatment helped to restore the neurotransmitter synthesis and thus decreased the patient’s depressive symptoms. In this case report we propose an innovative model in which immunity might disturbs neurotransmitters synthesis leading to depressive symptoms.
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Affiliation(s)
- Pierre Ellul
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Matthieu Gasnier
- Assistance Publique-Hôpitaux de Paris (AP-HP), Hotel-Dieu, Unité de Psychiatrie, Paris, France
| | - Vincent Trebossen
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Raphael Gaillard
- Centre Hospitalier Sainte-Anne, Faculty of Medicine Paris Descartes, Service Hospitalo-Universitaire, Paris, France.,Université Paris Descartes, INSERM UMR S894, Centre de Psychiatrie et Neurosciences, Laboratoire de Physiopathologie des Maladies Psychiatriques, Paris, France
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284
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Abstract
The gut microbiome serves an important role in the human body. Reportedly, one of the benefits of these microflora is on mental health. Once established, food and other dietary sources that enhance quality microbiome content in our gastrointestinal system will be a significant consideration in individuals’ day to day lives. This literature review conducted a PubMed search for studies about the gut microbiome and its relation to depression. In using several Medical Subject Heading (MeSH) keywords, relevant literature was selected. A total of 26 articles were selected after applying the inclusion and exclusion criteria, and after checking the articles’ accessibility. This literature would like to establish the role of the gut microbiome in depression. This study's findings showed that there is a strong association of microbiome function to mental well-being.
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Affiliation(s)
- Therese Limbana
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Farah Khan
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Noha Eskander
- Psychiatry, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
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285
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Schechter MS, Ostrenga JS, Fink AK, Barker DH, Sawicki GS, Quittner AL. Decreased survival in cystic fibrosis patients with a positive screen for depression. J Cyst Fibros 2020; 20:120-126. [PMID: 32800486 DOI: 10.1016/j.jcf.2020.07.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 07/26/2020] [Accepted: 07/26/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The International Depression Epidemiological Study (TIDES) found elevated rates of screen positivity for depression and anxiety among individuals with cystic fibrosis (CF). Depression is associated with worse adherence and health-related quality of life in CF. We investigated the relationship with mortality. METHODS Subjects were untransplanted participants in TIDES 12+ years of age receiving care at one of 45 collaborating US CF care centers who completed the Hospital Anxiety and Depression Scale and/or Center for Epidemiologic Studies Depression Scale during a stable visit between 2006 and 2010. Clinical characteristics and mortality data were obtained from the CF Foundation Patient Registry. The association of a positive screen with 5-year survival was evaluated using Cox Proportional Hazards modeling. RESULTS Of 1005 eligible patients, 25% screened positive for depression and 34% screened positive for anxiety. Patients who screened positive for depression were more likely to be older, have a residual function mutation, public insurance, and more pulmonary exacerbations in the screening year. There were 96 deaths. The unadjusted 5-year Hazard Ratio (HR) for death among those with depression was 2.0; 95% CI (1.3, 3.0)]. When adjusted for predetermined potential confounders the HR for the entire population was 1.4; 95% CI (0.9, 2.2). The adjusted HR was higher in adults [1.6; 95% CI (1.0, 2.4)] and those screening in the severe range [2.0; 95% CI (1.2, 3.4)]. Anxiety was not associated with mortality. CONCLUSIONS A positive depression screen is associated with increased mortality among adults with CF. Research into the etiology of this relationship is needed.
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Affiliation(s)
- Michael S Schechter
- Children's Hospital of Richmond at Virginia Commonwealth University, 1000East Broad Street, Richmond, VA 23298, USA.
| | - Joshua S Ostrenga
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Bethesda, MD 20814, USA
| | - Aliza K Fink
- Cystic Fibrosis Foundation, 4550 Montgomery Avenue, Bethesda, MD 20814, USA
| | - David H Barker
- Rhode Island Hospital Dept. of Psychiatry, 593 Eddy Street, Providence, RI 02903, USA
| | - Gregory S Sawicki
- Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Alexandra L Quittner
- Nicklaus Children's Research Institute, 3100 SW 62nd Avenue, Miami, FL 33155, USA
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286
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Yan T, Wang N, Liu B, Wu B, Xiao F, He B, Jia Y. Schisandra chinensis ameliorates depressive-like behaviors by regulating microbiota-gut-brain axis via its anti-inflammation activity. Phytother Res 2020; 35:289-296. [PMID: 32761702 DOI: 10.1002/ptr.6799] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 05/28/2020] [Accepted: 06/23/2020] [Indexed: 12/16/2022]
Abstract
The present study aimed to examine the antidepressant actions of the composition fractions of Schisandra chinensis using LPS-induced mice. Animals were treated with total extracts (SCE), lignans (SCL), polysaccharides (SCPS), and essential oil (SCVO), and then subjected to behavioral tests. The forced swimming test (FST) and tail suspension test (TST) were used as predictive animal models of antidepressant activity. Total extracts and lignans significantly decreased the duration of immobility in FST and TST. We found that treatment with SCE and SCL could significantly decrease the levels of pro-inflammatory cytokines both in the periphery and central nervous system (CNS). This was confirmed by the histopathological examination of the colon. The RT-PCR results demonstrated that SCE and SCL could greatly inhibit the TLR4/NF-κB/IKKα signaling pathway. In addition, the concentrations of Butyric acid and Propionic acid were upregulated by the administration, and the decreased diversity of intestinal microbiota and alterations of the relative proportions of Bacteroidetes and Firmicutes phylum members, Barnesiella and Lactobacillus genus members in LPS-induced mice were restored as well. All results suggested that lignans is the effective fraction of S.chinensis to ameliorating depressive disorders, which its anti-inflammation activity possibly involved in the bidirectional connection between gut microbiota and brain.
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Affiliation(s)
- Tingxu Yan
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
| | - Nizhi Wang
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, China
| | - Bing Liu
- School of Traditional Chinese Materia Medica, Shenyang Pharmaceutical University, Shenyang, China
| | - Bo Wu
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
| | - Feng Xiao
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
| | - Bosai He
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
| | - Ying Jia
- School of Functional Food and Wine, Shenyang Pharmaceutical University, Shenyang, China
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287
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Gur S, Taler M, Bormant G, Blattberg D, Nitzan U, Vaknin-Dembinsky A, Brill L, Krivoy A, Weizman A, Hochman E. Lack of association between unipolar or bipolar depression and serum aquaporin-4 autoantibodies. Brain Behav Immun 2020; 88:930-934. [PMID: 32380273 DOI: 10.1016/j.bbi.2020.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022] Open
Abstract
Aquaporin-4 (AQP4), an astrocyte water channel protein, is the target antigen of serum immunoglobulin G (IgG) autoantibody in neuromyelitis optica spectrum disorders (NMOsd), a group of inflammatory, demyelinating diseases of the central nervous system. Recently, a reduction in blood vessels coverage by AQP4-immunoreactive astrocytes was demonstrated in depressed patients, indicating a role for AQP4 in mood disorders. Moreover, a possible association between depression and serum AQP4-IgG was suggested in a case report of a treatment resistant depression (TRD) patient diagnosed with NMOsd with positive serum AQP4 autoantibodies. We investigated, for the first time, the presence of serum AQP4-IgG in patients with unipolar and bipolar depression and healthy controls (HCs). In this multicenter study, 25 major depressive disorder (MDD) and 25 bipolar disorder (BD) patients, during an acute major depressive episode (MDE), and 30 matched HCs were screened for the presence of serum AQP4-IgG, using a cell-based assay. The MDE patients underwent a repeated AQP4-IgG assessment at a 3-month follow-up visit. The MDE group (N = 50) had illness duration of 12.7 years (SD = 10.5), 12% of them were psychotropic medication-free and 26% were defined as TRD. All MDE patients and HCs, including three BD patients who experienced a manic switch, were seronegative for AQP4-IgG at baseline and follow-up assessments. In conclusion, contrary to our hypothesis, AQP4 autoantibodies were not detected in serum of unipolar and bipolar depressed patients. However, AQP4 may still play a role in the pathogenesis of mood disorders through different mechanisms of action such as altered brain AQP4 expression.
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Affiliation(s)
- Shay Gur
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petah-Tikva, Israel
| | - Michal Taler
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel
| | - Gil Bormant
- Geha Mental Health Center, Petah-Tikva, Israel
| | | | - Uri Nitzan
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Shalvata Mental Health Center, Hod Hasharon, Israel
| | - Adi Vaknin-Dembinsky
- Department of Neurology and Laboratory of Neuroimmunology, and the Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Livnat Brill
- Department of Neurology and Laboratory of Neuroimmunology, and the Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Amir Krivoy
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petah-Tikva, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel; Psychosis Studies Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petah-Tikva, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel
| | - Eldar Hochman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petah-Tikva, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petah-Tikva, Israel.
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288
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Mueller AE, Georgiopoulos AM, Reno KL, Roach CM, Kvam CM, Quittner AL, Lomas P, Smith BA, Filigno SS. Introduction to Cystic Fibrosis for Mental Health Care Coordinators and Providers: Collaborating to Promote Wellness. HEALTH & SOCIAL WORK 2020; 45:202-210. [PMID: 32382728 DOI: 10.1093/hsw/hlaa009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 03/19/2019] [Accepted: 04/03/2019] [Indexed: 06/11/2023]
Abstract
To maximize health, individuals with cystic fibrosis (CF) follow a complex, burdensome daily care regimen. Managing CF is associated with a range of significant biopsychosocial challenges and places individuals with CF, and their caregivers, at greater risk for developing anxiety and depression. To promote wellness and address the potential barriers that affect management of this complex chronic illness, many individuals would benefit from treatment from a behavioral health provider. Social workers within multidisciplinary CF care teams are well positioned to respond to this need, and an expanding number of social workers serving as behavioral health providers in the community will be sought as a resource to provide treatment to this population. This article serves as a primer for social workers to maximize knowledge of the psychosocial and potential behavioral health needs of individuals with CF across the life span. To best support individuals with CF, authors describe the disease-specific manifestations and outline the numerous potential clinical targets for social work to promote wellness. The article concludes by highlighting the importance of communication with the medical team and considerations for effective collaborative care.
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Affiliation(s)
- Amy E Mueller
- Social Work Services Department, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102
| | | | - Kim L Reno
- Policy and Advocacy, Cystic Fibrosis Foundation, Compass, Bethesda, MD
| | - Christine M Roach
- Jacob School of Medical and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | | | | | - Paula Lomas
- Clinical Communications, Cystic Fibrosis Foundation, Bethesda, MD
| | - Beth A Smith
- Jacob School of Medical and Biomedical Sciences, University at Buffalo, Buffalo, NY
| | - Stephanie S Filigno
- University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center
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289
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Szabo YZ, Slavish DC, Graham-Engeland JE. The effect of acute stress on salivary markers of inflammation: A systematic review and meta-analysis. Brain Behav Immun 2020; 88:887-900. [PMID: 32371089 PMCID: PMC7478864 DOI: 10.1016/j.bbi.2020.04.078] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Salivary biomarkers of inflammation are increasingly used in stress research. This systematic review and meta-analysis provides a quantitative summary of changes in salivary inflammatory markers in response to acute stress. METHOD The review included 1558 participants (42 unique samples, 33 studies) obtained through electronic databases (PubMed, PsycINFO, Embase), reference treeing, and articles identified by a 2015 review on a similar topic. To be eligible, articles had to be quantitative and assess change in at least one biomarker of salivary inflammation in response to acute stress in adults. The primary outcome was magnitude of change in inflammatory biomarkers (Cohen's d for repeated measures [dav]). RESULTS Measures of salivary inflammation included: C-reactive protein (CRP), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, IL-18, IL-21, interferon (IFN)-α, IFN-γ, and tumor necrosis factor (TNF)-α. Cytokines IL-6 (k = 26, dav = 0.27), IL-10 (k = 11, dav = 0.34), TNF-α (k = 10, dav = 0.57), and IFN-γ (k = 6, dav = 0.28) significantly increased in response to stress. Post hoc sensitivity analyses revealed that IL-1β (k = 19, dav = 0.16) and IL-8 (k = 7, dav = 0.30) also increased from pre- to post-stress, but findings with IFN-γ did not hold after removing one outlier study. Examination of moderators suggested that study methodology and sample demographics moderated some associations. CONCLUSIONS This meta-analysis revealed that certain salivary inflammatory cytokines increase in response to acute stress. Significant heterogeneity in results and moderator analyses suggest need for standardization of research protocols. Directions for future research are discussed.
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Affiliation(s)
- Yvette Z Szabo
- Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX, USA; Texas A&M College of Medicine, Bryan, TX, USA; Department of Health, Human Performance and Recreation, Baylor University, Waco, TX, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA.
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290
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Flouri E, Lewis G, Francesconi M. Trajectories of internalising and externalising symptoms and inflammation in the general child population. Psychoneuroendocrinology 2020; 118:104723. [PMID: 32479966 DOI: 10.1016/j.psyneuen.2020.104723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 04/17/2020] [Accepted: 05/18/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Elevations in inflammatory marker levels have been shown to precede internalising and externalising problems in the general child population. One study has found the reverse, that elevations in inflammatory marker levels in childhood follow internalising and externalising problems. However, the authors did not explore the role of the course of these problems in childhood or adjust for a number of potential confounders including psychosocial stressors and prenatal and perinatal exposures. AIMS To investigate the association in childhood between the growth of internalising and externalising symptoms and levels of inflammatory markers, while accounting for potential confounders. METHODS Using data from the Avon Longitudinal Study of Parents and Children, we tested the association between the trajectories of internalising (emotional and social) and externalising (hyperactivity and conduct) problems, at ages 4, 6, 8 and 9 years, and levels of C-reactive protein (CRP) and interleukin 6 (IL-6) at age 9 years. We analysed data (n = 4525) using latent growth curve modelling and linear regression. RESULTS Children who had increasing levels of internalising symptoms over childhood were more likely to have higher levels of CRP and IL-6 at 9 years of age, even after adjustment for confounders. A one-unit increase in the rate of annual change of internalising symptoms was related to an increase of 12% and 8% in the level of CRP and IL-6, respectively. However, there was no evidence for an association between externalising symptoms and either inflammatory marker. CONCLUSIONS This study is the first step towards identifying a robust pathway, via increases in emotional and social difficulties, to elevated inflammation in healthy children. This association, if causal, suggests that effective interventions for children experiencing chronic emotional and social difficulties could also have physical health benefits.
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Affiliation(s)
- Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK.
| | - Glyn Lewis
- Division of Psychiatry, Faculty of Brain Sciences, University College London, UK
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, University College London, UK
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291
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Abstract
Periodontitis is a complex disease: (a) various causative factors play a role simultaneously and interact with each other; and (b) the disease is episodic in nature, and bursts of disease activity can be recognized, ie, the disease develops and cycles in a nonlinear fashion. We recognize that various causative factors determine the immune blueprint and, consequently, the immune fitness of a subject. Normally, the host lives in a state of homeostasis or symbiosis with the oral microbiome; however, disturbances in homeostatic balance can occur, because of an aberrant host response (inherited and/or acquired during life). This imbalance results from hyper- or hyporesponsiveness and/or lack of sufficient resolution of inflammation, which in turn is responsible for much of the disease destruction seen in periodontitis. The control of this destruction by anti-inflammatory processes and proresolution processes limits the destruction to the tissues surrounding the teeth. The local inflammatory processes can also become systemic, which in turn affect organs such as the heart. Gingival inflammation also elicits changes in the ecology of the subgingival environment providing optimal conditions for the outgrowth of gram-negative, anaerobic species, which become pathobionts and can propagate periodontal inflammation and can further negatively impact immune fitness. The factors that determine immune fitness are often the same factors that determine the response to the resident biofilm, and are clustered as follows: (a) genetic and epigenetic factors; (b) lifestyle factors, such as smoking, diet, and psychosocial conditions; (c) comorbidities, such as diabetes; and (d) local and dental factors, as well as randomly determined factors (stochasticity). Of critical importance are the pathobionts in a dysbiotic biofilm that drive the viscious cycle. Focusing on genetic factors, currently variants in at least 65 genes have been suggested as being associated with periodontitis based on genome-wide association studies and candidate gene case control studies. These studies have found pleiotropy between periodontitis and cardiovascular diseases. Most of these studies point to potential pathways in the pathogenesis of periodontal disease. Also, most contribute to a small portion of the total risk profile of periodontitis, often limited to specific racial and ethnic groups. To date, 4 genetic loci are shared between atherosclerotic cardiovascular diseases and periodontitis, ie, CDKN2B-AS1(ANRIL), a conserved noncoding element within CAMTA1 upstream of VAMP3, PLG, and a haplotype block at the VAMP8 locus. The shared genes suggest that periodontitis is not causally related to atherosclerotic diseases, but rather both conditions are sequelae of similar (the same?) aberrant inflammatory pathways. In addition to variations in genomic sequences, epigenetic modifications of DNA can affect the genetic blueprint of the host responses. This emerging field will yield new valuable information about susceptibility to periodontitis and subsequent persisting inflammatory reactions in periodontitis. Further studies are required to verify and expand our knowledge base before final cause and effect conclusions about the role of inflammation and genetic factors in periodontitis can be made.
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Affiliation(s)
- Bruno G Loos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Thomas E Van Dyke
- Center for Clinical and Translational Research, Forsyth Institute, Cambridge, Massachusetts, USA
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292
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Farrell SF, Zoete RMJ, Cabot PJ, Sterling M. Systemic inflammatory markers in neck pain: A systematic review with meta‐analysis. Eur J Pain 2020; 24:1666-1686. [DOI: 10.1002/ejp.1630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/28/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Scott F. Farrell
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- Menzies Health Institute Queensland Griffith University Gold Coast Queensland Australia
| | - Rutger M. J. Zoete
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
- School of Allied Health Science and Practice The University of Adelaide Adelaide South Australia Australia
| | - Peter J. Cabot
- School of Pharmacy The University of Queensland Brisbane Queensland Australia
| | - Michele Sterling
- RECOVER Injury Research Centre NHMRC Centre for Research Excellence in Recovery Following Road Traffic Injuries The University of Queensland Brisbane Queensland Australia
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293
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Swann OG, Kilpatrick M, Breslin M, Oddy WH. Dietary fiber and its associations with depression and inflammation. Nutr Rev 2020; 78:394-411. [PMID: 31750916 DOI: 10.1093/nutrit/nuz072] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Dietary fiber is a crucial component of a healthy diet, with benefits that can be attributed to processes in the gut microbiota and the resulting by-products. Observational studies support associations between dietary fiber intake and depression and inflammation, but the potential mechanisms are poorly understood. This review examines evidence of the effects of dietary fiber on depression and inflammation and considers plausible mechanisms linking dietary fiber and depression, including microbiota-driven modification of gene expression and increased production of neurotransmitters. Additionally, inflammation may mediate the relationship between dietary fiber intake and depression. A high-fiber diet potentially lowers inflammation by modifying both the pH and the permeability of the gut. The resultant reduction in inflammatory compounds may alter neurotransmitter concentrations to reduce symptoms of depression. Further research into the link between dietary fiber intake and inflammation and depression is essential, as findings could potentially provide guidance for improvement in or prevention of inflammatory and depressive disorders.
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Affiliation(s)
- Olivia G Swann
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Monique Breslin
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Wendy H Oddy
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
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294
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Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145028. [PMID: 32668726 PMCID: PMC7400692 DOI: 10.3390/ijerph17145028] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study aimed to examine the severity of psychological symptoms and their correlates among peri- and postmenopausal Emirati women (N = 60, mean age = 54.88 ± 6 years). Participants were interviewed using the Menopause-Specific Quality of Life (MENQOL) and attitudes toward menopause scale (ATMS). In four path analysis models, vasomotor symptoms, weight gain, and fatigue had significant direct effects on symptoms of anxiety, depression (only weight gain and fatigue), and psychological distress. Fatigue significantly mediated the effects of vasomotor symptoms and weight gain on symptoms of anxiety, depression (only vasomotor symptoms), psychological distress, and memory problems. These models explained 47.6%, 44.5%, 56.6%, and 29.1% of the variances in anxiety, depression, psychological distress, and memory problems, respectively. Participants with more severe menopausal symptoms expressed more negative attitudes toward menopause though regression analysis revealed that only vasomotor symptoms could significantly contribute to ATMS scores. In conclusion, psychological distress is widespread among menopausal women, and it is associated with vasomotor symptoms, fatigue, and change of body composition (obesity). Psychological symptoms, along with vasomotor symptoms, express a key link to negative attitudes toward menopause. Therefore, interventional strategies that target psychological distress may promote coping with midlife transition and improve mental health among menopausal women.
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295
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Zonulin-Dependent Intestinal Permeability in Children Diagnosed with Mental Disorders: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12071982. [PMID: 32635367 PMCID: PMC7399941 DOI: 10.3390/nu12071982] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022] Open
Abstract
Worldwide, up to 20% of children and adolescents experience mental disorders, which are the leading cause of disability in young people. Research shows that serum zonulin levels are associated with increased intestinal permeability (IP), affecting neural, hormonal, and immunological pathways. This systematic review and meta-analysis aimed to summarize evidence from observational studies on IP in children diagnosed with mental disorders. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of the Cochrane Library, PsycINFO, PubMed, and the Web of Science identified 833 records. Only non-intervention (i.e., observational) studies in children (<18 years) diagnosed with mental disorders, including a relevant marker of intestinal permeability, were included. Five studies were selected, with the risk of bias assessed according to the Newcastle–Ottawa scale (NOS). Four articles were identified as strong and one as moderate, representing altogether 402 participants providing evidence on IP in children diagnosed with attention deficit and hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and obsessive–compulsive disorder (OCD). In ADHD, elevated serum zonulin levels were associated with impaired social functioning compared to controls. Children with ASD may be predisposed to impair intestinal barrier function, which may contribute to their symptoms and clinical outcome compared to controls. Children with ASD, who experience gastro-intestinal (GI) symptoms, seem to have an imbalance in their immune response. However, in children with OCD, serum zonulin levels were not significantly different compared to controls, but serum claudin-5, a transmembrane tight-junction protein, was significantly higher. A meta-analysis of mean zonulin plasma levels of patients and control groups revealed a significant difference between groups (p = 0.001), including the four studies evaluating the full spectrum of the zonulin peptide family. Therefore, further studies are required to better understand the complex role of barrier function, i.e., intestinal and blood–brain barrier, and of inflammation, to the pathophysiology in mental and neurodevelopmental disorders. This review was PROSPERO preregistered, (162208).
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296
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Kumar S, Verma V, Kushwaha U, Calvello Hynes EJ, Arya A, Agarwal A. Prevalence and association of depression in in-patient orthopaedic trauma patients: A single centre study in India. J Clin Orthop Trauma 2020; 11:S573-S577. [PMID: 32774031 PMCID: PMC7394789 DOI: 10.1016/j.jcot.2019.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/12/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Depression is characterized by a persistent state of low mood and aversion to activity affecting a person's thoughts, behavior, feelings and sense of well-being. It has been reported in Orthopaedic trauma patients. Depression is likely to interfere in an individual's ability to sustain a long duration rehabilitation programme leading to poor function and delayed return to a productive lifestyle. The objective of this study was to identify the prevalence and identify factors associated with depression in indoor Orthopaedic trauma patients. METHODS This prospective cohort study was conducted on 190 adult Orthopaedic trauma patients enrolled on a randomly selected day of a week subject to written informed consent. Patients with conditions that may preclude assessment of the mental status were excluded from the study. Age, sex, duration since injury, Injury Severity Score (ISS), type of surgery, marital status, insurance coverage, level of education, socioeconomic status, familial support, substance abuse. Hospital anxiety and depression scale (HADS) score and pain score (visual analogue scale) were recorded as soon as the patient was stabilized. Bivariate analyses and Logistic regression were used to identify factors associated with a HADS score of ≥8. RESULTS Mean age was 33.8 years. One hundred fifty-one (79.47%) patients were males and thirty-nine patients were females (21.53%). A HADS score ≥8 was present in 42.63% enrolled cases. On logistic regression a higher pain score, nuclear family, and female sex were found to be significantly associated with HADS ≥8. CONCLUSION Depression is common in indoor Orthopaedic trauma patients. HADS may be used to screen patients for depression and refer patients to a psychiatrist for a definitive diagnosis and management.
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Affiliation(s)
| | - Vikas Verma
- Department of Orthopaedics, KGMU, India,Corresponding author.
| | | | - Emilie J. Calvello Hynes
- Department of Emergency Medicine, University of Colorado Anschutz medical campus School of Medicine, USA
| | - Amit Arya
- Department of Psychiatry, KGMU, India
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297
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Khandaker GM, Zuber V, Rees JMB, Carvalho L, Mason AM, Foley CN, Gkatzionis A, Jones PB, Burgess S. Shared mechanisms between coronary heart disease and depression: findings from a large UK general population-based cohort. Mol Psychiatry 2020; 25:1477-1486. [PMID: 30886334 PMCID: PMC7303009 DOI: 10.1038/s41380-019-0395-3] [Citation(s) in RCA: 133] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/29/2019] [Accepted: 02/14/2019] [Indexed: 12/15/2022]
Abstract
While comorbidity between coronary heart disease (CHD) and depression is evident, it is unclear whether the two diseases have shared underlying mechanisms. We performed a range of analyses in 367,703 unrelated middle-aged participants of European ancestry from UK Biobank, a population-based cohort study, to assess whether comorbidity is primarily due to genetic or environmental factors, and to test whether cardiovascular risk factors and CHD are likely to be causally related to depression using Mendelian randomization. We showed family history of heart disease was associated with a 20% increase in depression risk (95% confidence interval [CI] 16-24%, p < 0.0001), but a genetic risk score that is strongly associated with CHD risk was not associated with depression. An increase of 1 standard deviation in the CHD genetic risk score was associated with 71% higher CHD risk, but 1% higher depression risk (95% CI 0-3%; p = 0.11). Mendelian randomization analyses suggested that triglycerides, interleukin-6 (IL-6), and C-reactive protein (CRP) are likely causal risk factors for depression. The odds ratio for depression per standard deviation increase in genetically-predicted triglycerides was 1.18 (95% CI 1.09-1.27; p = 2 × 10-5); per unit increase in genetically-predicted log-transformed IL-6 was 0.74 (95% CI 0.62-0.89; p = 0.0012); and per unit increase in genetically-predicted log-transformed CRP was 1.18 (95% CI 1.07-1.29; p = 0.0009). Our analyses suggest that comorbidity between depression and CHD arises largely from shared environmental factors. IL-6, CRP and triglycerides are likely to be causally linked with depression, so could be targets for treatment and prevention of depression.
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Affiliation(s)
- Golam M Khandaker
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Verena Zuber
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Jessica M B Rees
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Livia Carvalho
- Department of Clinical Pharmacology, Queen Mary University of London, London, UK
| | - Amy M Mason
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
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298
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Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124242. [PMID: 32545876 PMCID: PMC7345112 DOI: 10.3390/ijerph17124242] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 02/07/2023]
Abstract
The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.
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299
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Fagundes CP, Wu EL. Matters of the heart: Grief, morbidity, and mortality. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE 2020; 29:235-241. [PMID: 33758475 PMCID: PMC7983846 DOI: 10.1177/0963721420917698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Spousal bereavement is associated with an elevated risk of morbidity and mortality. Several well-regarded multidisciplinary research teams have sought to understand the biopsychosocial processes underlying why widow(er)s are at elevated physical health risk. In this paper, we review research from multiple investigatory teams, including our own, showing that, on average, widow(er)s exhibit maladaptive patterns of autonomic, neuroendocrine, and immune activity compared to matched comparisons. Widow(er)s also exhibit poorer health behaviors than they did before their spouse's death. There is considerable variation in post-loss psychological adjustment trajectories among widow(er)s, which likely corresponds to physical health risk trajectories. Yet, there is little biobehavioral research on patterns of change in physical health risk after the death of a spouse. We summarize recently published work demonstrating the utility of attachment theory to characterize and predict individual differences in physical health biomarkers; we highlight the need for a biopsychosocial approach to understand and characterize post-loss trajectory patterns. We conclude by discussing the possibility that this line of inquiry could help researchers, and ultimately providers, identify adjustment trajectories earlier and thus deliver appropriate interventions when they are most needed.
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Affiliation(s)
- Christopher P Fagundes
- Rice University, Houston, TX
- The University of Texas MD Anderson Cancer Center, Houston, TX
- Baylor College of Medicine, Houston, TX
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300
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Shen M, Xiao Y, Su J, Zhao S, Li J, Tao J, Kang X, Wu B, Shan S, Wang X, Chen X. Prevalence and patient-reported outcomes of noncommunicable skin diseases among college students in China. JAAD Int 2020; 1:23-30. [PMID: 34409315 PMCID: PMC8361873 DOI: 10.1016/j.jdin.2020.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2020] [Indexed: 01/22/2023] Open
Abstract
Background The prevalence and health-related quality of life of skin disease have been understudied in adolescents. Objective To investigate the prevalence and relevant patient-reported outcomes of noncommunicable skin diseases in college students. Methods First-year college students from 5 universities in China were investigated in the cross-sectional study. Skin diseases were diagnosed by dermatologists in the field survey. Itch and pain, symptoms of depression and anxiety, and sleep quality were measured by validated tools. Results A total of 28,364 students consented to participate and completed the survey. The prevalence of acne, eczema, chronic urticaria, psoriasis, and vitiligo was 10.3%, 5.8%, 2.6%, 0.16%, and 0.23%, respectively. Eczema and chronic urticaria were associated with lower health utility estimates. Most diseases, but not psoriasis and vitiligo, were associated with the symptoms of depression and sleep disturbance. Itch intensity predicted other patient-reported outcome scores better in healthy controls than in individuals with skin diseases. Sex difference in the associations of skin diseases with patient-reported outcomes was not identified. Limitations Cross-sectional study design and limited generalizability to the nonstudent population. Conclusion Skin diseases are associated with moderately impaired emotional well-being, sleep quality, and quality of life, partly attributable to cutaneous symptoms.
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Affiliation(s)
- Minxue Shen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Yi Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Correspondence to: Yi Xiao, MD, Xiangya Hospital, 87 Xiangya Road, Changsha, Hunan, China 410008.
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Tao
- Department of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaojing Kang
- Department of Dermatology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumchi, China
| | - Bin Wu
- Department of Dermatology, The Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot, China
| | - Shijun Shan
- Department of Dermatology, Xiang'an Hospital, Xiamen University, Xiamen, China
| | - Xiaohui Wang
- Department of Dermatology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Xiang Chen, MD, Xiangya Hospital, 87 Xiangya Road, Changsha, Hunan, China 410008.
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