1
|
Pereira SC, Coeli-Lacchini FB, Pereira DA, Ferezin LP, Menezes IC, Baes CVW, Luizon MR, Juruena MF, Cleare AJ, Young AH, Lacchini R. Early life stress unravels epistatic genetic associations of cortisol pathway genes with depression. J Psychiatr Res 2024; 175:323-332. [PMID: 38759498 DOI: 10.1016/j.jpsychires.2024.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/26/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024]
Abstract
Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis represents one of the most consistent pathophysiological findings in depressive disorders. Cortisol signaling is affected by proteins that mediate its cellular responses or alters its availability to mineralocorticoid and glucocorticoid receptors. In our study, we evaluated candidate genes that may influence the risk for depression and suicide due to its involvement in cortisol signaling. The aim of the study was to assess whether the genotypes of these genes are associated with the risk for depression, severity of depressive symptoms, suicidal ideation, and suicide attempts. And whether there is interaction between genes and early-life stress. In this study, 100 healthy controls and 140 individuals with depression were included. The subjects were clinically assessed using the 21-item GRID-Hamilton questionnaires (GRID-HAMD-21), Beck Scale for Suicidal Ideation (BSI), and the Childhood Trauma Questionnaire (CTQ). A robust multifactorial dimensionality reduction analysis was used to characterize the interactions between the genes HSD11B1, NR3C1, NR3C2, and MDR1 and early-life stress. It was found a significant association of the heterozygous genotype of the MDR1 gene rs1128503 polymorphism with reduced risk of at least one suicide attempt (OR: 0.08, p = 0.003*) and a reduction in the number of suicide attempts (β = -0.79, p = 0.006*). Furthermore, it was found that the MDR1 rs1228503 and NR3C2 rs2070951 genes interact with early-life stress resulting in a strong association with depression (p = 0.001). Our findings suggest that polymorphisms in the MDR1 and NR3C2 genes and their interaction with childhood trauma may be important biomarkers for depression and suicidal behaviors.
Collapse
Affiliation(s)
- Sherliane Carla Pereira
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Daniela Alves Pereira
- Department of Genetics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Letícia Perticarrara Ferezin
- Department of Public Health Nursing, Ribeirão Preto Nursing School, University of São Paulo, Ribeirão Preto, Brazil
| | - Itiana Castro Menezes
- Department of Neuroscience and Behavior, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Cristiane von Werne Baes
- Department of Neuroscience and Behavior, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Marcelo Rizzatti Luizon
- Department of Genetics, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Anthony J Cleare
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Riccardo Lacchini
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirao Preto, Brazil.
| |
Collapse
|
2
|
Li W, Xiang M, Zhang EL, Liu Y, Ge X, Su Z, Cheung T, Jackson T, Xiang YT. Inter-relationships between suicidality and depressive symptoms among children and adolescents experiencing crisis: A network perspective. J Affect Disord 2024; 354:44-50. [PMID: 37827255 DOI: 10.1016/j.jad.2023.10.029] [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: 05/18/2023] [Revised: 09/13/2023] [Accepted: 10/08/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Suicidality and depressive symptoms have emerged as major mental health issues reported among children and adolescents experiencing crises. In light of these concerns, this study was conducted to elucidate interrelationships between depressive symptoms and suicidality at an item level within this population during the COVID-19 pandemic, a worldwide public health crisis affecting children and adolescents. METHOD A cross-sectional study design was used. Primary and secondary school students completed the Children's Depression Inventory - Short Version (CDI-S) and two standard suicidality questions tapping suicidal ideation and suicide plans, respectively. A network analysis was performed to examine inter-connections between depressive symptoms and suicidality. RESULTS A total of 5380 students participated in the study. Prevalence of suicidal ideation and suicide plans were 12.8 % (95 % CI = 11.9 %-13.7 %) and 9.9 % (95 % CI = 9.2 %-10.8 %), respectively; the prevalence of depressive symptoms was 41.2 % (95%CI = 39.8 %-42.5 %). The network analysis identified CDI4 (self-hatred) as the most influential node with the highest centrality, followed by CDI8 (loneliness), CDI5 (crying), and CDI1 (sadness). Additionally, CDI5 (crying), CDI1 (sadness), CDI4 (self-hatred), and CDI10 (feeling unloved) were the most meaningful nodes linking depressive symptoms with suicidality. CONCLUSIONS Critical depressive symptoms linked with suicidality among children and adolescents living through the COVID-19 pandemic included self-hatred, loneliness, crying, and sadness. Interventions that target these depressive symptoms may have increased utility in reducing the risk of suicidality within this population.
Collapse
Affiliation(s)
- Wen Li
- Shanghai Key Laboratory of Forensic Medicine, Key Laboratory of Forensic Science, Ministry of Justice, China; Shanghai Forensic Service Platform, Academy of Forensic Science, Shanghai, China
| | - Mi Xiang
- Hainan Branch, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Hainan, China; School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | - Er Liang Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yujie Liu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Ge
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Macao SAR, 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; Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| |
Collapse
|
3
|
Perrelli M, Goparaju P, Postolache TT, del Bosque-Plata L, Gragnoli C. Stress and the CRH System, Norepinephrine, Depression, and Type 2 Diabetes. Biomedicines 2024; 12:1187. [PMID: 38927393 PMCID: PMC11200886 DOI: 10.3390/biomedicines12061187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024] Open
Abstract
Major depressive disorder (MDD) increases the risk of type 2 diabetes (T2D) by 60% in untreated patients, and hypercortisolism is common in MDD as well as in some patients with T2D. Patients with MDD, despite hypercortisolism, show inappropriately normal levels of corticotropin-releasing hormone (CRH) and plasma adrenocorticotropin (ACTH) in the cerebrospinal fluid, which might implicate impaired negative feedback. Also, a positive feedback loop of the CRH-norepinephrine (NE)-CRH system may be involved in the hypercortisolism of MDD and T2D. Dysfunctional CRH receptor 1 (CRHR1) and CRH receptor 2 (CRHR2), both of which are involved in glucose regulation, may explain hypercortisolism in MDD and T2D, at least in a subgroup of patients. CRHR1 increases glucose-stimulated insulin secretion. Dysfunctional CRHR1 variants can cause hypercortisolism, leading to serotonin dysfunction and depression, which can contribute to hyperglycemia, insulin resistance, and increased visceral fat, all of which are characteristics of T2D. CRHR2 is implicated in glucose homeostasis through the regulation of insulin secretion and gastrointestinal functions, and it stimulates insulin sensitivity at the muscular level. A few studies show a correlation of the CRHR2 gene with depressive disorders. Based on our own research, we have found a linkage and association (i.e., linkage disequilibrium [LD]) of the genes CRHR1 and CRHR2 with MDD and T2D in families with T2D. The correlation of CRHR1 and CRHR2 with MDD appears stronger than that with T2D, and per our hypothesis, MDD may precede the onset of T2D. According to the findings of our analysis, CRHR1 and CRHR2 variants could modify the response to prolonged chronic stress and contribute to high levels of cortisol, increasing the risk of developing MDD, T2D, and the comorbidity MDD-T2D. We report here the potential links of the CRH system, NE, and their roles in MDD and T2D.
Collapse
Affiliation(s)
| | - Pruthvi Goparaju
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA;
| | - Teodor T. Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA;
- Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 19, Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80246, USA
- Mental Illness Research Education and Clinical Center (MIRECC), Veterans Integrated Service Network (VISN) 5, VA Capitol Health Care Network, Baltimore, MD 21090, USA
| | - Laura del Bosque-Plata
- Nutrigenetics, and Nutrigenomic Laboratory, National Institute of Genomic Medicine, Mexico City 14610, Mexico;
| | - Claudia Gragnoli
- Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE 68124, USA;
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, 8091 Zürich, Switzerland
- Molecular Biology Laboratory, Bios Biotech Multi-Diagnostic Health Center, 00197 Rome, Italy
| |
Collapse
|
4
|
Bogale EK, Zewdie A, Kassie TD, Anagaw TF, Mazengia EM, Gelaw SS, Fenta ET, Eshetu HB, Kebede N. Suicidal ideation, attempt, and its associated factors among adult HIV/AIDS patients in Ethiopia: A systematic review and meta-analysis study. PLoS One 2024; 19:e0294078. [PMID: 38484019 PMCID: PMC10939232 DOI: 10.1371/journal.pone.0294078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/24/2023] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND WHO statistics show that someone attempts suicide every three seconds and commits suicide every 40 seconds somewhere in the world. There is a scarcity of aggregate evidence in Ethiopia. The aim of this review was to assess the pooled prevalence of suicidal ideation, attempts, and associated factors among adult HIV/AIDS patients in Ethiopia to fill this gap. METHODS We extensively searched the bibliographic databases of PubMed, MEDLINE, Scopus, Google Scholar, and the Web of Science to obtain eligible studies. Further screening for a reference list of articles was also done. The Microsoft Excel Spreadsheet was used to extract data, and Stata 17 was used for analysis. To check heterogeneity, the Higgs I2 and Cochran's Q tests were employed. Sensitivity and subgroup analysis were implemented. To detect publication bias, Egger's test and funnel plots were used. RESULTS The pooled prevalence of suicidal ideation and attempts among adult HIV/AIDS patients in Ethiopia was 20.3 with a 95% CI (14, 26.5) and 11.1 with a 95% CI (6.6, 15.5), respectively. Living alone (AOR 4.98; 95% CI: 2.96-8.37), having comorbidity or other opportunistic infection (AOR 4.67; 95% CI: 2.57-8.48), female sex (AOR 2.86; 95% CI: 1.76, 4.62), having WHO clinical stage III of HIV (AOR 3.69; 95% CI: 2.15, 6.32), having WHO clinical stage IV of HIV (AOR 5.43; 95% CI: 2.81, 10.53), having co-morbid depression (AOR 5.25; 95% CI: 4.05, 6.80), having perceived HIV stigma (AOR 2.53; 95% CI: 1.67, 3.84), and having family history of suicidal attempt (AOR 2.79; 95% CI: 1.38, 5.66) were significantly associated with suicidal ideation. Being female (AOR 4.33; 95% CI: 2.36, 7.96), having opportunistic infections (AOR 2.73; 95% CI: 1.69, 4.41), having WHO clinical stage III of HIV (AOR 3.78; 95% CI: 2.04, 7.03), having co-morbid depression (AOR 3.47; 95% CI: 2.38, 5.05), having poor social support (AOR 3.02; 95% CI: 1.78, 5.13), and having WHO clinical stage IV (AOR 7.39; 95% CI: 3.54, 15.41) were significantly associated with suicidal attempts. CONCLUSION The pooled magnitude of suicidal ideation and attempt was high, and factors like opportunistic infection, WHO clinical stage III of HIV, WHO clinical stage III of HIV, and co-morbid depression were related to both suicidal ideation and attempt. Clinicians should be geared towards this mental health problem in HIV patients during management.
Collapse
Affiliation(s)
- Eyob Ketema Bogale
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amare Zewdie
- Department of Public Health, Collage of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia
| | - Tadele Derbew Kassie
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Tadele Fentabil Anagaw
- Department of Health Promotion and Behavioral Science, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Elyas Melaku Mazengia
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Sintayehu Shiferaw Gelaw
- Department of Public Health, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Promotion and Health Behaviour, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Natnael Kebede
- Department of Health Promotion, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
5
|
Kim AW. Psychosocial stress, adult suicidal ideation, and the mediating effect of poor sleep quality during the COVID-19 pandemic in South Africa. Am J Hum Biol 2024; 36:e24038. [PMID: 38174783 DOI: 10.1002/ajhb.24038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/28/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES South Africa instituted one of the world's strictest lockdowns during the COVID-19 pandemic, which generated heightened conditions of psychosocial stress and posed widespread mental health risks. Despite the elevated burdens of suicidal behaviors and risk of psychiatric disease in the country, few studies have examined the impacts of psychosocial stress from the pandemic on suicidal ideation in South Africa. This study examined the association between psychosocial stress experienced under the COVID-19 pandemic and adult suicidal ideation, as well as degree to which sleep quality and duration mediated this relationship. METHODS An online survey assessed experiences of COVID-19 psychosocial stress, sleep quality and duration, and suicidal ideation in a sample of 189 South African adults during the second and third waves of the COVID-19 pandemic. A causal inference framework for mediation analysis was used to assess the degree to which sleep quality and duration explained the association between COVID-19 psychosocial stress and suicidal ideation. RESULTS Suicidal ideation was reported in 21% of adults. Adults described having moderate sleep quality and an average of 6.9 hours of sleep per night. COVID-19 psychosocial stress significantly predicted adult suicidal ideation in fully adjusted models. Sleep quality, but not sleep duration, significantly mediated the association between COVID-19 psychosocial stress and suicidal ideation, accounting for 25.9% of the total effect. CONCLUSIONS Poor sleep quality may play an important role in exacerbating the alarming stress-induced mental health effects of the COVID-19 pandemic. Further research is necessary to understand the underlying sleep dynamics and associated psychological and neurobiological processes that perpetuate adult suicidal ideation.
Collapse
Affiliation(s)
- Andrew Wooyoung Kim
- Department of Anthropology, University of California, Berkeley, California, USA
- SAMRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
6
|
Wu A, Zhang J. Neuroinflammation, memory, and depression: new approaches to hippocampal neurogenesis. J Neuroinflammation 2023; 20:283. [PMID: 38012702 PMCID: PMC10683283 DOI: 10.1186/s12974-023-02964-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
As one of most common and severe mental disorders, major depressive disorder (MDD) significantly increases the risks of premature death and other medical conditions for patients. Neuroinflammation is the abnormal immune response in the brain, and its correlation with MDD is receiving increasing attention. Neuroinflammation has been reported to be involved in MDD through distinct neurobiological mechanisms, among which the dysregulation of neurogenesis in the dentate gyrus (DG) of the hippocampus (HPC) is receiving increasing attention. The DG of the hippocampus is one of two niches for neurogenesis in the adult mammalian brain, and neurotrophic factors are fundamental regulators of this neurogenesis process. The reported cell types involved in mediating neuroinflammation include microglia, astrocytes, oligodendrocytes, meningeal leukocytes, and peripheral immune cells which selectively penetrate the blood-brain barrier and infiltrate into inflammatory regions. This review summarizes the functions of the hippocampus affected by neuroinflammation during MDD progression and the corresponding influences on the memory of MDD patients and model animals.
Collapse
Affiliation(s)
- Anbiao Wu
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Jiyan Zhang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
| |
Collapse
|
7
|
Wang Q, Tang W, Zhang J, Wang Y, Wang Q, Ma Y, Mao JK, Ye C, Yu X. Visuospatial ability and attention as risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients: a cross-sectional study. BMC Psychiatry 2023; 23:765. [PMID: 37853396 PMCID: PMC10585849 DOI: 10.1186/s12888-023-05272-z] [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: 05/30/2023] [Accepted: 10/11/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Schizophrenia patients have a high risk of suicide, and their cognition function is impaired with increasing age. The association between neurocognitive and suicidality in schizophrenia patients are heterogeneous. We aimed to explore the relationship between neurocognitive function and suicidal ideation in schizophrenia patients across age groups. METHODS A total of 587 patients with schizophrenia were enrolled in this study. The schizophrenia patients were divided into young group (aged 18-44) and middle-aged and elderly group (aged 45-70). The schizophrenia patients were divided into suicidal ideation group and non-suicidal ideation group according to the evaluation results of the Beck Scale for Suicide Ideation. Insomnia symptoms were measured by the Insomnia Severity Index (ISI). Psychotic symptoms were measured by the Positive and Negative Syndrome Scale (PANSS), and cognitive function was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS There was a negative correlation between the age and attention scores of RBANS (P = 0.018). The young schizophrenia patients had higher risk of suicidality than middle-aged and elderly schizophrenia patients (P = 0.001). In the logistic regression analysis, the scores of ISI and positive symptoms scores of PANSS were associated with suicidal ideation among young schizophrenia patients (All P < 0.05). Age, BMI, the scores of ISI, general symptoms scores of PANSS, visuospatial scores of RBANS and attention scores of RBANS were associated with suicidal ideation in middle-aged and elderly schizophrenia patients (All P < 0.05). CONCLUSIONS High visuospatial scores of RBANS and attention scores of RBANS were risk factors for suicidal ideation in middle-aged and elderly schizophrenia patients.
Collapse
Affiliation(s)
- Qiongzhang Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Wei Tang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China.
| | - Junjie Zhang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yiwei Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Qing Wang
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Yimin Ma
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - Jian Kai Mao
- Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Chengyu Ye
- Wenzhou Central Hospital, The Dingli Clinical Institute of Wenzhou Medical University, Wenzhou, China.
| | - Xin Yu
- School of Mental Health, Wenzhou Medical University, Wenzhou, China.
- Peking University Institute of Mental Health (Sixth Hospital, Beijing, China.
- National Clinical Research Center for Mental Disorders and Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China.
- Beijing Municipal Key Laboratory for Translational Research on Diagnosis and Treatment of Dementia, Beijing, China.
| |
Collapse
|
8
|
László K, Vörös D, Correia P, Fazekas CL, Török B, Plangár I, Zelena D. Vasopressin as Possible Treatment Option in Autism Spectrum Disorder. Biomedicines 2023; 11:2603. [PMID: 37892977 PMCID: PMC10603886 DOI: 10.3390/biomedicines11102603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/29/2023] Open
Abstract
Autism spectrum disorder (ASD) is rather common, presenting with prevalent early problems in social communication and accompanied by repetitive behavior. As vasopressin was implicated not only in salt-water homeostasis and stress-axis regulation, but also in social behavior, its role in the development of ASD might be suggested. In this review, we summarized a wide range of problems associated with ASD to which vasopressin might contribute, from social skills to communication, motor function problems, autonomous nervous system alterations as well as sleep disturbances, and altered sensory information processing. Beside functional connections between vasopressin and ASD, we draw attention to the anatomical background, highlighting several brain areas, including the paraventricular nucleus of the hypothalamus, medial preoptic area, lateral septum, bed nucleus of stria terminalis, amygdala, hippocampus, olfactory bulb and even the cerebellum, either producing vasopressin or containing vasopressinergic receptors (presumably V1a). Sex differences in the vasopressinergic system might underline the male prevalence of ASD. Moreover, vasopressin might contribute to the effectiveness of available off-label therapies as well as serve as a possible target for intervention. In this sense, vasopressin, but paradoxically also V1a receptor antagonist, were found to be effective in some clinical trials. We concluded that although vasopressin might be an effective candidate for ASD treatment, we might assume that only a subgroup (e.g., with stress-axis disturbances), a certain sex (most probably males) and a certain brain area (targeting by means of virus vectors) would benefit from this therapy.
Collapse
Affiliation(s)
- Kristóf László
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dávid Vörös
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Pedro Correia
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Csilla Lea Fazekas
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Bibiána Török
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| | - Imola Plangár
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
| | - Dóra Zelena
- Institute of Physiology, Medical School, University of Pécs, 7624 Pecs, Hungary; (K.L.); (D.V.); (P.C.); (C.L.F.); (B.T.); (I.P.)
- Center of Neuroscience, University of Pécs, 7624 Pecs, Hungary
- Szentágothai Research Center, University of Pécs, 7624 Pecs, Hungary
- Hungarian Research Network, Institute of Experimental Medicine, 1083 Budapest, Hungary
| |
Collapse
|
9
|
Vieira R, Faria AR, Ribeiro D, Picó-Pérez M, Bessa JM. Structural and functional brain correlates of suicidal ideation and behaviors in depression: A scoping review of MRI studies. Prog Neuropsychopharmacol Biol Psychiatry 2023; 126:110799. [PMID: 37207727 DOI: 10.1016/j.pnpbp.2023.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/29/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
Identifying and integrating the neural correlates of suicidal ideation and behaviors is crucial to expand the knowledge and develop targeted strategies to prevent suicide. This review aimed to describe the neural correlates of suicidal ideation, behavior and the transition between them, using different magnetic resonance imaging (MRI) modalities, providing an up-to-date overview of the literature. To be included, the observational, experimental, or quasi-experimental studies must include adult patients currently diagnosed with major depressive disorder and investigate the neural correlates of suicidal ideation, behavior and/or the transition using MRI. The searches were conducted on PubMed, ISI Web of Knowledge and Scopus. Fifty articles were included in this review: 22 on suicidal ideation, 26 on suicide behaviors and two on the transition between them. The qualitative analysis of the included studies suggested alterations in the frontal, limbic and temporal lobes in suicidal ideation associated with deficits in emotional processing and regulation, and in the frontal, limbic, parietal lobes, and basal ganglia in suicide behaviors associated with impairments in decision-making. Gaps in the literature and methodological concerns were identified and might be addressed in future studies.
Collapse
Affiliation(s)
- Rita Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal
| | | | - Diogo Ribeiro
- Department of Psychiatry, Hospital de Braga, Braga, Portugal
| | - Maria Picó-Pérez
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Departamento de Psicología Básica, Clínica y Psicobiología, Universitat Jaume I, Castelló de la Plana, Spain
| | - João M Bessa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center - Braga, Braga, Portugal.
| |
Collapse
|
10
|
Laghaei M, Mehrabizadeh Honarmand M, Jobson L, Abdollahpour Ranjbar H, Habibi Asgarabad M. Pathways from childhood trauma to suicidal ideation: mediating through difficulties in emotion regulation and depressive symptoms. BMC Psychiatry 2023; 23:295. [PMID: 37118697 PMCID: PMC10148382 DOI: 10.1186/s12888-023-04699-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 03/20/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE Suicidal ideation is a clinical exigency heightening the risk of suicide at different levels of suicidal behavior. This study sought to explore crucial correlates of this phenomenon with a structural equation modeling approach. Accordingly, the mediating role of depressive symptoms and difficulties in emotion regulation between childhood trauma and suicidal ideation were explored. METHOD The sample consisted of 372 university students (57.3% females, M = 20.75, SD = 2.25) who completed self-report measures examining experiences of childhood trauma, depressive symptoms, difficulties in emotion regulation, and suicidal ideation. Structural equation modeling was employed, and mediation analysis was conducted. Confirmatory factor analysis was used to test the measurement model of each construct before evaluating the conceptual mediated model. RESULTS Findings indicate that depressive symptoms with difficulties in emotion regulation had the strongest association (r = 0.60, P = 0.001), then depressive symptoms and suicidal ideation (r = 0.58, P = 0.001), suicidal ideation with difficulties in emotion regulation (r = 0.45, P = 0.001) then suicidal ideation with childhood trauma (r = 0.39, P = 0.001), difficulties in emotion regulation with childhood trauma (r = 0.36 P = 0.001) and finally depressive symptoms and childhood trauma (r = 0.35, P = 0.001). Regarding indirect paths, difficulties in emotion regulation and depression function together (in a sequential path) to mediate the association between childhood trauma and suicidal ideation ( χ2(68) = 216.86, P < 0.01, CFI = 0.95, TLI = 0.93, RMSE = 0.077, CI [0.066 to 0.089], SRMR = 0.049). CONCLUSION Results demonstrate that childhood trauma, depressive symptoms, and difficulties in emotion regulation are linked to suicidal ideation, highlighting the necessity of recognizing and addressing suicidal ideation as well as the factors that contribute to suicidal ideation. Emotion regulation interventions can be effective in reducing the negative effects of childhood trauma and lowering the risk of suicide. These interventions can help in reducing depressive symptoms and improve overall mental well-being, leading to a lower risk of suicide.
Collapse
Affiliation(s)
- Marziyeh Laghaei
- Department of Psychology, Shahid Chamran University of Ahvaz, Ahvaz, Iran
| | | | - Laura Jobson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | | | - Mojtaba Habibi Asgarabad
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran.
- Department of Psychology, Norwegian University of Science and Technology, Dragvoll, 7491, Trondheim, Norway.
- Department of Health Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
- Positive Youth Development Lab, Human Development & Family Sciences, Texas Tech University, Texas, USA.
- Center of Excellence in Cognitive Neuropsychology, Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran.
| |
Collapse
|
11
|
Kim HB, Wolf BJ, Kim JH. Association of metabolic syndrome and its components with the risk of depressive symptoms: A systematic review and meta-analysis of cohort studies. J Affect Disord 2023; 323:46-54. [PMID: 36427648 PMCID: PMC10252993 DOI: 10.1016/j.jad.2022.11.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 11/02/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this meta-analysis was to quantitatively analyze the association between metabolic syndrome (MetS) and the risk of depressive symptoms. METHODS Three electronic databases (PubMed, Embase, and PsycINFO) were searched for articles published through February 15, 2022. Cohort studies evaluating the association between MetS and depressive symptoms were selected for inclusion in this study. A random-effects model was used to evaluate the pooled estimates of MetS, including each of its components, associated with depressive symptoms. RESULTS A total of 11 cohort studies were selected including >2.65 million participants. There was a significant association between MetS and depressive symptoms risk, albeit with a high degree of heterogeneity (relative risk = 1.29, 95 % confidence interval: 1.12-1.48; I2 = 79.3 %). This association was consistently significant in Western countries, but it was not significant in Asian countries. When stratified by sex, age, and geographical region, MetS and its components exhibited varying degrees of association with depressive symptoms. CONCLUSIONS MetS is a risk factor for depressive symptoms. Further large-scale prospective cohort studies are required to confirm our findings.
Collapse
Affiliation(s)
- Hong-Bae Kim
- Department of Family Medicine, Myongji Hospital, Hanyang University, College of Medicine, Goyang, Republic of Korea
| | - Bethany J Wolf
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, United States
| | - Jung-Ha Kim
- Department of Family Medicine, Chung-ang University Medical Center, Chung-ang University, College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
12
|
Yang L, Cheng Y, Zhu Y, Cui L, Li X. The Serotonergic System and Amyotrophic Lateral Sclerosis: A Review of Current Evidence. Cell Mol Neurobiol 2023:10.1007/s10571-023-01320-0. [PMID: 36729314 DOI: 10.1007/s10571-023-01320-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 01/18/2023] [Indexed: 02/03/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder characterized by the premature death of motor neurons. Serotonin (5-HT) is a crucial neurotransmitter, and its dysfunction, whether as a contributor or by-product, has been implicated in ALS pathogenesis. Here, we summarize current evidence linking serotonergic alterations to ALS, including results from post-mortem and neuroimaging studies, biofluid testing, and studies of ALS animal models. We also discuss the possible role of 5-HT in modulating some important mechanisms of ALS (i.e. glutamate excitotoxity and neuroinflammation) and in regulating ALS phenotypes (i.e. breathing dysfunction and metabolic defects). Finally, we discuss the promise and limitations of the serotonergic system as a target for the development of ALS biomarkers and therapeutic approaches. However, due to a relative paucity of data and standardized methodologies in previous studies, proper interpretation of existing results remains a challenge. Future research is needed to unravel the mechanisms linking serotonergic pathways and ALS and to provide valid, reproducible, and translatable findings.
Collapse
Affiliation(s)
- Lu Yang
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China
| | - Yanfei Cheng
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China
| | - Yicheng Zhu
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China.,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China.,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China
| | - Xiaoguang Li
- Department of Neurology, Peking Union Medical College Hospital (PUMCH), The Transformation Medical Center of PUMC, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100005, China. .,Neuroscience Center, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, China.
| |
Collapse
|
13
|
Serafini G, Costanza A, Aguglia A, Amerio A, Trabucco A, Escelsior A, Sher L, Amore M. The Role of Inflammation in the Pathophysiology of Depression and Suicidal Behavior: Implications for Treatment. Med Clin North Am 2023; 107:1-29. [PMID: 36402492 DOI: 10.1016/j.mcna.2022.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Depression and suicidal behavior are 2 complex psychiatric conditions of significant public health concerns due to their debilitating nature. The need to enhance contemporary treatments and preventative approaches for these illnesses not only calls for distillation of current views on their pathogenesis but also provides an impetus for further elucidation of their novel etiological determinants. In this regard, inflammation has recently been recognized as a potentially important contributor to the development of depression and suicidal behavior. This review highlights key evidence that supports the presence of dysregulated neurometabolic and immunologic signaling and abnormal interaction with microbial species as putative etiological hallmarks of inflammation in depression as well as their contribution to the development of suicidal behavior. Furthermore, therapeutic insights addressing candidate mechanisms of pathological inflammation in these disorders are proposed.
Collapse
Affiliation(s)
- Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy.
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), Geneva, Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland (USI), Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Andrea Escelsior
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| | - Leo Sher
- James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Psychiatry, New York, NY, USA
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, Genoa 16132, Italy
| |
Collapse
|
14
|
Mahony C, O'Ryan C. A molecular framework for autistic experiences: Mitochondrial allostatic load as a mediator between autism and psychopathology. Front Psychiatry 2022; 13:985713. [PMID: 36506457 PMCID: PMC9732262 DOI: 10.3389/fpsyt.2022.985713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
Molecular autism research is evolving toward a biopsychosocial framework that is more informed by autistic experiences. In this context, research aims are moving away from correcting external autistic behaviors and toward alleviating internal distress. Autism Spectrum Conditions (ASCs) are associated with high rates of depression, suicidality and other comorbid psychopathologies, but this relationship is poorly understood. Here, we integrate emerging characterizations of internal autistic experiences within a molecular framework to yield insight into the prevalence of psychopathology in ASC. We demonstrate that descriptions of social camouflaging and autistic burnout resonate closely with the accepted definitions for early life stress (ELS) and chronic adolescent stress (CAS). We propose that social camouflaging could be considered a distinct form of CAS that contributes to allostatic overload, culminating in a pathophysiological state that is experienced as autistic burnout. Autistic burnout is thought to contribute to psychopathology via psychological and physiological mechanisms, but these remain largely unexplored by molecular researchers. Building on converging fields in molecular neuroscience, we discuss the substantial evidence implicating mitochondrial dysfunction in ASC to propose a novel role for mitochondrial allostatic load in the relationship between autism and psychopathology. An interplay between mitochondrial, neuroimmune and neuroendocrine signaling is increasingly implicated in stress-related psychopathologies, and these molecular players are also associated with neurodevelopmental, neurophysiological and neurochemical aspects of ASC. Together, this suggests an increased exposure and underlying molecular susceptibility to ELS that increases the risk of psychopathology in ASC. This article describes an integrative framework shaped by autistic experiences that highlights novel avenues for molecular research into mechanisms that directly affect the quality of life and wellbeing of autistic individuals. Moreover, this framework emphasizes the need for increased access to diagnoses, accommodations, and resources to improve mental health outcomes in autism.
Collapse
Affiliation(s)
| | - Colleen O'Ryan
- Department of Molecular and Cell Biology, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
15
|
Moon JH, Oh CM, Kim H. Serotonin in the regulation of systemic energy metabolism. J Diabetes Investig 2022; 13:1639-1645. [PMID: 35762288 PMCID: PMC9533050 DOI: 10.1111/jdi.13879] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/15/2022] [Accepted: 06/22/2022] [Indexed: 11/29/2022] Open
Abstract
Serotonin is a well‐known neurotransmitter that is synthesized from the amino acid, tryptophan. To date, more than 14 different serotonin receptors have been discovered; they exist universally in our body and enable diverse biological functions in different organs. Central serotonin regulates mood and behavior, and impacts the systemic energy balance by decreasing appetite. A number of drugs that modulate central serotonin function (e.g., fenfluramine, sibutramine and lorcaserin) were approved and used as anti‐obesity drugs, but then later withdrawn due to adverse cardiovascular and carcinogenic effects. Over the past decade, the role of peripheral serotonin in regulating systemic energy metabolism has been extensively explored using tissue‐specific knockout animal models. By inhibiting the action of serotonin in liver and adipose tissues, hepatic steatosis was improved and lipid accumulation was mitigated, respectively. Recent findings show that modulation of the serotonergic system is a promising therapeutic target for metabolic diseases. This review summarizes the role of serotonin in regulating energy metabolism in different organs, and discusses the potential of serotonin modulation for treating metabolic diseases.
Collapse
Affiliation(s)
- Joon Ho Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Chang-Myung Oh
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea
| | - Hail Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| |
Collapse
|
16
|
Stacy M, Schulkin J. Suicide: Allostatic regulation and resilience. Psychoneuroendocrinology 2022; 139:105691. [PMID: 35218982 DOI: 10.1016/j.psyneuen.2022.105691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
Suicide is a complex public health problem that is the result of a number of intertwined biopsychosocial factors. The diathesis-stress model suggests that suicide is the result of an interaction between genetic vulnerability and environmental stressors. Chronic stress and trauma contribute to biologic adaptations, including hypothalamus-pituitary-adrenal axis dysregulation, that contribute to the degradation of regulatory mechanisms and promote wear and tear the body, represented by allostatic load (AL). AL has been associated with a number of negative outcomes, including mental health problems and suicide. Fortunately, there are pharmacological and non-pharmacological interventions that are effective at reducing AL and reversing its effects. Thus, AL may provide a construct for supporting early risk identification, prevention, and treatment of suicide. AL biomarkers that are amenable to measurable change, effective treatments to reduce AL and perhaps help prevent suicide, and how to best tailor them to the individual and societal levels are important avenues of therapeutic inquiry.
Collapse
Affiliation(s)
- Meaghan Stacy
- Department of Psychiatry, Yale University School of Medicine, 300 George St., Suite 901, New Haven, CT 06511, USA.
| | - Jay Schulkin
- School of Medicine, University of Washington, 1959 Pacific St NE, Seattle, WA 98105, USA.
| |
Collapse
|
17
|
Johnston JN, Campbell D, Caruncho HJ, Henter ID, Ballard ED, Zarate CA. Suicide Biomarkers to Predict Risk, Classify Diagnostic Subtypes, and Identify Novel Therapeutic Targets: 5 Years of Promising Research. Int J Neuropsychopharmacol 2022; 25:197-214. [PMID: 34865007 PMCID: PMC8929755 DOI: 10.1093/ijnp/pyab083] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/02/2021] [Accepted: 11/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Suicide is a global health crisis. However, no objective biomarkers of suicide risk currently exist, and self-reported data can be unreliable, which limits prediction, diagnostic, and treatment efforts. Reliable biomarkers that can differentiate between diagnostic subgroups, predict worsening symptoms, or suggest novel therapeutic targets would be extremely valuable for patients, researchers, and clinicians. METHODS MEDLINE was searched for reports published between 2016 and 2021 using search terms (suicid*) AND (biomarker*) OR (indicat*). Reports that compared biomarkers between suicidal ideation, suicide attempt, death from suicide, or any suicide subgroup against other neuropsychiatric disorders were included. Studies exclusively comparing suicidal behavior or death from suicide with healthy controls were not included to ensure that biomarkers were specific to suicide and not other psychopathology. RESULTS This review summarizes the last 5 years of research into suicide-associated biomarkers and provides a comprehensive guide for promising and novel biomarkers that encompass varying presentations of suicidal ideation, suicide attempt, and death by suicide. The serotonergic system, inflammation, hypothalamic-pituitary-adrenal axis, lipids, and endocannabinoids emerged as the most promising diagnostic, predictive, and therapeutic indicators. CONCLUSIONS The utility of diagnostic and predictive biomarkers is evident, particularly for suicide prevention. While larger-scale studies and further in-depth research are required, the last 5 years of research has uncovered essential biomarkers that could ultimately improve predictive strategies, aid diagnostics, and help develop future therapeutic targets.
Collapse
Affiliation(s)
- Jenessa N Johnston
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Darcy Campbell
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Hector J Caruncho
- Division of Medical Sciences, University of Victoria, Victoria, British Columbia, Canada
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Ioline D Henter
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Elizabeth D Ballard
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, Division of Intramural Research Programs, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland,USA
| |
Collapse
|
18
|
Notari L, Kirton R, Mills DS. Psycho-Behavioural Changes in Dogs Treated with Corticosteroids: A Clinical Behaviour Perspective. Animals (Basel) 2022; 12:ani12050592. [PMID: 35268161 PMCID: PMC8909229 DOI: 10.3390/ani12050592] [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: 01/22/2022] [Revised: 02/19/2022] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Corticosteroids hormones are central to stress responses and, along with other hormones and neurotransmitters, contribute to the onset of physiological and behavioural changes aimed at helping the animal cope with anticipated demand. Both the human and animal literature suggest that exposure to systemic exogenous corticosteroid treatments can be associated with negative emotional states. In this paper, the potential behavioural effects of exogenous corticosteroid treatment on dogs and other species are discussed to show why consideration should be given to this matter when prescribing these drugs. Abstract Arousal and distress are often important factors in problematic behaviours, and endogenous corticosteroids are important mediators in the associated stress responses. Exogenous corticosteroid treatments have been reported to change behaviour in human patients and laboratory animals, with similar changes also noted in pet dogs. These behaviours not only potentially adversely impact the welfare of the dogs, but also the quality of life of their owners. Indeed, corticosteroids can bias sensitivity towards aversion in dogs. A decrease in behaviours associated with positive affective states, such as play and exploratory behaviours, together with an increase in aggression and barking have also been described in dogs. According to the available literature, human patients with pre-existing psychiatric disorders are more at risk of developing behavioural side effects due to corticosteroid treatments. It is reasonable to consider that the same may happen in dogs with pre-existing behavioural problems. In this paper, the possible behavioural side effects of exogenous corticosteroids are summarised to help inform and support veterinarians prescribing these drugs.
Collapse
Affiliation(s)
- Lorella Notari
- Royal Society for the Prevention of Cruelty to Animals (RSPCA), Horsham RH13 9RS, UK;
- Correspondence:
| | - Roxane Kirton
- Royal Society for the Prevention of Cruelty to Animals (RSPCA), Horsham RH13 9RS, UK;
| | - Daniel S. Mills
- School of Life Sciences, University of Lincoln, Lincoln LN6 7TS, UK;
| |
Collapse
|
19
|
Defining the importance of stress reduction in managing cardiovascular disease - the role of exercise. Prog Cardiovasc Dis 2022; 70:84-93. [DOI: 10.1016/j.pcad.2022.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 01/29/2022] [Indexed: 12/14/2022]
|
20
|
González-Castro TB, Genis-Mendoza AD, León-Escalante DI, Hernández-Díaz Y, Juárez-Rojop IE, Tovilla-Zárate CA, López-Narváez ML, Marín-Medina A, Nicolini H, Castillo-Avila RG, Ramos-Méndez MÁ. Possible Association of Cholesterol as a Biomarker in Suicide Behavior. Biomedicines 2021; 9:biomedicines9111559. [PMID: 34829788 PMCID: PMC8615563 DOI: 10.3390/biomedicines9111559] [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: 09/04/2021] [Revised: 10/19/2021] [Accepted: 10/26/2021] [Indexed: 11/25/2022] Open
Abstract
Suicides and suicidal behavior are major causes of mortality and morbidity in public health and are a global problem. Various authors have proposed changes in lipid metabolism (total cholesterol decrease) as a possible biological marker for suicidal behavior. The objective of this study was to review the studies that have demonstrated a relationship between serum cholesterol levels and suicidal behavior and to describe the possible pathophysiological mechanisms that associate changes in cholesterol concentration and suicidal behavior. Relevant literature related to serum cholesterol levels and suicidal behavior was identified through various database searches. The data from the existing literature present the findings that relate low cholesterol levels and possible pathophysiological mechanisms (neuroinflammation, serotonergic neurotransmission), genes related to cholesterol synthesis, pharmacological treatments that alter lipid metabolism and the possible participation in suicidal behavior. Nevertheless, future research is required to describe how serum cholesterol affects cholesterol metabolism in the CNS to establish and understand the role of cholesterol in suicidal behavior.
Collapse
Affiliation(s)
- Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Tabasco, Mexico; (T.B.G.-C.); (Y.H.-D.)
| | - Alma Delia Genis-Mendoza
- Departamento de Genética Psiquiátrica, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
| | - Dulce Ivannia León-Escalante
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Tabasco, Mexico;
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez 86205, Tabasco, Mexico; (T.B.G.-C.); (Y.H.-D.)
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco 86650, Tabasco, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-9933581500 (ext. 6900) (C.A.T.-Z.); +52-53501900 (ext. 1197) (H.N.)
| | - María Lilia López-Narváez
- Secretaría de Salud de Chiapas, Hospital Chiapas Nos Une “Dr. Gilberto Gómez Maza”, Tuxtla Gutiérrez 29045, Chiapas, Mexico;
| | | | - Humberto Nicolini
- Departamento de Genética Psiquiátrica, Instituto Nacional de Medicina Genómica, Ciudad de México 14610, Mexico;
- Correspondence: (C.A.T.-Z.); (H.N.); Tel.: +52-9933581500 (ext. 6900) (C.A.T.-Z.); +52-53501900 (ext. 1197) (H.N.)
| | - Rosa Giannina Castillo-Avila
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
| | - Miguel Ángel Ramos-Méndez
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86100, Tabasco, Mexico; (I.E.J.-R.); (R.G.C.-A.); (M.Á.R.-M.)
| |
Collapse
|
21
|
Crossin R. Exploring the link between adolescent inhalant misuse and suicidal behaviour: a behavioural toxicology perspective. Neurotoxicol Teratol 2021; 88:107038. [PMID: 34678460 DOI: 10.1016/j.ntt.2021.107038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
Adolescent inhalant misuse has a known association with suicidal thoughts and behaviour. This association persists even after inhalant misuse has ceased. Previous studies have hypothesised that this association may derive from socioeconomic disadvantage or vulnerability, and potentially mediated by impulsivity. This association may also be due to the central nervous system depressant effects of inhalants. This review takes a behavioural toxicology perspective, focussed particularly on the serotonergic system and the Hypothalamic-Pituitary-Adrenal (HPA) axis, as potential links between adolescent inhalant misuse and suicidal behaviour. The challenges of bridging the pre-clinical and clinical literature in this area are discussed, along with promising avenues for future research; ultimately aimed at reducing suicide risk in a vulnerable adolescent population group.
Collapse
Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago (Christchurch), Christchurch 8140, New Zealand.
| |
Collapse
|
22
|
Wisłowska-Stanek A, Kołosowska K, Maciejak P. Neurobiological Basis of Increased Risk for Suicidal Behaviour. Cells 2021; 10:cells10102519. [PMID: 34685499 PMCID: PMC8534256 DOI: 10.3390/cells10102519] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/21/2021] [Accepted: 09/21/2021] [Indexed: 12/25/2022] Open
Abstract
According to the World Health Organization (WHO), more than 700,000 people die per year due to suicide. Suicide risk factors include a previous suicide attempt and psychiatric disorders. The highest mortality rate in suicide worldwide is due to depression. Current evidence suggests that suicide etiopathogenesis is associated with neuroinflammation that activates the kynurenine pathway and causes subsequent serotonin depletion and stimulation of glutamate neurotransmission. These changes are accompanied by decreased BDNF (brain-derived neurotrophic factor) levels in the brain, which is often linked to impaired neuroplasticity and cognitive deficits. Most suicidal patients have a hyperactive hypothalamus–pituitary–adrenal (HPA) axis. Epigenetic mechanisms control the above-mentioned neurobiological changes associated with suicidal behaviour. Suicide risk could be attenuated by appropriate psychological treatment, electroconvulsive treatment, and drugs: lithium, ketamine, esketamine, clozapine. In this review, we present the etiopathogenesis of suicide behaviour and explore the mechanisms of action of anti-suicidal treatments, pinpointing similarities among them.
Collapse
Affiliation(s)
- Aleksandra Wisłowska-Stanek
- Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1B Banacha Street, 02-097 Warsaw, Poland;
- Correspondence: ; Tel.: +48-221166160
| | - Karolina Kołosowska
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland;
| | - Piotr Maciejak
- Centre for Preclinical Research and Technology (CEPT), Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 1B Banacha Street, 02-097 Warsaw, Poland;
- Department of Neurochemistry, Institute of Psychiatry and Neurology, 9 Sobieskiego Street, 02-957 Warsaw, Poland;
| |
Collapse
|
23
|
Hernández-Díaz Y, González-Castro TB, Juárez-Rojop IE, Tovilla-Zárate CA, López-Narváez ML, Genis-Mendoza AD, Fresan A, Nicolini H. The role of rs242941, rs1876828, rs242939 and rs110402 polymorphisms of CRHR1 gene and the depression: systematic review and meta-analysis. Genes Genomics 2021; 43:1339-1349. [PMID: 34279801 DOI: 10.1007/s13258-021-01133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Several studies have evaluated the possible association between polymorphisms or variants in Corticotropin-releasing hormone 1 receptor gene (CRHR1) with depression; however, results remain contradictory and heterogeneous. OBJECTIVE To our knowledge, we conducted the first comprehensive systematic review and meta-analysis evaluating the association of the CRHR1 gene and the risk of depression. METHODS A search online was conducted in databases for any CRHR1 genetic association studies in depression. Data were extracted for evaluation of pooled estimates using meta-analytic techniques. Statistical analyses were performed using the Comprehensive Meta-analysis, v2.0 software. RESULT A total of 1403 cases and 2353 mentally healthy controls were included in this study. We found a significant association of rs242941, rs1876828 and rs242939 variants of the CRHR1 gene with depression. No association of CRHR1 rs110402 and depression was observed. CONCLUSION Our meta-analysis shows that some variants of the CRHR1 gene (rs242941, rs1876828 and rs242939) might confer susceptibility to depression. Further studies with larger sample sizes need to be conducted.
Collapse
Affiliation(s)
- Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, México
| | - Thelma Beatriz González-Castro
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez, Tabasco, México
| | - Isela Esther Juárez-Rojop
- División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa, Tabasco, México
| | - Carlos Alfonso Tovilla-Zárate
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco, Tabasco, México.
| | | | - Alma Delia Genis-Mendoza
- Instituto Nacional de Medicina Genómica, Servicios de Atención Psiquiátrica, Secretaría de Salud, Ciudad de México, México.
| | - Ana Fresan
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría "Ramón de La Fuente Muñíz", Ciudad de México, México
| | - Humberto Nicolini
- Instituto Nacional de Medicina Genómica, Servicios de Atención Psiquiátrica, Secretaría de Salud, Ciudad de México, México
| |
Collapse
|
24
|
Yang J, Chen S, Li Y, Wang B, Xin X, Xue X, Pan Z, Lyu J. Incidence rate and risk factors for suicide death in patients with skin malignant melanoma: a Surveillance, Epidemiology, and End Results analysis. Melanoma Res 2021; 30:402-409. [PMID: 30489483 DOI: 10.1097/cmr.0000000000000559] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to use the Surveillance, Epidemiology, and End Results database to identify the incidence rate and risk factors for suicide death in patients with skin malignant melanoma (MM) in the USA. We screened cases of skin MM in the SEER database. The balance of covariates between the two groups was examined by the χ-test and Fisher's exact test. Logistic regression was used to identify independent risk factors for committing suicide. A propensity 1: 2 matched analysis was applied to minimize the risk of bias. In total, 103 500 patients with skin MM were included in the study, of whom 623 had died of suicide. The rate of suicide death did not differ significantly between different time intervals. In logistic regression before propensity score matching, age, being divorced, separated, or widowed, receiving radiation or chemotherapy, and the elapsed time since diagnosis were independently associated with an increased rate of suicide death. Only age (P < 0.001) and being in the first year after a diagnosis (P < 0.001) significantly increased the risk of suicide death after propensity score matching. In addition, after the propensity score matching, age was a risk factor for localized, regional, and unstaged, and being the first year after a diagnosis was only a risk factor for regional. It is important to identify and treat people at risk of suicide as early as possible. These results can help clinicians to understand suicidal patients and provide them with appropriate support.
Collapse
Affiliation(s)
- Jin Yang
- Clinical Research Center.,School of Public Health
| | - Siying Chen
- Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center
| | - Bin Wang
- Outpatient Department, Qingdao Branch of Naval Aviation University, Qingdao, China
| | - Xiaojing Xin
- Outpatient Department, Qingdao Branch of Naval Aviation University, Qingdao, China
| | - Xia Xue
- Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an
| | - Zhenyu Pan
- Clinical Research Center.,School of Public Health.,Department of Pharmacy, The Affiliated Children Hospital of Xi'an Jiaotong University, Xi'an
| | - Jun Lyu
- Clinical Research Center.,School of Public Health
| |
Collapse
|
25
|
Trait anxiety, a personality risk factor associated with Alzheimer's Disease. Prog Neuropsychopharmacol Biol Psychiatry 2021; 105:110124. [PMID: 33035604 DOI: 10.1016/j.pnpbp.2020.110124] [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: 05/06/2020] [Revised: 09/24/2020] [Accepted: 10/02/2020] [Indexed: 12/25/2022]
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease in elderly population and the leading cause of dementia worldwide. While senile plaques and neurofibrillary tangles have been proposed as the principal histopathologic hallmarks of AD, the exact etiology of this disease is still far from being clearly understood. AD has been recognized as pathological consequences of complex interactions among genetic, aging, medical, life style and psychosocial factors. Recently, the roles of neuroticism personality traits in AD incidence and progression have come into focus. More specifically, increasing evidence has further shown that the trait anxiety, one major component of neuroticism predicting the individual vulnerability in response to stress, is a risk factor for AD and may correlated with various AD pathologies. In this review, we summarized recent literature on the association of trait anxiety with AD. We also discussed the possible neuroendocrinological and neurochemical mechanisms of this association, which may provide clinical implications for AD diagnosis and therapy.
Collapse
|
26
|
Nikolac Perkovic M, Sagud M, Tudor L, Konjevod M, Svob Strac D, Pivac N. A Load to Find Clinically Useful Biomarkers for Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:175-202. [PMID: 33834401 DOI: 10.1007/978-981-33-6044-0_11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is heterogeneous and complex disease with diverse symptoms. Its neurobiological underpinning is still not completely understood. For now, there are still no validated, easy obtainable, clinically useful noninvasive biomarker(s) or biomarker panel that will be able to confirm a diagnosis of depression, its subtypes and improve diagnostic procedures. Future multimodal preclinical and clinical research that involves (epi)genetic, molecular, cellular, imaging, and other studies is necessary to advance our understanding of the role of monoamines, GABA, HPA axis, neurotrophins, metabolome, and glycome in the pathogenesis of depression and their potential as diagnostic, prognostic, and treatment response biomarkers. These studies should be focused to include the first-episode depression and antidepressant drug-naïve patients with large sample sizes to reduce variability in different biological and clinical parameters. At present, metabolomics study revealed with high precision that a neurometabolite panel consisting of plasma metabolite biomarkers (GABA, dopamine, tyramine, kynurenine) might represent clinically useful biomarkers of MDD.
Collapse
Affiliation(s)
- Matea Nikolac Perkovic
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Marina Sagud
- University of Zagreb School of Medicine, Zagreb, Croatia
- Department of Psychiatry, University Hospital Center Zagreb, Zagreb, Croatia
| | - Lucija Tudor
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Marcela Konjevod
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Dubravka Svob Strac
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia
| | - Nela Pivac
- Division of Molecular Medicine, Laboratory for Molecular Neuropsychiatry, Rudjer Boskovic Institute, Zagreb, Croatia.
| |
Collapse
|
27
|
Dhrisya C, Prasathkumar M, Becky R, Anisha S, Sadhasivam S, Essa MM, Chidambaram SB, Al-Balushi B, Guillemin GJ, Qoronfleh MW. Social and Biological Parameters Involved in Suicide Ideation During the COVID-19 Pandemic: A Narrative Review. Int J Tryptophan Res 2020; 13:1178646920978243. [PMID: 35185341 PMCID: PMC8851148 DOI: 10.1177/1178646920978243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/08/2020] [Indexed: 12/24/2022] Open
Abstract
Fear is an indispensable characteristic of any infectious disease, and the alarm will be further amplified when the infection spreads uncontrollable, unpredictable, and global. The novel corona virus (SARS CoV-2) lead Covid-19, has been declared as a global emergency by WHO as it has affected millions of people with a high mortality rate. The non-availability of medicine for Covid-19 and the various control measures such as social distancing, self-isolation, house quarantine, and the new normal implementation by different nations across the world to control the spread of Covid-19 made people vulnerable to fear and anxiety. As a result, considerable number of Covid-19-related suicidal deaths has been reported across the world during this pandemic. There have been several studies which describe the psychosocial aspects of suicidal ideation. However, the research on the biological aspects of suicidal ideation/suicidal risk factors that are related to pandemic are unreported. Hence this review article is intended to provide a comprehensive analysis of suicidal deaths during Covid-19 and also aimed to addresses the possible link between suicidal ideation and different factors, including psycho-social, behavioral, neurobiological factors (proximal, distal, and inflammatory) and immunity. The alterations in glutamatergic and GABAergic neurotransmitters had upregulated the GABARB3, GABARA4, GABARA3, GABARR1, GABARG2, and GAD2 gene expressions in suicidal victims. The changes in the Kynurenine (KYN) pathway, Hypothalamus-Pituitary-Adrenal axis (HPA axis) hyperactivation, and dysregulation of serotonin biosynthesis would significantly alter the brain chemistry in people with suicide ideation.
Collapse
Affiliation(s)
- Chenthamara Dhrisya
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Murugan Prasathkumar
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Robert Becky
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Salim Anisha
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
| | - Subramaniam Sadhasivam
- Bioprocess and Biomaterials Laboratory, Department of Microbial Biotechnology, Bharathiar University, Coimbatore, India
- Department of Extension and Career Guidance, Bharathiar University, Coimbatore, India
| | - Musthafa Mohamed Essa
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
- Ageing and Dementia Research Group, Sultan Qaboos University, Muscat, Oman
| | - Saravana Babu Chidambaram
- Centre for Experimental Pharmacology & Toxicology (CPT), JSS Academy of Higher Education & Research, Mysuru, India
| | - Buthainah Al-Balushi
- Department of Food Science and Nutrition, CAMS, Sultan Qaboos University, Muscat, Oman
| | - Gilles J Guillemin
- Neuroinflammation Group, Faculty of Medicine and Health Sciences, Macquarie University, NSW, Australia
| | - M Walid Qoronfleh
- Research & Policy Department, World Innovation Summit for Health (WISH), Qatar Foundation, Doha, Qatar
| |
Collapse
|
28
|
Crossin R, Arunogiri S. Harms associated with inhalant misuse in adolescent females - a review of the pre-clinical and clinical evidence. Drug Alcohol Depend 2020; 216:108232. [PMID: 32862119 DOI: 10.1016/j.drugalcdep.2020.108232] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 08/03/2020] [Accepted: 08/06/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Inhalant misuse, or the misuse of products containing toluene is common in adolescents, and is associated with diverse physiological and psychological harms. Females comprise over half those who misuse inhalants in adolescence, however, the majority of the evidence has been derived from male-only or mixed-sex studies without exploration of sex differences. Female adolescence is a critical maturational period with potential for growth, reproductive, cognitive and psychological harms that may lead to long-term health consequences. We therefore summarise evidence of female-specific harms arising from inhalant misuse. METHODS We synthesised pre-clinical and clinical studies of inhalant misuse which were conducted in females, or where sex-differences were reported, into a narrative literature review. RESULTS Females experience growth impairments and metabolic dysfunction arising from inhalant misuse, but data on sex-differences are inconclusive. Inhalant misuse in early adolescence may impact menarche and subsequent reproductive capacity, but studies have predominantly focused on the effects of inhalants on offspring rather than on the exposed female. There is limited evidence of sex-differences in relation to cognitive outcomes following exposure to inhalants in pre-clinical models. Females are at an increased risk of psychological harms associated with inhalant misuse, particularly depression and suicidal behaviour. CONCLUSIONS The type and magnitude of harms associated with inhalant misuse are sex-specific, but data are limited. We recommend that both pre-clinical and clinical studies of inhalant misuse include both males and females, and should specifically test for and report sex-differences. This can be used to build an evidence base for screening and interventions tailored to females.
Collapse
Affiliation(s)
- Rose Crossin
- Department of Population Health, University of Otago Christchurch campus, 34 Gloucester Street, Christchurch, 8140, New Zealand; Florey Institute of Neuroscience and Mental Health, 30 Royal Parade, Parkville, Melbourne, Victoria, 3052, Australia.
| | - Shalini Arunogiri
- Central Clinical School, Monash Alfred Psychiatry Research Centre, Level 4, 607 St Kilda Road, Melbourne, Victoria, 3004, Australia; Turning Point, Eastern Health, 110 Church Street, Richmond, Melbourne, Victoria, 3121, Australia
| |
Collapse
|
29
|
Buchecker V, Waldron AM, van Dijk RM, Koska I, Brendel M, von Ungern-Sternberg B, Lindner S, Gildehaus FJ, Ziegler S, Bartenstein P, Potschka H. [ 18F]MPPF and [ 18F]FDG μPET imaging in rats: impact of transport and restraint stress. EJNMMI Res 2020; 10:112. [PMID: 32990819 PMCID: PMC7524912 DOI: 10.1186/s13550-020-00693-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background Stress exposure can significantly affect serotonergic signaling with a particular impact on 5-HT1A receptor expression. Positron emission tomography (PET) provides opportunities for molecular imaging of alterations in 5-HT1A receptor binding following stress exposure. Considering the possible role of 5-HT1A receptors in stress coping mechanisms, respective imaging approaches are of particular interest. Material and methods For twelve consecutive days, Sprague Dawley rats were exposed to daily transport with a 1 h stay in a laboratory or daily transport plus 1 h restraint in a narrow tube. Following, animals were subjected to μPET imaging with 2′-methoxyphenyl-(N-2′-pyridinyl)-p-[18F]fluoro-benzamidoethylpiperazine ([18F]MPPF) and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG). Behavioral and biochemical parameters were analyzed to obtain additional information. Results In rats with repeated transport, hippocampal [18F]MPPF binding exceeded that in the naive group, while no difference in [18F]FDG uptake was detected between the groups. A transient decline in body weight was observed in rats with transport or combined transport and restraint. Thereby, body weight development correlated with [18F]MPPF binding. Conclusions Mild-to-moderate stress associated with daily transport and exposure to a laboratory environment can trigger significant alterations in hippocampal binding of the 5-HT1A receptor ligand [18F]MPPF. This finding indicates that utmost care is necessary to control and report transport and associated handling procedures for animals used in μPET studies analyzing the serotonergic system in order to enhance the robustness of conclusions and allow replicability of findings. In view of earlier studies indicating that an increase in hippocampal 5-HT1A receptor expression may be associated with a resilience to stress, it would be of interest to further evaluate 5-HT1A receptor imaging approaches as a candidate biomarker for the vulnerability to stress.
Collapse
Affiliation(s)
- Verena Buchecker
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Königinstr. 16, 80539, Munich, Germany
| | - Ann-Marie Waldron
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Königinstr. 16, 80539, Munich, Germany
| | - R Maarten van Dijk
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Königinstr. 16, 80539, Munich, Germany
| | - Ines Koska
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Königinstr. 16, 80539, Munich, Germany
| | - Matthias Brendel
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | | | - Simon Lindner
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Franz Josef Gildehaus
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Sibylle Ziegler
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital of Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Königinstr. 16, 80539, Munich, Germany.
| |
Collapse
|
30
|
The Involvement of Hypothalamus-Pituitary-Adrenal (HPA) Axis in Suicide Risk. Brain Sci 2020; 10:brainsci10090653. [PMID: 32967089 PMCID: PMC7565104 DOI: 10.3390/brainsci10090653] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/12/2022] Open
Abstract
Stress and Hypothalamic–Pituitary–Adrenal (HPA) axis dysregulation play a major role in various pathophysiological processes associated with both mood disorders and suicidal behavior. We conducted a systematic review with the primary aim of clarifying the nature and extent of HPA axis activity and suicidal behavior. The second aim of this review was to investigate whether potential biomarkers related to HPA axis abnormalities act as individual susceptibility factors for suicide. The PRISMA statement for reporting systematic reviews was used. Only articles published in English peer-reviewed journals were considered for possible inclusion; we excluded case reports, meta-analyses, and systematic reviews, and studies that did not clearly report statistical analysis, diagnostic criteria, or the number of patients included. Overall, 36 articles on HPA axis and suicide risk met inclusion criteria and were reviewed. Studies that investigated tests detecting biomarkers and the role of early life stressors in suicide risk were also included. We found that HPA axis activity is involved in suicide risk, regardless of the presence or absence of psychiatric conditions. The HPA axis abnormalities, mainly characterized by hyperactivity of the HPA axis, may exert an important modulatory influence on suicide risk. Impaired stress response mechanisms contribute to suicide risk. Targeting HPA axis dysregulation might represent a fruitful strategy for identifying new treatment targets and improving suicide risk prediction.
Collapse
|
31
|
Mainali P, Rai T, Rutkofsky IH. From Child Abuse to Developing Borderline Personality Disorder Into Adulthood: Exploring the Neuromorphological and Epigenetic Pathway. Cureus 2020; 12:e9474. [PMID: 32874803 PMCID: PMC7455386 DOI: 10.7759/cureus.9474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 01/01/2023] Open
Abstract
Borderline personality disorder (BPD) is one of the most common personality disorders seen in the general population. Among multiple identified risk factors, one of the most influential elements is exposure to an adverse childhood experience in terms of emotional, physical, or sexual abuse. A cascade of neuromorphological and epigenetic changes occurs in response to these childhood stressors, which may have a strong link to the development of BPD. PubMed and Google Scholar were searched for articles relevant to child abuse and the development of BPD. The search was not restricted to any time frame or geographic location. Significant epigenetic and neuromorphological changes are seen with child abuse, contributing to the development of BPD. Chronic stressors lead to hypothalamic-pituitary axis (HPA) activation, releasing cortisol that acts on the prefrontal cortex, amygdala, and hippocampus, producing the behavioral patterns seen in BPD. Overstimulation of gray matter leads to permanent neuromorphological changes, which can be visualized in functional MRI/brain scans. Hypermethylation of messenger ribonucleic acid in various sites suggests the impact of child abuse on the genetic level. Interestingly, the prevalence of BPD is seen equally in both genders but is diagnosed more frequently in females because they tend to be more likely to seek help. Understanding the impact of early age life stressors into adulthood calls for serious focus on early diagnosis and intervention. This implies the need for more studies in patients with BPD with or without any childhood traumatic experience and a better understanding of the changes that occur biopsychologically and genetically in response to trauma.
Collapse
Affiliation(s)
- Pranita Mainali
- Psychiatry, Washington DC Veterans Affairs Medical Center, Washington, DC, USA
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Tehrima Rai
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Ian H Rutkofsky
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| |
Collapse
|
32
|
Siepsiak M, Sobczak AM, Bohaterewicz B, Cichocki Ł, Dragan WŁ. Prevalence of Misophonia and Correlates of Its Symptoms among Inpatients with Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5464. [PMID: 32751203 PMCID: PMC7432123 DOI: 10.3390/ijerph17155464] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
Misophonia is an underexplored condition that significantly decreases the quality of life of those who suffer from it. It has neurological and physiological correlates and is associated with a variety of psychiatric symptoms; however, a growing body of data suggests that it is a discrete disorder. While comorbid diagnoses among people with misophonia have been a matter of research interest for many years there is no data on the frequency of misophonia among people with psychiatric disorders. This could be the next step to reveal additional mechanisms underlying misophonia. Until recently, the use of a variety of non-validated questionnaires and the dominance of internet-based studies have been also a major obstacles to a proper definition of misophonia. A total of 94 inpatients diagnosed with depression were assessed for misophonia with face-to-face interviews as well as with MisoQuest-a validated misophonia questionnaire. The prevalence of misophonia among these patients and the congruence of MisoQuest with face-to-face interviews were evaluated. Additionally, the patients filled in a series of questionnaires that measured a variety of psychiatric symptoms and psychological traits. Anxiety, depression, impulsivity, somatic pain, vegetative symptoms, post-traumatic stress disorder (PTSD) symptoms, gender, and age were analyzed in relation to the severity of symptoms of misophonia. Between 8.5 to 12.76% of inpatients with depression were diagnosed with misophonia (depending on measurement and inclusion criteria). MisoQuest accuracy was equal to 92.55%, sensitivity-66.67% and specificity-96.34%. Severity of misophonia symptoms was positively correlated to the greatest extent with anxiety. Moderate positive correlation was also found between severity of misophonia symptoms and depressive symptoms, intrusions, and somatic pain; a weak positive correlation was found between severity of misophonia and non-planning impulsivity, motor impulsivity, avoidance, and vegetative symptoms. There was no relationship between the severity of misophonia symptoms and attentional impulsivity or the age of participants.
Collapse
Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, 00-183 Warsaw, Poland;
| | - Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Łukasz Cichocki
- Department of Psychiatry, Andrzej Frycz Modrzewski Cracow Academy, 30-705 Cracow, Poland;
| | | |
Collapse
|
33
|
Fan XX, Yuan J, Wei YJ, Zhou F, Xu L, Zhang Y, Meng JY, Jin XL, Yang JZ. Association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with major depressive disorder. BMC Psychiatry 2020; 20:345. [PMID: 32616039 PMCID: PMC7331122 DOI: 10.1186/s12888-020-02763-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 06/25/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Sarcopenia is a skeletal muscle disorder. Recent studies have shown an association between muscle health and suicide. However, there have been no previous studies on the relationship between suicide risk severity and sarcopenia in major depressive disorder (MDD). This study aimed to explore the association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with MDD. METHODS The first-episode drug-naïve MDD inpatients aged 20-59 years with the 24-item Hamilton Rating Scale for Depression (HAMD-24) scores of >20 were included, who were then classified into low, intermediate, high and very high suicide risk groups according to the Nurses' Global Assessment of Suicide Risk (NGASR). The HAMD-24, the Hamilton Rating Scale for Anxiety (HAMA) and the SARC-F questionnaire were used to assess depression severity, anxiety severity and sarcopenia, respectively. The plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were measured. RESULTS A total of 192 MDD inpatients (122 females, 70 males; aged 39.3 ± 11.7 years) were included, with 12.5% meeting criteria for sarcopenia. There were significant differences in gender, HAMD score and prevalence of sarcopenia among the suicide risk groups. Adjusted ordinal regression analysis showed that sarcopenia was significantly associated with more severe suicide risk (OR = 2.39, 95%CI 1.02-5.58, p = 0.044) independent of depression severity. CONCLUSIONS This study revealed that sarcopenia was significantly associated with higher suicide risk in non-elderly Chinese MDD inpatients after adjustment for depression severity. Intervention of sarcopenia might be effective in reducing the risk of suicide in non-elderly MDD patients.
Collapse
Affiliation(s)
- Xin-Xin Fan
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Jing Yuan
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Yu-Jun Wei
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Fang Zhou
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Li Xu
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Yan Zhang
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Jun-Yu Meng
- grid.415444.4Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101 Yunnan China
| | - Xiao-Long Jin
- grid.459918.8Department of Geriatrics, The Sixth Affiliated Hospital of Kunming Medical University (People’s Hospital of Yuxi), Yuxi, Yunnan China
| | - Jian-Zhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, 374 Dianmian Av, Kunming, 650101, Yunnan, China.
| |
Collapse
|
34
|
Yang J, Liu Q, Zhao F, Feng X, Kaaya RE, Lyu J. Incidence of and sociological risk factors for suicide death in patients with leukemia: A population-based study. J Int Med Res 2020; 48:300060520922463. [PMID: 32383398 PMCID: PMC7221221 DOI: 10.1177/0300060520922463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Suicide is closely related to sociological factors, but sociological analyses of suicide risk in leukemia are lacking. This study is the first to use the Surveillance, Epidemiology, and End Results Program (SEER) database to analyze sociological risk factors for suicide death in leukemia patients. METHODS A retrospective search of the SEER database was conducted. Logistic regression was used to identify independent risk factors for suicide death. Variables significant in the univariate logistic regression models were subsequently analyzed using multivariate regression. RESULTS The death rate was highest in California (1.73%). Suicide mortality was more common during the 1970s and 1980s, after which it trended downward. Young age at diagnosis (18-34 vs. >64 years: odds ratio [OR] = 1.537, 95% confidence interval [CI] = 1.007-2.347; 35-64 vs. >64 years: OR = 1.610, 95% CI = 1.309-1.979), being male (OR = 1.518, 95% CI = 1.230-1.873), and living where a high proportion of people have at least a bachelor's degree (>50% vs. <20%: OR = 8.115, 95% CI = 5.053-13.034) significantly increased suicide death risk. CONCLUSION Our findings could increase clinician awareness of and appropriate support for leukemia patients at risk of death by suicide.
Collapse
Affiliation(s)
- Jin Yang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Qingqing Liu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Fanfan Zhao
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Xiaojie Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Rahel Elishilia Kaaya
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong Province, China.,School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi Province, China
| |
Collapse
|
35
|
Orsolini L, Latini R, Pompili M, Serafini G, Volpe U, Vellante F, Fornaro M, Valchera A, Tomasetti C, Fraticelli S, Alessandrini M, La Rovere R, Trotta S, Martinotti G, Di Giannantonio M, De Berardis D. Understanding the Complex of Suicide in Depression: from Research to Clinics. Psychiatry Investig 2020; 17:207-221. [PMID: 32209966 PMCID: PMC7113180 DOI: 10.30773/pi.2019.0171] [Citation(s) in RCA: 162] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/27/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE Amongst psychiatric disorders, major depressive disorder (MDD) is the most prevalent, by affecting approximately 15-17% of the population and showing a high suicide risk rate equivalent to around 15%. The present comprehensive overview aims at evaluating main research studies in the field of MDD at suicide risk, by proposing as well as a schematic suicide risk stratification and useful flow-chart for planning suicide preventive and therapeutic interventions for clinicians. METHODS A broad and comprehensive overview has been here conducted by using PubMed/Medline, combining the search strategy of free text terms and exploded MESH headings for the topics of 'Major Depressive Disorder' and 'Suicide' as following: ((suicide [Title/Abstract]) AND (major depressive disorder [Title/Abstract])). All articles published in English through May 31, 2019 were summarized in a comprehensive way. RESULTS Despite possible pathophysiological factors which may explain the complexity of suicide in MDD, scientific evidence supposed the synergic role of genetics, exogenous and endogenous stressors (i.e., interpersonal, professional, financial, as well as psychiatric disorders), epigenetic, the hypothalamic-pituitary-adrenal stress-response system, the involvement of the monoaminergic neurotransmitter systems, particularly the serotonergic ones, the lipid profile, neuro-immunological biomarkers, the Brain-derived neurotrophic factor and other neuromodulators. CONCLUSION The present overview reported that suicide is a highly complex and multifaceted phenomenon in which a large plethora of mechanisms could be variable implicated, particularly amongst MDD subjects. Beyond these consideration, modern psychiatry needs a better interpretation of suicide risk with a more careful assessment of suicide risk stratification and planning of clinical and treatment interventions.
Collapse
Affiliation(s)
- Laura Orsolini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy.,Polyedra, Teramo, Italy
| | - Roberto Latini
- Neomesia Mental Health, Villa Jolanda Hospital, Jesi, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, S. Andrea Hospital, Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Umberto Volpe
- Department of Clinical Neurosciences/DIMSC, School of Medicine, Section of Psychiatry, Polytechnic University of Marche, Ancona, Italy
| | - Federica Vellante
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Michele Fornaro
- Polyedra, Teramo, Italy.,Department of Psychiatry, Federico II University, Naples, Italy
| | - Alessandro Valchera
- Polyedra, Teramo, Italy.,Villa S. Giuseppe Hospital, Hermanas Hospitalarias, Ascoli Piceno, Italy
| | - Carmine Tomasetti
- Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "SS. Annunziata" ASL 4, Giulianova, Italy
| | - Silvia Fraticelli
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Marco Alessandrini
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Raffaella La Rovere
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Sabatino Trotta
- Department of Mental Health, National Health Service, Azienda Sanitaria Locale, Pescara, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy
| | - Domenico De Berardis
- Department of Neuroscience, Imaging and Clinical Science, Chair of Psychiatry, University of "G. D'Annunzio", Chieti, Italy.,Department of Mental Health, National Health Service, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy
| |
Collapse
|
36
|
Abstract
Suicide is a global health issue accounting for at least 800,000 deaths per annum. Numerous models have been proposed that differ in their emphasis on the role of psychological, social, psychiatric and neurobiological factors in explaining suicide risk. Central to many models is a stress-diathesis component which states that suicidal behavior is the result of an interaction between acutely stressful events and a susceptibility to suicidal behavior (a diathesis). This article presents an overview of studies that demonstrate that stress and dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, are important additional risk factors for suicide. Evidence for other putative stress-related suicide risk factors including childhood trauma, impaired executive function, impulsivity and disrupted sleep are considered together with the impact of family history of suicide, perinatal and epigenetic influences on suicide risk.
Collapse
|
37
|
Fehling KB, Selby EA. Suicide in DSM-5: Current Evidence for the Proposed Suicide Behavior Disorder and Other Possible Improvements. Front Psychiatry 2020; 11:499980. [PMID: 33613330 PMCID: PMC7891495 DOI: 10.3389/fpsyt.2020.499980] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
Suicide continues to be one of the greatest challenges faced by mental health clinicians and researchers, an issue made worse by increasing trends in the global suicide rate. Suicide behavior disorder (SBD) was introduced in DSM-5 as a disorder for further consideration and potential acceptance into the diagnostic system. There are numerous positive developments that would arise from the addition of a suicide-related diagnosis. Utilizing the 2009 guidelines established by Kendler and colleagues, the present review examines the evidence for SBD's validity and discusses the diagnosis' potential clinical benefits and limitations. Altogether, growing evidence indicates that SBD has preliminary validity and benefit. SBD presents with several significant limitations, however, and possible alternative additions to future DSMs are highlighted.
Collapse
Affiliation(s)
| | - Edward A Selby
- Department of Psychology, Rutgers, The State University of New Jersey, New Brunswick, NJ, United States
| |
Collapse
|
38
|
Audira G, Sarasamma S, Chen JR, Juniardi S, Sampurna BP, Liang ST, Lai YH, Lin GM, Hsieh MC, Hsiao CD. Zebrafish Mutants Carrying Leptin a (lepa) Gene Deficiency Display Obesity, Anxiety, Less Aggression and Fear, and Circadian Rhythm and Color Preference Dysregulation. Int J Mol Sci 2018; 19:ijms19124038. [PMID: 30551684 PMCID: PMC6320766 DOI: 10.3390/ijms19124038] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/05/2018] [Accepted: 12/11/2018] [Indexed: 01/14/2023] Open
Abstract
Leptin, a hormone secreted by peripheral adipose tissues, regulates the appetite in animals. Recently, evidence has shown that leptin also plays roles in behavioral response in addition to controlling appetite. In this study, we examined the potential function of leptin on non-appetite behaviors in zebrafish model. By using genome editing tool of Transcription activator-like effector nuclease (TALEN), we successfully knocked out leptin a (lepa) gene by deleting 4 bp within coding region to create a premature-translation stop. Morphological and appetite analysis showed the lepa KO fish display a phenotype with obese, good appetite and elevation of Agouti-related peptide (AgRP) and Ghrelin hormones, consistent with the canonical function of leptin in controlling food intake. By multiple behavior endpoint analyses, including novel tank, mirror biting, predator avoidance, social interaction, shoaling, circadian rhythm, and color preference assay, we found the lepa KO fish display an anxiogenic phenotype showing hyperactivity with rapid swimming, less freezing time, less fear to predator, loose shoaling area forming, and circadian rhythm and color preference dysregulations. Using biochemical assays, melatonin, norepinephrine, acetylcholine and serotonin levels in the brain were found to be significantly reduced in lepa KO fish, while the levels of dopamine, glycine and cortisol in the brain were significantly elevated. In addition, the brain ROS level was elevated, and the anti-oxidative enzyme catalase level was reduced. Taken together, by performing loss-of-function multiple behavior endpoint testing and biochemical analysis, we provide strong evidence for a critical role of lepa gene in modulating anxiety, aggression, fear, and circadian rhythm behaviors in zebrafish for the first time.
Collapse
Affiliation(s)
- Gilbert Audira
- Department of Chemistry, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
| | - Sreeja Sarasamma
- Department of Chemistry, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
| | - Jung-Ren Chen
- Department of Biological Science & Technology College of Medicine, I-Shou University, Kaohsiung, 82445, Taiwan.
| | - Stevhen Juniardi
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
| | | | - Sung-Tzu Liang
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
| | - Yu-Heng Lai
- Department of Chemistry, Chinese Culture University, Taipei 11114, Taiwan.
| | - Geng-Ming Lin
- Laboratory of Marine Biology and Ecology, Third Institute of Oceanography, State OceanicAdministration, Xiamen 361005, China.
| | - Ming-Chia Hsieh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua 50094, Taiwan.
| | - Chung-Der Hsiao
- Department of Chemistry, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
- Department of Bioscience Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
- Center of Nanotechnology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
- Center of Biomedical Technology, Chung Yuan Christian University, Chung-Li 32023, Taiwan.
| |
Collapse
|
39
|
Meng Q, Kim HC, Oh S, Lee YM, Hu Z, Oh KW. Cocaine- and Amphetamine-Regulated Transcript (CART) Peptide Plays Critical Role in Psychostimulant-Induced Depression. Biomol Ther (Seoul) 2018; 26:425-431. [PMID: 30157614 PMCID: PMC6131014 DOI: 10.4062/biomolther.2018.141] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/08/2018] [Accepted: 08/08/2018] [Indexed: 12/28/2022] Open
Abstract
Cocaine- and amphetamine-regulated transcript (CART) peptide is a widely distributed neurotransmitter expressed in the central nervous systems. Previously, several reports demonstrated that nucleus accumbal-injected CART peptide positively modulated behavioral sensitization induced by psychostimulants and regulated the mesocorticolimbic dopaminergic pathway. It is confirmed that CART peptide exerted inhibitory effect on psychostimulant-enhanced dopamine receptors signaling, Ca2+/calmodulin-dependent kinase signaling and crucial transcription factors expression. Besides modulation of dopamine receptors-related pathways, CART peptide also exhibited elaborated interactions with other neurotransmitter receptors, such as glutamate receptors and γ-aminobutyric acid receptors, which further account for attribution of CART peptide to inhibition of psychostimulant-potentiated locomotor activity. Recently, CART peptide has been shown to have anxiolytic functions on the aversive mood and uncontrolled drug-seeking behaviors following drug withdrawal. Moreover, microinjection of CART peptide has been shown to have an anti-depressant effect, which suggests its potential utility in the mood regulation and avoidance of depression-like behaviors. In this review, we discuss CART pathways in neural circuits and their interactions with neurotransmitters associated with psychostimulant-induced depression.
Collapse
Affiliation(s)
- Qing Meng
- Queen Mary Institute, School of Medicine, Nanchang University, Nanchang, Jiangxi 33006, China
| | - Hyoung-Chun Kim
- Neuropsychopharmacology and Toxicology Program, College of Pharmacy, Kangwon National University, Chuncheon 24341, Republic of Korea
| | - Seikwan Oh
- Department of Molecular Medicine and TIDRC, School of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Yong-Moon Lee
- Department of Pharmacy, College of Pharmacy, Chungbuk National University, Osong 28160, Republic of Korea
| | - Zhenzhen Hu
- Department of Pathophysiology, College of Medicine, Nanchang University, Nanchang, Jiangxi 33006, China
| | - Ki-Wan Oh
- Department of Pharmacy, College of Pharmacy, Chungbuk National University, Osong 28160, Republic of Korea
| |
Collapse
|
40
|
Korucu CÇ, Atay İM, Zayıf SS, Gültekin F. May nesfatin-1 be a state marker in major depressive disorder with suicidal ideation? Psychiatry Res 2018; 267:272-276. [PMID: 29940459 DOI: 10.1016/j.psychres.2018.05.086] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 05/05/2018] [Accepted: 05/29/2018] [Indexed: 12/17/2022]
Abstract
The best known effects of nesfatin-1 are on appetite and metabolic regulation. Moreover, several research suggest that nesfatin-1 play a role in stress responses. This molecule may be involved in the pathophysiology of mood disorders and suicidal behavior. We compared nesfatin-1 levels between depressed patients with suicidal ideation (n = 32, mean ± SD, 1,40 ± 0.11), without suicidal ideation(n = 31, 1.46 ± 0.14) and healthy controls (n = 32, 1.52 ± 0.13). Suicidal ideation was assessed with the Suicide Probability Scale, Scale for Suicide Ideation and depressive symptoms were evaluated with the Hamilton Depression Rating Scale. Blood samples were collected to measure serum nesfatin-1levels by using ELISA method. The study revealed that serum nesfatin-1 levels were significantly lower in MDD with suicidal ideation than in healthy volunteers (p < 0.001). There were a negative correlation between the scores of suicidal ideation and nesfatin-1 levels in MDD with SI group (r = -0.215; p = 0.016). In the future, nesfatin-1 levels may one day be applied in predicting and monitoring patients' suicide risk. Further prospective studies are required to elucidate this potential association.
Collapse
Affiliation(s)
- Cafer Çağrı Korucu
- Department of Psychiatry, Usak University Education and Research Hospital, Usak, Turkey.
| | - İnci Meltem Atay
- Department of Psychiatry, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Seden Sert Zayıf
- Department of Biochemistry, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Fatih Gültekin
- Department of Biochemistry, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| |
Collapse
|
41
|
Petrunich-Rutherford ML, Garcia F, Battaglia G. 5-HT 1A receptor-mediated activation of neuroendocrine responses and multiple protein kinase pathways in the peripubertal rat hypothalamus. Neuropharmacology 2018; 139:173-181. [PMID: 30005975 DOI: 10.1016/j.neuropharm.2018.07.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 07/03/2018] [Accepted: 07/07/2018] [Indexed: 01/08/2023]
Abstract
Increasing evidence suggests that multiple factors can produce effects on the immature brain that are distinct and more long-lasting than those produced in adults. The hypothalamic paraventricular nucleus (PVN) is a region integral to the hypothalamic-pituitary-adrenal axis and is affected by anxiety, depression, and drugs used to treat these disorders, yet receptor signaling mechanisms operative in hypothalamus prior to maturation remain to be elucidated. In peripubertal male rats, systemic injection of the selective serotonin 1A (5-HT1A) receptor agonist (+)8-OH-DPAT (0.2 mg/kg) markedly elevated plasma levels of oxytocin and adrenocorticotropic hormone (ACTH) at 5 and 15 min post-injection. The 5-HT1A receptor selectivity was demonstrated by the ability of the 5-HT1A receptor selective antagonist WAY100635 to completely block both oxytocin and ACTH responses at 5 min, with some recovery of the ACTH response at 15 min. At 15 min post-injection, (+)8-OH-DPAT also increased levels of phosphorylated extracellular signal-regulated kinase (pERK) and phosphorylated protein kinase B (pAkt) in the PVN. As previously observed in adults, (+)8-OH-DPAT reduced levels of pERK in hippocampus. WAY100635 also completely blocked (+)8-OH-DPAT-mediated elevations in hypothalamic pERK and pAkt and the reductions in hippocampal pERK, demonstrating 5-HT1A receptor selectivity of both kinase responses. This study provides the first demonstration of functional 5-HT1A receptor-mediated ERK and Akt signaling pathways in the immature hypothalamus, activated by a dose of (+)8-OH-DPAT that concomitantly stimulates neuroendocrine responses. This information is fundamental to identifying potential signaling pathways targeted by biased agonists in the development of safe and effective treatment strategies in children and adolescents.
Collapse
Affiliation(s)
| | - Francisca Garcia
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, United States
| | - George Battaglia
- Neuroscience Institute, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, United States; Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, 2160 South First Avenue, Maywood, IL 60153, United States.
| |
Collapse
|
42
|
Plasma cortisol and oxytocin levels predict help-seeking intentions for depressive symptoms. Psychoneuroendocrinology 2018; 87:159-165. [PMID: 29096223 DOI: 10.1016/j.psyneuen.2017.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/20/2017] [Accepted: 10/20/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Depressed individuals often refuse or withdraw from help, a phenomenon termed help-negation, which is a risk factor for poor outcomes. Most previous research has investigated psychosocial factors including stigma as causes of low help-seeking intentions for depression, however these do not adequately explain the problem. We hypothesised that because help-negation worsens with symptom severity, it might be linked to important biological changes associated with depression itself. We investigated the relative contributions of cortisol, a stress hormone linked to depression, and oxytocin, a hormone which mediates social behaviours, alongside psychosocial factors, to help-seeking intentions among depressed and non-depressed individuals. METHODS Morning plasma cortisol and oxytocin levels, psychopathology, suicidal ideation, help-seeking intentions from informal sources including family and friends, and formal sources including health professionals, and perceived social support were quantified in 63 adults meeting DSM-5 criteria for major depressive disorder (MDD) who were not receiving any treatment, and 60 healthy controls. Between-group analyses of variance, correlations, and hierarchical multiple regressions were employed. RESULTS Help-seeking intentions were lower in depressed than healthy participants, negatively correlated to cortisol and positively correlated to oxytocin. Cortisol negatively, and oxytocin positively, predicted help-seeking intentions from informal but not formal sources, after controlling for psychopathology and psychosocial factors. CONCLUSIONS Neuroendocrine changes associated with depression may contribute to low help-seeking from friends and family, which may have implications for interpersonal support and outcomes. Research and clinical approaches which incorporate biological as well as psychosocial factors may allow for more targeted and effective early interventions to address lack of help-seeking and depression progression.
Collapse
|
43
|
Shrivastava A, Johnston M, Campbell R, De Sousa A, Shah N. Serum cholesterol and Suicide in first episode psychosis: A preliminary study. Indian J Psychiatry 2017; 59:478-482. [PMID: 29497191 PMCID: PMC5806328 DOI: 10.4103/psychiatry.indianjpsychiatry_185_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Low levels of cholesterol have been described in suicide behavior including among those individuals who have an increased tendency for impulsivity. Violent suicide attempters show significantly lower cholesterol levels than nonviolent suicide attempters. The suicide rate is particularly high in the prodromal and early phase of schizophrenia. It is unclear if there is a psychopathological relationship between early psychosis, suicide, and cholesterol levels. The present study examines levels of cholesterol and suicide behavior in a cohort of early psychosis. METHODOLOGY Sixty admitted patients with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnosis of nonaffective schizophrenia spectrum disorder (early psychosis) were assessed in a naturalistic cross-sectional, cohort study. Psychopathology was assessed with the Positive and Negative Symptom Scale for Schizophrenia (PANSS), Hamilton Depression Rating Scale, and Scale for Impact of Suicidality-Management, Assessment and Planning of Care (SIS-MAP). Serum levels of cholesterol were estimated in the cohort as well. The findings were analyzed for a clinical correlation of cholesterol levels, suicidal attempters, and psychopathology. RESULTS Out of 60 patients, 13 patients had a suicide attempt in the recent past. No serum cholesterol abnormality (3.7 ± 1.2 mmol/L) was observed in patients as a group and those with low suicidality (SIS-MAP <17, serum cholesterol: 4.1 ± 1.3 mmol/L). However, low levels of cholesterol were observed in a subgroup with severe suicidality (SIS-MAP >33; serum cholesterol: 3.5 ± 1.4 mmol/L). Females with moderate suicidality showed statistically significant lower cholesterol levels than males (P = 0.047). CONCLUSIONS The study suggests lower levels of cholesterol in patients of psychosis with severe suicidal thoughts and depression in early psychosis. More research is required in this field to determine the neurochemistry of suicide behavior in psychosis and its significance in the prediction of suicidal behavior.
Collapse
Affiliation(s)
- Amresh Shrivastava
- Department of Mental Health, University of Western Ontario, Ontario, Canada
| | - Megan Johnston
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Robbie Campbell
- Department of Psychiatry, University of Western Ontario, Ontario, Canada
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| | - Nilesh Shah
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, Maharashtra, India
| |
Collapse
|
44
|
Crassifoside H improve the depressive-like behavior of rats under chronic unpredictable mild stress: Possible involved mechanisms. Brain Res Bull 2017; 135:77-84. [DOI: 10.1016/j.brainresbull.2017.09.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 08/27/2017] [Accepted: 09/28/2017] [Indexed: 02/06/2023]
|
45
|
Popovic D, Damjanovic S, Djordjevic T, Martic D, Ignjatovic S, Milinkovic N, Banovic M, Lasica R, Petrovic M, Guazzi M, Arena R. Stress hormones at rest and following exercise testing predict coronary artery disease severity and outcome. Stress 2017; 20:523-531. [PMID: 28845719 DOI: 10.1080/10253890.2017.1368488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Despite considerable knowledge regarding the importance of stress in coronary artery disease (CAD) pathogenesis, its underestimation persists in routine clinical practice, in part attributable to lack of a standardized, objective assessment. The current study examined the ability of stress hormones to predict CAD severity and prognosis at basal conditions as well as during and following an exertional stimulus. MATERIALS AND METHODS Forty Caucasian subjects with significant coronary artery lesions (≥50%) were included. Within 2 months of coronary angiography, cardiopulmonary exercise testing (CPET) on a recumbent ergometer was performed in conjunction with stress echocardiography (SE). At rest, peak and after 3 min of recovery following CPET, plasma levels of cortisol, adrenocorticotropic hormone (ACTH) and NT-pro-brain natriuretic peptide (NT-pro-BNP) were measured by immunoassay sandwich technique, radioimmunoassay, and radioimmunometric technique, respectively. Subjects were subsequently followed a mean of 32 ± 10 months. RESULTS AND DISCUSSION Mean ejection fraction was 56.7 ± 9.6%. Subjects with 1-2 stenotic coronary arteries (SCA) demonstrated a significantly lower plasma cortisol levels during CPET compared to those with 3-SCA (p < .05), whereas ACTH and NT-pro-BNP were not significantly different (p > .05). Among CPET, SE, and hormonal parameters, cortisol at rest and during CPET recovery demonstrated the best predictive value in distinguishing between 1-, 2-, and 3-SCA [area under ROC curve 0.75 and 0.77 (SE = 0.11, 0.10; p = .043, .04) for rest and recovery, respectively]. ΔCortisol peak/rest predicted cumulative cardiac events (area under ROC curve 0.75, SE = 0.10, p = .049). CONCLUSIONS Cortisol at rest and following an exercise test holds predictive value for CAD severity and prognosis, further demonstrating a link between stress and unwanted cardiac events.
Collapse
Affiliation(s)
- Dejana Popovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | | | - Tea Djordjevic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | - Dejana Martic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | | | - Neda Milinkovic
- b Faculty of Pharmacy , University of Belgrade , Belgrade , Serbia
| | - Marko Banovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Ratko Lasica
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Milan Petrovic
- a Division of Cardiology , University of Belgrade , Belgrade , Serbia
| | - Marco Guazzi
- d Heart Failure Unit and Cardiopulmonary Laboratory, Cardiology , I.R.C.C.S, Policlinico San Donato University Hospital , Milan , Italy
| | - Ross Arena
- e Department of Physical Therapy, College of Applied Health Sciences , University of Illinois Chicago , Chicago , IL , USA
| |
Collapse
|
46
|
Cattane N, Rossi R, Lanfredi M, Cattaneo A. Borderline personality disorder and childhood trauma: exploring the affected biological systems and mechanisms. BMC Psychiatry 2017; 17:221. [PMID: 28619017 PMCID: PMC5472954 DOI: 10.1186/s12888-017-1383-2] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/06/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND According to several studies, the onset of the Borderline Personality Disorder (BPD) depends on the combination between genetic and environmental factors (GxE), in particular between biological vulnerabilities and the exposure to traumatic experiences during childhood. We have searched for studies reporting possible alterations in several biological processes and brain morphological features in relation to childhood trauma experiences and to BPD. We have also looked for epigenetic mechanisms as they could be mediators of the effects of childhood trauma in BPD vulnerability. DISCUSSION We prove the role of alterations in Hypothalamic-Pituitary-Adrenal (HPA) axis, in neurotrasmission, in the endogenous opioid system and in neuroplasticity in the childhood trauma-associated vulnerability to develop BPD; we also confirm the presence of morphological changes in several BPD brain areas and in particular in those involved in stress response. Not so many studies are available on epigenetic changes in BPD patients, although these mechanisms are widely investigated in relation to stress-related disorders. A better comprehension of the biological and epigenetic mechanisms, affected by childhood trauma and altered in BPD patients, could allow to identify "at high risk" subjects and to prevent or minimize the development of the disease later in life.
Collapse
Affiliation(s)
- Nadia Cattane
- grid.419422.8Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy
| | - Roberta Rossi
- grid.419422.8Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy
| | - Mariangela Lanfredi
- grid.419422.8Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio - Fatebenefratelli, via Pilastroni 4, Brescia, Italy. .,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, King's College London, 125 Coldharbour Lane, London, SE5 9NU, UK. .,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, 125 Coldharbour Lane, London, SE5 9NU, UK.
| |
Collapse
|
47
|
Non-violent and violent forms of childhood abuse in the prediction of suicide attempts: Direct or indirect effects through psychiatric disorders? J Affect Disord 2017; 215:15-22. [PMID: 28292658 DOI: 10.1016/j.jad.2017.03.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 02/27/2017] [Accepted: 03/08/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Childhood abuse is linked to suicide. Potential pathways include the increased risk for the development of psychiatric disorders and the contribution of abuse to suicide capability. The current study compared the effects of childhood non-violent and violent abuse in the prediction of suicide attempts, and examined the potential mediated effects of psychiatric disorders. METHODS Data from the National Comorbidity Surveys were obtained. At baseline, assessments of childhood non-violent abuse (e.g., parental verbal abuse) and violent abuse (e.g., parental physical abuse, relative rape) were obtained. We also assessed for other adverse childhood experiences, baseline suicidal behaviors, and psychiatric disorders. At the ten-year follow-up, we assessed for psychiatric disorders and suicide attempts that had occurred over time. RESULTS Both non-violent and violent abuse predicted attempts, though participants experiencing violent abuse had significantly higher rates. Bootstrapped mediation analyses determined that the influence of non-violent abuse on suicide attempts was indirect, and exerted its influence through the psychiatric disorders that occurred during the ten-year follow-up. LIMITATIONS The study relied on retrospective reports of childhood abuse. Further, we could not clearly determine the temporal order of the psychiatric disorders and suicide attempts occurring over follow-up. CONCLUSION Different mechanisms may underlie the pathway between violent and non-violent abuse and suicide attempts. Verbal abuse may lead to negative cognitive styles and psychiatric disorders associated with suicidality; violent abuse may contribute to the capacity for suicide. Interventions may need to be specifically tailored to meet the distinct needs of individuals who have experienced past childhood abuse.
Collapse
|
48
|
Commons KG, Cholanians AB, Babb JA, Ehlinger DG. The Rodent Forced Swim Test Measures Stress-Coping Strategy, Not Depression-like Behavior. ACS Chem Neurosci 2017; 8:955-960. [PMID: 28287253 PMCID: PMC5518600 DOI: 10.1021/acschemneuro.7b00042] [Citation(s) in RCA: 321] [Impact Index Per Article: 45.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The forced swim test (FST) measures coping strategy to an acute inescapable stress and thus provides unique insight into the neural limb of the stress response. Stress, particularly chronic stress, is a contributing factor to depression in humans and depression is associated with altered response to stress. In addition, drugs that are effective antidepressants in humans typically promote active coping strategy in the FST. As a consequence, passive coping in the FST has become loosely equated with depression and is often referred to as "depression-like" behavior. This terminology oversimplifies complex biology and misrepresents both the utility and limitations of the FST. The FST provides little construct- or face-validity to support an interpretation as "depression-like" behavior. While stress coping and the FST are arguably relevant to depression, there are likely many factors that can influence stress coping strategy. Importantly, there are other neuropsychiatric disorders characterized by altered responses to stress and difficulty in adapting to change. One of these is autism spectrum disorder (ASD), and several mouse genetic models of ASD exhibit altered stress-coping strategies in the FST. Here we review evidence that argues a more thoughtful consideration of the FST, and more precise terminology, would benefit the study of stress and disorders characterized by altered response to stress, which include but are not limited to depression.
Collapse
Affiliation(s)
- Kathryn G. Commons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Aram B. Cholanians
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Jessica A. Babb
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| | - Daniel G. Ehlinger
- Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children’s Hospital and Department of Anesthesia, Harvard Medical School, 300 Longwood Avenue, Boston, Massachusetts 02115, United States
| |
Collapse
|
49
|
Chen H, Wang XT, Bo QG, Zhang DM, Qi ZB, Liu X, Jia CX. Menarche, menstrual problems and suicidal behavior in Chinese adolescents. J Affect Disord 2017; 209:53-58. [PMID: 27886570 DOI: 10.1016/j.jad.2016.11.027] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 10/29/2016] [Accepted: 11/16/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Menarche is the first menstrual cycle. Menstrual problems, such as dysmenorrheal menorrhagia, oligomenorrhea, and irregular cycle are common in female adolescents. This research aims to examine the associations between age at menarche and menstrual problems and suicidal behavior among Chinese female adolescents. METHODS An epidemiological survey of 5831 female adolescents from eight high schools of three counties of Shandong province, China, was conducted. A self-administered paper-and-pencil questionnaire was used to collect information. Logistic regression analyses were used to examine the association between menstruation and suicidality. RESULTS The mean age of the sample was 15.02 (SD=1.44) years. Of the sample, 5,231 (90.0%) had experienced their first menstrual cycle, and 23.2%, 10.4%, and 4.5% of the sample reported having had suicidal ideation, plan and attempt, respectively. In multivariate models, menarche at ≤11 years was associated with increased risk of suicidal ideation (OR=1.41, 95%CI: 1.10-1.81) and menarche at 12 years was associated with suicide plan (OR=1.23, 95%CI: 1.00-1.51). Irregular menstrual cycle was significantly associated with increased risk of suicidal ideation (OR=1.40, 95%CI: 1.05-1.86) and menstrual period less than or equal to 4 days was significantly associated with increased risk of suicide plan (OR=1.32, 95%CI: 1.06-1.66). LIMITATIONS This cross-sectional study cannot establish the causal directions between menstrual problems and suicidality in adolescents. CONCLUSIONS Our study suggests that earlier menarche, irregular menstrual cycle and short menstrual period are associated with suicidal behavior in female adolescents. Further research is warranted to examine the causal relationship between menstrual problems and suicidal behavior in adolescents.
Collapse
Affiliation(s)
- Hua Chen
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
| | - Xin-Ting Wang
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China
| | - Qi-Gui Bo
- Centers for Disease Control and Prevention of Lijin County, Lijin, China
| | - Dao-Ming Zhang
- Centers for Disease Control and Prevention of Yanggu County, Yanggu, China
| | - Zhen-Biao Qi
- Centers for Disease Control and Prevention of Zoucheng County, Zoucheng, China
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China; The University of Tennessee Health Science Center, Memphis, TN, USA
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health & Shandong University Center for Suicide Prevention Research, Jinan, China.
| |
Collapse
|
50
|
de Lima MM, Tobias-Machado M. Suicide in patients with genitourinary malignancies. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28134462 DOI: 10.1111/ecc.12635] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 09/20/2016] [Accepted: 11/20/2016] [Indexed: 12/21/2022]
Abstract
Genitourinary cancers are significant causes of morbidity and mortality around the world. The present review summarises the current literature on suicide and its risk factors among patients with genitourinary cancers. The review was based on relevant articles published in MEDLINE, ProQuest, PsycINFO, Science Direct and Scopus databases. Patients with prostate cancer represented the most important risk group for suicide, among patients with urogenital cancers. Other risk factors are male gender, older age, white race, advanced disease, living alone and co-existing psychological comorbidities. Findings from the review call for a greater caregiver awareness on psychosocial morbidity and suicidality among genitourinary cancer patients pre- and post-treatment and their early identification, adoption of risk-reduction strategies and prompt referral for expert mental health care.
Collapse
Affiliation(s)
- M M de Lima
- Department of Urology, Coronel Mota Hospital, Roraima, Brazil
| | - M Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, São Paulo, UK
| |
Collapse
|