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Chen H, Sun Y, Song Z, Lin Z, Sang Y, Fu XA, Ding Y. Association of depressive symptom severity and suicidal ideation with health-related quality of life among stroke survivors, NHANES 2005-2018. Psychiatry Res 2024; 336:115891. [PMID: 38615520 DOI: 10.1016/j.psychres.2024.115891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/03/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024]
Abstract
Stroke, a critical health issue in the US, not only has physical repercussions but also potentially affects the health-related quality of life (HRQoL) through neuropsychiatric outcomes like depressive symptoms and suicidal thoughts. This study utilized a nationally representative sample of 1302 US stroke survivors (age ≥ 20) from the US National Health and Nutrition Examination Survey (2005-2018) to assessed relationships between QoL via the CDC HRQOL-4 and evaluated depressive symptoms and suicidal ideation using the Patient Health Questionnaire-9 (PHQ-9). Participants (mean age: 64.4; 56.0 % female) showed that 40.7 % had at least mild depressive symptoms, and 18.8 % exhibited major depressive symptoms. Suicidal ideation was reported by 8.1 %. After sociodemographic and health condition adjustments, mild and major depressive symptoms, along with suicidal ideation, were associated with poorer general health status and more physically and mentally unhealthy days and activity limitation days. A dose-response relationship between PHQ-9 scores and HRQoL outcomes was evident (All P for trend <0.001). Stroke survivors with suicidal ideation also experienced more physically and mentally unhealthy days and activity limitation days. Depressive symptoms and suicidal ideation are associated with reduced HRQoL among US stroke survivors, underscoring the importance of thorough neuropsychiatric evaluations and interventions to bolster stroke survivors' well-being.
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Affiliation(s)
- Hewen Chen
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China
| | - Yulin Sun
- Department of Plastic and Reconstructive Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200092, China
| | - Zewu Song
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China
| | - Zexi Lin
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China
| | - Yuange Sang
- The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Xi-An Fu
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China.
| | - Yuhao Ding
- Department of Neurosurgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China.
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Le Bozec M, Tebeka S, Dubertret C, Sleurs D, Mhanna E, Le Strat Y. The association of stroke with mental and physical disorders in US adults: A nationally representative study. J Psychiatr Res 2023; 168:45-51. [PMID: 37897836 DOI: 10.1016/j.jpsychires.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 09/05/2023] [Accepted: 10/16/2023] [Indexed: 10/30/2023]
Abstract
Stroke has been linked to various physical and mental disorders, with both stroke and its comorbidities significantly impacting public health. In this population-based study, we evaluate the relationships between stroke, physical conditions, mental disorders, and their effect on quality of life. Data were gathered from a nationally representative sample of 36,309 civilian participants aged 18 years and older in the National Epidemiologic Survey on Alcohol and Related Conditions-III. We examined the prevalence of past-year stroke, its sociodemographic characteristics, and its associations with past-year mental disorders (according to the DSM-5) and physical conditions. Furthermore, we explored the connections between stroke and health-related quality of life, accounting for comorbidities. The past 12-month stroke prevalence was estimated at 0.82%. Participants with stroke exhibited a significantly higher past 12-month mental disorder prevalence than those without stroke. Specifically, individuals with stroke faced a higher risk of mood disorders, anxiety disorders, tobacco use disorder, and opioid use disorder compared to those without stroke. Stroke was also positively associated with 24 out of the 27 physical conditions assessed in this study. Participants with stroke experienced lower mental and physical quality of life compared to those without stroke. Stroke was significantly related to numerous mental and physical disorders. The association of stroke with diminished health-related quality of life was not only mediated by these comorbidities but should also be considered as inherently linked to stroke itself.
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Affiliation(s)
- Manon Le Bozec
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France.
| | - Sarah Tebeka
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Caroline Dubertret
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - David Sleurs
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Elsa Mhanna
- Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
| | - Yann Le Strat
- AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, France; Université de Paris, INSERM UMR1266, Institute of Psychiatry and Neuroscience of Paris, F-75014, Paris, France; Department of Neurology and Psychogeriatrics, Leopold Bellan Hospital, Paris, France
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Hedna K, Waern M. Use of Psychoactive Medications and Risk of Suicide in Late Life (75+): A Total Population Study. Drugs Real World Outcomes 2023; 10:491-498. [PMID: 37421593 PMCID: PMC10491562 DOI: 10.1007/s40801-023-00380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/10/2023] Open
Abstract
BACKGROUND Psychoactive medications play an important role for the mental health and risk of suicidal behaviour in the oldest segment of the population (75+). A better understanding of psychoactive medication use is advocated to prevent suicide in this age group. PURPOSE We investigated the risk of suicide associated with the use of psychoactive medications in the total population aged ≥ 75 years, with and without exposure to antidepressants. METHOD A national population-based register study, including all Swedish residents aged ≥ 75 years between 2006 and 2014 (N = 1,413,806). A nested case-control design was used to investigate psychoactive medications associated with suicide among users and non-users of antidepressants. Risk estimates were calculated in adjusted conditional logistic regression models for the entire cohort and by gender. RESULTS Suicide occurred in 1305 persons (907 men and 398 women). Among them, 555 (42.5%) were on an antidepressant at the time of suicide. Adjusted incidence rate ratio (aIRR) for suicide was increased in those who were on hypnotics in the total cohort (aIRR 2.05, 95% confidence interval 1.74 to 2.41), in both users and non-users of antidepressants and for both genders. Elevated suicide risk was observed in those who concomitantly used anxiolytics with antidepressants (1.51, 1.25 to 1.83). Decreased risk of suicide was observed among those who were on anti-dementia drugs, in the total cohort (0.33, 0.21 to 0.52) and in both users and non-users of antidepressants. Use of antipsychotics and mood stabilisers showed no effect on suicide risk. CONCLUSION Use of hypnotics and concomitant use of anxiolytics with antidepressants was associated with increased risk of late-life suicide. Our findings suggest the need for careful evaluation of the benefit-risk balance of psychoactive medications as well as their availability as a possible suicide means. Future research should consider the indication of use of the psychoactive medications and the severity of psychiatric and medical illnesses of the patients.
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Affiliation(s)
- Khedidja Hedna
- AgeCap Center, Department of Psychiatry and Neurochemistry, Gothenburg University, 41345, Gothenburg, Sweden.
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Statistikkonsulterna Västra AB, Gothenburg, Sweden.
| | - Margda Waern
- AgeCap Center, Department of Psychiatry and Neurochemistry, Gothenburg University, 41345, Gothenburg, Sweden
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychosis Clinic, Gothenburg, Sweden
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Ongeri L, Theuri C, Nyawira M, Penninx BWJH, Tijdink JK, Kariuki SM, Newton CRJC. Risk of suicidality in mental and neurological disorders in low and middle-income countries: A systematic review and meta-analysis. Compr Psychiatry 2023; 123:152382. [PMID: 36905857 DOI: 10.1016/j.comppsych.2023.152382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 02/07/2023] [Accepted: 02/28/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Both fatal and nonfatal suicidal behaviours are important complications of mental, neurological, and substance use disorders (MNSDs) worldwide. We aimed at quantifying the association of suicidal behaviour with MNSDs in Low and Middle Income Countries (LMICs) where varying environmental and socio-cultural factors may impact outcome. METHODS We conducted a systematic review and meta-analysis to report the associations between MNSDs and suicidality in LMICs and the study-level factors of these associations. We searched the following electronic databases: PUBMED, PsycINFO, MEDLINE, CINAHL, World Cat, and Cochrane library for studies on suicide risk in MNSDs, with a comparison/control group of persons without MNSDs, published from January 1, 1995 to September 3, 2020. Median estimates were calculated for relative risks for suicide behaviour and MNSDs, and when appropriate, these were pooled using random effects metanalytic model. This study was registered with PROSPERO, CRD42020178772. RESULTS The search identified 73 eligible studies: 28 were used for quantitative synthesis of estimates and 45 for description of risk factors. Studies included came from low and upper middle-income countries with a majority of these from Asia and South America and none from a low-income country. The sample size was 13,759 for MNSD cases and 11,792 hospital or community controls without MNSD. The most common MNSD exposure for suicidal behaviour was depressive disorders (47 studies (64%)), followed by schizophrenia spectrum, and other psychotic disorders (28 studies (38%)). Pooled estimates from the meta-analysis were statistically significant for suicidal behaviour with any MNSDs (odds ratios (OR) = 1∙98 (95%CI = 1∙80-2∙16))) and depressive disorder (OR = 3∙26 (95%CI = 2∙88-3∙63))), with both remaining significant after inclusion of high-quality studies only. Meta-regression identified only hospital-based studies (ratio of OR = 2∙85, CI:1∙24-6∙55) and sample size (OR = 1∙00, CI:0∙99-1∙00) as possible sources of variability in estimates. Risk for suicidal behaviour in MNSDs was increased by demographic factors (e.g., male sex, and unemployment), family history, psychosocial context and physical illness. INTERPRETATION There is an association between suicidal behaviour and MNSDs in LMICs, the association is greater for depressive disorder in LMICs than what has been reported in High Income Countries (HICs). There is urgent need to improve access for MNSDs care in LMICs. FUNDING None.
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Affiliation(s)
- Linnet Ongeri
- Centre for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya.
| | - Cyrus Theuri
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya
| | - Miriam Nyawira
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Joeri K Tijdink
- Department of Ethics, Law and Humanities, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Symon M Kariuki
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya; Department of Public Health, Pwani University, Kilifi, Kenya
| | - Charles R J C Newton
- Neuroscience Unit, Kenya Medical Research Institute-Wellcome Trust Research Program, Kilifi, Kenya; Department of Psychiatry, University of Oxford, United Kingdom
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Wang H, Zhang Y, Tan G, Chen D, Fu Y, Liu L. Suicidality and epilepsy: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1097516. [PMID: 37065883 PMCID: PMC10090680 DOI: 10.3389/fpsyt.2023.1097516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/16/2023] [Indexed: 04/18/2023] Open
Abstract
Background We aimed to evaluate the association between epilepsy and suicidality, including suicidal ideation, attempts and completed suicide. Methods We systematically searched PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov from 1946 to June 21, 2021 and assessed the quality of the studies using the Newcastle-Ottawa Scale. We calculated the pooled OR and the crude rate for suicidal ideation, suicide attempts and completed suicide in patients with epilepsy (PWE). Results We screened 2,786 studies and included 88 articles with 1,178,401 PWE and 6,900,657 participants as controls. Search terms included epilepsy and suicide. The pooled rates of suicidal ideation, suicide attempts and completed suicide in PWE were 19.73% (95% CI: 17.00-22.62%), 5.96% (95% CI: 4.82-7.20%), and 0.24% (95% CI: 0.11-0.42%), respectively. Compared to the control group, PWE were at a significantly higher risk of total suicidality (pooled OR, 2.60; 95%: 2.13-3.18), including suicidal ideation (pooled OR, 2.70; 95% CI, 2.21-3.30), suicide attempts (pooled OR, 2.74; 95% CI, 2.08-3.61) and completed suicide (pooled OR, 2.36; 95% CI, 1.45-3.83). Subgroup analyses showed significant differences in the subgroups of the measurement of suicidality. Conclusion The rate of suicidal ideation, suicide attempts and completed suicide in PWE were about 19.73, 5.96, and 0.24%. And there was an increased risk of suicidality in PWE especially temporal lobe epilepsy and drug-resistant epilepsy. Clinicians need to be aware of this risk in PWE with early identification and prevention at the time of diagnosis.Protocol Registration: PROSPERO CRD42021278220.
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Affiliation(s)
- Haijiao Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha City, China
| | - Yu Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, China
| | - Ge Tan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Deng Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yaoqi Fu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Ling Liu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Ling Liu,
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Basheti IA, Ayasrah SM, Ahmad MM, Abu-Snieneh HM, Abuadas FH. Medications adherence and associated factors among patients with stroke in the Kingdom of Saudi Arabia. Pharm Pract (Granada) 2022; 20:2736. [PMID: 36793903 PMCID: PMC9891775 DOI: 10.18549/pharmpract.2022.4.2736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022] Open
Abstract
Background Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients' adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients' adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient's details and medications was done via the patient's hospital file. Results The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients' adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. Conclusion Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in focusing the efforts to improve adherence and health outcomes for stroke patients in the future.
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Affiliation(s)
- Iman A Basheti
- Faculty of Pharmacy, Applied Science Private University, 11931, Amman, Jordan; Faculty of Pharmacy, The University of Sydney, 2006, Sydney, Australia.
| | - Shahnaz M Ayasrah
- PhD. Associate professor, Department of Applied Science/Nursing, Al-Balqa Applied University, Al-Salt - Jordan.
| | - Muayyad M Ahmad
- PhD. Professor, Clinical Nursing Department, School of Nursing, University of Jordan, Amman 11942 - Jordan.
| | - Hana M Abu-Snieneh
- RN, PhD. Assistant professor, Faculty of Nursing/ The University of Jordan/ Aqaba Campus Aqaba- Jordan. ;
| | - Fuad H Abuadas
- Assistant professor, College of Nursing, Community Health Nursing Department, Jouf University, Sakaka, 72388, Saudi Arabia.
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Zhang S, Wang A, Zhu W, Qiu Z, Zhang Z. Meta-analysis of risk factors associated with suicidal ideation after stroke. Ann Gen Psychiatry 2022; 21:1. [PMID: 34986853 PMCID: PMC8734070 DOI: 10.1186/s12991-021-00378-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 12/23/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Over the past decade, increasing attention has been paid on post stroke suicide (PSS), which is one of complications of stroke. The rates of stroke and suicide are relatively high, especially in Asian populations. Thus, a deeper understanding of the prevalence and epidemiological impact of suicide after stroke is urgently needed. Clinical diagnosis and prevention of PSS are at the incipient stage, but the risk factors responsible for the occurrence of PSS in different regions and stages of the disease remain largely unknown. The present meta-analysis aimed to determine the incidence of PSS at different stages and time courses, and to identify the underlying risk factors for PSS. METHODS We systematically searched the Cochrane library, Embase, PubMed, CNKI and Web of Science databases from their inception until April 2019.The research articles reporting on the risk factor for PSS were screened and included in the meta-analysis. The data from the included studies were extracted according to the predefined criteria. RESULTS A total of 12 studies (n = 2,693,036) were included for meta-analyses. Of these studies, 7 reporting suicide prevalence were meta-analyzed. The pooled estimate of suicidal ideation rates after stroke was 12%, which could be influenced by multiple risk factors, including sex, smoking, depression, sleep disorders, previous stroke and low household income. Studies conducted in Asia demonstrated higher suicide prevalence (approximately 15%) compared to other regions. Smoking, low family income, depression, heart disease and sleep disorders were important risk factors for PSS. When compared to PSS of more than 1 year, the incidence of suicide within 1 year after stroke was more likely to be statistically significant. It was found that 4 out of every 1000 stroke survivors tended to commit suicide. The results of this meta-analysis showed that depression (OR = 2.32; p < 0.01) was significantly associated with suicidal ideation, regardless of stroke duration. CONCLUSION PSS is one of the common complications of stroke. Despite some limitations, we successfully identified the risk factors associated with suicidal ideation after stroke. Notably, depression was significantly associated with suicidal ideation, regardless of stroke duration. Targeting this risk factor may be helpful to improve stroke patient care and prevent suicidal ideation after stroke. Future research will be carried out to assess whether suicidal ideation or thoughts and actual suicide attempts are strongly predictive of suicide deaths after stroke (Registration No. CRD42019128813).
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Affiliation(s)
- Shuangmei Zhang
- Department of Rehabilitation, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, 310022, China
- Institute of Cancer and Basic Medicine (IBMC), Chinese Academy of Sciences, Hangzhou, 310022, China
| | - Anrong Wang
- Science and Technology Innovation Center Affiliated To Guangzhou, University of Traditional Chinese Medicine, Guangzhou, 510145, China
| | - Weifeng Zhu
- Department of Neurology, Affiliated Chinese Medicine Hospital of Guangzhou Medical University, Guangzhou, 510145, China
| | - Zhaoyang Qiu
- Department of Neurology, First College of Clinical Medicine Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250014, China
| | - Zhaoxu Zhang
- Department of Neurology, Peking University People's Hospital, Beijing, 100044, China.
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Costanza A, Amerio A, Aguglia A, Magnani L, Serafini G, Amore M, Merli R, Ambrosetti J, Bondolfi G, Marzano L, Berardelli I. "Hard to Say, Hard to Understand, Hard to Live": Possible Associations between Neurologic Language Impairments and Suicide Risk. Brain Sci 2021; 11:brainsci11121594. [PMID: 34942896 PMCID: PMC8699610 DOI: 10.3390/brainsci11121594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/03/2023] Open
Abstract
In clinical practice, patients with language impairments often exhibit suicidal ideation (SI) and suicidal behavior (SB, covering the entire range from suicide attempts, SA, to completed suicides). However, only few studies exist regarding this subject. We conducted a mini-review on the possible associations between neurologic language impairment (on the motor, comprehension, and semantic sides) and SI/SB. Based on the literature review, we hypothesized that language impairments exacerbate psychiatric comorbidities, which, in turn, aggravate language impairments. Patients trapped in this vicious cycle can develop SI/SB. The so-called “affective prosody” provides some relevant insights concerning the interaction between the different language levels and the world of emotions. This hypothesis is illustrated in a clinical presentation, consisting of the case of a 74-year old woman who was admitted to a psychiatric emergency department (ED) after a failed SA. Having suffered an ischemic stroke two years earlier, she suffered from incomplete Broca’s aphasia and dysprosody. She also presented with generalized anxiety and depressive symptoms. We observed that her language impairments were both aggravated by the exacerbations of her anxiety and depressive symptoms. In this patient, who had deficits on the motor side, these exacerbations were triggered by her inability to express herself, her emotional status, and suffering. SI was fluctuant, and—one year after the SA—she completed suicide. Further studies are needed to ascertain possible reciprocal and interacting associations between language impairments, psychiatric comorbidities, and SI/SB. They could enable clinicians to better understand their patient’s specific suffering, as brought on by language impairment, and contribute to the refining of suicide risk detection in this sub-group of affected patients.
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Affiliation(s)
- Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
- Correspondence: ; Tel.: +41-22-3797111
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (L.M.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (L.M.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Luca Magnani
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (L.M.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (L.M.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16132 Genoa, Italy; (A.A.); (A.A.); (L.M.); (G.S.); (M.A.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Roberto Merli
- Mental Health and Suicide Prevention Center, Department of Mental Health, 13900 Biella, Italy;
| | - Julia Ambrosetti
- Emergency Psychiatric Unit (UAUP), Department of Psychiatry and Department of Emergency, Geneva University Hospitals (HUG), 1211 Geneva, Switzerland;
| | - Guido Bondolfi
- Department of Psychiatry, Faculty of Medicine, University of Geneva (UNIGE), 1211 Geneva, Switzerland
- Department of Psychiatry, Service of Liaison Psychiatry and Crisis Intervention (SPLIC), Geneva University Hospitals (HUG), 1211 Geneva, Switzerland;
| | - Lisa Marzano
- Faculty of Science and Technology, Middlesex University, London NW4 4BT, UK;
| | - Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, 00185 Rome, Italy;
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Alias A, Bertrand L, Bisson-Gervais V, Henry M. Suicide in obstructive lung, cardiovascular and oncological disease. Prev Med 2021; 152:106543. [PMID: 34538370 DOI: 10.1016/j.ypmed.2021.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023]
Abstract
Healthcare institutions face increasing demands stemming from the burden of noncommunicable diseases. The personal, social, financial and societal impact of these diseases are well-documented. However, the mental health concerns and trajectories of patients afflicted by chronic medical diseases have been under-recognized and are under-resourced. Despite that chronic diseases are associated with substantially increased risk of suicide, the medical world has largely failed to properly address suicide in the medically ill. Considering their high prevalence and mortality rate, this review article will highlight the mental health burden and suicide risk in obstructive lung, cardiovascular (including stroke) and oncological disease, in light of relevant data and conceptual models of suicide. Finally, general evidence-based suicide intervention strategies and potential selective adaptation of these strategies to the chronic medically ill patient populations and medical settings will be reviewed.
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Affiliation(s)
- Ali Alias
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Lia Bertrand
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Joseph's Healthcare Hamilton, West 5(th) Campus, 100 West 5(th) Street, Hamilton, ON L8N 3K7, Canada.
| | - Vanessa Bisson-Gervais
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, 5100 de Maisonneuve Blvd. West, Suite 720, Montreal, QC H4A 3T2, Canada; Segal Cancer Centre, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada; Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada
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10
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Chen VCH, Kao CJ, Tsai YH, Cheok MT, McIntyre RS, Weng JC. Assessment of Disrupted Brain Structural Connectome in Depressive Patients With Suicidal Ideation Using Generalized Q-Sampling MRI. Front Hum Neurosci 2021; 15:711731. [PMID: 34512298 PMCID: PMC8430248 DOI: 10.3389/fnhum.2021.711731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Suicide is one of the leading causes of mortality worldwide. Various factors could lead to suicidal ideation (SI), while depression is the predominant cause among all mental disorders. Studies have shown that alterations in brain structures and networks may be highly associated with suicidality. This study investigated both neurological structural variations and network alterations in depressed patients with suicidal ideation by using generalized q-sampling imaging (GQI) and Graph Theoretical Analysis (GTA). This study recruited 155 participants and divided them into three groups: 44 depressed patients with suicidal ideation (SI+; 20 males and 24 females with mean age = 42, SD = 12), 56 depressed patients without suicidal ideation (Depressed; 24 males and 32 females with mean age = 45, SD = 11) and 55 healthy controls (HC; nine males and 46 females with mean age = 39, SD = 11). Both the generalized fractional anisotropy (GFA) and normalized quantitative anisotropy (NQA) values were evaluated in a voxel-based statistical analysis by GQI. We analyzed different topological parameters in the graph theoretical analysis and the subnetwork interconnections in the Network-based Statistical (NBS) analysis. In the voxel-based statistical analysis, both the GFA and NQA values in the SI+ group were generally lower than those in the Depressed and HC groups in the corpus callosum and cingulate gyrus. Furthermore, we found that the SI+ group demonstrated higher global integration and lower local segregation among the three groups of participants. In the network-based statistical analysis, we discovered that the SI+ group had stronger connections of subnetworks in the frontal lobe than the HC group. We found significant structural differences in depressed patients with suicidal ideation compared to depressed patients without suicidal ideation and healthy controls and we also found several network alterations among these groups of participants, which indicated that white matter integrity and network alterations are associated with patients with depression as well as suicidal ideation.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chun-Ju Kao
- Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Man Teng Cheok
- Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.,Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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11
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Maggi G, Baldassarre I, Barbaro A, Cavallo ND, Cropano M, Nappo R, Santangelo G. Mental health status of Italian elderly subjects during and after quarantine for the COVID-19 pandemic: a cross-sectional and longitudinal study. Psychogeriatrics 2021; 21:540-551. [PMID: 33955115 PMCID: PMC8242477 DOI: 10.1111/psyg.12703] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/26/2021] [Accepted: 04/09/2021] [Indexed: 01/07/2023]
Abstract
BACKGROUND The elderly are more vulnerable to COVID-19 and therefore need to adopt long-term social distancing measures. The duration of quarantine impacts the psychological status of the general population. However, until now no study has explored the psychological impact of the pandemic and quarantine together with longitudinal changes in the mental health status of Italian elderly. METHODS An online questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, coping style, and other dimensions related to the pandemic was completed by participants during (T0) and two months after the end (T1) of the quarantine. RESULTS The sample recruited at T0 included 334 elderly participants. About 45% of the participants experienced depression, anxiety, or anger. Moreover, more fear of getting infected was related to more severe depression, anxiety, and anger, but resilience was found to mediate these relationships. More severe depressive and anger symptoms were related to more severe cognitive failures. No significant difference was observed in mental health scores between T0 and T1. Finally, more severe depression at T0 was associated with the development of post-traumatic stress symptoms at T1. CONCLUSIONS The fear of getting infected, probably due to perceived vulnerability to disease, seems to play a crucial role in the development of psychological symptoms in the elderly, but resilience seems to mediate the impact of fear. The presence of long-term psychological consequences and the possible risk of developing PTS symptoms in the elderly suggest the need for targeted interventions to reduce possible long-term psychological and cognitive consequences.
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Affiliation(s)
- Gianpaolo Maggi
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Ivana Baldassarre
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Andrea Barbaro
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Maria Cropano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Raffaele Nappo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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12
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Facucho-Oliveira J, Esteves-Sousa D, Espada-Santos P, Moura N, Albuquerque M, Fraga AM, Sousa S, Cintra P, Mendonça L, Pita F. Depression after stroke. Pract Neurol 2021; 21:384-391. [PMID: 33990426 DOI: 10.1136/practneurol-2020-002622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2021] [Indexed: 01/01/2023]
Abstract
Stroke treatment has dramatically improved in recent decades. However, although new treatments have reduced its mortality and the severity of its physical and cognitive sequelae, many people still have incapacitating disabilities following a stroke. Depression is the most common psychiatric disorder following stroke; it is important to recognise and treat as it limits motor and cognitive rehabilitation. Antidepressant medication is an effective treatment and can improve adherence to clinically recommended physical and cognitive tasks, thereby enhancing functional remodelling of neuronal pathways and improving rehabilitation outcomes.
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Affiliation(s)
| | - Daniel Esteves-Sousa
- Department of Mental Health and Psychiatry, Lusiadas Health Group, Lisboa, Portugal
| | - Pedro Espada-Santos
- Department of Mental Health and Psychiatry, Lusiadas Health Group, Lisboa, Portugal
| | - Nuno Moura
- Department of Mental Health and Psychiatry, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | | | - Ana Margarida Fraga
- Department of Mental Health and Psychiatry, Lusiadas Health Group, Lisboa, Portugal
| | - Sandra Sousa
- Department of Neurology, Lusiadas Health Group, Lisboa, Portugal
| | - Pedro Cintra
- Department of Mental Health and Psychiatry, Lusiadas Health Group, Lisboa, Portugal
| | - Luis Mendonça
- Department of Mental Health and Psychiatry, Lusiadas Health Group, Lisboa, Portugal
| | - Fernando Pita
- Department of Neurology, Lusiadas Health Group, Lisboa, Portugal
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13
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Kang HJ, Lee EH, Kim JW, Kim SW, Shin IS, Kim JT, Park MS, Cho KH, Han JS, Lyoo IK, Kim JM. Association of SLC6A4 methylation with long-term outcomes after stroke: focus on the interaction with suicidal ideation. Sci Rep 2021; 11:2710. [PMID: 33526821 PMCID: PMC7851135 DOI: 10.1038/s41598-021-81854-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 12/31/2020] [Indexed: 12/15/2022] Open
Abstract
Serotonin (5-HT) plays an important role in cerebrovascular homeostasis and psychiatric disorders, including suicidality. Methylation of the serotonin transporter gene (SLC6A4) is associated with 5-HT expression. However, the prognostic roles of SLC6A4 methylation and suicidal ideation (SI) in long-term outcomes of stroke have not been evaluated. We investigated the independent and interactive effects of SLC6A4 methylation and SI immediately after stroke on long-term outcomes. Blood SLC6A4 methylation status and SI based on the suicide item of the Montgomery–Åsberg Depression Rating Scale were assessed in 278 patients at 2 weeks after stroke. After the index stroke, cerebro-cardiovascular events by SLC6A4 methylation status and SI were investigated over an 8–14-year follow-up period and using Cox regression models adjusted for a range of covariates. SLC6A4 hypermethylation and SI within 2 weeks of stroke both predicted worse long-term outcomes, independent of covariates. A significant interaction effect of SI and the methylation status of CpG 4 on long-term stroke outcomes was also identified. The association between SLC6A4 methylation and long-term adverse outcomes may be strengthened in the presence of SI within 2 weeks after stroke. Evaluation of methylation and SI status during the acute phase can be helpful when assessing stroke patients.
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Affiliation(s)
- Hee-Ju Kang
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea
| | - Eun-Hye Lee
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea
| | - Ju-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea
| | - Il-Seon Shin
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Man-Seok Park
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ki-Hyun Cho
- Department of Neurology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jung-Soo Han
- Department of Biological Science, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, Republic of Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Graduate School of Pharmaceutical Sciences, and Department of Brain and Cognitive Sciences, Ewha W. University, Seoul, Republic of Korea
| | - Jae-Min Kim
- Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju, 61669, Republic of Korea.
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14
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Abstract
Neuropsychiatric disturbances represent a common and uniquely challenging consequence of stroke. These disorders arise at the intersection of lesion-related brain dysfunction and psychological distress related to the event and its aftermath, making it difficult to identify what symptom is a direct physiological consequence of the stroke. Depression, anxiety, fatigue, apathy, emotionalism, and anger are the most common of these syndromes, and posttraumatic stress disorder related to the stroke event has become increasingly recognized as a relevant entity. Mania, obsessive-compulsive disorder, and psychosis are less commonly encountered but potentially highly debilitating conditions that may be underrecognized. Early identification and treatment may mitigate functional impairment and improve quality of life. Evidence-based guidelines from the general population are often relied upon to guide treatment. Further research is needed to understand and tailor treatment of these disorders in the poststroke population.
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Affiliation(s)
- Katlyn Nemani
- Departments of Neurology and Psychiatry, NYU Langone Health, New York, New York
| | - Lindsey Gurin
- Departments of Neurology, Psychiatry, and Rehabilitation Medicine, NYU Langone Health, New York, New York
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15
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Expression of fibroblast growth factor 9 and its receptors in the dentate gyrus of hippocampus in poststroke depression rats. Neuroreport 2021; 32:321-325. [PMID: 33470768 DOI: 10.1097/wnr.0000000000001591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Studies have found that fibroblast growth factor 9 (FGF9) might have a negative effect in the psychiatric diseases, such as depression or anxiety, but its potential role in the pathophysiology of poststroke depression (PSD) remains uncertain. Here, we set out to investigate the expression changes of FGF9 and its receptors in PSD rats. Middle cerebral artery occlusion (MCAO) combined with chronic unpredictable mild stress was used to establish the PSD rat model. Then, the rats were randomly divided into four groups: control (sham-operation), MCAO, PSD and treated (fluoxetine injection by intraperitoneal). Weight measurement, sucrose preference test, open-field test and forced swim test were performed to evaluate the behavioral changes, and then Western blot and real-time quantitative PCR were used to detect the expression level of FGF9, fibroblast growth factor receptor 1 (FGFR1) and receptor 3 (FGFR3) in the dentate gyrus of rat hippocampus. We found that FGF9 protein and mRNA expression increased significantly in the MCAO and PSD groups; FGFR3 protein and mRNA expression decreased significantly in the MCAO and PSD groups; FGFR1 protein and mRNA expression decreased significantly in the PSD group, but increased in the treated group. Furthermore, the changes mentioned above were reversed obviously by fluoxetine. These results indicated that upregulated FGF9 expression and downregulated FGFR1 and FGFR3 expression may be involved in the pathogenesis of PSD, and the FGF9/FGFR signaling pathway may be considered as an attractive target for further study.
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16
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Sarkar A, Sarmah D, Datta A, Kaur H, Jagtap P, Raut S, Shah B, Singh U, Baidya F, Bohra M, Kalia K, Borah A, Wang X, Dave KR, Yavagal DR, Bhattacharya P. Post-stroke depression: Chaos to exposition. Brain Res Bull 2020; 168:74-88. [PMID: 33359639 DOI: 10.1016/j.brainresbull.2020.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 12/09/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022]
Abstract
Cerebral ischemia contributes to significant disabilities worldwide, impairing cognitive function and motor coordination in affected individuals. Stroke has severe neuropsychological outcomes, the major one being a stroke. Stroke survivors begin to show symptoms of depression within a few months of the incidence that overtime progresses to become a long-term ailment. As the pathophysiology for the progression of the disease is multifactorial and complex, it limits the understanding of the disease mechanism completely. Meta-analyses and randomized clinical trials have shown that intervening early with tricyclic antidepressants and selective serotonin receptor inhibitors can be effective. However, these pharmacotherapies possess several limitations that have given rise to newer approaches such as brain stimulation, psychotherapy and rehabilitation therapy, which in today's time are gaining attention for their beneficial results in post-stroke depression (PSD). The present review highlights numerous factors like lesion location, inflammatory mediators and genetic abnormalities that play a crucial role in the development of depression in stroke patients. Further, we have also discussed various mechanisms involved in post-stroke depression (PSD) and strategies for early detection and diagnosis using biomarkers that may revolutionize treatment for the affected population. Towards the end, along with the preclinical scenario, we have also discussed the various treatment approaches like pharmacotherapy, traditional medicines, psychotherapy, electrical stimulation and microRNAs being utilized for effectively managing PSD.
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Affiliation(s)
- Ankan Sarkar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Deepaneeta Sarmah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Aishika Datta
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Harpreet Kaur
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Priya Jagtap
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Swapnil Raut
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Birva Shah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Upasna Singh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Falguni Baidya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Mariya Bohra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Kiran Kalia
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Anupom Borah
- Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam, India
| | - Xin Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Kunjan R Dave
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Dileep R Yavagal
- Department of Neurology and Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India.
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17
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Yahya T, Jilani MH, Khan SU, Mszar R, Hassan SZ, Blaha MJ, Blankstein R, Virani SS, Johansen MC, Vahidy F, Cainzos-Achirica M, Nasir K. Stroke in young adults: Current trends, opportunities for prevention and pathways forward. Am J Prev Cardiol 2020; 3:100085. [PMID: 34327465 PMCID: PMC8315351 DOI: 10.1016/j.ajpc.2020.100085] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/12/2020] [Accepted: 08/23/2020] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease remains a major contributor to morbidity and mortality in the US and elsewhere, and stroke is a leading cause of disability worldwide. Despite recent success in diminishing stroke incidence in the general US population, in parallel there is now a concerning propensity for strokes to happen at younger ages. Specifically, the incidence of stroke for US adults 20-44 years of age increased from 17 per 100,000 US adults in 1993 to 28 per 100,000 in 2015. Occurrence of strokes in young adults is particularly problematic as these patients are often affected by physical disability, depression, cognitive impairment and loss of productivity, all of which have vast personal, social and economic implications. These concerning trends among young adults are likely due to increasing trends in the prevalence of modifiable risk factors amongst this population including hypertension, hyperlipidemia, obesity and diabetes, highlighting the importance of early detection and aggressive prevention strategies in the general population at early ages. In parallel and compounding to the issue, troublesome trends are evident regarding increasing rates of substance abuse among young adults. Higher rates of strokes have been noted particularly among young African Americans, indicating the need for tailored prevention and social efforts targeting this and other vulnerable groups, including the primordial prevention of risk factors in the first place, reducing stroke rates in the presence of prevalent risk factors such as hypertension, and improving outcomes through enhanced healthcare access. In this narrative review we aim to emphasize the importance of stroke in young adults as a growing public health issue and increase awareness among clinicians and the public health sector. For this purpose, we summarize the available data on stroke in young adults and discuss the underlying epidemiology, etiology, risk factors, prognosis and opportunities for timely prevention of stroke specifically at young ages. Furthermore, this review highlights the gaps in knowledge and proposes future directions moving forward.
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Affiliation(s)
- Tamer Yahya
- Division of Cardiovascular Prevention & Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | | | - Safi U. Khan
- Department of Medicine, West Virginia University, Morgantown, WV, USA
| | - Reed Mszar
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Syed Zawahir Hassan
- Division of Cardiovascular Prevention & Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
| | - Michael J. Blaha
- Ciccarone Center of the Prevention of Cardiovascular Disease, Baltimore, MD, USA
| | - Ron Blankstein
- Harvard Medical School, Harvard University, Boston, MA, USA
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Salim S. Virani
- Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | | | - Farhaan Vahidy
- Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention & Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Outcomes Research, Houston Methodist, Houston, TX, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention & Wellness, Houston Methodist DeBakey Heart & Vascular Center, Houston, TX, USA
- Center for Outcomes Research, Houston Methodist, Houston, TX, USA
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18
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Jung J, Choi S, Han KM, Kim A, Kang W, Paik JW, Lee HW, Ham BJ. Alterations in functional brain networks in depressed patients with a suicide attempt history. Neuropsychopharmacology 2020; 45:964-974. [PMID: 31673097 PMCID: PMC7162936 DOI: 10.1038/s41386-019-0560-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/19/2019] [Accepted: 10/08/2019] [Indexed: 12/25/2022]
Abstract
Suicide is a major challenge in public health and is strongly associated with major depressive disorder (MDD). Despite recent neuroimaging developments, the neural correlates of suicide behavior in patients with MDD remain unclear. Independent component analysis (ICA) for neuroimaging data allows the identification of functional brain networks without prior regions of interest and may help to identify neurobiological markers of specific disorders. Using ICA, we investigated the differences in resting-state brain networks in patients with MDD who had or did not have a history of suicide attempts and in healthy controls (HCs). Suicidal depressed (SD) patients, non-suicidal depressed (NSD) patients, and HCs significantly differed from each other in the pattern of connectivity of multiple functional networks, network synchronization, and functional network connectivity (FNC). The patient groups had a decreased network synchronization in the insular, cerebellum, basal ganglia, thalamus, operculum, frontoparietal cortices, and sensory cortices relative to the HCs. The decreased FNC between these networks (insular-default mode network and insular-cerebellum) was found in the SD group compared to the NSD and HC groups. These differences were not related to illness duration and medication status differences between SD and NSD. Furthermore, the degree of FNC in these networks was associated with the suicide ideation and stress level. Our results demonstrated that widespread but discrete network changes in brain networks and their interconnectivity was associated with suicide attempts in patients with MDD. Our results suggest that the neural basis underlying the psychopathology of attempted suicide in patients with MDD involves multiple brain networks and their interaction.
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Affiliation(s)
- JeYoung Jung
- 0000 0004 1936 8868grid.4563.4School of Psychology, University of Nottingham, Nottingham, UK
| | - Sunyoung Choi
- Clinical Research Division, Korean Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Kyu-Man Han
- 0000 0004 0474 0479grid.411134.2Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- 0000 0001 0840 2678grid.222754.4Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Wooyoung Kang
- 0000 0001 0840 2678grid.222754.4Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jong-Woo Paik
- 0000 0001 2171 7818grid.289247.2Department of Neuropsychiatry, College of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hae-Woo Lee
- 0000 0004 0642 340Xgrid.415520.7Department of Psychiatry, Seoul Medical Center, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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19
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Conroy SK, Brownlowe KB, McAllister TW. Depression Comorbid With Stroke, Traumatic Brain Injury, Parkinson's Disease, and Multiple Sclerosis: Diagnosis and Treatment. FOCUS: JOURNAL OF LIFE LONG LEARNING IN PSYCHIATRY 2020; 18:150-161. [PMID: 33162852 DOI: 10.1176/appi.focus.20200004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Depression is common among patients with neurologic disorders, and it has long been considered more difficult to treat than depression in the general population. In this review, the authors consider challenges in the diagnosis and treatment of depression among patients with stroke, traumatic brain injury, Parkinson's disease, and multiple sclerosis. For each disorder, the authors discuss the epidemiology and time course of depression as well as review the physiologic and psychological etiologies of depression. In addition, for each disorder, they review screening tools and diagnostic considerations, including differential diagnosis; discuss etiological factors, both neurobiological and psychological; and assess evidence for various depression treatments, including pharmacologic, psychosocial, and neuromodulatory therapies. The evidence suggests that depression is common among patients with neurologic disorders and that it is crucial for general psychiatrists to provide treatment for this population.
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Affiliation(s)
- Susan K Conroy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
| | - Katherine B Brownlowe
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
| | - Thomas W McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Conroy, McAllister); Department of Psychiatry, Wexner Medical Center, Ohio State University, Columbus (Brownlowe)
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20
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Amtul Z, Randhawa J, Najdat AN, Hill DJ, Arany EJ. Role of Delayed Neuroglial Activation in Impaired Cerebral Blood Flow Restoration Following Comorbid Injury. Cell Mol Neurobiol 2020; 40:369-380. [PMID: 31522299 DOI: 10.1007/s10571-019-00735-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Accepted: 09/04/2019] [Indexed: 11/27/2022]
Abstract
Besides other causes, ischemia and Alzheimer's disease pathology is also linked to decreased cerebral blood flow (CBF). There is little or no consensus about the role of neuroglial cells in maintaining CBF in various neuropathologies. This consensus becomes scarcer when it comes to clinical and experimental cases of comorbid Abeta-amyloid (Aβ) toxicity and ischemia. Here, a comorbid rat model of Aβ toxicity and endothelin-1 induced ischemia (ET1) not only demonstrated the appearance of axotomized phagocytosed pyknotic neurons (NeuN) immediately after the injury, but also showed a diversity of continuously changing neuroglia (MHC Class II/OX6, Iba1) and macrophage (Iba1/CD68) phenotypes with round, stout somas, and retracted processes. This is indicative of a response to a concomitant increase in large fluid-filled spaces due to the vascular leakage. Ironically 4 weeks after the injury despite a conclusive reduction in neurons, CBF restoration in ET1 rats was associated with a massive increase in neuroglial cell numbers, hypertrophy, ramification, and soma sizes bordering the continuously reducing lesion core and inflamed vasculature, possibly to shield their leaky phenotype. Astrocytes were also found to be releasing matrix metalloproteinase9 (MMP9), which stabilized matrix ligand β-dystroglycan (β-DG) in repaired or functional vessels. Changing neuroglia phenotypes, responses, motility, astrocytic recruitment of MMP9, and β-DG stabilization implies the role of communication between neuroglia and endothelium in recovering CBF, in the absence of neurons, in ET1 rats compared to Aβ+ET1 rats, which showed characteristics delayed neuroglial activation. Stimulation of timely neuroglial reactivity may serve as a viable strategy to compensate for the neuronal loss in restoring CBF in comorbid cases of ischemia and Aβ toxicity.
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Affiliation(s)
- Zareen Amtul
- Department of Anatomy and Cell Biology, University of Western Ontario, London, N6A 5C1, Canada.
| | - Jasmine Randhawa
- Department of Biology, University of Western Ontario, London, N6A 5B7, Canada
| | - Abdullah N Najdat
- Department of Biology, University of Western Ontario, London, N6A 5B7, Canada
| | - David J Hill
- Departments of Medicine, Physiology, and Pharmacology, and Pediatrics, University of Western Ontario, London, N6A 5C1, Canada
- Lawson Health Research Institute, London, ON, N6A 4V2, Canada
| | - Edith J Arany
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, N6A 5C1, Canada
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Amoke CV, Ede MO, Nwokeoma BN, Onah SO, Ikechukwu-Ilomuanya AB, Albi-Oparaocha FC, Nweke ML, Amoke CV, Amadi KC, Aloh HE, Anyaegbunam EN, Nwajiuba CA, Onwuama OP, Ede KR, Ononaiwu AI, Nweze T. Effects of group cognitive-behavioral therapy on psychological distress of awaiting-trial prison inmates. Medicine (Baltimore) 2020; 99:e18034. [PMID: 32332591 PMCID: PMC7220664 DOI: 10.1097/md.0000000000018034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND/OBJECTIVES The level of psychological distress among awaiting-trial inmates is rapidly increasing in Nigeria. Studies have recommended increasing attention and additional psychological intervention that could improve the psychological wellbeing of prisoners. This study evaluates the effect of cognitive behavioral therapy on psychological distress among awaiting-trial prison inmates in Nigeria. METHODS A total of 34 awaiting-trial prison inmates in Enugu state Nigeria were used as the study participants. Two measures (perceived emotional distress inventory and general health Questionnaire) were used for data collection. Repeated measures with analysis of variance (ANOVA) were used to examine the effects of the intervention. Effect sizes were also reported with partial Eta Squared ((Equation is included in full-text article.)). RESULTS The result showed that there was no significant difference in psychological distress between the treatment and no-intervention groups. The results showed that CBT had a significant effect on psychological distress of awaiting-trial prison inmates when compared to their counterparts in the no-intervention group at Time 2. Additionally, the efficacy of CBT on the psychological distress of awaiting-trial prison inmates was significantly sustained at the follow-up measurements (Time 3). CONCLUSION This study suggests that cognitive behavioral therapy is an effective intervention for decreasing psychological distress among awaiting-trial prison inmates. Additionally, the impactful benefit of the intervention can persist in overtime. Therefore, cognitive behavioral therapists can further explore the efficacy of CBT using various cultures.
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Affiliation(s)
| | | | - Bonaventure N. Nwokeoma
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | - Sebastian O. Onah
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | | | - Florence C. Albi-Oparaocha
- Department of Educational Foundations, Faculty of Education, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Maduka L. Nweke
- Department of Physiology, Faculty of Basic Medical Sciences, College of Medicine, University of Nigeria, Ituku Ozalla Enugu Campus
| | | | - Kingsley C. Amadi
- Department of Sociology and Anthropology, Faculty of Social Sciences, University of Nigeria, Nsukka
| | - Henry E. Aloh
- Health Economics and Research Unit, Department of Health Services, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Emenike N. Anyaegbunam
- Department of Psychology, Faculty of Management, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Chinyere A. Nwajiuba
- Department of Educational Foundations, Faculty of Education, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | | | - Kelechi R. Ede
- Department of Agricultural Science Education, University of Nigeria, Nsukka
| | | | - Tina Nweze
- Department of Educational Foundations, Ebonyi State University, Abakaliki Nigeria
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Choi JW, Lee SG, Kim TH, Han E. Poststroke suicide risk among older adults in South Korea: A retrospective longitudinal cohort study. Int J Geriatr Psychiatry 2020; 35:282-289. [PMID: 31859411 DOI: 10.1002/gps.5245] [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: 07/26/2019] [Accepted: 11/24/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The present study evaluated suicide risk within 1 year after discharge among older adults with stroke as a function of depression onset. METHOD We used the Korean National Health Insurance Service-Senior cohort data and included first discharged patients with a stroke as the principal diagnosis. The comparison group was selected by a 1:2 case-control propensity score matching for age, sex, Charlson comorbidity index, and diagnosis year between 2005 and 2012. Suicide deaths were measured by code for causes of death from Statistics Korea, and the main outcome was suicide death within 1 year following discharge. An adjusted hazard ratio (AHR) of suicidal risk was measured using a Cox proportional hazard model. RESULTS In the total sample of 128 286 older adults (aged 63-114 years), the higher suicidal risk was examined for stroke patients vs the comparison group (AHR = 1.4; 95% confidence interval [CI], 1.1-1.8). Stroke patients with depression had an increased suicide risk (AHR = 2.9; 95% CI, 1.8-4.8) but only for poststroke depression (AHR = 4.1; 95% CI, 1.8-9.5). Pre and poststroke depression suicidality (AHR = 4.8; 95% CI, 2.1-11.1) was also higher when compared to stroke patients without depression. CONCLUSIONS Poststroke patients are at increased suicidal risk during 1 year following discharge. Furthermore, patients who were diagnosed with depression after a stroke are more likely to commit suicide than stroke patients without depression. This suggests a necessity for early suicide preventive intervention for stroke patients while considering depressive symptomology.
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Affiliation(s)
- Jae Woo Choi
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
| | - Sang Gyu Lee
- Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Tae Hyun Kim
- Department of Hospital Administration, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Incheon, South Korea
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Hirdes JP, van Everdingen C, Ferris J, Franco-Martin M, Fries BE, Heikkilä J, Hirdes A, Hoffman R, James ML, Martin L, Perlman CM, Rabinowitz T, Stewart SL, Van Audenhove C. The interRAI Suite of Mental Health Assessment Instruments: An Integrated System for the Continuum of Care. Front Psychiatry 2020; 10:926. [PMID: 32076412 PMCID: PMC6978285 DOI: 10.3389/fpsyt.2019.00926] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 11/21/2019] [Indexed: 12/21/2022] Open
Abstract
The lives of persons living with mental illness are affected by psychological, biological, social, economic, and environmental factors over the life course. It is therefore unlikely that simple preventive strategies, clinical treatments, therapeutic interventions, or policy options will succeed as singular solutions for the challenges of mental illness. Persons living with mental illness receive services and supports in multiple settings across the health care continuum that are often fragmented, uncoordinated, and inadequately responsive. Appropriate assessment is an important tool that health systems must deploy to respond to the strengths, preferences, and needs of persons with mental illness. However, standard approaches are often focused on measurement of psychiatric symptoms without taking a broader perspective to address issues like growth, development, and aging; physical health and disability; social relationships; economic resources; housing; substance use; involvement with criminal justice; stigma; and recovery. Using conglomerations of instruments to cover more domains is impractical, inconsistent, and incomplete while posing considerable assessment burden. interRAI mental health instruments were developed by a network of over 100 researchers, clinicians, and policy experts from over 35 nations. This includes assessment systems for adults in inpatient psychiatry, community mental health, emergency departments, mobile crisis teams, and long-term care settings, as well as a screening system for police officers. A similar set of instruments is available for child/youth mental health. The instruments form an integrated mental health information system because they share a common assessment language, conceptual basis, clinical emphasis, data collection approach, data elements, and care planning protocols. The key applications of these instruments include care planning, outcome measurement, quality improvement, and resource allocation. The composition of these instruments and psychometric properties are reviewed, and examples related to homeless are used to illustrate the various applications of these assessment systems.
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Affiliation(s)
- John P. Hirdes
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Coline van Everdingen
- Psychiatry and Neuropsychology Department, Maastricht University, Maastricht, Netherlands
| | - Jason Ferris
- Centre for Health Services Research, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | | | - Brant E. Fries
- Institute of Gerontology, University of Michigan, Ann Arbor, MI, United States
| | - Jyrki Heikkilä
- Division of Psychiatry, Turku University Hospital, Turku, Finland
| | - Alice Hirdes
- Graduate Program in Health Promotion, Human Development and Society, Lutheran University of Brazil, Canoas, Brazil
| | - Ron Hoffman
- School of Criminology and Criminal Justice, Nipissing University, North Bay, ON, Canada
| | - Mary L. James
- Institute of Gerontology, University of Michigan, Ann Arbor, MI, United States
| | - Lynn Martin
- Department of Health Sciences for Lynn Martin, Lakehead University, Thunder Bay, ON, Canada
| | - Christopher M. Perlman
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - Terry Rabinowitz
- Departments of Psychiatry and Family Medicine Larner College of Medicine, University of Vermont, Burlington, VT, United States
| | - Shannon L. Stewart
- Faculty of Education, Althouse College, Western University, London, ON, Canada
| | - Chantal Van Audenhove
- LUCAS Center for Care Research and Consultancy & Academic Center for General Practice in the Department of Public Health and Primary Care, KU Leuven University, Leuven, Belgium
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Castilla-Guerra L, Fernandez Moreno MDC, Esparrago-Llorca G, Colmenero-Camacho MA. Pharmacological management of post-stroke depression. Expert Rev Neurother 2019; 20:157-166. [PMID: 31860359 DOI: 10.1080/14737175.2020.1707666] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: Post-stroke depression (PSD) is a common clinical problem affecting approximately one-third of stroke survivors. PSD is associated with poor functional outcome and higher morbidity and mortality rates. Currently, uncertainty remains regarding optimal pharmacological strategies for its prevention and treatment.Areas covered: This article reviews the state of the current literature on pharmacologic intervention strategies for PSD, providing a summary of the most recent evidence to support pharmacological treatment in PSD.Expert opinion: Experimental and clinical research have increased our knowledge on PSD, although unanswered questions still remain regarding the best time to begin treatment, the effect of the antidepressants in areas other than emotion, or their capability to reduce mortality in stroke patients, among others.Currently, though numerous trials and meta-analyses suggest that antidepressants are effective in treating PSD and guidelines recommend their use for PSD, in the daily clinical practice, only a minority of patients are properly assessed and treated. Therefore, though further evidence is needed to clarify the real role of antidepressants in patients with stroke, physicians and other healthcare professionals must be familiar with the pharmacological treatment of PSD, in order to improve the outcome and increase the quality of life of this vulnerable group of patients.
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Affiliation(s)
- Luis Castilla-Guerra
- Department of Internal Medicine, Hospital Universitario Virgen Macarena, Seville, Spain.,Department of Medicine, University of Seville, Seville, Spain
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Li Z, Wei D, Zhu C, Zhang Q. Effect of a patient education and rehabilitation program on anxiety, depression and quality of life in muscle invasive bladder cancer patients treated with adjuvant chemotherapy. Medicine (Baltimore) 2019; 98:e17437. [PMID: 31689748 PMCID: PMC6946406 DOI: 10.1097/md.0000000000017437] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study aimed to investigate the effect of a patient education and rehabilitation program (PERP) on anxiety, depression, and quality of life in muscle invasive bladder cancer (MIBC) patients underwent adjuvant chemotherapy.One hundred and thirty MIBC patients about to receive adjuvant chemotherapy with 4-cycle gemcitabine and cisplatin (GC) regimen (16 weeks) were consecutively enrolled and randomly allocated into PERP group and control group as 1:1 ratio. Hospital Anxiety and Depression Scale (HADS) anxiety and depression scores and Quality of Life Questionnaire (QLQ-C30) scores were assessed before treatment (W0) and after treatment (W16).After 16-week treatment, PERP group exhibited decreased HADS anxiety score (P = .036), ΔHADS anxiety score (W16-W0) (P < .001) and percentage of anxiety patients (P = .019) compared to control group. And PERP group presented with numerically reduced HADS depression score but without statistical significance (P = .076) compared to control group, while lower ΔHADS depression score (W16-W0) (P = .014) and percentage of depression patients (P = .015) compared to control group. As to quality of life, QLQ-C30 global health status score (P = .032), Δglobal health status score (W16-W0) (P = .003) and Δfunctional score (W16-W0) (P = .005) were higher in PERP group compared to control group. However, no difference of QLQ-C30 functional score (P = .103), QLQ-C30 symptom score (P = .808) or Δsymptom score (W16-W0) (P = .680) was observed between two groups.PERP relieves anxiety, depression and improves quality of life in MIBC patients underwent adjuvant chemotherapy.
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Affiliation(s)
| | - Dan Wei
- Department of Urology Surgery
| | | | - Qing Zhang
- Department of Thoracic Surgery, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
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26
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The Suicidal Outpatient: Balancing Autonomy, Trust, and Responsibilities. PM R 2019; 10:758-765. [PMID: 30007592 DOI: 10.1016/j.pmrj.2018.05.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 11/20/2022]
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Further Exploration of Personal and Social Functioning: The Role of Interpersonal Violence, Service Engagement, and Social Network. J Nerv Ment Dis 2019; 207:832-837. [PMID: 31365432 DOI: 10.1097/nmd.0000000000001036] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Social functioning (SF) has mainly been studied in major psychoses in relation to symptom severity, but other factors may interfere with the achievement of a functional remission. The aim of this study is to explore interpersonal violence (IV), service engagement (SE), and social network (SN), together with demographics, as predictors of SF in a sample of subjects with severe mental illness (SMI). Consecutive adult inpatients were evaluated using self-report and clinician-rated questionnaires. Findings suggest that IV, SE, SN, male sex, and illness duration explained 39.1% of SF variance in people affected by SMI. IV was the strongest predictor, followed by sex and duration of illness. Lifetime expression of violence is a stronger predictor than lifetime exposure to violence. Positive SE and SN were found to predict SF, whereas age was not associated. This study underlines the need of other non-symptom-related variables for the comprehension of SF in mental disorders.
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Nwokeoma BN, Ede MO, Nwosu N, Ikechukwu-Illomuanya A, Ogba FN, Ugwoezuonu AU, Offordile EE, Agu PU, Amoke C, Eze CO, Nnamani O, Nwafor B, Omeke FC, Omeje GN, Vita-Agundu UC, Onuh EA, Okorie CO, Ede KR, Nwadike N. Impact of rational emotive occupational health coaching on work-related stress management among staff of Nigeria police force. Medicine (Baltimore) 2019; 98:e16724. [PMID: 31517811 PMCID: PMC6750331 DOI: 10.1097/md.0000000000016724] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Empirical studies indicated that job-related stress is threatening the well-being of Nigerian public workers. The objective of this investigation was to examine the impact of REOHC for improving work-stress management among Staff of Nigeria Police Force in southeast Nigeria. METHOD This is a pretest-posttest control group design study with follow-up. A total of 63 Nigerian police officers (randomized into one of 2 groups: n = 32 for treatment group, n = 31 for waitlist control group) completed the study. Two self-report questionnaire measuring organizational and operational stressors associated with police general well-being were used as outcome measures. The intervention group received a 12-week REBC manual intervention. The intervention and waitlisted groups were evaluated at 3-time points: Time1, Time2, and Time3. Statistical analyses were achieved using repeated-measures ANOVA. RESULTS Results showed that there was no significant difference between the REOHC group and waiting-list control group in initial work-related stress management among staff of Nigerian Police Force. REOHC program had a significant effect on work-related stress management among staff of Nigerian Police Force when compared to their counterparts in the waiting-list control group. CONCLUSION Therefore, REOHC program is a time-effective treatment approach for improving work-stress management among Staff of Nigeria Police Force in southeast Nigeria.
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Affiliation(s)
| | - Moses O. Ede
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Nneka Nwosu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | | | - Francisca N. Ogba
- Department of Educational Foundations, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Amanda U. Ugwoezuonu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Edmund E. Offordile
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Patricia U. Agu
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Chijioke Amoke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Celestine O. Eze
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Ogechi Nnamani
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Bernedeth Nwafor
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Faith C. Omeke
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Grace N. Omeje
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | | | - Eucharia A. Onuh
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
| | - Cornelius O. Okorie
- Department of Educational Foundations, Alex Ekwueme Federal University, Ndufu-Alike Ebonyi State
| | - Kelechi R. Ede
- Department of Agricultural Science Education, Faculty of Education, Delta State University, Abraka, Delta State, Nigeria
| | - Ngozi Nwadike
- Department of Educational Foundations, Faculty of Education, University of Nigeria, Nsukka, Enugu State
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Chinnasamy P, Hsu MJ, Agoramoorthy G. Groundwater Storage Trends and Their Link to Farmer Suicides in Maharashtra State, India. Front Public Health 2019; 7:246. [PMID: 31544100 PMCID: PMC6728897 DOI: 10.3389/fpubh.2019.00246] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 08/13/2019] [Indexed: 11/13/2022] Open
Abstract
Threats posed by land degradation and desertification continue to destabilize India's agriculture productivity and food security. The enduring negative environmental consequences of the agricultural intensification that started during the 1960s have further contributed to the depletion of soil nutrients in farmlands through heavy input of chemical fertilizers and pesticides. More than half of India's population depends on farming. When crop productivity fails, the economically-depressed farmers are unfortunately pushed toward suicide. The news of farmers committing mass suicide in Maharashtra state of India has lately received world attention. Although suicide may involve various psychological, social and economic factors, access to irrigation water remains a contentious matter in the agriculture business. The groundwater (GW) data from government sources are limited and not displayed in the public domain for verification. Hence, this study used the Gravity Recovery and Climate Experiment (GRACE) satellite data to compare farmer suicide rate in Maharashtra with GW storage estimates at broad spatiotemporal scales. The results show significant correlations (r = -0.85, p < 0.005) between water storage and suicide rate when time lags of 2 years are introduced between them. Based on the new findings, this study recommends that the GW status needs to be monitored scientifically across India's suicide zone. By doing so, the worst case scenarios can be logically predicted well in advance. The government then may have the advantage to mobilize its resources on the ground to implement rapid emergency measures and farmer consultations to minimize future farmer suicide cases.
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Affiliation(s)
| | - Minna J Hsu
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Govindasamy Agoramoorthy
- N. M. Sadguru Water and Development Foundation, Dahod, India.,College of Pharmacy and Health Care, Tajen University, Yanpu, Taiwan
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Jaffe DH, Rive B, Denee TR. The burden of suicidal ideation across Europe: a cross-sectional survey in five countries. Neuropsychiatr Dis Treat 2019; 15:2257-2271. [PMID: 31496708 PMCID: PMC6689539 DOI: 10.2147/ndt.s204265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/16/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Suicidal ideation (SI) is an associated risk of depression, affecting 30-40% of the depressed population. However, there is a paucity of studies investigating the impact of SI in Europe. This retrospective observational study examined the burden of SI among adults with major depressive disorder (MDD) in the 2017 National Health and Wellness Survey in five European countries: France, Germany, Italy, Spain, and the UK. METHODS Bivariate analyses evaluated group differences between respondents with MDD with and without SI according to demographic characteristics, self-reported health-related quality of life, work productivity and activity impairment (WPAI), and healthcare resource utilization (HRU). Generalized linear models examined group differences country-wise, after controlling for relevant confounders. RESULTS Among 52,060 respondents, 3,308 individuals were diagnosed with MDD, comprising SI (n=905) and non-SI (nSI) (n=2403) patients. Adjusted differences (ADs), compared to the general population, were observed using the Medical Outcomes Study Short Form Survey (SF-12v2) mental component summary scores (AD: SI=-20.02, nSI=-10.77), physical component summary scores (AD: SI=-4.49, nSI=-2.50), and EuroQoL-5 Dimensions (AD: SI=-0.34, nSI=-0.15) (for all, p<0.001). Significantly greater WPAI and higher HRU were associated with SI compared to nSI. CONCLUSION The results illustrate the unique impact of SI within the MDD population and the need to reduce the burden.
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Affiliation(s)
| | - Benoit Rive
- Janssen-Cilag S.A., Health Economics Market Access and Reimbursement Statistics
, Paris, France
| | - Tom R Denee
- Janssen-Cilag Limited, Health Economics Market Access and Reimbursement
, High Wycombe, UK
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Humby T, Davies W. Brain Gene Expression in a Novel Mouse Model of Postpartum Mood Disorder. Transl Neurosci 2019; 10:168-174. [PMID: 31410299 PMCID: PMC6689211 DOI: 10.1515/tnsci-2019-0030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/26/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Steroid sulfatase (STS) cleaves sulfate groups from steroid hormones; its expression/activity increases in late pregnancy and into the postpartum period. STS-deficient human and mouse mothers display elevated psychopathology and abnormal behaviour respectively; in mice, these effects can be partially normalised by antipsychotic (ziprasidone) administration. METHODOLOGY We compared brain gene expression in new mouse mothers administered the STS inhibitor 667-Coumate, or vehicle; significant changes were followed-up with pathway analysis and quantitative polymerase chain reaction (qPCR). Finally, the effects of combined 667-Coumate and ziprasidone administration on expression of the most robustly differentially-expressed genes were examined. RESULTS Surprisingly, no between-group gene expression changes were detected at a False Discovery Rate (FDR)-corrected p<0.1. 1,081 unique expression changes were detected at p<0.05, two top hits were verified by qPCR, and pathway analysis indicated enrichment of genes involved in olfactory transduction. The expression of Stoml3 and Cyp2g1 was unaffected by ziprasidone administration. CONCLUSIONS Postpartum behavioural abnormalities in STS-deficient mothers are likely to be the culmination of many small gene expression changes. Our data are consistent with the idea that olfactory function is key to maternal behaviour in mice, and suggest that aberrant expression of olfactory system genes may underlie abnormal maternal behaviour in STS-deficient women.
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Affiliation(s)
- Trevor Humby
- School of Psychology, Cardiff University, Cardiff CF10 3AT, Cardiff, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, CardiffCF24 4HQ, UK
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, CardiffCF24 4HQ, UK
| | - William Davies
- School of Psychology, Cardiff University, Cardiff CF10 3AT, Cardiff, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, CardiffCF24 4HQ, UK
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics and Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, CardiffCF24 4HQ, UK
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Risk factors for suicidal tendency in adult patients with epilepsy in China. Epilepsy Behav 2019; 97:118-122. [PMID: 31234043 DOI: 10.1016/j.yebeh.2019.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 06/01/2019] [Accepted: 06/02/2019] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The major cause of premature mortality in people with epilepsy (PWE) is suicide. Actual data on the risk of suicidal tendency in adult PWE in China are scarce. In our study, associations between possible risk factors and suicidal tendency in adult PWE in China were investigated. METHODS People with epilepsy (n = 251) were recruited, and their demographic and clinical characteristics were evaluated. Suicide risk was examined using the suicidality module (SM) of the Mini International Neuropsychiatric Interview (MINI) Plus Chinese Version 5.0.0. RESULTS Suicidal tendency was present in 36 (14.3%) of the 251 PWE. On the basis of the results of univariate analyses, family relationship (P < 0.001), age at epilepsy onset (P = 0.037), seizure-free period (P = 0.041), seizures/month (P = 0.015), depressive disorders (P < 0.001), and number of antiepileptic drugs (AEDs) (P = 0.017) were associated with suicidal tendency. Multivariate analysis revealed that moderate or poor family relationships (odds ratio (OR): 6.468, 95% confidence interval (CI): 2.418-17.300) and depressive disorders (OR: 3.548, 95% CI: 1.575-7.995) were associated with high odds of suicidal tendency. CONCLUSION Suicidal tendency is common among adult PWE. This study reveals that family relationships and depressive disorders are independent risk factors for suicidal tendency among adult PWE. Therefore, while maintaining treatment of epilepsy, more attention should be directed to the social support and mental state of PWE to prevent suicide.
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Hashikawa-Hobara N, Otsuka A, Ishikawa R, Hashikawa N. Roman chamomile inhalation combined with clomipramine treatment improves treatment-resistant depression-like behavior in mice. Biomed Pharmacother 2019; 118:109263. [PMID: 31369988 DOI: 10.1016/j.biopha.2019.109263] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/19/2019] [Accepted: 07/24/2019] [Indexed: 12/27/2022] Open
Abstract
It is well known that chamomile is one of the oldest known medicinal herbs and has been used to treat various disorders, but it is mainly German chamomile. The effects of Roman chamomile on depression still unclear. In this study, we used chronically stressed mice to investigate whether inhalation of Roman chamomile essential oil affects depression-like behavior. We previously reported that restraint and water immersion stress produce depression-like behavior and a blunted response to the tricyclic antidepressant clomipramine. Each mouse was exposed to restraint and water immersion stress for 15 days, and resistance to the effect of clomipramine was induced in a behavioral despair paradigm. In the present study, we found that cotreatment with clomipramine and inhalation of Roman chamomile attenuated depression-like behavior in a forced swim test. Next, we examined the hippocampal mRNA levels of two cytokines, tumor necrosis factor (TNF) alpha and interleukin-6 (IL-6); a neurotrophic factor, brain derived-neurotrophic factor (BDNF); and nerve growth factor (NGF). TNF alpha, IL-6 and BDNF mRNA levels did not change in the hippocampus of stressed mice. However, the NGF mRNA level was significantly decreased, and this decrease was not attenuated by treatment with clomipramine or inhalation of Roman chamomile alone. We also examined whether Roman chamomile combined with clomipramine treatment affects hippocampal neurogenesis and serum corticosterone levels. Stressed mice had fewer doublecortin (DCX)-positive cells in the subgranular zone of the dentate gyrus, but this was significantly attenuated by Roman chamomile and clomipramine treatment. In addition, the serum corticosterone level was also significantly decreased by treatment with Roman chamomile and clomipramine. These results suggest that Roman chamomile inhalation may enhance the antidepressant effect of clomipramine by increasing hippocampal neurogenesis and modulating corticosterone levels in patients with treatment-resistant depression.
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Affiliation(s)
- Narumi Hashikawa-Hobara
- Department of Life Science, Okayama University of Science, 1-1 Ridai-cho, Kita-ku, Okayama, 700-0005, Japan.
| | - Ami Otsuka
- Department of Life Science, Okayama University of Science, 1-1 Ridai-cho, Kita-ku, Okayama, 700-0005, Japan.
| | - Risa Ishikawa
- Department of Life Science, Okayama University of Science, 1-1 Ridai-cho, Kita-ku, Okayama, 700-0005, Japan.
| | - Naoya Hashikawa
- Department of Life Science, Okayama University of Science, 1-1 Ridai-cho, Kita-ku, Okayama, 700-0005, Japan.
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Vargas T, Zou DS, Conley RE, Mittal VA. Assessing Developmental Environmental Risk Factor Exposure in Clinical High Risk for Psychosis Individuals: Preliminary Results Using the Individual and Structural Exposure to Stress in Psychosis-Risk States Scale. J Clin Med 2019; 8:jcm8070994. [PMID: 31323940 PMCID: PMC6678455 DOI: 10.3390/jcm8070994] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 07/03/2019] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder. METHODS CHR individuals (n = 35) and healthy volunteers (n = 28) completed structured clinical interviews as well as our group's newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined. RESULTS Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11-13 age range, and significant group differences for the 14-18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed. DISCUSSION Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations.
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Affiliation(s)
- Teresa Vargas
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA.
| | - Denise S Zou
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Rachel E Conley
- Department of Psychology, Northwestern University, Evanston, IL 60208, USA
| | - Vijay A Mittal
- Department of Psychology, Department of Psychiatry, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA
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Timberlake Ii M, Roy B, Dwivedi Y. A Novel Animal Model for Studying Depression Featuring the Induction of the Unfolded Protein Response in Hippocampus. Mol Neurobiol 2019; 56:8524-8536. [PMID: 31267370 DOI: 10.1007/s12035-019-01687-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/21/2019] [Indexed: 02/08/2023]
Abstract
Depression is the leading cause of disability worldwide with global distribution of 322 million people suffering from the disease. While much is understood about depression, the underlying pathophysiology is yet to be fully characterized. Recently, the unfolded protein response (UPR) has been shown to be involved in regulating key aspects like inflammation, cell death, and behavioral depression. The UPR is an evolutionarily conserved ancient response system that reacts to the stressful environmental impact on a cell; the net effect of stress to a cell is that the quality of protein folding is diminished. The UPR responds by repairing and removing misfolded proteins and, if necessary, initiates apoptosis. Here, we demonstrate that the UPR is not only involved in depression, but that its activation causes a depressive phenotype. The hippocampi of rats were directly infused with 500 ng of tunicamycin (TM), an agent that initiates the UPR by blocking N-terminal glycosylation. Three to 8 days post-surgery, the rats showed depressive behavior in escape latency, forced swim despair, sucrose preference anhedonia, and also physiological signs of depression like decreased weight. Further, these behavioral changes were associated with enhanced expression of key UPR genes and proteins in the hippocampus. We propose that this model will make an excellent tool for studying depression and for understanding pathways that are affected by the UPR which directly causes depressive behavior.
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Affiliation(s)
- Matthew Timberlake Ii
- Department of Psychiatry and Behavioral Neurobiology, SC711 Sparks Center, University of Alabama at Birmingham, 1720 7th Avenue South, Birmingham, AL, 35294, USA
| | - Bhaskar Roy
- Department of Psychiatry and Behavioral Neurobiology, SC711 Sparks Center, University of Alabama at Birmingham, 1720 7th Avenue South, Birmingham, AL, 35294, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, SC711 Sparks Center, University of Alabama at Birmingham, 1720 7th Avenue South, Birmingham, AL, 35294, USA.
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Associations between depression, anxiety, stress, hopelessness, subjective well-being, coping styles and suicide in Chinese university students. PLoS One 2019; 14:e0217372. [PMID: 31260454 PMCID: PMC6602174 DOI: 10.1371/journal.pone.0217372] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/09/2019] [Indexed: 12/13/2022] Open
Abstract
Suicide is a major public health concern worldwide. This study aimed to predict the suicidal behavior of Chinese university students by studying psychological measures such as hopelessness, orientation to happiness, meaning in life, depression, anxiety, stress, and coping styles. In November 2016, a stratified-clustered-random sampling approach was utilized to select subjects from two large public medical-related universities in Shandong province, China. This sample consisted of 2,074 undergraduate students (706 males, 1,368 females; mean age = 19.79±1.39 years). The students’ major risk factors for suicide were depression, anxiety, stress, and hopelessness, and the students’ minor risk factors included orientation to happiness and coping styles (including self-distraction, self-blame and substance use). Notably, the presence of meaning in life had a positive effect on preventing suicide and acted as a protective factor, which suggests that it is important to identify risk factors as well as protective factors relevant to the target population group in order to increase the effectiveness of counseling and suicide prevention programs.
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Rey L, Mérida-López S, Sánchez-Álvarez N, Extremera N. When and How Do Emotional Intelligence and Flourishing Protect against Suicide Risk in Adolescent Bullying Victims? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2114. [PMID: 31207915 PMCID: PMC6616872 DOI: 10.3390/ijerph16122114] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 06/06/2019] [Accepted: 06/12/2019] [Indexed: 11/16/2022]
Abstract
This study contributes to current knowledge on the protective role of emotional intelligence and flourishing in cases of suicide risk (namely depressive symptoms and suicidal ideation) in a sample of adolescent victims of traditional bullying. The proposed model tested the mediator role of flourishing in the relationship between emotional intelligence (EI) and suicide risk together with the moderating effect of EI in the relationship between low flourishing and increased suicide risk. Considering an initial sample of 1847 adolescents (52.5% female), a subsample of 494 pure bullying victims (61.3% female) took part in this research. The main results showed EI to be linked to decreased suicide risk through levels of flourishing. Moreover, EI buffered the relationship between low flourishing and the associated suicide risk. Victimized adolescents with both low levels of EI and of flourishing reported higher levels of suicide risk than their counterparts with high EI levels. This suggests the protective role of EI of both predicting higher flourishing and reducing the likelihood of suicide risk among victimized adolescents with low levels of flourishing. Finally, the practical implications of these novel findings regarding the role of EI and flourishing in the prevention of suicide risk among victimized adolescents are discussed.
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Affiliation(s)
- Lourdes Rey
- Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Málaga, 29071 Málaga, Spain.
| | - Sergio Mérida-López
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, Faculty of Psychology, University of Málaga, 29071 Málaga, Spain.
| | - Nicolás Sánchez-Álvarez
- Department of Developmental and Educational Psychology, Faculty of Psychology, University of Málaga, 29071 Málaga, Spain.
| | - Natalio Extremera
- Department of Social Psychology, Social Work, Social Anthropology and East Asian Studies, Faculty of Psychology, University of Málaga, 29071 Málaga, Spain.
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Zhang Z, Zhang L, Zu X, Liu T, Zheng J. From Neighboring Behavior to Mental Health in the Community: The Role of Gender and Work-Family Conflict. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2101. [PMID: 31200572 PMCID: PMC6617099 DOI: 10.3390/ijerph16122101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 06/04/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022]
Abstract
This research emphasizes the potential influences of social community environments on low-income employees' mental health. Using a two-wave panel design, we collect 218 matched data from low-income employees in Harbin City, China. We developed a moderated mediation model to test our hypotheses with the following significant results: (1) neighboring behavior, defined as both giving and receiving various kinds of assistance to and from one's neighbors, positively influenced mental health; (2) work-family conflict mediated the relationship between neighboring behavior and mental health; (3) gender moderated the influences of neighboring behavior on mental health, such that neighboring behavior had a stronger positive influence on mental health for females than for males; (4) gender moderated the mediating effect of work-family conflict; that is, the positive influences of neighboring behavior were stronger for female employees than for male employees. This research explores the mechanism and boundary conditions of the relationship between neighboring behavior and mental health. In practice, community managers support community social workers by organizing community-building social activities and supportive programs to enhance residents' neighboring behavior.
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Affiliation(s)
- Zhenduo Zhang
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Li Zhang
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Xiaoqian Zu
- School of Management, Harbin Institute of Technology, Harbin 150001, China.
| | - Tiansen Liu
- School of Economics and Management, Harbin Engineering University, Harbin 150001, China.
| | - Junwei Zheng
- Department of Construction Management, Kunming University of Science and Technology, Kunming 650500, China.
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The Influence of Social Support and Care Burden on Depression among Caregivers of Patients with Severe Mental Illness in Rural Areas of Sichuan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111961. [PMID: 31159499 PMCID: PMC6603995 DOI: 10.3390/ijerph16111961] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 05/29/2019] [Indexed: 12/22/2022]
Abstract
Depression is one of the most common psychological consequences of caregiving. Caring for patients with severe mental illness (SMI) adds significant challenges to family caregivers’ mental health. The purpose of this study was to describe the prevalence of depression among caregivers of SMI patients in rural areas of Sichuan province of China, to examine the influence of social support and care burden on depression, and to explore the intermediary effect of care burden between social support and depression among caregivers of SMI patients. Data were collected from 256 primary caregivers of SMI patients in rural Sichuan Province in China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. We found that a total of 53.5% of caregivers had depression. Both care burden (β = 0.599, 95%CI: 0.392–0.776) and social support (β = −0.307, 95%CI: (−0.494)–(−0.115)) were directly related to depression, while social support had a direct association with care burden (β = −0.506, 95%CI: (−0.672)–(−0.341)). Care burden mediated the relationship between social support and depression. For the socio-demographic variables, gender, education level and per capita annual income of household had significant correlations with depression (p < 0.05). The results strongly demonstrated that social support and care burden were predictors of depression, especially social support. Policymakers should fully recognize the role of primary family caregivers in caring for SMI patients and promote interventions to decrease care burden and reduce caregivers’ depression by improving social support and network. More attention should be given to female caregivers and caregivers with lower education and lower household income levels.
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Assessing interpersonal and mood factors to predict trajectories of suicidal ideation within an inpatient setting. J Affect Disord 2019; 252:315-324. [PMID: 30999088 DOI: 10.1016/j.jad.2019.04.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 03/06/2019] [Accepted: 04/07/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND A limited amount of research has assessed how suicide risk changes over time, and how changes can be predicted. The current study assessed suicidal ideation and risk factors throughout inpatient visits to a psychiatric facility to refine prediction of suicide risk. METHOD In total, 491 patients (73% Female; mean age = 39.21) at a psychiatric inpatient facility self-reported the frequency of their suicidal thoughts, perceived burdensomeness, thwarted belongingness, hopelessness, depression, and anxiety in the prior 24 h on a daily basis. Levels of suicidal ideation and risk factors at each quarter of an inpatient's stay were identified, and latent class growth analysis used to identify common patterns of change over time. RESULTS Changes in mood and interpersonal factors were associated with changes in suicidal ideation over days and weeks. Further, they contributed to the prediction of future levels of suicidal ideation. Thwarted belongingness at admission predicted whether patients had pervasively high suicidal thoughts over the course of inpatient visits or showed marked improvements, while perceived burdensomeness predicted which patients would develop suicidal thoughts during their visit. LIMITATIONS The use of single item measures may limit specificity of measurement of suicide risk factors. Hourly, rather than daily measurement used in the current study, may more accurately identify suicide risk. CONCLUSIONS Change in suicidal ideation is associated with changes in a number of psychological risk factors. Regular assessment of interpersonal risk factors may identify warning signs and aid clinical interventions in reducing suicidal thoughts and associated self-injurious behaviours.
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Dhungel B, Sugai MK, Gilmour S. Trends in Suicide Mortality by Method from 1979 to 2016 in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101794. [PMID: 31117173 PMCID: PMC6571574 DOI: 10.3390/ijerph16101794] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 11/16/2022]
Abstract
Suicide is a major public health concern in Japan. This study aimed to characterize the trends in suicide mortality in Japan by method since 1979. Using data from the Japan vital registration system, we calculated age-standardized rates of suicide mortality separately by sex and method. We conducted a log-linear regression of suicide mortality rates separately by sex, and linear regression analysis of the proportion of deaths due to hanging, including a test for change in level and trend in 1998. While crude suicide rates were static over the time period, age-adjusted rates declined. The significant increase in suicide mortality in 1998 was primarily driven by large changes in the rate of hanging, with suicide deaths after 1998 having 36.7% higher odds of being due to hanging for men (95% CI: 16.3–60.8%), and 21.9% higher odds of being due to hanging for women (95% CI: 9.2–35.9%). Hanging has become an increasingly important method for committing suicide over the past 40 years, and although suicide rates have been declining continuously over this time, more effort is needed to prevent hanging and address the potential cultural drivers of suicide if the rate is to continue to decline in the future.
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Affiliation(s)
- Bibha Dhungel
- Graduate School of Public Health, St. Luke's International University, Tokyo 104-0045, Japan.
| | - Maaya Kita Sugai
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan.
- Institute of Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo 162-8655, Japan.
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo 104-0045, Japan.
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Effects of Inflammation and Depression on Telomere Length in Young Adults in the United States. J Clin Med 2019; 8:jcm8050711. [PMID: 31109116 PMCID: PMC6572156 DOI: 10.3390/jcm8050711] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/13/2019] [Accepted: 05/13/2019] [Indexed: 11/21/2022] Open
Abstract
Little is known about the associations of inflammation and depression with telomere length. Using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, the current study assessed the effects of inflammation and depression on telomere length in 1141 young adults in the USA. Depression status was assessed from the World Health Organization Composite International Diagnostic Interview and inflammation status was measured based on C-reactive protein (CRP) concentrations. Information on telomere length was obtained using the quantitative polymerase chain reaction method to measure telomere length relative to standard reference DNA (T/S ratio). Unadjusted and adjusted linear and logistic regression models were used to assess the relationship between the tertiles of CRP concentration and the telomere length stratified by the status of depression such as major depression or depressed affect vs. no depression. The adjusted models were controlled for age, family poverty income ratio, race/ethnicity, marital status, physical activity, body mass index, and alcohol drinking status. A significant and decreasing linear trend in telomere length was found as CRP levels increased in men, regardless of the depression status, and women with major depression or depressed affect (p values < 0.05). Among men without depression, those with an elevated CRP level had increased odds of having a shortened telomere length compared to men with low CRP levels after controlling for covariates (adjusted odds ratio 1.77, 95% confidence interval (CI) 1.09–2.90). In women, there was no association between CRP and telomere length, regardless of the depression status. In conclusion, there was a significant and inverse association between inflammation and telomere length according to the depression status in men but not in women. The present findings may be of clinical significance for the monitoring of inflammation levels and depression status as determinants of telomere length.
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Ojagbemi A, Bello T. Tedium vitae in stroke survivors: a comparative cross-sectional study. Top Stroke Rehabil 2019; 26:195-200. [PMID: 30890043 DOI: 10.1080/10749357.2019.1590971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Suicide is best studied by deconstructing the psychological experiences preceding suicidal death. We assessed the characteristics of tedium vitae (feeling tired of life) after first ever stroke in Nigerian survivors. METHODS Using the Schedule for Clinical Assessment in Neuropsychiatry, tedium vitae was assessed in 130 stroke survivors attending rehabilitation in a large Nigerian university hospital. Global cognitive and executive dysfunctions were evaluated, respectively, using the Mini Mental State Examination and the modified Indiana University Token test. All participants had their index stroke 3 to 24 months before recruitment into the study. We also examined a comparative group of 130 age, gender, and education matched apparently normal persons who were unrelated to the stroke survivors. Associations were explored using univariate and multivariate logistic regression analyses. RESULTS Tedium vitae was experienced by 16 (12.3%) stroke survivors compared with 5 (3.9%) in the comparative group (O. R = 3.5, 95% C. I = 1.3-9.9, p = 0.018). Among stroke survivors, those who were retired were more likely to experience tedium vitae (56.2%, p = 0.045). In analyses adjusting for the effect of systemic hypertension, cognitive dysfunction, retirement and marital separation, there was a 3.5-fold increase in the odds of experiencing tedium vitae after surviving a stroke (O. R = 3.5, 95% C. I = 1.1-11.6, p = 0.042). CONCLUSIONS Tedium vitae is a common suicidal experience after stroke and may be among the earliest perceptible pointer to impending poststroke suicide. It is easy to assess and may be less costly to obtain an adequate sample size in studies aiming to understand the phenomenon of suicide in the stroke population.
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Affiliation(s)
- Akin Ojagbemi
- a World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance abuse, Department of Psychiatry, College of Medicine , University of Ibadan , Ibadan , Nigeria
| | - Toyin Bello
- a World Health Organization (WHO) Collaborating Centre for Research and Training in Mental health, Neuroscience, and Substance abuse, Department of Psychiatry, College of Medicine , University of Ibadan , Ibadan , Nigeria
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Ojagbemi A, Bello T, Elugbadebo F. Suicidal Thoughts and Contexts in Black African Stroke Survivors. J Geriatr Psychiatry Neurol 2019; 32:74-80. [PMID: 30630386 DOI: 10.1177/0891988718824035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES Poststroke suicide has not been studied in Black Africans. We assessed the characteristics and contexts of serious suicidal thoughts after first-ever stroke in Nigerians. METHODS Using a comparative cross-sectional design, we consecutively recruited 130 stroke survivors attending rehabilitation in a large university hospital. Also included were 130 age-, sex-, and education-matched caregivers who were unrelated to stroke survivors. Along with clinical and historical details, cognitive functions, experience of serious suicidal thoughts, and major depressive disorder (MDD) were independently assessed using validated semi-structured interviews. RESULTS Serious suicidal thoughts were present in 20 (15.4%) stroke survivors and 19 (14.6%) controls. Poststroke suicidal thoughts occurred in the contexts of MDD ( P < .001), marital separation ( P = .019), and cognitive dysfunction ( P = .037). In a multivariate logistic regression model including age, gender, MDD, marital separation, and cognitive dysfunction as covariates, poststroke MDD and marital separation led to 5.6-fold (95% confidence interval [CI]: 3.5-21.0) and 4-fold (95% CI: 1.2-14.0) increases, respectively, in the odds of serious suicidal thoughts. CONCLUSIONS Serious suicidal thoughts after stroke in this African sample were more common than the reported average prevalence in the global literature. Poststroke major depression was the key reversible risk factor for suicidal thoughts. Depression is treatable and prompt treatment may prevent suicidal deaths and reduce the burden of stroke in black Africans.
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Affiliation(s)
- Akin Ojagbemi
- 1 Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- 1 Department of Psychiatry, World Health Organization (WHO) Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Fisayo Elugbadebo
- 2 Department of Psychiatry, University College Hospital Ibadan, Ibadan, Nigeria
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Baccaro A, Wang YP, Candido M, Conforto AB, Brunoni AR, Leite CDC, Busatto Filho G, Lotufo PA, Benseñor IM, Goulart AC. Post-stroke depression and cognitive impairment: Study design and preliminary findings in a Brazilian prospective stroke cohort (EMMA study). J Affect Disord 2019; 245:72-81. [PMID: 30368073 DOI: 10.1016/j.jad.2018.10.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 09/13/2018] [Accepted: 10/04/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Post-stroke depression (PSD) and cognitive impairment (PCI) are common conditions. This study aims to describe the protocol and preliminary findings of an investigation into factors associated with PSD and PCI 1-3 months after stroke (subacute phase) in survivors from the Study of Stroke Mortality and Morbidity (EMMA study). METHODS Stroke patients underwent to clinical and neurological evaluations on admission to hospital. Cerebral magnetic resonance and biomarkers (serotonin, BDNF, IL-6 and IL-18) were carried out in the subacute phase. DSM-IV major depression for the diagnosis of PSD, cognitive functioning for the diagnosis of PCI and functional disability were also recorded at same time. RESULTS Of the 103 eligible patients, 85.4% had ischemic stroke and 73.7% had first-ever stroke. In the subacute phase, 27.2% had PCI and 13.6% had current PSD (5.8% with 'first episode' and 7.8% with 'recurrent' depression). PCI was associated with low education (0-7 years of formal education: 75%) and ageing (median age: 70; interquartile range: 59-75 y-old). Left-sided stroke was more frequently associated with increased PCI than right-sided stroke (71.4% vs. 28.4%, p = 0.005). PSD was neither associated with stroke laterality nor tentorial area. Overall, biomarkers levels were not alterated in patients with PSD and PCI. LIMITATIONS Findings are based on small sample and less disabled stroke participants, e.g. those without aphasia and deafness. CONCLUSIONS Findings reinforce the need of early recognition and rehabilitation of PCI and PSD, mainly among those less educated and with left-sided stroke. PSD might occur through a pathophysiological pathway other than classical depression.
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Affiliation(s)
- Alessandra Baccaro
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil; Laboratory of Psychiatric Neuroimaging (LIM21), Departamento de Psiquiatria, Universidade de Sao Paulo, Medical School, Brazil.
| | - Yuan-Pang Wang
- Institute of Psychiatry, Hospital das Clinicas, Universidade de Sao Paulo, Medical School, Brazil; Laboratory of Medical Investigations of Psychopharmacology and Clinical Psychophysiology (LIM23), Universidade de Sao Paulo, Medical School, Brazil
| | - Miriam Candido
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil
| | - Adriana Bastos Conforto
- Department of Neurology, Hospital das Clinicas, Universidade de Sao Paulo, Medical School, Brazil
| | - André Russowsky Brunoni
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil; Institute of Psychiatry, Hospital das Clinicas, Universidade de Sao Paulo, Medical School, Brazil
| | - Claudia da Costa Leite
- Medical School, Universidade de Sao Paulo, Brazil; Nucleo de Apoio a Pesquisa em Neurociencia Aplicada (NAPNA), Universidade de Sao Paulo, Brazil; Institute of Radiology and Oncology, Hospital das Clinicas, Universidade de Sao Paulo, Brazil
| | - Geraldo Busatto Filho
- Laboratory of Psychiatric Neuroimaging (LIM21), Departamento de Psiquiatria, Universidade de Sao Paulo, Medical School, Brazil; Institute of Psychiatry, Hospital das Clinicas, Universidade de Sao Paulo, Medical School, Brazil; Medical School, Universidade de Sao Paulo, Brazil; Nucleo de Apoio a Pesquisa em Neurociencia Aplicada (NAPNA), Universidade de Sao Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil; Medical School, Universidade de Sao Paulo, Brazil
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil; Medical School, Universidade de Sao Paulo, Brazil
| | - Alessandra Carvalho Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitario, Universidade de Sao Paulo, Brazil.
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Chen GC, Chen PY, Su YC, Hsiao CL, Yang FY, Hsu PJ, Lin SK. Vascular, Cognitive, and Psychomental Survey on Elderly Recycling Volunteers in Northern Taiwan. Front Neurol 2019; 9:1176. [PMID: 30687225 PMCID: PMC6338017 DOI: 10.3389/fneur.2018.01176] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/20/2018] [Indexed: 12/01/2022] Open
Abstract
Background: Stroke and dementia represent frequent causes of psychophysical and socioeconomic burdens. We conducted a vascular, cognitive, and psychomental survey involving elderly volunteers at community-based recycling stations in Northern Taiwan. Methods: Recycling volunteers aged ≥60 years were surveyed. We recorded seven parameters, namely (1) body mass index (BMI), (2) fasting glucose, (3) fasting cholesterol, (4) ankle-brachial index (ABI), (5) carotid duplex sonography, (6) five-item Brief Symptom Rating Scale (BSRS-5) score, and (7) eight-item Interview to Differentiate Aging and Dementia (AD8). During the carotid duplex study, we measured the carotid intima-media thickness (CIMT) and the carotid total plaque score (CTPS) of the common and internal carotid arteries. Results: In total, 985 subjects (mean age: 70.8 years) participated in this study. Among these, 81% were women, and 52% were vegetarians. The average ABI, CIMT, and CTPS were higher in men, whereas women had higher cholesterol levels and BSRS-5 scores. Obesity, hypertension, hyperglycemia, and hyperlipidemia were present in 21, 38, 9, and 27% of all subjects, respectively. Carotid plaques with mild (CTPS 1–5), moderate (CTPS 5.1–10), and severe (CTPS > 10) atherosclerosis were detected in 45, 16, and 7% of the subjects, respectively. Mild cognitive impairment (AD8 > 2) was observed in 13% of the subjects, whereas moderate mood disorder (BSRS-5≧10) was observed in only 1% of subjects. Vegetarians had a lower BMI, systolic blood pressure (SBP), cholesterol, CIMT, and CTPS than did non-vegetarians. Substantial predictors of severe atherosclerosis were advanced age (>70 years), male sex, history of heart disease, hyperlipidemia, and currently elevated SBP and cholesterol levels. Predictors of mild cognitive impairment were illiteracy, history of hypertension, hyperlipidemia, and moderate mood disorder. Conclusions: Subclinical carotid atherosclerosis was common in elderly recycling volunteers, with 23% having moderate to severe stenosis. Vegetarians had a reduced risk of atherosclerosis. The low incidence of moderate mood disorder might indicate that recycling work enhances psychomental health. In addition, a healthier lifestyle, better mood condition, and vegetarian diet might contribute to lower incidence of mild cognitive impairment.
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Affiliation(s)
- Guei-Chiuan Chen
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Pei-Ya Chen
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Yu-Chin Su
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Cheng-Lun Hsiao
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Fu-Yi Yang
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Po-Jen Hsu
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan
| | - Shinn-Kuang Lin
- Stroke Center and Department of Neurology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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Use of Cognitive Screening Tools to Detect Cognitive Impairment After an Ischaemic Stroke: a Systematic Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s42399-018-0035-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Gurok MG, Korkmaz H, Yıldız S, Bakış D, Atmaca M. QT and P-wave dispersion during the manic phase of bipolar disorder. Neuropsychiatr Dis Treat 2019; 15:1805-1811. [PMID: 31308673 PMCID: PMC6613347 DOI: 10.2147/ndt.s208253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/10/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIM Patients with bipolar disorder (BD) are at increased risk for cardiovascular diseases and complications. This increased risk is considered to be associated with the autonomic nervous system (ANS) abnormalities. However, there is little or no documentation of the relationship between this increased risk and the phases of BD. In this study, we aimed to compare the changes in the QT dispersion (QTd) and P-wave dispersion (Pd), which are predictors of sudden cardiac death and atrial fibrillation, between the patients with manic BD and healthy controls. PARTICIPANTS AND METHODS The study included a patient group of 44 patients (26 female and 18 male) that were hospitalized due to a diagnosis of manic BD and met the inclusion criteria, and a control group of 34 age- and gender-matched healthy individuals (21 female and 13 male) with no history of psychiatric and neurological disorders. The QTd and Pd values were determined in each participant by performing the standard 12-lead body surface electrocardiography (ECG). RESULTS The principal electrocardiographic indicators including corrected maximum QT interval, corrected QT dispersion, and minimum P-wave duration significantly increased in the patient group compared to the control group (t=2.815, p<0.01; t=4.935, p<0.001; t=3.337, p<0.001, respectively). CONCLUSION The results indicated that patients with manic BD are at increased risk for cardiovascular autonomic dysfunction. Therefore, clinicians should be more careful about ECG changes and related possible cardiac conduction problems such as cardiac arrthythmias in patients with manic BD. Further longitudinal studies are needed to investigate BD and its phases (depression, mania, and hypomania) with regard to ANS and cardiac abnormalities.
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Affiliation(s)
- Mehmet Gurkan Gurok
- Fırat University, School of Medicine, Department of Psychiatry, Elazig, Turkey
| | - Hasan Korkmaz
- Fırat University, School of Medicine, Department of Cardiology, Elazig, Turkey
| | - Sevler Yıldız
- Fırat University, School of Medicine, Department of Psychiatry, Elazig, Turkey
| | - Dilek Bakış
- Fırat University, School of Medicine, Department of Psychiatry, Elazig, Turkey
| | - Murad Atmaca
- Fırat University, School of Medicine, Department of Psychiatry, Elazig, Turkey
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Jones M, Corcoran A, Jorge RE. The psychopharmacology of brain vascular disease/poststroke depression. PSYCHOPHARMACOLOGY OF NEUROLOGIC DISEASE 2019; 165:229-241. [DOI: 10.1016/b978-0-444-64012-3.00013-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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50
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Higashiyama M, Hayashida T, Sakuta K, Fujimura Y, Masuya J, Ichiki M, Tanabe H, Kusumi I, Inoue T. Complex effects of childhood abuse, affective temperament, and subjective social status on depressive symptoms of adult volunteers from the community. Neuropsychiatr Dis Treat 2019; 15:2477-2485. [PMID: 31695384 PMCID: PMC6717723 DOI: 10.2147/ndt.s209100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND How subjective social status is associated with childhood abuse and affective temperament in the mechanism of depressive symptom exacerbation remains unknown. In this study, we investigated how the complex effects of subjective social status, childhood abuse, and affective temperament influence depressive symptoms in adulthood. METHODS Self-report questionnaires were distributed to 853 adult volunteers between January and August 2014. Of them, 404 people gave full consent and returned complete anonymous responses. The following five questionnaires were analyzed: demographic information, Patient Health Questionnaire-9, subjective social status, Child Abuse and Trauma Scale, and Temperament Evaluation of Memphis, Pisa, Paris and San Diego autoquestionnaire. The associations between the scores were analyzed by structural equation modeling. This study was conducted with approval from the ethics committees of Tokyo Medical University and Hokkaido University Hospital. RESULTS Covariance structure analysis demonstrated that childhood abuse and subjective social status did not have a direct effect on adulthood depressive symptoms. Childhood abuse had direct effects on subjective social status and affective temperament and childhood abuse indirectly affected adulthood depressive symptoms through subjective social status and affective temperament. Subjective social status also affected depressive symptoms through an effect on affective temperament. This model explained 43% of the variability in depressive symptoms and the fitness of this model was good. CONCLUSION Regarding childhood abuse and adulthood depressive symptoms, subjective social status as well as affective temperament may be mediators. The results of this study are expected to contribute to the elucidation of the mechanism of depression.
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Affiliation(s)
- Motoki Higashiyama
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Taito Hayashida
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Keisuke Sakuta
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Yota Fujimura
- Department of Psychiatry, Tokyo Medical University Hachioji Medical Center, Tokyo 193-0998, Japan
| | - Jiro Masuya
- Department of Psychiatry, Tokyo Medical University Ibaraki Medical Center, Ibaraki 300-0395, Japan
| | - Masahiko Ichiki
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
| | - Hajime Tanabe
- Department of Clinical Human Sciences, Graduate School of Humanities and Social Sciences, Shizuoka University, Shizuoka 422-8529, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo 060-8638, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo 160-0023, Japan
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