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Kolar DR, Monteleone AM, Cascino G, Ertl S, Meule A, Naab S, Voderholzer U. Pathways between Child Maltreatment, Psychological Symptoms, and Life Satisfaction: A Network Analysis in Adolescent Inpatients. Res Child Adolesc Psychopathol 2024; 52:969-982. [PMID: 38289540 PMCID: PMC11108895 DOI: 10.1007/s10802-024-01172-2] [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: 01/22/2024] [Indexed: 05/22/2024]
Abstract
Child maltreatment is a risk factor for mental disorders and decreased life satisfaction during adolescence. We investigated whether child maltreatment would link to life satisfaction both directly and through psychological symptoms, whether these relations would change from admission to discharge after treatment, and which types of maltreatment, symptoms and facets of life satisfaction would be most influential in adolescent inpatients with internalizing mental disorders. N = 896 adolescent receiving inpatient psychotherapeutic treatment completed questionnaires on child maltreatment experiences, current psychopathology and subjective life satisfaction at admission and discharge (n = 765). Main diagnoses were affective (n = 322), eating (n = 447), obsessive-compulsive (n = 70) and anxiety disorders (n = 57). Network models of child maltreatment, psychopathology and life satisfaction nodes were estimated at admission and discharge and compared using network comparison tests. Potential causal shortest pathways were investigated using directed acyclic graphs.Network models were stable with no significant differences between admission and discharge. Strongest nodes of each cluster were "emotional abuse" (child maltreatment), "worthlessness", "thinking about dying" and "feeling lonely" (psychopathology) and "satisfied with life" (life satisfaction) at both admission and discharge. Emotional neglect showed direct connections to life satisfaction, indicating its relevance for therapeutic interventions. At both admission and discharge, "sexual abuse" indirectly predicted lower life satisfaction through psychological symptoms. In conclusion, child maltreatment is directly and indirectly connected to life satisfaction in adolescents with mental disorders. Emotional abuse and neglect were especially important in linking child maltreatment to life satisfaction and psychopathology.
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Affiliation(s)
- David R Kolar
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy Institute of Psychology, University of Regensburg, Sedanstr. 1, 93055, Regensburg, Germany.
| | | | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy
| | - Sebastian Ertl
- Department of Psychology, Clinical Child and Adolescent Psychology and Psychotherapy Institute of Psychology, University of Regensburg, Sedanstr. 1, 93055, Regensburg, Germany
| | - Adrian Meule
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Institute of Medical Psychology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Silke Naab
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Schoen Clinic Roseneck, Prien am Chiemsee, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
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Wang Y, Li Z, Cao X. Investigating the network structure and causal relationships among bridge symptoms of comorbid depression and anxiety: A Bayesian network analysis. J Clin Psychol 2024; 80:1271-1285. [PMID: 38366938 DOI: 10.1002/jclp.23663] [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: 09/03/2023] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND The network analysis method emphasizes the interaction between individual symptoms to identify shared or bridging symptoms between depression and anxiety to understand comorbidity. However, the network analysis and community detection approach have limitations in identifying causal relationships among symptoms. This study aims to address this gap by applying Bayesian network (BN) analysis to investigate potential causal relationships. METHOD Data were collected from a sample of newly enrolled college students. The network structure of depression and anxiety was estimated using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder (GAD-7) Scale measures, respectively. Shared symptoms between depression and anxiety were identified through network analysis and clique percolation (CP) method. The causal relationships among symptoms were estimated using BN. RESULTS The strongest bridge symptoms, as indicated by bridge strength, include sad mood (PHQ2), motor (PHQ8), suicide (PHQ9), restlessness (GAD5), and irritability (GAD6). These bridge symptoms formed a distinct community using the CP algorithm. Sad mood (PHQ2) played an activating role, influencing other symptoms. Meanwhile, restlessness (GAD5) played a mediating role with reciprocal influences on both anxiety and depression symptoms. Motor (PHQ8), suicide (PHQ9), and irritability (GAD6) assumed recipient positions. CONCLUSION BN analysis presents a valuable approach for investigating the complex interplay between symptoms in the context of comorbid depression and anxiety. It identifies two activating symptoms (i.e., sadness and worry), which serve to underscore the fundamental differences between these two disorders. Additionally, psychomotor symptoms and suicidal ideations are recognized as recipient roles, being influenced by other symptoms within the network.
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Affiliation(s)
- Yu Wang
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, Nanjing, China
| | - Xing Cao
- Mental Health Education Center, Southeast University, Nanjing, China
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3
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Yarwood B, Taylor R, Angelakis I. User Experiences of CBT for Anxiety and Depression: A Qualitative Systematic Review and Meta-synthesis. Community Ment Health J 2024; 60:662-671. [PMID: 37884830 DOI: 10.1007/s10597-023-01196-w] [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: 04/11/2023] [Accepted: 09/27/2023] [Indexed: 10/28/2023]
Abstract
Cognitive behavioural therapy (CBT) is an evidence-based treatment for anxiety and depression. It is important to determine the positive and negative aspects of CBT from the perspective of service users. However, there has been a lack of qualitative exploration into service user experiences of the therapy. This review aimed to address this gap by examining participants' experiences of CBT for anxiety and depression. Databases were searched and data were synthesised thematically. CBT was well-received by participants, though barriers to engagement were identified. CBT was often perceived as too difficult or demanding, as well as interventions being short and therefore superficial. Clinician qualities of being trustworthy, non-judgemental, and understanding appear to be significant contributors to client engagement and recovery. Findings support the delivery of in-depth clinician led CBT for anxiety and depression, as well as highlighting the need to review CBT delivery to better support service users.
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Nkoka O, Munthali-Mkandawire S, Mwandira K, Nindi P, Dube A, Nyanjagha I, Mainjeni A, Malava J, Amoah AS, McLean E, Stewart RC, Crampin AC, Price AJ. Association between physical multimorbidity and common mental health disorders in rural and urban Malawian settings: Preliminary findings from Healthy Lives Malawi long-term conditions survey. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002955. [PMID: 38574079 PMCID: PMC10994288 DOI: 10.1371/journal.pgph.0002955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/03/2024] [Indexed: 04/06/2024]
Abstract
In low-income Africa, the epidemiology of physical multimorbidity and associated mental health conditions is not well described. We investigated the multimorbidity burden, disease combinations, and relationship between physical multimorbidity and common mental health disorders in rural and urban Malawi using early data from 9,849 adults recruited to an on-going large cross-sectional study on long-term conditions, initiated in 2021. Multimorbidity was defined as having two or more measured (diabetes, hypertension) or self-reported (diabetes, hypertension, disability, chronic pain, HIV, asthma, stroke, heart disease, and epilepsy) conditions. Depression and anxiety symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) and the 7-item General Anxiety Disorder scale (GAD-7) and defined by the total score (range 0-27 and 0-21, respectively). We determined age-standardized multimorbidity prevalence and condition combinations. Additionally, we used multiple linear regression models to examine the association between physical multimorbidity and depression and anxiety symptom scores. Of participants, 81% were rural dwelling, 56% were female, and the median age was 30 years (Inter Quartile Range 21-43). The age-standardized urban and rural prevalence of multimorbidity was 14.1% (95% CI, 12.5-15.8%) and 12.2% (95% CI, 11.6-12.9%), respectively. In adults with two conditions, hypertension, and disability co-occurred most frequently (18%), and in those with three conditions, hypertension, disability, and chronic pain were the most common combination (23%). Compared to adults without physical conditions, having one (B-Coefficient (B) 0.79; 95% C1 0.63-0.94%), two- (B 1.36; 95% CI 1.14-1.58%), and three- or more- physical conditions (B 2.23; 95% CI 1.86-2.59%) were associated with increasing depression score, p-trend <0.001. A comparable 'dose-response' relationship was observed between physical multimorbidity and anxiety symptom scores. While the direction of observed associations cannot be determined with these cross-sectional data, our findings highlight the burden of multimorbidity and the need to integrate mental and physical health service delivery in Malawi.
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Affiliation(s)
- Owen Nkoka
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Kondwani Mwandira
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Providence Nindi
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Albert Dube
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | | | - Angella Mainjeni
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Jullita Malava
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Abena S. Amoah
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Estelle McLean
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Robert C. Stewart
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Division of Psychiatry, Centre for Clinical Brain Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Amelia C. Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alison J. Price
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Forbes MK, Neo B, Nezami OM, Fried EI, Faure K, Michelsen B, Twose M, Dras M. Elemental psychopathology: distilling constituent symptoms and patterns of repetition in the diagnostic criteria of the DSM-5. Psychol Med 2024; 54:886-894. [PMID: 37665038 DOI: 10.1017/s0033291723002544] [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] [Indexed: 09/05/2023]
Abstract
BACKGROUND The DSM-5 features hundreds of diagnoses comprising a multitude of symptoms, and there is considerable repetition in the symptoms among diagnoses. This repetition undermines what we can learn from studying individual diagnostic constructs because it can obscure both disorder- and symptom-specific signals. However, these lost opportunities are currently veiled because symptom repetition in the DSM-5 has not been quantified. METHOD This descriptive study mapped the repetition among the 1419 symptoms described in 202 diagnoses of adult psychopathology in section II of the DSM-5. Over a million possible symptom comparisons needed to be conducted, for which we used both qualitative content coding and natural language processing. RESULTS In total, we identified 628 distinct symptoms: 397 symptoms (63.2%) were unique to a single diagnosis, whereas 231 symptoms (36.8%) repeated across multiple diagnoses a total of 1022 times (median 3 times per symptom; range 2-22). Some chapters had more repetition than others: For example, every symptom of every diagnosis in the bipolar and related disorders chapter was repeated in other chapters, but there was no repetition for any symptoms of any diagnoses in the elimination disorders, gender dysphoria or paraphilic disorders. The most frequently repeated symptoms included insomnia, difficulty concentrating, and irritability - listed in 22, 17 and 16 diagnoses, respectively. Notably, the top 15 most frequently repeating diagnostic criteria were dominated by symptoms of major depressive disorder. CONCLUSION Overall, our findings lay the foundation for a better understanding of the extent and potential consequences of symptom overlap.
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Affiliation(s)
- Miriam K Forbes
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Bryan Neo
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Sydney, Australia
| | | | - Eiko I Fried
- Clinical Psychology Unit, Leiden University, Leiden, Netherlands
| | - Katherine Faure
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Brier Michelsen
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Maddison Twose
- Centre for Emotional Health and School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Mark Dras
- School of Computing, Macquarie University, Sydney, Australia
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Lolk K, Rytgaard HCW, Madsen MG, Arteaga-Henríquez G, Madsen KB, Dreier JW, Munk-Olsen T. Duration and timing of depression and risk of family dissolution: A register-based cohort study of newly-formed Danish families. J Affect Disord 2024; 349:420-430. [PMID: 38199414 DOI: 10.1016/j.jad.2024.01.022] [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: 06/08/2023] [Revised: 11/30/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND Depression is detrimental to partnership stability. However, it remains unclear if and how the duration and timing of depression affect the risk of family dissolution. METHODS We conducted a Danish register-based cohort study of newly-formed cohabiting and married couples in 2008 and 2009, who were followed from the second year after family formation. Depressive episodes were defined by individual-level prescription patterns of antidepressant drugs (ATC codes N06A) in either partner. Family dissolution was characterized by the discontinuation of a shared residential address. Using Longitudinal Targeted Minimum Loss-based Estimation, we estimated the risk of family dissolution after 5 years of follow-up under various lengths and timings of depressive episodes. RESULTS There were 102,335 families included. The covariate-adjusted risk of family dissolution in families without depressive episodes was 30.0 % (95 % CI 29.6-30.4 %) and 35.5 % (95 % CI 29.5-41.5 %) in families with at least one depressive episode during follow-up. The risk of family dissolution increased with the duration of depressive episodes to 42.2 % (95 % CI 40.8-43.6 %) for five coherent years of depression. Depression shortly after family formation carried higher risk of family dissolution; this risk was 42.3 % (95 % CI 38.4-46.3 %) for depression experienced in the first year of family formation versus 32.9 % (95 % CI 31.8-34.0 %) in the fifth year of family formation. LIMITATIONS Proxy measures of depression by antidepressant prescriptions fails to identify milder depression. Annual measures of family dissolution precluded more fine-grained analyses of time-intervals. CONCLUSIONS Depression is disruptive to family stability, particularly with longer duration and early onset after family formation.
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Affiliation(s)
- Kasper Lolk
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark.
| | | | - Malene Galle Madsen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
| | - Gara Arteaga-Henríquez
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
| | - Kathrine Bang Madsen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark
| | - Julie Werenberg Dreier
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Denmark; Department of Clinical Research, Odense University Hospital, Odense, Denmark
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Tenekedjieva LT, McCalley DM, Goldstein-Piekarski AN, Williams LM, Padula CB. Transdiagnostic Mood, Anxiety, and Trauma Symptom Factors in Alcohol Use Disorder: Neural Correlates Across 3 Brain Networks. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00064-8. [PMID: 38432622 DOI: 10.1016/j.bpsc.2024.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Alcohol use disorder (AUD) is associated with high rates of trauma, mood, and anxiety disorders. Across these diagnoses, individual symptoms substantially overlap, highlighting the need for a transdiagnostic approach. Furthermore, there is limited research on how transdiagnostic psychopathology impacts the neural correlates of AUD. Thus, we aimed to identify symptom factors spanning diagnoses and examine how they relate to the neurocircuitry of addiction. METHODS Eighty-six veterans with AUD completed self-report measures and reward, incentive salience, and cognitive control functional magnetic resonance imaging tasks. Factor analysis was performed on self-reported trauma, depression, anxiety, and stress symptoms to obtain transdiagnostic symptom compositions. Neural correlates of a priori-defined regions of interest in the 3 networks were assessed. Independent sample t tests were used to compare the same nodes by DSM-5 diagnosis. RESULTS Four symptom factors were identified: Trauma distress, Negative affect, Hyperarousal, and Somatic anxiety. Trauma distress score was associated with increased cognitive control activity during response inhibition (dorsal anterior cingulate cortex). Negative affect was related to lower activation in reward regions (right caudate) but higher activation in cognitive control regions during response inhibition (left dorsolateral prefrontal cortex). Hyperarousal was related to lower reward activity during monetary reward anticipation (left caudate, right caudate). Somatic anxiety was not significantly associated with brain activation. No difference in neural activity was found by posttraumatic stress disorder, major depressive disorder, or generalized anxiety disorder diagnosis. CONCLUSIONS These hypothesis-generating findings offer transdiagnostic symptom factors that are differentially associated with neural function and could guide us toward a brain-based classification of psychiatric dysfunction in AUD. Results warrant further investigation of transdiagnostic approaches in addiction.
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Affiliation(s)
- Lea-Tereza Tenekedjieva
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California.
| | - Daniel M McCalley
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Andrea N Goldstein-Piekarski
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
| | - Claudia B Padula
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California; Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, California
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Dykxhoorn J, Osborn D, Walters K, Kirkbride JB, Gnani S, Lazzarino AI. Temporal patterns in the recorded annual incidence of common mental disorders over two decades in the United Kingdom: a primary care cohort study. Psychol Med 2024; 54:663-674. [PMID: 37605881 DOI: 10.1017/s0033291723002349] [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] [Indexed: 08/23/2023]
Abstract
BACKGROUND Common mental disorders (CMDs) including depression, anxiety, and stress are very common, but it is unclear whether the last decades of social, economic, and political change have impacted incidence of CMD. This study explored temporal trends in the recorded incidence of CMD in the United Kingdom. METHODS We used data from general practices in the United Kingdom (Clinical Practice Research Datalink) to estimate the annual recorded incidence of CMD for 2000-2020, including symptoms, diagnosis, or pharmaceutical treatment. Trends were explored by sex, age, ethnicity, region, deprivation, and comorbidity. RESULTS We included 29 480 164 individuals who were followed up for 12.5 years on average (s.d. = 6.4 years). The recorded incidence of CMD episodes was 55.9 per 1000 person-years in 2000 [95% confidence interval (CI) 55.8-56.1], increasing to 79.6 per 1000 person-years in 2019 (95% CI 79.5-79.8). Females had higher recorded incidence rates, as did those living in more deprived areas. We observed striking patterns by age over time, with rates in ages 16-24 increasing from 40.2 per 1000 in 2000 (95% CI 39.8-40.5), to 107.8 per 1000 in 2019 (95% CI 107.0-108.6). In contrast, the rates in those aged ≥55 years decreased since 2014. There were differing patterns of incidence by ethnic group, with a steeper increase in Asian, Black, and mixed groups in recent years. CONCLUSIONS Overall, the incidence of recorded CMD in the UK general practice increased between 2000 and 2019 with a small decrease in 2020. The overall trends obscured important differences across population subgroups, which may have implications for prevention.
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Affiliation(s)
- J Dykxhoorn
- Department of Primary Care and Population Health, UCL, London, UK
- Division of Psychiatry, UCL, London, UK
| | - D Osborn
- Division of Psychiatry, UCL, London, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - K Walters
- Department of Primary Care and Population Health, UCL, London, UK
| | | | - S Gnani
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Powell CLYM, Chiu CY, Sun X, So SHW. A meta-analysis on the efficacy of low-intensity cognitive behavioural therapy for generalised anxiety disorder. BMC Psychiatry 2024; 24:10. [PMID: 38166836 PMCID: PMC10763350 DOI: 10.1186/s12888-023-05306-6] [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: 11/03/2022] [Accepted: 10/25/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Low-intensity cognitive behavioural therapy (LICBT) has been recommended as a primary intervention in the tiered care for mild to moderate generalised anxiety disorder. However, LICBT for generalised anxiety disorder are markedly diverse and efficacy data on various outcomes have not been systematically reviewed. This meta-analysis aimed to synthesise effect sizes of three NICE-recommended LICBT for generalised anxiety disorder: non-facilitated self-help, guided self-help, and psychoeducational groups. METHODS A systematic literature review of randomised controlled trials (RCTs) examining LICBT for generalised anxiety disorder in the last 23 years (2000-2023) was conducted. Efficacy data for anxiety, depression, and worry outcomes were separately meta-analysed. The study was reported following the PRISMA guidelines. RESULTS The systematic review identified 12 RCTs out of 1205 papers. The three meta-analyses consisted of 12 (anxiety), 11 (depression), and 9 (worry) effect sizes respectively, including total sample sizes of 1201 (anxiety), 1164 (depression), and 908 (worry). The adjusted effect sizes for reductions in anxiety (g = -0.63), depression (g = -0.48), and worry (g = -0.64) were all in the medium range, favouring LICBT over control conditions. Between-study heterogeneity was significant on anxiety and worry, with no specific moderators identified by meta-regression. CONCLUSIONS LICBT has shown promise as an effective and efficient treatment modality for individuals with generalised anxiety disorder. Future research comparing various LICBT subtypes and treatment components will further inform clinical practice. TRIAL REGISTRATION This systematic review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; record ID CRD42021285590).
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Affiliation(s)
- Candice L Y M Powell
- Clinical Psychological Services, New Life Psychiatric Rehabilitation Association, Hong Kong Special Administrative Region, China
| | - Chun Yuen Chiu
- Clinical Psychological Services, New Life Psychiatric Rehabilitation Association, Hong Kong Special Administrative Region, China
| | - Xiaoqi Sun
- Department of Psychology, Hunan Normal University, Hunan, China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Hunan, China
| | - Suzanne Ho-Wai So
- Department of Psychology, The Chinese University of Hong Kong, Room 321, Wong Foo Yuan Building, Shatin, Hong Kong SAR, China.
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10
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McNaughton BA, Burrows K, Choquette E, Poplin T, Kuplicki R, Paulus MP, Ironside M, Stewart JL. Impaired eating behaviors but intact metabolic hormone levels in individuals with major depressive disorder and generalized anxiety disorder. J Psychiatr Res 2023; 168:193-203. [PMID: 37918032 PMCID: PMC10842703 DOI: 10.1016/j.jpsychires.2023.10.042] [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: 05/23/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) and generalized anxiety disorder (GAD) contribute significantly to global health burdens. Identifying disease markers for these comorbid disorders can increase understanding of pathogenesis and improve screening and intervention strategies. This study examined the association of physical health factors with MDD and MDD + GAD, across sexes. METHODS Two samples of participants from the Tulsa-1000 study (exploratory cohort: N = 136; confirmatory cohort: N = 185) completed body composition measurements, eating behavior (Three Factor Eating Questionnaire [TFEQ], Eating Disorder Diagnostic Scale [EDDS]), exercise questionnaires, and a blood draw. Metabolic hormone concentrations (leptin, insulin, and adiponectin) were analyzed from blood samples. Within each cohort, a two-way analysis of variance compared three groups (MDD, MDD + GAD, and healthy controls [HC]), sex, and their interaction on dependent variables. Hedges g was calculated to reflect effect size magnitude. RESULTS Medium-to-large group main effects across cohorts indicated that compared to HC: (1) MDD (g = 1.71/0.57) and MDD + GAD (g = 0.93/0.69) reported higher TFEQ Disinhibition scores; (2) MDD endorsed higher TFEQ Hunger scores (g = 0.66/0.48); and (3) MDD (g = 1.60/1.30) and MDD + GAD (g = 0.92/1.72) reported greater EDDS scores. Large sex main effects across cohorts indicated that females exhibited higher levels than males for percent body fat (g = 1.07/1.17), leptin (g = 1.27/1.12), and adiponectin (g=0.82/0.88). LIMITATIONS The power to detect group*sex interactions was limited due to a greater number of females (than males) in the study, and over half of clinical participants were taking medications. CONCLUSIONS Individuals with MDD and MDD + GAD demonstrate difficulties in regulating eating behaviors, potentially contributing to functional impairment and increased disease burden.
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Affiliation(s)
| | | | | | - Tate Poplin
- Laureate Institute of Brain Research, Tulsa, OK, USA
| | | | - Martin P Paulus
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA
| | - Maria Ironside
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA
| | - Jennifer L Stewart
- Laureate Institute of Brain Research, Tulsa, OK, USA; The University of Tulsa, Tulsa, OK, USA.
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11
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Bär A, Bär HE, Rijkeboer MM, Lobbestael J. Early Maladaptive Schemas and Schema Modes in clinical disorders: A systematic review. Psychol Psychother 2023; 96:716-747. [PMID: 37026578 DOI: 10.1111/papt.12465] [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: 07/06/2022] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Although schema therapy has been predominantly applied to treat personality disorders, interest into its application in other clinical disorders is growing. Central to schema therapy are Early Maladaptive Schemas (EMS) and Schema Modes. Since existing EMS and Schema Modes were primarily developed in the context of personality disorders, their relevance for clinical disorders is unclear. METHODS We conducted a systematic review of the presence of EMS and Schema Modes in clinical disorders according to DSM criteria. Per disorder, we evaluated which EMS and Schema Modes were more pronounced in comparison with clinical as well as non-clinical control groups and which EMS and Schema Modes were most highly endorsed within the disorder. RESULTS Although evidence concerning EMS was scarce for several disorders, and only few studies on Schema Modes survived inclusion criteria, we identified meaningful relationships and patterns for EMS and Schema Modes in various clinical disorders. CONCLUSIONS The present review highlights the relevance of EMS and Schema Modes for clinical disorders beyond personality disorders. Depending on the theme of the representation, EMS act as vulnerabilities both across diagnoses and for specific disorders. Thus, EMS and resulting Schema Modes are potential, valuable targets for the prevention and treatment of clinical disorders.
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Affiliation(s)
- Andreas Bär
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Hannah E Bär
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychology and Psychotherapy, University of Freiburg, Freiburg im Breisgau, Germany
| | - Marleen M Rijkeboer
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Jill Lobbestael
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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12
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Anderson NJ, Rozenman M, Pennington BF, Willcutt EG, McGrath LM. Compounding Effects of Domain-General Cognitive Weaknesses and Word Reading Difficulties on Anxiety Symptoms in Youth. JOURNAL OF LEARNING DISABILITIES 2023; 56:343-358. [PMID: 35658570 PMCID: PMC9720039 DOI: 10.1177/00222194221098719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
This study examined whether domain-general cognitive weaknesses in processing speed (PS) or executive functioning (EF) moderate the relation between word reading scores and anxiety such that lower word reading scores in combination with lower cognitive scores are associated with higher anxiety symptoms. The sample consisted of 755 youth ages 8-16 who were recruited as part of the Colorado Learning Disabilities Research Center twins study. Lower scores on PS (R2 = .007, p = .014), EF (R2 = .009, p = .006), and word reading (R2 = .006-.008, p = .010-.032) were associated with higher anxiety scores. In addition, the word reading × cognitive interactions were significant such that lower scores on PS (R2 = .010, p = .005) or EF (R2 = .013, p = .010) combined with lower word reading were associated with higher-than-expected anxiety symptoms. Results suggest that weaknesses in PS, EF, and word reading are modestly associated with higher anxiety symptoms, and these anxiety symptoms may be compounded in youth with both PS or EF weaknesses and word reading difficulties. These findings can guide assessment approaches for identifying youth with word reading challenges who may be at increased risk for anxiety.
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13
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Subramanian M, McAuliffe T, Agrawal H. Assessing Variability in Reporting Severity of the Same Symptom (Fatigue) in the Context of Different Psychiatric Syndromes. Cureus 2023; 15:e44112. [PMID: 37750117 PMCID: PMC10518187 DOI: 10.7759/cureus.44112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
Objective The objective of this study is to examine the variability in the self-reported fatigue symptom severity in major depressive disorder (MDD) compared to generalized anxiety disorder (GAD). Methods A retrospective chart review was conducted of 100 patients evaluated for fatigue using depression and anxiety questionnaires. The study examined whether ratings of fatigue varied based on whether fatigue was being rated by the patient in the context of MDD vs. when fatigue was being rated by the same patient in the context of GAD. A related-sample Wilcoxon signed-rank test and Mann-Whitney U test were used to compare the median differences between depression and anxiety fatigue scores. The significance level used was 0.05. Results This study found a statistically significant difference in the median difference of the paired depression fatigue and anxiety fatigue scores (depression score - anxiety score) regardless of the order of administration (Wilcoxon signed-rank test statistic = 135.500, p-value =.008, N = 100 paired scores). Conclusion The study's conclusions show that although the symptom of fatigue is listed in the Diagnostic Statistical Manual 5 (DSM-5) criteria for MDD as well as GAD, it may be perceived by patients differently based on the context of the syndrome. This emphasizes the importance of considering the context of symptom reporting in patients with MDD and GAD to improve diagnostic methodologies and treatment strategies.
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Affiliation(s)
- Maya Subramanian
- College of Medicine, Medical College of Wisconsin, Milwaukee, USA
| | - Timothy McAuliffe
- Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, USA
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Guineau MG, Ikani N, Rinck M, Collard RM, van Eijndhoven P, Tendolkar I, Schene AH, Becker ES, Vrijsen JN. Anhedonia as a transdiagnostic symptom across psychological disorders: a network approach. Psychol Med 2023; 53:3908-3919. [PMID: 35348051 PMCID: PMC10317820 DOI: 10.1017/s0033291722000575] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 02/09/2022] [Accepted: 02/16/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Anhedonia is apparent in different mental disorders and is suggested to be related to dysfunctions in the reward system and/or affect regulation. It may hence be a common underlying feature associated with symptom severity of mental disorders. METHODS We constructed a cross-sectional graphical Least Absolute Shrinkage and Selection Operator (LASSO) network and a relative importance network to estimate the relationships between anhedonia severity and the severity of symptom clusters of major depressive disorder (MDD), anxiety sensitivity (AS), attention-deficit hyperactivity disorder (ADHD), and autism spectrum disorder (ASD) in a sample of Dutch adult psychiatric patients (N = 557). RESULTS Both these networks revealed anhedonia severity and depression symptom severity as central to the network. Results suggest that anhedonia severity may be predictive of the severity of symptom clusters of MDD, AS, ADHD, and ASD. MDD symptom severity may be predictive of AS and ADHD symptom severity. CONCLUSIONS The results suggest that anhedonia may serve as a common underlying transdiagnostic psychopathology feature, predictive of the severity of symptom clusters of depression, AS, ADHD, and ASD. Thus, anhedonia may be associated with the high comorbidity between these symptom clusters and disorders. If our results will be replicated in future studies, it is recommended for clinicians to be more vigilant about screening for anhedonia and/or depression severity in individuals diagnosed with an anxiety disorder, ADHD and/or ASD.
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Affiliation(s)
- Melissa G. Guineau
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Overwaal, Center of Expertise for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders, Pro Persona, Institute for Integrated Mental Health Care, Nijmegen, The Netherlands
| | - N. Ikani
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Overwaal, Center of Expertise for Anxiety, Obsessive-Compulsive, and Posttraumatic Stress Disorders, Pro Persona, Institute for Integrated Mental Health Care, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, The Netherlands
| | - M. Rinck
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - R. M. Collard
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P. van Eijndhoven
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - I. Tendolkar
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany
| | - A. H. Schene
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - E. S. Becker
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - J. N. Vrijsen
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
- Depression Expertise Center, Pro Persona Mental Health Care, Nijmegen, The Netherlands
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15
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Yifei Huang E, Hansen AV, Tidemandsen C, la Cour Freiesleben N, Nielsen HS, Backer V, Ulrik CS. Anxiety and depression in women with asthma prior to fertility treatment. Eur Clin Respir J 2023; 10:2221376. [PMID: 37313367 PMCID: PMC10259298 DOI: 10.1080/20018525.2023.2221376] [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: 03/08/2023] [Accepted: 05/31/2023] [Indexed: 06/15/2023] Open
Abstract
Objective We investigate symptoms of anxiety and depression among women with asthma prior to fertility treatment. Methods This is a cross-sectional study of women screened for eligibility to the PRO-ART study (RCT of omalizumab versus placebo in asthmatic women undergoing fertility treatment (NCT03727971)). All participants were scheduled for in vitro fertilization (IVF) treatment at four public fertility clinics in Denmark. Data on demographics and asthma control (ACQ-5) were obtained. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS-A and D, respectively) and defined as being present on both subscales if a score >7 was obtained. Spirometry, diagnostic asthma test, and measurement of fractional exhaled nitric oxide (FeNO) were conducted. Results A total of 109 women with asthma were included (mean age 31.8 ± 4.6 and BMI 25.5 ± 4.6). Most women had male factor infertility (36.4%) or unexplained infertility (35.5%). Twenty-two percent of the patients reported uncontrolled asthma (ACQ-5 score > 1.5). The mean HADS-A and HADS-D scores were 6.0 ± 3.8 (95% CI 5.3-6.7) and 2.5 ± 2.2 (95% CI 2.1-3.0), respectively. Thirty (28.0%) women reported anxiety symptoms, and four (3.7%) had concomitant depressive symptoms. Uncontrolled asthma was significantly associated with both depressive (p = 0.04) and anxiety symptoms (p = 0.03). Conclusions More than 25% of women with asthma prior to fertility treatment had self-reported symptoms of anxiety, and just below 5% had self-reported depressive symptoms, possibly related to uncontrolled asthma.
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Affiliation(s)
- Emilia Yifei Huang
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Anne Vejen Hansen
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Casper Tidemandsen
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
| | - Nina la Cour Freiesleben
- Department of Obstetrics and Gynaecology, the Fertility Clinic, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Obstetrics and Gynaecology, the Fertility Clinic, Copenhagen University Hospital, Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Backer
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Otorhinolaryngology and Head & Neck Surgery, Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Suppli Ulrik
- Department of Respiratory Medicine, Copenhagen University Hospital – Hvidovre, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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16
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Losiewicz OM, Metts AV, Zinbarg RE, Hammen C, Craske MG. Examining the indirect contributions of irritability and chronic interpersonal stress on symptoms of anxiety and depression in adolescents. J Affect Disord 2023; 329:350-358. [PMID: 36863468 DOI: 10.1016/j.jad.2023.02.125] [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: 10/24/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Chronic interpersonal stress has been identified as predictive of anxiety and depression. However, more research is needed to understand predictors of chronic interpersonal stress and mediators of its relationship with anxiety and depression. Irritability, a transdiagnostic symptom closely related to chronic interpersonal stress, may provide more insight into this relationship. While some research has demonstrated that irritability is related to chronic interpersonal stress, directionality is unknown. A bidirectional relationship between irritability and chronic interpersonal stress was hypothesized, such that irritability mediates the relationship between chronic interpersonal stress and internalizing symptoms and chronic interpersonal stress mediates the relationship between irritability and internalizing symptoms. METHODS This study used three cross-lagged panel models to investigate the indirect effects of irritability and chronic interpersonal stress on anxiety and depression symptoms using data from 627 adolescents (68.9 % female, 57.7 % white) over a six-year period. RESULTS In partial support for our hypotheses, we found that the relationships between chronic interpersonal stress and both fears and anhedonia were mediated by irritability, and that the relationship between irritability and anhedonia was mediated by chronic interpersonal stress. LIMITATIONS Study limitations include some temporal overlap in symptom measurements, an irritability measure that has not been previously validated to measure the construct, and lack of a lifespan perspective. CONCLUSIONS More targeted approaches in intervention for both chronic interpersonal stress and irritability may improve prevention and intervention efforts to address anxiety and depression.
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Affiliation(s)
- Olivia M Losiewicz
- University of California, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA
| | - Allison V Metts
- University of California, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA
| | - Richard E Zinbarg
- Northwestern University, Department of Psychology, 2029 Sheridan Road, Swift Hall 102, Evanston, IL 60208, USA; The Family Institute, Northwestern University, Evanston, IL, USA
| | - Constance Hammen
- University of California, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA
| | - Michelle G Craske
- University of California, Department of Psychology, 1285 Franz Hall, Los Angeles, CA 90025, USA.
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17
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Jegede O, Stefanovics EA, Rhee TG, Rosenheck RA. Multimorbidity and Correlates of Comorbid Depression and Generalized Anxiety Disorder in a Nationally Representative US Sample. J Nerv Ment Dis 2023; 211:355-361. [PMID: 36807207 DOI: 10.1097/nmd.0000000000001625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
ABSTRACT Generalized anxiety disorder (GAD) and major depressive disorder (MDD) frequently occur together, but sociodemographic, behavioral, and diagnostic correlates of this comorbidity have not been comprehensively studied. Data from the nationally representative US sample surveyed in the National Epidemiologic Survey on Alcohol and Related Conditions-III ( N = 36,309) were used to define three groups, individuals with a) both past-year GAD and MDD ( n = 909, 16.9%), b) GAD only ( n = 999, 18.6%), and c) MDD only ( n = 3471, 64.5%). The comorbid group was compared with each single-diagnosis group on sociodemographic, behavioral, and diagnostic characteristics based on effect sizes (risk ratios and Cohen's d ) rather than p values because of the large sample sizes. Multivariable-adjusted logistic regression analyses were used to identify factors independently associated with the comorbid group. Bivariate analysis showed that the comorbid group had more parental and childhood adversities, additional psychiatric disorders, and poorer mental health quality of life than both single-disorder groups. Multivariable-adjusted logistic regression of the comorbid group showed that on two of five factors, additional psychiatric diagnoses were significantly more frequent than in the GAD-only group, and that on three of six factors, additional psychiatric diagnoses were significantly more frequent than in the MDD-only group. There is a significantly higher burden of social adjustment problems, comorbid psychiatric disorders, and poorer mental health-related quality of life among individuals with comorbid GAD-MDD than those with single disorders. The adversities associated with this non-SUD psychiatric comorbidity are comparable to those associated with the more extensively studied comorbidity of psychiatric and substance use disorders and deserve further research and treatment.
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18
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Carbone EA, Menculini G, de Filippis R, D’Angelo M, De Fazio P, Tortorella A, Steardo L. Sleep Disturbances in Generalized Anxiety Disorder: The Role of Calcium Homeostasis Imbalance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4431. [PMID: 36901441 PMCID: PMC10002427 DOI: 10.3390/ijerph20054431] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/16/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Patients with a generalized anxiety disorder (GAD) often report preeminent sleep disturbances. Recently, calcium homeostasis gained interest because of its role in the regulation of sleep-wake rhythms and anxiety symptoms. This cross-sectional study aimed at investigating the association between calcium homeostasis imbalance, anxiety, and quality of sleep in patients with GAD. A total of 211 patients were assessed using the Hamilton Rating Scale for Anxiety (HAM-A), Pittsburgh Sleep Quality Index questionnaire (PSQI) and Insomnia Severity Index (ISI) scales. Calcium, vitamin D, and parathyroid hormone (PTH) levels were evaluated in blood samples. A correlation and linear regression analysis were run to evaluate the association of HAM-A, PSQI, and ISI scores with peripheral markers of calcium homeostasis imbalance. Significant correlations emerged between HAM-A, PSQI, ISI, PTH, and vitamin D. The regression models showed that patients with GAD displaying low levels of vitamin D and higher levels of PTH exhibit a poor subjective quality of sleep and higher levels of anxiety, underpinning higher psychopathological burden. A strong relationship between peripheral biomarkers of calcium homeostasis imbalance, insomnia, poor sleep quality, and anxiety symptomatology was underlined. Future studies could shed light on the causal and temporal relationship between calcium metabolism imbalance, anxiety, and sleep.
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Affiliation(s)
- Elvira Anna Carbone
- Department of Medical and Surgical Sciences, University Magna Graecia, 88100 Catanzaro, Italy
| | - Giulia Menculini
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Renato de Filippis
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Martina D’Angelo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, Piazzale Lucio Severi, 1, 06132 Perugia, Italy
| | - Luca Steardo
- Department of Health Sciences, University “Magna Graecia”, 88100 Catanzaro, Italy
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19
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Grigutytė N, Mikuličiūtė V, Petraškaitė K, Kairys A. Beck Scales (BDI-II, BAI, BHS, BSS, and CBOCI): Clinical and Normative Samples’ Comparison and Determination of Clinically Relevant Cutoffs. PSICHOLOGIJA 2023. [DOI: 10.15388/psichol.2022.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
This article aims to evaluate 5 Beck scales – Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), Beck Hopelessness Scale (BHS), Beck Suicidal Ideation Scale (BSS), and Clark–Beck Obsession-Compulsion Inventory (CBOCI) – comparing clinical and normative samples, and to determine clinically relevant cutoffs. The clinical sample consisted of 242 persons aged 18–74; 39 percent were men and 61 percent were women. The normative sample consisted of 1296 persons aged 18–95; 44 percent were men and 56 percent were women. In order to compare the estimates of the normative and clinical samples of the Beck scales, a paired data study sample was formed – 230 participants from the clinical and normative groups each. The clinical sample was divided into four groups according to the primary diagnoses: 107 (46.5%) patients were diagnosed with mood (affective) disorder (F30–F39), 38 (16.5%) with neurophysical stress and somatoform disorders (F40–F49), 51 (22.2%) with disorders due to the use of psychoactive substances (F10–F19), 34 (14.8%) with high risk of suicide (X60–X84; Z91.5; R45.81). 27 percent of patients had comorbid diagnoses. The results show high internal consistency of the Beck scales in all samples. The discrimination abilities of all five Beck scales are good; the cutoffs for each Beck scale in four clinical groups are estimated. Both the total clinical sample and the 4 clinical sample groups had significantly higher BDI-II, BAI, BHS, BSS, and CBOCI scores than the normative sample. In conclusion, the Beck scales alone are not sufficient for making a decision about the clinical diagnosis.
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20
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Vîslă A, Allemand M, Flückiger C. Within- and between-patients associations between self-efficacy, outcome expectation, and symptom change in cognitive behavioral therapy for generalized anxiety disorder. J Clin Psychol 2023; 79:86-104. [PMID: 35781807 PMCID: PMC10084306 DOI: 10.1002/jclp.23407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/05/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES There is limited information on how a change in patients' expectations over time results in symptom change in psychotherapy. This study aimed to investigate the changes in patients' expectations and symptoms during treatment and across follow-up as well as to determine the within- and between-patient relationships between two types of patient expectations, that is, self-efficacy and outcome expectation, and symptom change. METHODS Participants (80 participants × 6 repeated measures; 480 observations) with generalized anxiety disorder were treated using cognitive behavioral therapy and the within- and between-patient scores of self-efficacy and outcome expectation were evaluated in multilevel models as predictors of symptom change. RESULTS Patients' self-efficacy and outcome expectation increased, whereas severity of their symptoms reduced during and after treatment. At the within-patient (WP) level, an increase in self-efficacy was associated with a decrease in worry and depressive symptoms, and an increase in outcome expectation was associated with a decrease in depressive symptoms. The between-patient (BP) effect, however, was contrary to the WP effect, that is, self-efficacy was positively correlated with worry and outcome expectation was positively correlated with depressive symptoms CONCLUSION: These results highlight the importance of disaggregating the WP variability from BP variability in psychotherapy process-outcome research as they exhibit different associations at the within- and between-patient levels. Clinical Trial Registration: ClinicalTrial.gov (NCT03079336).
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Affiliation(s)
- Andreea Vîslă
- Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Mathias Allemand
- Department of Psychology, University of Zürich, Zürich, Switzerland
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21
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Dave B, O'Connor C. A systematic review of the antecedents, correlates, and consequences of continuum beliefs about depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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22
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Mangoo S, Erridge S, Holvey C, Coomber R, Barros DAR, Bhoskar U, Mwimba G, Praveen K, Symeon C, Sachdeva-Mohan S, Rucker JJ, Sodergren MH. Assessment of clinical outcomes of medicinal cannabis therapy for depression: analysis from the UK Medical Cannabis Registry. Expert Rev Neurother 2022; 22:995-1008. [PMID: 36573268 DOI: 10.1080/14737175.2022.2161894] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Although pre-clinical experiments associate cannabinoids with reduced depressive symptoms, there is a paucity of clinical evidence. This study aims to analyze the health-related quality of life changes and safety outcomes in patients prescribed cannabis-based medicinal products (CBMPs) for depression. METHODS A series of uncontrolled cases from the UK Medical Cannabis Registry were analyzed. The primary outcomes were changes from baseline in the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Sleep Quality Scale (SQS), and EQ-5D-5 L at 1, 3, and 6 months. Secondary outcomes included adverse events incidence. RESULTS 129 patients were identified for inclusion. Median PHQ-9 at baseline was 16.0 (IQR: 9.0-21.0). There were reductions in PHQ-9 at 1-month (median: 8.0; IQR: 4.0-14.0; p < 0.001), 3-months (7.0; 2.3-12.8; p < 0.001), and 6-months (7.0; 2.0-9.5; p < 0.001). Improvements were also observed in GAD-7, SQS, and EQ-5D-5L Index Value at 1, 3, and 6 months (p < 0.050). 153 (118.6%) adverse events were recorded by 14.0% (n = 18) of participants, 87% (n = 133) of which were mild or moderate. CONCLUSION CBMP treatment was associated with reductions in depression severity at 1, 3, and 6 months. Limitations of the study design mean that a causal relationship cannot be proven. This analysis provides insights for further study within clinical trial settings.
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Affiliation(s)
- Sajed Mangoo
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Simon Erridge
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Medicine, Sapphire Medical Clinics, London, UK
| | - Carl Holvey
- Department of Medicine, Sapphire Medical Clinics, London, UK
| | - Ross Coomber
- Department of Medicine, Sapphire Medical Clinics, London, UK.,St. George's Hospital NHS Trust, London, UK
| | - Daniela A Riano Barros
- Department of Medicine, Sapphire Medical Clinics, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK
| | - Urmila Bhoskar
- Department of Medicine, Sapphire Medical Clinics, London, UK
| | - Gracia Mwimba
- Department of Medicine, Sapphire Medical Clinics, London, UK
| | - Kavita Praveen
- Department of Medicine, Sapphire Medical Clinics, London, UK
| | - Chris Symeon
- Department of Medicine, Sapphire Medical Clinics, London, UK
| | | | - James J Rucker
- Department of Medicine, Sapphire Medical Clinics, London, UK.,South London & Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Kings College London, London, UK
| | - Mikael H Sodergren
- Imperial College Medical Cannabis Research Group, Department of Surgery and Cancer, Imperial College London, London, UK.,Department of Medicine, Sapphire Medical Clinics, London, UK
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Hennessy LA, Seewoo BJ, Jaeschke LA, Mackie LA, Figliomeni A, Arena-Foster Y, Etherington SJ, Dunlop SA, Croarkin PE, Rodger J. Accelerated low-intensity rTMS does not rescue anxiety behaviour or abnormal connectivity in young adult rats following chronic restraint stress. NEUROIMAGE: REPORTS 2022; 2. [PMID: 36277329 PMCID: PMC9583935 DOI: 10.1016/j.ynirp.2022.100104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Currently approved repetitive transcranial magnetic stimulation (rTMS) protocols for the treatment of major depressive disorder (MDD) involve once-daily (weekday) stimulation sessions, with 10 Hz or intermittent theta burst stimulation (iTBS) frequencies, over 4–6 weeks. Recently, accelerated treatment protocols (multiple daily stimulation sessions for 1–2 weeks) have been increasingly studied to optimize rTMS treatments. Accelerated protocols might confer unique advantages for adolescents and young adults but there are many knowledge gaps related to dosing in this age group. Off-label, clinical practice frequently outpaces solid evidence as rigorous clinical trials require substantial time and resources. Murine models present an opportunity for high throughput dose finding studies to focus subsequent clinical trials in humans. This project investigated the brain and behavioural effects of an accelerated low-intensity rTMS (LI-rTMS) protocol in a young adult rodent model of chronic restraint stress (CRS). Depression and anxiety-related behaviours were induced in young adult male Sprague Dawley rats using the CRS model, followed by the 3-times-daily delivery of 10 Hz LI-rTMS, for two weeks. Behaviour was assessed using the Elevated Plus Maze and Forced Swim Test, and functional, chemical, and structural brain changes measured using magnetic resonance imaging techniques. CRS induced an agitated depression-like phenotype but therapeutic effects from the accelerated protocol were not detected. Our findings suggest that the age of rodents may impact response to CRS and LI-rTMS. Future studies should also examine higher intensities of rTMS and accelerated theta burst protocols.
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Jacobson NC, Feng B. Digital phenotyping of generalized anxiety disorder: using artificial intelligence to accurately predict symptom severity using wearable sensors in daily life. Transl Psychiatry 2022; 12:336. [PMID: 35977932 PMCID: PMC9385727 DOI: 10.1038/s41398-022-02038-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is a highly prevalent condition. Monitoring GAD symptoms requires substantial time, effort, and cost. The development of digital phenotypes of GAD may enable new scalable, timely, and inexpensive assessments of GAD symptoms. METHOD The current study used passive movement data collected within a large national cohort (N = 264) to assess GAD symptom severity. RESULTS Using one week of movement data, machine learning models accurately predicted GAD symptoms across a continuum (r = 0.511) and accurately detected those individuals with elevated GAD symptoms (AUC = 0.892, 70.0% Sensitivity, 95.5% Specificity, Brier Score = 0.092). Those with a risk score at the 90th percentile or above had 21 times the odds of having elevated GAD symptoms compared to those with lower risk scores. The risk score was most strongly associated with irritability, worry controllability, and restlessness (individual rs > 0.5). The risk scores for GAD were also discriminant of major depressive disorder symptom severity (r = 0.190). LIMITATIONS The current study examined the detection of GAD symptom severity rather than the prediction of GAD symptom severity across time. Furthermore, the instant sample of data did not include nighttime actigraphy, as participants were not asked to wear the actigraphs at night. CONCLUSIONS These results suggest that artificial intelligence can effectively utilize wearable movement data collected in daily life to accurately infer risk of GAD symptoms.
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Affiliation(s)
- Nicholas C. Jacobson
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA ,grid.254880.30000 0001 2179 2404Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA ,grid.254880.30000 0001 2179 2404Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA
| | - Brandon Feng
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, PA USA
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Sordo Vieira L, Nguyen B, Nutley SK, Bertolace L, Ordway A, Simpson H, Zakrzewski J, Jean Gilles ME, Nosheny R, Weiner M, Mackin RS, Mathews CA. Self-reporting of psychiatric illness in an online patient registry is a good indicator of the existence of psychiatric illness. J Psychiatr Res 2022; 151:34-41. [PMID: 35436704 PMCID: PMC10024540 DOI: 10.1016/j.jpsychires.2022.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 03/07/2022] [Accepted: 03/21/2022] [Indexed: 11/20/2022]
Abstract
Online registries offer many advantages for research, including the ability to efficiently assess large numbers of individuals and identify potential participants for clinical trials and genetic studies. Of particular interest is the validity and utility of self-endorsement of psychiatric disorders in online registries, which, while increasingly more common, remain understudied. We thus assessed the comparability of prevalence estimated from self-endorsement of psychiatric disorders in one such registry, the Brain Health Registry (BHR) to prevalence computed from large US-based epidemiological studies and the degree to which BHR participants report psychiatric disorders consistently. We also examined the concordance between self-report and clinically determined diagnoses of various DSM-5 psychiatric disorders in a subset of participants who underwent direct assessments and identified possible reasons for discordance. Rates of self-reported psychiatric disorders were closest to previously reported population prevalence rates when endorsed at multiple timepoints, and accuracy was at least 70% for all except Hoarding Disorder as compared to the clinical diagnoses. Clinical data suggested that self-endorsement of a given psychiatric diagnosis was indicative of the presence of a closely related condition, although not necessarily for the specific disorder, with the exception of major depressive disorder, panic disorder, and hoarding disorder, which had high positive predictive values (85%, 73%, 100%, respectively). We conclude that self-reporting of psychiatric conditions in an online setting is a fair indicator of psychopathology, but should be accompanied by more in-depth interviews if using data from a participant for a specific disorder.
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Affiliation(s)
- Luis Sordo Vieira
- Department of Medicine, University of Florida, Gainesville, FL, United States; Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Binh Nguyen
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Sara K Nutley
- Department of Epidemiology, University of Florida, Gainesville, FL, United States
| | - Lyvia Bertolace
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Ashley Ordway
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Heather Simpson
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Jessica Zakrzewski
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Marie E Jean Gilles
- Department of Psychiatry, University of Florida, Gainesville, FL, United States
| | - Rachel Nosheny
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Michael Weiner
- San Francisco VA Medical Center, San Francisco, CA, United States; Department of Radiology, University of California, San Francisco, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - R Scott Mackin
- San Francisco VA Medical Center, San Francisco, CA, United States; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Carol A Mathews
- Department of Psychiatry, University of Florida, Gainesville, FL, United States.
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De Zorzi L, Ranfaing S, Roux C, Honoré J, Sequeira H. Impact of visual eccentricity on emotional reactivity: implications for anxious and depressive symptomatology. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2021.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Liu R, Chen X, Qi H, Feng Y, Su Z, Cheung T, Jackson T, Lei H, Zhang L, Xiang YT. Network analysis of depressive and anxiety symptoms in adolescents during and after the COVID-19 outbreak peak. J Affect Disord 2022; 301:463-471. [PMID: 34995705 PMCID: PMC8730647 DOI: 10.1016/j.jad.2021.12.137] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/18/2021] [Accepted: 12/31/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND This study examined the extent to which the network structure of anxiety and depression among adolescents identified during the peak of the COVID-19 pandemic could be cross-validated in a sample of adolescents assessed after the COVID-19 peak. METHODS Two cross-sectional surveys were conducted between February 20 and 27, 2020 and between April 11 and 19, 2020, respectively. Depressive and anxiety symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression and 7-item Generalized Anxiety Disorder, respectively. Anxiety-depression networks of the first and second assessments were estimated separately using a sparse Graphical Gaussian Model combined with the graphical least absolute shrinkage and selection operator method. A Network Comparison Test was conducted to assess differences between the two networks. RESULTS The most central symptoms in the first and second survey networks were Depressed affect and Nervousness. Compared with connections in the first survey network, connections in the second survey network analysis between Relax-Nervousness-Depressed affect-Interpersonal problems (diff, contrast: second survey-first survey. diff=-0.04, P = 0.04; diff=-0.03, P = 0.03; diff=-0.03, P = 0.04), and Irritability-Somatic complaints (diff=-0.04, P = 0.02) were weaker while connections of Somatic complaints-Nervousness (diff=0.05, P<0.001), Somatic complaints-Depressed affect (diff=0.03, P = 0.009), and Irritability-Control worry-Restlessness (diff=0.02, P = 0.03; diff=0.05, P = 0.02) were stronger. CONCLUSIONS Depressed affect emerged as a robust central symptom and bridge symptom across Anxiety-Depression networks. Considering the negative impact of depression and anxiety on daily life, timely interventions targeting depressed affect should be implemented to reduce the co-occurrence of anxious and depressive symptoms among adolescents during the COVID-19 pandemic.
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Affiliation(s)
- Rui Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China,Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China,Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China,Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China
| | - Xu Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Han Qi
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Zhaohui Su
- Center on Smart and Connected Health Technologies, Mays Cancer Center, School of Nursing, UT Health San Antonio, San Antonio, TX, United States of America
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, China
| | - Hui Lei
- College of Education, Hunan Agricultural University, Changsha, China
| | - Ling Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Center for Cognitive and Brain Sciences, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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De D, Kumar S, Handa S, Mahajan R, Singh SM. Psychische Morbidität bei Pemphigus‐Patienten in klinischer Remission und deren Zusammenhang mit klinisch‐demographischen Parametern. J Dtsch Dermatol Ges 2022; 20:26-34. [PMID: 35040566 DOI: 10.1111/ddg.14605_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/14/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shubh Mohan Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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The Relation Between Worry and Mental Health in Nonclinical Population and Individuals with Anxiety and Depressive Disorders: A Meta-Analysis. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-021-10288-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Relationship between workplace violence and work-related depression/anxiety, separating the types of perpetrators: a cross-sectional study using data from the fourth and fifth Korean Working Conditions Surveys (KWCS). Ann Occup Environ Med 2022; 34:e13. [PMID: 35923792 PMCID: PMC9300452 DOI: 10.35371/aoem.2022.34.e13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/27/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Background Work is an inseparable element of a person’s life, and violence in the workplace has various effects on individual workers and companies. While most studies have focused on specific industries, very few studies have investigated the influence of workplace violence by co-workers. Therefore, this study aimed to evaluate the association between workplace violence and work-related depression/anxiety in various occupations by differentiating the perpetrators of violence as co-workers and clients. Methods This study was conducted based on data from the 4th and 5th Korean Working Conditions Surveys (KWCS). The experience of workplace violence was classified in terms of the perpetrator: workplace violence by co-workers and that by clients. Work-related depression and anxiety were assessed using questions about health problems related to depression and anxiety and whether the problems were related to work. Descriptive statistics, χ2 tests, and multiple logistic regression analyses were performed using the SPSS 26.0. Results After adjusting for sociodemographic characteristics (age, education, income, subjective health status) and occupational characteristics (occupation, weekly working hours, type of employment, size of workplace, and shift work), male workers with experience of workplace violence by co-workers were found to be at a higher risk of work-related depression/anxiety (odds ratio [OR], 11.52; 95% confidence interval [CI], 8.65–15.36). The same was confirmed for female workers (OR, 10.89; 95% CI, 7.90–15.02). Conclusions Employees who experienced workplace violence from co-workers were found to be more vulnerable to work-related depression/anxiety. Continuous contact between the victim and the perpetrator may occur, and the possibility of a secondary assault can frighten the victim. Appropriate prevention and intervention measures that focus on the perpetrators of violence are needed.
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Cassiani-Miranda CA, Scoppetta O, Cabanzo-Arenas DF. Validity of the Hospital Anxiety and Depression Scale (HADS) in primary care patients in Colombia. Gen Hosp Psychiatry 2022; 74:102-109. [PMID: 33750606 DOI: 10.1016/j.genhosppsych.2021.01.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 01/24/2021] [Accepted: 01/30/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. METHODS A criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. RESULTS Cronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. CONCLUSION The HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.
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Affiliation(s)
- Carlos Arturo Cassiani-Miranda
- University of Santander, Faculty of Health Sciences, Medicine Program, UDES Neuroscience Research Group, Bucaramanga, Colombia.
| | - Orlando Scoppetta
- Catholic University of Colombia, Faculty of Psychology, GAEM Research Group (Research methods applied to behavioral science), Bogotá, Colombia.
| | - Diego Fernando Cabanzo-Arenas
- University of Santander, Faculty of Health Sciences, Medicine Program, Positive Psychiatry Research Incubator, UDES Neuroscience Research Group, Bucaramanga, Colombia
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Zhu S, Zhang X, Zhou M, Kendrick KM, Zhao W. Therapeutic applications of transcutaneous auricular vagus nerve stimulation with potential for application in neurodevelopmental or other pediatric disorders. Front Endocrinol (Lausanne) 2022; 13:1000758. [PMID: 36313768 PMCID: PMC9596914 DOI: 10.3389/fendo.2022.1000758] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/27/2022] [Indexed: 11/13/2022] Open
Abstract
Non-invasive transcutaneous auricular vagus nerve stimulation (taVNS) as a newly developed technique involves stimulating the cutaneous receptive field formed by the auricular branch of the vagus nerve in the outer ear, with resulting activation of vagal connections to central and peripheral nervous systems. Increasing evidence indicates that maladaptive neural plasticity may underlie the pathology of several pediatric neurodevelopmental and psychiatric disorders, such as autism spectrum disorder, attention deficit hyperactivity disorder, disruptive behavioral disorder and stress-related disorder. Vagal stimulation may therefore provide a useful intervention for treating maladaptive neural plasticity. In the current review we summarize the current literature primarily on therapeutic use in adults and discuss the prospects of applying taVNS as a therapeutic intervention in specific pediatric neurodevelopmental and other psychiatric disorders. Furthermore, we also briefly discuss factors that would help optimize taVNS protocols in future clinical applications. We conclude from these initial findings that taVNS may be a promising alternative treatment for pediatric disorders which do not respond to other interventions.
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Affiliation(s)
- Siyu Zhu
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiaolu Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Menghan Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Keith M. Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Weihua Zhao
- The Clinical Hospital of Chengdu Brain Science Institute, Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Institute of Electronic and Information Engineering of University of Electronic Science and Technology of China (UESTC) in Guangdong, Dongguan, China
- *Correspondence: Weihua Zhao,
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Tanyeri MH, Buyukokuroglu ME, Tanyeri P, Mutlu O, Ozturk A, Yavuz K, Kaya RK. Effects of mirabegron on depression, anxiety, learning and memory in mice. AN ACAD BRAS CIENC 2021; 93:e20210638. [PMID: 34878051 DOI: 10.1590/0001-3765202120210638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 09/16/2021] [Indexed: 11/21/2022] Open
Abstract
Mirabegron is the first b3-adrenoceptor agonist to enter clinical practice and has been approved for the treatment of symptoms of OAB. The aim of this study is to investigate whether the mirabegron has an effect on depression, anxiety, learning, and memory. We investigated the effects of mirabegron on depression, anxiety, learning and memory by using forced swimming test, elevated plus maze test, passive avoidance and Morris water maze in mice. Imipramine and mirabegron (3, 6 and 9 mg/kg) significantly reduced immobility time in forced swimming test. Diazepam and mirabegron (3, 6 and 9 mg/kg) significantly increased the time spent in open arms and the number of entries to the open arms in elevated plus maze test. Furthermore, cognitive performance impaired with scopolamine has been significantly improved with 9 mg/kg mirabegron. Mirabegron (6 and 9 mg/kg) significantly increased the time spent in the target quadrant in naive mice. While scopolamine significantly increased the swimming speed, mirabegron (9 mg/kg) significantly decreased the swimming speed in scopolamine-treated mice. Mirabegron might be clinically useful for the treatment of OAB in elderly patients that should use drugs against depression and anxiety, without disrupt learning and memory.
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Affiliation(s)
- Mehmet H Tanyeri
- Yenikent Government Hospital, Department of Urology, Cahit Kirac Street, 54290, Adapazarı, 54100, Sakarya, Turkey
| | - Mehmet E Buyukokuroglu
- Sakarya University, Department of Pharmacology, Faculty of Medicine, Konuralp Street, Number 81, 54290, Adapazarı, 54100, Sakarya, Turkey
| | - Pelin Tanyeri
- Sakarya University, Department of Pharmacology, Faculty of Medicine, Konuralp Street, Number 81, 54290, Adapazarı, 54100, Sakarya, Turkey
| | - Oguz Mutlu
- Kocaeli University, Department of Pharmacology, Faculty of Medicine, Umuttepe street, Number 515, 41001, İzmit, 41380, Kocaeli, Turkey
| | - Aykut Ozturk
- Sakarya University, Department of Pharmacology, Faculty of Medicine, Konuralp Street, Number 81, 54290, Adapazarı, 54100, Sakarya, Turkey
| | - Kubra Yavuz
- Sakarya University, Department of Pharmacology, Faculty of Medicine, Konuralp Street, Number 81, 54290, Adapazarı, 54100, Sakarya, Turkey
| | - Rumeysa K Kaya
- Sakarya University, Department of Pharmacology, Faculty of Medicine, Konuralp Street, Number 81, 54290, Adapazarı, 54100, Sakarya, Turkey
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Symptom profiles of women at risk of mood disorders: A latent class analysis. J Affect Disord 2021; 295:139-147. [PMID: 34450523 DOI: 10.1016/j.jad.2021.08.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Depression is the leading cause of disease burden among women worldwide. However, an understanding of symptom profiles among women at risk of mood disorders is limited. We determined distinct profiles of affective symptoms among high risk women, along with their distinguishing characteristics. METHODS Women were recruited from 17 clinical sites affiliated with the National Network of Depression Centers. They completed measures of depression (Patient Health Questionnaire - 9) and anxiety (Generalized Anxiety Disorder - 7) as well as questions regarding demographics, reproductive status, behavioral/mental health history, and life stress/adversity. Latent class analysis and multinomial logistic regression were used to identify and characterize symptom profiles. RESULTS 5792 women participated, ages 18 to 90 (M = 38). Three latent classes were identified: generally asymptomatic (48%), elevated symptoms of comorbid anxiety and depression (16%), and somatic symptoms (36%). Financial security and greater social support were protective factors that distinguished asymptomatic women. The profile of the class with elevated anxiety/depressive symptoms constituted a complex mix of adverse social determinants and potentially heritable clinical features, including a diagnosis of Bipolar Disorder. Women in the 3rd latent class were characterized by menstrual irregularity and a stronger expression of neurovegetative symptoms, especially sleep disturbance and fatigue. LIMITATIONS Limitations included less than optimal racial diversity of our sample and reliance on self-report. CONCLUSIONS Different symptom profiles may reflect distinct subtypes of women at risk of mood disorders. Understanding the etiology and mechanisms underlying clinical and psychosocial features of these profiles can inform more precisely targeted interventions to address women's diverse needs.
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De D, Kumar S, Handa S, Mahajan R, Singh SM. Psychological morbidity in pemphigus patients in clinical remission and its relation with clinico-demographic parameters. J Dtsch Dermatol Ges 2021; 20:26-33. [PMID: 34821016 DOI: 10.1111/ddg.14605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Significant psychological morbidity exists in patients with active pemphigus. Pemphigus being a chronic disease, psychological morbidity may exist in pemphigus patients in remission as well. The objectives of the study were to assess the psychological morbidity in pemphigus patients in clinical remission and to correlate it with clinico-demographic parameters. PATIENTS AND METHODS Pemphigus patients in clinical remission were consecutively included and were asked to respond to the Hindi/English version of Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7) and panic disorder module of PHQ. RESULTS Of 107 patients recruited, 41 (38.3 %, 95 % CI: 29.1-48.2 %) patients were found to have either depression (33 [30.8 %, 95 % CI: 22.2-40.5 %]) or anxiety (38 [35.5 %, 95 % CI: 26.5-45.4 %] syndrome based on cut-offs of PHQ-9 score and GAD-7 score, respectively. Number of patients with mild, moderate and moderately severe/severe depression syndrome were 26 (24.3 %, 95 % CI: 17.2-33.2 %), 7 (6.5 %, 95 % CI: 0.3-12.9 %) and 0 respectively and patients with mild, moderate, severe anxiety syndrome were 29 (27.1 %, 95 % CI: 19.6-36.2 %), 9 (8.4 %, 95 % CI: 4.5-15.2 %) and 0 respectively. Patients with anxiety or depression syndrome had significantly higher clinical disease activity in the past, number of days spent in dermatology inpatient and significantly shorter clinical remission at the time of assessment as compared to those without these symptoms. CONCLUSIONS Significant burden of mild/moderate depression or anxiety syndrome associated with past severity of disease and shorter duration of clinical remission was found.
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Affiliation(s)
- Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sheetanshu Kumar
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjeev Handa
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shubh Mohan Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Liao W, Luo Z, Dong X, Wu X, Mei Y, Cui N, Kang N, Lan Y, Liu X, Huo W, Wang F, Wang C. Associations between depressive symptoms, anxiety symptoms, their comorbidity and health-related quality of life: a large-scale cross-sectional study. BMC Public Health 2021; 21:1911. [PMID: 34674681 PMCID: PMC8532277 DOI: 10.1186/s12889-021-11969-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 10/11/2021] [Indexed: 12/12/2022] Open
Abstract
Background There were few studies exploring the associations between depressive symptoms, anxiety symptoms and health-related quality of life (HRQoL) in the general population, especially in resource limited area. The aims of this study were to assess the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL in rural area. Methods A total of 23,496 eligible participants from Henan rural cohort were included. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) were employed to assess depressive and anxiety symptoms, respectively. HRQoL was measured via European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L). Tobit regression and generalized linear model were utilized to explore the associations between depressive symptoms, anxiety symptoms, their comorbidity and HRQoL. Results A total of 1320 individuals were identified as depressive symptoms with a prevalence rate of 5.62%, while 1198 participants were classified as anxiety symptoms with a prevalence rate of 5.10%. After multiple adjustment, the regression coefficients (β) and 95% confidence interval (CI) of utility index for depressive and anxiety symptoms were − 0.166 (− 0.182, − 0.149) and − 0.132 (− 0.149, − 0.114), respectively. The β and 95% CI of VAS score for depressive and anxiety symptoms were − 7.65 (− 8.60, − 6.70) and − 5.79 (− 6.78, − 4.80), respectively. Additionally, the comorbidity was strongly associated with low utility index and VAS score. These findings were observed robustly in men and women. Conclusion Depressive symptoms, anxiety symptoms and their comorbidity were associated with low HRQoL in rural population, which needed further efforts on preventive and treatment interventions. Clinical trial registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 06 July, 2015. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11969-1.
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Affiliation(s)
- Wei Liao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xueyan Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Yongxia Mei
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Ningning Cui
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Ning Kang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.,Department of Preventive Medicine, School of Medicine, Henan University of Chinese Medicine, Zhengzhou, Henan, P.R. China
| | - Yali Lan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Wenqian Huo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, P.R. China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, People's Republic of China.
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Ilardi CR, Gamboz N, Iavarone A, Chieffi S, Brandimonte MA. Psychometric properties of the STAI-Y scales and normative data in an Italian elderly population. Aging Clin Exp Res 2021; 33:2759-2766. [PMID: 33733325 PMCID: PMC7968568 DOI: 10.1007/s40520-021-01815-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 02/13/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Early detection of anxiety symptoms in older people is capital as it may be linked to increased physical/functional disabilities, onset and progression of neurodegenerative disorders, and poor cognitive functioning. Nonetheless, there is a paucity of psychometrically validated anxiety measures in the elderly. AIMS This study aimed at assessing the psychometric properties of the State-Trait Anxiety Inventory-Form Y (STAI-Y) and providing the first normative data for the Italian elderly population. METHODS The sample included 361 individuals aged 65-94. All subjects underwent the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS), and the state (S-Anxiety) and trait anxiety (T-anxiety) scales of the STAI-Y. RESULTS The S-Anxiety and T-Anxiety scales showed reliable internal consistency and, overall, good item characteristics. Divergent validity was "apparently" threatened, with S-Anxiety scale correlating with MMSE and GDS, and T-Anxiety scale only with GDS. The principal component analysis revealed a three-factor solution for both scales, i.e., presence and absence of state (or trait) anxiety, and performance anxiety. Since no effect of sociodemographic variables was found, unadjusted cutoffs were provided. CONCLUSIONS Although some questions on the psychometric properties of the STAI-Y remain unanswered, this normative study can help clinicians and researchers to monitor anxiety levels in the Italian elderly population.
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Affiliation(s)
- Ciro Rosario Ilardi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Nadia Gamboz
- Laboratory of Experimental Psychology, Suor Orsola Benincasa University, Naples, Italy
| | | | - Sergio Chieffi
- Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Yu J, Rawtaer I, Feng L, Kua EH, Mahendran R. The functional and structural connectomes associated with geriatric depression and anxiety symptoms in mild cognitive impairment: Cross-syndrome overlap and generalization. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110329. [PMID: 33865926 DOI: 10.1016/j.pnpbp.2021.110329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Geriatric depression and anxiety disorders often manifest as neuropsychiatric symptoms among those with mild cognitive impairment. Both tend to co-occur, and overlap in symptomology and etiology. Such commonalities are likely to be reflected in the brain as common neural correlates. Using connectome-based predictive modeling (CPM), we examined the functional and structural connectomes predicting depression and anxiety symptoms, and subsequently the overlap and cross-syndrome generalization of the connectomes associated with either disorder. Ninety-one older adults completed self-reported measures of depression and anxiety, and underwent diffusion tensor imaging and resting-state functional magnetic resonance imaging. Functional connectivity (FC) and structural connectivity (SC) matrices were derived from these scans and, in various combinations, entered into CPM models to predict either type of symptoms. Leave-one-out cross-validation was performed. Predictive accuracy was assessed via the correlation between predicted and observed scores (ρpredicted-observed). While FC or SC features alone significantly predicted either type of symptoms, these symptoms were best predicted by models that consisted of both FC and SC features (depression: ρpredicted-observed = 0.497; anxiety: ρpredicted-observed = 0.455). The features common to depression and anxiety were identified and entered into another model which was similarly accurate in predicting either type of symptoms. Moreover, cross-syndrome generalization was observed- the depression-associated features significantly predicted anxiety symptoms (ρpredicted-observed = 0.403) and vice-versa (ρpredicted-observed = 0.378). These FC and SC features are complementary biomarkers of geriatric depression and anxiety symptoms. Both types of symptoms are largely underpinned by common patterns of altered FC and SC, alluding to the transdiagnostic neurobiological susceptibility in both disorders.
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Affiliation(s)
- Junhong Yu
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore.
| | - Iris Rawtaer
- Department of Psychological Medicine, Sengkang General Hospital, 110 Sengkang E way, 544886, Singapore
| | - Lei Feng
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Ee-Heok Kua
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore
| | - Rathi Mahendran
- Department of Psychological Medicine, Mind Science Centre, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, 117597, Singapore; Academic Development Department, Duke-NUS Medical School, 8 College Road, 169857, Singapore.
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Analysis of genetic differences between psychiatric disorders: exploring pathways and cell types/tissues involved and ability to differentiate the disorders by polygenic scores. Transl Psychiatry 2021; 11:426. [PMID: 34389699 PMCID: PMC8363629 DOI: 10.1038/s41398-021-01545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 07/13/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023] Open
Abstract
Although displaying genetic correlations, psychiatric disorders are clinically defined as categorical entities as they each have distinguishing clinical features and may involve different treatments. Identifying differential genetic variations between these disorders may reveal how the disorders differ biologically and help to guide more personalized treatment. Here we presented a statistical framework and comprehensive analysis to identify genetic markers differentially associated with various psychiatric disorders/traits based on GWAS summary statistics, covering 18 psychiatric traits/disorders and 26 comparisons. We also conducted comprehensive analysis to unravel the genes, pathways and SNP functional categories involved, and the cell types and tissues implicated. We also assessed how well one could distinguish between psychiatric disorders by polygenic risk scores (PRS). SNP-based heritabilities (h2snp) were significantly larger than zero for most comparisons. Based on current GWAS data, PRS have mostly modest power to distinguish between psychiatric disorders. For example, we estimated that AUC for distinguishing schizophrenia from major depressive disorder (MDD), bipolar disorder (BPD) from MDD and schizophrenia from BPD were 0.694, 0.602 and 0.618, respectively, while the maximum AUC (based on h2snp) were 0.763, 0.749 and 0.726, respectively. We also uncovered differences in each pair of studied traits in terms of their differences in genetic correlation with comorbid traits. For example, clinically defined MDD appeared to more strongly genetically correlated with other psychiatric disorders and heart disease, when compared to non-clinically defined depression in UK Biobank. Our findings highlight genetic differences between psychiatric disorders and the mechanisms involved. PRS may help differential diagnosis of selected psychiatric disorders in the future with larger GWAS samples.
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40
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Tracy A, Jopling E, LeMoult J. The effect of self-referential processing on anxiety in response to naturalistic and laboratory stressors. Cogn Emot 2021; 35:1320-1333. [PMID: 34242133 DOI: 10.1080/02699931.2021.1951675] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Although stressful life events increase risk for symptoms of Generalised Anxiety Disorder (GAD), we know little about mechanisms that increase GAD symptoms during times of stress. Despite evidence that self-referential processing contributes to other forms of psychopathology, namely depression, it is unknown whether self-referential processing also contributes to symptoms of GAD. Thus, we examined the association of self-referential processing with GAD symptoms in response to a naturalistic stressor (Study 1; n=135) and with anxiety-tension in response to a laboratory stressor (Study 2; n=56). In Study 1, participants completed the self-referential encoding task (SRET) in their initial weeks of university, and we assessed GAD symptoms four times across the semester. In Study 2, participants completed the SRET immediately before a laboratory stressor, and we assessed moment-to-moment changes in anxiety-tension. Greater negatively biased self-referential processing was associated with higher GAD symptoms at the start of university and greater reactivity to the laboratory stressor. In contrast, greater positively biased self-referential processing served as a protective factor associated with greater decline in symptoms over time. This study is the first to demonstrate that there are valence-specific effects of self-referential processing on anxiety, suggesting that self-referential processing may be relevant to GAD.
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Affiliation(s)
- Alison Tracy
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T1Z4
| | - Ellen Jopling
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T1Z4
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T1Z4
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41
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Ziobrowski HN, Leung LB, Bossarte RM, Bryant C, Keusch JN, Liu H, Puac-Polanco V, Pigeon WR, Oslin DW, Post EP, Zaslavsky AM, Zubizarreta JR, Kessler RC. Comorbid mental disorders, depression symptom severity, and role impairment among Veterans initiating depression treatment through the Veterans Health Administration. J Affect Disord 2021; 290:227-236. [PMID: 34004405 PMCID: PMC8508583 DOI: 10.1016/j.jad.2021.04.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/21/2021] [Accepted: 04/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psychiatric comorbidities may complicate depression treatment by being associated with increased role impairments. However, depression symptom severity might account for these associations. Understanding the independent associations of depression severity and comorbidity with impairments could help in treatment planning. This is especially true for depressed Veterans, who have high psychiatric comorbidity rates. METHODS 2,610 Veterans beginning major depression treatment at the Veterans Health Administration (VHA) were administered a baseline self-report survey that screened for diverse psychiatric comorbidities and assessed depression severity and role impairments. Logistic and generalized linear regression models estimated univariable and multivariable associations of depression severity and comorbidities with impairments. Population attributable risk proportions (PARPs) estimated the relative importance of depression severity and comorbidities in accounting for role impairments. RESULTS Nearly all patients (97.8%) screened positive for at least one comorbidity and half (49.8%) for 4+ comorbidities. The most common positive screens were for generalized anxiety disorder (80.2%), posttraumatic stress disorder (77.9%), and panic/phobia (77.4%). Depression severity and comorbidities were significantly and additively associated with impairments in multivariable models. Associations were attenuated much less for depression severity than for comorbidities in multivariable versus univariable models. PARPs indicated that 15-60% of role impairments were attributable to depression severity and 5-32% to comorbidities. LIMITATIONS The screening scales could have over-estimated comorbidity prevalence. The cross-sectional observational design cannot determine either temporal or causal priorities. CONCLUSIONS Although positive screens for psychiatric comorbidity are pervasive among depressed VHA patients, depression severity accounts for most of the associations of these comorbidities with role impairments.
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Affiliation(s)
| | - Lucinda B. Leung
- Center for the Study of Healthcare Innovation,
Implementation, and Policy, VA Greater Los Angeles Healthcare System, Los Angeles,
CA, USA,Division of General Internal Medicine and Health Services
Research, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Robert M. Bossarte
- Department of Behavioral Medicine and Psychiatry, West
Virginia University, Morgantown, WV, USA,Center of Excellence for Suicide Prevention, Canandaigua VA
Medical Center, Canandaigua, NY, USA
| | - Corey Bryant
- Center for Clinical Management Research, VA Ann Arbor, Ann
Arbor, MI, USA
| | - Janelle N. Keusch
- Center for Clinical Management Research, VA Ann Arbor, Ann
Arbor, MI, USA
| | - Howard Liu
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA,Center of Excellence for Suicide Prevention, Canandaigua VA
Medical Center, Canandaigua, NY, USA
| | - Victor Puac-Polanco
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA,Department of Epidemiology, Columbia University Mailman
School of Public Health, New York, NY, USA
| | - Wilfred R. Pigeon
- Center of Excellence for Suicide Prevention, Canandaigua VA
Medical Center, Canandaigua, NY, USA,Department of Psychiatry, University of Rochester Medical
Center, Rochester, NY, USA
| | - David W. Oslin
- VISN 4 Mental Illness Research Education and Clinical
Center, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA,Perelman School of Medicine, University of Pennsylvania,
Philadelphia, PA, USA
| | - Edward P. Post
- Center for Clinical Management Research, VA Ann Arbor, Ann
Arbor, MI, USA,Department of Medicine, University of Michigan Medical
School, Ann Arbor, MI, USA
| | - Alan M. Zaslavsky
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA,Department of Statistics, Harvard University, Cambridge,
MA, USA
| | - Jose R. Zubizarreta
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA,Department of Statistics, Harvard University, Cambridge,
MA, USA,Department of Biostatistics, Harvard University,
Cambridge, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School,
Boston, MA, USA
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42
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Stein AT, Carl E, Cuijpers P, Karyotaki E, Smits JAJ. Looking beyond depression: a meta-analysis of the effect of behavioral activation on depression, anxiety, and activation. Psychol Med 2021; 51:1491-1504. [PMID: 32138802 DOI: 10.1017/s0033291720000239] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression is a prevalent and impairing condition. Behavioral activation (BA) is a parsimonious, cost-effective, and easily disseminated psychological intervention for depression. The current meta-analysis expands on the existing literature supporting the efficacy of BA for depression by examining the effects of BA on additional relevant outcomes for patients with depression, namely the reduction in anxiety symptoms and increase in activation. METHODS Randomized controlled trials of BA for depression compared to active and inactive control were identified via a systematic review. Effect sizes using Hedges's g were calculated for each outcome compared to both active and inactive control using random effects models. Subgroup analyses were used to examine the inclusion of a discussion of values as a moderator of depression symptom outcome in BA. RESULTS Twenty-eight studies were included. Meta-analyses of symptom change between groups from baseline-to-post intervention indicated that BA outperformed inactive control conditions for improvements in depression (g = 0.83), anxiety (g = 0.37), and activation (g = 0.64). The difference between BA and active control conditions was not significant for improvements in depression (g = 0.15), anxiety (g = 0.03), and activation (g = 0.04). There was no evidence for a discussion of values augmenting BA efficacy. Study quality was generally low, and there was evidence of publication bias. CONCLUSIONS In addition to improving depression, BA shows efficacy for reducing symptoms of anxiety and increasing activation. BA may not offer better outcomes relative to other active interventions. There is room for improvement in the quality of research in this area.
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Affiliation(s)
| | - Emily Carl
- University of Texas at Austin, Austin, TX, USA
| | - Pim Cuijpers
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Harvard Medical School, Boston, MA, USA
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Morissette MP, Prior HJ, Tate RB, Wade J, Leiter JRS. Associations between concussion and risk of diagnosis of psychological and neurological disorders: a retrospective population-based cohort study. Fam Med Community Health 2021; 8:fmch-2020-000390. [PMID: 32719017 PMCID: PMC7388873 DOI: 10.1136/fmch-2020-000390] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate associations between concussion and the risk of follow-up diagnoses of attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease. Design A retrospective population-based cohort study. Setting Administrative health data for the Province of Manitoba between 1990–1991 and 2014–2015. Participants A total of 47 483 individuals were diagnosed with a concussion using International Classification of Diseases (ICD) codes (ICD-9-CM: 850; ICD-10-CA: S06.0). All concussed subjects were matched with healthy controls at a 3:1 ratio based on age, sex and geographical location. Associations between concussion and conditions of interest diagnosed later in life were assessed using a stratified Cox proportional hazards regression model, with adjustments for socioeconomic status and pre-existing medical conditions. Results 28 021 men (mean age ±SD, 25±18 years) and 19 462 women (30±21 years) were included in the concussion group, while 81 871 men (25±18 years) and 57 159 women (30±21 years) were included in the matched control group. Concussion was associated with adjusted hazard ratios of 1.39 (95% CI 1.32 to 1.46, p<0.001) for ADHD, 1.72 (95% CI 1.69 to 1.76; p<0.001) for MADs, 1.72 (95% CI 1.61 to 1.84; p<0.001) for dementia and 1.57 (95% CI 1.41 to 1.75; p<0.001) for Parkinson’s disease. Conclusion Concussion was associated with an increased risk of diagnosis for all four conditions of interest later in life.
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Affiliation(s)
- Marc P Morissette
- Pan Am Clinic Foundation, Winnipeg, Manitoba, Canada .,Applied Health Sciences, Faculty of Graduate Studies, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Heather J Prior
- Manitoba Centre for Health Policy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert B Tate
- Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - John Wade
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeff R S Leiter
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada
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Schwartz L, Caixàs A, Dimitropoulos A, Dykens E, Duis J, Einfeld S, Gallagher L, Holland A, Rice L, Roof E, Salehi P, Strong T, Taylor B, Woodcock K. Behavioral features in Prader-Willi syndrome (PWS): consensus paper from the International PWS Clinical Trial Consortium. J Neurodev Disord 2021; 13:25. [PMID: 34148559 PMCID: PMC8215770 DOI: 10.1186/s11689-021-09373-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/09/2021] [Indexed: 02/06/2023] Open
Abstract
Prader-Willi syndrome (PWS) is a rare neurodevelopmental genetic disorder associated with a characteristic behavioral phenotype that includes severe hyperphagia and a variety of other behavioral challenges such as temper outbursts and anxiety. These behaviors have a significant and dramatic impact on the daily functioning and quality of life for the person with PWS and their families. To date, effective therapies addressing these behavioral challenges have proven elusive, but several potential treatments are on the horizon. However, a limiting factor for treatment studies in PWS is the lack of consensus in the field regarding how to best define and measure the complex and interrelated behavioral features of this syndrome. The International PWS Clinical Trials Consortium (PWS-CTC, www.pwsctc.org) includes expert PWS scientists, clinicians, and patient advocacy organization representatives focused on facilitating clinical trials in this rare disease. To address the above gap in the field, members of the PWS-CTC “Behavior Outcomes Working Group” sought to develop a unified understanding of the key behavioral features in PWS and build a consensus regarding their definition and description. The primary focus of this paper is to present consensus definitions and descriptions of key phenotypic PWS behaviors including hyperphagia, temper outbursts, anxiety, obsessive–compulsive behaviors, rigidity, and social cognition deficits. Patient vignettes are provided to illustrate the interrelatedness and impact of these behaviors. We also review some available assessment tools as well as new instruments in development which may be useful in measuring these behavioral features in PWS.
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Affiliation(s)
- Lauren Schwartz
- Foundation for Prader-Willi Research, Walnut, CA, USA. .,Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA.
| | - Assumpta Caixàs
- Endocrinology and Nutrition Department, Parc Taulí University Hospital, Parc Taulí Research and Innovation Institute, Sabadell, Spain.,Medicine Department, Autonomous University of Barcelona, Sabadell, Spain
| | | | - Elisabeth Dykens
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, TN, USA
| | - Jessica Duis
- Section of Genetics & Inherited Metabolic Diseases, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Stewart Einfeld
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Louise Gallagher
- Trinity College Dublin Trinity Translational Medicine Institute, St. James's Hospital, Dublin, 8, Ireland
| | - Anthony Holland
- Department of Psychiatry, Cambridge Intellectual and Developmental Disabilities Research Group, University of Cambridge, Cambridge, UK
| | - Lauren Rice
- Brain and Mind Centre
- Faculty of Health Sciences, The University of Sydney, Faculty of Medicine and Health, Camperdown, NSW, Australia
| | - Elizabeth Roof
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
| | - Parisa Salehi
- Division of Endocrinology and Diabetes, Seattle Children's, University of Washington, Seattle, WA, USA
| | - Theresa Strong
- Foundation for Prader-Willi Research, Walnut, CA, USA.,Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bonnie Taylor
- Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Kate Woodcock
- Centre for Applied Psychology, School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
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Mazaud D, Capano A, Rouach N. The many ways astroglial connexins regulate neurotransmission and behavior. Glia 2021; 69:2527-2545. [PMID: 34101261 DOI: 10.1002/glia.24040] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022]
Abstract
Astrocytes have emerged as major players in the brain, contributing to many functions such as energy supply, neurotransmission, and behavior. They accomplish these functions in part via their capacity to form widespread intercellular networks and to release neuroactive factors, which can modulate neurotransmission at different levels, from individual synapses to neuronal networks. The extensive network communication of astrocytes is primarily mediated by gap junction channels composed of two connexins, Cx30 and Cx43, which present distinct temporal and spatial expression patterns. Yet, astroglial connexins are also involved in direct exchange with the extracellular space via hemichannels, as well as in adhesion and signaling processes via unconventional nonchannel functions. Accumulating evidence indicate that astrocytes modulate neurotransmission and behavior through these diverse connexin functions. We here review the many ways astroglial connexins regulate neuronal activity from the molecular level to behavior.
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Affiliation(s)
- David Mazaud
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR 7241, INSERM U1050, Labex Memolife, PSL Research University, Paris, France
| | - Anna Capano
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR 7241, INSERM U1050, Labex Memolife, PSL Research University, Paris, France.,Doctoral School N°158, Sorbonne University, Paris, France
| | - Nathalie Rouach
- Neuroglial Interactions in Cerebral Physiology and Pathologies, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR 7241, INSERM U1050, Labex Memolife, PSL Research University, Paris, France
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Batterham PJ, Calear AL. Incorporating psychopathology into the interpersonal-psychological theory of suicidal behavior (IPTS). Suicide Life Threat Behav 2021; 51:482-491. [PMID: 33378114 DOI: 10.1111/sltb.12727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 02/03/2020] [Accepted: 09/11/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND The interpersonal-psychological theory of suicidal behavior (IPTS) posits that the joint presence of perceived burdensomeness (PB), thwarted belongingness (TB), and capability for suicide (CS) is necessary for suicide attempt. Emerging evidence demonstrates these effects are not consistently observed. Psychopathology may independently impact on the explanatory power of the IPTS constructs. AIMS The aims of the current study were to assess whether the inclusion of psychopathology indicators into the IPTS explains additional variance in recent suicide attempt and to assess the relative influence of interpersonal-psychological constructs versus mental illness on suicide attempt. METHOD Australian adults (N = 1,323; 77% female) who reported suicidal ideation in the past year were recruited using social media advertising to complete an online cross-sectional survey. RESULTS None of the predicted IPTS interactions was significantly associated with recent suicide attempt, although PB and CS had significant independent associations. The addition of psychopathology indicators to the IPTS model explained significant additional variation in suicide attempt (18% vs. 14%). CONCLUSIONS The influence of psychopathology on suicide attempt may be insufficiently explained by interpersonal-psychological constructs. The IPTS may have greater explanatory power to identify transitions from suicidal ideation to suicide attempt after accounting for mental illness.
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Affiliation(s)
- Philip J Batterham
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Alison L Calear
- Centre for Mental Health Research, Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Sharma A, Verbeke WJMI. Understanding importance of clinical biomarkers for diagnosis of anxiety disorders using machine learning models. PLoS One 2021; 16:e0251365. [PMID: 33970950 PMCID: PMC8109802 DOI: 10.1371/journal.pone.0251365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 04/25/2021] [Indexed: 11/23/2022] Open
Abstract
Anxiety disorders are a group of mental illnesses that cause constant and overwhelming feelings of anxiety and fear. Excessive anxiety can make an individual avoid work, school, family get-togethers, and other social situations that in turn might amplify these symptoms. According to the World Health Organization (WHO), one in thirteen persons globally suffers from anxiety. It is high time to understand the roles of various clinical biomarker measures that can diagnose the types of anxiety disorders. In this study, we apply machine learning (ML) techniques to understand the importance of a set of biomarkers with four types of anxiety disorders—Generalized Anxiety Disorder (GAD), Agoraphobia (AP), Social Anxiety Disorder (SAD) and Panic Disorder (PD). We used several machine learning models and extracted the variable importance contributing to a type of anxiety disorder. The study uses a sample of 11,081 Dutch citizens’ data collected by the Lifelines, Netherlands. The results show that there are significant and low correlations among GAD, AP, PD and SAD and we extracted the variable importance hierarchy of biomarkers with respect to each type of anxiety disorder which will be helpful in designing the experimental setup for clinical trials related to influence of biomarkers on type of anxiety disorder.
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Affiliation(s)
- Amita Sharma
- Erasmus University, Rotterdam, Netherlands
- Department of Operations Research & Quantitative Analysis, Institute of Agri-Business Management, Swami Keshwanand Rajasthan Agricultural University, Bikaner, Rajasthan, India
- * E-mail:
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Correlates of the discrepancy between objective and subjective cognitive functioning in non-demented patients with Parkinson's disease. J Neurol 2021; 268:3444-3455. [PMID: 33723623 PMCID: PMC8357714 DOI: 10.1007/s00415-021-10519-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 11/05/2022]
Abstract
Background Subjective complaints of cognitive deficits are not necessarily consistent with objective evidence of cognitive impairment in Parkinson’s disease (PD). Here we examined the factors associated with the objective-subjective cognitive discrepancy. Methods We consecutively enrolled 90 non-demented patients with PD who completed the Parkinson’s Disease Cognitive Functional Rating Scale (subjective cognitive measure) and the Montreal Cognitive Assessment (MoCA; objective cognitive measure). The patients were classified as “Overestimators”, “Accurate estimators”, and “Underestimators” on the basis of the discrepancy between the objective vs. subjective cognitive measures. To identify the factors distinguishing these groups from each other, we used chi-square tests or one-way analyses of variance, completed by logistic and linear regression analyses. Results Forty-nine patients (54.45%) were classified as “Accurate estimators”, 29 (32.22%) as “Underestimators”, and 12 (13.33%) as “Overestimators”. Relative to the other groups, the “Underestimators” scored higher on the Fatigue Severity Scale (FSS), Beck Depression Inventory (BDI), and Parkinson Anxiety Scale (p < 0.01). Logistic regression confirmed that FSS and BDI scores distinguished the “Underestimators” group from the others (p < 0.05). Linear regression analyses also indicated that FSS and BDI scores positively related to objective-subjective cognitive discrepancy (p < 0.01). “Overestimators” scored lower than other groups on the MoCA’s total score and attention and working memory subscores (p < 0.01). Conclusion In more than 45% of consecutive non-demented patients with PD, we found a ‘mismatch’ between objective and subjective measures of cognitive functioning. Such discrepancy, which was related to the presence of fatigue and depressive symptoms and frontal executive impairments, should be carefully evaluated in clinical setting. Supplementary Information The online version contains supplementary material available at 10.1007/s00415-021-10519-4.
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Li C, Huo L, Wang R, Qi L, Wang W, Zhou X, Zhou Y, Zhang X. The prevalence and risk factors of depression in prenatal and postnatal women in China with the outbreak of Corona Virus Disease 2019. J Affect Disord 2021; 282:1203-1209. [PMID: 33601697 PMCID: PMC7800140 DOI: 10.1016/j.jad.2021.01.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND The prevalence of depression increase with the outbreaks of epidemic disease. The prevalence of depression during the outbreak of Corona Virus Disease 2019 (COVID-19) in prenatal and postnatal women was examined in China. METHODS 2201 prenatal and postnatal women in mainland China were recruited in this cross-sectional study from February 28th to April 26th, 2020. The Patient Health Questionnaire (PHQ-9) was used to assess depression in prenatal and postnatal women. RESULTS The prevalence rate of depression was 35.4%. The risk factors for depression included drinking (p = 0.04; adjusted OR = 2.81, 95%CI: 1.26~6.24), nausea and vomiting during pregnancy (p < 0.001; adjusted OR = 3.54, 95%CI: 1.10~11.44), pregnancy's influence on mobility (p = 0.02; adjusted OR = 1.42, 95%CI: 1.11~1.83), anxiety (p < 0.001; adjusted OR = 1.66, 95%CI: 1.57~1.75), insomnia (p < 0.001; adjusted OR = 1.17, 95%CI: 1.14~1.21) and daily attention to fetal movement (p < 0.001; adjusted OR = 0.41, 95%CI: 0.31~0.56). LIMITATIONS This study used a cross-sectional design, and cannot compare changes in the incidence of depression before and after the COVID-19 outbreak. CONCLUSIONS During the COVID-19 outbreak, the prevalence rate of depression among Chinese prenatal and postnatal women was 35.4%. Moreover, anxiety, insomnia, drinking, nausea and vomiting during pregnancy, as well as the impaired movement and less daily monitoring of fetal movement were risk factors for depression.
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Affiliation(s)
- Chuanxiao Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
| | - Lijuan Huo
- Department of Psychiatry, Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China,The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, 430023, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Savage K, Kingshott D, Gubko A, Thee AW, Burjawi T, Croft K, Sarris J, Stough C. The Relationship between Oxidative Stress and Anxiety in a Healthy Older Population. Exp Aging Res 2021; 47:322-346. [PMID: 33616006 DOI: 10.1080/0361073x.2021.1883966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background/study context: F2-Isoprostanes are putative markers of oxidative stress, one of the processes associated with biological senescence. Evidence exists for elevated F2-Isoprostanes in chronic conditions including psychiatric disorders. Few studies have examined the relationship between oxidative stress and mood in older healthy samples, to establish the influence on mental health. Given current aging demographics in many nations, management of brain and mental health is crucial for longevity, chronic disease management, and quality of life.Method: We investigated the relationship between F2-Isoprostanes, a marker for oxidative stress, and anxiety and mood in 262 healthy adults aged 60-75 years, using baseline data from the Australian Research Council Longevity Intervention (ARCLI; ANZCTR12611000487910), a 12-month nutraceutical intervention study.Results: Higher F2 levels significantly predicted increased Depression-dejection and Anger-hostility subscale scores from the Profile of Mood States (POMS). Fatigue-inertia subscale was predicted by increased Body Mass Index. Spielberger State-Trait Inventory (STAI) scores were significantly higher in females.Conclusion: While the primary outcome data did not find a definitive relationship between F2 and total mood or general anxiety levels, the sub-scale data adds weight toward growing literature that biological processes such as oxidative stress are in part related to mood. This is a modifiable risk factor contributing to physical and mental wellbeing that are crucial to healthy aging.
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Affiliation(s)
- Karen Savage
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia.,Professorial Unit, the Melbourne Clinic, Department of Psychiatry, Melbourne University, Richmond, Australia
| | - Davy Kingshott
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia
| | - Andrew Gubko
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia
| | - Alicia Wt Thee
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia
| | - Tamer Burjawi
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia
| | - Kevin Croft
- School of Biomedical Science, The University of Western Australia, Crawley, Australia
| | - Jerome Sarris
- Professorial Unit, the Melbourne Clinic, Department of Psychiatry, Melbourne University, Richmond, Australia.,NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Advanced Technologies Centre, Hawthorn, Australia
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