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Chen Y, Han X, Jiang Y, Jiang Y, Huang X, Wang W, Guo L, Xia R, Liao Y, Zhang H, Teopiz KM, McIntyre RS, Fan B, Lu C. Longitudinal Association between Stressful Life Events and Suicidal Ideation in Adults with Major Depression Disorder: The Mediating Effects of Insomnia Symptoms. Behav Sci (Basel) 2024; 14:467. [PMID: 38920799 PMCID: PMC11200868 DOI: 10.3390/bs14060467] [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: 03/15/2024] [Revised: 05/28/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Stressful life events (SLEs) and suicidal ideation (SI) are prevalent in persons with major depression disorder (MDD). Less is known about the underlying role of insomnia symptoms in the association between SLEs and SI. This three-wave prospective cohort study sought to investigate the longitudinal association among SLEs, insomnia symptoms, and SI in persons with MDD. The study population included 511 persons with MDD (mean [SD] age, 28.7 [6.7] years; 67.1% were females). Generalized estimated equations (GEEs) were utilized to explore prospective association among exposure of SLEs, insomnia symptoms, and SI. Additionally, a structural equation model (SEM) was employed to estimate the longitudinal mediating effect of insomnia symptoms in the relationship between SLEs and SI. Our study demonstrated that cumulative SLEs were determined to be longitudinally associated with SI in persons with MDD. We further observed that the association between SLEs and SI was significantly mediated by insomnia symptoms. Clinicians assessing persons with MDD, especially those with the history of SLE, could carefully evaluate and promptly treat insomnia symptoms as part of personalized assessment of their depressive illness, thereby achieving early prevention and intervention for suicidal behaviors in persons with MDD.
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Affiliation(s)
- Ya Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Xue Han
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Yingchen Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Yunbin Jiang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Xinyu Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
| | - Ruirui Xia
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Yuhua Liao
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Huimin Zhang
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Kayla M. Teopiz
- Brain and Cognition Discovery Foundation, Toronto, ON M2J 4A6, Canada
| | - Roger S. McIntyre
- Brain and Cognition Discovery Foundation, Toronto, ON M2J 4A6, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON M2J 4A6, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M2J 4A6, Canada
| | - Beifang Fan
- Department of Psychiatry, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen 518054, China; (X.H.)
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (Y.C.)
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou 510080, China
- Guangdong Engineering Technology Research Center of Nutrition Translation, Guangzhou 510080, China
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Chu Z, Wang X, Cheng Y, Yuan L, Jin M, Lu Y, Shen Z, Xu X. Subcortical neural mechanisms of childhood trauma impacts on personality traits. Asian J Psychiatr 2024; 94:103966. [PMID: 38364748 DOI: 10.1016/j.ajp.2024.103966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/18/2024]
Abstract
This study aims to explore the relationships between childhood trauma (CT), personality traits, and subcortical structures. 171 healthy individuals completed the Childhood Trauma Questionnaire (CTQ), the Neuroticism-Extraversion-Openness Five-Factor Inventory (NEO-FFI), and underwent 3D T1-weighted MRI scans. Linear regression analyses indicated the complex relationship between CT, personality traits, and subcortical gray matter volume (GMV). Mediation analyses revealed that the right hippocampal GMV partially mediated the effects of CT on neuroticism. These findings suggest that CT affects the development of the Big Five personality traits, and alterations in subcortical structures are closely related to this process. Altered GMV in the right hippocampus may be a key neural mechanism for CT-induced neuroticism.
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Affiliation(s)
- Zhaosong Chu
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Xin Wang
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Yuqi Cheng
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Lijin Yuan
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Mengyun Jin
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China
| | - Yi Lu
- Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
| | - Zonglin Shen
- Department of Psychiatry, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, China.
| | - Xiufeng Xu
- Yunnan Province Clinical Research Center for Mental Health, Kunming 650032, China.
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Yu C, Zhang X, Wang Y, Mao F, Cao F. Stress begets stress: The moderating role of childhood adversity in the relationship between job stress and sleep quality among nurses. J Affect Disord 2024; 348:345-352. [PMID: 38171417 DOI: 10.1016/j.jad.2023.12.090] [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: 07/11/2023] [Revised: 12/19/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Nurses exhibit considerable variations in sleep quality and experience high job stress levels. Distal factors, such as childhood adversity, and proximal factors, both influence sleep quality. We investigated the moderating role of childhood adversity with job stress and sleep quality, and whether this aligns with the stress-sensitization or stress-amplification models. METHODS The impact of job stressors' total score and its dimensions on sleep quality was analyzed using traditional linear regression models and the extreme gradient boosting machine learning algorithm. The hierarchical regression examined the moderating role of childhood adversity in the relationship between job stress and sleep quality. An interactive tool was used to visualize the results. RESULTS Among the dimensions of job stress, "time allocation and workload" strongly correlated with sleep quality, followed by "nursing profession and work problems," "patient care issues," "management and interpersonal problems," and "working environment and equipment problems." The moderating role of childhood adversity in the relationship between different dimensions of job stressors (except working environment and equipment problems) and sleep quality aligns with the stress-sensitization model. LIMITATIONS This study was susceptible to recall bias and objective sleep data were unavailable. Cross-sectional study design was used, thus limiting causal inferences. Finally, the moderating effect of childhood adversity on subsequent stress among nurses remains unclear. CONCLUSION Childhood adversity and job stress were integrated into a stress-sensitization model, providing a nuanced and specific examination of sleep quality. Healthcare policymakers should focus on job stress and childhood adversity, improve nurses' sleep quality, and ultimately benefit patient care and outcomes.
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Affiliation(s)
- Cheng Yu
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Xuan Zhang
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Ying Wang
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Fangxiang Mao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhua Xi Road, Jinan, Shandong Province 250012, China
| | - Fenglin Cao
- Department of Health Psychology, School of Nursing and Rehabilitation, Shandong University, No.44 Wenhua Xi Road, Jinan, Shandong Province 250012, China.
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Bertollo AG, Galvan ACL, Dallagnol C, Cortez AD, Ignácio ZM. Early Life Stress and Major Depressive Disorder-An Update on Molecular Mechanisms and Synaptic Impairments. Mol Neurobiol 2024:10.1007/s12035-024-03983-2. [PMID: 38307968 DOI: 10.1007/s12035-024-03983-2] [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: 07/05/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
Early life stress (ELS), characterized as abuse, neglect, and abandonment, can cause several adverse consequences in the lives of affected individuals. ELS experiences can affect an individual's development in variable ways, persisting in the long term and promoting lasting impacts, considering that early exposure to stressors can be biologically incorporated, as prolonged stimulation of stress response systems affects the development of the brain structure and other body systems, increasing the risk of diseases associated with stress and cognitive impairment. This type of stress increases the risk of developing major depressive disorder (MDD) in a severe form that does not respond adequately to traditional antidepressant treatments. Several alterations are studied as mechanisms that relate ELS with MDD, such as epigenetic alterations, neurotransmitters, and neuronal signaling. This review discusses research that brings evidence about the ELS mechanisms involved in synaptic impairments and MDD. The processes involved in epigenetic changes and the HPA axis are highlighted, as well as changes in neurotransmitters and neuronal signaling mechanisms.
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Affiliation(s)
- Amanda Gollo Bertollo
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Agatha Carina Leite Galvan
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Claudia Dallagnol
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Arthur Dellazeri Cortez
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil
| | - Zuleide Maria Ignácio
- Laboratory of Physiology Pharmacology and Psychopathology, Graduate Program in Biomedical Sciences, Federal University of Fronteira Sul, Chapecó, SC, 89815-899, Brazil.
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Su Y, Ye C, Xin Q, Si T. Major depressive disorder with suicidal ideation or behavior in Chinese population: A scoping review of current evidence on disease assessment, burden, treatment and risk factors. J Affect Disord 2023; 340:732-742. [PMID: 37619652 DOI: 10.1016/j.jad.2023.08.106] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 07/28/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Identifying and managing major depressive disorder (MDD) patients with suicidal ideation or behavior (MDSI) is critical for reducing the disease burden. This scoping review aims to map the existing evidence related to MDSI in the Chinese population. METHOD A scoping review was conducted to summarize the published evidence regarding epidemiology or disease burden, evaluation, diagnosis, management, and prognosis of MDSI. The search strategy imposed restriction on English or Chinese publications between 1 January 2011 and 28 February 2022. RESULTS Of the 14,005 identified records, 133 met the eligibility criteria and were included for analysis. The included studies were characterized as high heterogeneity in evaluation of suicidal ideation or behavior. Compared with MDD patients without suicidal ideation or behavior, MDSI patients were more likely to suffer from psychological and somatic symptoms, social function impairment, and lower quality of life. Younger age, female gender, longer disease course, and comorbid psychological or physical symptoms were consistently found to be risk factors of suicidal ideation or behavior. Relevant research gaps remain regarding comprehensive evaluation of standard clinical diagnosis, disease burden, social-cultural risk factors, and effectiveness of interventions targeting MDSI. Studies with large sample size, representative population are warranted to provide high-quality evidence. CONCLUSIONS MDD patients with suicidal ideation or behavior should be prioritized in treatment and resource allocation. Heterogeneity exists in the definition and evaluation of MDSI in different studies. To better inform clinical practice, it is imperative to establish a unified standard for evaluation and diagnosis of suicidal ideation or behavior among MDD population.
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Affiliation(s)
- Yun'Ai Su
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chong Ye
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Qin Xin
- Xi'an Janssen Pharmaceutical Ltd, Beijing, China
| | - Tianmei Si
- Peking University Sixth Hospital, Beijing, China; Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University), Beijing, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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Anderson G. Depression Pathophysiology: Astrocyte Mitochondrial Melatonergic Pathway as Crucial Hub. Int J Mol Sci 2022; 24:ijms24010350. [PMID: 36613794 PMCID: PMC9820523 DOI: 10.3390/ijms24010350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 12/15/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
Major depressive disorder (MDD) is widely accepted as having a heterogenous pathophysiology involving a complex mixture of systemic and CNS processes. A developmental etiology coupled to genetic and epigenetic risk factors as well as lifestyle and social process influences add further to the complexity. Consequently, antidepressant treatment is generally regarded as open to improvement, undoubtedly as a consequence of inappropriately targeted pathophysiological processes. This article reviews the diverse array of pathophysiological processes linked to MDD, and integrates these within a perspective that emphasizes alterations in mitochondrial function, both centrally and systemically. It is proposed that the long-standing association of MDD with suppressed serotonin availability is reflective of the role of serotonin as a precursor for the mitochondrial melatonergic pathway. Astrocytes, and the astrocyte mitochondrial melatonergic pathway, are highlighted as crucial hubs in the integration of the wide array of biological underpinnings of MDD, including gut dysbiosis and permeability, as well as developmental and social stressors, which can act to suppress the capacity of mitochondria to upregulate the melatonergic pathway, with consequences for oxidant-induced changes in patterned microRNAs and subsequent patterned gene responses. This is placed within a development context, including how social processes, such as discrimination, can physiologically regulate a susceptibility to MDD. Future research directions and treatment implications are derived from this.
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Affiliation(s)
- George Anderson
- CRC Scotland & London, Eccleston Square, London SW1V 1PX, UK
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Wesarg C, Van den Akker AL, Oei NY, Wiers RW, Staaks J, Thayer JF, Williams DP, Hoeve M. Childhood adversity and vagal regulation: A systematic review and meta-analysis. Neurosci Biobehav Rev 2022; 143:104920. [DOI: 10.1016/j.neubiorev.2022.104920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/05/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022]
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Hashimoto K. Mental health during the COVID-19 pandemic, impact of childhood trauma in psychiatric disorders, and predictable biomarkers for bipolar disorder. Eur Arch Psychiatry Clin Neurosci 2022; 272:753-755. [PMID: 35751656 PMCID: PMC9243931 DOI: 10.1007/s00406-022-01445-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, 1-8-1 Inohana, Chiba, 260-8670, Japan.
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