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Jang S, Kim IY, Choi SW, Lee A, Lee JY, Shin H, Lee J, Lee M, Lee KR, Jung S, Ryu JS, Oh J, Kwon M, Kim J, Ahn R, Jung YC, Seok JH. Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics. Psychiatry Investig 2024; 21:230-241. [PMID: 38569581 PMCID: PMC10990624 DOI: 10.30773/pi.2023.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. METHODS Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic-pituitary-adrenal (HPA) axis. RESULTS Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with "adrenal exhaustion stage" was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). CONCLUSION This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Sun-Woo Choi
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Anna Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Ju-Yeal Lee
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Hyunkyung Shin
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junwoo Lee
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Mikyeong Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Kyoung-Ryul Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Saeeun Jung
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Jin Sun Ryu
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Jihee Oh
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Manjae Kwon
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joohan Kim
- Department of Communication, Yonsei University, Seoul, Republic of Korea
| | - Ryunsup Ahn
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Hormone Analysis Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Jung
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Frost A, Hagaman A, Baranov V, Chung EO, Bhalotra S, Sikander S, Maselko J. Non-linear associations between HPA axis activity during infancy and mental health difficulties during early childhood among children in rural Pakistan. Dev Psychopathol 2023; 35:2086-2095. [PMID: 35959681 PMCID: PMC9922341 DOI: 10.1017/s0954579422000773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Hypothalamic pituitary adrenal (HPA) axis activity may be a mechanism linking early adversity to child mental health difficulties. However, there is a dearth of longitudinal evidence for the association between HPA axis activity and mental health among children in low-resource contexts. The goal of this study is to examine linear and curvilinear associations between HPA axis activity during infancy and mental health difficulties in early childhood among children in rural Pakistan. Participants included 104 children (46% male) from the Bachpan study, a longitudinal cohort embedded within a maternal depression trial in Pakistan. We examined the associations between hair-derived cortisol and dehydroepiandosterone (DHEA) at 12 months old and mental health difficulties, measured with the Strengths and Difficulties Questionnaire (SDQ), at 36 months old. There was a significant quadratic association between hair cortisol and SDQ scores, with results showing a U-shaped relationship (i.e., having relatively high or low cortisol predicted increased mental health difficulties). DHEA showed a quadratic association with SDQ scores with an inverted U-shaped relationship (i.e., high and low DHEA was associated with decreased mental health difficulties). Results provide evidence of longitudinal and curvilinear effects of cortisol and DHEA during infancy on mental health difficulties in early childhood.
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Affiliation(s)
- Allison Frost
- Carolina Population Center, University of North Carolina, Chapel Hill
| | - Ashley Hagaman
- Social Behavioral Sciences, Yale School of Public Health, Yale University
| | - Victoria Baranov
- Department of Economics, Faculty of Business and Economics, University of Melbourne
| | - Esther O. Chung
- Carolina Population Center, University of North Carolina, Chapel Hill
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill
| | | | - Siham Sikander
- Human Development Research Foundation, Islamabad, Pakistan
- Health Services Academy, Islamabad, Pakistan
| | - Joanna Maselko
- Carolina Population Center, University of North Carolina, Chapel Hill
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill
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Panza F, Solfrizzi V, Sardone R, Dibello V, Castellana F, Zupo R, Stallone R, Lampignano L, Bortone I, Mollica A, Berardino G, Ruan Q, Altamura M, Bellomo A, Daniele A, Lozupone M. Depressive and Biopsychosocial Frailty Phenotypes: Impact on Late-life Cognitive Disorders. J Alzheimers Dis 2023:JAD230312. [PMID: 37355907 DOI: 10.3233/jad-230312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
In older age, frailty is a detrimental transitional status of the aging process featuring an increased susceptibility to stressors defined by a clinical reduction of homoeostatic reserves. Multidimensional frailty phenotypes have been associated with all-cause dementia, mild cognitive impairment (MCI), Alzheimer's disease (AD), AD neuropathology, vascular dementia, and non-AD dementias. In the present article, we reviewed current evidence on the existing links among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders, also examining common pathways and mechanisms underlying these links. The depressive frailty phenotype suggested by the construct of late-life depression (LLD) plus physical frailty is poorly operationalized. The biopsychosocial frailty phenotype, with its coexistent biological/physical and psychosocial dimensions, defines a biological aging status and includes motivational, emotional, and socioeconomic domains. Shared biological pathways/substrates among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders are hypothesized to be inflammatory and cardiometabolic processes, together with multimorbidity, loneliness, mitochondrial dysfunction, dopaminergic neurotransmission, specific personality traits, lack of subjective/objective social support, and neuroendocrine dysregulation. The cognitive frailty phenotype, combining frailty and cognitive impairment, may be a risk factor for LLD and vice versa, and a construct of depressive frailty linking physical frailty and LLD may be a good dementia predictor. Frailty assessment may enable clinicians to better target the pharmacological and psychological treatment of LLD. Given the epidemiological links of biopsychosocial frailty with dementia and MCI, multidomain interventions might contribute to delay the onset of late-life cognitive disorders and other adverse health-related outcomes, such as institutionalization, more frequent hospitalization, disability, and mortality.
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Affiliation(s)
- Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vittorio Dibello
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical 14 College, Fudan University, Shanghai, China
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
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Drinčić T, van Dalfsen JH, Kamphuis J, Jentsch MC, van Belkum SM, Meddens MJM, Penninx BWJH, Schoevers RA. The Relationship between Insomnia and the Pathophysiology of Major Depressive Disorder: An Evaluation of a Broad Selection of Serum and Urine Biomarkers. Int J Mol Sci 2023; 24:ijms24098437. [PMID: 37176140 PMCID: PMC10179282 DOI: 10.3390/ijms24098437] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/20/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Insomnia exhibits a clinically relevant relationship with major depressive disorder (MDD). Increasing evidence suggests that insomnia is associated with neurobiological alterations that resemble the pathophysiology of MDD. However, research in a clinical population is limited. The present study, therefore, aimed to investigate the relationship between insomnia and the main pathophysiological mechanisms of MDD in a clinical sample of individuals with MDD. Data were extracted from three cohorts (N = 227) and included an evaluation of depression severity (Quick Inventory of Depressive Symptomatology, QIDS-SR16) and insomnia severity (QIDS-SR16 insomnia items) as well as serum and urine assessments of 24 immunologic (e.g., tumour necrosis factor α receptor 2 and calprotectin), neurotrophic (e.g., brain-derived neurotrophic factor and epidermal growth factor), neuroendocrine (e.g., cortisol and aldosterone), neuropeptide (i.e., substance P), and metabolic (e.g., leptin and acetyl-L-carnitine) biomarkers. Linear regression analyses evaluating the association between insomnia severity and biomarker levels were conducted with and without controlling for depression severity (M = 17.32), antidepressant use (18.9%), gender (59.0% female; 40.5% male), age (M = 42.04), and the cohort of origin. The results demonstrated no significant associations between insomnia severity and biomarker levels. In conclusion, for the included biomarkers, current findings reveal no contribution of insomnia to the clinical pathophysiology of MDD.
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Affiliation(s)
- Tina Drinčić
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
| | - Jens H van Dalfsen
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
| | - Jeanine Kamphuis
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
| | - Mike C Jentsch
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
| | - Sjoerd M van Belkum
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
| | | | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam University Medical Centre (VUmc), De Boelelaan 1118, 1081 HZ Amsterdam, The Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, University Medical Centre Groningen, Hanzeplein 1, 9713 RB Groningen, The Netherlands
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5
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Chronically dysregulated corticosterone impairs dopaminergic transmission in the dorsomedial striatum by sex-divergent mechanisms. Neuropsychopharmacology 2023:10.1038/s41386-023-01551-1. [PMID: 36810463 PMCID: PMC10353992 DOI: 10.1038/s41386-023-01551-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 01/09/2023] [Accepted: 02/07/2023] [Indexed: 02/24/2023]
Abstract
Major depressive disorder (MDD) is a leading cause of disability worldwide. Individuals with MDD exhibit decreased motivation and deficits in reward processing. In a subset of MDD patients, chronic dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis occurs, resulting in increased levels of the 'stress hormone' cortisol during the normal rest period (i.e., evening and night). However, the mechanistic relationship between chronically elevated resting cortisol and behavioral deficits in motivation and reward processing remains unclear. Given that women are diagnosed with MDD at twice the rate of men, it is important to understand whether the mechanisms linking cortisol to the symptoms of MDD differ by sex. In this study, we used subcutaneous implants to chronically elevate free plasma corticosterone (the rodent homolog of cortisol; 'CORT') during the rest period in male and female mice and examined changes in behavior and dopamine system function. We found that chronic CORT treatment impaired motivated reward-seeking in both sexes. In female but not male mice, CORT treatment reduced dopamine content in the dorsomedial striatum (DMS). In male but not female mice, CORT treatment impaired the function of the dopamine transporter (DAT) in DMS. From these studies, we conclude that chronic CORT dysregulation impairs motivation by impairing dopaminergic transmission in the DMS, but via different mechanisms in male and female mice. A better understanding of these sex-specific mechanisms could lead to new directions in MDD diagnosis and treatment.
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6
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Immune-endocrine biomarkers associated with mental health: A 9-year longitudinal investigation from the Hertfordshire Ageing Study. Brain Behav Immun 2022; 101:146-152. [PMID: 34973397 DOI: 10.1016/j.bbi.2021.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/14/2021] [Accepted: 12/25/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The study of neural-endocrine-immune system interactions has led to substantial advances in our understanding of neuropsychiatric disorders. Growing evidence reveals the pivotal roles of inflammatory cytokines signalling the brain to produce neurochemical, neuroendocrine, and neuroimmune changes which affect mood and behaviour. Ageing is accompanied by the development of low-grade systemic inflammation which may promote changes in the neural systems predisposing to geriatric depression via the hypothalamic-pituitary-adrenal (HPA) axis. The aim of this study was to investigate the longitudinal associations between baseline values and conditional changes (independent of baseline) in immune-endocrine biomarkers and mental health status in a population-based cohort of older adults. METHODS Data from 347 subjects (200 men, 147 women) who participated in the Hertfordshire Ageing Study at baseline (1994/5, mean age 67.3 years) and at 9-year follow-up were analysed. Serum samples for analysis of inflammatory and endocrinological measures were collected at baseline and follow-up. At follow-up, depression (Hospital Anxiety and Depression Scale) and mental health (Short Form-36 questionnaire) were assessed. Baseline values and changes in biomarkers in relation to risk of high depression scores (top sex-specific third) and low mental health scores (bottom sex-specific third) were examined using logistic regression. RESULTS Lower baseline cortisol was related to greater risk of high depression scores; higher baseline cortisol: dehydroepiandrosterone sulphate ratio (men only) and higher baseline C-reactive protein (CRP) (women only) were related to greater risk of poor mental health scores. In addition, greater decline in cortisol was related to increased risk of high depression scores among men. These relationships were robust (p < 0.05) after controlling for sex, age, BMI, smoking, alcohol consumption and number of systems medicated. CONCLUSION This study provides further evidence of the role of the HPA axis and inflammation in older adults with poor mental health. In addition, the findings highlight sex differences where increased inflammation in women and declines in cortisol in men were linked to poorer mental health. Further research is warranted to confirm these findings. This could lead to the search for potential biomarkers to stratify medications as well as developing novel intervention targets to improve mental health at older age.
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Beserra A, Oliveira B, Portugal E, Dutra P, Laks J, Deslandes A, Moraes H. Cortisol Reactivity to a physical stressor in Patients with Depression and Alzheimer's disease. Dement Neuropsychol 2022; 16:61-68. [PMID: 35719259 PMCID: PMC9170255 DOI: 10.1590/1980-5764-dn-2021-0066] [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: 06/30/2021] [Revised: 08/21/2021] [Accepted: 09/16/2021] [Indexed: 11/29/2022] Open
Abstract
Some prevalent mental disorders in the elderly, such as Alzheimer's disease (AD) and major depression disorder (MDD), are associated with chronic stress and consequently with possible dysregulation of hypothalamic–pituitary–adrenal (HPA) axis and cortisol levels in basal conditions or in the reactivity of an acute stressor. However, evidence of cortisol behavior after a physical stressor in patients with AD and MDD is scarce.
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Affiliation(s)
- Ana Beserra
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil
| | - Bruno Oliveira
- Universidade Federal Rural do Rio de Janeiro, Departamento de Educação Física e Esportes, Rio de Janeiro RJ, Brazil
| | - Eduardo Portugal
- Universidade Federal do Rio de Janeiro, Laboratório de Fisiologia do Exercício, Rio de Janeiro RJ, Brazil
| | - Patrícia Dutra
- Universidade do Estado do Rio de Janeiro, Laboratório de Imunofisiologia do Exercício, Rio de Janeiro RJ, Brazil
| | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade do Grande Rio, Programa de Biomedicina Translacional, Rio de Janeiro RJ, Brazil
| | - Andrea Deslandes
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil
| | - Helena Moraes
- Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brazil.,Universidade Federal do Rio de Janeiro, Laboratório de Fisiologia do Exercício, Rio de Janeiro RJ, Brazil
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FKBP5 and early life stress affect the hippocampus by an age-dependent mechanism. Brain Behav Immun Health 2021; 9:100143. [PMID: 34589890 PMCID: PMC8474669 DOI: 10.1016/j.bbih.2020.100143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 01/30/2023] Open
Abstract
Early life stress (ELS) adversely affects the brain and is commonly associated with the etiology of mental health disorders, like depression. In addition to the mood-related symptoms, patients with depression show dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, increased peripheral inflammation, and structural brain alterations. Although the underlying causes are unknown, polymorphisms in the FK506-binding protein 5 (FKBP5) gene, a regulator of glucocorticoid receptor (GR) activity, interact with childhood adversities to increase vulnerability to depressive disorders. We hypothesized that high FKBP5 protein levels combined with early life stress (ELS) would alter the HPA axis and brain, promoting depressive-like behaviors. To test this, we exposed males and females of a mouse model overexpressing FKBP5 in the brain (rTgFKBP5 mice), or littermate controls, to maternal separation for 14 days after birth. Then, we evaluated neuroendocrine, behavioral, and brain changes in young adult and aged mice. We observed lower basal corticosterone (CORT) levels in rTgFKBP5 mice, which was exacerbated in females. Aged, but not young, rTgFKBP5 mice showed increased depressive-like behaviors. Moreover, FKBP5 overexpression reduced hippocampal neuron density in aged mice, while promoting markers of microglia expression, but these effects were reversed by ELS. Together, these results demonstrate that high FKBP5 affects basal CORT levels, depressive-like symptoms, and numbers of neurons and microglia in the hippocampus in an age-dependent manner. High FKBP5 reduces basal corticosterone levels in mice, especially in females. ELS prevents FKBP5-induced susceptibility to depressive-like behavior in aged mice. FKBP5 overexpression reduces hippocampal neuron density in aged mice, while increasing microglial markers.
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Galvão ACDM, Almeida RN, de Sousa Júnior GM, Leocadio-Miguel MA, Palhano-Fontes F, de Araujo DB, Lobão-Soares B, Maia-de-Oliveira JP, Nunes EA, Hallak JEC, Sarris J, Galvão-Coelho NL. Potential biomarkers of major depression diagnosis and chronicity. PLoS One 2021; 16:e0257251. [PMID: 34587177 PMCID: PMC8480905 DOI: 10.1371/journal.pone.0257251] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/26/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Molecular biomarkers are promising tools to be routinely used in clinical psychiatry. Among psychiatric diseases, major depression disorder (MDD) has gotten attention due to its growing prevalence and morbidity. METHODS We tested some peripheral molecular parameters such as serum mature Brain-Derived Neurotrophic Factor (mBDNF), plasma C-Reactive Protein (CRP), serum cortisol (SC), and the salivary Cortisol Awakening Response (CAR), as well as the Pittsburgh sleep quality inventory (PSQI), as part of a multibiomarker panel for potential use in MDD diagnosis and evaluation of disease's chronicity using regression models, and ROC curve. RESULTS For diagnosis model, two groups were analyzed: patients in the first episode of major depression (MD: n = 30) and a healthy control (CG: n = 32). None of those diagnosis models tested had greater power than Hamilton Depression Rating Scale-6. For MDD chronicity, a group of patients with treatment-resistant major depression (TRD: n = 28) was tested across the MD group. The best chronicity model (p < 0.05) that discriminated between MD and TRD included four parameters, namely PSQI, CAR, SC, and mBDNF (AUC ROC = 0.99), with 96% of sensitivity and 93% of specificity. CONCLUSION These results indicate that changes in specific biomarkers (CAR, SC, mBDNF and PSQI) have potential on the evaluation of MDD chronicity, but not for its diagnosis. Therefore, these findings can contribute for further studies aiming the development of a stronger model to be commercially available and used in psychiatry clinical practice.
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Affiliation(s)
- Ana Cecília de Menezes Galvão
- Laboratory of Hormone Measurement, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Raíssa Nobrega Almeida
- Laboratory of Hormone Measurement, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Geovan Menezes de Sousa Júnior
- Laboratory of Hormone Measurement, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Mário André Leocadio-Miguel
- Laboratory of Hormone Measurement, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | | | | | - Bruno Lobão-Soares
- National Institute of Science and Technology in Translational Medicine, Ribeirao Preto, Brazil
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - João Paulo Maia-de-Oliveira
- National Institute of Science and Technology in Translational Medicine, Ribeirao Preto, Brazil
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Emerson Arcoverde Nunes
- National Institute of Science and Technology in Translational Medicine, Ribeirao Preto, Brazil
- Department of Psychiatry, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Jaime Eduardo Cecilio Hallak
- National Institute of Science and Technology in Translational Medicine, Ribeirao Preto, Brazil
- Department of Neurosciences and Behavior, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Professorial Unit, Department of Psychiatry, The Melbourne Clinic, University of Melbourne, Melbourne, Australia
| | - Nicole Leite Galvão-Coelho
- Laboratory of Hormone Measurement, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- National Institute of Science and Technology in Translational Medicine, Ribeirao Preto, Brazil
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
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de Menezes Galvão AC, Almeida RN, de Sousa GM, Leocadio-Miguel MA, Palhano-Fontes F, de Araujo DB, Lobão-Soares B, Maia-de-Oliveira JP, Nunes EA, Hallak JEC, Schuch FB, Sarris J, Galvão-Coelho NL. Pathophysiology of Major Depression by Clinical Stages. Front Psychol 2021; 12:641779. [PMID: 34421705 PMCID: PMC8374436 DOI: 10.3389/fpsyg.2021.641779] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/23/2021] [Indexed: 01/01/2023] Open
Abstract
The comprehension of the pathophysiology of the major depressive disorder (MDD) is essential to the strengthening of precision psychiatry. In order to determine the relationship between the pathophysiology of the MDD and its clinical progression, analyzed by severity of the depressive symptoms and sleep quality, we conducted a study assessing different peripheral molecular biomarkers, including the levels of plasma C-reactive protein (CRP), serum mature brain-derived neurotrophic factor (mBDNF), serum cortisol (SC), and salivary cortisol awakening response (CAR), of patients with MDD (n = 58) and a control group of healthy volunteers (n = 62). Patients with the first episode of MDD (n = 30) had significantly higher levels of CAR and SC than controls (n = 32) and similar levels of mBDNF of controls. Patients with treatment-resistant depression (TRD, n = 28) presented significantly lower levels of SC and CAR, and higher levels of mBDNF and CRP than controls (n = 30). An increased severity of depressive symptoms and worse sleep quality were correlated with levels low of SC and CAR, and with high levels of mBDNF. These results point out a strong relationship between the stages clinical of MDD and changes in a range of relevant biological markers. This can assist in the development of precision psychiatry and future research on the biological tests for depression.
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Affiliation(s)
- Ana Cecília de Menezes Galvão
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raíssa Nobrega Almeida
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Geovan Menezes de Sousa
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Mario André Leocadio-Miguel
- Laboratory of Neurobiology and Biological Rhythms, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Bruno Lobão-Soares
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - João Paulo Maia-de-Oliveira
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Emerson Arcoverde Nunes
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Psychiatry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Jaime Eduardo Cecilio Hallak
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Nicole Leite Galvão-Coelho
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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Mills JG, Larkin TA, Deng C, Thomas SJ. Cortisol in relation to problematic eating behaviours, adiposity and symptom profiles in Major Depressive Disorder. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2021; 7:100067. [PMID: 35757061 PMCID: PMC9216397 DOI: 10.1016/j.cpnec.2021.100067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/25/2021] [Accepted: 06/14/2021] [Indexed: 11/06/2022] Open
Abstract
Aims Major Depressive Disorder (MDD) is associated with an increased risk of chronic disease related to weight gain, problematic eating behaviours and neuroendocrine changes. MDD is frequently associated with altered hypothalamic-pituitary-adrenal axis activity and cortisol secretion, where cortisol has been implicated in regulating energy balance, food intake and depressogenic weight changes. However, little research has examined the relationships between cortisol, adiposity and depressogenic problematic eating behaviours. Method Plasma cortisol concentrations were compared between 37 participants with MDD reporting appetite/weight loss, 43 participants with MDD reporting appetite/weight gain, and 60 healthy controls, by sex. Associations between cortisol, indices of adiposity and problematic eating behaviours were then assessed after accounting for demographic variables and depressive symptoms. Depressive symptoms were assessed using the Depression subscale of the Depression, Anxiety and Stress Scale, and eating behaviours with the Dutch Eating Behaviours Questionnaire and Yale Food Addiction Scale. Results Participants with MDD reporting appetite/weight loss had higher cortisol compared to controls, and marginally higher cortisol than those with MDD reporting appetite/weight gain. Cortisol negatively and significantly accounted for unique variance in body mass index and waist circumference after accounting for variance associated with age, sex and depressive symptoms, however it was not a significant predictor of problematic eating behaviours, such as emotional eating or food addiction. Cortisol concentrations did not differ between sexes. Conclusion The results indicate that cortisol is related to lower indices of adiposity and depressogenic symptoms of appetite/weight loss but is not related to problematic eating behaviours and appetite increases in MDD. These findings provide further evidence that the melancholic and atypical subtypes of MDD are associated with differential neuroendocrine and anthropometric indices, as well as behavioural and symptom profiles. Further research investigating the temporal nature of the identified relationships may assist in facilitating the development of improved interventions for individuals affected by weight changes in MDD. Appetite changes, adiposity and problematic eating in Major Depressive Disorder (MDD) were examined relative to cortisol. Cortisol was higher in those with MDD with decreased/unchanged appetite/weight than controls, and marginally higher than those with MDD with increased appetite/weight. Cortisol was a negative predictor of indices of adiposity, but was not associated with problematic eating. Cortisol may be more relevant to melancholic compared to atypical MDD, supporting differential neuroendocrine and behavioural symptom profiles between depressogenic subtypes.
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12
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Romijn M, van Tilburg LJL, Hollanders JJ, van der Voorn B, de Goede P, Dolman KM, Heijboer AC, Broekman BFP, Rotteveel J, Finken MJJ. The Association between Maternal Stress and Glucocorticoid Rhythmicity in Human Milk. Nutrients 2021; 13:nu13051608. [PMID: 34064929 PMCID: PMC8151700 DOI: 10.3390/nu13051608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Chronic stress is often accompanied by alterations in the diurnal rhythm of hypothalamus–pituitary–adrenal activity. However, there are limited data on the diurnal rhythmicity of breast milk glucocorticoids (GCs) among women with psychological distress. We compared mothers who sought consultation at an expertise center for pregnant women with an increased risk of psychological distress with control mothers for GC diurnal rhythmicity in milk and saliva obtained at the same time. Methods: We included 19 mothers who sought consultation at the psychiatry–obstetric–pediatric (POP) outpatient clinic and 44 control mothers. One month postpartum, mothers collected on average eight paired milk and saliva samples during a 24 h period. GC levels were measured using liquid chromatography–tandem mass spectrometry. GC rhythmicity parameters were determined with specialized software. Results: For both milk and saliva, no group differences regarding GC rhythms were found. Milk cortisol area under the curve with respect to the ground was lower in the POP group than in the control group (p = 0.02). GC levels in human milk and saliva were highly correlated within each group (p < 0.001). Conclusion: Although there were no differences between groups in GC rhythmicity, the total amount of milk cortisol was lower in the POP group. Long-term follow-up is needed to address the impact of vertical transmission of breast milk GCs.
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Affiliation(s)
- Michelle Romijn
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-(0)20-444-3137
| | - Luca J. L. van Tilburg
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Jonneke J. Hollanders
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Bibian van der Voorn
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Paul de Goede
- Laboratory of Endocrinology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, 1105 AZ Amsterdam, The Netherlands;
| | - Koert M. Dolman
- Department of Pediatrics, Onze Lieve Vrouwe Gasthuis (OLVG), 1006 AE Amsterdam, The Netherlands;
| | - Annemieke C. Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Birit F. P. Broekman
- Department of Psychiatry, VU University Medical Centre, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Joost Rotteveel
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Martijn J. J. Finken
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
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13
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Wu J, Tong H, Liu Z, Tao J, Chen L, Chan CCH, Lee TMC. Neurobiological effects of perceived stress are different between adolescents and middle-aged adults. Brain Imaging Behav 2021; 15:846-854. [PMID: 32737826 PMCID: PMC8032601 DOI: 10.1007/s11682-020-00294-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Stress is an inevitable element of everyday living. Developmental studies suggested that adolescents are more vulnerable and sensitive to the effect of stress due to their developing brains, especially in areas related to stress perception and processing. This voxel-based morphometry study examined the association between various neurobiological markers and the level of perceived stress experienced by adolescents (n = 26) and middle-aged adults (n = 26). Our findings indicated that differences existed in the relationships between perceived stress and the structural volume of the orbitofrontal cortex (OFC) extending to the insula and amygdala. Specifically, the levels of perceived stress and the grey matter volume of the orbitofrontal cortex, the insula, and the amygdala were positively related in adolescents but negatively related for adults. Furthermore, a significant negative correlation between perceived stress and cortisol levels was observed in adults, whereas the relationship between perceived stress and cortisol levels was not significant for adolescents. Perceived stress measurement may be better than cortisol levels in terms of reflecting the emotional states of adolescents. In sum, the relationships between perceived stress and neurobiological markers were different between adolescents and middle-aged adults and thus appeared to be age dependent.
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Affiliation(s)
- Jingsong Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Horace Tong
- Brain Hospital, Guangzhou Medical University, Guangzhou, China.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.,Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Zhongwan Liu
- Brain Hospital, Guangzhou Medical University, Guangzhou, China.,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China.,Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Chetwyn C H Chan
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
| | - Tatia M C Lee
- Brain Hospital, Guangzhou Medical University, Guangzhou, China. .,State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China. .,Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China.
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14
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Arinami H, Suzuki Y, Tajiri M, Tsuneyama N, Someya T. Role of insulin-like growth factor 1, sex and corticosteroid hormones in male major depressive disorder. BMC Psychiatry 2021; 21:157. [PMID: 33731067 PMCID: PMC7967945 DOI: 10.1186/s12888-021-03116-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/10/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hormones of the hypothalamic-pituitary-gonadal (HPG), hypothalamic-pituitary-adrenal (HPA), and hypothalamic-pituitary-somatotropic (HPS) axes are potentially involved in major depressive disorder (MDD), but these hormones have not been simultaneously investigated in male patients with MDD. We investigated the association between male MDD symptoms and estradiol, testosterone, cortisol, dehydroepiandrosterone sulfate (DHEAS), and insulin-like growth factor 1 (IGF1). METHODS Serum estradiol, testosterone, cortisol, DHEAS, and IGF1 levels were measured in 54 male patients with MDD and 37 male controls and were compared with clinical factors. We investigated the associations between hormone levels and Hamilton Depression Rating Scale (HAM-D) scores. The correlations among hormones were also investigated. RESULTS Patients had significantly lower estradiol levels than controls (22.4 ± 8.4 pg/mL vs. 26.1 ± 8.5 pg/mL, P = 0.040). Serum estradiol levels were negatively correlated with HAM-D scores (P = 0.000094) and positively correlated with Global Assessment of Functioning scores (P = 0.000299). IGF1 levels and the cortisol:DHEAS ratio were higher in patients than in controls (IGF1: 171.5 ± 61.8 ng/mL vs. 144.1 ± 39.2 ng/mL, P = 0.011; cortisol:DHEAS ratio: 0.07 ± 0.05 vs. 0.04 ± 0.02, P = 0.001). DHEAS levels were lower in patients than in controls (227.9 ± 108.4 μg/dL vs. 307.4 ± 131.2 μg/dL, P = 0.002). IGF1, cortisol:DHEAS ratio, and DHEAS were not significantly correlated with HAM-D scores. Cortisol and testosterone levels were not significantly different between patients and controls. Serum estradiol levels were positively correlated with DHEAS levels (P = 0.00062) in patients, but were not significantly correlated with DHEAS levels in controls. CONCLUSION Estradiol may affect the pathogenesis and severity of patients with MDD in men, and other hormones, such as those in the HPA and HPS axes, may also be involved in male MDD. Additionally, a correlation between estradiol and DHEAS may affect the pathology of MDD in men.
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Affiliation(s)
- Hiroshi Arinami
- grid.260975.f0000 0001 0671 5144Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Yutaro Suzuki
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Misuzu Tajiri
- grid.260975.f0000 0001 0671 5144Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Nobuto Tsuneyama
- grid.260975.f0000 0001 0671 5144Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
| | - Toshiyuki Someya
- grid.260975.f0000 0001 0671 5144Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, 951-8510 Japan
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15
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Biopsychosocial correlates of psychological distress in Latina mothers. J Affect Disord 2021; 282:617-626. [PMID: 33445084 PMCID: PMC7889736 DOI: 10.1016/j.jad.2020.12.193] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Few studies have explored the relationship between psychological, psychosocial and biological factors among Latinas. An integrated understanding of how these factors associate with psychological distress is necessary for the development of culturally relevant screening tools and interventions. The study aim was to examine the relationships among (a) psychological distress symptoms, (b) psychosocial factors (discrimination, acculturation, acculturative stress, economic hardship), and (c) biological (DNA methylation of stress-related genes) factors among Latinas during pregnancy and postpartum period. METHODS A sample of 150 pregnant Latinas completed the Inventory of Depression and Anxiety Symptoms II (IDAS-II), psychosocial questionnaires (discrimination, acculturation, acculturative stress, economic hardship) before (24-32 weeks) and after gestation (4-6 weeks postpartum). Blood samples were collected between 24-32 weeks gestation. Correlations were determined between psychosocial and biological measures and psychological distress measures. Multivariable linear regression models were conducted to assess the relationships between IDAS and stressors. RESULTS Several correlations among psychosocial measures,DNA methylation factors and IDAS-II variables were identified. Among the psychosocial measures, everyday discrimination was the most strongly and consistently associated with IDAS-II. DNA methylation of NR3C1 affects the associations between psychological and psychosocial distress. LIMITATIONS We only assessed DNA methylation during pregnancy and focused on four HPA-related genes. Longitudinal assessment of DNA methylation and genome-wide analysis can provide a better picture of the role of methylation in psychological distress. CONCLUSIONS This work may assist clinicians and policy makers in effectively recognizing and preventing maternal mental health disparities based on discrimination and other psychosocial stressors in at-risk groups.
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16
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Liu H, Li D, Zhao X, Fang B, Zhang Q, Li T. Longitudinal Impact of Frailty States and Sleep Duration on Subsequent Depressive Symptoms of Older Adults. J Am Geriatr Soc 2021; 69:1003-1011. [PMID: 33533055 DOI: 10.1111/jgs.16999] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To determine the effects of baseline and changes in frailty states on subsequent depressive symptoms, and whether sleep duration would modify these effects. DESIGN Prospective, cohort study. SETTING The 2011 baseline and 2013 follow-up waves of the China Health and Retirement Longitudinal Study (CHARLS). PARTICIPANTS Community-dwelling old adults who were aged 60 or above at baseline and participated in the 2011 and 2013 waves of the CHARLS (N = 5,026). MEASUREMENTS Frailty was measured using the physical frailty phenotype (PFP) scale. Levels of depressive symptoms were measured by the 10-item Center for Epidemiologic Studies Depression Scale (CES-D). Using the generalized estimating equations (GEE), the effects of baseline and transitions in frailty states were examined on subsequent depressive symptoms, adjusting for a range of confounding variables. RESULTS Baseline prefrail (b = 0.97, P < .05) and frail states (b = 0.35, P < .05) were associated with higher subsequent level of depressive symptoms 2 years later. Within individuals who were robust at baseline, transitioning into prefrail/frail (b = 3.04, P < .001) was associated with a higher subsequent level of depressive symptoms, and this association was accelerated by short sleep duration. Within individuals who were prefrail at baseline, transitioning into frail (b = 1.76, P < .001) was associated with higher subsequent levels of depressive symptoms, and this association was stronger among those who reported short sleep duration. CONCLUSION Baseline and transitions in frailty states were significantly related with higher subsequent levels of subsequent depressive symptoms. Short sleep duration significantly moderated the effects of baseline or transitions of frailty on subsequent depressive symptoms. Targeted interventions could be implemented to improve sleep quality for prefrail and frail older adults.
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Affiliation(s)
- Huiying Liu
- Department of Sociology, Central South University, Changsha, China
| | - Danyu Li
- Social Survey and Opinion Research Centre, Central South University, Changsha, China
| | - Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Boye Fang
- School of Sociology & Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Tingyu Li
- Social Survey and Opinion Research Centre, Central South University, Changsha, China
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Dwyer JB, Aftab A, Radhakrishnan R, Widge A, Rodriguez CI, Carpenter LL, Nemeroff CB, McDonald WM, Kalin NH. Hormonal Treatments for Major Depressive Disorder: State of the Art. Am J Psychiatry 2020; 177:686-705. [PMID: 32456504 PMCID: PMC7841732 DOI: 10.1176/appi.ajp.2020.19080848] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Major depressive disorder is a common psychiatric disorder associated with marked suffering, morbidity, mortality, and cost. The World Health Organization projects that by 2030, major depression will be the leading cause of disease burden worldwide. While numerous treatments for major depression exist, many patients do not respond adequately to traditional antidepressants. Thus, more effective treatments for major depression are needed, and targeting certain hormonal systems is a conceptually based approach that has shown promise in the treatment of this disorder. A number of hormones and hormone-manipulating compounds have been evaluated as monotherapies or adjunctive treatments for major depression, with therapeutic actions attributable not only to the modulation of endocrine systems in the periphery but also to the CNS effects of hormones on non-endocrine brain circuitry. The authors describe the physiology of the hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary thyroid (HPT), and hypothalamic-pituitary-gonadal (HPG) axes and review the evidence for selected hormone-based interventions for the treatment of depression in order to provide an update on the state of this field for clinicians and researchers. The review focuses on the HPA axis-based interventions of corticotropin-releasing factor antagonists and the glucocorticoid receptor antagonist mifepristone, the HPT axis-based treatments of thyroid hormones (T3 and T4), and the HPG axis-based treatments of estrogen replacement therapy, the progesterone derivative allopregnanolone, and testosterone. While some treatments have largely failed to translate from preclinical studies, others have shown promising initial results and represent active fields of study in the search for novel effective treatments for major depression.
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Affiliation(s)
| | | | | | - Alik Widge
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis
| | - Carolyn I. Rodriguez
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and VA Palo Alto Health Care System, Palo Alto, Calif
| | - Linda L. Carpenter
- Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I
| | | | - William M. McDonald
- Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta
| | - Ned H. Kalin
- Department of Psychiatry, University of Wisconsin–Madison
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- Child Study Center and Department of Radiology and Biomedical Imaging, Yale University, New Haven, Conn. (Dwyer); Department of Psychiatry, Case Western Reserve University, Cleveland, and Northcoast Behavioral Healthcare Hospital, Northfield, Ohio (Aftab); Yale School of Medicine, New Haven, Conn. (Radhakrishnan); Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis (Widge); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, Calif., and VA Palo Alto Health Care System, Palo Alto, Calif. (Rodriguez); Department of Psychiatry and Human Behavior, Butler Hospital, Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Texas at Austin (Nemeroff); Department of Psychiatry and Human Behavior, Emory University School of Medicine, Atlanta (McDonald); and Department of Psychiatry, University of Wisconsin-Madison (Kalin)
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18
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Gerber M, Imboden C, Beck J, Brand S, Colledge F, Eckert A, Holsboer-Trachsler E, Pühse U, Hatzinger M. Effects of Aerobic Exercise on Cortisol Stress Reactivity in Response to the Trier Social Stress Test in Inpatients with Major Depressive Disorders: A Randomized Controlled Trial. J Clin Med 2020; 9:E1419. [PMID: 32403243 PMCID: PMC7291068 DOI: 10.3390/jcm9051419] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/30/2020] [Accepted: 05/05/2020] [Indexed: 12/01/2022] Open
Abstract
Physical activity is associated with a favourable (blunted) cortisol stress reactivity in healthy people. However, evidence from experimental study and with psychiatric patients is missing. This study examines whether exercise training impacts on cortisol stress reactivity in inpatients with major depressive disorder (MDD). These new insights are important because the stress reactivity of healthy people and patients with severe symptoms of depression might differ. Methods: The study was designed as a randomized controlled trial (trial registration number: NCT02679053). In total, 25 patients (13 women, 12 men, mean age: 38.1 12.0 years) completed a laboratory stressor task before and after a six-week intervention period. Nine samples of salivary free cortisol were taken before and after the Trier social stress test (TSST). Fourteen participants took part in six weeks of aerobic exercise training, while 11 patients were allocated to the control condition. While the primary outcome of the study was depressive symptom severity, the focus of this paper is on one of the secondary outcomes (cortisol reactivity during the TSST). The impact of aerobic exercise training was examined with a repeated-measures analysis of variance. We also examined the association between change in depression and cortisol response via correlational analysis. Cortisol reactivity did not change from baseline to post-intervention, either in the intervention or the control group. Participation in six weeks of aerobic exercise training was not associated with participants' cortisol reactivity. Moreover, depressive symptom change was not associated with change in cortisol response. Aerobic exercise training was not associated with patients' stress reactivity in this study. Because many patients initially showed a relatively flat/blunted cortisol response curve, efforts might be needed to find out which treatments are most efficient to promote a normalization of HPA axis reactivity.
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Affiliation(s)
- Markus Gerber
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Christian Imboden
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
- Private Clinic Wyss, 3053 Muenchenbuchsee, Switzerland
| | | | - Serge Brand
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
- Substance Abuse Prevention Research Center and Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran
| | - Flora Colledge
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Anne Eckert
- University Psychiatric Clinics (UPK), Neurobiology Laboratory for Brain Aging and Mental Health, University of Basel, 4002 Basel, Switzerland;
| | - Edith Holsboer-Trachsler
- University Psychiatric Clinics (UPK), Center for Affective, Stress and Sleep Disorders, University of Basel, 4002 Basel, Switzerland;
| | - Uwe Pühse
- Sport Science Section, Department of Sport, Exercise and Health, University of Basel, CH-4052 Basel, Switzerland; (S.B.); (F.C.); (U.P.)
| | - Martin Hatzinger
- Psychiatric Services Solothurn, 4503 Solothurn, Switzerland; (C.I.); (M.H.)
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19
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Muscatello RA, Andujar J, Taylor JL, Corbett BA. Exploring Key Physiological System Profiles at Rest and the Association with Depressive Symptoms in Autism Spectrum Disorder. J Autism Dev Disord 2020; 51:15-29. [PMID: 32350791 DOI: 10.1007/s10803-020-04516-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Depression is often associated with dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). Individuals with autism spectrum disorder (ASD) may experience physiological dysregulation and psychological comorbidities; however, the extent to which the interactions between these systems predict internalizing symptoms in ASD has not been investigated. The study examined interactions with the HPA axis and ANS in 10-13-year-old children with ASD (n = 41) and typical development (TD; n = 46). The interrelated systems uniquely contributed to depressive symptoms in ASD above and beyond any system in isolation. A reciprocal, parasympathetic-dominant ANS was related to fewer affective symptoms in ASD. Findings highlight the importance of examining arousal across multiple systems to more precisely identify profiles associated with maladaptive psychiatric outcomes in ASD.
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Affiliation(s)
- Rachael A Muscatello
- Vanderbilt Brain Institute, Neuroscience Graduate Program, 1500 21st Avenue S., Nashville, TN, 37212, USA.
| | - Justin Andujar
- Vanderbilt University, Nashville, TN, USA.,Department of Genetic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Julie L Taylor
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.,Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Blythe A Corbett
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Psychology, Vanderbilt University, Nashville, TN, USA
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20
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Santiago GTP, de Menezes Galvão AC, de Almeida RN, Mota-Rolim SA, Palhano-Fontes F, Maia-de-Oliveira JP, de Araújo DB, Lobão-Soares B, Galvão-Coelho NL. Changes in Cortisol but Not in Brain-Derived Neurotrophic Factor Modulate the Association Between Sleep Disturbances and Major Depression. Front Behav Neurosci 2020; 14:44. [PMID: 32410966 PMCID: PMC7199815 DOI: 10.3389/fnbeh.2020.00044] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 03/13/2020] [Indexed: 12/18/2022] Open
Abstract
Sleep disturbance is a symptom consistently found in major depression and is associated with a longer course of illness, reduced response to treatment, increased risk of relapse and recurrence. Chronic insomnia has been associated with changes in cortisol and serum brain-derived neurotrophic factor (BDNF) levels, which in turn are also changed in major depression. Here, we evaluated the relationship between sleep quality, salivary cortisol awakening response (CAR), and serum BDNF levels in patients with sleep disturbance and treatment-resistant major depression (n = 18), and in a control group of healthy subjects with good (n = 21) and poor (n = 18) sleep quality. We observed that the patients had the lowest CAR and sleep duration of all three groups and a higher latency to sleep than the healthy volunteers with a good sleep profile. Besides, low CAR was correlated with more severe depressive symptoms and worse sleep quality. There was no difference in serum BDNF levels between groups with distinct sleep quality. Taken together, our results showed a relationship between changes in CAR and in sleep quality in patients with treatment-resistant depression, which were correlated with the severity of disease, suggesting that cortisol could be a physiological link between sleep disturbance and major depression.
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Affiliation(s)
| | - Ana Cecília de Menezes Galvão
- Laboratory of Hormonal Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raíssa Nóbrega de Almeida
- Laboratory of Hormonal Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Sergio Arthuro Mota-Rolim
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - João Paulo Maia-de-Oliveira
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Dráulio Barros de Araújo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Bruno Lobão-Soares
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Nicole Leite Galvão-Coelho
- Laboratory of Hormonal Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
- National Science and Technology Institute for Translational Medicine (INCT-TM), Natal, Brazil
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21
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Figaro-Drumond FV, Pereira SC, Menezes IC, von Werne Baes C, Coeli-Lacchini FB, Oliveira-Paula GH, Cleare AJ, Young AH, Tanus-Santos JE, Juruena MF, Lacchini R. Association of 11β-hydroxysteroid dehydrogenase type1 (HSD11b1) gene polymorphisms with outcome of antidepressant therapy and suicide attempts. Behav Brain Res 2020; 381:112343. [PMID: 31704233 DOI: 10.1016/j.bbr.2019.112343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/16/2019] [Accepted: 11/04/2019] [Indexed: 02/08/2023]
Abstract
The hypothalamic-pituitary-adrenal axis has been implicated in the pathophysiology of depressive disorders. HSD11B1 encodes 11β-hydroxysteroid dehydrogenase type1 enzyme, responsible for converting cortisone to cortisol. Genetic polymorphisms in HSD11B1 may impact in depression outcome and risk of suicide. This study aimed to assess whether HSD11B1 genotypes and haplotypes are associated with depression risk, severity of symptoms and suicidal attempts, considering early-life stress as an environmental factor. Here, 142 depressive patients and 103 healthy controls were included. Patients were enrolled from the Affective Disorders ambulatory and day hospital units, both within the University General Hospital of Ribeirao Preto. All subjects were clinically assessed applying the Mini-PLUS International Neuropsychiatric Interview, followed by the 21-item GRID-Hamilton Depression Scale, Childhood Trauma Questionnaire and Beck Scale for Suicidal Ideation (BSI). All subjects underwent antecubital vein puncture to obtain blood for DNA extraction. Genotyping of rs11119328 and rs11811440 were performed using allele-specific oligonucleotide polymerase chain reaction. We found a significant association of rs11119328 variant genotypes with increased risk for at least one suicide attempt (OR: 7.10, p = 0.049) and an association of variant genotypes of rs11811440 with euthymic mood under optimized pharmacological treatment (OR: 0.05, P = 0.014). These tests included correction for confounding factors. The association of genetic markers with depression risk, GRID-HAM-D21 and BSI scores and the number of suicidal attempts were nonsignificant. Haplotypes combining both markers were not associated with the studied phenotypes. We conclude that HSD11B1 polymorphisms may be relevant biomarkers for detecting subjects genetically vulnerable to poorer antidepressant response and higher risk of suicide attempts.
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Affiliation(s)
- Fernanda Viana Figaro-Drumond
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, Brazil
| | - Sherliane Carla Pereira
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Itiana Castro Menezes
- Department of Neuroscience and Behavior, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Cristiane von Werne Baes
- Department of Neuroscience and Behavior, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Fernanda Borchers Coeli-Lacchini
- Department of Clinical Analyses, Toxicology and Food Science, School of Pharmaceutical Sciences of Ribeirão Preto, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Anthony J Cleare
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Jose Eduardo Tanus-Santos
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Mario F Juruena
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, United Kingdom
| | - Riccardo Lacchini
- Department of Psychiatric Nursing and Human Sciences, Ribeirao Preto College of Nursing, University of Sao Paulo, Brazil.
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22
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Normann C, Buttenschøn HN. Gene-environment interactions between HPA-axis genes and childhood maltreatment in depression: a systematic review. Acta Neuropsychiatr 2020; 32:1-11. [PMID: 31902387 DOI: 10.1017/neu.2020.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Gene-environment (GxE) interactions may comprise an important part of the aetiology of depression, and childhood maltreatment (CM), a significant stressor, has consistently been linked to depression. Hence, in this systematic review, we aimed to investigate the interaction between hypothalamus-pituitary-adrenal axis (HPA-axis) genes and CM in depression. METHODS We conducted a literature search using the Pubmed, Embase, and PsychINFO databases in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. We included studies investigating GxE interactions between HPA-axis genes [Angiotensin Converting Enzyme (ACE), Arginine Vasopressin (AVP), Corticotrophin Releasing Hormone (CRH), Corticotrophin Releasing Hormone Receptor 1 (CRHR1), Corticotrophin Releasing Hormone Receptor 2 (CRHR2), FK506 binding protein (FKBP5), Nuclear Receptor subfamily 3 group C member 1 (NR3C1), Nuclear Receptor subfamily 3 group C member 2 (NR3C2)] and CM in depression. RESULTS The literature search identified 159 potentially relevant studies. Following screening, 138 of these were excluded. Thus, 21 studies, investigating a total of 51 single nucleotide polymorphisms, were included in the final study. The most prevalent genes in the current study were CRHR1 and FKBP5. Significant GxE interactions were reported in seven of eight studies for CRHR1:rs110402 and CM, and in five of eight studies for FKBP5:rs1360780 and CM. In summary, our results suggest possible GxE interactions between CRHR1, FKBP5, NR3C1, and NR3C2 and CM, respectively. For the remaining genes, no relevant literature emerged. CONCLUSIONS We find that genetic variation in four HPA-axis genes may influence the effects of CM in depression.
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Affiliation(s)
- Caroline Normann
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Henriette N Buttenschøn
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- NIDO Denmark, Research and Education in Health, Regional Hospital West Jutland, Herning, Denmark
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23
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Jain FA, Connolly CG, Reus VI, Meyerhoff DJ, Yang TT, Mellon SH, Mackin S, Hough CM, Morford A, Wolkowitz OM. Cortisol, moderated by age, is associated with antidepressant treatment outcome and memory improvement in Major Depressive Disorder: A retrospective analysis. Psychoneuroendocrinology 2019; 109:104386. [PMID: 31382170 PMCID: PMC6842706 DOI: 10.1016/j.psyneuen.2019.104386] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 07/20/2019] [Accepted: 07/22/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Studies testing the relationship between cortisol levels, depression, and antidepressant treatment response have yielded divergent results suggesting the possibility of moderators of a cortisol effect. Several studies indicate that age may moderate the relationship between cortisol and depression. In patients with Major Depressive Disorder (MDD), we studied the interactive effects of age and cortisol in association with MDD diagnostic status and mood and memory response to antidepressant treatment. METHODS Serum cortisol levels in 66 unmedicated patients with MDD and 75 matched healthy controls (HC) were measured at baseline and retrospectively analyzed. Logistic regression was used to determine an association of age, cortisol and their interaction with MDD diagnosis in the pooled sample of MDD and HC participants. Thirty-four of the MDD participants (age range: 19-65 years; median: 36) underwent treatment with a selective serotonin reuptake inhibitor (SSRl) for 8 weeks. Clinician and self-ratings of depression symptoms, as well as tests of verbal and visual delayed recall were obtained at baseline and post treatment. Moderation analyses determined the effect of age on the relationship between baseline cortisol and treatment outcome. RESULTS Cortisol, moderated by age, was associated with MDD diagnosis (p < .05), treatment-associated reduction of depression symptoms (p < .001) and improvement of delayed recall (p < .001). Modeling the Cortisol × Age interaction suggested that for participants below the median age of our sample, lower cortisol levels were associated with a lower rate of MDD diagnosis and higher antidepressant effects. On the contrary, in those above the median sample age, lower cortisol was associated with a higher rate of MDD and less improvement in depression symptoms and memory performance. CONCLUSIONS Our results add to the body of literature suggesting that age might be an important factor in moderating the relationship between peripheral cortisol levels, depression, cognition, and prognosis. These results indicate that previous disparities in the literature linking peripheral cortisol levels with depression characteristics and treatment response may critically relate, at least in part, to the age of the participants studied.
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Affiliation(s)
- Felipe A. Jain
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA,Corresponding Author: Felipe A. Jain, M.D, Present Address Depression Clinical and Research Program, Massachusetts General Hospital, One Bowdoin Square, 6 Floor, Boston, MA 02114, Phone: 617-643-4682, Fax: 617-724-3028,
| | - Colm G. Connolly
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Victor I. Reus
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Dieter J. Meyerhoff
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA,Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, 4150 Clement St, San Francisco, CA 94121, USA
| | - Tony T. Yang
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Synthia H. Mellon
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, 505 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Scott Mackin
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Christina M. Hough
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Alexandra Morford
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Owen M. Wolkowitz
- Weill Institute for Neurosciences, Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA
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24
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Kokras N, Hodes GE, Bangasser DA, Dalla C. Sex differences in the hypothalamic-pituitary-adrenal axis: An obstacle to antidepressant drug development? Br J Pharmacol 2019; 176:4090-4106. [PMID: 31093959 PMCID: PMC6877794 DOI: 10.1111/bph.14710] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 04/11/2019] [Accepted: 04/23/2019] [Indexed: 12/30/2022] Open
Abstract
Hypothalamic-pituitary-adrenal (HPA) axis dysfunction has long been implicated in the pathophysiology of depression, and HPA axis-based compounds have served as potential new therapeutic targets, but with no success. This review details sex differences from animal and human studies in the function of HPA axis elements (glucocorticoids, corticotropin releasing factor, and vasopressin) and related compounds tested as candidate antidepressants. We propose that sex differences contribute to the failure of novel HPA axis-based drugs in clinical trials. Compounds studied preclinically in males were tested in clinical trials that recruited more, if not exclusively, women, and did not control, but rather adjusted, for potential sex differences. Indeed, clinical trials of antidepressants are usually not stratified by sex or other important factors, although preclinical and epidemiological data support such stratification. In conclusion, we suggest that clinical testing of HPA axis-related compounds creates an opportunity for targeted, personalized antidepressant treatments based on sex. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
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Affiliation(s)
- Nikolaos Kokras
- Department of PharmacologyNational and Kapodistrian University of AthensAthensGreece
- First Department of Psychiatry, Eginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Georgia E. Hodes
- School of NeuroscienceVirginia Polytechnic Institute and State UniversityBlacksburgVirginia
| | | | - Christina Dalla
- Department of PharmacologyNational and Kapodistrian University of AthensAthensGreece
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25
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Gene-environment interactions between HPA-axis genes and stressful life events in depression: a systematic review. Acta Neuropsychiatr 2019; 31:186-192. [PMID: 31106715 DOI: 10.1017/neu.2019.16] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Depression is a disorder caused by genetics and environmental factors. The aim of this study was to perform a review investigating the interaction between genetic variations located in genes involved in hypothalamus-pituitary-adrenal axis (HPA-axis) and stressful life events (SLEs) in depression. METHODS In this systematic review, we selected articles investigating the interaction between genes involved in the HPA-axis, such as Arginine Vasopressin (AVP), Angiotensin Converting Enzyme (ACE), Corticotrophin Releasing Hormone (CRH), Corticotrophin Releasing Hormone Receptor 1 (CRHR1), Corticotrophin Releasing Hormone Receptor 2 (CRHR2), FK506 binding protein (FKBP5), Nuclear Receptor subfamily 3 group C member 1 (NR3C1), Nuclear Receptor subfamily 3 group C member 2 (NR3C2), and SLE. The literature search was conducted using the Pubmed, Embase, and PsychINFO databases in adherence with the PRISMA guidelines. RESULTS The search yielded 48 potentially relevant studies, of which 40 were excluded following screening. Eight studies were included in the final review. A total of 97 single nucleotide polymorphisms (SNPs) were examined in the eight included studies. The most prevalent gene was FKBP5, and the best studied polymorphism was FKBP5:rs1360780. Two of the five studies reported significant gene-environment (G × E) interactions between rs1360780 and SLE. Overall, four studies reported significant G × E interactions between FKBP5, CRH, or CRHR1 and SLE, respectively. No significant G × E interactions were found for the remaining genes. CONCLUSIONS Our results suggest that genetic variation in three genes in the HPA-axis possibly moderate the effects of SLEs in depression.
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26
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Jiang Y, Peng T, Gaur U, Silva M, Little P, Chen Z, Qiu W, Zhang Y, Zheng W. Role of Corticotropin Releasing Factor in the Neuroimmune Mechanisms of Depression: Examination of Current Pharmaceutical and Herbal Therapies. Front Cell Neurosci 2019; 13:290. [PMID: 31312123 PMCID: PMC6614517 DOI: 10.3389/fncel.2019.00290] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 06/14/2019] [Indexed: 12/17/2022] Open
Abstract
Approximately 3% of the world population suffers from depression, which is one of the most common form of mental disorder. Recent findings suggest that an interaction between the nervous system and immune system might be behind the pathophysiology of various neurological and psychiatric disorders, including depression. Neuropeptides have been shown to play a major role in mediating response to stress and inducing immune activation or suppression. Corticotropin releasing factor (CRF) is a major regulator of the hypothalamic pituitary adrenal (HPA) axis response. CRF is a stress-related neuropeptide whose dysregulation has been associated with depression. In this review, we summarized the role of CRF in the neuroimmune mechanisms of depression, and the potential therapeutic effects of Chinese herbal medicines (CHM) as well as other agents. Studying the network of CRF and immune responses will help to enhance our understanding of the pathogenesis of depression. Additionally, targeting this important network may aid in developing novel treatments for this debilitating psychiatric disorder.
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Affiliation(s)
- Yizhou Jiang
- Center of Reproduction, Development and Aging and Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Macau, China.,Department of Biology, Southern University of Science and Technology, Shenzhen, China
| | - Tangming Peng
- Center of Reproduction, Development and Aging and Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Macau, China.,Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.,Neurosurgical Clinical Research Center of Sichuan Province, Luzhou, China
| | - Uma Gaur
- Center of Reproduction, Development and Aging and Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Macau, China
| | - Marta Silva
- Center of Reproduction, Development and Aging and Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Macau, China
| | - Peter Little
- School of Pharmacy, Pharmacy Australia Centre of Excellence, The University of Queensland, Woolloongabba, QLD, Australia
| | - Zhong Chen
- Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, Institute of Pharmacology and Toxicology, Zhejiang University, Hangzhou, China
| | - Wei Qiu
- The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yandong Zhang
- Department of Biology, Southern University of Science and Technology, Shenzhen, China
| | - Wenhua Zheng
- Center of Reproduction, Development and Aging and Institute of Translation Medicine, Faculty of Health Sciences, University of Macau, Macau, China
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27
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Karstens AJ, Korzun I, Avery ET, Kassel MT, Keelan R, Kales H, Abercrombie H, Eisenlohr-Moul T, Langenecker SA, Weisenbach S. Examining HPA-axis functioning as a mediator of the relationship between depression and cognition across the adult lifespan. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2019; 26:507-520. [PMID: 29993318 PMCID: PMC6329657 DOI: 10.1080/13825585.2018.1495309] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/22/2018] [Indexed: 10/28/2022]
Abstract
Altered HPA-axis functioning is a hypothesized mechanism for worsened cognition in depression. The current study examines the indirect effects of depression on processing speed, executive functioning, and memory as a function of the HPA-axis. 38 individuals with a depression diagnosis and 50 healthy controls (HCs) aged 18-86 underwent neuropsychological testing and at-home diurnal salivary cortisol collection. Depression was assessed via structured clinical interviews and rating scales. Cognitive composite scores were derived from factor analysis. Daytime cortisol exposure was estimated using area under the curve (AUC). Depression was associated with higher cortisol levels and slower processing speed . A significant suppression effect of AUC was present on the relationship between depression and processing speed. Limitations include the cross-sectional design and limited sample heterogeneity. Though poorly modulated HPA-axis is one proposed mechanism of cognitive alterations in depression, our results did not support this conclusion for processing speed. Alternative mechanisms should be considered to inform interventions to target cognitive alterations in depression.
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Affiliation(s)
- Aimee James Karstens
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
| | - Inez Korzun
- University of Illinois at Chicago, Department of Neuroscience, Chicago, IL
| | - Erich T. Avery
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | | | - Rachel Keelan
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
- James A Haley VA, Tampa, FL
| | - Helen Kales
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | | | - Tory Eisenlohr-Moul
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
| | - Scott A. Langenecker
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
| | - Sara Weisenbach
- University of Illinois at Chicago, Departments of Psychology & Psychiatry, Chicago, IL
- University of Michigan, Department of Psychiatry, Ann Arbor, MI
- University of Utah, Department of Psychiatry, Salt Lake City, UT
- VA Salt Lake City, Mental Health Service, Salt Lake City, UT
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28
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Chan SHW, Tsang HWH. The beneficial effects of Qigong on elderly depression. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2019; 147:155-188. [PMID: 31607353 DOI: 10.1016/bs.irn.2019.06.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Health Qigong, especially the Eight-Section Brocades (or Baduanjin), has been well established as an effective adjunct intervention to alleviate depressive symptoms of older adults. The easy to learn and safe format of health Qigong allows the promotion and employment by health care professionals to improve the physical and psychosocial wellness of older adults. The cultural relevance of Qigong practice enhances its popularity as a health maintenance practice in Chinese community. In general, the antidepressive effects of Qigong are put forward through psychosocial, physiological, and neurobiological mechanisms. More specific, the beneficial effects of Qigong can be further substantiated by findings of several research studies.
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Affiliation(s)
- Sunny H W Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
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29
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Liu Y, Almeida DM, Rovine MJ, Zarit SH. Modeling Cortisol Daily Rhythms of Family Caregivers of Individuals With Dementia: Daily Stressors and Adult Day Services Use. J Gerontol B Psychol Sci Soc Sci 2019; 73:457-467. [PMID: 27738082 DOI: 10.1093/geronb/gbw140] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 09/27/2016] [Indexed: 11/15/2022] Open
Abstract
Objectives The study examined the typical diurnal cortisol trajectory and its differential associations with an intervention, the adult day services (ADS) use, among a sample of family caregivers who experienced high levels of daily stress. Method On hundred and sixty-five caregivers of individuals with dementia completed an 8-day diary on daily stressors, positive events, sleep quality, and ADS use. The caregivers also provided five saliva samples on each diary day. Daily cortisol trajectories were modeled as a function of time elapsed since awakening, and three spline growth curve models were fit to the cortisol data. Based on the best-fitting linear spline model, the effect of daily ADS use was examined at both daily and person levels. Covariates included daily experiences and other caregiving characteristics. Results On ADS days, caregivers had a steeper cortisol awakening response (CAR) slope and a steeper morning decline. ADS use remained significant after controlling for covariates at both daily and person levels. Discussion The findings suggested potential biophysiological benefits of daily ADS use for a sample that was under chronic stress and high levels of daily stress.
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Affiliation(s)
- Yin Liu
- Center for Healthy Aging, The Pennsylvania State University, State College
| | - David M Almeida
- Center for Healthy Aging, The Pennsylvania State University, State College.,Department of Human Development and Family Studies, The Pennsylvania State University, State College
| | - Michael J Rovine
- Human Development and Quantitative Methods Division, Graduate School of Education, University of Pennsylvania, Philadelphia
| | - Steven H Zarit
- Department of Human Development and Family Studies, The Pennsylvania State University, State College
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Dulawa SC, Janowsky DS. Cholinergic regulation of mood: from basic and clinical studies to emerging therapeutics. Mol Psychiatry 2019; 24:694-709. [PMID: 30120418 PMCID: PMC7192315 DOI: 10.1038/s41380-018-0219-x] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/06/2018] [Accepted: 07/09/2018] [Indexed: 12/16/2022]
Abstract
Mood disorders are highly prevalent and are the leading cause of disability worldwide. The neurobiological mechanisms underlying depression remain poorly understood, although theories regarding dysfunction within various neurotransmitter systems have been postulated. Over 50 years ago, clinical studies suggested that increases in central acetylcholine could lead to depressed mood. Evidence has continued to accumulate suggesting that the cholinergic system has a important role in mood regulation. In particular, the finding that the antimuscarinic agent, scopolamine, exerts fast-onset and sustained antidepressant effects in depressed humans has led to a renewal of interest in the cholinergic system as an important player in the neurochemistry of major depression and bipolar disorder. Here, we synthesize current knowledge regarding the modulation of mood by the central cholinergic system, drawing upon studies from human postmortem brain, neuroimaging, and drug challenge investigations, as well as animal model studies. First, we describe an illustrative series of early discoveries which suggest a role for acetylcholine in the pathophysiology of mood disorders. Then, we discuss more recent studies conducted in humans and/or animals which have identified roles for both acetylcholinergic muscarinic and nicotinic receptors in different mood states, and as targets for novel therapies.
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Affiliation(s)
- Stephanie C. Dulawa
- Department of Psychiatry, University of California at San Diego,Corresponding author: Stephanie Dulawa, Ph.D., Associate Professor in Psychiatry, University of California San Diego, 9500 Gilman Drive, Mailcode 0804, La Jolla, CA 92093-0804, USA ()
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Lauriola M, Mangiacotti A, D'Onofrio G, Cascavilla L, Paris F, Ciccone F, Greco M, Paroni G, Seripa D, Greco A. Late-Life Depression versus Amnestic Mild Cognitive Impairment: Alzheimer's Disease Incidence in 4 Years of Follow-Up. Dement Geriatr Cogn Disord 2019; 46:140-153. [PMID: 30199883 DOI: 10.1159/000492489] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 07/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM The aim of the study was to evaluate the prognostic power of late-life depression (LLD) compared with amnestic mild cognitive impairment (aMCI) for the onset of Alzheimer's disease (AD) within 4 years of follow-up. METHODS We estimated the incidence of AD in 60 patients presenting with aMCI, 115 patients suffering of LLD treated with antidepressants with good compliance, and 66 healthy control (HC) patients, followed for 4 years. RESULTS The risk to develop AD, within 4 years, was 68.33% for aMCI and 49.57% for LLD. In AD patients 5.60% deteriorated without depression, and 72.20% deteriorated with depression after 4 years of follow-up (p < 0.0001). No HC patients deteriorated to AD or any other dementia type. CONCLUSION In our results, aMCI was the first predictive condition that increased the risk to develop AD. Depression is a potentially preventable medical condition across the lifespan and may be a modifiable risk factor.
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Affiliation(s)
- Michele Lauriola
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Antonio Mangiacotti
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Grazia D'Onofrio
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo,
| | - Leandro Cascavilla
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Francesco Paris
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Filomena Ciccone
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Monica Greco
- Clinical Unit of Internal Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino, Genova, Italy
| | - Giulia Paroni
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Davide Seripa
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Antonio Greco
- Complex Unit of Geriatrics, Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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Soares NM, Pereira GM, Altmann V, de Almeida RMM, Rieder CRM. Cortisol levels, motor, cognitive and behavioral symptoms in Parkinson's disease: a systematic review. J Neural Transm (Vienna) 2018; 126:219-232. [PMID: 30374595 DOI: 10.1007/s00702-018-1947-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/22/2018] [Indexed: 12/19/2022]
Abstract
Parkinson's disease (PD) is a progressive and multifactorial neurodegenerative disease. It has been suggested that a dysregulation of the hypothalamic-pituitary-adrenal axis (HPA) occurs in PD. Furthermore, this dysregulation may be involved in triggering, exacerbation or progression of disease. The objective of this study was to systematically review the literature regarding cortisol levels and their relation with motor, cognitive and behavioral symptoms in patients with PD. A systematic search was performed in PubMed and Embase databases, according to PRISMA norms. Twenty-one studies were included, which evaluated baseline levels of cortisol and motor, cognitive, behavioral symptoms, drugs administration or deep brain stimulation to PD treatment. Sample size ranged from 7 to 249 individuals. In 14 studies that assessed cortisol levels in PD patients, seven showed elevation of cortisol levels. In relation to symptomatology, high levels of cortisol were associated with worst functional scores evaluated by UPDRS, depression and behavior in risk preference. Medication interactions showed an influence on the regulation of cortisol release, mainly, conventional drugs used in the PD's treatment, such as levodopa. The results found in this review point to a possible relationship between cortisol levels and symptoms in PD, indicating that an HPA axis dysfunction related to cortisol level occurs in PD.
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Affiliation(s)
- Nayron Medeiros Soares
- Medical Science Post Graduation Program, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil.
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil.
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil.
- Federal University of Health Science of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil.
| | - Gabriela Magalhães Pereira
- Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil
| | - Vivian Altmann
- Institute of Biosciences, Federal University of Rio Grande do Sul, Av. Bento Gonçalves, 9500, Porto Alegre, RS, Brazil
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
| | - Rosa Maria Martins de Almeida
- Institute of Psychology, Laboratory of Psychology, Neuroscience and Behavior (LPNeC), Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, Porto Alegre, RS, Brazil
| | - Carlos R M Rieder
- Medical Science Post Graduation Program, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, Porto Alegre, RS, Brazil
- Hospital de Clinicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350, Porto Alegre, RS, Brazil
- Federal University of Health Science of Porto Alegre (UFCSPA), Rua Sarmento Leite, 245, Porto Alegre, RS, Brazil
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Monteleone AM, Patriciello G, Ruzzi V, Cimino M, Giorno CD, Steardo L, Monteleone P, Maj M. Deranged emotional and cortisol responses to a psychosocial stressor in anorexia nervosa women with childhood trauma exposure: Evidence for a "maltreated ecophenotype"? J Psychiatr Res 2018; 104:39-45. [PMID: 29936175 DOI: 10.1016/j.jpsychires.2018.06.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 05/24/2018] [Accepted: 06/18/2018] [Indexed: 10/28/2022]
Abstract
Exposure to trauma in the childhood and abnormal interpersonal stress reactivity are believed to contribute to the pathophysiology of anorexia nervosa (AN), which suggests a possible role of the hypothalamus-pituitary adrenal (HPA) axis. Although an effect of early traumatic experiences on the cortisol awakening response has been proved in patients with AN, the consequences of childhood trauma exposure on HPA axis reactivity to psychosocial stressors has been never investigated in such individuals. Therefore, we have assessed emotional and cortisol responses to an acute psycho-social stress in AN patients with a history of childhood trauma exposure. Twenty-four AN women and 17 healthy women were enrolled in the study. Patients were classified as maltreated (Mal) or non-maltreated (noMal) according to their Childhood Trauma Questionnaire scores. Participants underwent the Trier Social Stress Test (TSST) and their emotional responses were measured through the state scale of the State-Trait Anxiety Inventory. Saliva samples were collected to measure cortisol production. Compared to both healthy subjects and noMal AN patients, Mal AN women exhibited a blunted cortisol response to TSST. With respect to healthy controls, pre-TSST anxiety levels were enhanced in both AN groups; moreover, Mal AN patients displayed a reduced anxiety increase after TSST as compared to both noMal patients and healthy women. Our findings for the first time provide the evidence of deranged biological and emotional responses to an acute social stress in AN patients with childhood trauma exposure, corroborating the idea of a maltreated ecophenotype in AN as in other psychiatric disorders.
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Affiliation(s)
| | | | - Valeria Ruzzi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Monica Cimino
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Chiara Del Giorno
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luca Steardo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Wu Y, Zhong X, Mai N, Wen Y, Shang D, Hu L, Chen B, Zhang M, Ning Y. Kynurenine pathway changes in late-life depression. J Affect Disord 2018; 235:76-81. [PMID: 29655078 DOI: 10.1016/j.jad.2018.04.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/05/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Kynurenine pathway (KP) activation is associated with several neuropsychiatric diseases, including major depression disorder (MDD). Although several investigations have been conducted on MDD, these have seldom shed light on KP changes in late-life depression (LLD). OBJECTIVE We aimed to investigate whether tryptophan (TRP) metabolism and kynurenine (KYN) metabolism are imbalanced in LLD patients and to explore the differences in KP characteristics between early onset depression (EOD) and late onset depression (LOD) patients. METHODS We investigated 170 LLD patients (EOD 90, LOD 80) and 135 normal controls. Serum concentrations of TRP, KYN and kynurenic acid (KYNA) were detected by the liquid chromatography-tandem mass spectrometry method. Depressive symptoms were assessed by the 17-item Hamilton Depression Scale (HAMD-17). RESULTS LLD patients exhibited lower levels of TRP, KYN, KYNA and KYNA/KYN ratio and a higher level of KYN/TRY ratio than normal controls. The decrease in TRP and the increase in KYN/TRP ratio were found in LOD patients. A low TRP level without increased KYN/TRP ratio was found in EOD patients. The "Depression" factor, which was extracted from HAMD-17 by the principal component factor analysis, was correlated with the TRP level and KYNA/KYN ratio in the EOD group, but no such correlation was found in the LOD group. CONCLUSIONS KP changes were observed in LLD patients; LOD patients showed profound shifts in TRP metabolism, while EOD patients showed low TRP level and a shift in KYN metabolism.
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Affiliation(s)
- Yujie Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Xiaomei Zhong
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Naikeng Mai
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Yuguan Wen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Dewei Shang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Lijun Hu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Ben Chen
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Min Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, Guangdong, China.
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Veltman EM, Lamers F, Comijs HC, Stek ML, van der Mast RC, Rhebergen D. Inflammatory markers and cortisol parameters across depressive subtypes in an older cohort. J Affect Disord 2018. [PMID: 29522944 DOI: 10.1016/j.jad.2018.02.080] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND There is growing evidence that inflammatory and cortisol dysregulation are underlying pathophysiological mechanisms in the aetiology of major depressive disorder, particularly in younger adults. However, findings of biological disturbances in late-life depression have been divergent, probably due to the even greater heterogeneity of depression in older adults with aging processes influencing biological factors. Using empirically derived subtypes may enable the identification of biological disturbances underlying depression in older adults. METHODS Data were used from the Netherlands Study of Depression in Older Persons (NESDO) of 359 persons aged 60 years or older, with a current diagnosis of major depressive disorder (MDD). Depressive subtypes (severe atypical, severe melancholic, and moderate severe subtype) that were previously identified through latent class analysis (LCA), were examined on differences in inflammatory markers including C-reactive protein (CRP), interleukin-6 (IL-6), and neutrophil gelatinase-associated lipocalin (NGAL), as well as cortisol parameters. RESULTS No differences in measures for inflammation and cortisol across subtypes were observed in uncorrected or for putative confounders corrected models. LIMITATIONS Several subjects had missing cortisol and inflammatory data, decreasing the power. However, results did not change after imputation analysis. DISCUSSION In this cohort of depressed older adults, no differences in inflammation and cortisol measures between depression subtypes were observed. This is probably due to the many (patho)physiological processes that are involved in aging, thereby clouding the results.
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Affiliation(s)
- E M Veltman
- Department of Psychiatry, Leiden University Medical Center, The Netherlands.
| | - F Lamers
- GGZ inGeest/Department of Psychiatry and the Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - H C Comijs
- GGZ inGeest/Department of Psychiatry and the Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - M L Stek
- GGZ inGeest/Department of Psychiatry and the Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - R C van der Mast
- Department of Psychiatry, Leiden University Medical Center, The Netherlands; Department of Psychiatry, CAPRI-University of Antwerp, Belgium
| | - D Rhebergen
- GGZ inGeest/Department of Psychiatry and the Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
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Korten NCM, Penninx BWJH, Rhebergen D, Deeg DJH, Comijs HC. Hypothalamus-Pituitary-Adrenal-axis activity and cognitive functioning in older adults. Psychoneuroendocrinology 2018. [PMID: 29525585 DOI: 10.1016/j.psyneuen.2017.12.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Inconsistent results are found in the involvement of the Hypothalamus-Pituitary-Adrenal (HPA)-axis in cognitive functioning. This study examined the association between various saliva cortisol measures (the 1-h awakening cortisol, evening cortisol, diurnal change, and cortisol suppression) and cognitive functioning (episodic memory, processing speed, interference control, and working memory). Participants were older adults, between 60 and 93 years with (N = 328) and without (N = 119) a depressive disorder from the Netherlands Study of Depression in Older adults. No significant associations between cortisol and cognitive functioning were observed in the total sample. Only in non-depressed older adults, higher total cortisol secretion over the first hour after awakening and worse episodic memory, higher cortisol levels at awakening and better working memory, and higher diurnal change and better processing speed were significantly associated. Cortisol was not associated with cognitive functioning in depressed older adults. In older adults, the association between depression and cognitive functioning is likely the consequence of other biological or psychological mechanisms.
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Affiliation(s)
- Nicole C M Korten
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Brenda W J H Penninx
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Didi Rhebergen
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Onete V, Henry RM, Sep SJS, Koster A, van der Kallen CJ, Dagnelie PC, Schaper N, Köhler S, Reesink K, Stehouwer CDA, Schram MT. Arterial stiffness is associated with depression in middle-aged men - the Maastricht Study. J Psychiatry Neurosci 2018; 43. [PMID: 29481318 PMCID: PMC5837883 DOI: 10.1503/jpn.160246] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Arterial stiffening may underlie the association between depression and cardiovascular disease (CVD), but reported data are inconsistent. We investigated the associations between aortic stiffness and major depressive disorder (MDD) and depressive symptoms, and whether these differed by sex and age. METHODS We measured carotid to femoral pulse wave velocity (cfPWV) using applanation tonometry, and we assessed depression using the Mini-International Neuropsychiatric Interview (MINI) and the Patient Health Questionnaire-9 (PHQ-9) in a cohort of participants from The Maastricht Study. Logistic and negative binominal models were adjusted for age, type 2 diabetes mellitus (T2DM), mean arterial pressure (MAP) and CVD risk factors. RESULTS We included 2757 participants in our analyses (48.8% men, mean age 59.8 ± 8.1 yr, 27% T2DM). We found that cfPWV was associated with MDD in men (fully adjusted odds ratio [OR] 2.36, 95% confidence interval [CI] 1.45-3.84), but not in women (OR 1.57, 95% CI 0.93-2.66), aged 60 years or younger. The ORs were not significant in individuals older than 60 years (men: OR 1.03, 95% CI 0.63-1.68; women: OR 0.64, 95% CI 0.32-1.31). Similarly, cfPWV was associated with a higher PHQ-9 score in men (rate ratio 1.28, 95% CI 1.09-1.52), but not in women (rate ratio 1.11, 95% CI 0.99-1.23), aged 60 years or younger. Associations were not significant in individuals older than 60 years (men: rate ratio 0.96, 95% CI 0.84-1.08; women: rate ratio 1.00, 95% CI 0.90-1.12). LIMITATIONS We cannot rule out reversed causation in this cross-sectional study. CONCLUSION Greater aortic stiffness is associated with MDD and depressive symptoms among middle-aged men and to a lesser extent in women, whereas this association was not observed in old age.
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Affiliation(s)
- Veronica Onete
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Ronald M Henry
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Simone J S Sep
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Annemarie Koster
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Carla J van der Kallen
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Pieter C Dagnelie
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Nicolaas Schaper
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Sebastian Köhler
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Koen Reesink
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Coen D A Stehouwer
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
| | - Miranda T Schram
- From the Department of Medicine, Maastricht University Medical Center, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Schaper, Stehouwer, Schram); the Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, the Netherlands (Onete, Henry, Sep, Kallen, Dagnelie, Schaper, Reesink, Stehouwer, Schram); the Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, the Netherlands (Henry, Reesink, Schram); the Department of Social Medicine, Maastricht University, Maastricht, the Netherlands (Koster); the School for Care and Public Health Research (CAPHRI), Maastricht University, Maastricht, the Netherlands (Koster, Dagnelie, Schaper); the Department of Epidemiology, Maastricht University, Maastricht, the Netherlands (Dagnelie); and the Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, Maastricht University Medical Centre (MUMC), and School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, the Netherlands (Köhler)
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Galvão ACDM, de Almeida RN, Silva EADS, Freire FAM, Palhano-Fontes F, Onias H, Arcoverde E, Maia-de-Oliveira JP, de Araújo DB, Lobão-Soares B, Galvão-Coelho NL. Cortisol Modulation by Ayahuasca in Patients With Treatment Resistant Depression and Healthy Controls. Front Psychiatry 2018; 9:185. [PMID: 29867608 PMCID: PMC5952178 DOI: 10.3389/fpsyt.2018.00185] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/20/2018] [Indexed: 12/20/2022] Open
Abstract
Major depression is a highly prevalent mood disorder, affecting about 350 million people, and around 30% of the patients are resistant to currently available antidepressant medications. Recent evidence from a randomized controlled trial (RCT) supports the rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression. The aim of this study was to explore the effect of ayahuasca on plasma cortisol and awakening salivary cortisol response, in the same group of treatment-resistant patients (MD) and in healthy volunteers (C). Subjects received a single dose of ayahuasca or placebo (dosing session), and both plasma and awakening salivary cortisol response were measured at baseline (before dosing session) and 48 h after the dosing session. Baseline assessment (D0) showed blunted awakening salivary cortisol response and hypocortisolemia in patients, with respect to healthy controls. Salivary cortisol was also measured during dosing session, and we observed higher increases for both C and MD that ingested ayahuasca than placebo. After 48 h from the dosing session with ayahuasca, patients' awakening salivary cortisol response is similar to the ones detected in controls. No significant changes in plasma cortisol levels were observed 48 h after the sessions. Therefore, these findings point to new evidence on the modulation of salivary cortisol levels as a result of an ayahuasca session, both in healthy and depressive volunteers. Considering that cortisol acts in regulation of distinct physiological pathways, emotional and cognitive processes, it is assumed to be critically involved to the etiology of depression and its regulation seems to be important for the treatment and remission of major depression, ayahuasca use as antidepressant should be further investigated. Moreover, this study highlights the importance of psychedelics in the treatment of human mental disorders.
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Affiliation(s)
- Ana C de Menezes Galvão
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raíssa N de Almeida
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Erick A Dos Santos Silva
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Fúlvio A M Freire
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Fernanda Palhano-Fontes
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.,Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Heloisa Onias
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.,Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Emerson Arcoverde
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - João P Maia-de-Oliveira
- Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil.,Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil.,National Institute of Science and Technology in Translational Medicine, Natal, Brazil
| | - Dráulio B de Araújo
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil.,Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Bruno Lobão-Soares
- National Institute of Science and Technology in Translational Medicine, Natal, Brazil.,Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Nicole L Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil.,Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil.,National Institute of Science and Technology in Translational Medicine, Natal, Brazil
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Lee HH, Chang CH, Wang LJ, Wu CC, Chen HL, Lu T, Lu RB, Lee SY. The correlation between longitudinal changes in hypothalamic-pituitary-adrenal (HPA)-axis activity and changes in neurocognitive function in mixed-state bipolar II disorder. Neuropsychiatr Dis Treat 2018; 14:2703-2713. [PMID: 30410339 PMCID: PMC6199219 DOI: 10.2147/ndt.s173616] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In this study, we aim to determine 1) the differences in cortisol in patients with bipolar II disorder (BD-II) and control subjects and 2) the correlation between cortisol levels and cognitive function in patients with BD-II during a 24-week follow-up period. METHODS We recruited a total of 32 BD-II patients and 30 healthy control subjects. The BD-II patients were assessed for clinical severity and serum cortisol level at baseline and at weeks 8, 16, and 24. The Brief Assessment of Cognition in Affective Disorders (BACA) was adopted to evaluate cognitive function at baseline and endpoint (week 24). Meanwhile, we assessed the controls for serum cortisol level and BACA at baseline. RESULTS We observed that the BD-II group had a higher serum cortisol level and lower BACA composite scores compared with the healthy controls at baseline. A significant correlation was found between changes in Verbal Fluency, a subset of BACA, and changes in serum cortisol level after the 24-week follow-up, controlling for age, gender, years of education, and clinical severity (P<0.001). CONCLUSION We propose that serum cortisol may be involved in the psychopathological mechanisms of cognitive decline in BD-II.
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Affiliation(s)
- Hsuan-Han Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - Cheng-Ho Chang
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Ching Wu
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Hsing-Ling Chen
- Department of Nuclear Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ti Lu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
| | - Ru-Band Lu
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan, .,Institute of Behavioral Medicine Sciences, College of Medicine and Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Yu Lee
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, .,Department of Psychiatry, National Cheng Kung University Hospital, Tainan, Taiwan, .,Department of Psychiatry, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, .,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan,
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Ancelin ML, Scali J, Norton J, Ritchie K, Dupuy AM, Chaudieu I, Ryan J. The effect of an adverse psychological environment on salivary cortisol levels in the elderly differs by 5-HTTLPR genotype. Neurobiol Stress 2017; 7:38-46. [PMID: 28377990 PMCID: PMC5369865 DOI: 10.1016/j.ynstr.2017.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 12/06/2016] [Accepted: 03/20/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND An adverse psychological environment (e.g. stressful events or depression) has been shown to influence basal cortisol levels and cortisol response to stress. This differs depending on the adverse stimuli, but also varies across individuals and may be influenced by genetic predisposition. An insertion/deletion polymorphism in the serotonin transporter gene (5-HTTLPR) is a strong candidate in this regard. OBJECTIVE To investigate how stressful life events and depression are associated with diurnal cortisol levels in community-dwelling elderly and determine whether this varies according to genetic variability in the 5-HTTLPR. METHODS This population-based study included 334 subjects aged 65 and older (mean (SD) = 76.5 (6.3)). Diurnal cortisol was measured on two separate days, under quiet (basal) and stressful conditions. The number of recent major stressful events experienced during the past year was assessed from a 12-item validated questionnaire as an index of cumulative recent stressful events. Lifetime trauma was evaluated using the validated Watson's PTSD inventory, which evaluates the most severe traumatic or frightening experience according to DSM criteria. Depression was defined as having a Mini-International Neuropsychiatric Interview (MINI) diagnosis of current major depressive disorder or high levels of depressive symptoms (Center for Epidemiologic Studies-Depression Scale ≥16). 5-HTTLPR genotyping was performed on blood samples. RESULTS Exposure to stressful life events was associated with lower basal evening cortisol levels overall, and in the participants with the 5-HTTLPR L allele but not the SS genotype. The greatest effects (over 50% decrease, p < 0.001) were observed for the LL participants having experienced multiple recent stressful events or severe lifetime traumas. Participants with the L allele also had higher evening cortisol stress response. Conversely, depression tended to be associated with a 42% higher basal morning cortisol in the SS participants specifically, but did not modify the association between stressful events and cortisol levels. CONCLUSION An adverse psychological environment is associated with basal cortisol levels and cortisol stress response, but this differs according to 5-HTTLPR genotype.
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Affiliation(s)
- Marie-Laure Ancelin
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Jacqueline Scali
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Joanna Norton
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Karen Ritchie
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France; Center for Clinical Brain Sciences, University of Edinburgh, UK
| | - Anne-Marie Dupuy
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France; Lapeyronie University Hospital, Montpellier, France
| | - Isabelle Chaudieu
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France
| | - Joanne Ryan
- Inserm, U1061, Montpellier, France; University of Montpellier, Montpellier, France; Disease Epigenetics Group, Murdoch Children's Research Institute and Department of Paediatrics, The University of Melbourne, Parkville, Australia; Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Prahran, Australia
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Funke R, Eichler A, Distler J, Golub Y, Kratz O, Moll GH. Stress system dysregulation in pediatric generalized anxiety disorder associated with comorbid depression. Stress Health 2017; 33:518-529. [PMID: 27982510 DOI: 10.1002/smi.2736] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 11/02/2016] [Accepted: 11/03/2016] [Indexed: 12/19/2022]
Abstract
Because chronic stress is an important risk factor for anxiety states and depressive disorders, we studied hypothalamus-pituitary-adrenal (HPA) axis and sympathetic system activity via changes in cortisol and alpha amylase activity levels in pediatric generalized anxiety disorder (GAD) patients (n = 26) with comorbid depression and a healthy comparison group (n = 26). Morning plasma cortisol and diurnal profiles of salivary cortisol and salivary alpha amylase (sAA) activity were assessed, also reactivity of HPA-axis, sAA activity, and heart rate following a psychosocial stressor (Trier Social Stress Test for children). GAD patients with comorbid depression showed increased morning plasma and salivary cortisol levels, ameliorating throughout in-patient treatment, and higher sAA activity in their diurnal profile. Both HPA and sympathetic activity positively correlated with the severity of anxiety and depression. We also demonstrated a blunted HPA and sympathetic response to acute stress in patients. This pattern of neuroendocrine and sympathetic changes seems to be distinct from the one previously reported in pediatric patients with only social anxiety or depressive disorders. We propose morning plasma and saliva cortisol levels as potential physiological indicators for supporting the evaluation of symptoms' severity and treatment progress in children with GAD and comorbid depressive disorder.
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Affiliation(s)
- R Funke
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | - A Eichler
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | - J Distler
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Y Golub
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, JW Goethe University Hospital, Frankfurt am Main, Germany
| | - O Kratz
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
| | - G H Moll
- Department of Child and Adolescent Mental Health, University of Erlangen-Nuremberg, Erlangen, Germany
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Galvão-Coelho NL, Galvão ACDM, da Silva FS, de Sousa MBC. Common Marmosets: A Potential Translational Animal Model of Juvenile Depression. Front Psychiatry 2017; 8:175. [PMID: 28983260 PMCID: PMC5613153 DOI: 10.3389/fpsyt.2017.00175] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/05/2017] [Indexed: 12/04/2022] Open
Abstract
Major depression is a psychiatric disorder with high prevalence in the general population, with increasing expression in adolescence, about 14% in young people. Frequently, it presents as a chronic condition, showing no remission even after several pharmacological treatments and persisting in adult life. Therefore, distinct protocols and animal models have been developed to increase the understanding of this disease or search for new therapies. To this end, this study investigated the effects of chronic social isolation and the potential antidepressant action of nortriptyline in juvenile Callithrix jacchus males and females by monitoring fecal cortisol, body weight, and behavioral parameters and searching for biomarkers and a protocol for inducing depression. The purpose was to validate this species and protocol as a translational model of juvenile depression, addressing all domain criteria of validation: etiologic, face, functional, predictive, inter-relational, evolutionary, and population. In both sexes and both protocols (IDS and DPT), we observed a significant reduction in cortisol levels in the last phase of social isolation, concomitant with increases in autogrooming, stereotyped and anxiety behaviors, and the presence of anhedonia. The alterations induced by chronic social isolation are characteristic of the depressive state in non-human primates and/or in humans, and were reversed in large part by treatment with an antidepressant drug (nortriptyline). Therefore, these results indicate C. jacchus as a potential translational model of juvenile depression by addressing all criteria of validation.
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Affiliation(s)
- Nicole Leite Galvão-Coelho
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
- National Institute of Science and Technology in Translational Medicine Natal, Natal, Brazil
| | - Ana Cecília de Menezes Galvão
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Flávia Santos da Silva
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Maria Bernardete Cordeiro de Sousa
- Laboratory of Hormone Measurement, Department of Physiology, Federal University of Rio Grande do Norte, Natal, Brazil
- Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
- Brain Institute, Federal University of Rio Grande do Norte, Natal, Brazil
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van Neijenhof RJGP, van Duijn E, Van Den Berg JF, de Waal MWM, van der Mast RC, Comijs HC. Subjective insomnia symptoms and sleep duration are not related to hypothalamic-pituitary-adrenal axis activity in older adults. J Sleep Res 2017; 27:40-46. [DOI: 10.1111/jsr.12570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 04/26/2017] [Indexed: 01/01/2023]
Affiliation(s)
| | - Erik van Duijn
- Center for Mental Health Care Delfland; Delft The Netherlands
- Department of Psychiatry; Leiden University Medical Center; Leiden The Netherlands
| | - Julia F. Van Den Berg
- Parnassia Psychiatric Institute; Den Haag The Netherlands
- Department of Clinical Psychology; Leiden University; Leiden The Netherlands
| | - Margot W. M. de Waal
- Department of Public Health and Primary Care; Leiden University Medical Center; Leiden The Netherlands
| | - Roos C. van der Mast
- Department of Psychiatry; Leiden University Medical Center; Leiden The Netherlands
- Department of Psychiatry; CAPRI-University of Antwerp; Antwerp Belgium
| | - Hannie C. Comijs
- Department of Psychiatry/EMGO Institute for Health and Care Research; VU University Medical Center; GGZ InGeest; Amsterdam The Netherlands
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Moraes H, Deslandes A, Maciel-Pinheiro PDT, Corrêa H, Laks J. Cortisol, DHEA, and depression in the elderly: the influence of physical capacity. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 74:456-61. [PMID: 27332070 DOI: 10.1590/0004-282x20160059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 03/31/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Major depression have been associated with cortisol and dehydroepiandrosterone (DHEA) changes in old depressed patients. We examined the association between depression, cortisol, and DHEA, correcting for confounding variables, including physical capacity. In addition, the association between hormone levels and physical capacity in these two experimental groups was also analyzed. METHOD Depressed patients (n = 32) and healthy control (n = 31) old adults, both matched for age, were analyzed. Subjects were submitted to a physical capacity evaluation, including physical activity levels, functional fitness test, and balance scale. RESULTS Depressed patients showed significant lower levels of cortisol than controls, which became non-significant after controlling for physical capacity. A positive correlation was observed between cortisol levels and physical capacity. CONCLUSIONS The data suggest that physical capacity modulates the relationship between depression and cortisol levels and needs to be taken into consideration in the future investigations.
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Affiliation(s)
- Helena Moraes
- Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ , Brasil, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brasil;,Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Desordens Relacionadas, Rio de Janeiro RJ , Brasil, Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Desordens Relacionadas, Rio de Janeiro RJ, Brasil
| | - Andrea Deslandes
- Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ , Brasil, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brasil;,Universidade do Estado do Rio de Janeiro, Universidade Estadual do Rio de Janeiro, Instituto de Educação Física e Desportos, Rio de Janeiro RJ , Brasil, Universidade Estadual do Rio de Janeiro, Instituto de Educação Física e Desportos, Rio de Janeiro RJ, Brasil
| | - Paulo de Tarso Maciel-Pinheiro
- Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ , Brasil, Universidade Federal do Rio de Janeiro, Laboratório de Neurociência do Exercício, Rio de Janeiro RJ, Brasil;,Universidade Federal Fluminense, Universidade Federal Fluminense, Rio de Janeiro RJ , Brasil, Universidade Federal Fluminense, Programa de Pós Graduação Neurologia/Neurociências, Rio de Janeiro RJ, Brasil;,Universidade Federal Fluminense, Universidade Federal Fluminense, Instituto de Educação Física, Rio de Janeiro RJ , Brasil, Universidade Federal Fluminense, Instituto de Educação Física, Rio de Janeiro RJ, Brasil
| | - Humberto Corrêa
- Universidade Federal de Minas Gerais, Universidade Federal de Minhas Gerais, Belo Horizonte MG , Brasil, Universidade Federal de Minhas Gerais, Belo Horizonte MG, Brasil
| | - Jerson Laks
- Universidade Federal do Rio de Janeiro, Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Desordens Relacionadas, Rio de Janeiro RJ , Brasil, Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Desordens Relacionadas, Rio de Janeiro RJ, Brasil;,Instituto Vital Brasil, Centro de Estudos e Pesquisas do Envelhecimento, Rio de Janeiro RJ , Brasil, Instituto Vital Brasil, Centro de Estudos e Pesquisas do Envelhecimento, Rio de Janeiro RJ, Brasil
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Wingenfeld K, Kuehl LK, Boeker A, Schultebraucks K, Ritter K, Hellmann-Regen J, Otte C, Spitzer C. Stress reactivity and its effects on subsequent food intake in depressed and healthy women with and without adverse childhood experiences. Psychoneuroendocrinology 2017; 80:122-130. [PMID: 28324701 DOI: 10.1016/j.psyneuen.2017.03.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/06/2017] [Accepted: 03/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACE) increase the risk to develop major depressive disorder (MDD) and obesity or metabolic syndrome in adulthood. In addition, ACE may be associated with an exaggerated endocrine response to stress, which, in turn, may lead to enhanced food intake resulting in obesity and metabolic problems. METHODS We systematically examined the stress response and consecutive food intake in 32 women with MDD and ACE as determined by a clinical interview (Early Trauma Inventory), 52 women with MDD without ACE, 22 women with ACE but no current or lifetime MDD and 37 healthy women without either MDD or ACE. All participants underwent a psychosocial stress test (Trier Social Stress Test, TSST) and a control condition (Placebo-TSST) before they were offered a buffet of snacks. Participants were not aware that the primary outcome variable was the amount of consumed kilocalories (kcal). RESULTS The four groups did not differ in demographic variables. Stress resulted in higher cortisol release and higher blood pressure compared to the control condition. Patients with MDD without ACE had a significantly lower cortisol response to stress compared to controls. Across groups, we found higher kcal intake after stress compared to the control condition. Comparing high and low cortisol responders to stress, higher kcal intake after stress was only seen in those with low cortisol release. CONCLUSIONS This study provides evidence that blunted rather than enhanced cortisol release to stress might lead to increased food intake, independent from MDD and ACE.
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Affiliation(s)
- Katja Wingenfeld
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany.
| | - Linn K Kuehl
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Anita Boeker
- Asklepios Fachklinikum Tiefenbrunn, Rosdorf, Germany
| | - Katharina Schultebraucks
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Kristin Ritter
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Julian Hellmann-Regen
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Christian Otte
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
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Han J. Chronic Illnesses and Depressive Symptoms Among Older People: Functional Limitations as a Mediator and Self-Perceptions of Aging as a Moderator. J Aging Health 2017; 30:1188-1204. [PMID: 28555515 DOI: 10.1177/0898264317711609] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This research examined the mediation of functional limitations in the relationship between chronic illnesses and depressive symptoms among older Americans along with tests for the moderation of self-perceptions of aging. METHOD Data from the Health and Retirement Study (2008, 2010, and 2012) were used. Longitudinal mediation models were tested using a sample of 3,382 Americans who responded to psychosocial questions and were over 65 years old in 2008. RESULTS Functional limitations mediated the linkage between chronic illnesses and depressive symptoms. Negative self-perceptions of aging exacerbated the effects of chronic illnesses on depressive symptoms. DISCUSSION Health care professionals should be aware of depressive symptoms in older adults reporting chronic illnesses and particularly in those reporting functional limitations. To decrease the risk of depressive symptoms caused by chronic illnesses, negative self-perceptions of aging may need to be challenged.
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Affiliation(s)
- Jina Han
- 1 Silla University, Busan, South Korea
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47
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Maripuu M, Wikgren M, Karling P, Adolfsson R, Norrback KF. Hyper- and hypocortisolism in bipolar disorder - A beneficial influence of lithium on the HPA-axis? J Affect Disord 2017; 213:161-167. [PMID: 28237543 DOI: 10.1016/j.jad.2017.02.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/24/2017] [Accepted: 02/18/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND A hyperactive hypothalamic-pituitary-adrenal axis (HPA-axis) is a well-known phenomenon in bipolar disorder (BD). However, hypocortisolism has also been described and found associated with depression, low quality of life and cardiovascular risk factors in BD patients. Although the pathophysiology related to hypocortisolism in BD is largely unknown, hypocortisolism is associated with chronic stress exposure and after inducing an initial rise in cortisol long-term stress may result in a transition to hypocortisolism. BD patients are throughout life often exposed to chronic stress. We therefore hypothesized that higher age would be associated with lower HPA-axis activity especially among patients without previous mood stabilizing treatment. METHODS This cross-sectional study consisted of 159 bipolar outpatients and 258 controls. A low-dose-dexamethasone-suppression-test (DST) was used to measure HPA-axis activity. RESULTS Patients with BD showed a negative association between post DST cortisol and age (-3.0 nmol/l per year; p=0.007). This association gradually increased in subgroups that were naïve to lithium (-7.7 nmol/l per year; p=0.001) and "all mood stabilizers" (-11.4 nmol/l per year; p=0.004). Patients exhibiting hypercortisolism were characterized by younger age and female gender, whereas patients exhibiting hypocortisolism were characterized by long disease duration without prophylactic lithium treatment as well as absence of current lithium medication. LIMITATIONS Cross sectional study design. CONCLUSIONS There was a negative association between HPA-axis activity and age in BD, rendering BD patients at risk for developing hypocortisolism. This association was most pronounced among patients without previous or current lithium prophylaxis.
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Affiliation(s)
- Martin Maripuu
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, SE-901 87 Umeå, Sweden.
| | - Mikael Wikgren
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, SE-901 87 Umeå, Sweden
| | - Pontus Karling
- Division of Medicine, Department of Public Health and Clinical Medicine, Umeå University, SE-901 87 Umeå, Sweden
| | - Rolf Adolfsson
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, SE-901 87 Umeå, Sweden
| | - Karl-Fredrik Norrback
- Division of Psychiatry, Department of Clinical Sciences, Umeå University, SE-901 87 Umeå, Sweden
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48
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Ancelin ML, Scali J, Norton J, Ritchie K, Dupuy AM, Chaudieu I, Ryan J. Heterogeneity in HPA axis dysregulation and serotonergic vulnerability to depression. Psychoneuroendocrinology 2017; 77:90-94. [PMID: 28024274 DOI: 10.1016/j.psyneuen.2016.11.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 12/26/2022]
Abstract
Variability in the serotonin transporter (5-HTTLPR) gene can influence the risk of depression associated with adversity, as well as cortisol stress reactivity, although not consistently. No study has examined the impact of both a stressful environment and corticotropic-axis dysfunction on depression, as a function of 5-HTTLPR. This population-based study included 334 subjects aged 65 and older. Depression was measured at both diagnostic (major depression according to DSM-IV) and symptomatic (subthreshold depression) levels of caseness, in addition to 5-HTTLPR and rs25531 genotyping and diurnal cortisol measures. For participants with the SS genotype, higher morning cortisol levels were associated with a 4-fold increased risk of depression. Among LL participants, both evening cortisol levels and recent stressful events increased depression risk, although only the latter remained significant after multivariable adjustment. Conversely, SL individuals appeared somewhat resilient to depression in terms of cortisol and recent stress. These findings indicate that 5-HTTLPR genetic variability appears to influence the association between stress-related factors and late-life depression, although the gene-environment interactions failed to reach statistical significance levels. Participants homozygous for the short allele appeared to have a cortisol-related neuroendocrine vulnerability to depression, while long allele homozygotes were more reactive to stressful events in terms of depression risk.
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Affiliation(s)
| | | | - Joanna Norton
- Inserm, U1061, University Montpellier, Montpellier, France
| | - Karen Ritchie
- Inserm, U1061, University Montpellier, Montpellier, France; Center for Clinical Brain Sciences, University of Edinburgh, UK
| | - Anne-Marie Dupuy
- Inserm, U1061, University Montpellier, Montpellier, France; Lapeyronie University Hospital, Montpellier, France
| | | | - Joanne Ryan
- Inserm, U1061, University Montpellier, Montpellier, France; Disease Epigenetics Group, Murdoch Children's Research Institute, and Department of Paediatrics, The University of Melbourne, Parkville, Australia; Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Prahran, Australia
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Ng TP, Nyunt MSZ, Feng L, Feng L, Niti M, Tan BY, Chan G, Khoo SA, Chan SM, Yap P, Yap KB. Multi-Domains Lifestyle Interventions Reduces Depressive Symptoms among Frail and Pre-Frail Older Persons: Randomized Controlled Trial. J Nutr Health Aging 2017; 21:918-926. [PMID: 28972245 DOI: 10.1007/s12603-016-0867-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND We investigated the effect of multi-domain lifestyle (physical, nutritional, cognitive) interventions among frail and pre-frail community-living older persons on reducing depressive symptoms. METHOD Participants aged 65 and above were randomly allocated to 24 weeks duration interventions with nutritional supplementation (N=49), physical training (N=48), cognitive training (N=50), combination intervention (N=49) and usual care control (N=50). Depressive symptoms were assessed by the Geriatric Depression Scale (GDS-15) at baseline (0M), 3 month (3M), 6 month (6M) and 12 month (12M). RESULTS Mean GDS scores in the control group increased from 0.52 (0M) and 0.54 (3M) to 0.74 (6M), and 0.83 (12M). Compared to the control group, interventions showed significant differences (∆=change) at 6M for cognitive versus control (∆=-0.39, p=0.021, group*time interaction p=0.14); physical versus control (∆ =-0.37, p=0.026, group*time interaction p=0.13), and at 12M for nutrition versus control (∆ =-0.46, p=0.016, group*time interaction p=0.15). The effect for combination versus control was significant at 6M (∆ =-0.43, p=0.020) and 12M (∆ =-0.51, p=0.005, group*time interaction p=0.026). Estimated 12-month cumulative incidence of depressive symptoms (GDS≥2) relative to control were OR=0.38, p=0.037 (nutrition); OR=0.71, p=0.40 (cognitive); OR=0.39, p=0.042 (physical training) and OR=0.38, p=0.037 (combination). Changes in gait speed and energy level were significantly associated with changes in GDS scores over time. CONCLUSION Multi-domain interventions that reverse frailty among community-living older persons also reduce depressive symptomatology. Public health education and programmatic measures combining nutritional, physical and cognitive interventions for at-risk frail older people may likely benefit psychological wellbeing.
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Affiliation(s)
- T P Ng
- A/P Tze-Pin Ng, Gerontology Research Programme, National University of Singapore, Department of Psychological Medicine, NUHS Tower Block, 9th Floor, 1E Kent Ridge Road, Singapore 119228 Fax: 65-67772191, Tel: 65-67723478
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The Very Low-Dose Dexamethasone Suppression Test in the General Population: A Cross-Sectional Study. PLoS One 2016; 11:e0164348. [PMID: 27736954 PMCID: PMC5063373 DOI: 10.1371/journal.pone.0164348] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 09/24/2016] [Indexed: 11/19/2022] Open
Abstract
Determinants of the hypothalamic-pituitary-adrenal (HPA) axis functioning are increasingly explored in population-based studies. However, functional tests measuring the negative feedback of the HPA axis cannot easily be implemented into large observational studies. Furthermore, high doses of dexamethasone often completely suppress the HPA axis in healthy persons. This study aimed to detect the effects of the health, lifestyle and sociodemographic factors, psychiatric problems and cognitive functions on the negative feedback of the HPA axis using a very low-dose (0.25 mg) dexamethasone suppression test (DST).We evaluated the associations of several determinants with the saliva cortisol concentrations after dexamethasone intake in a confounder-adjusted model also corrected for baseline saliva cortisol concentrations in the Rotterdam Study, a large population-based study (N = 1822). We found that female sex, low income, lack of exercise, instrumental disability and smoking were all independently associated with stronger suppression of the HPA axis. Even though there were no linear associations between psychiatric measures and cortisol suppression, we found that depressive symptoms and anxiety disorders were more common in persons with non-suppression of cortisol. Conversely, psychotropic medication use was related to enhanced suppression of cortisol after DST. In this large study, we found that female gender, low socioeconomic status and poor health were all related to suppression of the HPA axis. Non-linear associations were detected between the suppression of the HPA axis and common psychiatric disorders in community-dwelling persons.
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