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Gandarela L, de A. Sampaio TP, Marçal L, Burdmann EA, Neto FL, Bernik MA. Inflammatory markers changes following acceptance-based behavioral psychotherapy in generalized anxiety disorder patients: Evidence from a randomized controlled trial. Brain Behav Immun Health 2024; 38:100779. [PMID: 38725444 PMCID: PMC11081778 DOI: 10.1016/j.bbih.2024.100779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 04/20/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Introduction Generalized anxiety disorder (GAD) has been associated with elevated levels of C-reactive protein (CRP) and proinflammatory cytokines. Despite robust evidence as an effective treatment for GAD, research on the effects of cognitive-behavioral therapies (CBT) in the inflammatory profile of patients with clinical anxiety has presented mixed results. Objective The present study aimed to investigate the effect of an acceptance-based behavior therapy (ABBT) on inflammatory biomarkers and their association with anxiety levels in GAD patients in comparison to supportive therapy as an active control. Methods Peripheral inflammatory biomarkers (CRP, IL-1β, IL-4, IL-6, IL-10, TNF-α) were measured in 77 GAD patients who participated in a 14-week 10-session randomized clinical trial of group ABBT (experimental, n = 37) or supportive group therapy (ST: active control group, n = 40). Results The concentrations of IL-1β decreased in the control group and the concentrations of IL-6 increased in the experimental group from baseline to post-treatment, whereas no difference was identified in IL-4, IL-10, TNF, or CRP. Although anxiety and depression levels decreased in both treatment conditions, no correlation with inflammation markers was found for most clinical and biological variables. A negative correlation between changes in IL-6 and IL-10 and anxiety symptom score changes was identified. Conclusions The present study results found that a short trial of acceptance-based behavior therapy did not change the proinflammatory profile which may be associated with GAD. Additional research is needed to evaluate the influence of other inflammation-related variables, longer periods of follow-up as well as the effect of supportive therapy on peripheral inflammatory biomarkers in GAD patients.
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Affiliation(s)
- Lucas Gandarela
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
| | - Thiago P. de A. Sampaio
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Lia Marçal
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Emmanuel A. Burdmann
- LIM 12, Division of Nephrology, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Francisco Lotufo Neto
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
- Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
| | - Marcio A. Bernik
- Experimental Pathophysiology Program, School of Medicine, University of São Paulo, São Paulo, Brazil
- Department and Institute of Psychiatry, Anxiety Disorders Program, University of São Paulo, São Paulo, Brazil
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Rawls A, Nyugen D, Dziabis J, Anbarci D, Clark M, Dzirasa K, Bilbo S. Microglial MyD88-dependent pathways are regulated in a sex-specific manner in the context of HMGB1-induced anxiety. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.22.590482. [PMID: 38712142 PMCID: PMC11071353 DOI: 10.1101/2024.04.22.590482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Chronic stress is a significant risk factor for the development and recurrence of anxiety disorders. Chronic stress impacts the immune system, causing microglial functional alterations in the medial prefrontal cortex (mPFC), a brain region involved in the pathogenesis of anxiety. High mobility group box 1 protein (HMGB1) is an established modulator of neuronal firing and a potent pro-inflammatory stimulus released from neuronal and non-neuronal cells following stress. HMGB1, in the context of stress, acts as a danger-associated molecular pattern (DAMP), instigating robust proinflammatory responses throughout the brain, so much so that localized drug delivery of HMGB1 alters behavior in the absence of any other forms of stress, i.e., social isolation, or behavioral stress models. Few studies have investigated the molecular mechanisms that underlie HMGB1-associated behavioral effects in a cell-specific manner. The aim of this study is to investigate cellular and molecular mechanisms underlying HMGB1-induced behavioral dysfunction with regard to cell-type specificity and potential sex differences. Here, we report that both male and female mice exhibited anxiety-like behavior following increased HMGB1 in the mPFC as well as changes in microglial morphology. Interestingly, our results demonstrate that HMGB1-induced anxiety may be mediated by distinct microglial MyD88-dependent mechanisms in females compared to males. This study supports the hypothesis that MyD88 signaling in microglia may be a crucial mediator of the stress response in adult female mice.
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Biazus Soares G, Mahmoud O, Yosipovitch G, Mochizuki H. The mind-skin connection: A narrative review exploring the link between inflammatory skin diseases and psychological stress. J Eur Acad Dermatol Venereol 2024; 38:821-834. [PMID: 38311707 DOI: 10.1111/jdv.19813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 11/16/2023] [Indexed: 02/06/2024]
Abstract
Inflammatory skin diseases are known to negatively impact patient psychology, with individuals experiencing higher rates of stress and subsequent diminished quality of life, as well as mental health issues including anxiety and depression. Moreover, increased psychological stress has been found to exacerbate existing inflammatory skin diseases. The association between inflammatory skin diseases and psychological stress is a timely topic, and a framework to better understand the relationship between the two that integrates available literature is needed. In this narrative review article, we discuss potential neurobiological mechanisms behind psychological stress due to inflammatory skin diseases, focusing mainly on proinflammatory cytokines in the circulating system (the brain-gut-skin communications) and the default mode network in the brain. We also discuss potential descending pathways from the brain that lead to aggravation of inflammatory skin diseases due to psychological stress, including the central and peripheral hypothalamic-pituitary-adrenal axes, peripheral nerves and the skin barrier function.
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Affiliation(s)
- G Biazus Soares
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - O Mahmoud
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - G Yosipovitch
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - H Mochizuki
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, University of Miami Miller School of Medicine, Miami, Florida, USA
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Kutcher AM, Byon HD, Esquivel JH. Depression, Anxiety, and Resilience: The Association of Emotions With Self-care in Patients With Heart Failure. J Cardiovasc Nurs 2024; 39:E72-E79. [PMID: 39137264 DOI: 10.1097/jcn.0000000000001049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
BACKGROUND Engaging in self-care behaviors improves outcomes in patients with heart failure. Identifying psychological factors that affect self-care behaviors and the role of resilience may inform interventions that improve outcomes. OBJECTIVES The study objective was to determine the relationships among depression, anxiety, resilience, and self-care, including whether resilience mediates or moderates the effects of depression and anxiety on self-care. METHODS Pearson correlation coefficients were computed to estimate the relationships of depression, anxiety, and resilience with self-care behaviors. Mediating and moderating effects of resilience on the relationships of depression and anxiety with self-care were evaluated using multiple linear regression. RESULTS Depression and anxiety were associated with lower self-care. Higher resilience was associated with lower depression and anxiety, but resilience did not mediate or moderate the relationship of depression and anxiety with self-care. CONCLUSIONS Interventions that foster resilience may improve outcomes by reducing anxiety and depression in patients with heart failure.
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Cook CE, Keter D, Cade WT, Winkelstein BA, Reed WR. Manual therapy and exercise effects on inflammatory cytokines: a narrative overview. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1305925. [PMID: 38745971 PMCID: PMC11091266 DOI: 10.3389/fresc.2024.1305925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/12/2024] [Indexed: 05/16/2024]
Abstract
Background Matching disease and treatment mechanisms is a goal of the Precision Medicine Initiative. Pro- and anti-inflammatory cytokines (e.g., Tumor Necrosis Factor-alpha, Transforming Growth Factor-beta, and Interleukin-2, 10, and 12) have gained a significant amount of interest in their potential role in persistent pain for musculoskeletal (MSK) conditions. Manual therapy (MT) and exercise are two guideline-recommended approaches for treating MSK conditions. The objective of this narrative overview was to investigate of the effects of MT and exercise on pro- and anti-inflammatory cytokines and determine the factors that lead to variability in results. Methods Two reviewers evaluated the direction and variabilities of MT and exercise literature. A red, yellow, and green light scoring system was used to define consistencies. Results Consistencies in responses were seen with acute and chronic exercise and both pro- and anti-inflammatory cytokines. Chronic exercise is associated with a consistent shift towards a more anti-inflammatory cytokine profile (Transforming Growth Factor-beta, and Interleukin-2 and 13, whereas acute bouts of intense exercise can transiently increase pro-inflammatory cytokine levels. The influence of MT on cytokines was less commonly studied and yielded more variable results. Conclusion Variability in findings is likely related to the subject and their baseline condition or disease, when measurement occurs, and the exercise intensity, duration, and an individual's overall health and fitness.
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Affiliation(s)
- Chad E. Cook
- Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, NC, United States
- Department of Population Health Sciences, Duke University, Durham, NC, United States
- Duke Clinical Research Institute, Duke University, Durham, NC, United States
| | - Damian Keter
- Department of Veterans Affairs Medical Center, Cleveland, OH, United States
| | - William Todd Cade
- Doctor of Physical Therapy Division, Department of Orthopaedics, Duke University, Durham, NC, United States
| | - Beth A. Winkelstein
- Departments of Bioengineering & Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States
| | - William R. Reed
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, United States
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Zhang Y, Huang K, Duan J, Zhao R, Yang L. Gut microbiota connects the brain and the heart: potential mechanisms and clinical implications. Psychopharmacology (Berl) 2024; 241:637-651. [PMID: 38407637 DOI: 10.1007/s00213-024-06552-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/04/2024] [Indexed: 02/27/2024]
Abstract
Nowadays, high morbidity and mortality of cardiovascular diseases (CVDs) and high comorbidity rate of neuropsychiatric disorders contribute to global burden of health and economics. Consequently, a discipline concerning abnormal connections between the brain and the heart and the resulting disease states, known as psychocardiology, has garnered interest among researchers. However, identifying a common pathway that physicians can modulate remains a challenge. Gut microbiota, a constituent part of the human intestinal ecosystem, is likely involved in mutual mechanism CVDs and neuropsychiatric disorder share, which could be a potential target of interventions in psychocardiology. This review aimed to discuss complex interactions from the perspectives of microbial and intestinal dysfunction, behavioral factors, and pathophysiological changes and to present possible approaches to regulating gut microbiota, both of which are future directions in psychocardiology.
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Affiliation(s)
- Yi Zhang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Kai Huang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Jiahao Duan
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China
| | - Rong Zhao
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China.
| | - Ling Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, 213003, China.
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Fang J, Yang J, Zhai M, Zhang Q, Zhang M, Xie Y. Effects of short-term preoperative intranasal dexmedetomidine plus conventional treatment on delirium following cardiac surgery in patients with sleep disorders. Perioper Med (Lond) 2024; 13:17. [PMID: 38461276 PMCID: PMC10924345 DOI: 10.1186/s13741-024-00371-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 02/27/2024] [Indexed: 03/11/2024] Open
Abstract
STUDY OBJECTIVES To assess whether preoperative dexmedetomidine (DEX) nasal drips combined with conventional treatment could mitigate the occurrence of postoperative delirium (POD). DESIGN A prospective randomised controlled study. SETTING The cardiac surgery intensive care unit (CSICU) and patient hospitalisation ward at a university hospital. PARTICIPANTS A total of 100 patients (aged ≥60 years) undergoing cardiac surgery at a university hospital between 7 January 2022, and 30 November 2022 met the eligibility criteria and were included in the study. INTERVENTIONS Patients with sleep disorders (Pittsburgh Sleep Quality Index ≥8) were divided into two groups: Group A (the placebo group, n=50), receiving a short-term preoperative placebo combined with conventional treatment and Group B (the DEX group, n=50), receiving short-term preoperative DEX combined with conventional treatment. MEASUREMENTS AND RESULTS The Confusion Assessment Method for the ICU (CAM-ICU) was used for POD assessment in the CSICU, while the CAM was employed to assess delirium in the patient ward. Group B demonstrated a reduced incidence of POD compared to Group A (12% vs. 30%, odds ratio: 0.318, 95% confidence interval: 0.112-0.905, p=0.027). CONCLUSION The combined treatment involving DEX demonstrated a decreased incidence of POD in elderly individuals with sleep disorders undergoing cardiac surgery compared to the placebo combination treatment. TRIAL REGISTRATION URL: www.chictr.org.cn with registration number ChiCTR 2100043968, registered on 06/03/2021.
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Affiliation(s)
- Jun Fang
- Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Jia Yang
- Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Mingyu Zhai
- Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Qiong Zhang
- Department of Cardiovascular Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China
| | - Min Zhang
- Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
| | - Yanhu Xie
- Department of Anaesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001, Anhui, China.
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Mancuso RA, Ross KM, Accortt E, Coussons-Read M, Okun ML, Irwin J, Carroll J, Hobel CJ, Schetter CD. Prenatal mood and anxiety disorders and associated cytokine changes. J Affect Disord 2024; 347:635-644. [PMID: 38070749 PMCID: PMC11375962 DOI: 10.1016/j.jad.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 11/11/2023] [Accepted: 12/02/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND We examined whether women with prenatal mood and anxiety disorders would exhibit differential pro- and anti-inflammatory marker trajectories during the prenatal and postpartum periods compared to women without these disorders. METHODS Approximately 179 pregnant women participated in a longitudinal study conducted in two urban areas. Blood samples for inflammatory markers were collected at six study visits. The Structured Clinical Interview for the DSM-IV (SCID) was administered to participants scoring above cutoffs on anxiety and depression. Pregnant women with SCID Axis I diagnoses of mood and/or anxiety disorders were compared to other participants on inflammatory markers. Multilevel modeling tested associations between SCID diagnoses and within-person interleukin (IL)6 and IL10 trajectories. RESULTS Prenatal SCID diagnoses were associated with linear, quadratic and cubic change in IL6 from prenatal to postpartum timepoints. Women with a prenatal SCID diagnosis had steeper decreases and increases in IL6 during prenatal and postpartum periods. SCID diagnoses were associated with lower IL10 in mid-pregnancy to postpartum (b = -0.078, SE = 0.019; p = .015). LIMITATIONS Future studies would benefit from a larger sample size and a larger number of participants with SCID diagnoses. Future research should also examine whether different prenatal Axis 1 diagnoses are associated with different patterns of immune response in pregnancy. CONCLUSIONS Pregnant women with prenatal mood and anxiety disorders had greater fluctuations in IL6 across prenatal and postpartum periods and lower IL10 through pregnancy and postpartum. They may have different proinflammatory states that remain after birth without a reciprocal anti-inflammatory response.
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Affiliation(s)
- Roberta A Mancuso
- Department of Psychology and Neuroscience, Regis University, Denver, CO, USA.
| | - Kharah M Ross
- Centre for Social Sciences, Athabasca University, Athabasca, AB, Canada
| | - Eynav Accortt
- Reproductive Psychology Program, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mary Coussons-Read
- Department of Psychology, University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Michele L Okun
- Sleep and Biobehavioral Health Research Laboratory, University of Colorado - Colorado Springs, Colorado Springs, CO, USA
| | - Jessica Irwin
- Department of Psychology, University of La Verne, La Verne, CA, USA
| | - Judith Carroll
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Calvin J Hobel
- Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Tamayo JM, Osman HC, Schwartzer JJ, Ashwood P. The influence of asthma on neuroinflammation and neurodevelopment: From epidemiology to basic models. Brain Behav Immun 2024; 116:218-228. [PMID: 38070621 DOI: 10.1016/j.bbi.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/08/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
Asthma is a highly heterogeneous inflammatory disease that can have a significant effect on both the respiratory system and central nervous system. Population based studies and animal models have found asthma to be comorbid with a number of neurological conditions, including depression, anxiety, and neurodevelopmental disorders. In addition, maternal asthma during pregnancy has been associated with neurodevelopmental disorders in the offspring, such as autism spectrum disorders and attention deficit hyperactivity disorder. In this article, we review the most current epidemiological studies of asthma that identify links to neurological conditions, both as it relates to individuals that suffer from asthma and the impacts asthma during pregnancy may have on offspring neurodevelopment. We also discuss the relevant animal models investigating these links, address the gaps in knowledge, and explore the potential future directions in this field.
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Affiliation(s)
- Juan M Tamayo
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA
| | - Hadley C Osman
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA
| | - Jared J Schwartzer
- Program in Neuroscience and Behavior, Department of Psychology and Education, Mount Holyoke College, 50 College Street, South Hadley, MA 01075, USA
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology, and the M.I.N.D. Institute, University of California at Davis, CA 95817, USA.
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Wiley KS, Kwon D, Knorr DA, Fox MM. Regulatory T-cell phenotypes in prenatal psychological distress. Brain Behav Immun 2024; 116:62-69. [PMID: 38016492 DOI: 10.1016/j.bbi.2023.11.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/18/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Experiencing symptoms of psychological distress during pregnancy is common and has been linked to dysregulated immune functioning. In this context, immunoregulatory function is especially relevant because of its crucial role in establishment and maintenance of healthy pregnancy. However, little research has examined associations between women's prenatal psychological distress and immunoregulatory biomarkers. We investigated how symptoms of depression, anxiety, and stress relate to circulating levels of regulatory T-cells (Tregs). MATERIALS AND METHODS Pregnant Latina women were assessed at around 12 weeks of pregnancy (N = 82). These assessments included blood draws and self-report questionnaires assessing symptoms of depression, state anxiety, pregnancy-related anxiety, and perceived stress. Flow cytometry on PBMCs was used to quantify circulating Tregs, defined as CD3+CD4+CD25hiCD127loFoxP3+, and subpopulations positive for one of the following intra- or extracellular markers, CD45RA, CTLA-4, Helios, PD-1, TIM-3, and TIGIT. We collected 82 samples at 12 weeks. Multivariable linear regressions tested for associations between symptoms of psychological distress and Treg concentrations, adjusted for gestational age. RESULTS State anxiety symptoms at 12 weeks were negatively associated with parent Treg cell levels (b = -4.02, p = 0.023) and subpopulations Helios+ (b = -3.29, p = 0.019) and TIM3+ (b = -3.17, p = 0.008). Perceived stress was negatively associated with the PD-1+ subpopulation at 12 weeks (b = -4.02, p = 0.023). Depression was not related to Tregs or the subpopulations. CONCLUSION Our observation that symptoms of anxiety and stress are related to tolerogenic immunology suggests a possible biomechanism explaining correlations of maternal mood disorders with adverse outcomes for mothers and offspring.
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Affiliation(s)
- Kyle S Wiley
- Department of Anthropology, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States.
| | - Dayoon Kwon
- Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, United States
| | - Delaney A Knorr
- Department of Anthropology, University of California, Los Angeles, United States
| | - Molly M Fox
- Department of Anthropology, University of California, Los Angeles, United States; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, United States
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Biltz RG, Swanson SP, Draime N, Davis AC, Yin W, Goodman EJ, Gallagher NR, Bhattacharya A, Sheridan JF, Godbout JP. Antagonism of the brain P2X7 ion channel attenuates repeated social defeat induced microglia reactivity, monocyte recruitment and anxiety-like behavior in male mice. Brain Behav Immun 2024; 115:356-373. [PMID: 37914101 PMCID: PMC10807695 DOI: 10.1016/j.bbi.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/18/2023] [Accepted: 10/14/2023] [Indexed: 11/03/2023] Open
Abstract
Chronic stress is linked to increased anxiety. Repeated social defeat (RSD) in mice causes anxiety that is dependent on activated neurons, reactive microglia, and accumulation of monocytes in the brain. This response requires interactions between the immune system and central nervous system (CNS). Neuronal activation within threat appraisal regions is a key response to RSD, however, it is unclear how microglia become activated. One potential explanation is that microglia express a purinergic non-selective ligand gated adenosine-triphosphate (ATP) receptor 7 (P2X7). Activation of P2X7 promotes the release of chemokines and cytokines, and recruitment of monocytes to the brain. Thus, the purpose of this study was to determine if a novel P2X7 antagonist blocked neuronal and microglia interactions and the corresponding anxiety following RSD. Male mice were administered (i.p.) a P2X7 antagonist, JNJ-54471300, prior to each cycle of RSD. Fourteen hours after RSD, behavioral deficits including social avoidance and anxiety-like were determined. Moreover, several immune parameters were assessed. RSD caused neuronal activation in stress-responsive regions, monocyte production and release, splenomegaly, and social avoidance. These parameters were unaffected by P2X7 antagonism. RSD-associated proportional area of Iba-1+ microglia, monocyte accumulation in the brain, IL-1β mRNA expression in enriched myeloid cells, plasma IL-6, and anxiety-like behavior were ameliorated by P2X7 antagonism. Gene expression analysis in the hippocampus and amygdala showed regional specific responses to RSD and some were reversed with P2X7 antagonism. Overall, blocking P2X7 activation attenuated RSD-induced microglia reactivity with corresponding reduction in neuroinflammation, monocyte accumulation, and anxiety-like behavior in male mice.
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Affiliation(s)
- Rebecca G Biltz
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Samuel P Swanson
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Natalie Draime
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Amara C Davis
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Wenyuan Yin
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Ethan J Goodman
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States
| | - Natalie R Gallagher
- Division of Biosciences, The Ohio State University College of Dentistry, United States; Institute for Behavioral Medicine Research, The Ohio State University, Wexner Medical Center, United States
| | - Anindya Bhattacharya
- Neuroscience, Janssen Research and Development, LLC, San Diego, CA, United States
| | - John F Sheridan
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States; Division of Biosciences, The Ohio State University College of Dentistry, United States; Chronic Brain Injury Program, The Ohio State University, United States; Institute for Behavioral Medicine Research, The Ohio State University, Wexner Medical Center, United States.
| | - Jonathan P Godbout
- Department of Neuroscience, The Ohio State University, Wexner Medical Center, United States; Chronic Brain Injury Program, The Ohio State University, United States; Institute for Behavioral Medicine Research, The Ohio State University, Wexner Medical Center, United States.
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Bahadori-Birgani G, Molavynejad S, Rashidi M, Amiri F, Maraghi E, Dashtbozorgi B, Ulhaq ZS, Alizadeh-Attar G. Investigating the association of physical and psychological problems with the levels of interleukin-1 and -6 in COVID-19 patients. Front Psychiatry 2023; 14:1241190. [PMID: 37692307 PMCID: PMC10486266 DOI: 10.3389/fpsyt.2023.1241190] [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: 06/19/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction The COVID-19 virus spreads at a high rate, exerting many physical, mental and psychological effects on patients. Patients with COVID-19 have been reported to have high levels of interleukin 1 and interleukin 6. Therefore, this study was conducted to determine the association of physical, mental, and psychological problems with the levels of interleukin-1 and -6 in COVID-19 patients. Methodology This is cross-sectional descriptive-analytical research on 121 COVID-19 patients selected using simple random sampling method. The patients were hospitalized in university hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences and Amir al-Momenin Hospital. Data collection tools included the depression anxiety stress scale (DASS), a demographic questionnaire, and a checklist of physical problems. Blood sampling was also done to perform an ELISA test and measure the level of interleukin-1 and -6. Data were analyzed based on independent t-tests, chi-square, regression, and Pearson's correlation coefficient, using SPSS ver. 22. Results The average age of the 121 patients participating in this study was 53.31 ± 14.09. A direct and statistically significant correlation was observed between body temperature on the first day and interleukin 1 level. A statistically significant negative correlation was observed between blood oxygen saturation level and interleukin-1 and -6 on the first, third and fifth days. Shortness of breath and coughing had a statistically significant correlation with the level of interleukin 1 on the third and fifth days. A direct and statistically significant correlation was observed between body temperature on the first, third and fifth days and interleukin 6 level. Coughing on the third and fifth days had a statistically significant relationship with interleukin 6 level. No direct and non-significant statistical correlation was found between depression and stress and the serum level of interleukin 1, but a significant correlation was observed between anxiety and serum level of interleukin 1. Finally, the results showed that depression, anxiety and stress had a direct and statistically significant correlation with the serum level of interleukin 6. Conclusion Given the relationship between interleukin-1 and -6 and most physical and psychological problems, level of the inflammatory biomarkers interleukin-1 and -6 can be used to estimate the severity of physical and psychological symptoms in COVID-19 patients.
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Affiliation(s)
- Galia Bahadori-Birgani
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Mahbobe Rashidi
- Pain Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Fereshteh Amiri
- Pain Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Elham Maraghi
- Department of Epidemiology and Biostatistics, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Dashtbozorgi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Zulvikar Syambani Ulhaq
- Research Center for Pre-Clinical and Clinical Medicine, National Research and Innovation Agency Republic of Indonesia, Cibinong, Indonesia
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Diao Z, Xu W, Guo D, Zhang J, Zhang R, Liu F, Hu Y, Ma Y. Causal association between psycho-psychological factors, such as stress, anxiety, depression, and irritable bowel syndrome: Mendelian randomization. Medicine (Baltimore) 2023; 102:e34802. [PMID: 37653741 PMCID: PMC10470701 DOI: 10.1097/md.0000000000034802] [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: 03/15/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Pathogenesis, diagnosis, and treatment of irritable bowel syndrome (IBS) have been reported to be challenging hotspots in clinical practice. Previous observational studies have found that stress, anxiety, depression, and other mental and psychological diseases are closely associated with IBS. This study aimed to further explore the causal relationships of these associations through Mendelian randomization (MR). METHODS The data needed for MR were obtained from publicly published genome-wide association databases. We performed a bidirectional, 2-sample MR analysis using instrumental variables (IV) associated with stress, anxiety, and depression, and other mental and psychological factors as exposures and IBS as the outcome. A reverse MR analysis with IBS as exposure and stress, anxiety, depression, and other mental and psychological factors as the outcomes was also performed. The inverse variance weighting (IVW) method was adopted as the main method of MR, and the causal effect between stress, anxiety, depression, and other mental and psychological factors and IBS was evaluated as the main result of the study. In addition, a series of sensitivity analyses was conducted to comprehensively evaluate the causal relationship between them. RESULTS Stress, anxiety, depression, and other mental and psychological factors were the underlying etiologies for IBS (odds ratio [OR] = 1.06, 95% confidence interval [CI]: 1.03-1.08), and they were positively correlated. Univariate analysis further supported the above conclusions (Depression, [OR = 1.31, 95% CI: 1.05-1.63, P = .016], Anxiety, [OR = 1.53, 95% CI: 1.16-2.03, P = .003]). However, in reverse MR analysis, we found that IBS did not affect stress, anxiety, depression, or other mental and psychological factors and that there was no causal relationship between IBS and stress, anxiety, depression, or other mental and psychological factors (P > .05). CONCLUSION This study demonstrates that mental and psychological factors are the underlying etiologies for IBS. These findings may provide important information for physicians regarding the clinical treatment of IBS.
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Affiliation(s)
- Zhihao Diao
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wenchang Xu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Danyang Guo
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jingzhi Zhang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ruiyu Zhang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Fengzhao Liu
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yufei Hu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuxia Ma
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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14
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Ortí JEDLR, Cuerda-Ballester M, Sanchis-Sanchis CE, Lajara Romance JM, Navarro-Illana E, García Pardo MP. Exploring the impact of ketogenic diet on multiple sclerosis: obesity, anxiety, depression, and the glutamate system. Front Nutr 2023; 10:1227431. [PMID: 37693246 PMCID: PMC10485376 DOI: 10.3389/fnut.2023.1227431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Background Multiple sclerosis (MS) is a neurodegenerative disorder. Individuals with MS frequently present symptoms such as functional disability, obesity, and anxiety and depression. Axonal demyelination can be observed and implies alterations in mitochondrial activity and increased inflammation associated with disruptions in glutamate neurotransmitter activity. In this context, the ketogenic diet (KD), which promotes the production of ketone bodies in the blood [mainly β-hydroxybutyrate (βHB)], is a non-pharmacological therapeutic alternative that has shown promising results in peripheral obesity reduction and central inflammation reduction. However, the association of this type of diet with emotional symptoms through the modulation of glutamate activity in MS individuals remains unknown. Aim To provide an update on the topic and discuss the potential impact of KD on anxiety and depression through the modulation of glutamate activity in subjects with MS. Discussion The main findings suggest that the KD, as a source of ketone bodies in the blood, improves glutamate activity by reducing obesity, which is associated with insulin resistance and dyslipidemia, promoting central inflammation (particularly through an increase in interleukins IL-1β, IL-6, and IL-17). This improvement would imply a decrease in extrasynaptic glutamate activity, which has been linked to functional disability and the presence of emotional disorders such as anxiety and depression.
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Affiliation(s)
| | | | | | - Jose María Lajara Romance
- Faculty of Legal, Economic and Social Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
| | - Esther Navarro-Illana
- Department of Nursing, Catholic University of Valencia San Vicente Mártir, Valencia, Spain
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15
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Baghdadi LR, Alhassan MK, Alotaibi FH, Alsuwaida AA, Shehadah AE, Alzahrani MT. Effect of type of disease-modifying antirheumatic drugs on depression and anxiety of patients with rheumatoid arthritis in Saudi Arabia: a cross-sectional study. Front Psychiatry 2023; 14:1184720. [PMID: 37346903 PMCID: PMC10280020 DOI: 10.3389/fpsyt.2023.1184720] [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: 03/12/2023] [Accepted: 05/16/2023] [Indexed: 06/23/2023] Open
Abstract
Background Rheumatoid arthritis (RA) can cause depression and anxiety. This study evaluated the factors associated with depression and anxiety in patients with RA and examined the effect of conventional and biologic disease-modifying antirheumatic drugs (DMARDs). Methods This cross-sectional study was conducted in a regional hospital in Riyadh between March and November 2022 and included 213 patients with RA. Depression and anxiety were measured using the Hospital Anxiety and Depression Scale (HADS) and data about patients' DMARDs use was obtained from the hospital's medical records. Results Based on the HADS scores, 35 (16.4%) and 49 (23%) patients with RA had depression and anxiety, respectively. There was a significant association between the level of depression and anxiety and the use of leflunomide and tocilizumab among patients with RA (p = 0.006 and p = 0.009, respectively). Patients with RA who took leflunomide had significantly higher scores for anxiety (β = 0.158, value of p = 0.037) when compared to patients who did not take leflunomide. Patients with RA who took etanercept showed a significantly lower depression score even after adjusting for confounders, including sociodemographic, clinical, and lifestyle factors (β = -0.189, p = 0.043). Conclusion The present study highlighted the prevalence of psychiatric disorders among patients with RA and the level of depression and anxiety may differ between patients with RA depending on the type of DMARDs used. We recommend patients with RA be screened regularly for depression and anxiety to avoid further extra-articular systemic complications associated with RA.
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Affiliation(s)
- Leena R. Baghdadi
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Ali E. Shehadah
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Qiu T, Jiang Z, Chen X, Dai Y, Zhao H. Comorbidity of Anxiety and Hypertension: Common Risk Factors and Potential Mechanisms. Int J Hypertens 2023; 2023:9619388. [PMID: 37273529 PMCID: PMC10234733 DOI: 10.1155/2023/9619388] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 06/06/2023] Open
Abstract
Anxiety is more common in patients with hypertension, and these two conditions frequently coexist. Recently, more emphasis has been placed on determining etiology in patients with comorbid hypertension and anxiety. This review focuses on the common risk factors and potential mechanisms of comorbid hypertension and anxiety. Firstly, we analyze the common risk factors of comorbid hypertension and anxiety including age, smoking, alcohol abuse, obesity, lead, and traffic noise. The specific mechanisms underlying hypertension and anxiety were subsequently discussed, including interleukin (IL)-6 (IL-6), IL-17, reactive oxygen species (ROS), and gut dysbiosis. Increased IL-6, IL-17, and ROS accelerate the development of hypertension and anxiety. Gut dysbiosis leads to hypertension and anxiety by reducing short-chain fatty acids, vitamin D, and 5-hydroxytryptamine (5-HT), and increasing trimethylamine N-oxide (TAMO) and MYC. These shared risk factors and potential mechanisms may provide an effective strategy for treating and preventing hypertension and comorbid anxiety.
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Affiliation(s)
- Tingting Qiu
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
- The Central Hospital of Changsha City, Hengyang Medical School, University of South China, Changsha, Hunan 410000, China
| | - Zhiming Jiang
- Department of Cardiology, The Fourth Hospital of Changsha, Changsha, Hunan 410006, China
| | - Xuancai Chen
- Urinary Surgery, Affiliated Nanhua Hospital, University of South China, Hengyang 421002, China
| | - Yehua Dai
- Nursing College, University of Xiangnan, Chenzhou, Hunan 423000, China
| | - Hong Zhao
- School of Nursing, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
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17
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Yang KL, Detroyer E, Van Grootven B, Tuand K, Zhao DN, Rex S, Milisen K. Association between preoperative anxiety and postoperative delirium in older patients: a systematic review and meta-analysis. BMC Geriatr 2023; 23:198. [PMID: 36997928 PMCID: PMC10064748 DOI: 10.1186/s12877-023-03923-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/24/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Postoperative delirium (POD) is a common postoperative complication associated with multiple adverse consequences on patient outcomes and higher medical expenses. Preoperative anxiety has been suggested as a possible precipitating factor for the development of POD. As such, we aimed to explore the association between preoperative anxiety and POD in older surgical patients. METHODS Electronic databases including MEDLINE (via PubMed), EMBASE (via Embase.com), Web of Science Core Collection, Cumulative Index to Nursing and Allied Health Literature (CINAHL Complete; via EBSCOhost) and clinical trial registries were systematically searched to identify prospective studies examining preoperative anxiety as a risk factor for POD in older surgical patients. We used Joanna Briggs Institute Critical Appraisal Checklist for Cohort Studies to assess the quality of included studies. The association between preoperative anxiety and POD was summarized with odds ratios (ORs) and 95% confidence intervals (CIs) using DerSimonian-Laird random-effects meta-analysis. RESULTS Eleven studies were included (1691 participants; mean age ranging between 63.1-82.3 years). Five studies used a theoretical definition for preoperative anxiety, with the Anxiety subscale of Hospital Anxiety and Depression Scale (HADS-A) as the instrument being most often used. When using dichotomized measures and within the HADS-A subgroup analysis, preoperative anxiety was significantly associated with POD (OR = 2.17, 95%CI: 1.01-4.68, I2 = 54%, Tau2 = 0.4, n = 5; OR = 3.23, 95%CI: 1.70-6.13, I2 = 0, Tau2 = 0, n = 4; respectively). No association was observed when using continuous measurements (OR = 0.99, 95%CI: 0.93-1.05, I2 = 0, Tau2 = 0, n = 4), nor in the subgroup analysis of STAI-6 (six-item version of state scale of Spielberger State-Trait Anxiety Inventory, OR = 1.07, 95%CI: 0.93-1.24, I2 = 0, Tau2 = 0, n = 2). We found the overall quality of included studies to be moderate to good. CONCLUSIONS An unclear association between preoperative anxiety and POD in older surgical patients was found in our study. Given the ambiguity in conceptualization and measurement instruments used for preoperative anxiety, more research is warranted in which a greater emphasis should be placed on how preoperative anxiety is operationalized and measured.
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Affiliation(s)
- Ke-Lu Yang
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Elke Detroyer
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Bastiaan Van Grootven
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium
| | - Krizia Tuand
- KU Leuven Libraries - 2Bergen - Learning Centre Désiré Collen, Leuven, Belgium
| | - Dan-Ni Zhao
- The Second Clinic School, Lanzhou University, Lanzhou, China
| | - Steffen Rex
- Department of Anesthesiology, University Hospitals of Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven - University of Leuven, Kapucijnenvoer 35/4, B-3000, Leuven, Belgium.
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.
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18
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Mohamed NH, Beckstein A, Winship G, Ashraf Khan Mou T, Pang NTP, Relojo-Howell D. Effects of self-expressive writing as a therapeutic method to relieve stress among university students. JOURNAL OF POETRY THERAPY 2023. [DOI: 10.1080/08893675.2023.2174678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Affiliation(s)
- Noor Hassline Mohamed
- Faculty of Psychology & Education, University Malaysia Sabah, Kota Kinabalu, Malaysia
| | | | - Gary Winship
- Faculty of Education and Mental Health, University of Nottingham, Nottingham, UK
| | - Tanjina Ashraf Khan Mou
- Department of Science (Psychology), International University of Malaya-Wales, Kuala Lumpur, Malaysia
| | - Nicholas Tze Ping Pang
- Faculty of Medical and Health Science, University Malaysia Sabah, Kota Kinabalu, Malaysia
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19
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Wang Q, Song D, Lin Q, Tao A, Zhang Y, Li X, Qiu X. The critical role of physical frailty and function on depressive symptoms among community-dwelling older adults in China: A cross-sectional study. Front Psychiatry 2023; 14:1134427. [PMID: 36873198 PMCID: PMC9975574 DOI: 10.3389/fpsyt.2023.1134427] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
INTRODUCTION With rapid population aging in China, geriatric depression has imposed a heavy burden on public health and society. This study aimed to investigate the prevalence and influencing factors of depressive symptoms among community-dwelling older adults in China. The findings of this study will contribute to the early detection and effective interventions for older adults with depressive symptoms. METHODS A cross-sectional study was conducted among people aged ≥65 years old in urban communities in Shenzhen, China, in 2021. This study assessed depressive symptoms (Geriatric Depression Scale-5, GDS-5), physical frailty (FRAIL Scale, FS), and physical function (Katz index of independence in the Activities of Daily Living, ADL). Multiple linear regression was used to examine potential predictors of depressive symptoms. RESULTS A total of 576 participants aged 71.73 ± 6.41 years were included in the analysis. More than half of them were females (53.0%). The average score of GDS-5 was 0.57 ± 1.11, with 78 (13.61%) participants with depressive symptoms (≥2). The mean scores of FS and ADL were 0.80 ± 1.08 and 9.49 ± 1.67, respectively. The final regression model indicated that those who were living alone, less satisfied with their personal life, frailer, and with worse abilities in ADL had a higher level of depression symptoms (R2 = 0.406, p < 0.001). CONCLUSION The prevalence of depressive symptoms is high in this urban community-dwelling older adults in China. Given the critical role of frailty and ADL on depressive symptoms, specific attention to psychological support should be paid to older adults who are living alone and with poor physical conditions.
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Affiliation(s)
- Qun Wang
- School of Nursing, Shenzhen University, Shenzhen, China
| | - Dan Song
- Department of Nursing, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, China
| | - Qiuru Lin
- School of Nursing, Shenzhen University, Shenzhen, China
| | - An Tao
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Yao Zhang
- School of Nursing, Shenzhen University, Shenzhen, China
| | - Xilin Li
- School of Nursing, Shenzhen University, Shenzhen, China
| | - Xichenhui Qiu
- School of Nursing, Shenzhen University, Shenzhen, China
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20
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Orsolini L, Pompili S, Volpe U. C-Reactive Protein (CRP): A Potent Inflammation Biomarker in Psychiatric Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1411:135-160. [PMID: 36949309 DOI: 10.1007/978-981-19-7376-5_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
An increasing number of studies have investigated the role of inflammation in psychiatric disorders, by demonstrating how an altered/dysfunctional immunological and inflammatory system may underpin a psychiatric condition. Particularly, several studies specifically investigated the role of a neuroinflammatory biomarker, named C-reactive protein (CRP), in psychiatric disorders. Overall, even though scientific literature so far published still does not appear definitive, CRP is more likely reported to be elevated in several psychiatric disorders, including schizophrenia, mood disorders, anxiety disorders and post-traumatic stress disorder. Moreover, a low-grade inflammation (CRP >3 mg/L) has been more likely observed in a subgroup of patients affected with a more severe psychopathological symptomatology, more treatment resistance and worst clinical mental illness course, strengthening the hypothesis of the need for a different clinical and prognostic characterization based on this concomitant neuroinflammatory predisposition. However, even though further research studies are needed to confirm this preliminary evidence, CRP may represent a potential clinical routine biomarker which could be integrated in the clinical routine practice to better characterize clinical picture and course as well as address clinicians towards a personalized treatment.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy.
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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Schepko M, Stumpf KC, Tumala S, Peters EM, Kupfer JP, Schut C. Study protocol: Neuro-inflammatory parameters as mediators of the relationship between social anxiety and itch intensity: A cross-sectional, controlled laboratory study in patients with psoriasis and healthy skin controls. PLoS One 2023; 18:e0281989. [PMID: 36928456 PMCID: PMC10019658 DOI: 10.1371/journal.pone.0281989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/02/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Psoriasis (PSO) is a disease that in the majority of patients is accompanied by itch, which imposes a great burden and positively relates to anxiety. Social anxiety, a facet of anxiety associated with social withdrawal, may be a predictor of itch intensity in this patient group. Moreover, anxiety is linked to the secretion of neuroendocrine and inflammatory parameters such as substance P (SP), interleukin (IL)-6 and IL-17, which are also related to itch. In this research project, we investigate first, whether there is a direct relationship between social anxiety and itch intensity in patients with PSO and second whether the secretion of SP, IL-6 and IL-17 in the skin mediates this relationship. Additionally, PSO-patients are compared to healthy skin controls regarding their level of social anxiety, itch intensity and the secretion of SP, IL-6 and IL-17. METHODS AND ANALYSES For study 1, we aim to recruit 250 psoriasis patients and 250 healthy skin controls who complete questionnaires to assess social anxiety, itch intensity and control variables (e.g. sociodemographic variables and severity of PSO). A linear hierarchic regression will be used to determine whether social anxiety significantly contributes to itch intensity. In study 2, we plan to apply the suction blister method to 128 patients and healthy skin controls recruited from study 1 to determine SP, IL-6 and IL-17 in tissue fluid extracted from the skin. A mediation analysis will be conducted using the SPSS-macro PROCESS to test whether the relationship between social anxiety and itch is mediated by SP, IL-6 and IL-17. TRIAL REGISTRATION NUMBERS DRKS00023621 (study 1) and DRKS00023622 (study 2).
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Affiliation(s)
- Marcel Schepko
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Katharina C. Stumpf
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Susanne Tumala
- Department of Psychosomatic Medicine and Psychotherapy, Psychoneuroimmunology Laboratory, Justus-Liebig-University Giessen, Giessen, Germany
| | - Eva M. Peters
- Department of Psychosomatic Medicine and Psychotherapy, Psychoneuroimmunology Laboratory, Justus-Liebig-University Giessen, Giessen, Germany
| | - Jörg P. Kupfer
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
| | - Christina Schut
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
- * E-mail:
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Belzer A, Leasure AC, Damsky W, Cohen JM. The association of anxiety with granuloma annulare: a case-control study of the National Institutes of Health 'All of Us' research programme. Br J Dermatol 2022; 188:558-560. [PMID: 36715356 DOI: 10.1093/bjd/ljac114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/22/2022] [Accepted: 12/17/2022] [Indexed: 01/22/2023]
Abstract
Dear Editor, Granuloma annulare (GA) is an inflammatory skin disease that has been associated with diabetes, dyslipidaemia, hypothyroidism and autoimmune disorders.1,2 The annualized incidence and prevalence of GA in the USA are approximately 0.04% and 0.06%, respectively (with a female predominance).3 GA is clinically classified as localized (75% of cases), generalized or subcutaneous.4 There is a body of evidence supporting an association between several inflammatory dermatoses, such as psoriasis, and mental health conditions.5 Improvement of depression and anxiety following treatment of certain inflammatory dermatoses has also been described.5 It has been postulated that this association may, in part, relate to proinflammatory cytokines, which have been proposed to mechanistically connect inflammatory dermatoses and mental health conditions.6 A recent nested case-control study demonstrated a significant association of GA with depression, insomnia, opioid dependence and post-traumatic stress disorder.7 This study aims to investigate whether an association exists between GA and anxiety.
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Affiliation(s)
| | | | - William Damsky
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA.,Department of Pathology, Yale School of Medicine, New Haven, CT, USA
| | - Jeffrey M Cohen
- Department of Dermatology, Yale School of Medicine, New Haven, CT, USA
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Moreira LKDS, Turones LC, Campos HM, Nazareth AM, Thomaz DV, Gil EDS, Ghedini PC, Rocha FFD, Menegatti R, Fajemiroye JO, Costa EA. LQFM212, a piperazine derivative, exhibits potential antioxidant effect as well as ameliorates LPS-induced behavioral, inflammatory and oxidative changes. Life Sci 2022; 312:121199. [PMID: 36402170 DOI: 10.1016/j.lfs.2022.121199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/11/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022]
Abstract
AIMS Oxidative stress, impaired antioxidant defense and neuroinflammation are often associated with the onset and progression of neuropsychiatric diseases. Conversely, several piperazine compounds presents beneficial neuropharmacological effects as well as antioxidant activity, and some derivatives combine both activities. LQFM212 (2,6-di-tert-butyl-4-((4-(2-hydroxyethyl)piperazin-1-yl)methyl)phenol) was synthesized to produce effects on CNS and to have an additional antioxidant effect. Previous preclinical tests have been shown anxiolytic- and antidepressant-like effects of LQFM212 in mice. Herein, the main objective was to verify the possible antioxidant potential and the effects of LQFM212 against behavioral changes, inflammatory and oxidative markers induced by lipopolysaccharide (LPS). MAIN METHODS Initially, antioxidant potential of LQFM212 was evaluated by electrochemical assays. Afterwards, the effects of oral treatment with LQFM212 were evaluated in mice using LPS-induced models of systemic or local inflammation. KEY FINDINGS In LPS-induced neuroinflammation, LQFM212 treatment reverted changes caused by LPS, demonstrated by attenuated anxiogenic- and depressive-like behaviors, reduced pro-inflammatory cytokines (TNF-α and IL-1β) and increased anti-inflammatory cytokines (IL-4 and IL-10) on serum, and also improved oxidative stress-related changes (levels of nitrite, malondialdehyde, glutathione and carbonylated protein, and superoxide dismutase, catalase, myeloperoxidase and cholinesterase activities) on brain cortex and hippocampus. However, LQFM212 treatment did not attenuate the inflammatory changes in LPS-induced pleurisy model. SIGNIFICANCE LQFM212 presents antioxidant activity and ameliorates behavioral, inflammatory and oxidative changes after LPS-induced neuroinflammation model. These effects do not seem to be secondary to a peripheral anti-inflammatory action of LQFM212, since this compound failed to attenuate the inflammatory changes in LPS-induced pleurisy model.
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Affiliation(s)
- Lorrane Kelle da Silva Moreira
- Laboratory of Pharmacology of Natural and Synthetic Products, Institute of Biological Sciences, Federal University of Goiás, Campus Samambaia, Goiânia, GO, Brazil
| | - Larissa Córdova Turones
- Laboratory of Pharmacology of Natural and Synthetic Products, Institute of Biological Sciences, Federal University of Goiás, Campus Samambaia, Goiânia, GO, Brazil
| | - Hericles Mesquita Campos
- Laboratory of Biochemical and Molecular Pharmacology, Institute of Biological Sciences, Federal University of Goias, Campus Samambaia, Goiânia, GO, Brazil
| | - Aline Martins Nazareth
- Laboratory of Pharmacology of Natural and Synthetic Products, Institute of Biological Sciences, Federal University of Goiás, Campus Samambaia, Goiânia, GO, Brazil
| | - Douglas Vieira Thomaz
- Laboratory of Medicinal Pharmaceutical Chemistry, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO, Brazil
| | - Eric de Souza Gil
- Laboratory of Medicinal Pharmaceutical Chemistry, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO, Brazil
| | - Paulo César Ghedini
- Laboratory of Biochemical and Molecular Pharmacology, Institute of Biological Sciences, Federal University of Goias, Campus Samambaia, Goiânia, GO, Brazil
| | - Fábio Fagundes da Rocha
- Department of Physiological Sciences, Institute of Biology, Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil
| | - Ricardo Menegatti
- Laboratory of Medicinal Pharmaceutical Chemistry, Faculty of Pharmacy, Federal University of Goiás, Goiânia, GO, Brazil
| | - James Oluwagbamigbe Fajemiroye
- Laboratory of Pharmacology of Natural and Synthetic Products, Institute of Biological Sciences, Federal University of Goiás, Campus Samambaia, Goiânia, GO, Brazil
| | - Elson Alves Costa
- Laboratory of Pharmacology of Natural and Synthetic Products, Institute of Biological Sciences, Federal University of Goiás, Campus Samambaia, Goiânia, GO, Brazil.
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Ji D, Francesconi M, Flouri E, Papachristou E. The role of inflammatory markers and cortisol in the association between early social cognition abilities and later internalising or externalising problems: Evidence from a UK birth cohort. Brain Behav Immun 2022; 105:225-236. [PMID: 35835432 DOI: 10.1016/j.bbi.2022.07.002] [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: 02/02/2022] [Revised: 05/29/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE Deficits in social cognition are associated with internalising (emotional and peer problems) and externalising (conduct problems and hyperactivity/inattention) symptoms in youth. It has been suggested that stress may be one of the mechanisms underlying these associations. However, no empirical studies have investigated if physiological stress can explain the prospective associations between social cognition deficits and internalising and externalising symptoms in the general youth population. This study addressed this question and focused on two indicators of physiological stress, dysregulated diurnal cortisol patterns and systemic inflammation. METHOD Participants were 714 individuals from the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK population-based birth cohort. Bayesian structural equation modelling was used to investigate a) the associations of social cognition abilities at ages 8, 11, and 14 years with internalising and externalising problems at age 17 years and b) the potential mediating effects of cortisol parameters at age 15 years and inflammatory markers [interleukin 6 (IL-6) and C-reactive protein (CRP)] at ages 9 and 16 years. RESULTS We found that social cognition difficulties were associated with later internalising and externalising problems. Flattened diurnal cortisol slope was associated with hyperactivity/inattention problems two years later. Lower morning cortisol partially mediated the direct association between social communication deficits at 8 years and hyperactivity/inattention and conduct problems at 17 years, even after adjustments for inflammation and confounders (for hyperactivity/inattention: indirect effect = 0.07, 95% CI [0.00, 0.18], p = .042; for conduct problems: indirect effect = 0.04, 95% CI [0.00, 0.11], p = .040). We did not find a significant association between systemic inflammation and social cognition difficulties, internalising problems, or externalising problems. CONCLUSION Our findings suggest that part of the effect of social communication difficulties in childhood on externalising problems in adolescence was mediated by lower morning cortisol. Hence, our study indicates that the hypoactivity of the hypothalamic-pituitary-adrenal (HPA) axis may be one of the physiological mechanisms linking some social cognition deficits to externalising problems.
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Affiliation(s)
- Dongying Ji
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Marta Francesconi
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Eirini Flouri
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
| | - Efstathios Papachristou
- Department of Psychology and Human Development, UCL Institute of Education, 25 Woburn Square, London WC1H 0AA, UK.
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Cruz A, Vieira M, Mesquita AR, Sampaio A, Mendes-Pinto I, Soares I, Freitas PP. Non-invasive diagnosis and monitoring tool of children’s mental health: A point-of-care immunosensor for IL-6 quantification in saliva samples. Front Neurosci 2022; 16:919551. [PMID: 36225733 PMCID: PMC9549322 DOI: 10.3389/fnins.2022.919551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/30/2022] [Indexed: 11/13/2022] Open
Abstract
Mental disorders are commonly featured as chronic conditions with often onset during childhood. In this context, inflammation has been associated with a higher risk of developing physical and mental health problems. Interleukin (IL)-6 is a key mediator of inflammatory responses and plays a pivotal role in immune and nervous system interaction. High levels of IL-6 during childhood are associated with mental problems, indicating that the IL-6 molecular pathway may represent a new target for monitoring and treating these conditions. Here, we report the detection of IL-6 in saliva samples from children (N = 118, mean age 4.4 years old) with behavioral problems using an immunosensor based on electrochemical impedance spectroscopy. This work demonstrates that the proposed immunosensor requires smaller sample volumes and is significantly faster and more sensitive than conventional ELISA while maintaining comparable levels of specificity and reproducibility. The point-of care immunosensor for detection of IL-6 in saliva samples presented herewith is, therefore, an attractive solution to the clinical practice as a rapid non-invasive, high-sensitive monitoring tool of mental health problems, especially in vulnerable patient populations such as children.
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Affiliation(s)
- Andrea Cruz
- ProChild CoLAB Against Child Poverty and Social Exclusion, Portuguese Foundation for Science and Technology (FCT) Collaborative Laboratory, Guimarães, Portugal
- *Correspondence: Andrea Cruz, ,
| | - Maria Vieira
- International Iberian Nanotechnology Laboratory, Braga, Portugal
| | - Ana R. Mesquita
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | | | - Isabel Soares
- CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Paulo P. Freitas
- International Iberian Nanotechnology Laboratory, Braga, Portugal
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Dahchour A. Anxiolytic and antidepressive potentials of rosmarinic acid: A review with a focus on antioxidant and anti-inflammatory effects. Pharmacol Res 2022; 184:106421. [PMID: 36096427 DOI: 10.1016/j.phrs.2022.106421] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 10/14/2022]
Abstract
Depression and anxiety are the most prevalent neuropsychiatric disorders that have emerged as global health concerns. Anxiolytic and antidepressant drugs, such as benzodiazepines, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, and tricyclics, are the first line used in treating anxiety and depression. Although these drugs lack efficacy and have a delayed response time and numerous side effects, their widespread abuse and market continue to grow. Over time, traditional practices using natural and phytochemicals as alternative therapies to chemical drugs have emerged to treat many pathological conditions, including anxiety and depression. Recent preclinical studies have demonstrated that the phenolic compound, rosmarinic acid, is effective against several neuropsychiatric disorders, including anxiety and depression. In addition, rosmarinic acid showed various pharmacological effects, such as cardioprotective, hepatoprotective, lung protective, antioxidant, anti-inflammatory, and neuroprotective effects. However, the potentialities of the use of rosmarinic acid in the treatment of nervous system-related disorders, such as anxiety and depression, are less or not yet reviewed. Therefore, the purpose of this review was to present several preclinical and clinical studies, when available, from different databases investigating the effects of rosmarinic acid on anxiety and depression. These studies showed that rosmarinic acid produces advantageous effects on anxiety and depression through its powerful antioxidant and anti-inflammatory properties. This review will examine and discuss the possibility that the anxiolytic and anti-depressive effects of rosmarinic acid could be associated with its potent antioxidant and anti-inflammatory activities.
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Affiliation(s)
- Abdelkader Dahchour
- Clinical Neurosciences Laboratory, Faculty of Medicine and Pharmacy. Department of Biology, Faculty of Sciences, Sidi Mohamed Ben Abdellah University, Fez 30000, Morocco.
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Chen M, Liu M, Guo X, Zhou J, Yang H, Zhong G, Men L, Xie Y, Tong G, Liu Q, Luan J, Zhou H. Effects of Xinkeshu tablets on coronary heart disease patients combined with anxiety and depression symptoms after percutaneous coronary intervention: A meta-analysis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 104:154243. [PMID: 35717809 DOI: 10.1016/j.phymed.2022.154243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/17/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Xinkeshu tablets (XKS), a well-known Chinese patent drug, have been administered to coronary heart disease (CHD) patients with anxiety and depression after percutaneous coronary intervention (PCI). PURPOSE This meta-analysis aimed to systematically evaluate the clinical effects of XKS for treating CHD patients with anxiety and depression after PCI. METHODS Randomized controlled trials (RCTs) about XKS alone or combined with conventional drugs for the treatment of CHD patients with anxiety and depression after PCI were retrieved from 7 databases (MEDLINE, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM) and Wanfang Database) through November 2021. First, the studies were reviewed and screened by two independent assessors according to the eligibility criteria. Second, the methodological quality of the eligible studies was evaluated based on the Cochrane Collaboration's tool for assessing the risk of bias. Subsequently, meta-analysis was performed by using RevMan 5.4 software, and publication bias was evaluated by Stata 12.0 software. Finally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to rate the quality of the evidence. RESULTS In total, 11 clinical RCTs involving 1000 patients were included in this study. This meta-analysis found that compared with conventional treatment alone, XKS combined with conventional treatment significantly improved the anxiety scale scores (SMD = -1.97, 95% CI -3.13 to -0.82; p = 0.0008; I2 = 98%), the depression scores (SMD = -2.80, 95% CI -4.49 to -1.10; p = 0.001; I2 = 98%), the scores on the Medical Outcomes Study 36 Item Short Form Health Survey (SF36) (MD = 11.22, 95% CI 4.19 to 18.26; p =0.002; I2 = 95%) and the blood lipid levels of total cholesterol (TC) (MD = -0.38, 95% CI -0.62 to -0.13; p = 0.003; I2 = 0%) and triglyceride (TG) (MD = -0.31, 95% CI -0.46 to -0.17; p < 0.0001; I2 = 0%). CONCLUSION The current evidence suggests that XKS might benefit CHD patients experiencing anxiety and depression after PCI by helping to improve their depression symptoms, TC and TG blood lipid levels. However, due to insufficient methodological quality of the studies, several risks of bias and inadequate reporting of the clinical data, more rigorous, multicenter, sufficient-sample and double-blind randomized clinical trials are warranted.
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Affiliation(s)
- Mingtai Chen
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China.
| | - Mengnan Liu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, PR China
| | - Xin Guo
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Jie Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Huayi Yang
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Guofu Zhong
- Intensive Care Unit, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Ling Men
- Department of Neurology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Ying Xie
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macao, PR China
| | - Guangdong Tong
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Department of Liver Disease, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Qiang Liu
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China
| | - Jienan Luan
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China
| | - Hua Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Macau University of Science and Technology, Taipa, Macao, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, PR China.
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Fong TCT, Ho RTH, Yau JCY. Longitudinal associations between salivary cortisol to C-reactive protein ratios and psychological well-being in Chinese adults. Psychoneuroendocrinology 2022; 143:105824. [PMID: 35689984 DOI: 10.1016/j.psyneuen.2022.105824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Salivary C-reactive protein (CRP) could be a viable biomarker of inflammation and has been associated with stress outcomes. The hypothalamic-pituitary-adrenal axis can modulate stress-related inflammation. This study aimed to evaluate the interaction effects of immune-endocrine markers on psychological outcomes. METHODS The study participants were 52 healthy Chinese adults who collected 10 saliva samples over 2 consecutive days at baseline. The participants completed validated measures on anxiety, depression, positive affect, and sleep disturbance at baseline and 1 month later. The stability and diurnal patterns of salivary cortisol and CRP were investigated via paired t-tests and repeated-measures analyses of variance. Regression analysis was used to examine the longitudinal associations between immune-endocrine markers and their interactions (cortisol [Cort]: morning CRP [CRPmorn] and Cort:CRPeven) and psychological measures. RESULTS Salivary cortisol and CRP displayed satisfactory stability over 2 consecutive days and diurnal patterns of abrupt and gradual decline during the day, respectively. Controlling for baseline psychological measures and confounding variables, Cortmorn and diurnal cortisol slope was significantly and negatively associated with anxiety symptoms and positive affect 1 month later, respectively. Cort:CRPeven and Cort:CRPmorn was significantly and positively associated with depressive symptoms and sleep disturbance 1 month later, respectively. CONCLUSION These findings offer initial support for the prognostic utility of salivary cortisol and CRP and their balance as determinants of psychological health in healthy adults.
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Affiliation(s)
- Ted C T Fong
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
| | - Rainbow T H Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Dept of Social Work & Social Administration, The University of Hong Kong, Hong Kong.
| | - Joshua C Y Yau
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong
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Interaction effect of the serum interleukin-6 level and anxiety on the 12-week pharmacotherapeutic responses of patients with depressive disorders. J Affect Disord 2022; 308:166-171. [PMID: 35429543 DOI: 10.1016/j.jad.2022.04.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/23/2022] [Accepted: 04/09/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite the pathogenic role played by interleukin-6 (IL-6) signaling in depression, the association between baseline peripheral IL-6 signaling and the antidepressant treatment responses noted in clinical studies remains controversial. We investigated the effects of the baseline serum IL-6 (sIL-6) level and anxiety symptoms on the 12-week remission rate of depressed outpatients who received stepwise antidepressant treatments. METHODS At baseline, sIL-6 levels were measured, and anxiety symptoms were evaluated using the Hospital Anxiety Depression Scale-Anxiety subscale (HADS-A), in 1094 patients. All received stepwise antidepressant treatment. Subsequently, 12-week remission, defined as a Hamilton Depression Rating Scale (HAMD) score ≤ 7, was assessed. RESULTS The individual and interaction effects of the sIL-6 level (as a binary [low vs. high, based on the median value of 1.65 pg/mL] or continuous variable) and the HADS-A score (as a binary [<12 vs. ≥12] or continuous variable) on the 12-week remission rate were analyzed using logistic regression models after adjusting for relevant covariates. Patients with both low sIL-6 levels (<1.65 pg/mL) and HADS-A scores <12 had the highest 12-week remission rate; a significant interaction effect was also apparent. This effect was significant even when the data were analyzed as continuous variables. CONCLUSIONS Our study suggests that the sIL-6 level can serve as a biomarker predicting the outcome of antidepressant treatment according to the severity of anxiety symptoms.
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Schultheiß C, Willscher E, Paschold L, Gottschick C, Klee B, Henkes SS, Bosurgi L, Dutzmann J, Sedding D, Frese T, Girndt M, Höll JI, Gekle M, Mikolajczyk R, Binder M. The IL-1β, IL-6, and TNF cytokine triad is associated with post-acute sequelae of COVID-19. Cell Rep Med 2022; 3:100663. [PMID: 35732153 PMCID: PMC9214726 DOI: 10.1016/j.xcrm.2022.100663] [Citation(s) in RCA: 174] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/28/2022] [Accepted: 05/25/2022] [Indexed: 02/07/2023]
Abstract
Post-acute sequelae of COVID-19 (PASC) is emerging as global problem with unknown molecular drivers. Using a digital epidemiology approach, we recruited 8,077 individuals to the cohort study for digital health research in Germany (DigiHero) to respond to a basic questionnaire followed by a PASC-focused survey and blood sampling. We report the first 318 participants, the majority thereof after mild infections. Of those, 67.8% report PASC, predominantly consisting of fatigue, dyspnea, and concentration deficit, which persists in 60% over the mean 8-month follow-up period and resolves independently of post-infection vaccination. PASC is not associated with autoantibodies, but with elevated IL-1β, IL-6, and TNF plasma levels, which we confirm in a validation cohort with 333 additional participants and a longer time from infection of 10 months. Blood profiling and single-cell data from early infection suggest the induction of these cytokines in COVID-19 lung pro-inflammatory macrophages creating a self-sustaining feedback loop. We report a post-COVID-19 digital epidemiology study with biomarker analysis (n = 651) PASC persists in 60% of participants up to 24 months after mild COVID-19 PASC is associated with high IL-1β, IL-6, and TNF levels but not autoantibodies Overactivated monocytes/macrophages are likely the source of cytokine production
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Affiliation(s)
- Christoph Schultheiß
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Edith Willscher
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Lisa Paschold
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Cornelia Gottschick
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097 Halle (Saale), Germany
| | - Bianca Klee
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097 Halle (Saale), Germany
| | - Svenja-Sibylla Henkes
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Lidia Bosurgi
- I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20251 Hamburg, Germany; Protozoa Immunology, Bernhard Nocht Institute for Tropical Medicine, Bernhard Nocht Strasse 74, 20359 Hamburg, Germany
| | - Jochen Dutzmann
- Mid-German Heart Center, Department of Cardiology and Intensive Care Medicine, University Hospital, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Daniel Sedding
- Mid-German Heart Center, Department of Cardiology and Intensive Care Medicine, University Hospital, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112 Halle (Saale), Germany
| | - Matthias Girndt
- Department of Internal Medicine II, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Jessica I Höll
- Pediatric Hematology and Oncology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany
| | - Michael Gekle
- Julius Bernstein-Institute of Physiology, Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 6, 06110 Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Center for Health Sciences, Medical School of the Martin-Luther University Halle-Wittenberg, Magdeburger Strasse 8, 06097 Halle (Saale), Germany
| | - Mascha Binder
- Department of Internal Medicine IV, Oncology/Hematology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
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Symptoms of anxiety but not depression before start of taxane-based chemotherapy are associated with peripheral neuropathy: a multicenter study in women with breast cancer. Support Care Cancer 2022; 30:6947-6953. [PMID: 35543818 PMCID: PMC9213366 DOI: 10.1007/s00520-022-07093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/22/2022] [Indexed: 11/05/2022]
Abstract
Background Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of chemotherapy, especially after taxane-based therapy. This study aimed to examine the relationship between symptoms of anxiety and depression before the start of taxane-based chemotherapy and the development of CIPN in women with breast cancer. Methods In this prospective study, women with breast cancer receiving taxane-based (neo)adjuvant chemotherapy were recruited from four hospitals in the Netherlands. Patients completed questionnaires assessing anxiety and depressive symptoms before treatment and CIPN before treatment (T0), 6 weeks after start of treatment (T1), after the last cycle of chemotherapy (T2), and 6 months after the end of treatment (T3). Mixed model analyses were used to investigate whether medium/high levels of anxiety or depression at baseline are associated with the level of CIPN during and after treatment. Results Among the 61 participating women, 14 (23%) reported medium/high levels of anxiety and 29 (47.5%) reported medium/high levels of depressive symptoms at baseline. The group of women with medium/high baseline levels of anxiety showed a significantly higher increase in CIPN during and after chemotherapy than women with low baseline levels of anxiety (p < .001). No relationship between depressive symptoms at baseline and the development of CIPN was found. Conclusion This study showed that baseline medium to high levels of anxiety but not depressive symptoms impacted the development of CIPN during and in the 6 months after treatment.
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Mamede A, Merkelbach I, Noordzij G, Denktas S. Mindfulness as a Protective Factor Against Depression, Anxiety and Psychological Distress During the COVID-19 Pandemic: Emotion Regulation and Insomnia Symptoms as Mediators. Front Psychol 2022; 13:820959. [PMID: 35432084 PMCID: PMC9010863 DOI: 10.3389/fpsyg.2022.820959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesResearch has linked mindfulness to improved mental health, yet the mechanisms underlying this relationship are not well understood. This study explored the mediating role of emotion regulation strategies and sleep in the relationship between mindfulness and symptoms of depression, anxiety and psychological distress during the COVID-19 pandemic.MethodsAs detailed in this study’s pre-registration (osf.io/k9qtw), a cross-sectional research design was used to investigate the impact of mindfulness on mental health and the mediating role of emotion regulation strategies (i.e., cognitive reappraisal, rumination and suppression) and insomnia. A total of 493 participants from the general population answered an online survey and were included in the final analysis. The online survey consisted of the short form of the Five-Facets Mindfulness Questionnaire (FFMQ-SF), the Impact of Event Scale-revised (IES-R), the Generalised Anxiety Disorder Scale (GAD-7), the Patient Health Questionnaire (PHQ-8), the Emotion Regulation Questionnaire (ERQ), the short form of the Rumination Response Scale (RSS-SF), and the Insomnia Severity Index (ISI).ResultsStructural equation modelling revealed that mindfulness was related to lower symptoms of depression, anxiety and psychological distress, both directly and indirectly. Mindfulness was negatively associated with rumination and insomnia. As hypothesised, models revealed that the associations between mindfulness and depression, anxiety and psychological distress were significantly mediated by its negative associations with rumination and insomnia. Our findings also demonstrated that rumination was related to increased insomnia symptoms, which in turn was associated with increased mental health problems, indicating a mediated mediation. Mindfulness was also positively associated with cognitive reappraisal and negatively associated with suppression, which were, respectively, negatively and positively associated with depressive symptoms, and thus functioned as specific mediators of the association between mindfulness and depression.ConclusionOur findings suggest that rumination and insomnia operate transdiagnostically as interrelated mediators of the effects of mindfulness on mental health, whereas cognitive reappraisal and suppression function as specific mediators for depression. These insights emphasise the importance of targeting emotion regulation and sleep in mindfulness interventions for improving mental health. Limitations and implications for practice are discussed.
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Affiliation(s)
- André Mamede
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- *Correspondence: André Mamede,
| | - Inge Merkelbach
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Gera Noordzij
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Erasmus University College, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
| | - Semiha Denktas
- Department of Psychology, Education and Child Development, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
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Janelsins MC, Lei L, Netherby-Winslow C, Kleckner AS, Kerns S, Gilmore N, Belcher E, Thompson BD, Werner ZA, Hopkins JO, Long J, Cole S, Culakova E. Relationships between cytokines and cognitive function from pre- to post-chemotherapy in patients with breast cancer. J Neuroimmunol 2022; 362:577769. [PMID: 34871864 PMCID: PMC10659959 DOI: 10.1016/j.jneuroim.2021.577769] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/01/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022]
Abstract
Cancer-related cognitive decline (CRCD) is a clinically important problem and negatively affects daily functioning and quality of life. We conducted a pilot longitudinal study from pre- to post-chemotherapy in patients with breast cancer to assess changes in inflammation and cognition over time, as well as the impact of baseline cytokine level on post-chemotherapy cognitive scores. We found that concentrations of IL-6, MCP-1, sTNFRI, and sTNFRII significantly increased in patients, while IL-1β significantly decreased (p < 0.05). After controlling for covariates, increases in IL-6 and MCP-1 were associated with worse executive function and verbal fluency in patients from pre- to post-chemotherapy (p < 0.05). Higher baseline IL-6 was associated with better performance on executive function and verbal fluency post chemotherapy (p < 0.05). Overall, these results suggest that chemotherapy-associated increases in cytokines/receptors is associated with worse cognitive function. Larger studies are needed to confirm these findings.
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Affiliation(s)
- Michelle C Janelsins
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States; Wilmot Cancer Institute, Rochester, NY 14642, United States.
| | - Lianlian Lei
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, United States
| | - Colleen Netherby-Winslow
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States
| | - Amber S Kleckner
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States; Wilmot Cancer Institute, Rochester, NY 14642, United States
| | - Sarah Kerns
- Wilmot Cancer Institute, Rochester, NY 14642, United States; Department of Radiation Oncology, University of Rochester, Rochester, NY 14624, United States
| | - Nikesha Gilmore
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States; Wilmot Cancer Institute, Rochester, NY 14642, United States
| | - Elizabeth Belcher
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States; Wilmot Cancer Institute, Rochester, NY 14642, United States
| | - Bryan D Thompson
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States
| | - Zachary A Werner
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States
| | - Judith O Hopkins
- Southeast Clinical Oncology Research Consortium (SCOR), 2150 Country Club Road Suite 200, Winston Salem, NC 27104, United States
| | - Joan Long
- Cancer Research Consortium of West Michigan NCORP (CRCWM), 25 Michigan St. NE, Suite 3100, Grand Rapids, MI 49503, United States
| | - Sharon Cole
- Dayton Clinical Oncology Program, 3123 Research Blvd., Suite 150, Dayton, OH 45420, United States
| | - Eva Culakova
- Department of Surgery, Supportive Care in Cancer, University of Rochester, 265 Crittenden Blvd., Rochester, NY 14642, United States
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Malik S, Alnaji O, Malik M, Gambale T, Rathbone MP. Correlation between Mild Traumatic Brain Injury-Induced Inflammatory Cytokines and Emotional Symptom Traits: A Systematic Review. Brain Sci 2022; 12:brainsci12010102. [PMID: 35053845 PMCID: PMC8773760 DOI: 10.3390/brainsci12010102] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 01/09/2023] Open
Abstract
Both mild traumatic brain injuries (mTBI) and systemic injuries trigger a transient neuroinflammatory response that result in similar clinical outcome. The ensuing physical, cognitive, and emotional symptoms fail to subside in approximately 15–20% of the concussed population. Emotional impairments, particularly depression, anxiety, and post-traumatic stress disorder (PTSD), are commonly associated with poor recovery following mTBI. These emotional impairments also have a significant neuroinflammatory component. We hypothesized that the inflammatory cytokines seen in mTBI patients with emotional symptoms would coincide with those commonly seen in patients with emotional symptoms without mTBI. A systematic review was conducted to identify the most common neuroinflammatory cytokines in the mTBI population with psychological symptoms (depression, anxiety, PTSD). The electronic databases EMBASE, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and PSYCINFO were searched from data inception to 31 August 2021. A systematic screening approach was employed from screening to data analysis. A total of 994 articles were screened, 108 were selected for full article review, and 8 were selected for data analysis. The included studies consisted of 875 patients of which 81.3% were male. The mean sample size of patients with at least one mTBI was 73.8 ± 70.3 (range, 9–213), with a mean age of 33.9 ± 4.8 years. The most common cytokines associated with poor psychological outcomes involving PTSD and/or depression in the chronic mTBI population were IL-6, TNFα, IL-10, and CRP.
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Affiliation(s)
- Shazia Malik
- Neurosciences Graduate Program, McMaster University, Hamilton, ON L8S 4L8, Canada
- Correspondence:
| | - Omar Alnaji
- Faculty of Life Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Mahnoor Malik
- Bachelor of Health Sciences Program, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Teresa Gambale
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada; (T.G.); (M.P.R.)
| | - Michel Piers Rathbone
- Division of Neurology, Department of Medicine, McMaster University, Hamilton, ON L8S 4L8, Canada; (T.G.); (M.P.R.)
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Bonhof CS, van de Graaf DL, Wasowicz DK, Vreugdenhil G, Mols F. Symptoms of pre-treatment anxiety are associated with the development of chronic peripheral neuropathy among colorectal cancer patients. Support Care Cancer 2022; 30:5421-5429. [PMID: 35303166 PMCID: PMC9046137 DOI: 10.1007/s00520-022-06971-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/10/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Identifying potentially modifiable predictors of chronic (chemotherapy-induced) peripheral neuropathy (PN) is important, especially in light of the limited treatment options. We aimed to examine pre-treatment anxiety and depressive symptoms as predictors of chronic PN symptom severity in colorectal cancer (CRC) patients up to 2 years after diagnosis. METHODS Newly diagnosed CRC patients from four Dutch hospitals were eligible for participation. Patients (N = 336) completed a questionnaire on anxiety and depressive symptoms (HADS) and sensory (SPN) and motor peripheral neuropathy (MPN) (EORTC QLQ-CIPN20) before initial treatment (baseline) and 1 and 2 years after diagnosis. Patients were included in the analyses if they either developed some level of SPN or MPN symptoms, or experienced a worsening of pre-treatment SPN or MPN symptoms. RESULTS At 1-year follow-up, 115 patients (34%) reported SPN symptoms and 134 patients (40%) reported MPN symptoms. Of these patients, SPN and MPN symptoms had not returned to baseline level at 2-year follow-up in, respectively, 51% and 54% of patients. In multivariable regression analyses, neither pre-treatment anxiety symptoms nor pre-treatment depressive symptoms were associated with SPN or MPN symptom severity at 1-year follow-up. At 2-year follow-up, pre-treatment anxiety symptoms (β = 0.44, p = 0.01), but not depressive symptoms, were associated with SPN symptom severity. CONCLUSIONS Pre-treatment anxiety symptoms, but not depressive symptoms, were associated with SPN symptom severity 2 years after diagnosis. Future studies are needed that assess whether interventions targeted to reduce anxiety before and during treatment can reduce chronic PN severity or even prevent the persistence of PN.
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Affiliation(s)
- Cynthia S Bonhof
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
| | - Daniëlle L van de Graaf
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Dareczka K Wasowicz
- Department of Surgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Gerard Vreugdenhil
- Department of Internal Medicine, Máxima Medical Centre, Eindhoven and Veldhoven, The Netherlands
| | - Floortje Mols
- CoRPS - Center of Research On Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
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Bokma WA, Zhutovsky P, Giltay EJ, Schoevers RA, Penninx BW, van Balkom AL, Batelaan NM, van Wingen GA. Predicting the naturalistic course in anxiety disorders using clinical and biological markers: a machine learning approach. Psychol Med 2022; 52:57-67. [PMID: 32524918 PMCID: PMC8711102 DOI: 10.1017/s0033291720001658] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 03/25/2020] [Accepted: 05/12/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Disease trajectories of patients with anxiety disorders are highly diverse and approximately 60% remain chronically ill. The ability to predict disease course in individual patients would enable personalized management of these patients. This study aimed to predict recovery from anxiety disorders within 2 years applying a machine learning approach. METHODS In total, 887 patients with anxiety disorders (panic disorder, generalized anxiety disorder, agoraphobia, or social phobia) were selected from a naturalistic cohort study. A wide array of baseline predictors (N = 569) from five domains (clinical, psychological, sociodemographic, biological, lifestyle) were used to predict recovery from anxiety disorders and recovery from all common mental disorders (CMDs: anxiety disorders, major depressive disorder, dysthymia, or alcohol dependency) at 2-year follow-up using random forest classifiers (RFCs). RESULTS At follow-up, 484 patients (54.6%) had recovered from anxiety disorders. RFCs achieved a cross-validated area-under-the-receiving-operator-characteristic-curve (AUC) of 0.67 when using the combination of all predictor domains (sensitivity: 62.0%, specificity 62.8%) for predicting recovery from anxiety disorders. Classification of recovery from CMDs yielded an AUC of 0.70 (sensitivity: 64.6%, specificity: 62.3%) when using all domains. In both cases, the clinical domain alone provided comparable performances. Feature analysis showed that prediction of recovery from anxiety disorders was primarily driven by anxiety features, whereas recovery from CMDs was primarily driven by depression features. CONCLUSIONS The current study showed moderate performance in predicting recovery from anxiety disorders over a 2-year follow-up for individual patients and indicates that anxiety features are most indicative for anxiety improvement and depression features for improvement in general.
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Affiliation(s)
- Wicher A. Bokma
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Paul Zhutovsky
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Erik J. Giltay
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Anton L.J.M. van Balkom
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Neeltje M. Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health research institute, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam UMC, Location AMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
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Gao J, Zou J, Yang L, Zhao J, Wang L, Liu T, Fan X. Alteration of peripheral cortisol and autism spectrum disorder: A meta-analysis. Front Psychiatry 2022; 13:928188. [PMID: 35911217 PMCID: PMC9334910 DOI: 10.3389/fpsyt.2022.928188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Cortisol is the main HPA axis hormone secreted by the adrenal cortex, and influences metabolism, cognition, and behavior. Recently, a plethora of studies have tried to confirm the correlation between peripheral cortisol and autism spectrum disorder (ASD). However, the results were controversial. We assessed the effects of peripheral cortisol on ASD in this study. The included studies were identified according to the inclusion and exclusion criteria. The pooled Hedges' g and its 95% confidence interval were selected to evaluate the association between peripheral cortisol and ASD. Subgroup analyses, sensitivity analyses, meta-regression, and publication bias tests were also undertaken based on the obtained information. There were a total of twelve studies with 375 ASD patients and 335 controls included in our meta-analysis. Obvious heterogeneity across studies was found in the overall analysis. Peripheral cortisol levels were significantly elevated in ASD patients compared with controls in the absence of obvious heterogeneity. A single study did not influence the overall comparison results. Meta-regression analyses revealed that age and gender of the included subjects, sample size, and publication year did not moderate effects on the present results. These findings may provide us some targeted strategies to the diagnosis and treatment of ASD.
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Affiliation(s)
- Junwei Gao
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Jiao Zou
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Ling Yang
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Jinghui Zhao
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Army Medical University, Chongqing, China
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Liu L, Cheng B, Ye J, Qi X, Cheng S, Meng P, Chen Y, Yang X, Yao Y, Zhang H, Zhang Z, Zhang J, Li C, Pan C, Wen Y, Jia Y, Zhang F. Understanding the Complex Interactions between Coffee, Tea Intake and Neurologically Relevant Tissues Proteins in the Development of Anxiety and Depression. J Nutr Health Aging 2022; 26:1070-1077. [PMID: 36519770 DOI: 10.1007/s12603-022-1869-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Coffee and tea intake might be associated with psychiatry diseases. However, it is unclear whether the effect of coffee/tea on anxiety and depression depending on the different types of proteins. DESIGN This was a cross-sectional study. SETTING Our datasets were downloaded from online. PARTICIPANTS Phenotypic and genotypic data for coffee intake(N=376,196) and tea intake (N=376,078) were derived from UK Biobank. GWAS data of proteins (N=1,537) from neurologically relevant tissues (brain, cerebrospinal fluid (CSF) and plasma) were obtained from a recently published study. MEASUREMENTS Multivariate linear analysis was then used to evaluate the potential interaction effect between coffee/tea intake and proteins polygenetic risk score (PRS) on the risks of anxiety and depression controlling for age, sex, Townsend deprivation index (TDI), smoke, drinking and education level. RESULTS 34 coffee intake-proteins interactions and 15 tea intake-proteins interactions were observed in anxiety individuals, such as coffee intake-c-Jun interaction (β=0.0169, P=4.131×10-3), coffee intake-Fas interaction (β=-0.0190, P=8.132×10-4), tea intake-sL-Selectin interaction (β=0.0112, P=5.412×10-3) and tea intake-IL-1F6 (β=0.0083, P=4.471×10-2). 25 coffee intake-proteins and 14 tea intake-proteins interactions were observed in depression individuals, including coffee intake- IL-1 sRI (β=0.0171, P=4.888×10-3) and coffee intake-NXPH1 interaction (β=0.0156, P=9.819×10-3), tea intake-COLEC12 interaction (β=0.0127, P=3.280×10-3), and tea intake-Layilin interaction (β=0.0117, P=7.926×10-3). CONCLUSIONS Our results suggested the important role of multiple proteins in neurologically relevant tissues in the associations between coffee/tea intake and psychiatry diseases, providing entry points to explore the mechanisms underlying anxiety and depression.
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Affiliation(s)
- L Liu
- Feng Zhang, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, P. R. China 710061,
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Akkermann S, Halling T, Löffler F, Silber-Peest AS, Krüger T, Bleich S, Bauersachs J, Kahl KG, Westhoff-Bleck M. Impact of COVID-19 on Medical Supply in Adults With Congenital Heart Disease. Front Psychiatry 2022; 13:812611. [PMID: 35370818 PMCID: PMC8968127 DOI: 10.3389/fpsyt.2022.812611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION In March 2020, the World Health organization declared COVID-19 a global pandemic. One year later, the direct and indirect burden of the COVID-19 pandemic become more visible. In this context, there is concern about the allocation of medical resources and medical treatment of other diseases than COVID-19. Particularly, patients with chronic diseases need constant medical and pharmacological treatment. Therefore, we evaluated a large cohort of patients with adult congenital heart disease (ACHD) regarding postponed medical appointments and their possibilities to receive medical treatment during the COVID-19 pandemic. METHODS This cross-sectional study included 559 patients with ACHD (mean age 37.32 ± 11.98; 47% female). Clinical characteristics, answers to questionnaires concerning lifestyle, psychological well-being, addictive behavior and adherence were related to postponed medical appointments and limited access to medical care. RESULTS One hundred and nine patients (19.5%) reported problems getting necessary medical treatment or visiting a physician. Higher anxiety levels (p = 0.004) emerged as the main factor associated with medical undertreatment. The main risk factors for postponement of least one medical appointment (n = 91) were higher depression (p = 0.013) and anxiety (p = 0.05) symptoms as well as female sex (p ≤ 0.0001) and documented arrhythmias (p = 0.007) indicating a particular risk group of cardiovascular complications. In contrast, frequent physical activity identified patients at lower risk. CONCLUSION In ACHD anxiety and depressive symptoms handicap patients to receive medical care. Postponement of medical appointments additionally relates to female sex and documented arrhythmias. The latter indicates that patients at high risk of adverse cardiac outcome avoid routine medical care. Our data may lead policy makers to develop strategies for the provision of medical services to particular vulnerable patient groups, and to optimize management of both future pandemics and daily routine.
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Affiliation(s)
- Steffen Akkermann
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Tim Halling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Friederike Löffler
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Ann S Silber-Peest
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Tillmann Krüger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Johann Bauersachs
- Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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A short Mindfulness retreat can improve biological markers of stress and inflammation. Psychoneuroendocrinology 2022; 135:105579. [PMID: 34775250 DOI: 10.1016/j.psyneuen.2021.105579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/29/2021] [Accepted: 10/29/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Mindfulness practice, a form of meditation, has shown benefit for psychological and physical health. In this study, we investigated the effect of an intensive period of Mindfulness practice on some biological mediators of stress and inflammation during a 3-day residential retreat. METHODS A total of 95 healthy individuals (aged 18-67) were recruited and randomized to a Mindfulness retreat arm or an active control arm. Before (t0) and after (t1) the intervention, all the participants were assessed for salivary cortisol levels and for a panel of pro- and anti-inflammatory cytokines measured in saliva. Psychometric measures on stress, anxiety and awareness were carried out using PSS, STAI-Y and MAAS questionnaires, respectively. RESULTS As to the within-group differences, we observed a statistically significant decrease in perceived stress (β = -8.85, p < 0.0001), and anxiety scores (β = -12.39, p < 0.0001), while awareness increased (β = 15.26, p < 0.0001) between t0 to t1 in retreat participants. In the mindfulness intervention group, we also observed a statistically significant reduction in the levels of pro-inflammatory cytokines IL-6 (β = -0.94 p = 0.001) and IL-8 (β = -176.40, p < 0.0001), and an increase in anti-inflammatory IL-10 (β = 0.89 p < 0.0001) levels at the end of the retreat. At t1 we observed a highly significant correlation between cortisol levels and both anxiety (r = 0.56, p < 0.0001) and perceived stress (r = 0.92, p < 0.0001) scores. CONCLUSIONS Mindfulness retreat participants showed a significant reduction in perceived stress and anxiety levels, as well as an improved balance of some key mediators of inflammatory states. Our data provide evidence that a mindfulness retreat may be effective in improving physical and mental health. Future studies with larger numbers of subjects and follow-up periods may examine mindfulness practice as a non-pharmacological alternative to promote stress reduction and overall health and wellbeing.
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Ghane M, Sullivan-Toole H, DelGiacco AC, Richey JA. Subjective arousal and perceived control clarify heterogeneity in inflammatory and affective outcomes. Brain Behav Immun Health 2021; 18:100341. [PMID: 34988494 PMCID: PMC8710414 DOI: 10.1016/j.bbih.2021.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 01/10/2023] Open
Abstract
Only a portion of individuals experiencing chronic stress and associated increases in inflammation go on to develop pathological elevations in mood and anxiety symptoms. Some prevailing models suggest that the outcomes of chronic stress may largely depend on individual differences in perceived control. In the current study, we used this theoretical framework to disambiguate the influence of autonomic arousal and perceived control on inflammatory and psychological outcomes in a large sample of adults from the Midlife in the United States dataset (wave 2; MIDUS-2) (Final N = 1030), and further replicated our approach in a second (MIDUS-Refresher) cohort (Final N = 728). Using k-means clustering we created subgroups systematically differing in subjective arousal (high/low) and perceived control (low/high) and compared these subgroups on inflammatory markers and psychological outcomes. Overall results showed that individuals in the high subjective arousal subgroups had higher levels of IL-6, CRP, and FIB, independent of level of CNTL. However, distinctive, and pathological psychological symptom patterns became more apparent when individuals were characterized by both subjective arousal and perceived control. These findings suggest that subtyping individuals based on subjective arousal and perceived control can help us disentangle pathological versus adaptive mental health outcomes in those with co-occurring inflammation and may help identify those vulnerable to psychopathology in the context of physical or psychological stressor exposure.
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Affiliation(s)
- Merage Ghane
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
- National Institute of Mental Health, Intramural Research Training Program, Bethesda, MD, USA
| | - Holly Sullivan-Toole
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
- Department of Psychology, Temple University, 1701 North 13th Street, Weiss Hall, Philadelphia, PA, 19122, USA
| | - Amanda C. DelGiacco
- National Institute of Mental Health, Intramural Research Training Program, Bethesda, MD, USA
| | - John A. Richey
- Virginia Tech, Department of Psychology, Clinical Science Program, Blacksburg, VA, USA
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Renna ME. A review and novel theoretical model of how negative emotions influence inflammation: The critical role of emotion regulation. Brain Behav Immun Health 2021; 18:100397. [PMID: 34927103 PMCID: PMC8649080 DOI: 10.1016/j.bbih.2021.100397] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 12/02/2022] Open
Abstract
Psychological distress is an inevitable part of life. Research drawing on theories from clinical psychology, health psychology, and psychoneuroimmunology (PNI) has identified relationships between negative emotions such as anxiety and sadness with inflammation. When not regulated properly, negative emotions can create biological wear and tear on the body that can increase risk for morbidity and mortality. This review discusses previously available research on relationships between negative emotions and emotion regulation with inflammation among both physically healthy adults and those with chronic illnesses. I then present a novel comprehensive biobehavioral model of negative emotionality. This model emphasizes the influence of negative emotions and their contribution to heightened inflammation. Further, I also discuss how emotion regulation (including perseverative processes such as worry and rumination) mediates this association. The relationships between negative emotionality and emotion regulation may be bidirectional, and empirical investigation of this model should specifically seek to disentangle these relationships. The proposed model offers the opportunity to advance PNI research through understanding how emotional factors alter inflammation and contribute to accelerated biological aging and disease risk.
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Affiliation(s)
- Megan E. Renna
- School of Psychology, University of Southern Mississippi, USA
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Psychosocial and Biological Outcomes of Immersive, Mindfulness-Based Treks in Nature for Groups of Young Adults and Caregivers Affected by Cancer: Results from a Single Arm Program Evaluation from 2016-2021. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312622. [PMID: 34886348 PMCID: PMC8657001 DOI: 10.3390/ijerph182312622] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has left many individuals suffering from “connection deficit disorder” given changes to the way we work, go to school, socialize, and engage in daily activities. Young adults affected by cancer between the ages of 18–39 have known this connection deficit long before the pandemic. Being diagnosed and treated for cancer during this time can significantly disrupt engagement in important educational, career, social, and reproductive pursuits, and contribute to increased stress, anxiety, depression, and other negative outcomes. Experiencing meaningful connection—with nature, with peers who understand, and with oneself, may help assuage this adverse effect of disconnect. A single arm within-subjects program evaluation was conducted to examine outcomes following participation in immersive, multi-night, mindfulness-based treks in nature in a sample of young adults (n = 157) and caregivers (n = 50) affected by cancer from 2016–2021. Pre to post-trek changes included significant (p < 0.001) self-reported improvements in feeling connected to nature (d = 0.93–0.95), peers (d = 1.1–1.3), and oneself (d = 0.57–1.5); significant (p < 0.001) improvements on PROMIS Anxiety (d = 0.62–0.78), Depression (d = 0.87–0.89), and Sleep Disturbance (d = 0.37–0.48) short forms; and significant (p < 0.05) changes in pro-inflammatory biomarkers (d = 0.55–0.82). Connection-promoting experiences like this have the potential to improve health and wellbeing in this population and serve as a model for others.
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Mirzaei E, Mirjalili M, Jahangard L, Haghighi M, Yasrebifar F, Mohammadi Y, Larki-Harchagani A, Mehrpooya M. Influence of Simvastatin as Augmentative Therapy in the Treatment of Generalized Anxiety Disorder: A Pilot Randomized, Placebo-Controlled Study. Neuropsychobiology 2021; 80:242-252. [PMID: 33070132 DOI: 10.1159/000510853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 07/23/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Preliminary evidence is promising regarding the anxiolytic effects of statins in animal models of anxiety. Hence, this study aimed to evaluate the efficacy of simvastatin augmentation versus placebo in the treatment of patients with generalized anxiety disorder (GAD) with residual symptoms despite treatment with selective serotonin reuptake inhibitors (SSRIs). METHODS A double-blind, 8-week controlled trial was conducted from August 2018 to December 2019 in an outpatient psychiatry clinic in Hamadan, Iran. A total of 138 patients with a diagnosis of GAD were assessed for eligibility. Of them, 84 patients who met the study criteria were randomly assigned either to the adjuvant simvastatin (20 mg/day) or to the placebo group. Standard medication consisting of SSRIs was consistent 2 months prior to and during the study. The severity of anxiety symptoms for each patient was assessed based on the Hamilton Anxiety Rating Scale (HAM-A) score at baseline, week 4, and week 8 after treatment. Additionally, blood lipid values were assessed at baseline and on completion of the study. RESULTS Thirty-three out of 42 patients in the intervention group and 35 out of 42 patients in the control group completed the 8 weeks of the study period. Compared to the placebo group, in the simvastatin group cholesterol, triglycerides, and low-density lipoprotein significantly decreased, and high-density lipoprotein significantly increased over time. General linear model analysis demonstrated that although over time a higher decrease in mean HAM-A scores was observed in the intervention group compared to the control group, this difference was not statistically significant (p = 0.11). In addition, at the end of the study, the number of responders and remitters was comparable in the two groups. CONCLUSIONS The results from this clinical study did not support the potential efficacy of adjunctive simvastatin in the treatment of patients with GAD. Thus, large-scale and long-term clinical trials are required to more accurately assess the potential efficacy of statins in the treatment of patients with anxiety disorders.
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Affiliation(s)
- Ehsan Mirzaei
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtabalsadat Mirjalili
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Jahangard
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fatemeh Yasrebifar
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Younes Mohammadi
- Modeling of Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Larki-Harchagani
- Department of Toxicology and Pharmacology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Mehrpooya
- Department of Clinical Pharmacy, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran,
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van Tuijl LA, Voogd AC, de Graeff A, Hoogendoorn AW, Ranchor AV, Pan KY, Basten M, Lamers F, Geerlings MI, Abell JG, Awadalla P, Bakker MF, Beekman ATF, Bjerkeset O, Boyd A, Cui Y, Galenkamp H, Garssen B, Hellingman S, Huisman M, Huss A, Keats MR, Kok AAL, Luik AI, Noisel N, Onland-Moret NC, Payette Y, Penninx BWJH, Portengen L, Rissanen I, Roest AM, Rosmalen JGM, Ruiter R, Schoevers RA, Soave DM, Spaan M, Steptoe A, Stronks K, Sund ER, Sweeney E, Teyhan A, Vaartjes I, van der Willik KD, van Leeuwen FE, van Petersen R, Verschuren WMM, Visseren F, Vermeulen R, Dekker J. Psychosocial factors and cancer incidence (PSY-CA): Protocol for individual participant data meta-analyses. Brain Behav 2021; 11:e2340. [PMID: 34473425 PMCID: PMC8553309 DOI: 10.1002/brb3.2340] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 08/12/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Psychosocial factors have been hypothesized to increase the risk of cancer. This study aims (1) to test whether psychosocial factors (depression, anxiety, recent loss events, subjective social support, relationship status, general distress, and neuroticism) are associated with the incidence of any cancer (any, breast, lung, prostate, colorectal, smoking-related, and alcohol-related); (2) to test the interaction between psychosocial factors and factors related to cancer risk (smoking, alcohol use, weight, physical activity, sedentary behavior, sleep, age, sex, education, hormone replacement therapy, and menopausal status) with regard to the incidence of cancer; and (3) to test the mediating role of health behaviors (smoking, alcohol use, weight, physical activity, sedentary behavior, and sleep) in the relationship between psychosocial factors and the incidence of cancer. METHODS The psychosocial factors and cancer incidence (PSY-CA) consortium was established involving experts in the field of (psycho-)oncology, methodology, and epidemiology. Using data collected in 18 cohorts (N = 617,355), a preplanned two-stage individual participant data (IPD) meta-analysis is proposed. Standardized analyses will be conducted on harmonized datasets for each cohort (stage 1), and meta-analyses will be performed on the risk estimates (stage 2). CONCLUSION PSY-CA aims to elucidate the relationship between psychosocial factors and cancer risk by addressing several shortcomings of prior meta-analyses.
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Affiliation(s)
- Lonneke A van Tuijl
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Adri C Voogd
- Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Epidemiology, GROW, Maastricht University, Maastricht, The Netherlands.,Department of Research, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, Cancer Center University Medical Center, University of Utrecht, Utrecht, The Netherlands
| | - Adriaan W Hoogendoorn
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Adelita V Ranchor
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Kuan-Yu Pan
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Maartje Basten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Femke Lamers
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Jessica G Abell
- Department of Behavioural Science and Health, University College London, London, UK
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Marije F Bakker
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ottar Bjerkeset
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Faculty of Medicine and Health Sciences, Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andy Boyd
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Yunsong Cui
- Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Henrike Galenkamp
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Bert Garssen
- Department of Internal Medicine, Maasstad Hospital, Rotterdam, The Netherlands
| | - Sean Hellingman
- Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Martijn Huisman
- Amsterdam UMC, Department of Epidemiology & Data Science, Amsterdam Public Health institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Melanie R Keats
- School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, Canada
| | - Almar A L Kok
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands.,Amsterdam UMC, Department of Epidemiology & Data Science, Amsterdam Public Health institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands
| | - Nolwenn Noisel
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - N Charlotte Onland-Moret
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Yves Payette
- CARTaGENE, CHU Sainte-Justine, 3175, Chemin de la Côte-Sainte-Catherine, Montréal, Québec, Canada
| | - Brenda W J H Penninx
- Amsterdam UMC, Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ina Rissanen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Annelieke M Roest
- Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands
| | - Judith G M Rosmalen
- Departments of Psychiatry and Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rikje Ruiter
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Department of Internal Medicine, Maasstad, Rotterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - David M Soave
- Ontario Institute for Cancer Research, Toronto, Ontario, Canada.,Department of Mathematics, Wilfrid Laurier University, Waterloo, Canada
| | - Mandy Spaan
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam UMC, and Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands
| | - Erik R Sund
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.,Department of Public Health and Nursing, HUNT Research Centre, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Levanger hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Ellen Sweeney
- Atlantic Partnership for Tomorrow's Health, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alison Teyhan
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - Kimberly D van der Willik
- Department of Epidemiology, Erasmus MC-University Medical Center, Rotterdam, The Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Rutger van Petersen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.,Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Utrecht, the Netherlands
| | - Frank Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Joost Dekker
- Amsterdam Public Health Research Institute, Amsterdam, Noord-Holland, The Netherlands.,Department of Rehabilitation Medicine and Department of Psychiatry, Amsterdam UMC - VUMC, Amsterdam, Noord-Holland, The Netherlands
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Molnar DS, Moore J, O'Leary DD, MacNeil AJ, Wade TJ. Perfectionistic cognitions, Interleukin-6, and C-Reactive protein: A test of the perfectionism diathesis stress model. Brain Behav Immun Health 2021; 13:100211. [PMID: 34589737 PMCID: PMC8474573 DOI: 10.1016/j.bbih.2021.100211] [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: 01/23/2021] [Accepted: 01/23/2021] [Indexed: 02/08/2023] Open
Abstract
Previous research has demonstrated that perfectionism is implicated in poorer health and earlier mortality. However, to our knowledge, research has not yet determined how individual differences in perfectionistic cognitions are related to intermediary health markers such as inflammation. Thus, within the theoretical frameworks of the perfectionism diathesis-stress model (Hewitt and Flett, 1993) and the cognitive theory of perfectionism (Flett et al., 2018; Flett et al., 2016) the aims of our study were to test whether individual differences in perfectionistic cognitions were associated with low-grade inflammation via c-reactive CRP and IL-6 biomarkers and whether these relationships varied as a function perceived stress. The sample included 248 Canadian young adults (52% female, Mage = 22.89, SD = 1.53) who completed surveys assessing key constructs such as perfectionistic cognitions and perceived stress along with providing assessments of body fat percentage and serum samples of IL-6 and CRP. Regression analyses indicated that perfectionistic cognitions were not related to IL-6 under any conditions of stress. However, under high levels of stress perfectionistic cognitions were associated with elevated levels of CRP and these findings held after accounting for the effects of smoking status, body fat percentage, and respondent sex. The present work adds to the growing body of evidence supporting links between personality and inflammation. These findings raise the possibility that experiencing more frequent thoughts centered on the need to be perfect when coupled with higher levels of stress may set the stage for greater vulnerability for chronic inflammation. Perfectionistic cognitions were related to elevated levels of CRP under high levels of perceived stress. Perfectionistic cognitions were not related to CRP under low or moderate levels of perceived stress. Perfectionistic cognitions were not related to IL-6 under any conditions of stress.
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Affiliation(s)
- Danielle S Molnar
- Department of Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Jessy Moore
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Terrance J Wade
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
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Increased telomerase activity in major depressive disorder with melancholic features: Possible role of pro-inflammatory cytokines and the brain-derived neurotrophic factor. Brain Behav Immun Health 2021; 14:100259. [PMID: 34589765 PMCID: PMC8474565 DOI: 10.1016/j.bbih.2021.100259] [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: 12/29/2020] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 01/10/2023] Open
Abstract
The biological mechanisms responsible for depression symptoms are not yet understood. For this reason, it is important to reveal the etiopathogenetic mechanisms in this disease. This study aims to compare the levels of pro-inflammatory cytokines, Brain-Derived Neurotrophic Factor (BDNF), and telomerase activity in patients with major depressive disorder (MDD) and healthy controls. Plasma BDNF, interleukin-6 (IL-6), IL-1beta, and Tumor Necrosis Factor-alpha (TNF-alpha) levels, and telomerase activity were measured in 39 patients with major depression and 39 healthy controls matched with patients in terms of age, gender, and education year. Plasma concentration of BDNF, IL-6 levels, and telomerase activity was significantly different between patients with MDD and healthy controls. Correlation analysis showed a positive trend between plasma BDNF levels and plasma IL-6 levels in patients with MDD with melancholic features. Furthermore, the path analysis results showed that the telomerase activity was indirectly affected by gender, IL-1β, IL-6, BDNF, and BMI, via the severity of depression and anxiety and MDD status as the mediators. Further studies are needed to examine the molecular mechanism of the telomerase activity and the role of BDNF and pro-inflammatory cytokines in the telomerase activation in MDD.
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The relationships between obstructive sleep apnea and psychiatric disorders: a narrative review. CURRENT PROBLEMS OF PSYCHIATRY 2021. [DOI: 10.2478/cpp-2021-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder. Its prevalence tends to increase worldwide. Untreated sleep apnea is associated with a higher risk of metabolic diseases, cardiovascular diseases, stroke, road accidents, and death, but also it is suggested that it increases the risk of mental disorders.
Method: The literature review was based on a search of articles on Medline, Pubmed, and Google Scholar from 2003 to 2021 using the keywords: obstructive sleep apnea; mental disorders; cognitive functions; affective disorders; depression; bipolar disorder; schizophrenia; psychotic disorders. The analysis included original studies, meta-analysis, and review articles.
Discussion: The result obtained from researches published so far does not allow for drawing unequivocal conclusions. There is a lot of bias present in study protocols and inclusion/exclusion criteria. Nonetheless, it seems that some disorders have a better proven correlation with OSA. Cognitive impairment, depression, and anxiety disorders are linked to OSA not only in terms of the overlapping of symptoms but also of a causal relationship. Psychotic disorders and bipolar disorders connections with OSA are confirmed, but they are not yet well understood. All correlations are found to be possibly bidirectional.
Conclusion: 1. Multiple lines of evidence increasingly point towards a bidirectional connection between OSA and mental disorders, and the cause and effect relationship between these two groups of disorders requires further research.
2. Due to reports of an increased risk of OSA with antipsychotic drugs, caution should be exercised when initiating therapy with this type of drug in patients with known risk factors for it.
3. Screening for OSA in psychiatric patients should be introduced as OSA can increase cognitive impairment, affective, and psychotic symptoms.
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Zhi WI, Baser RE, Zhi LM, Talukder D, Li QS, Paul T, Patterson C, Piulson L, Seluzicki C, Galantino ML, Bao T. Yoga for cancer survivors with chemotherapy-induced peripheral neuropathy: Health-related quality of life outcomes. Cancer Med 2021; 10:5456-5465. [PMID: 34213086 PMCID: PMC8366077 DOI: 10.1002/cam4.4098] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/18/2022] Open
Abstract
Background Yoga is a meditative movement therapy focused on mind‐body awareness. The impact of yoga on health‐related quality of life (HRQOL) outcomes in patients with chemotherapy‐induced peripheral neuropathy (CIPN) is unclear. Methods We conducted a pilot randomized wait‐list controlled trial of 8 weeks of yoga (n = 21) versus wait‐list control (n = 20) for CIPN in 41 breast and gynecological cancer survivors with persistent moderate to severe CIPN. HRQOL endpoints were Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), and Insomnia Severity Index (ISI). The Treatment Expectancy Scale (TES) was administered at baseline. We estimated mean changes and 95% confidence intervals (CIs) from baseline to weeks 8 and 12 and compared arms using constrained linear mixed models. Results At week 8, HADS anxiety scores decreased −1.61 (−2.75, −0.46) in the yoga arm and −0.32 (−1.38, 0.75) points in the wait‐list control arm (p = 0.099). At week 12, HADS anxiety scores decreased −1.42 (−2.57, −0.28) in yoga compared to an increase of 0.46 (−0.60, 1.53) in wait‐list control (p = 0.017). There were no significant differences in HADS depression, BFI, or ISI scores between yoga and wait‐list control. Baseline TES was significantly higher in yoga than in wait‐list control (14.9 vs. 12.7, p = 0.019). TES was not associated with HADS anxiety reduction and HADS anxiety reduction was not associated with CIPN pain reduction. Conclusions Yoga may reduce anxiety in patients with CIPN. Future studies are needed to confirm these findings. Clinical Trial Registration Number: ClinicalTrials.gov Identifier: NCT03292328.
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Affiliation(s)
- W Iris Zhi
- Breast Medicine Service, Solid Tumor Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Raymond E Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Dristi Talukder
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Qing S Li
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Tina Paul
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Clare Patterson
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lauren Piulson
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christina Seluzicki
- Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mary L Galantino
- School of Health Sciences, Stockton University, Galloway, NJ, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.,University of Witwatersrand, Johannesburg, South Africa
| | - Ting Bao
- Breast Medicine Service, Solid Tumor Division, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Integrative Medicine Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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50
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Liu Y, Forsythe P. Vagotomy and insights into the microbiota-gut-brain axis. Neurosci Res 2021; 168:20-27. [DOI: 10.1016/j.neures.2021.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/01/2021] [Accepted: 04/01/2021] [Indexed: 12/12/2022]
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