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Klyne DM, Smith SS, Hall M. Should cognitive behavioral therapy for insomnia be considered for preventing and managing chronic pain? Sleep 2024; 47:zsae177. [PMID: 39093687 PMCID: PMC11467058 DOI: 10.1093/sleep/zsae177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Indexed: 08/04/2024] Open
Affiliation(s)
- David M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Simon S Smith
- Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Michelle Hall
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, University of Sydney, Sydney, NSW, Australia
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Chen MA, Chen E, Gallivan SU, Brody EJ, Passarelli V, Miller GE. Socioeconomic Disadvantage, Neighborhood Belonging, and Inflammation Among Adolescents. Psychosom Med 2024; 86:660-669. [PMID: 39109943 PMCID: PMC11444907 DOI: 10.1097/psy.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
OBJECTIVE Childhood socioeconomic disadvantage is associated with a host of adverse health outcomes across the lifespan. However, there is increasing interest in identifying factors that may promote resilience to disadvantage's effects on health. One promising candidate in this regard is a sense of neighborhood belonging, which could offset health risks by providing a sense of connection to others, as well as a sense of belonging to a community larger than oneself. METHODS In a sample of 245 adolescents (age: mean [standard deviation] = 15.98 [0.54] years; sex: 64.1% female; race: 41.6% White, 37.6% Black/African American, 9.8% Other; ethnicity: 68.6% non-Hispanic), we examined neighborhood belonging as a moderator of the relationship between socioeconomic disadvantage (measured on a 0- to 5-point scale, mean [standard deviation] = 1.21 [1.36]) and low-grade inflammation (measured via a composite of circulating inflammatory biomarkers including IL-6, IL-8, IL-10, TNF-α, CRP, and suPAR). Covariates included age, sex, race/ethnicity, and pubertal status. RESULTS Neighborhood belonging buffered the relationship between socioeconomic disadvantage and low-grade inflammation, a key mechanistic pathway to multiple chronic diseases. Specifically, there was a positive relationship between socioeconomic disadvantage and low-grade inflammation among individuals with low neighborhood belonging, but not among individuals with high neighborhood belonging. CONCLUSIONS These findings suggest that neighborhood belonging is one type of social connection factor that can mitigate the relationship between socioeconomic disadvantage and low-grade inflammation in youth.
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Affiliation(s)
- Michelle A Chen
- From the Institute of Policy Research, Northwestern University (M. Chen, E. Chen, Gallivan, Brody, Passarelli, Miller), Evanston, Illinois; and Saint Louis University School of Medicine (Brody), St. Louis, Missouri
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Wang X, Chien WT, Chong YY. Effectiveness of psychosocial interventions for improving asthma symptoms and parental stress in families of school-age children with asthma: A systematic review and meta-analysis. Int J Nurs Stud 2024; 160:104905. [PMID: 39316993 DOI: 10.1016/j.ijnurstu.2024.104905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 06/07/2024] [Accepted: 09/03/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Asthma is a prevalent chronic disease affecting school-age children, with substantial psychosocial implications for children and their parents. OBJECTIVES This review aimed to synthesise current evidence on the effects of psychosocial interventions for families of school-age children with asthma and investigate the optimal features of effective interventions. METHODS Embase, MEDLINE, PsycINFO, CINAHL, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, Google Scholar, CNKI, and Wanfang Data were searched from inception to November 2023. Randomised controlled trials (RCTs) examining psychosocial interventions in children aged six to twelve with asthma on asthma symptoms and parental stress were included. Emergency department visits, hospitalisations, lung function, psychological symptoms and health-related quality of life in both children and parents were secondary outcomes. Data were pooled for short-term (≤ three months), medium-term (> three months and ≤ six months), and long-term (> six months) follow-ups. Risk of bias was appraised using version 2 of the Cochrane risk of bias tool for randomised trials. Meta-analysis was performed using RevMan 5.4.1. RESULTS Seven RCTs with 884 parent-child dyads from two countries were included. Meta-analyses found that psychosocial interventions improved asthma control (k = 2, n = 301, standardised mean difference [SMD] 0.35, 95 % confidence interval [CI] 0.12 to 0.58, P = 0.003), sleep problem (k = 2, n = 149, SMD -0.47, 95 % CI -0.79 to -0.14, P = 0.005), cough (k = 2, n = 149, SMD -0.97, 95 % CI -1.59 to -0.35, P = 0.002), wheezing (k = 2, n = 149, SMD -0.76, 95 % CI -1.09 to -0.42, P < 0.0001), and parental stress (k = 6, n = 813, SMD -0.32, 95 % CI -0.61 to -0.02, P = 0.03), compared to controls in the short term. Subgroup analysis revealed significant effects of psychoeducation, family empowerment interventions, and acceptance and commitment therapy-based interventions on reducing parental stress. No significant intervention effects were observed on parental symptoms of depression at any follow-up. Narrative synthesis indicated that psychosocial interventions may provide benefits in children's health-related quality of life in the short term, parental symptoms of anxiety in the medium term, and activity limitation, cough, and wheezing in the long term. The intervention effects for other reviewed outcomes were inconsistent. CONCLUSIONS Psychosocial interventions demonstrate possible benefits for families of school-aged children with asthma in asthma symptoms, parental stress, and children's health-related quality of life within three months post-intervention and parental symptoms of anxiety at six months post-intervention. Future research with rigorous design should investigate the optimal duration, frequency, and intervention approaches of psychosocial interventions. TWEETABLE ABSTRACT Psychosocial interventions improve asthma symptoms and parental stress within three months post-intervention for families of school-age children with asthma @ConnieChong1.
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Affiliation(s)
- Xu Wang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Jin H, Du D, Xie Y, Jin H, Tong J, Li B, Chu W. The role of marital status in gallbladder cancer: a real-world competing risk analysis. BMC Gastroenterol 2024; 24:276. [PMID: 39164628 PMCID: PMC11334324 DOI: 10.1186/s12876-024-03364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/08/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND The association between marital status and gallbladder cancer (GBC) remains uncertain. This study aimed to verify the relationship between marital status and GBC and construct a prognostic nomogram to predict the impact of marital status on GBC patients. METHOD GBC patients were divided into married and unmarried groups using data from the Surveillance, Epidemiology, and End Results (SEER) database. We employed competing risk analyses, propensity score matching (PSM), and Kaplan-Meier survival analyses. The relationship between marital status and GBC was then verified, and the predicted nomogram was constructed. RESULTS A total of 3913 GBC patients were obtained from the SEER database, and an additional 76 GBC patients from Hangzhou Traditional Chinese Medicine Hospital were selected as the external validation group. The competing risk analysis revealed a significant disparity in the 5-year cumulative incidence of cancer-specific death (CSD) between the two cohorts (59.1% vs. 65.2%, p = 0.003). Furthermore, the multivariate competing hazards regression analysis identified a significant association (HR, 1.17; 95% CI, 1.04-1.31; p = 0.007) between marital status and CSD. To assess the 1-, 3-, and 5-year risks of CSD, a comprehensive competing event nomogram was constructed using factors derived from the multivariate analysis. The area under the receiver operating characteristic curve (AUC) values for the 1-, 3-, and 5-year training cohorts were 0.806, 0.785, and 0.776, respectively. In the internal validation cohort, these values were 0.798, 0.790, and 0.790, while the external validation cohort exhibited AUC values of 0.748, 0.835, and 0.883 for the corresponding time intervals. Furthermore, calibration curves demonstrated a commendable level of concordance between the observed and predicted probabilities of CSD. CONCLUSION Marriage was a protective factor for GBC patients after taking competing risk into consideration. The proposed nomogram demonstrated exceptional predictive power.
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Affiliation(s)
- Haimin Jin
- Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang province, 310000, China
| | - Danwei Du
- Department of Anorectal, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, Zhejiang province, 310000, China
| | - Yangyang Xie
- Key Laboratory of Laparoscopic Technology of Zhejiang Province, Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang province, 310000, China
| | - Haijuan Jin
- Department of Obstetrics and Gynecology, Hangzhou Linping TCM Hospital, Hangzhou, Zhejiang province, 310000, China
| | - Jinfei Tong
- Department of Anorectal, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, Zhejiang province, 310000, China
| | - Binbin Li
- Department of Anorectal, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, Zhejiang province, 310000, China
| | - Weijian Chu
- Department of Anorectal, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, Zhejiang province, 310000, China.
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Maples-Keller JL, Michopoulos V. Virtual reality exposure therapy reduces inflammation and symptoms in social anxiety disorder: Is the future here already? Brain Behav Immun 2024; 120:32-33. [PMID: 38788965 DOI: 10.1016/j.bbi.2024.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Affiliation(s)
- Jessica L Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States
| | - Vasiliki Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, United States.
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Janak JC, Loughlin AM, Moore PC, Lemay CA, Mease PJ, Lebwohl M, Korzenik JR, Cross RK, Hudesman D. The Burden of Work Productivity and Activity Impairment in Patients with Psoriasis, Psoriatic Arthritis, Ulcerative Colitis, and Crohn's Disease. Dig Dis Sci 2024; 69:2784-2795. [PMID: 38811505 DOI: 10.1007/s10620-024-08451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/15/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Comparisons among autoimmune diseases enable understanding of the burden and factors associated with work productivity loss and impairment. AIMS The objective was to compare work productivity and activity and associated factors among patients with inflammatory bowel diseases and other autoimmune conditions. METHODS This cross-sectional study included employed, adult patients (age 20-64 years) in the CorEvitas Inflammatory Bowel Disease, Psoriasis, and Psoriatic Arthritis/Spondyloarthritis Registries between 5/2017 and 6/2020. Any patient-reported impairment on four domains of the Work Productivity and Activity Index (WPAI) was collected across registries. Prevalence for each autoimmune disease was reported and stratified by disease activity using direct age-sex-standardization. Factors associated with the presence of any WPAI were identified in logistic regression models. RESULTS A total of 7,169 patients with psoriasis (n = 4,768, 67%), psoriatic arthritis (n = 1,208, 17%), Crohn's disease (CD, n = 621, 9%), and ulcerative colitis (UC, n = 572, 8%) met inclusion criteria. Among patients not in remission across all disease cohorts, the age-sex-standardized prevalence of any presenteeism, work productivity loss, and activity impairment ranged from 54 to 97%. Patients with CD in remission had higher standardized prevalence of presenteeism (53% [48-57%]) and work productivity loss (54% [49-59%]), compared to those from other cohorts (presenteeism [range: 33-39%] and work productivity loss [range: 37-41%]). For all WPAI domains, the strongest adjusted associations were for moderate to severe disease activity and psychosocial symptoms. CONCLUSIONS Patients with moderate to severe disease activity reported the highest WPAI burden. However, patients in remission or mild disease activity also report some WPAI burden, emphasizing a multidisciplinary treatment approach to improve work productivity loss and impairment.
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Affiliation(s)
| | | | | | | | - Philip J Mease
- Swedish Medical Center/Providence St. Joseph Health, University of Washington School of Medicine, Seattle, WA, USA
| | | | | | - Raymond K Cross
- University of Maryland School of Medicine, Baltimore, MD, USA
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Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 PMCID: PMC11381009 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
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Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
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Butera KA, Chimenti RL, Alsouhibani AM, Berardi G, Booker SQ, Knox PJ, Post AA, Merriwether EN, Wilson AT, Simon CB. Through the Lens of Movement-Evoked Pain: A Theoretical Framework of the "Pain-Movement Interface" to Guide Research and Clinical Care for Musculoskeletal Pain Conditions. THE JOURNAL OF PAIN 2024; 25:104486. [PMID: 38316243 PMCID: PMC11180580 DOI: 10.1016/j.jpain.2024.01.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/05/2024] [Accepted: 01/29/2024] [Indexed: 02/07/2024]
Abstract
Over 120 million Americans report experiencing pain in the past 3 months. Among these individuals, 50 million report chronic pain and 17 million report pain that limits daily life or work activities on most days (ie, high-impact chronic pain). Musculoskeletal pain conditions in particular are a major contributor to global disability, health care costs, and poor quality of life. Movement-evoked pain (MEP) is an important and distinct component of the musculoskeletal pain experience and represents an emerging area of study in pain and rehabilitation fields. This focus article proposes the "Pain-Movement Interface" as a theoretical framework of MEP that highlights the interface between MEP, pain interference, and activity engagement. The goal of the framework is to expand knowledge about MEP by guiding scientific inquiry into MEP-specific pathways to disability, high-risk clinical phenotypes, and underlying individual influences that may serve as treatment targets. This framework reinforces the dynamic nature of MEP within the context of activity engagement, participation in life and social roles, and the broader pain experience. Recommendations for MEP evaluation, encompassing the spectrum from high standardization to high patient specificity, and MEP-targeted treatments are provided. Overall, the proposed framework and recommendations reflect the current state of science in this emerging area of study and are intended to support future efforts to optimize musculoskeletal pain management and enhance patient outcomes. PERSPECTIVE: Movement-evoked pain (MEP) is a distinct component of the musculoskeletal pain experience and emerging research area. This article introduces the "Pain-Movement Interface" as a theoretical framework of MEP, highlighting the interface between MEP, pain interference, and activity engagement. Evaluating and treating MEP could improve rehabilitation approaches and enhance patient outcomes.
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Affiliation(s)
- Katie A. Butera
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Ruth L. Chimenti
- Department of Physical Therapy & Rehabilitation Science, University of Iowa, Iowa City, Iowa, USA
| | - Ali M. Alsouhibani
- Department of Physical Therapy, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | - Giovanni Berardi
- Department of Physical Therapy & Rehabilitation Science, University of Iowa, Iowa City, Iowa, USA
| | - Staja Q. Booker
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, Florida, USA
| | - Patrick J. Knox
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Andrew A. Post
- Department of Physical Therapy & Rehabilitation Science, University of Iowa, Iowa City, Iowa, USA
| | - Ericka N. Merriwether
- Department of Physical Therapy, NYU Steinhardt School of Culture, Education, and Human Development, Department of Medicine, NYU Grossman School of Medicine, New York University, New York, New York, USA
| | - Abigail T. Wilson
- School of Kinesiology & Rehabilitation Sciences, University of Central Florida, Orlando, Florida, USA
| | - Corey B. Simon
- Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA
- Duke Clinical Research Institute, Durham, North Carolina, USA
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Dwi Ariyanto R, Rachmawati I, Nanda Eka Saputra W, Saputra R, Yuniar Setyaputri N. Correspondence to Antici et al. Salivary CRP predicts treatment response to virtual reality exposure therapy for social anxiety disorder. Brain Behav Immun 2024; 119:351-352. [PMID: 38579935 DOI: 10.1016/j.bbi.2024.03.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024] Open
Abstract
The study by Antici et al. (2024) investigates the effects of virtual reality exposure therapy on social anxiety disorder (SAD), focusing on the relationship between C-reactive protein (CRP) levels in saliva and therapy outcomes. Findings indicate that this therapy not only reduces SAD symptoms and discomfort but also correlates with decreased systemic inflammation, as evidenced by lowered CRP levels. Remarkably, higher baseline CRP levels predicted a greater reduction in anxiety symptoms, suggesting a unique response pattern in SAD compared to other psychological disorders. This study highlights systemic inflammation's significance in SAD and the promise of non-invasive biomarkers like salivary CRP for managing psychological disorders. It calls for more research to understand the underlying mechanisms and validate these initial findings.
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Affiliation(s)
| | | | | | - Rikas Saputra
- Universitas Islam Negeri Raden Fatah Palembang, south Sumatra, Indonesia.
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Gandarela L, de A. Sampaio TP, Marçal L, Burdmann EA, Neto FL, Bernik MA. Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial. Brain Behav Immun Health 2024; 38:100779. [PMID: 38725444 PMCID: PMC11081778 DOI: 10.1016/j.bbih.2024.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Generalized anxiety disorder (GAD) has been associated with elevated levels of C-reactive protein (CRP) and proinflammatory cytokines. Despite robust evidence as an effective treatment for GAD, research on the effects of cognitive-behavioral therapies (CBT) in the inflammatory profile of patients with clinical anxiety has presented mixed results. Objective The present study aimed to investigate the effect of an acceptance-based behavior therapy (ABBT) on inflammatory biomarkers and their association with anxiety levels in GAD patients in comparison to supportive therapy as an active control. Methods Peripheral inflammatory biomarkers (CRP, IL-1β, IL-4, IL-6, IL-10, TNF-α) were measured in 77 GAD patients who participated in a 14-week 10-session randomized clinical trial of group ABBT (experimental, n = 37) or supportive group therapy (ST: active control group, n = 40). Results The concentrations of IL-1β decreased in the control group and the concentrations of IL-6 increased in the experimental group from baseline to post-treatment, whereas no difference was identified in IL-4, IL-10, TNF, or CRP. Although anxiety and depression levels decreased in both treatment conditions, no correlation with inflammation markers was found for most clinical and biological variables. A negative correlation between changes in IL-6 and IL-10 and anxiety symptom score changes was identified. Conclusions The present study results found that a short trial of acceptance-based behavior therapy did not change the proinflammatory profile which may be associated with GAD. Additional research is needed to evaluate the influence of other inflammation-related variables, longer periods of follow-up as well as the effect of supportive therapy on peripheral inflammatory biomarkers in GAD patients.
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Affiliation(s)
- Lucas Gandarela
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
| | - Thiago P. de A. Sampaio
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Lia Marçal
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Emmanuel A. Burdmann
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Francisco Lotufo Neto
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Marcio A. Bernik
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
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11
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Zhou X, Ganz AB, Rayner A, Cheng TY, Oba H, Rolnik B, Lancaster S, Lu X, Li Y, Johnson JS, Hoyd R, Spakowicz DJ, Slavich GM, Snyder MP. Dynamic Human Gut Microbiome and Immune Shifts During an Immersive Psychosocial Therapeutic Program. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.26.600881. [PMID: 38979211 PMCID: PMC11230355 DOI: 10.1101/2024.06.26.600881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Background Depression is a leading cause of disability worldwide yet its underlying factors, particularly microbial associations, are poorly understood. Methods We examined the longitudinal interplay between the microbiome and immune system in the context of depression during an immersive psychosocial intervention. 142 multi-omics samples were collected from 52 well-characterized participants before, during, and three months after a nine-day inquiry-based stress reduction program. Results We found that depression was associated with both an increased presence of putatively pathogenic bacteria and reduced microbial beta-diversity. Following the intervention, we observed reductions in neuroinflammatory cytokines and improvements in several mental health indicators. Interestingly, participants with a Prevotella-dominant microbiome showed milder symptoms when depressed, along with a more resilient microbiome and more favorable inflammatory cytokine profile, including reduced levels of CXCL-1. Conclusions Our findings reveal a protective link between the Prevotella-dominant microbiome and depression, associated with a less inflammatory environment and moderated symptoms. These insights, coupled with observed improvements in neuroinflammatory markers and mental health from the intervention, highlight potential avenues for microbiome-targeted therapies in depression management.
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Affiliation(s)
- Xin Zhou
- Department of Genetics, Stanford University School of Medicine, CA, USA
- Stanford Center for Genomics and Personalized Medicine, Stanford university School of Medicine, CA, USA
- These authors contributed equally to the work
| | - Ariel B. Ganz
- Department of Genetics, Stanford University School of Medicine, CA, USA
- Stanford Healthcare Innovation Lab, Stanford University, CA, USA
- These authors contributed equally to the work
| | - Andre Rayner
- Department of Genetics, Stanford University School of Medicine, CA, USA
| | - Tess Yan Cheng
- Department of Genetics, Stanford University School of Medicine, CA, USA
- Department of Microbiology, College of Arts and Sciences, University of Washington, WA, USA
| | - Haley Oba
- Department of Genetics, Stanford University School of Medicine, CA, USA
| | - Benjamin Rolnik
- Department of Genetics, Stanford University School of Medicine, CA, USA
- Stanford Healthcare Innovation Lab, Stanford University, CA, USA
| | - Samuel Lancaster
- Department of Genetics, Stanford University School of Medicine, CA, USA
| | - Xinrui Lu
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Sichuan, China
| | - Yizhou Li
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Sichuan, China
| | - Jethro S. Johnson
- Oxford Centre for Microbiome Studies, Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK
| | - Rebecca Hoyd
- The Ohio State University Comprehensive Cancer Center, OH, USA
| | | | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Michael P. Snyder
- Department of Genetics, Stanford University School of Medicine, CA, USA
- Stanford Center for Genomics and Personalized Medicine, Stanford university School of Medicine, CA, USA
- Stanford Healthcare Innovation Lab, Stanford University, CA, USA
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Hemond CC, Deshpande M, Berrios-Morales I, Zheng S, Meyer JS, Slavich GM, Cole SW. A single-arm, open-label pilot study of neuroimaging, behavioral, and peripheral inflammatory correlates of mindfulness-based stress reduction in multiple sclerosis. Sci Rep 2024; 14:14044. [PMID: 38890336 PMCID: PMC11189512 DOI: 10.1038/s41598-024-62960-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
Multiple sclerosis (MS) is a chronic neurological disease frequently associated with significant fatigue, anxiety, depression, and stress. These symptoms are difficult to treat, and prominently contribute to the decreases in quality of life observed with MS. The underlying mechanisms of these "silent" symptoms are not well understood and include not just the psychological responses to a chronic disease, but also biological contributions from bidirectional psycho-neuro-immune (dys)regulation of systemic inflammatory biology. To address these issues, we conducted a prospective, observational pilot study to investigate the psychological, biological, and neuroarchitecture changes associated with a mindfulness-based stress reduction (MBSR) program in MS. The overarching hypothesis was that MBSR modulates systemic and central nervous system inflammation via top-down neurocognitive control over forebrain limbic areas responsible for the neurobiological stress response. 23 patients were enrolled in MBSR and assessed pre/post-program with structural 3 T MRI, behavioral measures, hair cortisol, and blood measures of peripheral inflammation, as indexed by the Conserved Transcriptional Response to Adversity (CTRA) profile. MBSR was associated with improvements across a variety of behavioral outcomes, as well as on-study enlargement of the head of the right hippocampus. The CTRA analyses revealed that greater inflammatory gene expression was related to worse patient-reported anxiety, depression, stress, and loneliness, in addition to lower eudaimonic well-being. Hair cortisol did not significantly change from pre- to post-MBSR. These results support the use of MBSR in MS and elucidate inflammatory mechanisms related to key patient-reported outcomes in this population.
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Affiliation(s)
- Christopher C Hemond
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA.
| | - Mugdha Deshpande
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Idanis Berrios-Morales
- Department of Neurology, University of Massachusetts Chan Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA
| | - Shaokuan Zheng
- Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA
| | - Jerrold S Meyer
- Department of Psychological & Brain Sciences, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Steven W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
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13
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Gogoll C, Peters E, Köllner V, Koczulla R. [S1 guideline long/post-COVID syndrome]. UROLOGIE (HEIDELBERG, GERMANY) 2024:10.1007/s00120-024-02373-9. [PMID: 38886205 DOI: 10.1007/s00120-024-02373-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Christian Gogoll
- Ambulante Dienste, Ev. Lungenklinik Berlin, Berlin, Deutschland.
| | - Eva Peters
- Universitätsklinik Gießen und Marburg, Gießen und Marburg, Deutschland
- Schwerpunkt Psychoneuroimmunologie, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Volker Köllner
- Forschungsgruppe Psychosomatische Rehabilitation & Rehazentrum Seehof der Deutschen Rentenversicherung mit aktuell Entwicklung eines kardiopsychosomatischen ambulanten Rehakonzeptes für Post-COVID Patienten, Charité Universitätsmedizin Berlin, Berlin, Deutschland
| | - Rembert Koczulla
- Schön Klinik Berchtesgadener Land, Forschungsinstitut für Pneumologische Rehabilitation, Philipps-Universität Marburg, Marburg, Deutschland
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14
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White MA, Hoffman VM, Yale M, Strong R, Tomayko MM. Psychosocial burden of autoimmune blistering diseases: A comprehensive survey study. J Eur Acad Dermatol Venereol 2024. [PMID: 38837452 DOI: 10.1111/jdv.20156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 05/03/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Autoimmune blistering diseases (AIBDs) are severe dermatologic disorders known for their debilitating physical impact. Recent research has reported that AIBDs lead to psychosocial impairment, including depression and anxiety. Missing from the extant literature is an examination of the impact of AIBDs on body image and related psychological constructs. OBJECTIVES The current study seeks to characterize the psychological and social consequences of AIBD diagnosis, with particular attention to body image dissatisfaction. METHODS We conducted a survey study of adults with AIBDs. The survey was open from February 2023 to March 2023. Validated self-report questionnaires assessed depressive symptomatology, body image disturbance and quality of life. Demographic information and self-reported psychiatric history before and after AIBD diagnosis were collected via self-report. Participants were 451 adults with AIBDs, recruited through the International Pemphigus and Pemphigoid Foundation newsletters, email distribution lists and social media. RESULTS Participants reported increased incidence of psychiatric disorders following AIBD diagnosis. Participants reported high levels of depressive symptomatology and impairments to quality of life compared to other patient groups. The sample reported extremely high levels of body image disturbance, more so than other patients with disfiguring diseases or injury. Correlation analyses revealed significant relationships between body image variables and quality of life, even after controlling for depression. CONCLUSIONS Current treatment guidelines for AIBDs focus primarily on the management of disease flares and the consequences of immunosuppression, without consideration of the psychosocial consequences of the disease. The current study underscores the need for mental health support for patients with AIBDs.
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Affiliation(s)
- Marney A White
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Victoria M Hoffman
- Jacobs School of Medicine, University of Buffalo, Getzville, New York, USA
| | - Marc Yale
- International Pemphigus & Pemphigoid Foundation, Roseville, California, USA
| | - Rebecca Strong
- International Pemphigus & Pemphigoid Foundation, Roseville, California, USA
| | - Mary M Tomayko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
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15
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Ballesio A, Zagaria A, Violani C, Lombardo C. Psychosocial and behavioural predictors of immune response to influenza vaccination: a systematic review and meta-analysis. Health Psychol Rev 2024; 18:255-284. [PMID: 37106577 DOI: 10.1080/17437199.2023.2208652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/26/2023] [Indexed: 04/29/2023]
Abstract
High variability of influenza vaccine efficacy requires the identification of modulators of immunisation that may be targeted as adjuvants in health psychology interventions. Psychosocial and behavioural variables such as psychological stress, greater negative and lower positive affectivity, poor sleep, loneliness, and lack of social support, have been associated with abnormal immune and inflammatory responses and negative health outcomes, yet their effects in modulating vaccine efficacy are yet to be fully understood. We conducted an updated systematic review of longitudinal and experimental studies examining the effects of such variables in predicting immune response to influenza vaccine. PubMed, Medline, PsycINFO, CINAHL and Scopus were searched up to November 2022. Twenty-five studies met the inclusion criteria for qualitative synthesis and 16 provided data for meta-analysis. Low positive and high negative affect were associated with low antibodies and weak cell-mediated immunity following vaccination in qualitative synthesis. Literature on sleep disturbance, loneliness and social support was limited and yielded inconsistent results. Psychological stress was associated with poorer antibody response in meta-analysis. In conclusion, findings from this review suggest a need for further longitudinal and experimental studies on these factors to support their inclusion as target variables in vaccine adjuvant interventions.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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16
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Chen X, Guo Y, Zhang T, Lin J, Ding X. Effects of cognitive behavioral therapy in patients with chronic obstructive pulmonary disease: A systematic review and meta-analysis. Worldviews Evid Based Nurs 2024; 21:288-306. [PMID: 38169138 DOI: 10.1111/wvn.12705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) causes airflow blockage and breathing-related issues. This chronic disease impacts people worldwide. Substantial evidence supports the use of cognitive behavioral therapy (CBT) to help patients with chronic illnesses cope with worrisome and painful symptoms. However, the impact of CBT on COPD outcomes is less understood. OBJECTIVE In this study, we systematically summarized the effects of CBT on lung function, anxiety and depressive symptoms, and quality of life of patients with COPD. METHODS Six English-language and four Chinese-language databases were systematically searched for relevant randomized controlled trials published through April 15, 2023. Studies in which CBT was the only difference in treatment administered to experimental and control groups were included in the review. The studies' risk of bias was evaluated using the Cochrane Criteria. RESULTS Sixteen studies (1887 participants) were included. The meta-analysis showed that CBT improved the percent-predicted forced expiratory volume in 1 second (FEV1%), forced vital capacity (FVC), FEV1/FVC ratio, maximal voluntary ventilation, peak expiratory flow, treatment compliance, and World Health Organization abbreviated quality of life, Self-rating Anxiety and Depression Scale, and St George's Respiratory Questionnaire scores compared with the control (all p < .05). CONCLUSION This review demonstrated that CBT improves the lung function, anxiety and depressive symptoms, treatment compliance, and quality of life of patients with COPD and can be used widely in the clinical treatment of this disease.
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Affiliation(s)
- Xinming Chen
- Nursing Department, Fujian Health College, Fuzhou, Fujian, China
| | - Yating Guo
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Tuoxin Zhang
- Marxism College, Fujian Polytechnic of lnformation Technology, Fuzhou, Fujian, China
| | - Jiamin Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xintong Ding
- The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
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17
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Antici EE, Kuhlman KR, Treanor M, Craske MG. Salivary CRP predicts treatment response to virtual reality exposure therapy for social anxiety disorder. Brain Behav Immun 2024; 118:300-309. [PMID: 38467380 DOI: 10.1016/j.bbi.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/17/2024] [Accepted: 03/02/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Social anxiety disorder (SAD) places a profound burden on public health and individual wellbeing. Systemic inflammation may be important to the onset and maintenance of SAD, and anti-inflammatory treatments have shown promise in relieving symptoms of SAD. In the present study, we conducted secondary analyses on data from a randomized clinical trial to determine whether C-reactive protein (CRP) concentrations and social anxiety symptoms decreased over the course of virtual reality exposure therapy, and whether changes in social anxiety symptoms as a function of treatment varied as a function of CRP. METHOD Adult participants (N = 78) with a diagnosis of SAD (59 % female) were randomized to receive exposure therapy alone, or exposure therapy supplemented with scopolamine. Social anxiety symptoms, salivary CRP, and subjective units of distress were measured across three exposure therapy sessions, at a post-treatment extinction retest, and at a 1-month follow-up. RESULTS CRP decreased over the course of treatment, b = -0.03 (SE = 0.01), p =.02 95 %CI [-0.06, -0.004], as did all social anxiety symptom domains and subjective distress. Higher CRP was associated with greater decreases from pre-treatment to 1-month follow-up in fear, b = -0.45 (SE = 0.15), p =.004 95 %CI [-0.74, -0.15], and avoidance, b = -0.62 (SE = 0.19), p =.002 95 %CI [-1.01, -0.23], and in-session subjective distress from pre-treatment to post-treatment, b = -0.42 (SE = 0.21), p =.05 95 %CI [-0.83, -0.001]. However, declines in CRP were not correlated with declines in fear, r = -0.07, p =.61, or avoidance, r = -0.10, p =.49, within-persons. CONCLUSIONS Virtual reality exposure therapy may be associated with an improvement in systemic inflammation in patients with severe SAD. Pre-treatment CRP may also be of value in predicting which patients stand to benefit the most from this treatment.
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Affiliation(s)
- Elizabeth E Antici
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, USA.
| | - Kate R Kuhlman
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, USA; Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael Treanor
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
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18
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Ahn S, Kim S, Zhang H, Dobalian A, Slavich GM. Lifetime adversity predicts depression, anxiety, and cognitive impairment in a nationally representative sample of older adults in the United States. J Clin Psychol 2024; 80:1031-1049. [PMID: 38294127 PMCID: PMC11216061 DOI: 10.1002/jclp.23642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 10/28/2023] [Accepted: 12/15/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Although life stress and adversity are well-known risk factors for mental health problems and cognitive impairment among older adults, limited research has comprehensively examined the impact of both childhood and adulthood adversity on psychiatric and cognitive impairment symptoms over a prolonged period. To address this issue, we investigated how lifetime adversity exposure is related to symptoms of depression, anxiety, and cognitive impairment in a nationally representative, longitudinal sample of older adults in the United States. METHOD We analyzed data from the Health and Retirement Study (1992-2016). The sample included 3496 individuals (59.9% female), aged ≥64 years old (Mage = 76.0 ± 7.6 years in 2016). We used the individual-level panel data and ordinary least squares regressions to estimate associations between childhood and adulthood adversities, and later-life depression, anxiety, and cognitive impairment. RESULTS Many participants experienced a significant early life (38%) or adulthood (79%) stressor. Moreover, experiencing one childhood adversity (vs. none) was associated with a 17.4% increased risk of adulthood adversity. Finally, as hypothesized, childhood adversity exposure was related to experiencing more depression and anxiety symptoms in later life, whereas adulthood stressor exposure predicted more cognitive impairment as well as more depression and anxiety symptoms. DISCUSSION These findings demonstrate significant associations between lifetime adversity and symptoms of depression, anxiety, and cognitive impairment in older adults. Screening for lifetime stressors may thus help healthcare professionals and policymakers identify individuals who could potentially benefit from interventions designed to reduce stress and enhance resilience.
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Affiliation(s)
- SangNam Ahn
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
- Center for Population Health and Aging, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Seonghoon Kim
- School of Economics, Singapore Management University, Singapore, Singapore
| | - Hongmei Zhang
- Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis, Tennessee, USA
| | - Aram Dobalian
- Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Nehme A, Moussa S, Fekih-Romdhane F, Hallit S, Obeid S, Haddad G. The mediating role of depression in the association between perceived financial wellbeing and somatization: a study in the context of Lebanon's financial crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-15. [PMID: 38598249 DOI: 10.1080/09603123.2024.2341132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/05/2024] [Indexed: 04/11/2024]
Abstract
The objectives of this study were to examine the association between financial wellbeing and somatization, in addition to the mediating effect of anxiety, depression and stress. To test such hypotheses, a cross-sectional study was carried out between September and October 2021; 403 participants (264 females; age = 32.76 ± 13.24 years) were recruited. Depression mediated the association between financial wellbeing and somatization. A worse financial wellbeing was significantly associated with more depression, which was associated with more somatization. Moreover, a worse financial wellbeing was significantly and directly associated with more somatization. Our study adds to the narrow body of research revolving around the relationship between financial wellbeing and somatization in Lebanese adults. Understanding that the effects of, depression are aggravated in a country such as Lebanon would help establish more preventative guidelines and mental health awareness campaigns. Identifying the correlates of somatization can also be translated into improved interventions.
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Affiliation(s)
- Antonio Nehme
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
| | - Sara Moussa
- Faculty of Medicine, University of Balamand, Koura, Lebanon
| | - Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Georges Haddad
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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20
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Milo F, Imondi C, D’Amore C, Angelino G, Knafelz D, Bracci F, Dall’Oglio L, De Angelis P, Tabarini P. Short-term Psychodynamic Psychotherapy in Addition to Standard Medical Therapy Increases Clinical Remission in Adolescents and Young Adults with Inflammatory Bowel Disease: a Randomised Controlled Trial. J Crohns Colitis 2024; 18:256-263. [PMID: 37621051 PMCID: PMC10896630 DOI: 10.1093/ecco-jcc/jjad145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Inflammatory bowel diseases [IBD] are chronic and pervasive conditions of the gastrointestinal tract with a rising incidence in paediatric and young adult populations. Evidence suggests that psychological disorders might be associated with relapse of disease activity. This study aims to evaluate the efficacy of short-term psychodynamic psychotherapy [STPP] in addition to standard medical therapy [SMT] in maintaining clinical remission in adolescents and young adults [AYA] with quiescent IBD, compared with SMT alone. METHODS A two-arm, single-centre, randomised, controlled trial was conducted in 60 IBD AYA in clinical remission. Patients were randomised to receive an 8-week STPP + SMT [n = 30] or SMT alone [n = 30]. The primary outcome was the steroid-free remission rate at 52 weeks after treatment. Secondary outcomes included the overall hospitalisation rate within 52 weeks after treatment, and medication adherence obtained from patient's electronic medical records. RESULTS Intention-to-treat analysis showed significant improvement in maintaining disease remission rates in the 8-week STPP + SMT group compared with the control one. The proportion of patients maintaining steroid-free remission at 52 weeks was higher in patients in STTP group [93.1%] compared with patients randomised to control group [64.3%; p = 0.01]. There were no significant differences in secondary outcomes, except for depression reduction in STPP + SMT group. CONCLUSIONS An 8-week STPP intervention in addition to SMT effectively increases the steroid-free remission rates in AYA with quiescent IBD. Results do not support effects for other secondary outcomes, except for depression reduction.
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Affiliation(s)
- Francesco Milo
- Clinical Psychology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Chiara Imondi
- Digestive Endoscopy Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Carmen D’Amore
- Clinical Epidemiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Angelino
- Digestive Endoscopy Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Daniela Knafelz
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Fiammetta Bracci
- Hepatology, Gastroenterology and Nutrition Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Luigi Dall’Oglio
- Digestive Surgery Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paola De Angelis
- Digestive Endoscopy Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paola Tabarini
- Clinical Psychology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Seaton N, Hudson J, Harding S, Norton S, Mondelli V, Jones ASK, Moss-Morris R. Do interventions for mood improve inflammatory biomarkers in inflammatory bowel disease?: a systematic review and meta-analysis. EBioMedicine 2024; 100:104910. [PMID: 38272759 PMCID: PMC10878994 DOI: 10.1016/j.ebiom.2023.104910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/23/2023] [Accepted: 11/28/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Psychoneuroimmunological mechanisms and the gut-brain axis appear relevant to disease activity and progression in Inflammatory Bowel Disease (IBD). A recent review showed no effect of psychological therapies on self-reported disease activity in IBD. This meta-analysis aims to establish whether interventions targeting mood outcomes (e.g., depression, anxiety and stress) impact inflammation levels in IBD and possible moderators of these effects. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. We searched five electronic databases and included randomised controlled trials where interventions targeted mood and assessed inflammatory outcomes pre- and post-intervention in adults with IBD. Independent reviewers screened studies, extracted data, and assessed methodological quality. Data were pooled to estimate standardised mean differences (SMDs) with 95% Confidence Intervals (CIs). A random-effects robust variance estimation accounted for studies measuring multiple biomarkers. Intervention type, mood as a primary or secondary outcome, effect on mood outcomes and IBD subtype were investigated as treatment effect moderators. Where there were sufficient biomarkers, individual meta-analyses were run (Pre-registration PROSPERO: CRD42023389401). FINDINGS 28 RCTs involving 1789 participants met inclusion criteria. Interventions demonstrated small, statistically significant effects on biomarkers (-0.35, 95% CI: -0.48, -0.22, p < 0.001) and medium effects on mood outcomes (-0.50, 95% CI: -0.73, -0.27, p < 0.001), without evidence of substantive heterogeneity or publication bias. Individual analyses showed small effects for improved faecal calprotectin (-0.19, 95% CI: -0.34, -0.03, p = 0.018) and C-Reactive Protein (-0.29, 95% CI: -0.47, -0.10, p = 0.002). Effect sizes were larger for psychological therapy interventions (compared with exercise or antidepressants) and when there was an effect (SMD ≥0.2) on mood. INTERPRETATION Treatments which address mood outcomes have beneficial effects on generic inflammation as well as disease-specific biomarkers (faecal calprotectin and C-Reactive Protein). Psychological interventions and interventions with larger treatment effects on mood accentuated the effect on biomarkers. More research is required to understand the biological or behavioural mechanisms underlying this effect. FUNDING The Medical Research Council and the National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre.
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Affiliation(s)
- Natasha Seaton
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK.
| | - Joanna Hudson
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
| | - Sophie Harding
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
| | - Sam Norton
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
| | - Valeria Mondelli
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
| | - Annie S K Jones
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
| | - Rona Moss-Morris
- Institute of Psychology Psychiatry and Neuroscience, King's College London, UK
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22
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Zhang H, Wang M, Zhao X, Wang Y, Chen X, Su J. Role of stress in skin diseases: A neuroendocrine-immune interaction view. Brain Behav Immun 2024; 116:286-302. [PMID: 38128623 DOI: 10.1016/j.bbi.2023.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/16/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Psychological stress is a crucial factor in the development of many skin diseases, and the stigma caused by skin disorders may further increase the psychological burden, forming a vicious cycle of psychological stress leading to skin diseases. Therefore, understanding the relationship between stress and skin diseases is necessary. The skin, as the vital interface with the external environment, possesses its own complex immune system, and the neuroendocrine system plays a central role in the stress response of the body. Stress-induced alterations in the immune system can also disrupt the delicate balance of immune cells and inflammatory mediators in the skin, leading to immune dysregulation and increased susceptibility to various skin diseases. Stress can also affect the skin barrier function, impair wound healing, and promote the release of pro-inflammatory cytokines, thereby exacerbating existing skin diseases such as psoriasis, atopic dermatitis, acne, and urticaria. In the present review, we explored the intricate relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective. We explored the occurrence and development of skin diseases in the context of stress, the stress models for skin diseases, the impact of stress on skin function and diseases, and relevant epidemiological studies and clinical trials. Understanding the relationship between stress and skin diseases from a neuroendocrine-immune interaction perspective provides a comprehensive framework for targeted interventions and new insights into the diagnosis and treatment of skin diseases.
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Affiliation(s)
- Hanyi Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Mi Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China; Department of Mental Health Center, Xiangya Hospital, Central South University, Changsha, China
| | - Xue Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Yujie Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Changsha, China.
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Silva RJG, Grippa WR, Pessanha RM, Enriquez-Martinez OG, Neto LCBS, Lopes-Júnior LC. Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio and Their Relationship with Nutritional Status and Quality of Life of Hospitalized Women with Breast Cancer. Nutr Cancer 2024; 76:296-304. [PMID: 38287698 DOI: 10.1080/01635581.2024.2304689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/31/2024]
Abstract
Blood cell biomarkers, such as the neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR), have been recently used as prognostic markers in tumors. In this study, we investigated the association between NLR and PLR with sociodemographic, clinical, anthropometric, and quality of life factors of hospitalized women with non-metastatic breast cancer. A cross-sectional observational study was conducted at a reference center for oncological treatment in Southeast Brazil. Female participants aged over 18 years, with a histopathological diagnosis of stage I, II or III breast cancer, in any phase of antineoplastic treatment, were included. Our study revealed a high risk for participants, with high mean values of NLR and PLR, indicating low antitumor activity and worse prognosis. The binary logistic regression model showed that there was a significant association of the NLR marker and marital status (OR = 3.1; 95%CI = 1.06-8.57; p = 0.03) and, in relation to PLR, a trend was shown for a higher chance in women of black ethnicity to have increased PLR compared to white women (OR = 4.13; 95%CI = 0.96-17.70; p = 0.05). However, the inflammatory markers (NLR and PLR) did not show any significant association with nutritional factors. NLR and PLR are inflammatory biomarkers that can be easily obtained and measured in clinical practice.
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Affiliation(s)
- Roberto Júnio Gomes Silva
- Graduate Program in Nutrition and Health at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Wesley Rocha Grippa
- Graduate Program in Public Health at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | - Raphael Manhães Pessanha
- Graduate Program in Public Health at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
| | | | | | - Luís Carlos Lopes-Júnior
- Graduate Program in Nutrition and Health at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
- Graduate Program in Public Health at the Federal University of Espírito Santo (UFES), Vitoria, ES, Brazil
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Gerdle B, Dragioti E, Rivano Fischer M, Ringqvist Å. Acceptance and Fear-Avoidance Mediate Outcomes of Interdisciplinary Pain Rehabilitation Programs at 12-Month Follow-Up: A Clinical Registry-Based Longitudinal Cohort Study from the Swedish Quality Registry for Pain Rehabilitation (SQRP). J Pain Res 2024; 17:83-105. [PMID: 38196970 PMCID: PMC10775695 DOI: 10.2147/jpr.s438260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
Background Factors that influence outcomes of interdisciplinary pain rehabilitation programs (IPRP) are poorly known. It is unclear how outcomes are influenced by pain intensity, psychological distress, and coping strategies. Aim This clinical registry-based longitudinal cohort study has three aims: 1) to determine the relative importance of pain intensity, psychological distress, acceptance, and fear-avoidance for changes in three outcomes of IPRP at 12-month follow-up; 2) to investigate whether the effects of pain intensity and psychological distress on the three outcomes are mediated via acceptance and fear-avoidance; and 3) to determine whether sex is a moderator. Methods This study uses Patient-Reported Outcome Measures (PROMs) from specialist units reporting data (2008-2016) to the Swedish Quality Registry for Pain Rehabilitation (SQRP). Adult chronic pain patients (N = 1991) answered the PROMs (background, pain, psychological distress, coping, participation, and health-related quality of life (HRQoL)). Partial Least Squares Structural Equation Modelling (PLS-SEM) was used to explore the aims. Results Changes in acceptance (β:0.424-0.553; all P<0.001) were the strongest predictor of the three outcomes (changes in life control, interference, and HRQoL) at 12-month follow-up. The next strongest predictor was baseline acceptance (β: 0.177-0.233; all P<0.001) and changes in fear-avoidance (β: -0.152- -0.186; all P<0.001). Baseline pain intensity and psychological distress showed weak positive associations. Their effects on the three outcomes were mediated via acceptance aspects. Sex was not a moderator. Discussion and Conclusion Acceptance aspects (baseline and changes) were important predictors of IPRP outcomes. Changes in fear-avoidance were also important although to a lesser degree. Some of the effects of pain intensity and psychological distress on outcomes were mediated via acceptance at baseline. Future PLS-SEM analysis of real-world IPRP should include more potential mediators (eg, catastrophizing and more facets of psychological flexibility and fear-avoidance) and the components of IPRP.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Åsa Ringqvist
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
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25
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O'Shields J, Mowbray O, Cooper Z. The effects of childhood maltreatment on social support, inflammation, and depressive symptoms in adulthood. Soc Sci Med 2024; 340:116481. [PMID: 38070306 DOI: 10.1016/j.socscimed.2023.116481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
RATIONALE Social Safety Theory (SST) suggests that social threats increase inflammation, exacerbating health risks, but that social support may decrease inflammatory signaling. One of the key health problems affected by both social forces and inflammation is major depression. OBJECTIVE The present study sought to test aspects of the SST, to understand how social support and inflammation may mediate the effects of childhood maltreatment on depressive symptoms in adulthood. METHODS This study utilized data from the national Midlife Development in the United States study (n = 1969; mean age 53; 77.2% White; 53.6% female) to model the effects of childhood maltreatment on depressive symptoms in adulthood and the potential serial mediating effects of social support and inflammation. Analyses were conducted via structural equation modeling, using the four subscales of the Center for Epidemiologic Studies Depression Scale to indicate depressive symptoms, the five subscales of the Childhood Trauma Questionnaire to indicate childhood maltreatment, and the Positive Relations Scale and a network level measure of support as indicators of social support. Inflammation was indexed using C-reactive protein (CRP). The model was estimated via maximum likelihood with robust standard errors and significance of indirect effects were assessed via a Sobel test. RESULTS Childhood maltreatment was associated with increased depressive symptoms and CRP but decreased social support. Social support was associated with decreased depressive symptoms while CRP was associated with increased depressive symptoms. Assessing indirect effects yielded no serial mediation effect; however, a significant indirect effect from childhood maltreatment to depressive symptoms through social support was identified. CONCLUSIONS Analyses indicate mixed support for the SST with respect to depressive symptoms. Results highlight the role of social support in mitigating the effects depressive symptoms in adulthood; although, alternative strategies may be needed to decrease the effects of childhood maltreatment on inflammation as indexed by CRP.
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K I, Y M, A N, D S, G G, R S, D G, V SN, O S, M F, S R, S O, J MG, A M. Cognitive behavioral and mindfulness with daily exercise intervention is associated with changes in intestinal microbial taxa and systemic inflammation in patients with Crohn's disease. Gut Microbes 2024; 16:2337269. [PMID: 38591914 PMCID: PMC11005811 DOI: 10.1080/19490976.2024.2337269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/27/2024] [Indexed: 04/10/2024] Open
Abstract
Crohn's disease (CD) is a chronic inflammatory bowel disease associated with psychological distress and intestinal microbial changes. Here, we examined whether a 3-month period of Cognitive Behavioral and Mindfulness with Daily Exercise (COBMINDEX) intervention, which improves the wellbeing and inflammatory state of CD patients, may also affect their gut microbiome. Gut microbiota, circulating inflammatory markers and hormones were analyzed in 24 CD patients before (T1) and after 3 months of COBMINDEX (T2), and in 25 age- and sex-matched wait-list control patients at the corresponding time-points. Microbiota analysis examined relative taxonomical abundance, alpha and beta diversity, and microbiome correlations with inflammatory and psychological parameters. At T1, CD patients exhibited a characteristic microbial profile mainly constituted of Proteobacteria (17.71%), Firmicutes (65.56%), Actinobacteria (8.46%) and Bacteroidetes (6.24%). Baseline bacterial abundances showed significant correlations with psychological markers of distress and with IFNγ . Following COBMINDEX, no significant changes in alpha and beta diversity were observed between both study groups, though a trend change in beta diversity was noted. Significant changes occurred in the abundance of phyla, families and genera only among the COBMINDEX group. Furthermore, abundance of phyla, families and genera that were altered following COBMNIDEX, significantly correlated with levels of cytokines and psychological parameters. Our results demonstrated that a short-term intervention of COBMINDEX was associated with changes in microbial indices, some of which are linked to psychological manifestations and systemic inflammation in CD patients. Psychological interventions to reduce chronic stress, such as COBMINDEX, appear to be beneficial in mitigating the pathobiology of CD patients, and may thus provide a useful adjunct to pharmacological therapy.
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Affiliation(s)
- Ilan K
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The National Institute of Biotechnology in the Negev, School of Brain Sciences and Cognition, and Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Motro Y
- MAGICAL Group, Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben‐Gurion University of the Negev, Beer‐Sheva, Israel
| | - Nemirovsky A
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The National Institute of Biotechnology in the Negev, School of Brain Sciences and Cognition, and Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Schwartz D
- Department of Gastroenterology and Hepatology, Soroka Medical Center, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Goren G
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Sergienko R
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Greenberg D
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Slonim-Nevo V
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Sarid O
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Friger M
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Regev S
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Odes S
- Department of Gastroenterology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Moran-Gilad J
- MAGICAL Group, Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben‐Gurion University of the Negev, Beer‐Sheva, Israel
| | - Monsonego A
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- The National Institute of Biotechnology in the Negev, School of Brain Sciences and Cognition, and Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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27
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Gilgoff R, Mengelkoch S, Elbers J, Kotz K, Radin A, Pasumarthi I, Murthy R, Sindher S, Harris NB, Slavich GM. The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology. Stress 2024; 27:2327333. [PMID: 38711299 PMCID: PMC11219250 DOI: 10.1080/10253890.2024.2327333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/02/2024] [Indexed: 05/08/2024] Open
Abstract
Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.
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Affiliation(s)
- Rachel Gilgoff
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jorina Elbers
- Trauma recovery Program, HeartMath Institute, Boulder Creek, CA, USA
| | | | | | - Isha Pasumarthi
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Reanna Murthy
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Sayantani Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | | | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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28
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Mengelkoch S, Gassen J, Lev-Ari S, Alley JC, Schüssler-Fiorenza Rose SM, Snyder MP, Slavich GM. Multi-omics in stress and health research: study designs that will drive the field forward. Stress 2024; 27:2321610. [PMID: 38425100 PMCID: PMC11216062 DOI: 10.1080/10253890.2024.2321610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 02/16/2024] [Indexed: 03/02/2024] Open
Abstract
Despite decades of stress research, there still exist substantial gaps in our understanding of how social, environmental, and biological factors interact and combine with developmental stressor exposures, cognitive appraisals of stressors, and psychosocial coping processes to shape individuals' stress reactivity, health, and disease risk. Relatively new biological profiling approaches, called multi-omics, are helping address these issues by enabling researchers to quantify thousands of molecules from a single blood or tissue sample, thus providing a panoramic snapshot of the molecular processes occurring in an organism from a systems perspective. In this review, we summarize two types of research designs for which multi-omics approaches are best suited, and describe how these approaches can help advance our understanding of stress processes and the development, prevention, and treatment of stress-related pathologies. We first discuss incorporating multi-omics approaches into theory-rich, intensive longitudinal study designs to characterize, in high-resolution, the transition to stress-related multisystem dysfunction and disease throughout development. Next, we discuss how multi-omics approaches should be incorporated into intervention research to better understand the transition from stress-related dysfunction back to health, which can help inform novel precision medicine approaches to managing stress and fostering biopsychosocial resilience. Throughout, we provide concrete recommendations for types of studies that will help advance stress research, and translate multi-omics data into better health and health care.
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Affiliation(s)
- Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jeffrey Gassen
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Shahar Lev-Ari
- Department of Genetics, Stanford University, Stanford, CA, USA
- Department of Health Promotion, Tel Aviv University, Tel Aviv, Israel
| | - Jenna C. Alley
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | | | | | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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29
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Palamarchuk IS, Slavich GM, Vaillancourt T, Rajji TK. Stress-related cellular pathophysiology as a crosstalk risk factor for neurocognitive and psychiatric disorders. BMC Neurosci 2023; 24:65. [PMID: 38087196 PMCID: PMC10714507 DOI: 10.1186/s12868-023-00831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/24/2023] [Indexed: 12/18/2023] Open
Abstract
In this narrative review, we examine biological processes linking psychological stress and cognition, with a focus on how psychological stress can activate multiple neurobiological mechanisms that drive cognitive decline and behavioral change. First, we describe the general neurobiology of the stress response to define neurocognitive stress reactivity. Second, we review aspects of epigenetic regulation, synaptic transmission, sex hormones, photoperiodic plasticity, and psychoneuroimmunological processes that can contribute to cognitive decline and neuropsychiatric conditions. Third, we explain mechanistic processes linking the stress response and neuropathology. Fourth, we discuss molecular nuances such as an interplay between kinases and proteins, as well as differential role of sex hormones, that can increase vulnerability to cognitive and emotional dysregulation following stress. Finally, we explicate several testable hypotheses for stress, neurocognitive, and neuropsychiatric research. Together, this work highlights how stress processes alter neurophysiology on multiple levels to increase individuals' risk for neurocognitive and psychiatric disorders, and points toward novel therapeutic targets for mitigating these effects. The resulting models can thus advance dementia and mental health research, and translational neuroscience, with an eye toward clinical application in cognitive and behavioral neurology, and psychiatry.
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Affiliation(s)
- Iryna S Palamarchuk
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J1H4, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Sunnybrook Health Sciences Centre, Division of Neurology, Toronto, ON, Canada.
- Temerty Faculty of Medicine, Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tracy Vaillancourt
- Counselling Psychology, Faculty of Education, University of Ottawa, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, 1001 Queen Street West, Toronto, ON, M6J1H4, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Faculty of Medicine, Toronto Dementia Research Alliance, University of Toronto, Toronto, ON, Canada
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30
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Delfel E, Hammond A, Shields GS, Moore DJ, Slavich GM, Thames AD. Psychological grit moderates the relation between lifetime stressor exposure and functional outcomes among HIV-seropositive and HIV-seronegative adults. Stress Health 2023; 39:1058-1071. [PMID: 36997157 PMCID: PMC10544691 DOI: 10.1002/smi.3245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 01/31/2023] [Accepted: 03/25/2023] [Indexed: 04/01/2023]
Abstract
The ability to maintain functional independence throughout the lifespan may be diminished among medically compromised and chronically stressed populations. People living with HIV are more likely to demonstrate functional impairment and report greater exposure to lifetime and chronic stressors than their seronegative counterparts. It is well-known that exposure to stressors and adversity is associated with functional impairment outcomes. However, to our knowledge, no studies have examined how protective factors such as psychological grit mitigate the negative effects of lifetime and chronic stressor exposure on functional impairment, and how this association differs by HIV-status. To address this issue, we studied associations between lifetime and chronic stressor exposure, grit, and functional impairment in 176 African American and non-Hispanic White HIV-seropositive (n = 100) and HIV-seronegative (n = 76) adults, aged 24-85 (M = 57.28, SD = 9.02). As hypothesised, HIV-seropositive status and lower grit, but not lifetime stressor exposure, were independently associated with more functional impairment. Moreover, there was a significant three-way interaction between HIV-status, grit, and lifetime stressor exposure, b = 0.07, p = 0.025, 95% CI [0.009, 0.135]. Specifically, lifetime stressor exposure was related to more functional impairment for HIV-seronegative-but not HIV-seropositive-adults who reported low levels of grit. These findings suggest that the protective effects of grit may differ across populations at risk for functional impairment.
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Affiliation(s)
- Everett Delfel
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
- Department of Psychology, California State University, Long Beach, California, USA
| | - Andrea Hammond
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
- Department of Psychology, California State University, Long Beach, California, USA
| | - Grant S. Shields
- Department of Psychological Science, University of Arkansas, Fayetteville, Arkansas, USA
| | - David J. Moore
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
| | - April D. Thames
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, California, USA
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Mar K, Rivers JK. The Mind Body Connection in Dermatologic Conditions: A Literature Review. J Cutan Med Surg 2023; 27:628-640. [PMID: 37898903 PMCID: PMC10714694 DOI: 10.1177/12034754231204295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/14/2023] [Accepted: 09/04/2023] [Indexed: 10/31/2023]
Abstract
Psychodermatology pertains to the relationship between the skin and brain. This review aims to summarize the evidence of the mind body connection in four psychophysiological conditions: rosacea, atopic dermatitis (AD), acne vulgaris (AV), and psoriasis. A literature search was conducted using several English language databases. All four conditions share similar psychiatric co-morbidities, including but not limited to anxiety, depression, and suicidality. In rosacea, the upregulation of transient receptor potential vanilloid type 1, Toll like receptor 2, and Th17 cells releases downstream products that are simultaneously implicated in mood disorders. Stress exacerbates AV through the hypothalamic-pituitary-adrenal (HPA) system, which alters functioning of sebocytes and Cutibacterium acnes. In AD and psoriasis, the HPA axis influences Th1, Th2, Th22, and Th1, Th17 immune mediated responses, respectively. This leads to the secretion of pro-inflammatory cytokines which are also involved in the pathogenesis of anxiety and depression. Neurotransmitters implicated in mental illness, such as gamma-aminobutyric acid and serotonin, may also play a role in the development of AD and psoriasis. The management of cutaneous disease may mitigate psychological distress, and future research may show the corollary to also be true.
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Affiliation(s)
- Kristie Mar
- University of British Columbia, Vancouver, BC, Canada
| | - Jason K. Rivers
- Pacific Derm, Vancouver, BC, Canada
- Department of Dermatology and Skin Science, University of British Columba, Vancouver, BC, Canada
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Axelsson E, Kern D, Hedman-Lagerlöf E, Lindfors P, Palmgren J, Hesser H, Andersson E, Johansson R, Olén O, Bonnert M, Lalouni M, Ljótsson B. Psychological treatments for irritable bowel syndrome: a comprehensive systematic review and meta-analysis. Cogn Behav Ther 2023; 52:565-584. [PMID: 37341454 DOI: 10.1080/16506073.2023.2225745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/05/2023] [Indexed: 06/22/2023]
Abstract
A wide range of psychological treatments have been found to reduce the symptoms of irritable bowel syndrome (IBS) but their relative effects are unclear. In this systematic review and meta-analysis, we determined the effects of psychological treatments for IBS, including subtypes of cognitive behavior therapy, versus attention controls. We searched 11 databases (March 2022) for studies of psychological treatments for IBS, reported in journal articles, books, dissertations, and conference abstracts. The resulting database comprised 9 outcome domains from 118 studies published in 1983-2022. Using data from 62 studies and 6496 participants, we estimated the effect of treatment type on improvement in composite IBS severity using random-effects meta-regression. In comparison with the attention controls, there was a significant added effect of exposure therapy (g = 0.52, 95% CI = 0.17-0.88) and hypnotherapy (g = 0.36, 95% CI = 0.06-0.67) when controlling for the pre- to post-assessment duration. When additional potential confounders were included, exposure therapy but not hypnotherapy retained a significant added effect. Effects were also larger with a longer duration, individual treatment, questionnaire (non-diary) outcomes, and recruitment outside of routine care. Heterogeneity was substantial. Tentatively, exposure therapy appears to be a particularly promising treatment for IBS. More direct comparisons in randomized controlled trials are needed. OSF.io identifier: 5yh9a.
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Affiliation(s)
- Erland Axelsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Liljeholmen Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
| | - Dorian Kern
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Erik Hedman-Lagerlöf
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Perjohan Lindfors
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Josefin Palmgren
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hugo Hesser
- Center for Health and Medical Psychology, School of Behavioural, Social and Legal Sciences, Örebro University, Örebro, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Erik Andersson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Robert Johansson
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Ola Olén
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatric Gastroenterology and Nutrition, Sachs' Children's Hospital, Stockholm, Sweden
| | - Marianne Bonnert
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Maria Lalouni
- Division of Neuro, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Brjánn Ljótsson
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Keřková B, Knížková K, Večeřová M, Šustová P, Fürstová P, Hrubý A, Španiel F, Rodriguez M. Inflammation and cognitive performance in first-episode schizophrenia spectrum disorders: The moderating effects of childhood trauma. Schizophr Res 2023; 261:185-193. [PMID: 37783016 DOI: 10.1016/j.schres.2023.09.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 07/28/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023]
Abstract
In this study, we aimed to determine whether childhood trauma moderated the relationship between inflammation and cognitive functioning in persons with first-episode schizophrenia spectrum disorders (SSDs). We included data from 92 individuals who participated in the nationwide Early-Stage Schizophrenia Outcome study. These individuals completed the Childhood Trauma Questionnaire, provided a fasting blood sample for high-sensitivity C-reactive protein analysis, and underwent extensive neuropsychological testing. The intervening effects of age, sex, education, smoking status, and body mass index were controlled. Results indicated that childhood trauma levels significantly moderated the relationship between inflammation and four cognitive domains: speed of processing, working memory, visual memory, and verbal memory. Inflammation also predicted verbal memory scores irrespective of childhood trauma levels or the covariates. Upon further exploration, the significant moderation effects appeared to be primarily driven by males. In conclusion, a history of childhood trauma may be an important determinant in evaluating how inflammation relates to the cognitive performance of people with first-episode SSDs, particularly in speed of processing, working memory, visual memory, and verbal memory. We recommend that future researchers examining the effect of inflammation on cognitive functioning in SSDs include trauma as a moderating variable in their models and further examine additional moderating effects of sex.
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Affiliation(s)
- Barbora Keřková
- National Institute of Mental Health, Klecany, Czech Republic.
| | - Karolína Knížková
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
| | - Monika Večeřová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Petra Šustová
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
| | - Petra Fürstová
- National Institute of Mental Health, Klecany, Czech Republic
| | - Aleš Hrubý
- National Institute of Mental Health, Klecany, Czech Republic
| | - Filip Španiel
- National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University in Prague, Czech Republic
| | - Mabel Rodriguez
- National Institute of Mental Health, Klecany, Czech Republic; Department of Psychology, Faculty of Arts, Charles University in Prague, Czech Republic
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De Hoyos G, Ramos-Sostre D, Torres-Reverón A, Barros-Cartagena B, López-Rodríguez V, Nieves-Vázquez C, Santiago-Saavedra F, Appleyard CB, Castro EM, Flores I. Efficacy of an environmental enrichment intervention for endometriosis: a pilot study. Front Psychol 2023; 14:1225790. [PMID: 37885745 PMCID: PMC10598732 DOI: 10.3389/fpsyg.2023.1225790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 09/11/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction We have previously shown that Environmental Enrichment (EE), a multi-modal psychosocial intervention consisting of increased social interaction, novelty, and open spaces, improved disease presentation, anxiety, and immune-related disturbances in the rat model of endometriosis. However, there is a knowledge gap regarding the effects of EE interventions in patients with this painful, inflammatory chronic disease. Aim To adapt and test the efficacy of an EE intervention on pelvic pain, mental health, perceived stress, quality of life, and systemic inflammation in endometriosis patients through a randomized clinical trial (RCT). Materials and methods A multidisciplinary team with expertise in physiology, neuroscience, psychology, and women's health adapted and implemented a two-arm RCT comparing an EE intervention with a wait-list control group. Six EE modules administered on alternate weeks were provided to patients in the intervention (N = 29); controls received education only. Survey data and biospecimens were collected at baseline, end-of-study, and 3-months post-intervention to assess pain (Brief Pain Inventory, BPI), endometriosis-related quality of life-QoL (Endometriosis Health Profile-30, EHP30), anxiety (Generalized Anxiety Disorder 7, GAD7), depression (Patient Health Questionnaire for Depression 8, PHQ8), pain catastrophizing (Pain Catastrophizing Score, PCS), stress (Perceived Stress Scale-14, PSS14), and saliva cortisol levels (AM, PM). Results Compared to the wait-list controls, participants in the EE intervention showed significantly decreased GAD-7 scores at the end of the intervention and 3-month follow-up. Depression, perceived stress, and QoL improved at the 3-month follow-up compared to baseline. While pain levels did not improve, they significantly correlated with anxiety, depression, QoL and pain catastrophizing scores. Conclusion This pilot RCT demonstrated significant improvements in anxiety and depressive symptoms, QoL, and perceived stress, supporting enriched environments as an integrative psychosocial intervention to be used as adjuvant to the standard of care for endometriosis pain.
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Affiliation(s)
- Grace De Hoyos
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Darlenne Ramos-Sostre
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Annelyn Torres-Reverón
- Department of Basic Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- Sur180 Therapeutics, Inc., McAllen, TX, United States
| | | | | | - Cristina Nieves-Vázquez
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Fanny Santiago-Saavedra
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Caroline B. Appleyard
- Department of Basic Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- Sur180 Therapeutics, Inc., McAllen, TX, United States
| | - Eida M. Castro
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Idhaliz Flores
- Department of Basic Sciences, Ponce Health Sciences University, Ponce, Puerto Rico
- Sur180 Therapeutics, Inc., McAllen, TX, United States
- Department of Obstetrics and Gynecology, Ponce Health Sciences University, Ponce, Puerto Rico
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Simon CB, Bishop MD, Wallace MR, Staud R, DelRocco N, Wu SS, Dai Y, Borsa PA, Greenfield WH, Fillingim RB, George SZ. Circulating Inflammatory Biomarkers Predict Pain Change Following Exercise-Induced Shoulder Injury: Findings From the Biopsychosocial Influence on Shoulder Pain Preclinical Trial. THE JOURNAL OF PAIN 2023; 24:1465-1477. [PMID: 37178095 PMCID: PMC10523877 DOI: 10.1016/j.jpain.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/03/2023] [Accepted: 04/02/2023] [Indexed: 05/15/2023]
Abstract
Shoulder pain is a highly prevalent musculoskeletal condition that frequently leads to suboptimal clinical outcomes. This study tested the extent to which circulating inflammatory biomarkers are associated with reports of shoulder pain and upper-extremity disability for a high-risk genetic by psychological subgroup (catechol-O-methyltransferase [COMT] variation by pain catastrophizing [PCS]). Pain-free adults meeting high-risk COMT × PCS subgroup criteria completed an exercise-induced muscle injury protocol. Thirteen biomarkers were collected and analyzed from plasma 48 hours after muscle injury. Shoulder pain intensity and disability (Quick-DASH) were reported at 48 and 96 hours to calculate change scores. Using an extreme sampling technique, 88 participants were included in this analysis. After controlling for age, sex, and BMI, there were moderate positive associations between higher c-reactive protein (CRP; βˆ = .62; 95% confidence interval [CI] = -.03, 1.26), interleukin-6 (IL-6; βˆ = 3.13; CI = -.11, 6.38), and interleukin-10 (IL-10; βˆ = 2.51; CI = -.30, 5.32); and greater pain reduction from 48 to 96 hours post exercise muscle injury. Using an exploratory multivariable model to predict pain changes from 48 to 96 hours, we found participants with higher IL-10 were less likely to experience a high increase in pain (βˆ = -10.77; CI = -21.25, -2.69). Study findings suggest CRP, IL-6, and IL-10 are related to shoulder pain change for a preclinical high-risk COMT × PCS subgroup. Future studies will translate to clinical shoulder pain and decipher the complex and seemingly pleiotropic interplay between inflammatory biomarkers and shoulder pain change. PERSPECTIVE: In a preclinical high-risk COMT × PCS subgroup, 3 circulating inflammatory biomarkers (CRP, IL-6, and IL-10) were moderately associated with pain improvement following exercise-induced muscle injury.
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Affiliation(s)
- Corey B Simon
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.
| | - Mark D Bishop
- Department of Physical Therapy, University of Florida, Gainesville, Florida
| | - Margaret R Wallace
- Department of Molecular Genetics and Microbiology, UF Genetics Institute, University of Florida, Gainesville, Florida
| | - Roland Staud
- Department of Medicine, University of Florida, Gainesville, Florida
| | - Natalie DelRocco
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Yunfeng Dai
- Department of Biostatistics, University of Florida, Gainesville, Florida
| | - Paul A Borsa
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida
| | | | - Roger B Fillingim
- Pain Research & Intervention Center of Excellence, University of Florida, Gainesville, Florida; Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida
| | - Steven Z George
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina; Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
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Moriarity DP, Slavich GM. The future is dynamic: A call for intensive longitudinal data in immunopsychiatry. Brain Behav Immun 2023; 112:118-124. [PMID: 37286174 PMCID: PMC10411233 DOI: 10.1016/j.bbi.2023.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/09/2023] [Accepted: 06/03/2023] [Indexed: 06/09/2023] Open
Abstract
The long-term value of immunopsychiatry will be based on its ability to translate basic science into effective clinical interventions. In this article, we discuss a key obstacle to achieving this important translational goal-namely, the preponderance of studies that are cross-sectional, or that have months-to-years long follow-up periods. Immunopsychiatric processes such as stress, inflammation, and depression symptoms are inherently dynamic and fluctuate over hours, days, and weeks. This fact suggests that higher-density data collection with only days between measurements is necessary to capture-with adequate resolution-the actual dynamics of these systems, determine optimal time lags with which to observe associations between variables of interest, and maximize the translational potential of these data. To illustrate these points, we use pilot data from our own intensive longitudinal immunopsychiatric study. We then conclude by making several recommendations for future research. By learning how to better use existing data for dynamically informative studies as well as collecting intensive longitudinal data, we believe immunopsychiatry will be much better positioned to advance our causal understanding of the interplay between the immune system and health.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Zhao J, Wang M, Huang R, Xu J, Gan C, Yu S, Tang L, Yao S, Li W, Cheng H. Effects of CALM intervention on neutrophil-to-lymphocyte ratio (NLR), fear of cancer recurrence and quality of life in patients with lung cancer. Support Care Cancer 2023; 31:447. [PMID: 37414980 DOI: 10.1007/s00520-023-07929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/04/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To evaluate the feasibility and practicability of Managing Cancer and Living Meaningfully (CALM) as a psychological intervention to reduce neutrophil to lymphocyte ratio (NLR), fear of cancer recurrence, general distress, and improve quality of life in lung cancer survivors. METHODS Eighty lung cancer patients with FCRI severity subscale (≥13 points) were recruited and randomly assigned to CALM or usual care (UC). NLR was recorded before and after treatment. The Fear of Cancer Recurrence Inventory (FCRI), Quality of Life Questionnaire Core 30 (QLQ-C30) and Depression-Anxiety-Stress Scale (DASS-21) were used to evaluate patients at baseline (T0), immediately after treatment (T1), and at 2 (T2) and 4 (T3) months. RESULTS Compared with UC, NLR was significantly different before and after CALM intervention (z=-5.498; P=0.000). There were significant differences in the scores of QLQ, FCR and general distress before and after the T1, T2 and T3 interventions (F=220.30, F=315.20, F=290.10, respectively; P<0.001). NLR was negatively correlated with QOL both before (r=-0.763; P<0.0001) and after the intervention (r=-0.810, P<0.0001). FCR and general distress were negatively correlated with QOL in CALM (T0: r=-0.726, r=-0.776, respectively; P<0.0001; T1: r=-0.664, r=-0.647, respectively; P<0.0001; T2: r=-0.678, r=-0.695, respectively; P<0.0001; T3: r=-0.511, P = 0.0008; r=-0.650, P<0.0001). CONCLUSION CALM intervention can effectively reduce the NLR, alleviate the recurrence fear and general distress and improve the quality of life in patients. This study suggests that CALM may be an effective psychological intervention for reducing symptoms associated with lung cancer survivors.
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Affiliation(s)
- Jie Zhao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Menglian Wang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Runze Huang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Jian Xu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Chen Gan
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Sheng Yu
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Lingxue Tang
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Senbang Yao
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Wen Li
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China
| | - Huaidong Cheng
- Department of Oncology, the Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China.
- Department of Oncology, Shenzhen Hospital of Southern Medical University, Shenzhen, 518000, Guangdong, China.
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Clayton MG, Nelson BW, Giletta M, Hastings PD, Nock MK, Rudolph KD, Slavich GM, Prinstein MJ. Interpersonal Life Stress and Inflammatory Reactivity as Prospective Predictors of Suicide Attempts in Adolescent Females. Res Child Adolesc Psychopathol 2023; 51:977-987. [PMID: 36853582 PMCID: PMC10330793 DOI: 10.1007/s10802-023-01033-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/01/2023]
Abstract
Adolescents' suicidal behavior frequently is preceded by interpersonal stress, but not all who experience distress attempt to end their lives. Recent theories have posited individual differences in stress-related inflammatory reactivity may be associated with psychopathology risk; this study examined inflammatory reactivity as a moderator of the prospective association between interpersonal stress and adolescents' suicidal behavior. Participants included 157 at-risk adolescent females (ages 12 to 16 years) and assessed individual differences in proinflammatory cytokine responses to a brief laboratory-based social stressor, both interpersonal and non-interpersonal life events, and suicidal behavior over an 18-month follow-up period. Measuring levels of the key proinflammatory cytokines interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) before and after an experimentally-induced social stressor, results revealed that blunted cytokine reactivity heightened the effect of high interpersonal stress exposure on risk for suicidal behaviors over the subsequent 9 months. Significant effects were not revealed for non-interpersonally themed stress. Finding highlight the urgent need for more research examining inflammation reactivity among adolescents.
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Affiliation(s)
- Matthew G Clayton
- Department of Psychology and Neuroscience, UNC Psychology and Neuroscience, University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, 27599-3270, 962-3988, Chapel Hill, NC, USA.
| | - Benjamin W Nelson
- Department of Psychology and Neuroscience, UNC Psychology and Neuroscience, University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, 27599-3270, 962-3988, Chapel Hill, NC, USA
| | - Matteo Giletta
- Department of Psychology, Ghent University, Ghent, Belgium
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Paul D Hastings
- Center for Mind and Brain, Department of Psychology, University of California, Davis, CA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, USA
| | - Karen D Rudolph
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, UNC Psychology and Neuroscience, University of North Carolina at Chapel Hill, Davie Hall, Campus Box 3270, 27599-3270, 962-3988, Chapel Hill, NC, USA
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Moriarity DP, Grehl MM, Walsh RFL, Roos LG, Slavich GM, Alloy LB. A systematic review of associations between emotion regulation characteristics and inflammation. Neurosci Biobehav Rev 2023; 150:105162. [PMID: 37028579 PMCID: PMC10425218 DOI: 10.1016/j.neubiorev.2023.105162] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
Elevated inflammation is a risk factor for many psychiatric (e.g., depression) and somatic conditions (e.g., rheumatoid arthritis). Inflammation is influenced by psychosocial processes such as emotion regulation. Characterization of which emotion regulation characteristics impact inflammation could help refine psychosocial interventions aimed at normalizing health-harming inflammatory activity for individuals with psychiatric and somatic illnesses. To investigate this issue, we systematically reviewed the literature on associations between a variety of emotion regulation traits and inflammation. Out of 2816 articles identified, 38 were included in the final review. 28 (74%) found that (a) poor emotion regulation is associated with higher inflammation and/or (b) strong emotion regulation skills are associated with lower inflammation. Consistency of results differed as a function of the emotion regulation construct investigated and methodological characteristics. Results were most consistent for studies testing positive coping/social support seeking or broadly defined emotion regulation/dysregulation. Methodologically, studies testing reactivity to a stressor, adopting a vulnerability-stress framework, or using longitudinal data were most consistent. Implications for integrated, transdiagnostic psychoimmunological theories are discussed, as well as recommendations for clinical research.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Mora M Grehl
- Department of Psychology & Neuroscience, Temple University, USA
| | | | - Lydia G Roos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Lauren B Alloy
- Department of Psychology & Neuroscience, Temple University, USA
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40
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Armadans-Tremolosa I, Selva-O'Callaghan A. Inflammatory myopathy in adults, health-related quality of life, and wellbeing: a round trip between immune disease and wellness. Expert Rev Clin Immunol 2023; 19:1239-1246. [PMID: 37452824 DOI: 10.1080/1744666x.2023.2238128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/07/2023] [Accepted: 07/14/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Health-related quality of life (HRQoL) and wellbeing are poorer in patients with chronic conditions than in the general population, and this is the case of individuals with myositis. Research has shown a negative relationship between this disease and wellbeing, but there is little data on the effect that enhanced wellbeing has on the disease course. AREAS COVERED HRQoL, wellbeing, and other related concepts are examined here with special emphasis on the benefits of positive status in the physical, environmental, psychological, and social function areas for reducing the severity of the clinical course and organ damage in a chronic condition such as myositis. The factors affecting HRQoL, and wellbeing are analyzed to delineate specific strategies that will lead to improvements in the life of adult patients with myositis. The mechanisms implicated in these changes are also discussed. EXPERT OPINION Myositis refers to a heterogeneous group of chronic systemic autoimmune diseases. HRQoL and wellbeing are poor in these patients, and evidence suggests that improvements in this line can have positive repercussions on the course and outcome of the disease. Strategies to improve HRQoL and wellbeing should be designed for adults with myositis.
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Affiliation(s)
- Immaculada Armadans-Tremolosa
- Department of Social Psychology and Quantitative Psychology, PsicoSAO-Research Group in Social, Environmental, and Organizational Psychology, Universitat de Barcelona, Barcelona, Spain
| | - Albert Selva-O'Callaghan
- Systemic Autoimmune Diseases Unit, Department of Medicine, Vall d'Hebron General Hospital, Universitat Autónoma de Barcelona, Barcelona, Spain
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Ballesio A, Zagaria A, Vacca M, Pariante CM, Lombardo C. Comparative efficacy of psychological interventions on immune biomarkers: A systematic review and network meta-analysis (NMA). Brain Behav Immun 2023; 111:424-435. [PMID: 37187256 DOI: 10.1016/j.bbi.2023.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/25/2023] [Accepted: 05/12/2023] [Indexed: 05/17/2023] Open
Abstract
Psychological interventions are viable, cost-effective strategies for improving clinical and psychological impact of inflammation-related conditions. However, their efficacy on immune system function remains controversial. We performed a systematic review and frequentist random-effects network meta-analysis of randomised controlled trials (RCTs) assessing the effects of psychological interventions, against a control condition, on biomarkers of innate and adaptive immunity in adults. PubMed, Scopus, PsycInfo, and Web of Science were searched from inception up to Oct 17, 2022. Cohen's d at 95% confidence interval (CI) was calculated to assess the effect sizes of each class of intervention against active control conditions at post-treatment. The study was registered in PROSPERO (CRD42022325508). Of the 5024 articles retrieved, we included 104 RCTs reporting on 7820 participants. Analyses were based on 13 types of clinical interventions. Compared with the control conditions, cognitive therapy (d = - 0.95, 95% CI: -1.64 to - 0.27), lifestyle (d = - 0.51, 95% CI: -0.99 to - 0.02), and mindfulness-based (d = - 0.38, 95% CI: -0.66 to - 0.09) interventions were associated with post-treatment reduction of proinflammatory cytokines and markers. Mindfulness-based interventions were also significantly associated with post-treatment increase in anti-inflammatory cytokines (d = 0.69, 95% CI: 0.09 to 1.30), while cognitive therapy was associated also with post-treatment increase in white blood cell count (d = 1.89, 95% CI: 0.05 to 3.74). Results on natural killer cells activity were non-significant. Grade of evidence was moderate for mindfulness and low-to-moderate for cognitive therapy and lifestyle interventions; however, substantial overall heterogeneity was detected in most of the analyses.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
| | - Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mariacarolina Vacca
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Carmine M Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Caterina Lombardo
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Gonda X, Serafini G, Dome P. Fight the Fire: Association of Cytokine Genomic Markers and Suicidal Behavior May Pave the Way for Future Therapies. J Pers Med 2023; 13:1078. [PMID: 37511694 PMCID: PMC10381806 DOI: 10.3390/jpm13071078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
The fight against suicide is highly challenging as it may be one of the most complex and, at the same time, most threatening among all psychiatric phenomena. In spite of its huge impact, and despite advances in neurobiology research, understanding and predicting suicide remains a major challenge for both researchers and clinicians. To be able to identify those patients who are likely to engage in suicidal behaviors and identify suicide risk in a reliable and timely manner, we need more specific, novel biological and genetic markers/indicators to develop better screening and diagnostic methods, and in the next step to utilize these molecules as intervention targets. One such potential novel approach is offered by our increasing understanding of the involvement of neuroinflammation based on multiple observations of increased proinflammatory states underlying various psychiatric disorders, including suicidal behavior. The present paper overviews our existing understanding of the association between suicide and inflammation, including peripheral and central biomarkers, genetic and genomic markers, and our current knowledge of intervention in suicide risk using treatments influencing inflammation; also overviewing the next steps to be taken and obstacles to be overcome before we can utilize cytokines in the treatment of suicidal behavior.
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Affiliation(s)
- Xenia Gonda
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, 1085 Budapest, Hungary
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, 443079 Samara, Russia
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16126 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Peter Dome
- Department of Psychiatry and Psychotherapy, Semmelweis University, 1085 Budapest, Hungary
- National Institute of Mental Health, Neurology and Neurosurgery, 1135 Budapest, Hungary
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43
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Brody GH, Yu T, Miller GE, Chen E. Longitudinal links between early adolescent temperament and inflammation among young black adults. Psychoneuroendocrinology 2023; 152:106077. [PMID: 36931166 PMCID: PMC10201910 DOI: 10.1016/j.psyneuen.2023.106077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/19/2023]
Abstract
A large body of research demonstrates that inflammation is involved in physical health problems that cause substantial morbidity and early mortality. Given inflammation's role in the etiology of chronic diseases, pediatric scientists have begun to study childhood factors that presage elevation of inflammatory biomarkers later in life. The purpose of this study was to test hypotheses designed to determine whether early adolescent emotionally intense and low attention temperaments forecast (a) inflammation at ages 25 and 29 years and (b) worsening levels of inflammation between these two data points. Toward this end, 307 Black children from the rural southeastern United States participated in an 18-year longitudinal study (mean age at baseline, 11.2 years) to determine whether and how early adolescent's behavioral styles or emotionally intense and low attention temperaments may be associated with absolute and worsening levels of inflammation in young adulthood. When children were 11-13 years of age, different teachers at each age provided assessments of emotionally intense and low attention temperaments. Thus, multiple measures of the same temperament constructs were obtained across 3 years for each participant. At age 25, participants provided data on their self-regulation abilities. Peripheral blood was collected at ages 25 and 29 years from which inflammation was quantified, using soluble urokinase plasminogen activator (suPAR), the proinflammatory cytokines interleukin (IL) IL-6, IL-10, and tumor necrosis factor-alpha (TNF-α). Covariates associated with inflammation in prior studies were also assessed; these included socioeconomic risk, gender, cigarette smoking, body mass index (BMI), adverse childhood experiences (ACEs), depressive symptoms, and medication use. An early adolescent emotionally intense temperament was associated directly with higher suPAR and cytokine levels at age 29, and with worsening cytokine levels between ages 25 and 29. A low attention temperament was associated with suPAR levels at age 29. Collectively, these observations highlight pathways that could underlie health risks associated with early adolescent temperaments. The findings suggest that emotionally intense and low-attention early adolescent temperaments forecast higher and worsening inflammation levels across young adulthood.
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Affiliation(s)
- Gene H Brody
- Center for Family Research, University of Georgia, Athens, GA, USA.
| | - Tianyi Yu
- Center for Family Research, University of Georgia, Athens, GA, USA
| | - Gregory E Miller
- Department of Psychology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA
| | - Edith Chen
- Department of Psychology, Northwestern University, Evanston, IL, USA; Institute for Policy Research, Northwestern University, Evanston, IL, USA
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O'Shields JD, Graves BD, Mowbray OP. Sex differences in childhood maltreatment, inflammation, and adulthood depression: A network analysis. Brain Behav Immun Health 2023; 29:100611. [PMID: 36937648 PMCID: PMC10017358 DOI: 10.1016/j.bbih.2023.100611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/25/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Background Efforts to improve treatment for adults with major depression (MD) and childhood maltreatment (CM) have identified inflammation as a potential target to improve health. Network models have emerged as a new way to understand the relationship between depressive symptoms and inflammation. However, none have accounted for the role of childhood maltreatment in the link between depressive symptoms and inflammation, or sex differences commonly found in these constructs. Methods Data from two waves of the Midlife Development in the United States study were used in this study (N = 1917). The Center for Epidemiological Studies Depression (CES-D) scale and Childhood Trauma Questionnaire, and six inflammation markers served as nodes in an undirected psychometric network analysis. Edges between nodes were calculated using partial Spearman's correlation. Separate networks were modeled for males and females. Results The total network revealed several associations between nodes of CM, MD, and inflammation, with emotional abuse having a strong association with somatic complaints. Network comparison testing revealed male-female network invariance, with several edge differences between male and female networks. Males and females showed differences in associations across inflammatory markers and depressive symptom clusters, particularly among somatic complaints and interpersonal difficulties. Conclusions Specific associations between dimensions of inflammation, CM, and MD may represent important targets for treatment. Network models disaggregated by sex showed that males and females may have fundamentally different associations between these constructs, suggesting that future studies should consider sex-specific interventions.
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Affiliation(s)
- Jay D. O'Shields
- Corresponding author. University of Georgia, School of Social Work, 279 Williams Street, Athens, GA, 30602, USA.
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45
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Birkenmaier J, Jung E, McMillin S, Qian Z. Are credit scores and financial well-being associated with physical health? SOCIAL WORK IN HEALTH CARE 2023; 62:162-178. [PMID: 37120849 DOI: 10.1080/00981389.2023.2207614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 11/03/2022] [Accepted: 04/21/2023] [Indexed: 05/30/2023]
Abstract
Consumer credit score has been used as an indicator of financial strain that could potentially impact health. Subjective financial well-being, or one's feelings about one's expectations, preferences, and satisfaction with their financial situation, is related to financial strain. This study examined whether subjective financial well-being mediates the association between credit score and self-reported physical health in a national representative sample. Using structural equation modeling (SEM), we test whether a mediating association exists between self-rated credit score and self-rated physical health. Results suggest that, after controlling for sociodemographic variables, those who reported higher credit scores have better health (β = 0.175, p < .001) and higher financial well-being (β = 0.469, p < .001), and those who reported higher financial well-being have better health (β = 0.265, p < .001). The mediation effect of financial well-being on the association between credit and physical health is also positive and statistically significant (β = 0.299, p < .001). Thus, subjective feelings about one's financial situation would enhance the observed positive association between credit and health. Practice and policy implications are included.
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Affiliation(s)
- Julie Birkenmaier
- School of Social Work, Saint Louis University, St Louis, Missouri, USA
| | - Euijin Jung
- Refugee Behavioral Health Postdoctoral Fellow, Research Program on Children and Adversity, Boston College School of Social Work, Chestnut Hill, Massachusetts, USA
| | - Stephen McMillin
- School of Social Work, Saint Louis University, St Louis, Missouri, USA
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
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Miguel C, Karyotaki E, Ciharova M, Cristea IA, Penninx BW, Cuijpers P. Psychotherapy for comorbid depression and somatic disorders: a systematic review and meta-analysis. Psychol Med 2023; 53:2503-2513. [PMID: 34792017 PMCID: PMC10123840 DOI: 10.1017/s0033291721004414] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological, cardiometabolic, and neurological disorders. METHODS We conducted a meta-analysis of 75 randomized trials (8209 participants) of psychotherapy for adults with somatic disorders and a diagnosis or elevated symptoms of depression. Outcomes included depression, QoL, somatic health-related outcomes, and mortality. RESULTS Psychotherapy significantly reduced the severity of depression at post-treatment across all categories of somatic disorders (Hedges'g = 0.65; 95% CI 0.52-0.79), with sustained effects at 6-11 months (g = 0.38; 95% CI 0.22-0.53) and at 12 months follow-up or longer (g = 0.13; 95% CI 0.04-0.21). Psychotherapy also showed significant effects on QoL (g = 0.26; 95% CI 0.17-0.35), maintained up to 11 months follow-up (g = 0.25; 95% CI 0.16-0.34). No significant effects were observed on the most frequently reported somatic health-related outcomes (glycemic control, pain), and neither on mortality. Heterogeneity in most analyses was very high, and only 29 (38%) trials were rated at low risk of bias (RoB). CONCLUSIONS Psychotherapy may be an effective treatment option for patients with depression and somatic disorders, with long-term effects on depression severity and QoL. However, these results should be interpreted with caution due to heterogeneity and RoB.
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Affiliation(s)
- Clara Miguel
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
| | - Marketa Ciharova
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Ioana A. Cristea
- Department of Brain and Behavioral Sciences, University of Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, The Netherlands
- WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit Amsterdam, The Netherlands
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47
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Liu ST, Lin SC, Chang JPC, Yang KJ, Chu CS, Yang CC, Liang CS, Sun CF, Wang SC, Satyanarayanan SK, Su KP. The Clinical Observation of Inflammation Theory for Depression: The Initiative of the Formosa Long COVID Multicenter Study (FOCuS). CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:10-18. [PMID: 36700308 PMCID: PMC9889898 DOI: 10.9758/cpn.2023.21.1.10] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 01/27/2023]
Abstract
There is growing evidence that the coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with increased risks of psychiatric sequelae. Depression, anxiety, cognitive impairments, sleep disturbance, and fatigue during and after the acute phase of COVID-19 are prevalent, long-lasting, and exerting negative consequences on well-being and imposing a huge burden on healthcare systems and society. This current review presented timely updates of clinical research findings, particularly focusing on the pathogenetic mechanisms underlying the neuropsychiatric sequelae, and identified potential key targets for developing effective treatment strategies for long COVID. In addition, we introduced the Formosa Long COVID Multicenter Study (FOCuS), which aims to apply the inflammation theory to the pathogenesis and the psychosocial and nutrition treatments of post-COVID depression and anxiety.
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Affiliation(s)
- Shu-Tsen Liu
- Division of Child and Adolescent Psychiatry & Division of Developmental and Behavioral Pediatrics, China Medical University Children’s Hospital, Taichung, Taiwan
| | - Sheng-Che Lin
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Jane Pei-Chen Chang
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan,Division of Child Psychiatry, Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Kai-Jie Yang
- Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taipei, Taiwan
| | - Chia-Chun Yang
- Department of Psychiatry, Taoyuan Psychiatric Center, Taoyuan City, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ching-Fang Sun
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion Clinic School of Medicine, Roanoke, VA, USA
| | - Shao-Cheng Wang
- Department of Psychiatry, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Tainan, Taiwan,Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan,Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan,Address for correspondence: Kuan-Pin Su China Medical University, No.2 Yuh-Der Road, North District, Taichung 404332, Taiwan , E-mail: , ORCID: https://orcid.org/0000-0002-4501-2502
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48
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Slavich GM, Mengelkoch S, Cole SW. Human social genomics: Concepts, mechanisms, and implications for health. LIFESTYLE MEDICINE 2023. [DOI: 10.1002/lim2.75] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
Affiliation(s)
- George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences University of California Los Angeles California USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences University of California Los Angeles California USA
| | - Steven W. Cole
- Department of Psychiatry and Biobehavioral Sciences University of California Los Angeles California USA
- Department of Medicine University of California Los Angeles California USA
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49
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Chiou PZ, Mulder L, Jia Y. Workplace Bullying in Pathology and Laboratory Medicine. Am J Clin Pathol 2023; 159:358-366. [PMID: 36749307 DOI: 10.1093/ajcp/aqac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/22/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES The specific aims of the study are to explore the prevalence of workplace bullying and to understand the impact of bullying on individual wellness in order to facilitate the development of future organizational solutions to mitigate workplace incivility. METHODS Cross-sectional data were collected via a web-based survey to gather exploratory demographic information and to assess the relationships between intensity of the exposure to the negative acts with laboratory productivity. Associations between laboratories offering resources to employees and their impacts on productivity and professional job fulfillment were also explored. RESULTS Results of the survey showed that over two-thirds of laboratorians (68.56%) were classified as victims of workplace bullying, and the perpetrator is most likely a peer of the victim (55.3%). The study revealed the intensity of workplace incivility was positively correlated with the number of sick days taken by the laboratory practitioner (F(2, 217) = 24.245, P < .001). Facilities with a supportive work environment were also associated with a reduction in the number of sick mental days taken (P < .001), a proxy for improved work and health outcomes. CONCLUSIONS The results of this study shed light on the prevalence of incivility at the workplace and offer evidence on the importance of providing a supportive work environment toward reducing workplace bullying.
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Affiliation(s)
- Paul Z Chiou
- Departments of Clinical Laboratory and Medical Imaging
| | - Lotte Mulder
- Department of Organizational Development and Leadership, ASCP, Chicago, IL, USA
| | - Yuane Jia
- Interdisciplinary Studies, Rutgers University, Newark, NJ, USAand
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50
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Mustanski B, Macapagal K. Clinical psychological science must move beyond documenting disparities in LGBTQ health toward eliminating them. J Consult Clin Psychol 2023; 91:57-59. [PMID: 36913281 PMCID: PMC10016627 DOI: 10.1037/ccp0000800] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
Psychology and other disciplines have exceptionally documented sexual orientation and gender identity disparities in mental and physical health outcomes with psychological antecedents. Research on sexual and gender minority (SGM) health has seen impressive growth, including the launch of dedicated conferences, journals, and designation as a disparity population for U.S. federal research purposes. From 2015 to 2020, the number of SGM-focused research projects funded by the U.S. National Institutes of Health (NIH) increased by 66.1% (cf. 21.8% for all NIH projects). SGM health research has expanded beyond HIV (73.0% of NIH's SGM projects in 2015 down to 59.8% in 2020) into other domains, such as mental health (41.6%), substance use disorders (23%), violence (7.2%), and transgender (21.9%) and bisexual (17.2%) health. Yet, only 8.9% of projects were clinical trials testing interventions. The need for more research on later stages in the translational research spectrum (i.e., mechanisms, intervention, implementation) to eradicate SGM health disparities is the focus of our Viewpoint article. First, research to eliminate SGM health disparities must move toward multilevel interventions aimed at cultivating health, wellbeing, and thriving. Second, research to test how psychological theories apply to SGM people can inform new theories or extend existing ones, which can spur new areas of inquiry. Third, translational SGM health research would benefit from a developmental lens to identify protective and promotive factors across the life span. Finally, using mechanistic findings to inform, develop, disseminate, and implement interventions to reduce SGM health disparities is crucial at this time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing
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