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Sims EE, Trattner JD, Garrison SM. Exploring the relationship between depression and delinquency: a sibling comparison design using the NLSY. Front Psychol 2024; 15:1430978. [PMID: 39011290 PMCID: PMC11247016 DOI: 10.3389/fpsyg.2024.1430978] [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: 05/10/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024] Open
Abstract
Relative to the general population, adolescents with psychiatric disorders such as major depression disorder are incarcerated (and reincarcerated) at higher rates. Current research is mixed on whether this association is a cause, consequence, or the product of selection. For example, aggression can lead to more depressive symptoms, yet depression is associated with antisocial behaviors (e.g., delinquency). To better understand the relationship between depression and delinquent behavior, we used the discordant kinship model to examine data from sibling pairs in the National Longitudinal Surveys of Youth 1979, a nationally representative study. By explicitly modeling within- and between-family variance, we reduced the influence of genetic and shared-environmental confounds on our analysis. Our results suggest that the relationship between depression and delinquency is not causal, but rather a product of selection.
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Affiliation(s)
- Emma E. Sims
- Department of Psychology, Wake Forest University, Winston Salem, NC, United States
| | - Jonathan D. Trattner
- Department of Interdisciplinary Studies, Wake Forest University, Winston Salem, NC, United States
| | - S. Mason Garrison
- Department of Psychology, Wake Forest University, Winston Salem, NC, United States
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2
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Moritz S, Scheunemann J, Jelinek L, Penney D, Schmotz S, Hoyer L, Grudzień D, Aleksandrowicz A. Prevalence of body-focused repetitive behaviors in a diverse population sample - rates across age, gender, race and education. Psychol Med 2024; 54:1552-1558. [PMID: 38087951 DOI: 10.1017/s0033291723003392] [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] [Indexed: 05/29/2024]
Abstract
BACKGROUND Prevalence estimates for body-focused repetitive behaviors (BFRBs) such as trichotillomania differ greatly across studies owing to several confounding factors (e.g. different criteria). For the present study, we recruited a diverse online sample to provide estimates for nine subtypes of BFRBs and body-focused repetitive disorders (BFRDs). METHODS The final sample comprised 1481 individuals from the general population. Several precautions were taken to recruit a diverse sample and to exclude participants with low reliability. We matched participants on gender, race, education and age range to allow unbiased interpretation. RESULTS While almost all participants acknowledged at least one BFRB in their lifetime (97.1%), the rate for BFRDs was 24%. Nail biting (11.4%), dermatophagia (8.7%), skin picking (8.2%), and lip-cheek biting (7.9%) were the most frequent BFRDs. Whereas men showed more lifetime BFRBs, the rate of BFRDs was higher in women than in men. Rates of BFRDs were low in older participants, especially after the age of 40. Overall, BFRBs and BFRDs were more prevalent in White than in non-White individuals. Education did not show a strong association with BFRB/BFRDs. DISCUSSION BFRBs are ubiquitous. More severe forms, BFRDs, manifest in approximately one out of four people. In view of the often-irreversible somatic sequelae (e.g. scars) BFRBs/BFRDs deserve greater diagnostic and therapeutic attention by clinicians working in both psychology/psychiatry and somatic medicine (especially dermatology and dentistry).
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Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jakob Scheunemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lena Jelinek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Danielle Penney
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Ouest-de-l'Île-de-Montréal, Douglas Mental Health University Institute, Montréal, Canada
| | - Stella Schmotz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Luca Hoyer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominik Grudzień
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Adrianna Aleksandrowicz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
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3
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Leerssen J, Aghajani M, Bresser T, Rösler L, Winkler AM, Foster-Dingley JC, Van Someren EJW. Cognitive, Behavioral, and Circadian Rhythm Interventions for Insomnia Alter Emotional Brain Responses. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:60-69. [PMID: 36958474 DOI: 10.1016/j.bpsc.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND The highest risk of depression is conveyed by insomnia. This risk can be mitigated by sleep interventions. Understanding brain mechanisms underlying increased emotional stability following insomnia treatment could provide insight relevant to the prevention of depression. Here, we investigated how different sleep interventions alter emotion-related brain activity in people with insomnia at high risk of developing depression. METHODS Functional magnetic resonance imaging was used to assess how the amygdala response to emotional stimuli (negative facial expression) in 122 people with insomnia disorder differed from 36 control subjects and how the amygdala response changed after 6 weeks of either no treatment or internet-based circadian rhythm support (CRS), cognitive behavioral therapy for insomnia (CBT-I), or their combination (CBT-I+CRS). Effects on depression, insomnia and anxiety severity were followed up for 1 year. RESULTS Only combined treatment (CBT-I+CRS) significantly increased the amygdala response, compared with no treatment, CBT-I, and CRS. Individual differences in the degree of response enhancement were associated with improvement of insomnia symptoms directly after treatment (r = -0.41, p = .021). Moreover, exclusively CBT-I+CRS enhanced responsiveness of the left insula, which occurred in proportion to the reduction in depressive symptom severity (r = -0.37, p = .042). CONCLUSIONS This functional magnetic resonance imaging study on insomnia treatment, the largest to date, shows that a combined cognitive, behavioral, and circadian intervention enhances emotional brain responsiveness and might improve resilience in patients with insomnia who are at high risk of developing depression.
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Affiliation(s)
- Jeanne Leerssen
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands.
| | - Moji Aghajani
- Section Forensic Family and Youth Care, Institute of Education and Child Studies, Leiden University, Leiden, the Netherlands; Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, VU University, Amsterdam, the Netherlands
| | - Tom Bresser
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands; Department of Clinical Genetics, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Lara Rösler
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Anderson M Winkler
- National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Jessica C Foster-Dingley
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, VU University, Amsterdam, the Netherlands
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4
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Altwaijri Y, Kazdin AE, Al-Subaie A, Al-Habeeb A, Hyder S, Bilal L, Naseem MT, De Vol E. Lifetime prevalence and treatment of mental disorders in Saudi youth and adolescents. Sci Rep 2023; 13:6186. [PMID: 37061556 PMCID: PMC10105730 DOI: 10.1038/s41598-023-33005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15-30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.
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Affiliation(s)
- Yasmin Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia.
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Health and Meaningful Dialogue (HAMD) Centre, Manchester, UK
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Edward De Vol
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
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van Loo HM, Beijers L, Wieling M, de Jong TR, Schoevers RA, Kendler KS. Prevalence of internalizing disorders, symptoms, and traits across age using advanced nonlinear models. Psychol Med 2023; 53:78-87. [PMID: 33849670 PMCID: PMC9874996 DOI: 10.1017/s0033291721001148] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 02/02/2021] [Accepted: 03/12/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Most epidemiological studies show a decrease of internalizing disorders at older ages, but it is unclear how the prevalence exactly changes with age, and whether there are different patterns for internalizing symptoms and traits, and for men and women. This study investigates the impact of age and sex on the point prevalence across different mood and anxiety disorders, internalizing symptoms, and neuroticism. METHODS We used cross-sectional data on 146 315 subjects, aged 18-80 years, from the Lifelines Cohort Study, a Dutch general population sample. Between 2012 and 2016, five current internalizing disorders - major depression, dysthymia, generalized anxiety disorder, social phobia, and panic disorder - were assessed according to DSM-IV criteria. Depressive symptoms, anxiety symptoms, neuroticism, and negative affect (NA) were also measured. Generalized additive models were used to identify nonlinear patterns across age, and to investigate sex differences. RESULTS The point prevalence of internalizing disorders generally increased between the ages of 18 and 30 years, stabilized between 30 and 50, and decreased after age 50. The patterns of internalizing symptoms and traits were different. NA and neuroticism gradually decreased after age 18. Women reported more internalizing disorders than men, but the relative difference remained stable across age (relative risk ~1.7). CONCLUSIONS The point prevalence of internalizing disorders was typically highest between age 30 and 50, but there were differences between the disorders, which could indicate differences in etiology. The relative gap between the sexes remained similar across age, suggesting that changes in sex hormones around the menopause do not significantly influence women's risk of internalizing disorders.
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Affiliation(s)
- Hanna M. van Loo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lian Beijers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Martijn Wieling
- Department of Information Science, University of Groningen, Groningen, The Netherlands
| | | | - Robert A. Schoevers
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Research School of Behavioural and Cognitive Neurosciences (BCN), Groningen, The Netherlands
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Machlitt-Northen S, Keers R, Munroe PB, Howard DM, Pluess M. Polygenic risk scores for schizophrenia and major depression are associated with socio-economic indicators of adversity in two British community samples. Transl Psychiatry 2022; 12:477. [PMID: 36376270 PMCID: PMC9663827 DOI: 10.1038/s41398-022-02247-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
Schizophrenia (SCZ) and major depressive disorder (MDD) are complex psychiatric disorders which contribute substantially to the global burden of disease. Both psychopathologies are heritable with some genetic overlap between them. Importantly, SCZ and MDD have also been found to be associated with environmental risk factors. However, rather than being independent of genetic influences, exposure to environmental risk factors may be under genetic control, known as gene-environment correlation (rGE). In this study we investigated rGE in relation to polygenic risk scores for SCZ and MDD in adults, derived from large genome-wide association studies, across two different British community samples: Understanding Society (USoc) and the National Child Development Study (NCDS). We tested whether established environmental risk factors for SCZ and/or MDD are correlated with polygenic scores in adults and whether these associations differ between the two disorders and cohorts. Findings partially overlapped between disorders and cohorts. In NCDS, we identified a significant correlation between the genetic risk for MDD and an indicator of low socio-economic status, but no significant findings emerged for SCZ. In USoc, we replicated associations between indicators of low socio-economic status and the genetic propensity for MDD. In addition, we identified associations between the genetic susceptibility for SCZ and being single or divorced. Results across both studies provide further evidence that the genetic risk for SCZ and MDD were associated with common environmental risk factors, specifically MDD's association with lower socio-economic status.
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Affiliation(s)
- Sandra Machlitt-Northen
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Robert Keers
- grid.4868.20000 0001 2171 1133Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK
| | - Patricia B. Munroe
- grid.4868.20000 0001 2171 1133Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London, UK
| | - David M. Howard
- grid.13097.3c0000 0001 2322 6764Social, Genetic and Developmental Psychiatry Centre, King’s College London, London, UK ,grid.4305.20000 0004 1936 7988Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Michael Pluess
- Department of Biological and Experimental Psychology, Queen Mary University of London, London, UK.
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7
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Leon M, Woo CC. Olfactory loss is a predisposing factor for depression, while olfactory enrichment is an effective treatment for depression. Front Neurosci 2022; 16:1013363. [PMID: 36248633 PMCID: PMC9558899 DOI: 10.3389/fnins.2022.1013363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 09/08/2022] [Indexed: 11/13/2022] Open
Abstract
The loss of olfactory stimulation correlates well with at least 68 widely differing neurological disorders, including depression, and we raise the possibility that this relationship may be causal. That is, it seems possible that olfactory loss makes the brain vulnerable to expressing the symptoms of these neurological disorders, while daily olfactory enrichment may decrease the risk of expressing these symptoms. This situation resembles the cognitive reserve that is thought to protect people with Alzheimer’s neuropathology from expressing the functional deficit in memory through the cumulative effect of intellectual stimulation. These relationships also resemble the functional response of animal models of human neurological disorders to environmental enrichment, wherein the animals continue to have the induced neuropathology, but do not express the symptoms as they do in a standard environment with restricted sensorimotor stimulation.
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Affiliation(s)
- Michael Leon
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
- Center for the Neurobiology of Learning and Memory, Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
- *Correspondence: Michael Leon,
| | - Cynthia C. Woo
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
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Lokman JC, Bockting CL. Pathways to depressive and anxiety disorders during and after the COVID-19 pandemic. Lancet Psychiatry 2022; 9:531-533. [PMID: 35717953 PMCID: PMC9212978 DOI: 10.1016/s2215-0366(22)00152-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 11/29/2022]
Affiliation(s)
- J C Lokman
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - C L Bockting
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
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9
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Machlitt-Northen S, Keers R, Munroe PB, Howard DM, Pluess M. Gene–Environment Correlation over Time: A Longitudinal Analysis of Polygenic Risk Scores for Schizophrenia and Major Depression in Three British Cohorts Studies. Genes (Basel) 2022; 13:genes13071136. [PMID: 35885920 PMCID: PMC9320197 DOI: 10.3390/genes13071136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Research suggests that both genetic and environmental risk factors are involved in the aetiology of schizophrenia (SCZ) and major depressive disorder (MDD). Importantly, environmental and genetic risk factors are often related as evidenced in gene–environment correlation (rGE), which describes the observation that genetic and environmental factors are associated with each other. It is understood that rGE gets stronger over time as individuals select their environments more actively based on their genetic propensities. However, little is known whether rGEs remain stable over time or change across different development periods. Using data from three British longitudinal cohorts, we investigated whether rGE patterns of polygenic risk scores (PRS) for SCZ and MDD changed over time across childhood and adulthood, as well as across both from birth to age 55 and whether results differed between SCZ and MDD. Overall, the majority of rGEs remained stable across the investigated development periods. Furthermore, the few detected rGE changes which did differ between SCZ and MDD, could not be explained by the confounding of clinical cases and are therefore likely the result of actual changes in environmental and cultural risk factors with genetic susceptibility to SCZ and MDD likely playing a less significant role.
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Affiliation(s)
- Sandra Machlitt-Northen
- Department of Biological and Experimental Psychology, Queen Mary University of London, London E1 4NS, UK;
| | - Robert Keers
- Department of Biological and Experimental Psychology, Queen Mary University of London, London E1 4NS, UK;
| | - Patricia B. Munroe
- Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK;
| | - David M. Howard
- Social, Genetic and Developmental Psychiatry Centre, King’s College London, London SE5 8AF, UK;
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh EH10 5HF, UK
| | - Michael Pluess
- Department of Biological and Experimental Psychology, Queen Mary University of London, London E1 4NS, UK;
- Correspondence: ; Tel.: +44-(0)207-882-8004
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Yildirim M, Gaynes BN, Keskinocak P, Pence BW, Swann J. DIP: Natural history model for major depression with incidence and prevalence. J Affect Disord 2022; 296:498-505. [PMID: 34624435 DOI: 10.1016/j.jad.2021.09.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 08/11/2021] [Accepted: 09/26/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Major depression is a treatable disease, and untreated depression can lead to serious health complications. Therefore, prevention, early identification, and treatment efforts are essential. Natural history models can be utilized to make informed decisions about interventions and treatments of major depression. METHODS We propose a natural history model of major depression. We use steady-state analysis to study the discrete-time Markov chain model. For this purpose, we solved the system of linear equations and tested the parameter and transition probabilities empirically. RESULTS We showed that bias in parameters might collectively cause a significant mismatch in a model. If incidence is correct, then lifetime prevalence is 33.2% for females and 20.5% for males, which is higher than reported values. If prevalence is correct, then incidence is .0008 for females and .00065 for males, which is lower than reported values. The model can achieve feasibility if incidence is at low levels and recall bias of the lifetime prevalence is quantified to be 31.9% for females and 16.3% for males. LIMITATIONS This model is limited to major depression, and patients who have other types of depression are assumed healthy. We assume that transition probabilities (except incidence rates) are correct. CONCLUSION We constructed a preliminary model for the natural history of major depression. We determined the lifetime prevalences are underestimated and the average incidence rates may be underestimated for males. We conclude that recall bias needs to be accounted for in modeling or burden estimates, where the recall bias should increase with age.
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Affiliation(s)
- Melike Yildirim
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Pinar Keskinocak
- School of Industrial and Systems Engineering and Center for Health and Humanitarian Systems, Georgia Institute of Technology, Atlanta, Georgia, USA; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Brian W Pence
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julie Swann
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina, USA.
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11
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Pena-Gralle APB, Talbot D, Trudel X, Aubé K, Lesage A, Lauzier S, Milot A, Brisson C. Validation of case definitions of depression derived from administrative data against the CIDI-SF as reference standard: results from the PROspective Québec (PROQ) study. BMC Psychiatry 2021; 21:491. [PMID: 34620134 PMCID: PMC8496029 DOI: 10.1186/s12888-021-03501-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 09/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Administrative data have several advantages over questionnaire and interview data to identify cases of depression: they are usually inexpensive, available for a long period of time and are less subject to recall bias and differential classification errors. However, the validity of administrative data in the correct identification of depression has not yet been studied in general populations. The present study aimed to 1) evaluate the sensitivity and specificity of administrative cases of depression using the validated Composite International Diagnostic Interview - Short Form (CIDI-SF) as reference standard and 2) compare the known-groups validity between administrative and CIDI-SF cases of depression. METHODS The 5487 participants seen at the last wave (2015-2018) of the PROQ cohort had CIDI-SF questionnaire data linked to hospitalization and medical reimbursement data provided by the provincial universal healthcare provider and coded using the International Classification of Disease. We analyzed the sensitivity and specificity of several case definitions of depression from this administrative data. Their association with known predictors of depression was estimated using robust Poisson regression models. RESULTS Administrative cases of depression showed high specificity (≥ 96%), low sensitivity (19-32%), and rather low agreement (Cohen's kappa of 0.21-0.25) compared with the CIDI-SF. These results were consistent over strata of sex, age and education level and with varying case definitions. In known-groups analysis, the administrative cases of depression were comparable to that of CIDI-SF cases (RR for sex: 1.80 vs 2.03 respectively, age: 1.53 vs 1.40, education: 1.52 vs 1.28, psychological distress: 2.21 vs 2.65). CONCLUSION The results obtained in this large sample of a general population suggest that the dimensions of depression captured by administrative data and by the CIDI-SF are partially distinct. However, their known-groups validity in relation to risk factors for depression was similar to that of CIDI-SF cases. We suggest that neither of these data sources is superior to the other in the context of large epidemiological studies aiming to identify and quantify risk factors for depression.
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Affiliation(s)
- Ana Paula Bruno Pena-Gralle
- CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC, Canada. .,Faculty of Medicine, Laval University, Québec, QC, Canada.
| | - Denis Talbot
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Xavier Trudel
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Karine Aubé
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Alain Lesage
- grid.14848.310000 0001 2292 3357Département de Psychiatrie et d’addictologie, Université de Montréal, Montréal, Canada
| | - Sophie Lauzier
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Pharmacy, Laval University, Québec, QC Canada
| | - Alain Milot
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada
| | - Chantal Brisson
- grid.411081.d0000 0000 9471 1794CHU de Québec Research Center, Population Health and Optimal Health Practices Unit, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Faculty of Medicine, Laval University, Québec, QC Canada ,grid.23856.3a0000 0004 1936 8390Centre de recherche sur les soins et les services de première ligne de l’Université Laval, Québec, QC Canada
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Goodman M, Wangamati SA, Maranga FKN, Gitari S, Seidel S, Keiser P. Childhood Experiences and Intimate Partner Violence Among Kenyan Males: Mediation by Self-Esteem and Impulsivity. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:9035-9059. [PMID: 31339427 PMCID: PMC9374165 DOI: 10.1177/0886260519862278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
This study evaluates associations between childhood social environments and current intimate partner conflict tactics in early adulthood. The subsample for this study (n = 251 men) were participants in a larger community-based study of men's mental and behavioral health in semirural Kenya. A survey questionnaire was administered by trained interviewers, including validated recall measures from childhood, collective self-esteem and impulsivity, and the conflict tactics scale short form. Analyses utilized regression and mediation methods. The recall measures evaluated the degree of relational warmth and safety recalled from early childhood and forms of abuse, neglect and dysfunction present in the childhood home. Collective self-esteem assessed the perceived value of one's social groups and one's value as a member of these groups. Impulsivity measured the propensity to act without thinking. The conflict tactics scale evaluates the presence and frequency of specific behaviors following intimate partner conflict, which lead to two factors-negotiation-based tactics and violence tactics. More early memories of relational warmth, responsiveness, and safety during childhood predict fewer violent intimate conflict tactics. More adverse childhood experiences predict more violent conflict tactics and fewer negotiation-based conflict tactics. Self-esteem and impulsivity mediated associations between recalled childhood experiences and conflict tactics. Further research is required to explore other predisposing factors, psychological processes, and cultural and social norms surrounding the use of violent and nonviolent intimate partner conflict resolution by young men in Sub-Saharan Africa. Violence prevention strategies and policies should explicitly link intimate partner violence prevention with prevention of violence against boys. Interventions should recognize men who perpetrate intimate partner violence are more likely victims of violent childhoods than men who do not perpetrate intimate partner violence. Promoting collective self-esteem and reducing impulsivity among young men may reduce violence against women.
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Affiliation(s)
- Michael Goodman
- University of Texas Medical Branch, Galveston, TX, USA
- Sodzo International, Houston, TX, USA
| | | | | | | | | | - Philip Keiser
- University of Texas Medical Branch, Galveston, TX, USA
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Ritter C, Buchmann A, Müller ST, Hersberger M, Haynes M, Ghisleni C, Tuura R, Hasler G. Cerebral perfusion in depression: Relationship to sex, dehydroepiandrosterone sulfate and depression severity. Neuroimage Clin 2021; 32:102840. [PMID: 34628302 PMCID: PMC8515484 DOI: 10.1016/j.nicl.2021.102840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading cause of disease burden and shows a marked sexual dimorphism. Previous studies reported changes in cerebral perfusion in MDD, an association between perfusion and dehydroepiandrosterone sulfate (DHEAS) levels, and large sex differences in perfusion. This study examines whether perfusion and DHEAS might mediate the link between sex and depressive symptoms in a large, unmedicated community sample. METHODS The sample included 203 healthy volunteers and 79 individuals with past or current MDD. Depression severity was assessed with the Hamilton Depression Scale (HAM-D) and Montgomery-Asberg Depression Rating Scale (MADRS). 3 T MRI perfusion data were collected with a pseudocontinuous arterial spin labelling sequence and DHEAS was measured in serum by LC-MS/MS. RESULTS Large sex differences in perfusion were observed (p < 0.001). Perfusion was negatively correlated with DHEAS (r = -0.23, p < 0.01, n = 250) and with depression severity (HAM-D: r = -0.17, p = 0.01, n = 242; partial Spearman correlation, controlling for age and sex), but not with anxiety. A significant sex*perfusion interaction on depression severity was observed. In women, perfusion showed more pronounced negative correlations with depressive symptoms, with absent or, in the case of the MADRS, opposite effects observed in men. A mediation analysis identified DHEAS and perfusion as mediating variables influencing the link between sex and the HAM-D score. CONCLUSION Perfusion was linked to depression severity, with the strongest effects observed in women. Perfusion and the neurosteroid DHEAS appear to mediate the link between sex and HAM-D scores, suggesting that inter-individual differences in perfusion and DHEAS levels may contribute to the sexual dimorphism in depression.
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Affiliation(s)
- Christopher Ritter
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland.
| | - Andreas Buchmann
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland; Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland; Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Sabrina Theresia Müller
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Martin Hersberger
- Division of Clinical Chemistry and Biochemistry, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Melanie Haynes
- Psychiatric University Hospital, University of Bern, Bolligenstrasse 111, 3000 Bern 60, Switzerland
| | - Carmen Ghisleni
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Ruth Tuura
- Center of MR-Research, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Gregor Hasler
- Unit of Psychiatry Research, University of Fribourg, Chemin du Cardinal-Journet 3, 1752 Villars-sur-Glâne, Fribourg, Switzerland
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Tillage RP, Foster SL, Lustberg D, Liles LC, McCann KE, Weinshenker D. Co-released norepinephrine and galanin act on different timescales to promote stress-induced anxiety-like behavior. Neuropsychopharmacology 2021; 46:1535-1543. [PMID: 33911187 PMCID: PMC8208976 DOI: 10.1038/s41386-021-01011-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 02/02/2023]
Abstract
Both the noradrenergic and galaninergic systems have been implicated in stress-related neuropsychiatric disorders, and these two neuromodulators are co-released from the stress-responsive locus coeruleus (LC); however, the individual contributions of LC-derived norepinephrine (NE) and galanin to behavioral stress responses are unclear. Here we aimed to disentangle the functional roles of co-released NE and galanin in stress-induced behavior. We used foot shock, optogenetics, and behavioral pharmacology in wild-type (WT) mice and mice lacking either NE (Dbh-/-) or galanin (GalcKO-Dbh) specifically in noradrenergic neurons to isolate the roles of these co-transmitters in regulating anxiety-like behavior in the elevated zero maze (EZM) either immediately or 24 h following stress. Foot shock and optogenetic LC stimulation produced immediate anxiety-like behavior in WT mice, and the effects of foot shock persisted for 24 h. NE-deficient mice were resistant to the anxiogenic effects of acute stress and optogenetic LC stimulation, while mice lacking noradrenergic-derived galanin displayed typical increases in anxiety-like behavior. However, when tested 24 h after foot shock, both Dbh-/- and GalcKO-Dbh mice lacked normal expression of anxiety-like behavior. Pharmacological rescue of NE, but not galanin, in knockout mice during EZM testing was anxiogenic. In contrast, restoring galanin, but not NE, signaling during foot shock normalized stress-induced anxiety-like behavior 24 h later. These results indicate that NE and noradrenergic-derived galanin play complementary, but distinguishable roles in behavioral responses to stress. NE is required for the expression of acute stress-induced anxiety, while noradrenergic-derived galanin mediates the development of more persistent responses following a stressor.
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Affiliation(s)
- Rachel P. Tillage
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University, Atlanta, GA USA
| | - Stephanie L. Foster
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University, Atlanta, GA USA
| | - Daniel Lustberg
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University, Atlanta, GA USA
| | - L. Cameron Liles
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University, Atlanta, GA USA
| | - Katharine E. McCann
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University, Atlanta, GA USA
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Price L, Briley J, Haltiwanger S, Hitching R. A meta-analysis of cranial electrotherapy stimulation in the treatment of depression. J Psychiatr Res 2021; 135:119-134. [PMID: 33477056 DOI: 10.1016/j.jpsychires.2020.12.043] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Depression rates have reached historic highs, with 49% of Americans reporting unabating symptoms and signs of depression, representing a 12% increase compared to the same time in 2019. With depression as a moderating factor for suicide, the need for efficacious treatments for depression has never been more pronounced. Although the armamentarium of the psychiatrist seems impressive having multiple medications and psychotherapy options, with guidelines for combination and augmentation treatments; many patients do not improve or are not suitable candidates for the usual, customary and reasonable (UCR) depression treatments. The use of various forms of brain stimulation technology as a complementary or alternative treatment for depression is growing and is expected to be part of the armamentarium of most psychiatrists by 2030. One form of brain stimulation, available in a phone sized prescription device, is cranial electrical stimulation (CES) which has been used as a treatment for depression since the 1970s. We have conducted two meta-analyses of CES research for depression separating randomized controlled trials (N = 5) from non-randomized studies on interventions (N = 12). For the double-blind RCTs 100 μA was used for 1 hour per day as 100 μA is a subsensory level of current so identical sham treatment devices could be used. METHODS Our literature review followed Cooper's Taxonomy of Literature Reviews that is appropriate for the behavioral and physical sciences and the PRISMA reporting guidelines. The evaluation of strengths and limitations of the research studies included in this report adheres to recommended published guidelines in the Cochrane Handbook for Systematic Reviews of Interventions, and in the Handbook of Research Synthesis and Meta-Analysis. We used the Cohen's d effect size summary metric in all analyses. Homogeneity of effect sizes within the fixed and random effects models are reported. Meta-analyses were performed using the Compressive Meta-Analysis, version 3 program. RESULTS The 5 RCTs represent a combined N of 242 and the 12 NRSIs represent 16 data sets with a combined N of 1173 for total of 1415 subjects across 17 studies. There were male and female subjects, from adolescents to 60 years old. The average effect for the 5 RCTs was calculated as d = -0.69 (i.e., the mean depression level at posttest for the active group was -0.69 standard deviations lower than the mean depression level for the sham group), a medium effect. The additional 12 NRSI studies analyzed show a small effect of d = -0.43 in favor of the active treatment group. CONCLUSION We conclude that CES has a small to medium significant effect in symptoms of depression across moderate to severe patients in civilian, military, veterans, advanced cancer and pediatric populations.
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Affiliation(s)
- Larry Price
- Methodology, Measurement & Statistical Analysis, Office of Research and Sponsored Programs, San Marcos, TX, USA; Psychometrics & Statistics, Texas State University, USA
| | - Josh Briley
- Electromedical Products International, Inc., Mineral Wells, TX, USA.
| | | | - Rita Hitching
- Electromedical Products International, Inc., Mineral Wells, TX, USA
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Brain tissue properties link cardio-vascular risk factors, mood and cognitive performance in the CoLaus|PsyCoLaus epidemiological cohort. Neurobiol Aging 2021; 102:50-63. [PMID: 33765431 DOI: 10.1016/j.neurobiolaging.2021.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/31/2021] [Accepted: 02/04/2021] [Indexed: 01/15/2023]
Abstract
Given the controversy about the impact of modifiable risk factors on mood and cognition in ageing, we sought to investigate the associations between cardio-vascular risk, mental health, cognitive performance and brain anatomy in mid- to old age. We analyzed a set of risk factors together with multi-parameter magnetic resonance imaging (MRI) in the CoLaus|PsyCoLaus cohort (n > 1200). Cardio-vascular risk was associated with differences in brain tissue properties - myelin, free tissue water, iron content - and regional brain volumes that we interpret in the context of micro-vascular hypoxic lesions and neurodegeneration. The interaction between clinical subtypes of major depressive disorder and cardio-vascular risk factors showed differential associations with brain structure depending on individuals' lifetime trajectory. There was a negative correlation between melancholic depression, anxiety and MRI markers of myelin and iron content in the hippocampus and anterior cingulate. Verbal memory and verbal fluency performance were positively correlated with left amygdala volumes. The concomitant analysis of brain morphometry and tissue properties allowed for a neuro-biological interpretation of the link between modifiable risk factors and brain health.
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Benschop L, Poppa T, Medani T, Shahabi H, Baeken C, Leahy RM, Pizzagalli DA, Vanderhasselt MA. Electrophysiological scarring in remitted depressed patients: Elevated EEG functional connectivity between the posterior cingulate cortex and the subgenual prefrontal cortex as a neural marker for rumination. J Affect Disord 2021; 281:493-501. [PMID: 33385828 DOI: 10.1016/j.jad.2020.12.081] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Prior resting state fMRI studies have revealed that elevated connectivity between the default mode network (DMN) and subgenual prefrontal cortex (sgPFC) connectivity may underly maladaptive rumination, which is a major risk factor for depression. To further evaluate such relationship, we investigated whether posterior regions of the DMN, showed elevated connectivity with the sgPFC in remitted depressed patients (rMDD) and whether this connectivity was related to maladaptive rumination. METHODS We examined whether rMDD (N = 20) had elevated EEG posterior DMN - sgPFC functional connectivity when compared to age and sex matched healthy controls (N = 17), and whether this posterior DMN - sgPFC connectivity positively correlated with rumination. Using minimum norm as the source estimation method, we extracted current density maps from six regions of interest (ROIs) within the posterior DMN. EEG source-space functional connectivity was calculated using the Amplitude Envelope Correlation method. RESULTS Relative to controls, rMDD showed increased posterior cingulate cortex (PCC) - sgPFC connectivity in the beta-3 (25-30 Hz) band. As hypothesized, PCC - sgPFC connectivity was positively associated with rumination for rMDD, even after controlling for depression and anxiety. LIMITATIONS The absence of an MDD patient group and the relatively small sample size can limit the generalizability of the results. CONCLUSIONS EEG resting state PCC - sgPFC functional connectivity is significantly elevated in rMDD and is associated with rumination, suggesting that EEG PCC - sgPFC connectivity may be useful as a neural marker to identify individuals at risk for depression.
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Affiliation(s)
- Lars Benschop
- Ghent University, Department of Psychiatry and Medical Psychology, Corneel Heymanslaan 10, 9000 Ghent Belgium.
| | - Tasha Poppa
- Ghent University, Department of Psychiatry and Medical Psychology, Corneel Heymanslaan 10, 9000 Ghent Belgium
| | | | | | - Chris Baeken
- Ghent University, Department of Psychiatry and Medical Psychology, Corneel Heymanslaan 10, 9000 Ghent Belgium; Free University of Brussels; Eindhoven University of Technology
| | | | | | - Marie-Anne Vanderhasselt
- Ghent University, Department of Psychiatry and Medical Psychology, Corneel Heymanslaan 10, 9000 Ghent Belgium
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18
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Erim DO. Cost-Effectiveness of Providing the Depression Care for People With Cancer Program to Patients With Prostate Cancer in the United States. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:216-226. [PMID: 33518028 DOI: 10.1016/j.jval.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 08/25/2020] [Accepted: 09/09/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The Depression Care for People with Cancer program (DCPC) is a cost-effective depression care model for UK patients with cancer. However, DCPC's cost-effectiveness in the United States is unknown, particularly for patients with prostate cancer in the United States. This study evaluates the health and economic impact of providing DCPC to patients with prostate cancer. METHODS DCPC was compared with usual care in a mathematical model that simulates depression and its outcomes in a hypothetical cohort of US patients with prostate cancer. DCPC was modeled as a sequential combination of universal depression screening, post-screening evaluations, and first-line combination therapy. Primary outcomes were lifetime direct costs of depression care, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Secondary outcomes included life expectancy, number of depression-free months and lifetime depressive episodes, duration of depressive episodes, cumulative incidence of depression, lifetime depression diagnoses/misdiagnoses, and the cumulative incidence of maintenance therapy for depression. Sensitivity analyses were used to examine uncertainty. RESULTS In the base case, DCPC dominated usual care by offering 0.11 more QALYs for $2500 less per patient (from averted misdiagnoses). DCPC also offered 5 extra depression-free months, shorter depressive episodes, and a lower chance of maintenance therapy. DCPC's trade-offs were a higher cumulative incidence of depression and more lifetime depressive episodes. Life expectancy was identical under usual care and DCPC. Sensitivity analyses indicate that DCPC was almost always preferable to usual care. CONCLUSION Compared with usual care, DCPC may offer more value to US patients with prostate cancer. DCPC should be considered for inclusion in prostate cancer survivorship care guidelines.
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Roy TC, Faller TN, Richardson MD, Taylor KM. Characterization of Limited Duty Neuromusculoskeletal Injuries and Return to Duty Times in the U.S. Army During 2017-2018. Mil Med 2021; 187:e368-e376. [PMID: 33420792 DOI: 10.1093/milmed/usaa392] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/03/2020] [Accepted: 01/04/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION Neuromusculoskeletal injuries (MSKI) are the leading cause of medical encounters, lost or limited duty days, medical evacuations, and disability in the U.S. Army. In the U.S. Army, objective MSKI incidence rate metrics can be determined through medical encounter data (M2SKIs) with International Classification of Diseases (ICD) 9 and ICD 10 codes or through documented limited duty profiles (LDPs) documenting time-loss MSKI (TLMSKI). The purpose of the current study was to characterize the population incidence of TLMSKIs among U.S. Army soldiers. MATERIALS AND METHODS This study was approved by the Medical Research and Development Command's Institutional Review Board. This was a retrospective population-level study. The U.S. Army's eProfile system was utilized to characterize all LDPs issued during 2017-2018 and to describe the body regions injured and activities associated with these TLMSKIs. RESULTS The incidence rate of TLMSKIs was found to be 44 and 40 TLMSKI/100 soldier-years for 2017 and 2018, respectively, which is lower than previously published incidence rates using MSKI receiving medical care. Approximately one quarter of the total active duty Army population in 2017 and 2018 recorded limited duty injuries, where those to the ankle/foot region resulted in the most LDPs and those to the knee resulted in the most lost duty days. The majority of all TLMSKIs were associated with fitness training-related activities. CONCLUSION This descriptive study is the first to present the U.S. Army population rates for MSKIs that result in LDPs, representing key time losses when soldiers cannot participate in their military occupational and physical training tasks. This study utilizes the LDP system to calculate limited duty days instead of attempting to estimate this information from other means. The eProfile system is limited in that it combines body regions such as ankle/foot and does not allow isolation of ankle or foot independently. It is recommended that research and training programs target the identification, development, and validation of effective and scaleable strategies to maximize performance without severely reducing combat effectiveness because of training TLMSKIs.
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Affiliation(s)
- Tanja C Roy
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Theresa N Faller
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Melissa D Richardson
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
| | - Kathryn M Taylor
- Military Performance Division, U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760, USA
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Adenylyl Cyclase (AC) Mediates the Antidepressant-Like Effects of Tropisetron on a Mouse Model of Maternal Separation Stress. DEPRESSION RESEARCH AND TREATMENT 2021; 2021:5586119. [PMID: 33976935 PMCID: PMC8084677 DOI: 10.1155/2021/5586119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 01/02/2023]
Abstract
The adenylyl cyclase (AC) pathway is involved in the pathophysiology of depression. Finding new antidepressants with high medicinal properties and low side effects is warranted. Therefore, this study was designed to determine the antidepressant-like effect of tropisetron on a maternal separation (MS) model in mice, considering the possible role of AC. NMRI male mice were divided into eleven groups. The control group was treated with saline and MS groups were treated with saline, tropisetron (a 5-HT3 receptor antagonist) at doses of 1, 3, and 5 mg/kg; forskolin (an activator of AC) at doses of 5, 10, and 25 mg/kg; a subeffective dose of forskolin with a subeffective dose of tropisetron; and an effective dose of tropisetron plus an effective dose of NB001 (3 mg/kg) (an AC inhibitor). After treatment, animals were subjected to behavioral tests including the forced swimming test (FST), splash test, and open field test (OFT). We showed that MS caused depressive-like behaviors determined as an increase in the immobility time in the forced swimming test (FST) and decreased grooming time in the splash test. Our results showed that administration of tropisetron, as well as forskolin, mitigated the depressive-like behaviors in MS mice. We found that coadministration of a subeffective dose of tropisetron plus a subeffective dose of forskolin potentiated the antidepressant-like effect of tropisetron. However, coadministration of an effective dose of NB001 with an effective dose of tropisetron did not significantly affect the antidepressant-like effect of tropisetron. We concluded that the antidepressant-like effects of tropisetron on MS mice are partially mediated through the adenylyl cyclase pathway.
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Lee S, Kim H, Park MJ, Jeon HJ. Current Advances in Wearable Devices and Their Sensors in Patients With Depression. Front Psychiatry 2021; 12:672347. [PMID: 34220580 PMCID: PMC8245757 DOI: 10.3389/fpsyt.2021.672347] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/21/2021] [Indexed: 11/13/2022] Open
Abstract
In this study, a literature survey was conducted of research into the development and use of wearable devices and sensors in patients with depression. We collected 18 studies that had investigated wearable devices for assessment, monitoring, or prediction of depression. In this report, we examine the sensors of the various types of wearable devices (e.g., actigraphy units, wristbands, fitness trackers, and smartwatches) and parameters measured through sensors in people with depression. In addition, we discuss future trends, referring to research in other areas employing wearable devices, and suggest the challenges of using wearable devices in the field of depression. Real-time objective monitoring of symptoms and novel approaches for diagnosis and treatment using wearable devices will lead to changes in management of patients with depression. During the process, it is necessary to overcome several issues, including limited types of collected data, reliability, user adherence, and privacy concerns.
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Affiliation(s)
- Seunggyu Lee
- School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Hyewon Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, South Korea
| | - Mi Jin Park
- Department of Psychiatry, Depression Center, Samsung Medical Center, Seoul, South Korea
| | - Hong Jin Jeon
- School of Medicine, Sungkyunkwan University, Seoul, South Korea.,Department of Psychiatry, Depression Center, Samsung Medical Center, Seoul, South Korea.,Department of Health Sciences and Technology, Department of Medical Device Management and Research, Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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22
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Bright S, Williams M. Should Australian Psychology Consider Enhancing Psychotherapeutic Interventions with Psychedelic Drugs? A Call for Research. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12345] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Stephen Bright
- School of Medical and Health Sciences, Edith Cowan University,
- National Drug Research Institute, Curtin University,
| | - Martin Williams
- Monash Institute of Pharmaceutical Sciences, Monash University,
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Basanovic J, Grafton B, Ford A, Hirani V, Glance D, MacLeod C, Almeida OP. Cognitive bias modification to prevent depression (COPE): results of a randomised controlled trial. Psychol Med 2020; 50:2514-2525. [PMID: 31544719 DOI: 10.1017/s0033291719002599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression. METHODS Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases. RESULTS Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases. CONCLUSIONS Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.
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Affiliation(s)
- Julian Basanovic
- Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
| | - Ben Grafton
- Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
| | - Andrew Ford
- Medical School, The University of Western Australia, Western Australia, Australia
- Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia
- Department of Psychiatry, Royal Perth Hospital, Western Australia, Australia
| | - Varsha Hirani
- Medical School, The University of Western Australia, Western Australia, Australia
- Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia
| | - David Glance
- UWA Centre for Software Practice, The University of Western Australia, Western Australia, Australia
| | - Colin MacLeod
- Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
| | - Osvaldo P Almeida
- Medical School, The University of Western Australia, Western Australia, Australia
- Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia
- Department of Psychiatry, Royal Perth Hospital, Western Australia, Australia
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U.S. Simulation of Lifetime Major Depressive Episode Prevalence and Recall Error. Am J Prev Med 2020; 59:e39-e47. [PMID: 32446751 PMCID: PMC7375917 DOI: 10.1016/j.amepre.2020.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/09/2020] [Accepted: 03/20/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Simulation models can improve measurement and understanding of mental health conditions in the population. Major depressive episodes are a common and leading cause of disability but are subject to substantial recall bias in survey assessments. This study illustrates the application of a simulation model to quantify the full burden of major depressive episodes on population health in the U.S. METHODS A compartmental model of major depressive episodes that explicitly simulates individuals' under-reporting of past episodes was developed and calibrated to 2005-2017 National Surveys on Drug Use and Health data. Parameters for incidence of a first major depressive episode and the probability of under-reporting past episodes were estimated. Analysis was conducted from 2017 to 2019. RESULTS The model estimated that 30.1% of women (95% range: 29.0%-32.5%) and 17.4% of men (95% range: 16.7%-18.8%) have lifetime histories of a major depressive episode after adjusting for recall error. Among all adults, 13.1% of women (95% range: 8.1%-16.5%) and 6.6% of men (95% range: 4.0%-8.3%) failed to report a past major depressive episode. Under-reporting of a major depressive episode history in adults aged >65 years was estimated to be 70%. CONCLUSIONS Simulation models can address knowledge gaps in disease epidemiology and prevention and improve surveillance efforts. This model quantifies the under-reporting of major depressive episodes and provides parameter estimates for future research. After adjusting for under-reporting, 23.9% of adults have a lifetime history of major depressive episodes, which is much higher than based on self-report alone (14.0%). Far more adults would benefit from depression prevention strategies than what survey estimates suggest.
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Tickell A, Byng R, Crane C, Gradinger F, Hayes R, Robson J, Cardy J, Weaver A, Morant N, Kuyken W. Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies. BMJ Open 2020; 10:e033892. [PMID: 32075835 PMCID: PMC7044862 DOI: 10.1136/bmjopen-2019-033892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This study aimed to describe the recovery journeys of people with a history of recurrent depression who took part in a psychosocial programme designed to teach skills to prevent depressive relapse (mindfulness-based cognitive therapy (MBCT)), alongside maintenance antidepressant medication (ADM). DESIGN A qualitative study embedded within a multicentre, single blind, randomised controlled trial (the PREVENT trial). SETTING Primary care urban and rural settings in the UK. PARTICIPANTS 42 people who participated in the MBCT arm of the parent trial were purposively sampled to represent a range of recovery journeys. INTERVENTIONS MBCT involves eight weekly group sessions, with four refresher sessions offered in the year following the end of the programme. It was adapted to offer bespoke support around ADM tapering and discontinuation. METHODS Written feedback and structured in-depth interviews were collected in the 2 years after participants undertook MBCT. Data were analysed using thematic analysis and case studies constructed to illustrate the findings. RESULTS People with recurrent depression have unique recovery journeys that shape and are shaped by their pharmacological and psychological treatment choices. Their journeys typically include several over-arching themes: (1) beliefs about the causes of depression, both biological and psychosocial; (2) personal agency, including expectations about their role in recovery and treatment; (3) acceptance, both of depression itself and the recovery journey; (4) quality of life; (5) experiences and perspectives on ADM and ADM tapering-discontinuation; and (6) the role of general practitioners, both positive and negative. CONCLUSIONS People with recurrent depression describe unique, complex recovery journeys shaped by their experiences of depression, treatment and interactions with health professionals. Understanding how several themes coalesce for each individual can both support their recovery and treatment choices as well as health professionals in providing more accessible, collaborative, individualised and empowering care. TRIAL REGISTRATION NUMBER Clinical trial number ISRCTN26666654; post results.
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Affiliation(s)
- Alice Tickell
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Richard Byng
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK
| | | | - Felix Gradinger
- Peninsula Medical School, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Rachel Hayes
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - James Robson
- Department of Education, University of Oxford, Oxford, UK
| | - Jessica Cardy
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Alice Weaver
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Nicola Morant
- Department of Psychiatry, University College London, London, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK
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26
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Villalobos-Gallegos L, Pérez-Matus S, Valdez-Santiago R, Marín-Navarrete R. Individual Contribution of Youth Antisocial Symptoms to Suicide Behavior in Adults with Substance Use Disorders. Arch Suicide Res 2020; 24:S126-S135. [PMID: 30856363 DOI: 10.1080/13811118.2019.1577193] [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] [Indexed: 10/27/2022]
Abstract
This study assesses the individual contribution of youth symptoms of antisocial personality disorder (before the age of 15) in past-month suicidal behavior in adults with substance use disorders. Youth antisocial symptoms and suicidal behavior were assessed using the Mini International Neuropsychiatric Interview. Indicators of youth antisocial symptoms were significantly associated with suicide outcomes; lack of remorse (OR = 2.68 CI 95% 1.37, 5.25), and sexual assault with planning, and destruction of property to attempt (OR = 4.22 CI 95% 1.29, 15.08). Our results suggest that specific antisocial indicators during adolescence could be associated with suicide in adulthood, even after controlling for major depressive disorder. Further implications for the research of antisocial symptoms and suicide behavior from a developmental perspective are discussed.
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Marquis SM, McGrail K, Hayes M. Mental health of parents of children with a developmental disability in British Columbia, Canada. J Epidemiol Community Health 2019; 74:173-178. [PMID: 31744849 PMCID: PMC6993017 DOI: 10.1136/jech-2018-211698] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 09/26/2019] [Accepted: 11/08/2019] [Indexed: 01/23/2023]
Abstract
Background There is evidence in the literature that parents of children who have a developmental disability experience an increased risk of mental health problems. Methods This study used population-level administrative data from the Ministry of Health, British Columbia, Canada, to assess the mental health of parents of children who have a developmental disability compared with the mental health of parents of children who do not have a developmental disability. Population-level and individual explanatory variables available in the data were included in the models. Results At a population level, the study found strong evidence that parents of children who have a developmental disability experience higher odds of depression or other mental health diagnoses compared with parents of children who do not have a developmental disability. Age of the parent at birth of the child, income and location of healthcare services were all associated with outcomes. Conclusion Parents of children who have a developmental disability may be in need of programmes and services that support their mental health.
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Affiliation(s)
- Sandra Maureen Marquis
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Kimberlyn McGrail
- Centre for Health Services and Policy Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Hayes
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
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Dunn BD, Widnall E, Reed N, Owens C, Campbell J, Kuyken W. Bringing light into darkness: A multiple baseline mixed methods case series evaluation of Augmented Depression Therapy (ADepT). Behav Res Ther 2019; 120:103418. [PMID: 31310929 DOI: 10.1016/j.brat.2019.103418] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/31/2019] [Accepted: 06/06/2019] [Indexed: 02/05/2023]
Abstract
Two core features of depression are elevations in negative valence system (NVS) functioning and reductions in positive valence system (PVS) functioning. Existing psychological treatments have focused on the NVS and neglected the PVS, which may contribute to sub-optimal outcomes. The present mixed methods multiple randomised baseline case series preliminarily evaluates Augmented Depression Therapy (ADepT), a novel depression treatment targeting PVS and NVS disturbance, that aims both to reduce depression and enhance wellbeing. Eleven clinically depressed participants were recruited. Intensive time series analyses showed that 7/11 participants improved on both wellbeing and depression. Reliable and clinically significant improvement was observed for 9/11 participants on at least one of these outcomes (and also across a range of other PVS and NVS outcomes). Group level analyses showed significant pre to post change on all outcomes. Benchmarking analyses indicated these effect sizes were at least comparable (and for some PVS outcomes superior) to existing treatments. Gains were largely sustained over one-year follow-up. Qualitative interviews indicated ADepT was feasible and acceptable. These findings provide preliminary support for ADepT as a novel depression treatment. Further evaluation, directly comparing ADepT to existing treatments using randomised controlled trial designs, is now required.
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Affiliation(s)
| | | | - Nigel Reed
- Mood Disorders Centre, University of Exeter, UK
| | | | - John Campbell
- College of Medicine and Health, University of Exeter, UK
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Dong D, Li C, Ming Q, Zhong X, Zhang X, Sun X, Jiang Y, Gao Y, Wang X, Yao S. Topologically state-independent and dependent functional connectivity patterns in current and remitted depression. J Affect Disord 2019; 250:178-185. [PMID: 30856495 DOI: 10.1016/j.jad.2019.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/23/2019] [Accepted: 03/04/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Identification of state-independent and -dependent neural biomarkers may provide insight into the pathophysiology and effective treatment of major depressive disorder (MDD), therefore we aimed to investigate the state-independent and -dependent topological alterations of MDD. METHOD Brain resting-state functional magnetic resonance imaging (fMRI) data were acquired from 59 patients with unmedicated first episode current MDD (cMDD), 48 patients with remitted MDD (rMDD) and 60 demographically matched healthy controls (HCs). Using graph theory, we systematically studied the topological organization of their whole-brain functional networks at the global and nodal level. RESULTS At a global level, both patient groups showed decreased normalized clustering coefficient in relative to HCs. On a nodal level, both patient groups showed decreased nodal centrality, predominantly in cortex-mood-regulation brain regions including the dorsolateral prefrontal cortex, posterior parietal cortex and posterior cingulate cortex. By comparison to cMDD patients, rMDD group had a higher nodal centrality in right parahippocampal gyrus. LIMITATIONS The present study, an exploratory analysis, may require further confirmation with task-based and experimental studies. CONCLUSIONS Deficits in the topological organization of the whole brain and cortex-mood-regulation brain regions in both rMDD and cMDD represent state-independent biomarkers.
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Affiliation(s)
- Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Chuting Li
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Qingsen Ming
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, PR China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China.
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Boysan M. An integration of quadripartite and helplessness-hopelessness models of depression using the Turkish version of the Learned Helplessness Scale (LHS). BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2019. [DOI: 10.1080/03069885.2019.1612033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Murat Boysan
- Department of Psychology, Faculty of Social Sciences, Van Yuzuncu Yil University, Van, Turkey
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Dunn BD, Widnall E, Reed N, Taylor R, Owens C, Spencer A, Kraag G, Kok G, Geschwind N, Wright K, Moberly NJ, Moulds ML, MacLeod AK, Handley R, Richards D, Campbell J, Kuyken W. Evaluating Augmented Depression Therapy (ADepT): study protocol for a pilot randomised controlled trial. Pilot Feasibility Stud 2019; 5:63. [PMID: 31061718 PMCID: PMC6486988 DOI: 10.1186/s40814-019-0438-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 03/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While existing psychological treatments for depression are effective for many, a significant proportion of depressed individuals do not respond to current approaches and few remain well over the long-term. Anhedonia (a loss of interest or pleasure) is a core symptom of depression which predicts a poor prognosis but has been neglected by existing treatments. Augmented Depression Therapy (ADepT) has been co-designed with service users to better target anhedonia alongside other features of depression. This mixed methods pilot trial aims to establish proof of concept for ADepT and to examine the feasibility and acceptability of a future definitive trial evaluating the clinical and cost-effectiveness of ADepT, compared to an evidence-based mainstream therapy (Cognitive Behavioural Therapy; CBT) in the acute treatment of depression, the prevention of subsequent depressive relapse, and the enhancement of wellbeing. METHODS We aim to recruit 80 depressed participants and randomise them 1:1 to receive ADepT (15 weekly acute and 5 booster sessions in following year) or CBT (20 weekly acute sessions). Clinical and health economic assessments will take place at intake and at 6-, 12-, and 18-month follow-up. Reductions in PHQ-9 depression severity and increases in WEMWBS wellbeing at 6-month assessment (when acute treatment should be completed) are the co-primary outcomes. Quantitative and qualitative process evaluation will assess mechanism of action, implementation issues, and contextual moderating factors. To evaluate proof of concept, intake-post effect sizes and the proportion of individuals showing reliable and clinically significant change on outcome measures in each arm at each follow-up will be reported. To evaluate feasibility and acceptability, we will examine recruitment, retention, treatment completion, and data completeness rates and feedback from patients and therapists about their experience of study participation and therapy. Additionally, we will establish the cost of delivery of ADepT. DISCUSSION We will proceed to definitive trial if any concerns about the safety, acceptability, feasibility, and proof of concept of ADepT and trial procedures can be rectified, and we recruit, retain, and collect follow-up data on at least 60% of the target sample. TRIAL REGISTRATION ISCRTN85278228, registered 27/03/2017.
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Affiliation(s)
| | - Emily Widnall
- Mood Disorders Centre, University of Exeter, Exeter, UK
| | - Nigel Reed
- Mood Disorders Centre, University of Exeter, Exeter, UK
| | - Rod Taylor
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Christabel Owens
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Anne Spencer
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Gerda Kraag
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Gerjo Kok
- Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Nicole Geschwind
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Kim Wright
- Mood Disorders Centre, University of Exeter, Exeter, UK
| | | | - Michelle L. Moulds
- School of Psychology, The University of New South Wales, Sydney, Australia
| | - Andrew K. MacLeod
- Department of Psychology, Royal Holloway University of London, London, UK
| | | | - David Richards
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - John Campbell
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, UK
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Dong D, Ming Q, Zhong X, Pu W, Zhang X, Jiang Y, Gao Y, Sun X, Wang X, Yao S. State-independent alterations of intrinsic brain network in current and remitted depression. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:475-480. [PMID: 30193990 DOI: 10.1016/j.pnpbp.2018.08.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 08/15/2018] [Accepted: 08/29/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND It has been proposed that state-independent, or trait, neurobiological alterations across illness phases may contribute to the high recurrence of major depressive disorder (MDD). Although intrinsic brain network abnormalities have been implicated consistently in MDD neuropathology, MDD state-independent and -dependent resting-state network alterations have not been clearly studied. METHODS Resting-state functional magnetic resonance imaging (fMRI) data were collected from 57 medication-naive first-episode current MDD patients, 35 remitted MDD patients, and 66 healthy controls (HCs). Independent component analysis (ICA) was used to extract subnetworks of the default mode network (DMN), central executive network (CEN), and salience network (SN). RESULTS Relative to HCs, the current MDD and remitted MDD groups had decreased intra-intrinsic functional connectivity (iFC) in the dorsal lateral prefrontal cortex (dlPFC) of the left CEN, increased inter-FC between the SN and right CEN (rCEN), and decreased inter-FC between the anterior DMN (aDMN) and rCEN. The altered intra-iFC in the left CEN were correlated negatively with the depressive level in the remitted MDD. CONCLUSIONS Hypoactivity of the dlPFC in the left CEN, increased inter-FC between the SN and rCEN, and decreased inter-FC between the aDMN and rCEN may reflect state-independent biomarkers of MDD.
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Affiliation(s)
- Daifeng Dong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Qingsen Ming
- Dpartment of Psychiatry, The First Affiliated Hospital of Sochoow University, Suzhou, Jiangsu, PR China
| | - Xue Zhong
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Weidan Pu
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yali Jiang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Yidian Gao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiaoqiang Sun
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China
| | - Shuqiao Yao
- Medical Psychological Center, The Second Xiangya Hospital of Central South University, Changsha, Hunan, PR China; Medical Psychological Institute of Central South University, Changsha, Hunan, PR China; China National Clinical Research Center on Mental Disorders (Xiangya), Changsha, Hunan, PR China.
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Zhao T, Markevych I, Standl M, Schulte-Körne G, Schikowski T, Berdel D, Koletzko S, Bauer CP, von Berg A, Nowak D, Heinrich J. Ambient ozone exposure and depressive symptoms in adolescents: Results of the GINIplus and LISA birth cohorts. ENVIRONMENTAL RESEARCH 2019; 170:73-81. [PMID: 30557694 DOI: 10.1016/j.envres.2018.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 12/05/2018] [Accepted: 12/06/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Depression has been associated with air pollution, as reported by animal and epidemiological studies. However, the relationship between ozone exposure and depression, especially among adolescents, is scarcely investigated. OBJECTIVES The study aimed to analyze associations between ozone exposure and depressive symptoms among German adolescents. METHODS The analyses were based on 2827 adolescents aged 15 from Munich and Wesel areas of the GINIplus and LISA birth cohorts. The depressive symptoms were assessed by the Depression Screener for Teenagers (DesTeen). Long-term ozone exposure was estimated by optimal interpolation techniques and assigned to home addresses. Nitrogen dioxide (NO2) and particulate matter with an aerodynamic diameter < 10 µm (PM10) were assessed by land use regression models. For short-term exposure, maximum 8-h averages of ozone and daily average concentrations of NO2 and PM10 from the background monitoring sites 0 (same day), 1, 2, 3, and 7 days prior to depressive symptoms assessment were adopted. The cross-sectional analyses were conducted by adjusted logistic regression models controlling for residuals of NO2 and PM10, and covariates identified by a directed acyclic graph. RESULTS The prevalence of depressive symptoms ranged from 10.9% to 13.8% depending on regions. Overall, long- and short-term exposure to ozone were not statistically significantly associated with depressive symptoms. However, subgroup analysis showed inconsistent significant protective associations for short-term exposure to ozone lag 0 day (same day) and depressive symptoms in Wesel (OR = 0.76, 95% CI: (0.59, 0.98)), but not in Munich (OR = 1.00, 95% CI: (0.83, 1.21)). CONCLUSIONS Our study does not support the hypothesis that ambient ozone exposure might increase the prevalence of depressive symptoms in German adolescents. Nevertheless, due to a lack of similar studies, these results need to be replicated in other samples.
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Affiliation(s)
- Tianyu Zhao
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich; Comprehensive Pneumology Center (CPC) Munich, member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Iana Markevych
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich; Comprehensive Pneumology Center (CPC) Munich, member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marie Standl
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Dietrich Berdel
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Sibylle Koletzko
- Division of Paediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital Munich, Ludwig Maximilian University of Munich, Germany
| | - Carl-Peter Bauer
- Department of Pediatrics, Technical University of Munich, Munich, Germany
| | - Andrea von Berg
- Research Institute, Department of Pediatrics, Marien-Hospital Wesel, Wesel, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich; Comprehensive Pneumology Center (CPC) Munich, member DZL, German Center for Lung Research, Munich, Germany
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University of Munich; Comprehensive Pneumology Center (CPC) Munich, member DZL, German Center for Lung Research, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
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Bean CG, Pingel R, Hallqvist J, Berg N, Hammarström A. Poor peer relations in adolescence, social support in early adulthood, and depressive symptoms in later adulthood—evaluating mediation and interaction using four-way decomposition analysis. Ann Epidemiol 2019; 29:52-59. [DOI: 10.1016/j.annepidem.2018.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 10/12/2018] [Accepted: 10/20/2018] [Indexed: 10/28/2022]
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Charlson FJ, Ferrari AJ, Santomauro DF, Diminic S, Stockings E, Scott JG, McGrath JJ, Whiteford HA. Global Epidemiology and Burden of Schizophrenia: Findings From the Global Burden of Disease Study 2016. Schizophr Bull 2018; 44:1195-1203. [PMID: 29762765 PMCID: PMC6192504 DOI: 10.1093/schbul/sby058] [Citation(s) in RCA: 793] [Impact Index Per Article: 132.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction The global burden of disease (GBD) studies have derived detailed and comparable epidemiological and burden of disease estimates for schizophrenia. We report GBD 2016 estimates of schizophrenia prevalence and burden of disease with disaggregation by age, sex, year, and for all countries. Method We conducted a systematic review to identify studies reporting the prevalence, incidence, remission, and/or excess mortality associated with schizophrenia. Reported estimates which met our inclusion criteria were entered into a Bayesian meta-regression tool used in GBD 2016 to derive prevalence for 20 age groups, 7 super-regions, 21 regions, and 195 countries and territories. Burden of disease estimates were derived for acute and residual states of schizophrenia by multiplying the age-, sex-, year-, and location-specific prevalence by 2 disability weights representative of the disability experienced during these states. Findings The systematic review found a total of 129 individual data sources. The global age-standardized point prevalence of schizophrenia in 2016 was estimated to be 0.28% (95% uncertainty interval [UI]: 0.24-0.31). No sex differences were observed in prevalence. Age-standardized point prevalence rates did not vary widely across countries or regions. Globally, prevalent cases rose from 13.1 (95% UI: 11.6-14.8) million in 1990 to 20.9 (95% UI: 18.5-23.4) million cases in 2016. Schizophrenia contributes 13.4 (95% UI: 9.9-16.7) million years of life lived with disability to burden of disease globally. Conclusion Although schizophrenia is a low prevalence disorder, the burden of disease is substantial. Our modeling suggests that significant population growth and aging has led to a large and increasing disease burden attributable to schizophrenia, particularly for middle income countries.
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Affiliation(s)
- Fiona J Charlson
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Alize J Ferrari
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Damian F Santomauro
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
| | - Sandra Diminic
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
| | - Emily Stockings
- National Drug and Alcohol Research Centre (NDARC), University of New South Wales, Randwick, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, Wacol, Australia
- Centre for Clinical Research, The University of Queensland, Herston, Australia
- Metro North Mental Health, Royal Brisbane and Women’s Hospital, Herston, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, Wacol, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Australia
- National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Harvey A Whiteford
- School of Public Health, The University of Queensland, Herston, Australia
- Queensland Centre for Mental Health Research, Wacol, Australia
- Department of Global Health, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA
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Figueroa CA, Mocking RJT, Mahmoud GA, Koeter MW, Bockting CL, van der Does W, Ruhe HG, Schene AH. The measurement of cognitive reactivity to sad mood in patients remitted from major depressive disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 57:313-327. [PMID: 29488231 PMCID: PMC6099317 DOI: 10.1111/bjc.12175] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 01/31/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Cognitive reactivity (CR) to sad mood is a risk factor for major depressive disorder (MDD). CR is usually measured by assessing change on the Dysfunctional Attitudes Scale (DAS-change) after sad mood-induction. It has, however, been suggested that the versions of the DAS (A/B) are not interchangeable, impacting the reliability and validity of the change score. The Leiden Index of Depression Sensitivity-Revised (LEIDS-R) is an alternative self-report measure of CR. Studies examining the relationship between LEIDS-R and DAS-change have shown mixed results. We examined whether scores of these CR measures differed between remitted MDD and controls, the relationship between these CR measures, and the effect of order of DAS administration on DAS-change. DESIGN Cross-sectional design with two groups (remitted MDD and controls). METHODS Sixty-eight MDD patients remitted from ≥2 previous episodes, not taking antidepressants, and 43 never-depressed controls participated in a mood-induction and filled in the DAS-A/B in randomized order before and after mood-induction, and LEIDS-R separately. RESULTS LEIDS-R scores and pre-mood-induction DAS scores were significantly higher in remitted MDD than controls (p < .001, Cohen's d = 1.48; p = .001, Cohen's d = 0.66, respectively). DAS-change did not differ between these groups (p = .67, Cohen's d = 0.08). LEIDS-R correlated with DAS-change (r = .30, p = .042), but only in the group that filled in DAS-B before DAS-A. In remitted MDD, DAS-change was dependent on the order of DAS versions before and after mood-induction (10.6 ± 19.0 vs. -1.2 ± 10.5, for order B-A and A-B, respectively), with a significant group × order interaction (p = .012). CONCLUSIONS Existing DAS versions are not interchangeable, which compromises the usefulness of mood-inductions in clinical practice. The LEIDS-R seems a valid measure of cognitive vulnerability to depression. PRACTITIONER POINTS Clinical implications: Cognitive reactivity (CR) is a risk factor of depressive recurrence. The current measurement of CR, by assessing change on the Dysfunctional Attitudes Scale (DAS) after mood-induction, is not reliable. The Leiden Index Depression Sensitivity-Revised (LEIDS-R) is an alternative CR measure. In contrast to mood-induction, it reliably assesses depression vulnerability. The use of mood-inductions for clinical/research purposes is unnecessary. LIMITATIONS OF THE STUDY We were not able to examine the effect of previous treatment, which could have affected results as psychological treatments probably have differential effects on CR. Examining un-medicated patients may have led to selection of a sample not completely representative for the general MDD population. We did not administer both parallel versions of the DAS (A/B) before and after mood-induction. This might have provided better understanding of their differential sensitivity to change.
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Affiliation(s)
- Caroline A. Figueroa
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryWarneford HospitalUniversity of OxfordUK
| | - Roel J. T. Mocking
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | - Gelera A. Mahmoud
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | - Maarten W. Koeter
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
| | | | - Willem van der Does
- Department of PsychologyLeiden UniversityThe Netherlands
- Department of PsychiatryLeiden University Medical CenterThe Netherlands
| | - Henricus G. Ruhe
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryWarneford HospitalUniversity of OxfordUK
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
| | - Aart H. Schene
- Department of PsychiatryProgram for Mood DisordersAcademic Medical CenterUniversity of AmsterdamThe Netherlands
- Department of PsychiatryRadboud University Medical CenterNijmegenThe Netherlands
- Donders Institute for Brain, Cognition and BehaviorRadboud University NijmegenThe Netherlands
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Yang J, Zhang M, Ahn H, Zhang Q, Jin TB, Li I, Nemesure M, Joshi N, Jiang H, Miller JM, Ogden RT, Petkova E, Milak MS, Sublette ME, Sullivan GM, Trivedi MH, Weissman M, McGrath PJ, Fava M, Kurian BT, Pizzagalli DA, Cooper CM, McInnis M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. Development and evaluation of a multimodal marker of major depressive disorder. Hum Brain Mapp 2018; 39:4420-4439. [PMID: 30113112 DOI: 10.1002/hbm.24282] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/16/2018] [Accepted: 06/04/2018] [Indexed: 12/30/2022] Open
Abstract
This study aimed to identify biomarkers of major depressive disorder (MDD), by relating neuroimage-derived measures to binary (MDD/control), ordinal (severe MDD/mild MDD/control), or continuous (depression severity) outcomes. To address MDD heterogeneity, factors (severity of psychic depression, motivation, anxiety, psychosis, and sleep disturbance) were also used as outcomes. A multisite, multimodal imaging (diffusion MRI [dMRI] and structural MRI [sMRI]) cohort (52 controls and 147 MDD patients) and several modeling techniques-penalized logistic regression, random forest, and support vector machine (SVM)-were used. An additional cohort (25 controls and 83 MDD patients) was used for validation. The optimally performing classifier (SVM) had a 26.0% misclassification rate (binary), 52.2 ± 1.69% accuracy (ordinal) and r = .36 correlation coefficient (p < .001, continuous). Using SVM, R2 values for prediction of any MDD factors were <10%. Binary classification in the external data set resulted in 87.95% sensitivity and 32.00% specificity. Though observed classification rates are too low for clinical utility, four image-based features contributed to accuracy across all models and analyses-two dMRI-based measures (average fractional anisotropy in the right cuneus and left insula) and two sMRI-based measures (asymmetry in the volume of the pars triangularis and the cerebellum) and may serve as a priori regions for future analyses. The poor accuracy of classification and predictive results found here reflects current equivocal findings and sheds light on challenges of using these modalities for MDD biomarker identification. Further, this study suggests a paradigm (e.g., multiple classifier evaluation with external validation) for future studies to avoid nongeneralizable results.
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Affiliation(s)
- Jie Yang
- Department of Family, Population and Preventive Medicine, Stony Brook University, New York, New York
| | - Mengru Zhang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Hongshik Ahn
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Qing Zhang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Tony B Jin
- Department of Psychiatry, Stony Brook University, New York, New York
| | - Ien Li
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey
| | - Matthew Nemesure
- Integrative Neuroscience Program, Binghamton University, Binghamton, New York
| | - Nandita Joshi
- Department of Electrical and Computer Engineering, Stony Brook University, New York, New York
| | - Haoran Jiang
- Department of Applied Mathematics and Statistics, Stony Brook University, New York, New York
| | - Jeffrey M Miller
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Eva Petkova
- Department of Child & Adolescent Psychiatry, Department of Population Health, New York University, New York, New York
| | - Matthew S Milak
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Gregory M Sullivan
- Chief Medical Officer, Clinical Research and Development program, Tonix Pharmaceuticals, Inc., New York, New York
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Myrna Weissman
- Department of Psychiatry, Columbia University, New York, New York
| | | | - Maurizio Fava
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Benji T Kurian
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Crystal M Cooper
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Maria A Oquendo
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph John Mann
- Department of Psychiatry, Columbia University, New York, New York
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, New York, New York
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Arabzadeh S, Hakkikazazi E, Shahmansouri N, Tafakhori A, Ghajar A, Jafarinia M, Akhondzadeh S. Does oral administration of ketamine accelerate response to treatment in major depressive disorder? Results of a double-blind controlled trial. J Affect Disord 2018; 235:236-241. [PMID: 29660637 DOI: 10.1016/j.jad.2018.02.056] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) exerts a high health and financial burden on society. The conventional pharmacotherapies for MDD are partially effective and the response to medication often starts with some delay. There are recent reports of antidepressant effects for oral ketamine. METHODS We employed a double-blind controlled trial to examine the time course of the therapeutic effect of ketamine when combined with the conventional administration of sertraline. A total of 81 patients participated in the study and were scored with the Hamilton Depression Rating Scale (HDRS) at baseline and at 2, 4 and 6 weeks after the start of the trial RESULTS: General linear model repeated measures demonstrated significant effect for time × treatment interaction on the HDRS scores, with significant difference at all time points post treatment. Early improvement was significantly greater in the ketamine group (85.4%) compared to the placebo group (42.5%). We did not observe any side effects for ketamine administration. LIMITATIONS Our follow up was limited to 6 weeks post initiation of treatment and cannot reveal the potential long-term adverse effects of oral ketamine and the sustainability of its benefit. CONCLUSION Altogether, our results suggest that oral ketamine may be considered as suitable adjuvant to sertraline in relieving depressive symptoms.
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Affiliation(s)
- Somaye Arabzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical sciences, Tehran, Iran
| | - Elham Hakkikazazi
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical sciences, Tehran, Iran
| | - Nazila Shahmansouri
- Psychosomatic Research Center, Tehran University of Medical sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Science, Iran
| | - Alireza Ghajar
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical sciences, Tehran, Iran
| | - Morteza Jafarinia
- Psychosomatic Research Center, Tehran University of Medical sciences, Tehran, Iran
| | - Shahin Akhondzadeh
- Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical sciences, Tehran, Iran.
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Li BJ, Friston K, Mody M, Wang HN, Lu HB, Hu DW. A brain network model for depression: From symptom understanding to disease intervention. CNS Neurosci Ther 2018; 24:1004-1019. [PMID: 29931740 DOI: 10.1111/cns.12998] [Citation(s) in RCA: 154] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 05/29/2018] [Accepted: 05/29/2018] [Indexed: 12/13/2022] Open
Abstract
Understanding the neural substrates of depression is crucial for diagnosis and treatment. Here, we review recent studies of functional and effective connectivity in depression, in terms of functional integration in the brain. Findings from these studies, including our own, point to the involvement of at least four networks in patients with depression. Elevated connectivity of a ventral limbic affective network appears to be associated with excessive negative mood (dysphoria) in the patients; decreased connectivity of a frontal-striatal reward network has been suggested to account for loss of interest, motivation, and pleasure (anhedonia); enhanced default mode network connectivity seems to be associated with depressive rumination; and diminished connectivity of a dorsal cognitive control network is thought to underlie cognitive deficits especially ineffective top-down control of negative thoughts and emotions in depressed patients. Moreover, the restoration of connectivity of these networks-and corresponding symptom improvement-following antidepressant treatment (including medication, psychotherapy, and brain stimulation techniques) serves as evidence for the crucial role of these networks in the pathophysiology of depression.
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Affiliation(s)
- Bao-Juan Li
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China.,Department of Radiology, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Karl Friston
- The Wellcome Trust Centre for Neuroimaging, University College London, London, UK
| | - Maria Mody
- Department of Radiology, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Hua-Ning Wang
- Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hong-Bing Lu
- School of Biomedical Engineering, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - De-Wen Hu
- Department of Automatic Control, College of Mechatronics and Automation, National University of Defense Technology, Changsha, Hunan, China
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40
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Figueroa CA, Mocking RJT, van Wingen G, Martens S, Ruhé HG, Schene AH. Aberrant default-mode network-hippocampus connectivity after sad memory-recall in remitted-depression. Soc Cogn Affect Neurosci 2018; 12:1803-1813. [PMID: 28981917 PMCID: PMC5714211 DOI: 10.1093/scan/nsx108] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 09/12/2017] [Indexed: 12/30/2022] Open
Abstract
Rumination and cognitive reactivity (dysfunctional cognitions after sad mood-induction) remain high in remitted Major Depressive Disorder (MDD) and can contribute to new episodes. These factors have been linked to increased fMRI resting-state functional-connectivity within the Default-Mode Network (DMN). It remains unclear whether (I) increased DMN-connectivity persists during MDD-remission, and (II) whether sad mood-induction differentially affects DMN-connectivity in remitted-MDD vs controls. Moreover, DMN-connectivity studies in remitted-MDD were previously confounded by antidepressant-use. Sixty-two MDD-patients remitted from ≥2 episodes, psychotropic-medication free, and 41 controls, participated in two 5-min neutral and sad mood-inductions by autobiographical-recall and neutral/sad music, each followed by 8-min resting-state fMRI-scanning. We identified DMN-components using Independent Component Analysis and entered subject- and sessions-specific components into a repeated measures analysis of variance. Connectivity-differences were extracted and correlated with baseline cognitive reactivity and rumination as measures of vulnerability for recurrence. After sad vs neutral mood-induction, controls, but not remitted-MDD, showed an increase in connectivity between the posterior-DMN and a cluster consisting mostly of the hippocampus (P = 0.006). Less posterior-DMN-hippocampal connectivity was associated with higher cognitive reactivity (r = −0.21, P = 0.046) and rumination (r = −0.27, P = 0.017). After recalling sad autobiographical-memories, aberrant posterior-DMN-hippocampal connectivity, associated with cognitive reactivity and rumination, remains a neural vulnerability in MDD-remission.
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Affiliation(s)
- Caroline A Figueroa
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Brain imaging Center, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Warneford Hospital, Department of Psychiatry, University of Oxford, OX3 7JX, Oxford, United Kingdom
| | - Roel J T Mocking
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Brain imaging Center, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Brain imaging Center, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Suzanne Martens
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands
| | - Henricus G Ruhé
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Brain imaging Center, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Warneford Hospital, Department of Psychiatry, University of Oxford, OX3 7JX, Oxford, United Kingdom.,Radboud University Medical Center, Department of Psychiatry, 6525 GC, Nijmegen, The Netherlands
| | - Aart H Schene
- Department of Psychiatry, Program for Mood Disorders, Academic Medical Center, University of Amsterdam, 1105 AZ, Amsterdam, The Netherlands.,Radboud University Medical Center, Department of Psychiatry, 6525 GC, Nijmegen, The Netherlands.,Donders Institute for Brain, Cognition and Behavior, Radboud University, 6525 GC, Nijmegen, The Netherlands
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Molenaar NM, Kamperman AM, Boyce P, Bergink V. Guidelines on treatment of perinatal depression with antidepressants: An international review. Aust N Z J Psychiatry 2018; 52:320-327. [PMID: 29506399 PMCID: PMC5871019 DOI: 10.1177/0004867418762057] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Several countries have developed Clinical Practice Guidelines regarding treatment of perinatal depressive symptoms and perinatal use of antidepressant. We aimed to compare guidelines to guide clinicians in best clinical practice. METHODS An extensive search in guideline databases, MEDLINE and PsycINFO was performed. When no guidelines were (publicly) available online, we contacted psychiatric-, obstetric-, perinatal- and mood disorder societies of all first world countries and the five largest second world countries. Only Clinical Practice Guidelines adhering to quality criteria of the Appraisal of Guidelines for Research and Evaluation instrument and including a systematic review of evidence were included. Data extraction focussed on recommendations regarding continuation or withdrawal of antidepressants and preferred treatment in newly depressed patients. RESULTS Our initial search resulted in 1094 articles. After first screening, 40 full-text articles were screened. Of these, 24 were excluded for not being an official Clinical Practice Guidelines. In total, 16 Clinical Practice Guidelines were included originating from 12 countries. Eight guidelines were perinatal specific and eight were general guidelines. CONCLUSION During pregnancy, four guidelines advise to continue antidepressants, while there is a lack of evidence supporting this recommendation. Five guidelines do not specifically advise or discourage continuation. For new episodes, guidelines agree on psychotherapy (especially cognitive behavioural therapy) as initial treatment for mild to moderate depression and antidepressants for severe depression, with a preference for sertraline. Paroxetine is not preferred treatment for new episodes but switching antidepressants for ongoing treatment is discouraged (three guidelines). If mothers use antidepressants, observation of the neonate is generally recommended and breastfeeding encouraged.
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Affiliation(s)
- Nina M Molenaar
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands,Nina M Molenaar, Department of Psychiatry, Erasmus MC, Antwoordnummer 55, 3000 WB Rotterdam, The Netherlands.
| | | | - Philip Boyce
- Department of Psychiatry, Westmead Hospital, Westmead, NSW, Australia
| | - Veerle Bergink
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands,Current affiliation: Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Child injuries in Ethiopia: A review of the current situation with projections. PLoS One 2018; 13:e0194692. [PMID: 29584763 PMCID: PMC5870992 DOI: 10.1371/journal.pone.0194692] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 03/07/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Heavy burden of child injuries and lack of policy response in Ethiopia call for an improved understanding of the situation and development of action plans from multiple governmental agencies and stakeholders. METHODS A consortium of international and Ethiopian researchers and stakeholders used extensive literature review and mixed analytical methods to estimate and project the burden of fatal and non-fatal child unintentional injuries in Ethiopia from 2015 to 2030. Estimates were derived for children aged 0-14 years. Data sources include a longitudinal study conducted by the Central Statistics Agency of Ethiopia and the World Bank as well as model-based estimates from World Health Organization 2017 and Global Burden of Disease 2016 project. RESULTS Injuries caused about 25 thousand deaths among 0-14-year olds in Ethiopia in 2015. The leading cause of fatal child unintentional injuries in Ethiopia was road-traffic injuries, followed by fire, heat and hot substances and drowning. The death rate due to injuries among 0-14 years olds was about 50 percent higher in males than females. Rural children were exposed to a greater risk of injury than their urban peers. The longitudinal survey suggests that the incidence rate of child injuries increased during the period 2011-2014. The annual mortality caused by injuries is projected to increase from 10,697 in 2015 to 11,279 in 2020 and 11,989 in 2030 among children under 5 years, an increase of 12 percentage points in 15 years. The number of deaths among 0-14-year olds will be 26,463, 27,807, and 30,364 respectively in 2015, 2020, and 2030. CONCLUSIONS As the first multisectoral collaboration on child injuries in Ethiopia, this study identified gaps in understanding of the burden of child injuries in Ethiopia. In consultation with Ethiopian government and other stakeholders, we propose starting an injury surveillance system at health clinics and hospitals and building an intervention package based on existing platforms.
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Lim GY, Tam WW, Lu Y, Ho CS, Zhang MW, Ho RC. Prevalence of Depression in the Community from 30 Countries between 1994 and 2014. Sci Rep 2018; 8:2861. [PMID: 29434331 PMCID: PMC5809481 DOI: 10.1038/s41598-018-21243-x] [Citation(s) in RCA: 817] [Impact Index Per Article: 136.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 02/01/2018] [Indexed: 12/13/2022] Open
Abstract
The prevalence of depression may be affected by changes in psychiatric practices and the availability of online mental health information in the past two decades. This study aimed to evaluate the aggregate prevalence of depression in communities from different countries between 1994 and 2014 and to explore the variations in prevalence stratified by geographical, methodological and socio-economic factors. A total of 90 studies were identified and met the inclusion criteria (n = 1,112,573 adults) with 68 studies on single point prevalence, 9 studies on one-year prevalence, and 13 studies on lifetime prevalence of depression. A random-effects model meta-analysis that was performed to calculate the aggregate point, one-year and lifetime prevalence of depression calculated prevalences of 12.9%, 7.2% and 10.8% respectively. Point prevalence of depression was significantly higher in women (14.4%), countries with a medium human development index (HDI) (29.2%), studies published from 2004 to 2014 (15.4%) and when using self-reporting instruments (17.3%) to assess depression. Heterogeneity was identified by meta-regression and subgroup analysis, and response rate, percentage of women and year of publication, respectively, were determined contribute to depression prevalence. This meta-analysis allows benchmarking of the prevalence of depression during the era when online health information emerged, facilitating future comparisons.
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Affiliation(s)
| | - Wilson W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanxia Lu
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
| | - Cyrus S Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Melvyn W Zhang
- National Addiction Management Service, Institute of Mental Health, Singapore, Singapore
| | - Roger C Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
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Lunghi C, Zongo A, Guénette L. Utilisation des bases de données médico-administratives du Québec pour des études en
santé mentale : opportunités, défis méthodologiques et limites – cas de la dépression chez
les personnes diabétiques. SANTE MENTALE AU QUEBEC 2018. [DOI: 10.7202/1058612ar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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45
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The reciprocal associations between identity disturbance, relationship disturbance, and suicidal ideation among Chinese adolescents: A three-wave cross-lag study. J Clin Psychol 2017; 74:1174-1188. [DOI: 10.1002/jclp.22573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 10/03/2017] [Accepted: 10/19/2017] [Indexed: 11/07/2022]
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Clustered repetitive transcranial magnetic stimulation for the prevention of depressive relapse/recurrence: a randomized controlled trial. Transl Psychiatry 2017; 7:1292. [PMID: 29249805 PMCID: PMC5802466 DOI: 10.1038/s41398-017-0001-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 08/04/2017] [Accepted: 08/17/2017] [Indexed: 12/25/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) may have the potential to prevent depressive relapse. This assessor-blinded, randomized controlled study was designed to evaluate the efficacy and safety of rTMS as a mono- and combination therapy in the prevention of depressive relapse/recurrence. A total of 281 depressed patients who had achieved stable full or partial remission on a 6-month antidepressant (ADP) run-in treatment were randomly assigned to an rTMS (n = 91), ADP (n = 108), or combined (rTMS + ADP, n = 82) treatment group for 12 months. Monthly clustered rTMS was conducted in 5-10 sessions over a 3-5-day period. Maintenance outcomes were assessed using time to relapse/recurrence and relapse/recurrence rate. Overall, 71.2% (200/281) of the participants completed the treatment per the protocol. rTMS + ADP and rTMS significantly reduced the risk of relapse/recurrence compared with ADP (P = 0.000), with hazard ratios of 0.297 and 0.466, respectively. Both rTMS-containing regimens produced significantly lower relapse/recurrence rates than ADP (15.9% and 24.2% vs. 44.4%, P < 0.001). In the relapsed/recurrent subgroup, first-episode depressed, rTMS-treated patients had a markedly lower relapse/recurrence rate than ADP-treated patients. Five patients on the ADP-containing regimens, but none on rTMS alone, developed acute mania. The rTMS-containing regimens had considerably more certain side effects than did the ADP group. We concluded that TMS, whether as a mono- or additional therapy, is superior to antidepressants in preventing depressive relapse/recurrence, particularly in first-episode depressed patients. The treatment does not increase the risk of manic switch, but may increase the risk of certain side effects.
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Lunghi C, Zongo A, Moisan J, Grégoire JP, Guénette L. The impact of incident depression on medication adherence in patients with type 2 diabetes. DIABETES & METABOLISM 2017; 43:521-528. [PMID: 28822618 DOI: 10.1016/j.diabet.2017.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/09/2017] [Accepted: 07/14/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Depression has been correlated with suboptimal adherence to antidiabetic drugs (ADs). Most studies on this topic were cross-sectional; thus, the directionality of this relationship could not be established. The objective of this study was to measure the association between incident depression and AD nonadherence among newly treated patients with diabetes. METHODS We performed a population-based cohort study among new AD users using the Quebec public health insurance data. To avoid immortal time bias, we carried out depression diagnosis-time distribution matching by assigning a date of depression diagnosis to individuals without depression. Nonadherence (i.e.,<90% of days covered by≥1 AD) during the year following depression diagnosis (real or assigned date) was the outcome. Multivariate logistic regression analyses that adjusted for baseline adherence and other confounders were used to estimate the adjusted effect of depression on AD nonadherence. RESULTS Between 2000 and 2006, we identified 3,106 new AD users with a subsequent diagnosis of depression and 70,633 without depression, of which 52% and 49% became non-adherent to AD treatment, respectively. Among patients with depression, 52.0% were considered AD non-adherent in the year after depression diagnosis compared with 49.0% of matched patients without depression. Depression was associated with AD nonadherence after accounting for baseline adherence and other confounders with an adjusted odds ratio of 1.24 (95% confidence interval: 1.13-1.37). CONCLUSIONS The results suggest that depression is an independent risk factor for AD nonadherence. Patients with type 2 diabetes and depression might benefit from adherence-enhancing interventions.
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Affiliation(s)
- C Lunghi
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - A Zongo
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - J Moisan
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - J-P Grégoire
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada
| | - L Guénette
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Center, Université Laval, Québec, QC, Canada.
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Lunghi C, Zongo A, Moisan J, Grégoire JP, Guénette L. Factors associated with antidiabetic medication non-adherence in patients with incident comorbid depression. J Diabetes Complications 2017; 31:1200-1206. [PMID: 28325698 DOI: 10.1016/j.jdiacomp.2017.02.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 02/09/2017] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
AIM To identify factors associated with antidiabetic drug (AD) non-adherence among patients with type 2 diabetes and depression. STUDY DESIGN AND SETTINGS We conducted a population-based retrospective cohort study among new AD users with a diagnosis of depression following AD initiation. We used public health insurance data from Quebec. The dependent variable was non-adherence (i.e., <90% of days covered by ≥1AD) in the year after a depression diagnosis. Different sociodemographic, clinical and medication-related variables were assessed as potential factors of non-adherence to AD treatment. We performed univariate and multivariate logistic regressions. RESULTS We identified 3106 new users of ADs with a diagnosis of depression between 2000 and 2006. Of these individuals, 52% were considered non-adherent to their ADs. Baseline non-adherence, younger age, the addition of another AD to the initial treatment, <4 drug claims, visits with several different physicians, high socioeconomic status, and a small number of diabetes complications were associated with AD non-adherence. CONCLUSIONS The factors identified in the present study may help clinicians recognize patients with type 2 diabetes and incident depression at increased risk for non-adherence. In these patients, close follow-up and targeted interventions could help improve adherence to AD treatment, improve glycemic control and reduce complications.
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Affiliation(s)
- Carlotta Lunghi
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada
| | - Arsène Zongo
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada
| | - Jocelyne Moisan
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada
| | - Jean-Pierre Grégoire
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada
| | - Line Guénette
- Faculty of Pharmacy, Université Laval, Québec, QC, Canada; Chair on Adherence to Treatments, Université Laval, Québec, QC, Canada; Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre - Université Laval, Québec, QC, Canada.
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Kendler KS, Gardner CO. Genetic and environmental influences on last-year major depression in adulthood: a highly heritable stable liability but strong environmental effects on 1-year prevalence. Psychol Med 2017; 47:1816-1824. [PMID: 28196550 DOI: 10.1017/s0033291717000277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This study seeks to clarify the contribution of temporally stable and occasion-specific genetic and environmental influences on risk for major depression (MD). METHOD Our sample was 2153 members of female-female twin pairs from the Virginia Twin Registry. We examined four personal interview waves conducted over an 8-year period with MD in the last year defined by DSM-IV criteria. We fitted a structural equation model to the data using classic Mx. The model included genetic and environmental risk factors for a latent, stable vulnerability to MD and for episodes in each of the four waves. RESULTS The best-fit model was simple and included genetic and unique environmental influences on the latent liability to MD and unique wave-specific environmental effects. The path from latent liability to MD in the last year was constant over time, moderate in magnitude (+0.65) and weaker than the impact of occasion-specific environmental effects (+0.76). Heritability of the latent stable liability to MD was much higher (78%) than that estimated for last-year MD (32%). Of the total unique environmental influences on MD, 13% reflected enduring consequences of earlier environmental insults, 17% diagnostic error and 70% wave-specific short-lived environmental stressors. CONCLUSIONS Both genetic influences on MD and MD heritability are stable over middle adulthood. However, the largest influence on last-year MD is short-lived environmental effects. As predicted by genetic theory, the heritability of MD is increased substantially by measurement at multiple time points largely through the reduction of the effects of measurement error and short-term environmental risk factors.
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Affiliation(s)
- K S Kendler
- Department of Psychiatry,Virginia Commonwealth University School of Medicine,Richmond, VA,USA
| | - C O Gardner
- Department of Psychiatry,Virginia Commonwealth University School of Medicine,Richmond, VA,USA
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Massoudi B, Blanker MH, van Valen E, Wouters H, Bockting CLH, Burger H. Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice [BLENDING]: study protocol of a non-inferiority randomized trial. BMC Psychiatry 2017; 17:218. [PMID: 28610561 PMCID: PMC5470276 DOI: 10.1186/s12888-017-1376-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Accepted: 06/01/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients' own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment. METHODS This is a pragmatic non-inferiority trial including 300 patients with depressive symptoms, recruited by collaborating GPs and MHWs. After inclusion, participants are randomized to either blended care or usual care in routine general practice. Blended care consists of the 'Act and Feel' treatment: an eight-week web-based program based on behavioral activation with integrated monitoring of depressive symptomatology and automatized feedback. GPs or their MHWs coach the participants through regular face-to-face or telephonic consultations with at least three sessions. Depressive symptomatology, health status, functional impairment, treatment satisfaction, daily activities and resource use are assessed during a follow-up period of 12 months. During treatment, real-time fluctuations in emotions and affect, and daily events will be rated using ecological momentary assessment. The primary outcome is the reduction of depressive symptoms from baseline to three months follow-up. We will conduct intention-to-treat analyses and supplementary per-protocol analyses. DISCUSSION This trial will show whether blended care might be an appropriate treatment strategy for patients with depressive symptoms and depressive disorder in general practice. TRIAL REGISTRATION Netherlands Trial Register: NTR4757; 25 August 2014. http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4757 . (Archived by WebCite® at http://www.webcitation.org/6mnXNMGef ).
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Affiliation(s)
- Btissame Massoudi
- Department of General Practice, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD, Groningen, the Netherlands.
| | - Marco H. Blanker
- Department of General Practice, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD Groningen, the Netherlands
| | - Evelien van Valen
- 0000000120346234grid.5477.1Department of Clinical Psychology, University of Utrecht, Utrecht, The Netherlands
| | - Hans Wouters
- Department of General Practice, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD Groningen, the Netherlands
| | - Claudi L. H. Bockting
- 0000000120346234grid.5477.1Department of Clinical Psychology, University of Utrecht, Utrecht, The Netherlands ,0000 0004 0407 1981grid.4830.fDepartment of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD Groningen, the Netherlands
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