1
|
Kanumuri M, Khan A, Neshat A, Alapati G, Mulaka GSR, Nisar N, Batool S, Arti F. Comparison of Risk of Stroke in Patients With and Without Depression: A Systematic Review and Meta-Analysis. Cureus 2024; 16:e53057. [PMID: 38410306 PMCID: PMC10896251 DOI: 10.7759/cureus.53057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
Individuals with depression face an elevated stroke risk, marked by an unfavorable prognosis. This meta-analysis aims to determine the impact of depression on stroke risk. The current meta-analysis was conducted using the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We selected studies through a systematic review of electronic databases, including PubMed, EMBASE, and CINAHL from January 2011 to January 2023. Google Scholar was utilized to identify supplementary studies. Furthermore, we scrutinized citation lists of reported articles for additional potential studies. Only English-language articles were included in the review. A total of 15 studies were included in this meta-analysis. The pooled sample size was 744,179. Sample size of the included studies ranged from 560 to 487,377. The pooled estimate of 15 studies showed that the risk of stroke was 1.47 times higher in individuals with depression compared to the individuals without depression, and the difference is statistically significant (RR: 1.47, 95% CI: 1.30 to 1.66, p-value<0.001). Age and hypertension emerged as significant predictors of stroke risk in depressed individuals identified through meta-regression. These findings underscore the importance of targeted preventive strategies for depression-related stroke risk, especially considering age-specific considerations and associated factors.
Collapse
Affiliation(s)
- Manisha Kanumuri
- Psychiatry, MediCiti Institute of Medical Sciences, Hyderabad, IND
| | - Areeba Khan
- Critical Care Medicine, United Medical and Dental College, Karachi, PAK
| | - Asfia Neshat
- Internal Medicine, Connolly Hospital, Dublin, IRL
| | - Goutham Alapati
- Oncology, St. Martinus University Faculty of Medicine, Willemstad, CUW
| | | | - Nimra Nisar
- Internal Medicine, Allama Iqbal Medical College, Lahore, PAK
| | - Saima Batool
- Internal Medicine, Hameed Latif Hospital, Lahore, PAK
| | - Fnu Arti
- Medicine, Muhammad Mahar Medical College, Sukkur, PAK
| |
Collapse
|
2
|
Krittanawong C, Maitra NS, Qadeer YK, Wang Z, Fogg S, Storch EA, Celano CM, Huffman JC, Jha M, Charney DS, Lavie CJ. Association of Depression and Cardiovascular Disease. Am J Med 2023; 136:881-895. [PMID: 37247751 DOI: 10.1016/j.amjmed.2023.04.036] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 04/27/2023] [Accepted: 04/27/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Cardiovascular disease remains the leading worldwide cause of mortality. There has been increased awareness of the impact of psychological health on cardiovascular disease. In particular, major depression has been linked to increased all-cause mortality, development of cardiovascular disease, and worse outcomes in those with existing cardiovascular disease. METHODS We conducted a meta-analysis assessing the incidence of cardiovascular disease and cardiovascular disease outcomes among those with major depressive disorder. RESULTS Among 26 studies of 1,957,621 individuals, depression was associated with increased risk of incident stroke (hazard ratio [HR] 1.13; 95% confidence interval [CI], 1.00-1.28), myocardial infarction (HR 1.28; 95% CI, 1.14-1.45), congestive heart failure (HR 1.04; 95% CI, 1.00-1.09), or any cardiovascular disease (HR 1.16; 95% CI, 1.04-1.30). Depression was associated with increased risk of all-cause mortality (HR 1.43; 95% CI, 1.27-1.60), cardiovascular disease mortality (HR 1.44; 95% CI, 1.27-1.63), and congestive heart failure mortality (HR 3.20; 95% CI, 1.29-7.94). CONCLUSION Depression has a significant negative impact on development of cardiovascular disease and on cardiovascular disease outcomes. Further efforts to understand and mitigate these impacts are prudent.
Collapse
Affiliation(s)
| | | | | | - Zhen Wang
- Mayo Clinic Evidence-based Practice Center, Rochester, Minn; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery; Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, Minn
| | - Sonya Fogg
- Library and Learning Resource Center, Texas Heart Institute, Houston
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Christopher M Celano
- Harvard Medical School, Boston, Mass; Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Jeff C Huffman
- Harvard Medical School, Boston, Mass; Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Manish Jha
- Department of Psychiatry and Center for Depression Research and Clinical Care, University of Texas Southwestern Medical Center, Dallas
| | - Dennis S Charney
- Department of Psychiatry, Depression and Anxiety Center for Discovery and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, La
| |
Collapse
|
3
|
Qin K, Bai S, Chen W, Li J, Guo VY. Association of comorbid depression and obesity with cardiometabolic multimorbidity among middle-aged and older Chinese adults: A cohort study. Arch Gerontol Geriatr 2023; 107:104912. [PMID: 36565606 DOI: 10.1016/j.archger.2022.104912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/24/2022] [Accepted: 12/18/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the association of comorbid depression and obesity with the risk of incident cardiometabolic multimorbidity among middle-aged and older Chinese adults. METHODS This cohort study extracted data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depression was confirmed by the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) with a cut-off score ≥10. Obesity was defined as a body mass index ≥28 kg/m2. Participants were categorized into four groups based on depression and obesity status at baseline, i.e., with neither condition, depression only, obesity only, and with both conditions. Cardiometabolic multimorbidity was defined as the coexistence of two or more of heart diseases, stroke, and diabetes mellitus. Logistic regression models were established to estimate the associations. RESULTS A total of 9,308 participants without cardiometabolic multimorbidity at baseline were included (mean [SD] age, 58.8 [9.0] years; 4,449 [47.8%] were males). During four-year of follow-up, 349 (3.8%) participants developed cardiometabolic multimorbidity. Compared to participants without depression or obesity, comorbid depression and obesity was associated with greater risk of cardiometabolic multimorbidity (adjusted OR: 4.79, 95% CI: 3.09-7.43) than that in participants with depression alone (adjusted OR: 1.84, 95% CI: 1.37-2.46) or obesity alone (adjusted OR: 2.26, 95% CI: 1.48-3.45). The findings were consistent in different gender and age groups. CONCLUSIONS Comorbid depression and obesity was associated with excessive risk of cardiometabolic multimorbidity. Intervention targeting at individuals with both depression and obesity might have substantial benefit in minimizing the risk of cardiometabolic multimorbidity.
Collapse
Affiliation(s)
- Kang Qin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Shigen Bai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Weiqing Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Jinghua Li
- Department of Biostatistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Vivian Yawei Guo
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| |
Collapse
|
4
|
Zhang L, Yang W, Li X, Dove A, Qi X, Pan KY, Xu W. Association of life-course traumatic brain injury with dementia risk: A nationwide twin study. Alzheimers Dement 2023; 19:217-225. [PMID: 35347847 PMCID: PMC10078668 DOI: 10.1002/alz.12671] [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: 11/18/2021] [Revised: 02/25/2022] [Accepted: 03/14/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION The impact of life-course traumatic brain injury (TBI) on dementia is unclear. METHODS Within the Swedish Twin Registry (STR), 35,312 dementia-free twins were followed for up to 18 years. TBI history was identified via medical records. Data were analyzed using generalized estimating equation (GEE) and conditional logistic regression. RESULTS In multi-adjusted GEE models, the odds ratio (OR, 95% confidence interval [CI]) of dementia was 1.27 (1.03-1.57) for TBI at any age, 1.55 (1.04-2.31) for TBI at 50 to 59 years, and 1.67 (1.12-2.49) for TBI at 60 to 69 years. Cardiometabolic diseases (CMDs) increased dementia risk associated with TBI at age 50 to 69 years. The ORs in GEE and conditional logistic regression did not differ significantly (P = .37). DISCUSSION TBI, especially between ages 50 and 69 years, is associated with an increased risk of dementia, and this is exacerbated among people with CMDs. Genetic and early-life environmental factors may not account for the TBI-dementia association.
Collapse
Affiliation(s)
- Lulu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Wenzhe Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xuerui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Kuan-Yu Pan
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
5
|
Zhang L, Wang J, Dove A, Yang W, Qi X, Xu W. Injurious falls before, during and after dementia diagnosis: a population-based study. Age Ageing 2022; 51:6964938. [PMID: 36580561 PMCID: PMC9799250 DOI: 10.1093/ageing/afac299] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND the timing of incident injurious falls at different stages of dementia diagnosis is unclear. OBJECTIVES to identify when the occurrence of injurious falls begins to increase among individuals who are going to develop dementia, to explore the time point at which people living with dementia are at highest risk of injurious falls and to ascertain differences in fall-related factors pre- and post-dementia diagnosis. DESIGN this study included 2,707 participants with incident dementia and 2,707 1:1 matched (i.e. same birth year and sex) controls without dementia. METHODS dementia diagnosis and date of onset were identified from the National Patient Registry (NPR) and the Swedish Cause of Death Register following international criteria. Information on injurious falls and history of chronic disease was obtained from the NPR. Data were analysed using conditional Poisson regression and generalized estimating equation models. RESULTS compared with controls, the incidence of injurious falls among participants with dementia started to increase beginning 4 years pre-diagnosis (incidence rate ratio [IRR] 1.70, 95% confidence interval [CI] 1.30-2.22), reaching a peak (IRR 3.73, 95% CI 3.16-4.41) in the year of dementia diagnosis. Heavy drinking, physically active and cardiometabolic diseases (CMDs) were associated with incident falls among those with dementia. CONCLUSION people with dementia have a higher incidence of injurious falls beginning 4 years leading up to diagnosis and peaking during the year of diagnosis. Older age, female, heavy drinking, physically active and CMDs may predict injurious falls among people with dementia.
Collapse
Affiliation(s)
| | | | - Abigail Dove
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Wenzhe Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Weili Xu
- Address correspondence to: Weili Xu, Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Tianjin 300070, Heping, China; Aging Research Center, Department of Neurobiology, Karolinska Institutet, Tomtebodavägen 18A Floor 10, SE-171 65 Solna, Stockholm, Sweden.
| |
Collapse
|
6
|
Cao H, Zhao H, Shen L. Depression increased risk of coronary heart disease: A meta-analysis of prospective cohort studies. Front Cardiovasc Med 2022; 9:913888. [PMID: 36110417 PMCID: PMC9468274 DOI: 10.3389/fcvm.2022.913888] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Background Depression, as an independent risk factor, can lead to a substantially increased risk of coronary heart disease (CHD). The overall body of evidence involving depression and CHD is not consistent. Therefore, we performed an update meta-analysis to evaluate the association between depression and the risk of patients with CHD. Methods Studies were identified through a comprehensive literature search of the PubMed, Embase, and the Cochrane Library database from its inception to 28 September 2021 for titles/abstracts with restricted to English language articles. The literature was screened according to the inclusion and exclusion criteria. Along with data extraction, we evaluated the quality of eligible studies using the Newcastle-Ottawa Scale (NOS). The primary outcome was fatal or non-fatal CHD. We calculated relative risk (RR) with 95% confidence intervals (CIs) using a random-effects models. The protocol was registered in the PROSPERO registration (registration number CRD42021271259). Results From 9,151 records, we included 26 prospective cohort studies published from 1998 to 2018, consisting of 402,597 patients. Either in depression-exposured group or non-depression-exposured group, the mean age of all participants ranged from 18 to 99 years. Moreover, the NOS scores of these studies are eventually indicated that the quality of these eligible studies was reliable. In general, the pooled results showed that patients with depression had a higher risk of CHD compared to patients without depression (RR = 1.21, 95% CI: 1.14–1.29). Additionally, the funnel plot appeared to be asymmetry, indicating there existing publication bias for the pooled results between depression and CHD. A sensitivity analysis was used to assess the stability of the relationship between depression and CHD that indicating the results robust (RR = 1.15, 95% CI: 1.09–1.21). Conclusion Depression may increase risk of CHD. Future studies on the share pathogenic mechanisms of both depression and CHD may develop novel therapies.
Collapse
Affiliation(s)
- Hongfu Cao
- Gulou Hospital of Traditional Chinese Medicine of Beijing, Beijing, China
| | - Hui Zhao
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Li Shen
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Li Shen,
| |
Collapse
|
7
|
Alqdwah-Fattouh R, Rodríguez-Martín S, Barreira-Hernández D, Izquierdo-Esteban L, Gil M, González-Bermejo D, Fernández-Antón E, Rodríguez-Miguel A, García-Lledó A, Bolúmar F, de Abajo FJ. Selective Serotonin Reuptake Inhibitors and Risk of Noncardioembolic Ischemic Stroke: A Nested Case-Control Study. Stroke 2022; 53:1560-1569. [PMID: 35109681 DOI: 10.1161/strokeaha.121.036661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Multiple studies have reported that the use of selective serotonin reuptake inhibitors (SSRIs) is associated with an increased risk of ischemic stroke; however, this finding may be the result of a confounding by indication. We examined the association using different approaches to minimize such potential bias. METHODS A nested case-control study was carried out in a Spanish primary health-care database over the study period 2001 to 2015. Cases were patients sustaining an ischemic stroke with no sign of cardioembolic or unusual cause. For each case, up to 5 matched controls (for exact age, sex, and index date) were randomly selected. Antidepressants were divided in 6 pharmacological subgroups according to their mechanism of action. The current use of SSRIs (use within a 30-day window before index date) was compared with nonuse, past use (beyond 365 days) and current use of other antidepressants through a conditional logistic regression model to obtain adjusted odds ratios and 95% CI. Only initiators of SSRIs and other antidepressants were considered. RESULTS A total of 8296 cases and 37 272 matched controls were included. Of them, 255 (3.07%) were current users of SSRIs among cases and 834 (2.24%) among controls, yielding an adjusted odds ratio of 1.14 (95% CI, 0.97-1.34) as compared with nonusers, 0.94 (95% CI, 0.77-1.13) as compared with past-users and 0.74 (95% CI, 0.58-0.93) as compared with current users of other antidepressants. No relevant differences were found by duration (≤1, >1 year), sex, age (<70, ≥70 years old) and background vascular risk. CONCLUSIONS The use of SSRIs was not associated with an increased risk of noncardioembolic ischemic stroke. On the contrary, as compared with other antidepressants, SSRIs appeared to be protective.
Collapse
Affiliation(s)
- Rasha Alqdwah-Fattouh
- Unit of Epidemiology and Public Health. School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain (R.A.-F., F.B.)
| | - Sara Rodríguez-Martín
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.).,Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcalá (IRYCIS), Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)
| | - Diana Barreira-Hernández
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.).,Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcalá (IRYCIS), Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)
| | - Laura Izquierdo-Esteban
- Stroke Unit, Department of Neurology, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (L.I.-E.)
| | - Miguel Gil
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain (M.G., D.G.-B.)
| | - Diana González-Bermejo
- Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Madrid, Spain (M.G., D.G.-B.)
| | - Encarnación Fernández-Antón
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.).,Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcalá (IRYCIS), Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)
| | - Antonio Rodríguez-Miguel
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.).,Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcalá (IRYCIS), Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)
| | - Alberto García-Lledó
- Department of Cardiology, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (A.G.-L.).,Department of Medicine, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain (A.G.-L.)
| | - Francisco Bolúmar
- Unit of Epidemiology and Public Health. School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain (R.A.-F., F.B.).,Department of Epidemiology and Biostatistics, Graduate School of Public Health, City University of New York (F.B.).,CIBERESP, Spain (F.B.)
| | - Francisco J de Abajo
- Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.).,Department of Biomedical Sciences (Pharmacology Sector), School of Medicine, University of Alcalá (IRYCIS), Alcalá de Henares, Madrid, Spain (S.R.-M., D.B.-H., E.F.-A., A.R.M., F.J.d.A.)
| |
Collapse
|
8
|
Ethanol potentiates mirtazapine-induced cardiotoxicity by inducing dysfunctional autophagy via HMGB1-dependent Akt/mTOR signaling pathway. Toxicol Lett 2022; 358:27-39. [DOI: 10.1016/j.toxlet.2022.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 12/27/2022]
|
9
|
Thanigaimani S, Phie J, Quigley F, Bourke M, Bourke B, Velu R, Jenkins J, Golledge J. Association of Diagnosis of Depression and Small Abdominal Aortic Aneurysm Growth. Ann Vasc Surg 2021; 79:256-263. [PMID: 34543710 DOI: 10.1016/j.avsg.2021.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 11/01/2022]
Abstract
BACKGROUND Depression is associated with an increased risk of cardiovascular events but its association with abdominal aortic aneurysm (AAA) progression is unknown. This study examined if a diagnosis of depression was association with more rapid AAA growth. METHODS Patients with small AAA measuring between 30 and 50 mm were recruited from surveillance programs at 4 Australian centres. Maximum AAA diameter was measured by ultrasound imaging using a standardised and reproducible protocol to monitor AAA growth. Depression was defined from medical records of treatment for depression at recruitment. Linear mixed effects modelling was performed to examine the independent association of depression with AAA growth. A propensity matched sub-analysis was performed. RESULTS A total of 574 participants were included of whom 73 (12.7%) were diagnosed with depression. Participants were followed with a median of 3 (Inter-quartile range (IQR): 2, 5) ultrasound scans for a median of 2.1 (IQR: 1.1, 3.5) years. The unadjusted model suggested that annual AAA growth was non-significantly reduced (mean difference: -0.3 mm/year; 95% confidence interval (CI): -0.7, 0.2; P = 0.26) in participants with a diagnosis of depression compared to other participants. After adjustment for covariates, depression was not significantly associated with AAA growth (mean difference: -0.3 mm/year; 95% CI: -0.8, 0.2; P = 0.27). Findings were similar in the propensity matched sub-analysis. Sensitivity analyses investigating the impact of initial AAA diameter and follow up on the association of depression with AAA growth found no interaction. CONCLUSIONS This study suggested that depression was not associated with faster AAA growth.
Collapse
Affiliation(s)
- Shivshankar Thanigaimani
- The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | - James Phie
- The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia
| | | | - Michael Bourke
- The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Gosford Vascular Services, Gosford, New South Wales, Australia
| | - Bernie Bourke
- The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Gosford Vascular Services, Gosford, New South Wales, Australia
| | - Ramesh Velu
- The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia
| | - Jason Jenkins
- Department of Vascular Surgery, The Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Jonathan Golledge
- The Queensland Research Centre for Peripheral Vascular Disease (QRC-PVD), College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia.
| |
Collapse
|
10
|
Yang W, Li X, Pan KY, Yang R, Song R, Qi X, Pedersen NL, Xu W. Association of life-course depression with the risk of dementia in late life: A nationwide twin study. Alzheimers Dement 2021; 17:1383-1390. [PMID: 33656267 DOI: 10.1002/alz.12303] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/07/2020] [Accepted: 01/02/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Whether depression is a prodromal phase or risk factor for dementia is under debate. We aimed to unveil the nature of depression-dementia association by looking into the time window of depression occurrence. METHODS Dementia-free twins (n = 41,727) from the Swedish Twin Registry were followed-up for 18 years. Data were analyzed using generalized estimating equation (GEE) for all individuals and conditional logistic regression for co-twin matched pairs. RESULTS In the GEE model, multi-adjusted odds ratios (ORs; 95% confidence intervals [CIs]) of dementia were 1.46 (1.09-1.95) for mid-life, 2.16 (1.82-2.56) for late-life, 2.24 (1.49-3.36) for mid- to late-life, and 2.65 (1.17-5.98) for lifelong depression. The ORs in conditional logistic regression and in GEE did not differ significantly (P = 0.60). Education ≥8 years attenuated dementia risk associated with mid-life depression. DISCUSSION Not only late-life depression, but also mid-life depression is associated with dementia. Genetic and early-life environmental factors could not account for this association. Education ≥8 years might buffer the impact of mid-life depression on dementia.
Collapse
Affiliation(s)
- Wenzhe Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xuerui Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Kuan-Yu Pan
- Amsterdam University Medical Center, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Rongrong Yang
- Public Health Science and Engineering College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.,Aging Research Center, Department of Neurobiology, Health Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
11
|
Antidepressants and the Risk of Cardiovascular Events in Elderly Affected by Cardiovascular Disease: A Real-Life Investigation From Italy. J Clin Psychopharmacol 2020; 40:112-121. [PMID: 32134848 DOI: 10.1097/jcp.0000000000001189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The purpose of this study was to assess the possible relation between use of antidepressant (AD) drugs, that is, tricyclic ADs, selective serotonin reuptake inhibitors (SSRIs), and atypical ADs (AAs), and the risk of hospitalization for cardiovascular (CV) events among older patients with previous CV diseases. METHODS A nested case-control study was carried out among patients aged 65 years and older from 5 Italian health care territorial units who were discharged for CV disease during 2008 to 2010. The cohort was composed by 344,747 individuals, and of these, 97,739 (28%) experienced hospital admission for CV events (myocardial infarction, arrhythmia, stroke, heart failure) during follow-up (until 2014) and were included as cases. Up to 5 controls were randomly selected and matched to each. A conditional logistic regression was fitted to estimate the risk of CV events associated with ADs past or current use. A within-patient comparison was performed by the case-crossover design to account the effect of depression. FINDINGS Current users of SSRIs and AAs were at increased risk of CV events with odds ratios of 1.25 (95% confidence interval, 1.21-1.29) and 1.31 (1.25-1.37), respectively. An increased risk of arrhythmia and stroke was associated with current use of SSRIs and AAs, whereas an increased risk of heart failure was detected with current use of any ADs. The results were confirmed by the case-crossover approach. IMPLICATIONS Evidence that AD use is associated with an increased risk of CV events in accordance with specific mechanisms of action among older people with CV disease was added by this study.
Collapse
|
12
|
Jeong HE, Oh IS, Kim WJ, Shin JY. Risk of Major Adverse Cardiovascular Events Associated with Concomitant Use of Antidepressants and Non-steroidal Anti-inflammatory Drugs: A Retrospective Cohort Study. CNS Drugs 2020; 34:1063-1074. [PMID: 32737794 DOI: 10.1007/s40263-020-00750-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Both antidepressants and non-steroidal anti-inflammatory drugs (NSAIDs) have been reported to affect platelet aggregation, blood pressure and heart rate. Despite the high prevalence of the combined use of antidepressants and NSAIDs, there is limited evidence on the potential risk of major adverse cardiovascular events (MACE) associated with their use. OBJECTIVE The objective of this study was to assess the association between concomitant antidepressant and NSAID use and MACE. METHODS We conducted a retrospective cohort study using South Korea's nationwide healthcare database. The study cohort was defined as those with new prescriptions for antidepressants and NSAIDs between 2004 and 2015. Exposure was assessed as time varying into four discrete periods: non-use, antidepressant use, NSAID use and concomitant use. Our primary outcome was MACE, a composite of haemorrhagic and thromboembolic events; secondary outcomes were the individual events of MACE. A multivariable Cox proportional hazards model was used to estimate hazards ratios with 95% confidence intervals. We also performed subgroup analyses by class of antidepressant/type of NSAIDs, age and sex. RESULTS From 240,982 patients, 235,080, 4393 and 1509 patients were users of NSAIDs, antidepressants or both drugs at cohort entry, respectively. The cohort generated 2.1 million person-years of follow-up with 22,453 events of MACE (incidence rate 1.07 per 100 person-years). Compared with non-use, concomitant use (hazard ratio 1.13, 95% confidence interval 1.01-1.26) and NSAID-only use (1.05, 1.001-1.10) were positively associated with MACE, while antidepressant-only use showed a negative association (0.91, 0.83-0.99). Concomitant use increased the individual risk of haemorrhagic stroke (1.46, 1.06-2.00), ischaemic stroke (1.22, 1.07-1.38) and heart failure (1.19, 1.02-1.38), but showed a protective effect on cardiovascular deaths (0.36, 0.21-0.62). Of the six possible combinations of antidepressants and NSAIDs by their classes, only concomitant use of tricyclic antidepressants and non-selective NSAIDs was positively associated with MACE (1.26, 1.09-1.47). The risk of MACE remained elevated with concomitant use among those aged ≥ 45 years (1.14, 1.01-1.29) and male patients (1.19, 1.01-1.42). CONCLUSIONS Concomitant use of antidepressants and NSAIDs moderately elevated the risk of MACE, of which the observed risk appears to be driven by the concomitant use of tricyclic antidepressants and non-selective NSAIDs. Thus, healthcare providers should take precaution when co-prescribing these drugs, weighing the potential benefits and risks associated with their use.
Collapse
Affiliation(s)
- Han Eol Jeong
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, South Korea
| | - In-Sun Oh
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, South Korea
| | - Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi-do, South Korea
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do, 16419, South Korea.
| |
Collapse
|
13
|
Mather L, Narusyte J, Ropponen A, Bergström G, Blom V, Helgadóttir B, Svedberg P. Sick leave due to mental disorders, morbidity and mortality: a prospective study of discordant twin pairs. Soc Psychiatry Psychiatr Epidemiol 2020; 55:25-32. [PMID: 31076801 DOI: 10.1007/s00127-019-01715-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 04/25/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate if sick leave due to mental disorders increases the risk of morbidity measured by inpatient and specialized outpatient care, and mortality among women and men, independent of familial factors. METHODS An open cohort study of 4979 twin pairs discordant for sick leave due to mental disorders was conducted in 2005-2013. Twins were followed up in the cause of death and national patient registries until the end of study, emigration, death, and inpatient and specialized outpatient care. Conditional Cox proportional hazard regression, adjusting for the familial factors shared by the twins, was used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In case of non-proportional hazards, time-varying covariates were used. RESULTS Sick leave due to mental disorders increased the risk for inpatient care among men (HR: 1.90, CI 1.66-2.17) and women (HR: 1.39, CI 1.27-1.51). For men, the risk of outpatient care was higher the first 2 years (HR: 2.08, CI 1.87-2.31), after which it was attenuated (HR: 1.32, CI 1.02-1.70). For women, the HR was 1.57 (CI 1.47-1.68) for the whole study time. There was an increased risk of death among men (HR: 2.91, CI 1.70-4.99), but not among women (HR: 0.84, CI 0.53-1.35). CONCLUSIONS Sick leave due to mental disorders was a risk factor for mortality for men only, and increased the risk of inpatient and specialized outpatient care among both women and men, but the risks were higher for men when stratifying for sex.
Collapse
Affiliation(s)
- Lisa Mather
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden.
| | - J Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden
| | - A Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden.,Finnish Institute of Occupational Health, Helsinki, Finland
| | - G Bergström
- Unit of Intervention and Implementation Research for Worker Health, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Occupational and Public Health Sciences, Centre for Musculoskeletal Research, University of Gävle, Gävle, Sweden
| | - V Blom
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden.,The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - B Helgadóttir
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden
| | - P Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Berzelius väg 3, 171 77, Stockholm, Sweden
| |
Collapse
|
14
|
[The risk of medical comorbidity in mental disorders with a particular focus on depressive syndromes]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2019; 65:129-143. [PMID: 31154922 DOI: 10.13109/zptm.2019.65.2.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The risk of medical comorbidity in mental disorders with a particular focus on depressive syndromes Objectives: It has long been recognized that certain mental disorders, and in particular depressive syndromes, are associated with increased medical comorbidity. However, reliable data on the prevalence of comorbid medical diagnoses as well as the impact of these comorbidities on mortality are often rare and sometimes conflicting. Methods: A systematic literature review was conducted using PubMed and Google Scholar to provide a critical account of the current state of research on the comorbidities of medical and mental disorders, with a particular focus on depressive syndromes. Results: Among patients with mental disorders, all-cause mortality is about doubled as compared to the general population causing a significantly shortened life expectancy in the range of one to two decades. This excess mortality is primarily due to increased physical morbidity and mortality, and it cannot be excluded that, for patients with severe mental disorders, excess mortality has been increased over time. Depressive syndromes are often linked to a broad range of somatic symptoms and can be found in diseases, such as heart disease, stroke, diabetes mellitus, overweight/obesity, and asthma. Conclusion: Current studies provide ample evidence of close interactions between physical and mental health. Further developments in the field of psychosomatic medicine should take into consideration the health-related consequences of these interactions.
Collapse
|
15
|
Antidepressants-related cardiovascular adverse events using the adverse event reporting system. Psychiatry Res 2018; 268:441-446. [PMID: 30130711 DOI: 10.1016/j.psychres.2018.07.044] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/25/2018] [Accepted: 07/31/2018] [Indexed: 01/17/2023]
Abstract
The aim of this study was to evaluate clinical manifestations and the age and sex distribution of cardiovascular adverse events (CVAEs) related to antidepressants. The FDA Adverse Event Reporting System (FAERS) and Korea Adverse Event Reporting System (KAERS) database records on patients prescribed antidepressants were used. The frequency of CVAEs was compared between adults (19-64 years) and an older (age ≥ 65 years) group. In total, 75,608 CVAEs from 43,824 patients and 325 CVAEs from 313 patients in FAERS and KAERS, respectively, were included in the analysis. Among them, 7066 (16.08%) and 103 (32.91%) patients were 65 years of age or older in FAERS and KAERS, respectively. Serious AEs were significantly more common among older patients compared to adults in both the FAERS and KAERS datasets. CVAEs were frequently reported with paroxetine and duloxetine in the FAERS, while amitriptyline and duloxetine were reported in the KAERS. The two most frequent CVAEs were "ventricular arrhythmias and cardiac arrest" and "rate and rhythm disorders" in the FAERS, while "hypotension", and "oedema", were found in the KAERS. Several CVAEs were detected by the reporting odds ratios and proportional reporting ratios methods. The serious AEs associated with antidepressants might have a significant impact on older patients.
Collapse
|
16
|
Individualized Anesthetic Management for Patients Undergoing Electroconvulsive Therapy. Anesth Analg 2017; 124:1943-1956. [DOI: 10.1213/ane.0000000000001873] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
17
|
Correll CU, Solmi M, Veronese N, Bortolato B, Rosson S, Santonastaso P, Thapa-Chhetri N, Fornaro M, Gallicchio D, Collantoni E, Pigato G, Favaro A, Monaco F, Kohler C, Vancampfort D, Ward PB, Gaughran F, Carvalho AF, Stubbs B. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry 2017; 16:163-180. [PMID: 28498599 PMCID: PMC5428179 DOI: 10.1002/wps.20420] [Citation(s) in RCA: 969] [Impact Index Per Article: 138.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
People with severe mental illness (SMI) - schizophrenia, bipolar disorder and major depressive disorder - appear at risk for cardiovascular disease (CVD), but a comprehensive meta-analysis is lacking. We conducted a large-scale meta-analysis assessing the prevalence and incidence of CVD; coronary heart disease; stroke, transient ischemic attack or cerebrovascular disease; congestive heart failure; peripheral vascular disease; and CVD-related death in SMI patients (N=3,211,768) versus controls (N=113,383,368) (92 studies). The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4-13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross-sectional studies (odds ratio, OR=1.53, 95% CI: 1.27-1.83; 11 studies), and higher odds of coronary heart disease (OR=1.51, 95% CI: 1.47-1.55) and cerebrovascular disease (OR=1.42, 95% CI: 1.21-1.66). People with major depressive disorder were at increased risk for coronary heart disease, while those with schizophrenia were at increased risk for coronary heart disease, cerebrovascular disease and congestive heart failure. Cumulative CVD incidence in SMI patients was 3.6% (95% CI: 2.7-5.3) during a median follow-up of 8.4 years (range 1.8-30.0). Adjusting for a median of six confounders, SMI patients had significantly higher CVD incidence than controls in longitudinal studies (hazard ratio, HR=1.78, 95% CI: 1.60-1.98; 31 studies). The incidence was also higher for coronary heart disease (HR=1.54, 95% CI: 1.30-1.82), cerebrovascular disease (HR=1.64, 95% CI: 1.26-2.14), congestive heart failure (HR=2.10, 95% CI: 1.64-2.70), and CVD-related death (HR=1.85, 95% CI: 1.53-2.24). People with major depressive disorder, bipolar disorder and schizophrenia were all at increased risk of CVD-related death versus controls. CVD incidence increased with antipsychotic use (p=0.008), higher body mass index (p=0.008) and higher baseline CVD prevalence (p=0.03) in patients vs. CONTROLS Moreover, CVD prevalence (p=0.007), but not CVD incidence (p=0.21), increased in more recently conducted studies. This large-scale meta-analysis confirms that SMI patients have significantly increased risk of CVD and CVD-related mortality, and that elevated body mass index, antipsychotic use, and CVD screening and management require urgent clinical attention.
Collapse
Affiliation(s)
- Christoph U Correll
- Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
- Institute for Clinical Research and Education in Medicine, Padua, Italy
| | - Marco Solmi
- Institute for Clinical Research and Education in Medicine, Padua, Italy
- Department of Neurosciences, University of Padua, Padua, Italy
- Mental Health Department, Local Health Unit 17, Padua, Italy
| | - Nicola Veronese
- Institute for Clinical Research and Education in Medicine, Padua, Italy
| | - Beatrice Bortolato
- Institute for Clinical Research and Education in Medicine, Padua, Italy
- Mental Health Department, Local Health Unit 10, Portogruaro, Italy
| | - Stella Rosson
- Department of Neurosciences, University of Padua, Padua, Italy
| | | | | | - Michele Fornaro
- New York Psychiatric Institute, Columbia University, New York, NY, USA
| | | | | | - Giorgio Pigato
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Angela Favaro
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Francesco Monaco
- Institute for Clinical Research and Education in Medicine, Padua, Italy
| | - Cristiano Kohler
- Department of Clinical Medicine and Translational Psychiatry Research Group, Federal University of Ceará, Fortaleza, Brazil
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- KU Leuven University Psychiatric Center, Leuven-Kortenberg, Belgium
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Fiona Gaughran
- South London and Maudsley, NHS Foundation Trust, London, UK
| | - André F Carvalho
- Institute for Clinical Research and Education in Medicine, Padua, Italy
- Department of Clinical Medicine and Translational Psychiatry Research Group, Federal University of Ceará, Fortaleza, Brazil
| | - Brendon Stubbs
- Institute for Clinical Research and Education in Medicine, Padua, Italy
- South London and Maudsley, NHS Foundation Trust, London, UK
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| |
Collapse
|
18
|
Loria AS, Osborn JL. Maternal separation diminishes α-adrenergic receptor density and function in renal vasculature from male Wistar-Kyoto rats. Am J Physiol Renal Physiol 2017; 313:F47-F54. [PMID: 28331064 DOI: 10.1152/ajprenal.00591.2016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 03/13/2017] [Accepted: 03/15/2017] [Indexed: 11/22/2022] Open
Abstract
Adult rats exposed to maternal separation (MatSep) are normotensive but display lower glomerular filtration rate and increased renal neuroadrenergic drive. The aim of this study was to determine the renal α-adrenergic receptor density and the renal vascular responsiveness to adrenergic stimulation in male rats exposed to MatSep. In addition, baroreflex sensitivity was assessed to determine a component of neural control of the vasculature. Using tissue collected from 4-mo-old MatSep and control rats, α1-adrenergic receptors (α1-ARs) were measured in renal cortex and isolated renal vasculature using receptor binding assay, and the α-AR subtype gene expression was determined by RT-PCR. Renal cortical α1-AR density was similar between MatSep and control tissues (Bmax = 44 ± 1 vs. 42 ± 2 fmol/mg protein, respectively); however, MatSep reduced α1-AR density in renal vasculature (Bmax = 47 ± 4 vs. 62 ± 4 fmol/mg protein, P < 0.05, respectively). In a separate group of rats, the pressor, bradycardic, and renal vascular constrictor responses to acute norepinephrine injection (NE, 0.03-0.25 μg/μl) were determined under anesthesia. Attenuated NE-induced renal vasoconstriction was observed in rats exposed to MatSep compared with control (P < 0.05). A third group of rats was infused at steady state with the α1 agonist phenylephrine (10 μg/min iv) and vasodilator sodium nitroprusside (5 μg/min iv). The difference between the change in heart rate/mean arterial pressure slopes was indicative of reduced baroreflex sensitivity in MatSep vs. control rats (-0.45 ± 0.04 vs. -0.95 ± 0.07 beats·min-1·mmHg-1, P < 0.05). These data support the notion that reduced α-adrenergic receptor expression and function in the renal vasculature could develop secondary to MatSep-induced overactivation of the renal neuroadrenergic tone.
Collapse
Affiliation(s)
- Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky; and
| | - Jeffrey L Osborn
- Department of Biology, University of Kentucky, Lexington, Kentucky
| |
Collapse
|
19
|
Murphy MO, Cohn DM, Loria AS. Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents. Neurosci Biobehav Rev 2017; 74:453-465. [PMID: 27450581 PMCID: PMC5250589 DOI: 10.1016/j.neubiorev.2016.07.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 02/07/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.
Collapse
Affiliation(s)
- M O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - D M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - A S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States.
| |
Collapse
|
20
|
Abstract
Addressing mental illness requires a culturally sensitive approach. As detailed in this literature review, treating mental illness in the South Asian immigrant community necessitates a thorough understanding of the South Asian conceptualization of mental illness. Past research, though limited, has described the different reasons the South Asian community attributes to causing mental illness, as well as the stigma associated with acknowledging the disease. Acculturation of the community also plays a significant role in cultural acceptability and the receipt of quality care. Lessons from local organizations can be applied at the national level to promote cultural responsiveness in treating mental illness in the South Asian immigrant community.
Collapse
|
21
|
Toni G, Belvederi Murri M, Piepoli M, Zanetidou S, Cabassi A, Squatrito S, Bagnoli L, Piras A, Mussi C, Senaldi R, Menchetti M, Zocchi D, Ermini G, Ceresini G, Tripi F, Rucci P, Alexopoulos GS, Amore M. Physical Exercise for Late-Life Depression: Effects on Heart Rate Variability. Am J Geriatr Psychiatry 2016; 24:989-997. [PMID: 27660194 DOI: 10.1016/j.jagp.2016.08.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 06/30/2016] [Accepted: 08/03/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Late-life major depression is associated with increased cardiovascular risk and impaired autonomic control of the heart, as evident from reduced heart rate variability (HRV). Moreover, antidepressant drug therapy also might be associated with further reductions of HRV. In the SEEDS study, we investigated whether sertraline associated with physical exercise protocols led to improvements of HRV, compared with antidepressant drug therapy alone. DESIGN Single-blind randomized controlled trial. SETTING Psychiatric consultation-liaison program for primary care. PARTICIPANTS Patients aged 65-85 years with major depression, recruited from primary care. INTERVENTIONS Sertraline plus structured, tailored group physical exercise (S + EX) versus sertraline alone (S) for 24 weeks. MEASUREMENTS HRV indices (RR, percentage of NN intervals greater than 50 msec [pNN50], square root of the mean squared differences of successive NN intervals [RMSSD], standard deviation of heart rate [SDHR], standard deviation of the NN interval [SDNN], high-frequency band [HF], low-frequency band [LF], and their ratio [LF/HF]) were measured at baseline, week 12, and week 24. Psychiatric and medical assessments. RESULTS Participants displayed significant improvements of most HRV indices over time, irrespective of the group assignment (pNN50, RMSSD, SDHR, SDNN, HF, LF, and LF/HF). Moreover, patients in the S + EX group displayed greater increases of different HRV indices(RR, pNN50, RMSSD, SDHR, SDNN, HF, and LF) compared with those in the S group. CONCLUSIONS The combination of structured physical exercise and sertraline might exert positive effects on the autonomic control of the heart among older patients with major depression.
Collapse
Affiliation(s)
- Giulio Toni
- Cardiology Unit, Ramazzini Hospital, Carpi, Italy
| | - Martino Belvederi Murri
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy; Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology, and Neuroscience, London, UK.
| | - Massimo Piepoli
- Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, Piacenza, Italy
| | - Stamatula Zanetidou
- Consultation Liaison Psychiatry Service, Department of Mental Health, Bologna, Italy
| | - Aderville Cabassi
- Cardiorenal Research Unit, Department of Clinical and Experimental Medicine, Parma University School of Medicine, Parma, Italy
| | - Salvatore Squatrito
- Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy
| | - Luigi Bagnoli
- Primary Care Physicians in Private Practice, Bologna, Italy
| | - Alessandro Piras
- Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy
| | - Chiara Mussi
- Department of Geriatrics, Nuovo Ospedale Civile S. Agostino Estense, Modena, and Reggio Emilia University, Modena, Italy
| | | | - Marco Menchetti
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Donato Zocchi
- Primary Care Physicians in Private Practice, Bologna, Italy
| | | | - Graziano Ceresini
- Department of Clinical and Experimental Medicine, Endocrinology of Aging Unit, University of Parma, Italy
| | | | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, Section of Human and General Physiology, University of Bologna, Italy
| | | | - Mario Amore
- Section of Psychiatry, Department of Neuroscience, Oftalmology, Genetics, and Infant-Maternal Science, University of Genoa, Genoa, Italy
| | | |
Collapse
|
22
|
Kuehl LK, Muhtz C, Hinkelmann K, Dettenborn L, Wingenfeld K, Spitzer C, Otte C. Association between major depression and cardiovascular risk: the role of antidepressant medication. Psychopharmacology (Berl) 2016; 233:3289-95. [PMID: 27465410 DOI: 10.1007/s00213-016-4361-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 06/18/2016] [Indexed: 10/21/2022]
Abstract
RATIONALE AND OBJECTIVES Major depressive disorder (MDD) is associated with an increased risk for cardiovascular disease (CVD). Apart from biological and life style factors, the use of antidepressants and their potentially adverse effects might contribute to the increased CVD risk. Therefore, we compared cardiovascular risk profiles between relatively young depressed patients without CVD with and without antidepressant medication and healthy participants. METHODS We investigated 44 depressed patients (with antidepressants N = 20 (13 women), mean age 43.2 years; without antidepressants N = 24 (15 women), mean age 40.0) and 41 healthy participants (matched for sex, age, education). As markers of CVD risk, blood pressure, body mass index (BMI), and plasma levels of fasting glucose, cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and high sensitivity C-reactive protein (h-CRP) were measured. RESULTS We found significant differences between groups for BMI (p < .01), systolic (p = .02) and diastolic blood pressure (p < .01), and glucose (p < .001). Post hoc analyses indicated differences between both patient groups compared to the healthy control group, but not between patients groups. Further controlling for BMI diminished the effect of diagnosis on blood pressure; however, this was not the case for glucose level. There were no between-group differences in cholesterol, LDL, HDL, and h-CRP. CONCLUSIONS We found a clearly increased CVD risk in this group of rather young depressed patients. Importantly, there was no significant difference in CVD risk between patients with vs. without antidepressants. This suggests that major depression per se and not antidepressant medication is associated with increased CVD risk.
Collapse
Affiliation(s)
- Linn K Kuehl
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Christoph Muhtz
- Department of Psychosomatic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kim Hinkelmann
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Lucia Dettenborn
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katja Wingenfeld
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany
| | | | - Christian Otte
- Department of Psychiatry, Charité University Medical School Berlin, Campus Benjamin Franklin, Berlin, Germany
| |
Collapse
|
23
|
Salagre E, Fernandes BS, Dodd S, Brownstein DJ, Berk M. Statins for the treatment of depression: A meta-analysis of randomized, double-blind, placebo-controlled trials. J Affect Disord 2016; 200:235-42. [PMID: 27148902 DOI: 10.1016/j.jad.2016.04.047] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/24/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND In epidemiological studies, statins appear to benefit mood, and there are now some randomized controlled trials examining the efficacy of statins. However, the role of statins in depression remains uncertain. Thus the aim of this paper was to assess the effect of statins on depressive symptoms by performing a meta-analysis of all double-blind, randomized, placebo controlled clinical trials (RCT) conducted in subjects with depression. METHODS A systematic search was executed using PubMed and ClinicalTrials.gov in November 30th, 2015 for all double-blind, RCT of statins versus placebo in persons with depressive symptoms. Sixty-seven potential articles were identified through search of electronic databases, of those three met inclusion criteria and were included in the meta-analysis. The outcome measure was change in Hamilton Depression Rating Scale (HDRS) scores associated with statin use. A meta-analysis was conducted and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. GRADE was used to assess study quality. RESULTS The three articles included provided data on 165 participants with moderate to severe depression. Of these, 82 were randomized to statins as an adjuvant therapy to antidepressant treatment (i.e., citalopram or fluoxetine) and 83 to the placebo arm. All studies were double-blind RCTs, with a follow-up of 6-12 weeks. The statin agents evaluated were lovastatin, atorvastatin, and simvastatin. When compared to placebo, statins, as add-on to treatment as usual, largely improved depressive symptoms as assessed by the HDRS (SMD=-0.73, 95% IC -1.04 to -0.42, p<0.001, 3 between-group comparisons, n=165). No serious adverse effects were reported. CONCLUSIONS Our results suggest that adjunctive treatment with statins could be useful for the treatment of depressive symptoms. Additional double-blind, randomised, placebo-controlled trials are necessary to settle the matter.
Collapse
Affiliation(s)
- Estela Salagre
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Geelong, Australia; Hospital de la Santa Creu i Sant Pau, Servei de Psiquiatria, Barcelona, Spain.
| | - Brisa S Fernandes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Geelong, Australia; Laboratory of Calcium Binding Proteins in the Central Nervous System, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | - Seetal Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Geelong, Australia; Department of Psychiatry, University of Melbourne, Parkville, Australia
| | - Daniel J Brownstein
- Monash University, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, and Barwon Health, Geelong, Australia; Florey Institute for Neuroscience and Mental Health, Department of Psychiatry and Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, Australia
| |
Collapse
|
24
|
Daskalopoulou M, George J, Walters K, Osborn DP, Batty GD, Stogiannis D, Rapsomaniki E, Pujades-Rodriguez M, Denaxas S, Udumyan R, Kivimaki M, Hemingway H. Depression as a Risk Factor for the Initial Presentation of Twelve Cardiac, Cerebrovascular, and Peripheral Arterial Diseases: Data Linkage Study of 1.9 Million Women and Men. PLoS One 2016; 11:e0153838. [PMID: 27105076 PMCID: PMC4841529 DOI: 10.1371/journal.pone.0153838] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 04/05/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Depression is associated with coronary heart disease and stroke, but associations with a range of pathologically diverse cardiovascular diseases are not well understood. We examine the risk of 12 cardiovascular diseases according to depression status (history or new onset). METHODS Cohort study of 1,937,360 adult men and women, free from cardiovascular disease at baseline, using linked UK electronic health records between 1997 and 2010. The exposures were new-onset depression (a new GP diagnosis of depression and/or prescription for antidepressants during a one-year baseline), and history of GP-diagnosed depression before baseline. The primary endpoint was initial presentation of 12 cardiovascular diseases after baseline. We used disease-specific Cox proportional hazards models with multiple imputation adjusting for cardiovascular risk factors (age, sex, socioeconomic status, smoking, blood pressure, diabetes, cholesterol). RESULTS Over a median [IQR] 6.9 [2.1-10.5] years of follow-up, 18.9% had a history of depression and 94,432 incident cardiovascular events occurred. After adjustment for cardiovascular risk factors, history of depression was associated with: stable angina (Hazard Ratio = 1.38, 95%CI 1.32-1.45), unstable angina (1.70, 1.60-1.82), myocardial infarction (1.21, 1.16-1.27), unheralded coronary death (1.23, 1.14-1.32), heart failure (1.18, 1.13-1.24), cardiac arrest (1.14, 1.03-1.26), transient ischemic attack (1.31, 1.25-1.38), ischemic stroke (1.26, 1.18-1.34), subarachnoid haemorrhage (1.17, 1.01-1.35), intracerebral haemorrhage (1.30, 1.17-1.45), peripheral arterial disease (1.24, 1.18-1.30), and abdominal aortic aneurysm (1.12,1.01-1.24). New onset depression developed in 2.9% of people, among whom 63,761 cardiovascular events occurred. New onset depression was similarly associated with each of the 12 diseases, with no evidence of stronger associations compared to history of depression. The strength of association between depression and these cardiovascular diseases did not differ between women and men. CONCLUSION Depression was prospectively associated with cardiac, cerebrovascular, and peripheral diseases, with no evidence of disease specificity. Further research is needed in understanding the specific pathophysiology of heart and vascular disease triggered by depression in healthy populations.
Collapse
Affiliation(s)
- Marina Daskalopoulou
- Department of Infection & Population Health, University College London, London, United Kingdom
| | - Julie George
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Kate Walters
- Department of Primary Care & Population Health, University College London, London, United Kingdom
| | - David P. Osborn
- Division of Psychiatry, University College London, London, United Kingdom
| | - G. David Batty
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Dimitris Stogiannis
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Eleni Rapsomaniki
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Mar Pujades-Rodriguez
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Spiros Denaxas
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| | - Ruzan Udumyan
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Mika Kivimaki
- Department of Epidemiology & Public Health, University College London, London, United Kingdom
| | - Harry Hemingway
- Farr Institute of Health Informatics Research, University College London, London, United Kingdom
| |
Collapse
|
25
|
Socioeconomic Position and Antidepressant Use as Predictors of Coronary Heart Disease Mortality: A Population-Based Registry Study of 362,271 Finns. Psychosom Med 2016; 78:144-52. [PMID: 26780300 DOI: 10.1097/psy.0000000000000258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The interplay between depression and socioeconomic position (SEP) in predicting cardiovascular outcomes has rarely been examined. We investigated whether SEP modified the effect of antidepressant use on coronary heart disease (CHD) mortality. METHODS The data consisted of an 11% random sample of the Finnish population aged 40 to 79 years at the end of 1999 with an oversample of 80% of those who died in 2000 to 2007. Participants free of CHD at baseline (n = 362,271) were followed up for CHD mortality in 2000 to 2007. SEP was assessed via registry-based information on education, occupational position, and income. Antidepressant use served as a proxy for depression and was derived from registry data on prescription medication purchases in the 5-year period preceding baseline. Age- and sex-adjusted Cox regression models with sampling weights were used. RESULTS Individuals with antidepressant purchases in any year 1995 to 1999 had a higher risk of CHD deaths (hazard ratio [HR] = 1.68, 95% confidence interval [CI] = 1.62-1.75) than did those without purchases. Basic level of education (HR = 2.09, 95% CI = 2.01-2.17), blue-collar occupations (HR = 1.70, 95% CI = 1.65-1.75), and the lowest income tertile (HR = 2.79, 95% CI = 2.69-2.91) were related to increased relative risks for CHD mortality. No significant (p < .05) interactions emerged between the SEP indicators and antidepressant purchases indicating that the effect of antidepressant use on the relative risk for CHD was similar across varying levels of SEP. CONCLUSIONS Our study demonstrates that in a country with tax-funded universal health care services, low SEP does not exacerbate the adverse effects of depression-as measured by antidepressant treatment-on cardiovascular health.
Collapse
|
26
|
Severity of Depression, Anxious Distress and the Risk of Cardiovascular Disease in a Swedish Population-Based Cohort. PLoS One 2015; 10:e0140742. [PMID: 26469703 PMCID: PMC4607409 DOI: 10.1371/journal.pone.0140742] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 09/30/2015] [Indexed: 12/30/2022] Open
Abstract
Background Depression is known to be associated with cardiovascular diseases (CVD). This population-based cohort study aimed to determine the association between depression of varying severity and risk for CVD and to study the effect of concomitant anxious distress on this association. Methods We utilized data from a longitudinal cohort study of mental health, work and relations among adults (20–64 years), with a total of 10,443 individuals. Depression and anxious distress were assessed using psychiatric rating scales and defined according to DSM-5. Outcomes were register-based and self-reported cardiovascular diseases. Findings Overall increased odds ratios of 1.5 to 2.6 were seen for the different severity levels of depression, with the highest adjusted OR for moderate depression (OR 2.1 (95% CI 1.3, 3.5). Similar odds ratios were seen for sub-groups of CVD: ischemic/hypertensive heart disease and stroke, 2.4 (95% CI 1.4, 3.9) and OR 2.1 (95%CI 1.2, 3.8) respectively. Depression with anxious distress as a specifier of severity showed OR of 2.1 (95% CI 1.5, 2.9) for CVD. Conclusion This study found that severity level of depression seems to be of significance for increased risk of CVD among depressed persons, although not in a dose-response manner which might be obscured due to treatment of depression. Further, we found a higher risk of CVD among depressed individuals with symptoms of anxious distress.
Collapse
|
27
|
Abstract
The Rotterdam Study is a prospective cohort study ongoing since 1990 in the city of Rotterdam in The Netherlands. The study targets cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. The findings of the Rotterdam Study have been presented in over 1200 research articles and reports (see www.erasmus-epidemiology.nl/rotterdamstudy ). This article gives the rationale of the study and its design. It also presents a summary of the major findings and an update of the objectives and methods.
Collapse
|
28
|
Swain NR, Lim CC, Levinson D, Fiestas F, de Girolamo G, Moskalewicz J, Lepine JP, Posada-Villa J, Haro JM, Medina-Mora ME, Xavier M, Iwata N, de Jonge P, Bruffaerts R, O’Neill S, Kessler RC, Scott KM. Associations between DSM-IV mental disorders and subsequent non-fatal, self-reported stroke. J Psychosom Res 2015; 79:130-6. [PMID: 26094010 PMCID: PMC4621960 DOI: 10.1016/j.jpsychores.2015.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 05/01/2015] [Accepted: 05/13/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To examine the associations between a wide range of mental disorders and subsequent onset of stroke. Lifecourse timing of stroke was examined using retrospectively reconstructed data from cross-sectional surveys. METHODS Data from the World Mental Health Surveys were accessed. This data was collected from general population surveys over 17 countries of 87,250 adults. The Composite International Diagnostic Interview retrospectively assessed lifetime prevalence and age at onset of DSM-IV mental disorders. A weighted subsample (n=45,288), was used for analysis in the present study. Survival analyses estimated associations between first onset of mental disorders and subsequent stroke onset. RESULTS Bivariate models showed that 12/16 mental disorders were associated with subsequent stroke onset (ORs ranging from 1.6 to 3.8). However, after adjustment for mental disorder comorbidity and smoking, only significant relationships between depression and stroke (OR 1.3) and alcohol abuse and stroke (OR 1.5) remained. Among females, having a bipolar disorder was also associated with increased stroke incidence (OR 2.1). Increasing number of mental disorders was associated with stroke onset in a dose-response fashion (OR 3.3 for 5+ disorders). CONCLUSIONS Depression and alcohol abuse may have specific associations with incidence of non-fatal stroke. General severity of psychopathology may be a more important predictor of non-fatal stroke onset. Mental health treatment should be considered as part of stroke risk prevention. Limitations of retrospectively gathered cross sectional surveys design mean further research on the links between mental health and stroke incidence is warranted.
Collapse
Affiliation(s)
- Nicola R. Swain
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand,Corresponding author at: Department of Psychological Medicine, Otago University, PO Box 913, Dunedin, New Zealand. (N.R. Swain)
| | - Carmen C.W. Lim
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | | | - Fabian Fiestas
- Unit of Analysis and Generation of Evidence for Public Health, Peruvian National Institute of Health, Peru
| | | | | | - Jean-Pierre Lepine
- Assistance Publique Hôpitaux de Paris, Universités Paris Descartes — Paris Diderot Inserm UMR-S 1144, France
| | | | - Josep Maria Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Universitat de Barcelona, Spain
| | | | - Miguel Xavier
- Chronic Diseases Research Center (CEDOC), Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Portugal
| | - Noboru Iwata
- Department of Clinical Psychology, Hiroshima International University, Japan
| | - Peter de Jonge
- University of Groningen, University Medical Center, Groningen Department of Psychiatry, Interdisciplinary Center, Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands
| | - Ronny Bruffaerts
- University Psychiatric Centre, University of Leuven, Campus Gasthuisberg, Belgium
| | - Siobhan O’Neill
- School of Psychology, University of Ulster, Northern Ireland
| | - Ron C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
| | - Kate M. Scott
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| |
Collapse
|
29
|
Abstract
BACKGROUND Altered cardiac autonomic control has often been reported in depressed persons and might play an important role in the increased risk for cardiovascular disease (CVD). A negative association between cardiac autonomic control and depression might become specifically clinically relevant in persons 60 years or older as CVD risk increases with age. METHODS This study included data of 321 persons with a depressive disorder and 115 controls participating in the Netherlands Study of Depression in Older Persons (mean age = 70.3 years, 65.7% female). Respiratory sinus arrhythmia (RSA), heart rate (HR), and preejection period (PEP) were measured and compared between depressed persons and controls. In addition, the role of antidepressants and clinical characteristics (e.g., age of depression onset and comorbid anxiety) was examined. RESULTS Compared with controls, depressed persons had lower RSA (mean [standard error of the mean] = 23.5 [1.2] milliseconds versus 18.6 [0.7] milliseconds, p = .001, d = 0.373) and marginally higher HR (73.1 [1.1] beats/min versus 75.6 [0.6] beats/min, p = .065, d = 0.212), but comparable PEP (113.9 [2.1] milliseconds versus 112.0 [1.2] milliseconds, p = .45, d = 0.087), fully adjusted. Antidepressants strongly attenuated the associations between depression and HR and RSA. Antidepressant-naïve depressed persons had similar HR and RSA to controls, whereas users of antidepressants showed significantly lower RSA. In addition, tricyclic antidepressant users had higher HR (p < .001, d = 0.768) and shorter PEP (p = .014, d = 0.395) than did controls. CONCLUSIONS Depression was not associated with cardiac autonomic control, but antidepressants were in this sample. All antidepressants were associated with low cardiac parasympathetic control and specifically tricyclic antidepressants with high cardiac sympathetic control.
Collapse
|
30
|
Impact of depression on incident stroke: A meta-analysis. Int J Cardiol 2015; 180:103-10. [DOI: 10.1016/j.ijcard.2014.11.198] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 10/24/2014] [Accepted: 11/24/2014] [Indexed: 11/23/2022]
|
31
|
Maruthappu M, Shalhoub J, Tariq Z, Williams C, Atun R, Davies AH, Zeltner T. Unemployment, government healthcare spending, and cerebrovascular mortality, worldwide 1981-2009: an ecological study. Int J Stroke 2015; 10:364-71. [PMID: 25588453 DOI: 10.1111/ijs.12408] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/13/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND The global economic downturn has been associated with unemployment rises, reduced health spending, and worsened population health. This has raised the question of how economic variations affect health outcomes. AIM We sought to determine the effect of changes in unemployment and government healthcare expenditure on cerebrovascular mortality globally. METHODS Data were obtained from the World Bank and World Health Organization. Multivariate regression analysis was used to assess the effect of changes in unemployment and government healthcare expenditure on cerebrovascular mortality. Country-specific differences in infrastructure and demographics were controlled for. One- to five-year lag analyses and robustness checks were conducted. RESULTS Across 99 countries worldwide, between 1981 and 2009, every 1% increase in unemployment was associated with a significant increase in cerebrovascular mortality (coefficient 187, CI: 86.6-288, P = 0.0003). Every 1% rise in government healthcare expenditure, across both genders, was associated with significant decreases in cerebrovascular deaths (coefficient 869, CI: 383-1354, P = 0.0005). The association between unemployment and cerebrovascular mortality remained statistically significant for at least five years subsequent to the 1% unemployment rise, while the association between government healthcare expenditure and cerebrovascular mortality remained significant for two years. These relationships were both shown to be independent of changes in gross domestic product per capita, inflation, interest rates, urbanization, nutrition, education, and out-of-pocket spending. CONCLUSIONS Rises in unemployment and reductions in government healthcare expenditure are associated with significant increases in cerebrovascular mortality globally. Clinicians may also need to consider unemployment as a possible risk factor for cerebrovascular disease mortality.
Collapse
|
32
|
Barlinn K, Kepplinger J, Puetz V, Illigens BM, Bodechtel U, Siepmann T. Exploring the risk-factor association between depression and incident stroke: a systematic review and meta-analysis. Neuropsychiatr Dis Treat 2015; 11:1-14. [PMID: 25565846 PMCID: PMC4274141 DOI: 10.2147/ndt.s63904] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
There is growing evidence that depression increases the risk of incident stroke. However, few studies have considered possible residual confounding effects by preexistent cerebrovascular and cardiac diseases. Therefore, we synthesized data from cohort studies to explore whether depressed individuals free of cerebrovascular and cardiac diseases are at higher risk of incident stroke. We searched the electronic databases PubMed and Medline for eligible cohort studies that examined the prospective association between depression and first-ever stroke. A random-effects model was used for quantitative data synthesis. Sensitivity analyses comprised cohort studies that considered a lag period with exclusion of incident strokes in the first years of follow-up to minimize residual confounding by preexistent silent strokes and excluded cardiac disease at baseline. Overall, we identified 28 cohort studies with 681,139 participants and 13,436 (1.97%) incident stroke cases. The pooled risk estimate revealed an increased risk of incident stroke for depression (relative risk 1.40, 95% confidence interval [CI] 1.27-1.53; P<0.0001). When we excluded incident strokes that occurred in the first years of follow-up, the prospective association between depression and incident stroke remained significant (relative risk 1.64, 95% CI 1.27-2.11; P<0.0001). This positive association also remained after we considered only studies with individuals with cardiac disease at baseline excluded (relative risk 1.43, 95% CI 1.19-1.72; P<0.0001). The prospective association of depression and increased risk of first-ever stroke demonstrated in this meta-analysis appears to be driven neither by preexistence of clinically apparent cerebrovascular and cardiovascular diseases nor by silent stroke.
Collapse
Affiliation(s)
- Kristian Barlinn
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, University of Technology Dresden, Dresden, Germany
| | - Jessica Kepplinger
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, University of Technology Dresden, Dresden, Germany
| | - Volker Puetz
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, University of Technology Dresden, Dresden, Germany
| | - Ben M Illigens
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ulf Bodechtel
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, University of Technology Dresden, Dresden, Germany
| | - Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus Dresden, University of Technology Dresden, Dresden, Germany
| |
Collapse
|
33
|
Early origins of chronic obstructive lung diseases across the life course. Eur J Epidemiol 2014; 29:871-85. [PMID: 25537319 DOI: 10.1007/s10654-014-9981-5] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 12/06/2014] [Indexed: 12/12/2022]
Abstract
Chronic obstructive lung diseases, like asthma and chronic obstructive pulmonary disease, have high prevalences and are a major public health concern. Chronic obstructive lung diseases have at least part of their origins in early life. Exposure to an adverse environment during critical periods in early life might lead to permanent developmental adaptations which results in impaired lung growth with smaller airways and lower lung volume, altered immunological responses and related inflammation, and subsequently to increased risks of chronic obstructive lung diseases throughout the life course. Various pathways leading from early life factors to respiratory health outcomes in later life have been studied, including fetal and early infant growth patterns, preterm birth, maternal obesity, diet and smoking, children's diet, allergen exposure and respiratory tract infections, and genetic susceptibility. Data on potential adverse factors in the embryonic and preconception period and respiratory health outcomes are scarce. Also, the underlying mechanisms how specific adverse exposures in the fetal and early postnatal period lead to chronic obstructive lung diseases in later life are not yet fully understood. Current studies suggest that interactions between early environmental exposures and genetic factors such as changes in DNA-methylation and RNA expression patterns may explain the early development of chronic obstructive lung diseases. New well-designed epidemiological studies are needed to identify specific critical periods and to elucidate the mechanisms underlying the development of chronic obstructive lung disease throughout the life course.
Collapse
|
34
|
Gan Y, Gong Y, Tong X, Sun H, Cong Y, Dong X, Wang Y, Xu X, Yin X, Deng J, Li L, Cao S, Lu Z. Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies. BMC Psychiatry 2014; 14:371. [PMID: 25540022 PMCID: PMC4336481 DOI: 10.1186/s12888-014-0371-z] [Citation(s) in RCA: 286] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 12/18/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Several systematic reviews and meta-analyses demonstrated the association between depression and the risk of coronary heart disease (CHD), but the previous reviews had some limitations. Moreover, a number of additional studies have been published since the publication of these reviews. We conducted an updated meta-analysis of prospective studies to assess the association between depression and the risk of CHD. METHODS Relevant prospective studies investigating the association between depression and CHD were retrieved from the PubMed, Embase, Web of Science search (up to April 2014) and from reviewing reference lists of obtained articles. Either a random-effects model or fixed-effects model was used to compute the pooled risk estimates when appropriate. RESULTS Thirty prospective cohort studies with 40 independent reports met the inclusion criteria. These groups included 893,850 participants (59,062 CHD cases) during a follow-up duration ranging from 2 to 37 years. The pooled relative risks (RRs) were 1.30 (95% CI, 1.22-1.40) for CHD and 1.30 (95% CI, 1.18-1.44) for myocardial infarction (MI). In the subgroup analysis by follow-up duration, the RR of CHD was 1.36 (95% CI, 1.24-1.49) for less than 15 years follow-up, and 1.09 (95% CI, 0.96-1.23) for equal to or more than 15 years follow-up. Potential publication bias may exist, but correction for this bias using trim-and-fill method did not alter the combined risk estimate substantially. CONCLUSIONS The results of our meta-analysis suggest that depression is independently associated with a significantly increased risk of CHD and MI, which may have implications for CHD etiological research and psychological medicine.
Collapse
Affiliation(s)
- Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Yanhong Gong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Xinyue Tong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Huilian Sun
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Yingjie Cong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Xiaoxin Dong
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Yunxia Wang
- Department of Tuberculosis Control, Bao'an Chronic Disease Prevent and Cure Hospital, Shenzhen, Guangdong, China.
| | - Xing Xu
- Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
| | - Xiaoxu Yin
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Jian Deng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Liqing Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
- Department of Management, School of Economics and Management, Jiangxi science and technology normal university, Nanchang, Jiangxi, China.
| | - Shiyi Cao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| | - Zuxun Lu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, Wuhan, Hubie, 430030, China.
| |
Collapse
|
35
|
The Generation R Study: Biobank update 2015. Eur J Epidemiol 2014; 29:911-27. [PMID: 25527369 DOI: 10.1007/s10654-014-9980-6] [Citation(s) in RCA: 174] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/06/2014] [Indexed: 12/14/2022]
Abstract
The Generation R Study is a population-based prospective cohort study from fetal life until adulthood. The study is designed to identify early environmental and genetic causes and causal pathways leading to normal and abnormal growth, development and health from fetal life, childhood and young adulthood. In total, 9,778 mothers were enrolled in the study. Data collection in children and their parents include questionnaires, interviews, detailed physical and ultrasound examinations, behavioural observations, Magnetic Resonance Imaging and biological samples. Efforts have been conducted for collecting biological samples including blood, hair, faeces, nasal swabs, saliva and urine samples and generating genomics data on DNA, RNA and microbiome. In this paper, we give an update of the collection, processing and storage of these biological samples and available measures. Together with detailed phenotype measurements, these biological samples provide a unique resource for epidemiological studies focused on environmental exposures, genetic and genomic determinants and their interactions in relation to growth, health and development from fetal life onwards.
Collapse
|
36
|
Zotto ED, Costa P, Morotti A, Poli L, Giuli VD, Giossi A, Volonghi I, Callea A, Padovani A, Pezzini A. Stroke and depression: A bidirectional link. World J Meta-Anal 2014; 2:49-63. [DOI: 10.13105/wjma.v2.i3.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/07/2014] [Accepted: 06/11/2014] [Indexed: 02/05/2023] Open
Abstract
A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertension and diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.
Collapse
|
37
|
Kahl KG, Hueper K, Schweiger U, Gutberlet M, Detlef AM, Weiss C, von Bohlen A, Pul R, Lichtinghagen R, Wacker F, Hartung D. Pericardial, intra-abdominal, and subcutaneous adipose tissue in patients with major depressive disorder. Acta Psychiatr Scand 2014; 130:137-43. [PMID: 24433292 DOI: 10.1111/acps.12242] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/03/2013] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Major depressive disorder (MDD) is associated with an increased risk for developing coronary artery disease (CAD). Recently, pericardial adipose tissue, a metabolically active visceral fat depot surrounding the heart, has been implicated in the pathogenesis of CAD. Therefore, we investigated pericardial adipose tissue volumes in patients with MDD and compared them to healthy comparison subjects. METHOD In this case-control study at a university medical center, 50 male and female in-patients with MDD and 25 healthy men and women were examined. The main outcome measures were the volumes of pericardial adipose tissue, intra-abdominal adipose tissue (IaAT) and subcutaneous adipose tissue (ScAT) which were measured using magnetic resonance imaging. RESULTS The pericardial adipose tissue volumes were greater in men and women with MDD compared with the healthy comparison group following adjustments for the effects of age, weight, height, and physical activity. CONCLUSION This study expands our knowledge about the alterations in body composition that occur in patients with MDD. The findings are highly relevant for understanding the comorbidity between heart disease and depressive disorders.
Collapse
Affiliation(s)
- K G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School (MHH), Hannover, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Abstract
PURPOSE OF REVIEW It is well established that depression is associated with increased risk of incident coronary heart disease (CHD). The strong research focus on this particular comorbidity may obscure an appreciation of the breadth of mental disorder-medical comorbidities. Some of the most prevalent of these are highlighted in this review, which features recent research on epidemiological associations of depression and anxiety disorders with a range of cardiometabolic diseases. The clinical implications of this broader set of mental-physical connections are discussed. RECENT FINDINGS New findings support the existence of an association between depression and a range of subtypes of heart disease, stroke and diabetes. The associations between anxiety and coronary heart disease are robust and there is emerging evidence of associations of anxiety with stroke and diabetes. SUMMARY The predictive associations of mental disorders with incident medical diseases extend well beyond the established association between depression and CHD. The breadth of mental-physical associations suggests a need for greater clinical attention to the physical health and health-related behavior of young people with persistent mental disorders of all types, at the time of life when the seeds of mental-physical comorbidity are sown.
Collapse
|
39
|
Loria AS, Ho DH, Pollock JS. A mechanistic look at the effects of adversity early in life on cardiovascular disease risk during adulthood. Acta Physiol (Oxf) 2014; 210:277-87. [PMID: 24330084 DOI: 10.1111/apha.12189] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 12/23/2022]
Abstract
Early origins of adult disease may be defined as adversity or challenges during early life that alter physiological responses and prime the organism to chronic disease in adult life. Adverse childhood experiences or early life stress (ELS) may be considered a silent independent risk factor capable of predicting future cardiovascular disease risk. Maternal separation (MatSep) provides a suitable model to elucidate the underlying molecular mechanisms by which ELS increases the risk to develop cardiovascular disease in adulthood. The aim of this review is to describe the links between behavioural stress early in life and chronic cardiovascular disease risk in adulthood. We will discuss the following: (i) adult cardiovascular outcomes in humans subjected to ELS, (ii) MatSep as an animal model of ELS as well as the limitations and advantages of this model in rodents and (iii) possible ELS-induced mechanisms that predispose individuals to greater cardiovascular risk. Overall, exposure to a behavioural stressor early in life sensitizes the response to a second stressor later in life, thus unmasking an exaggerated cardiovascular dysfunction that may influence quality of life and life expectancy in adulthood.
Collapse
Affiliation(s)
- A. S. Loria
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
| | - D. H. Ho
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
| | - J. S. Pollock
- Section of Experimental Medicine; Department of Medicine; Georgia Regents University; Augusta GA USA
| |
Collapse
|