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Bluett-Duncan M, Pickles A, Chandra PS, Hill J, Kishore MT, Satyanarayana V, Sharp H. Experience and Reporting of Postnatal Depression Across Cultures: A Comparison Using Anchoring Vignettes of Mothers in the United Kingdom and India. Am J Epidemiol 2024; 193:214-226. [PMID: 37667811 PMCID: PMC10773478 DOI: 10.1093/aje/kwad182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/06/2023] [Accepted: 08/30/2023] [Indexed: 09/06/2023] Open
Abstract
Postnatal mental health is often assessed using self-assessment questionnaires in epidemiologic research. Differences in response style, influenced by language, culture, and experience, may mean that the same response may not have the same meaning in different settings. These differences need to be identified and accounted for in cross-cultural comparisons. Here we describe the development and application of anchoring vignettes to investigate the cross-cultural functioning of the Edinburgh Postnatal Depression Scale (EPDS) in urban community samples in India (n = 549) and the United Kingdom (n = 828), alongside a UK calibration sample (n = 226). Participants completed the EPDS and anchoring vignettes when their children were 12-24 months old. In an unadjusted item-response theory model, UK mothers reported higher depressive symptoms than Indian mothers (d = 0.48, 95% confidence interval: 0.358, 0.599). Following adjustment for differences in response style, these positions were reversed (d = -0.25, 95% confidence interval: -0.391, -0.103). Response styles vary between India and the United Kingdom, indicating a need to take these differences into account when making cross-cultural comparisons. Anchoring vignettes offer a valid and feasible method for global data harmonization.
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Affiliation(s)
- Matthew Bluett-Duncan
- Correspondence to Dr. Matthew Bluett-Duncan, Division of Neuroscience, University of Manchester, Manchester M13 9NT, United Kingdom (e-mail: )
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Richmond JM, Patel D, Watanabe T, Chen HW, Martyanov V, Werner G, Garg M, Haddadi NS, Refat MA, Mahmoud BH, Wong LD, Dresser K, Deng A, Zhu JL, McAlpine W, Hosler GA, Feghali-Bostwick CA, Whitfield ML, Harris JE, Torok KS, Jacobe HT. CXCL9 Links Skin Inflammation and Fibrosis through CXCR3-Dependent Upregulation of Col1a1 in Fibroblasts. J Invest Dermatol 2023; 143:1138-1146.e12. [PMID: 36708947 DOI: 10.1016/j.jid.2022.11.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 01/27/2023]
Abstract
Morphea is characterized by initial inflammation followed by fibrosis of the skin and soft tissue. Despite its substantial morbidity, the pathogenesis of morphea is poorly studied. Previous work showed that CXCR3 ligands CXCL9 and CXCL10 are highly upregulated in the sera and lesional skin of patients with morphea. We found that an early inflammatory subcutaneous bleomycin mouse model of dermal fibrosis mirrors the clinical, histological, and immune dysregulation observed in human morphea. We used this model to examine the role of the CXCR3 chemokine axis in the pathogenesis of cutaneous fibrosis. Using the REX3 (Reporting the Expression of CXCR3 ligands) mice, we characterized which cells produce CXCR3 ligands over time. We found that fibroblasts contribute the bulk of CXCL9-RFP and CXCL10-BFP by percentage, whereas macrophages produce high amounts on a per-cell basis. To determine whether these chemokines are mechanistically involved in pathogenesis, we treated Cxcl9-, Cxcl10-, or Cxcr3-deficient mice with bleomycin and found that fibrosis is dependent on CXCL9 and CXCR3. Addition of recombinant CXCL9 but not CXCL10 to cultured mouse fibroblasts induced Col1a1 mRNA expression, indicating that the chemokine itself contributes to fibrosis. Taken together, our studies provide evidence that CXCL9 and its receptor CXCR3 are functionally required for inflammatory fibrosis.
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Affiliation(s)
- Jillian M Richmond
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Dhrumil Patel
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Tomoya Watanabe
- Division of Rheumatology & Immunology, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA; Department of Dermatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Henry W Chen
- Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Viktor Martyanov
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA; Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - Giffin Werner
- Department of Medicine, University of Pittsburg School of Medicine, Pittsburg, Pennsylvania, USA
| | - Madhuri Garg
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Nazgol-Sadat Haddadi
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Maggi Ahmed Refat
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Bassel H Mahmoud
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Lance D Wong
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Karen Dresser
- Department of Pathology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - April Deng
- Department of Pathology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Jane L Zhu
- Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - William McAlpine
- Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Carol A Feghali-Bostwick
- Division of Rheumatology & Immunology, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michael L Whitfield
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA; Department of Molecular and Systems Biology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
| | - John E Harris
- Department of Dermatology, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Kathryn S Torok
- Department of Medicine, University of Pittsburg School of Medicine, Pittsburg, Pennsylvania, USA
| | - Heidi T Jacobe
- Department of Dermatology, UT Southwestern Medical Center, Dallas, Texas, USA.
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Balázs PG, Erdősi D, Zemplényi A, Brodszky V. Time trade-off health state utility values for depression: a systematic review and meta-analysis. Qual Life Res 2023; 32:923-937. [PMID: 36178658 PMCID: PMC10063515 DOI: 10.1007/s11136-022-03253-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to systematically review the literature on health utility in depression generated by time trade-off (TTO) method and to compare health state vignettes. METHODS Systematic literature search was conducted following PRISMA guideline in 2020 November (updated in 2022 March) in Pubmed, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews. Random effect meta-analysis was conducted to pool vignette-based utility values of mild, moderate, and severe depression and to compare the preferences of depressed and nondepressed population. RESULTS Overall, 264 records were found, 143 screened by title and abstract after removing duplicates, 18 assessed full text, and 14 original publications included. Majority of the studies (n = 9) used conventional TTO method, and most of the studies (n = 8) applied 10-year timeframe. Eight studies evaluated self-experienced health (own-current depression). Six studies assessed vignette-based health states of remitted, mild, moderate, and severe depression, half of them applied McSad measure based health description. Altogether, 61 different utility values have been cataloged, mean utility of self-experienced depression states (n = 33) ranged between 0.89 (current-own depression) and 0.24 (worst experienced depression). Pooled utility estimates for vignette-based mild, moderate, and severe depression was 0.75, 0.66 and 0.50, respectively. Meta-regression showed that severe depression (β = -0.16) and depressed sample populations (β = -0.13) significantly decrease vignette-based utility scores. CONCLUSION Our review revealed extent heterogeneity both in TTO methodology and health state vignette development. Patient's perception of depression health states was worse than healthy respondents.
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Affiliation(s)
- Péter György Balázs
- Doctoral School of Business and Management, Corvinus University of Budapest, Budapest, Hungary
- Institute of Social and Political Sciences, Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary
| | - Dalma Erdősi
- Center for Health Technology Assessment and Pharmacoeconomic Research, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
- Center for Health Technology Assessment, Semmelweis University, Budapest, Hungary
| | - Antal Zemplényi
- Center for Health Technology Assessment and Pharmacoeconomic Research, Faculty of Pharmacy, University of Pécs, Pécs, Hungary
| | - Valentin Brodszky
- Institute of Social and Political Sciences, Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary
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