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Park SE, Chung J, Lee J, Kim MJB, Kim J, Jeon HJ, Kim H, Woo C, Kim H, Lee SA. Digital assessment of cognitive-affective biases related to mental health. PLOS DIGITAL HEALTH 2024; 3:e0000595. [PMID: 39208388 PMCID: PMC11361731 DOI: 10.1371/journal.pdig.0000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 07/28/2024] [Indexed: 09/04/2024]
Abstract
With an increasing societal need for digital therapy solutions for poor mental health, we face a corresponding rise in demand for scientifically validated digital contents. In this study we aimed to lay a sound scientific foundation for the development of brain-based digital therapeutics to assess and monitor cognitive effects of social and emotional bias across diverse populations and age-ranges. First, we developed three computerized cognitive tasks using animated graphics: 1) an emotional flanker task designed to test attentional bias, 2) an emotional go-no-go task to measure bias in memory and executive function, and 3) an emotional social evaluation task to measure sensitivity to social judgments. Then, we confirmed the generalizability of our results in a wide range of samples (children (N = 50), young adults (N = 172), older adults (N = 39), online young adults (N=93), and depression patients (N = 41)) using touchscreen and online computer-based tasks, and devised a spontaneous thought generation task that was strongly associated with, and therefore could potentially serve as an alternative to, self-report scales. Using PCA, we extracted five components that represented different aspects of cognitive-affective function (emotional bias, emotional sensitivity, general accuracy, and general/social attention). Next, a gamified version of the above tasks was developed to test the feasibility of digital cognitive training over a 2-week period. A pilot training study utilizing this application showed decreases in emotional bias in the training group (that were not observed in the control group), which was correlated with a reduction in anxiety symptoms. Using a 2-channel wearable EEG system, we found that frontal alpha and gamma power were associated with both emotional bias and its reduction across the 2-week training period.
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Affiliation(s)
- Sang-Eon Park
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jisu Chung
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jeonghyun Lee
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
| | - Minwoo JB Kim
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Jinhee Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyungsook Kim
- Hanyang Digital Healthcare Center, Hanyang University, Seoul, Republic of Korea
| | - Choongwan Woo
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, Republic of Korea
- Department of Biomedical Engineering, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Suwon, Republic of Korea
| | - Hackjin Kim
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Sang Ah Lee
- Department of Brain and Cognitive Sciences, Seoul National University, Seoul, Republic of Korea
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Han B, Yan J, Xiong R, Wang M, Liu J, Jia L, Dou J, Liu X, Fan H, Li J, Zhang C, Sun X, Du H, Ma Y, Teng S, Jiang N, Lu G. The relationship between psychological distress and cognitive failure among breast cancer survivors: a network analysis. Front Psychol 2024; 15:1420125. [PMID: 39055990 PMCID: PMC11271155 DOI: 10.3389/fpsyg.2024.1420125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Background Psychological distress is highly prevalent and has a severe impact on the quality of life among breast cancer survivors. This type of distress is associated with cognitive failure. However, previous studies have focused solely on the total scale scores of these two concepts while ignoring the unique relationship between specific components. In the present study, we utilized network analysis to explore the relationship between psychological distress and cognitive failure in breast cancer survivors. Methods The network analysis approach was adopted to estimate the regularized partial correlation network in a cross-sectional sample of 409 breast cancer survivors. All participants were assessed using the Depression Anxiety Stress Scale and the Cognitive Failure Questionnaire. The Gaussian Graphical Model was employed to estimate the network, centrality indices, and edge weights, providing a description of the characteristics of the network. Results The results indicated that anxiety-stress and depression-stress were the strongest edges in the community of psychological distress. Distractibility-memory was the strongest edge in the community of cognitive failure. Distractibility and memory were the most central nodes, with the highest expected influence in the network. Depression and motor coordination acted as important bridge nodes with the highest bridge expected influence. Conclusion Distractibility and memory in cognitive failure played important roles in activating and maintaining the relationship network. Motor coordination was identified as the crucial pathway for the impact of cognitive failure on psychological distress. Interventions targeting these specific issues might be more effective in improving cognitive failure and reducing psychological distress among breast cancer survivors.
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Affiliation(s)
- Bingxue Han
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Jialin Yan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Ruoyu Xiong
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Miaomiao Wang
- College of Teacher Education, Weifang University, Weifang, Shandong, China
| | - Jinxia Liu
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Liping Jia
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jinhua Dou
- Student Affairs Department, Shandong Second Medical University, Weifang, Shandong, China
| | - Xiaoli Liu
- School of Public Health, Shandong Second Medical University, Weifang, Shandong, China
| | - Huaju Fan
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Jianying Li
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Caiyun Zhang
- Department of Thyroid and Breast Surgery, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong, China
| | - Xiuhong Sun
- Department of Thyroid and Breast Surgery, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China
| | - He Du
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Yufeng Ma
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Shuai Teng
- Psychological Counseling Center, Weifang University, Weifang, Shandong, China
| | - Nengzhi Jiang
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
| | - Guohua Lu
- School of Psychology, Shandong Second Medical University, Weifang, Shandong, China
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Eberhard D, Gillberg C, Billstedt E. Cognitive functioning in adult psychiatric patients with and without attention-deficit/hyperactivity disorder. Brain Behav 2024; 14:e3626. [PMID: 39054265 PMCID: PMC11272415 DOI: 10.1002/brb3.3626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/11/2024] [Accepted: 06/19/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Studies of cognitive functioning in patients with attention-deficit/hyperactivity disorder (ADHD) have often used healthy comparison groups. The present study examines cognitive profiles, including general intellectual and executive functions, in a young adult psychiatric outpatient clientele with ADHD and evaluates whether their cognitive profiles can help differentiate them from patients with non-ADHD-associated psychiatric disorders. METHODS The study group comprised 141 young adult psychiatric patients (age range 18-25 years) of whom 78 had ADHD. Comprehensive neuropsychological assessment included the Wechsler Adult Intelligence Scale, 4th version and subtests from Delis-Kaplan Executive Function System. Clinical psychiatric assessments and diagnostic evaluation were performed. RESULTS The ADHD group (including all subtypes) had significantly lower verbal comprehension and full-scale intelligence quotient than the non-ADHD group. Tests measuring working memory or executive function did not separate those with and without ADHD. CONCLUSION The results of our study suggest that, except for the need to establish overall cognitive performance level, the clinical implication of testing is small if the purpose is to "rule out" an ADHD diagnosis.
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Affiliation(s)
- D. Eberhard
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
| | - C. Gillberg
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Child Neuropsychiatric ClinicQueen Silvia Children´s HospitalGothenburgSweden
| | - E. Billstedt
- Gillberg Neuropsychiatry Centre, Sahlgrenska Academy, University of GothenburgGothenburgSweden
- Child Neuropsychiatric ClinicQueen Silvia Children´s HospitalGothenburgSweden
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Li YT, Zhang C, Han JC, Shang YX, Chen ZH, Cui GB, Wang W. Neuroimaging features of cognitive impairments in schizophrenia and major depressive disorder. Ther Adv Psychopharmacol 2024; 14:20451253241243290. [PMID: 38708374 PMCID: PMC11070126 DOI: 10.1177/20451253241243290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/14/2024] [Indexed: 05/07/2024] Open
Abstract
Cognitive dysfunctions are one of the key symptoms of schizophrenia (SZ) and major depressive disorder (MDD), which exist not only during the onset of diseases but also before the onset, even after the remission of psychiatric symptoms. With the development of neuroimaging techniques, these non-invasive approaches provide valuable insights into the underlying pathogenesis of psychiatric disorders and information of cognitive remediation interventions. This review synthesizes existing neuroimaging studies to examine domains of cognitive impairment, particularly processing speed, memory, attention, and executive function in SZ and MDD patients. First, white matter (WM) abnormalities are observed in processing speed deficits in both SZ and MDD, with distinct neuroimaging findings highlighting WM connectivity abnormalities in SZ and WM hyperintensity caused by small vessel disease in MDD. Additionally, the abnormal functions of prefrontal cortex and medial temporal lobe are found in both SZ and MDD patients during various memory tasks, while aberrant amygdala activity potentially contributes to a preference to negative memories in MDD. Furthermore, impaired large-scale networks including frontoparietal network, dorsal attention network, and ventral attention network are related to attention deficits, both in SZ and MDD patients. Finally, abnormal activity and volume of the dorsolateral prefrontal cortex (DLPFC) and abnormal functional connections between the DLPFC and the cerebellum are associated with executive dysfunction in both SZ and MDD. Despite these insights, longitudinal neuroimaging studies are lacking, impeding a comprehensive understanding of cognitive changes and the development of early intervention strategies for SZ and MDD. Addressing this gap is critical for advancing our knowledge and improving patient prognosis.
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Affiliation(s)
- Yu-Ting Li
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chi Zhang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China
| | - Jia-Cheng Han
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yu-Xuan Shang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Zhu-Hong Chen
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Guang-Bin Cui
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi’an 710038, Shaanxi, China
| | - Wen Wang
- Department of Radiology, Functional and Molecular Imaging Key Lab of Shaanxi Province, Tangdu Hospital, Fourth Military Medical University, 569 Xinsi Road, Xi’an 710038, Shaanxi, China
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Luciano M, Carmassi C, Sampogna G, Bertelloni CA, Abbate-Daga G, Albert U, Castellini G, Della Rocca B, Fantasia S, Menchetti M, Pedrinelli V, Pompili M, Signorelli MS, Tosato S, Fiorillo A. Longitudinal trajectories of psychosocial functioning in patients with pre-existing mental disorders after one year of COVID-19 pandemic. J Psychiatr Res 2024; 172:200-209. [PMID: 38401365 DOI: 10.1016/j.jpsychires.2024.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/09/2024] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March-April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June-July 2021), and after 6 months from T1 (T2- November-December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p < .001), PHQ scores at baseline >10 (B = 2.89, p < .05), while not living alone was found to be a protective factor (B = -2.5, p < .05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies.
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Affiliation(s)
- M Luciano
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy.
| | - C Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Sampogna
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - C A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - G Abbate-Daga
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - U Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Trieste, Italy
| | - G Castellini
- Department of Health Sciences, University of Florence, Florence, Italy
| | - B Della Rocca
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
| | - S Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - V Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - M Pompili
- Department of Neuroscience, Mental Health and Sense Organs, University of Rome "La Sapienza", Rome, Italy
| | - M S Signorelli
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - S Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - A Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli,", Naples, Italy
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Ahn JY, Kang Y, Kim A, Tae WS, Han KM, Ham BJ. Association Between White Matter Tract Integrity and Frontal-Executive Function in Non-Geriatric Adult Patients With Major Depressive Disorder. Psychiatry Investig 2024; 21:133-141. [PMID: 38321889 PMCID: PMC10910163 DOI: 10.30773/pi.2023.0229] [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: 07/18/2023] [Revised: 10/09/2023] [Accepted: 10/25/2023] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE This study investigated the association between white matter tract integrity and frontal executive function in adult non-geriatric patients with major depressive disorder (MDD) and healthy controls (HCs) using diffusion tensor imaging (DTI). METHODS In total, 57 patients with MDD and 115 HCs participated in this study. We calculated the integrity of the white matter tracts using the Tracts Constrained by Underlying Anatomy tool (TRACULA) from FreeSurfer. We performed cognitive function tests. Oneway analysis of covariance was used to investigate the DTI parameters as dependent variables; diagnosis of MDD as an independent variable; and age, sex, and education level as covariates. For correlation analysis between the DTI parameters and cognitive function tests, Pearson's partial correlation analyses were performed in the MDD and HC groups. RESULTS The patients with MDD showed significantly decreased axial diffusivity (AD) in forceps major (FMajor), left corticospinal tract (CST), left superior longitudinal fasciculus-parietal bundle (SLFP), right anterior thalamic radiation (ATR), right CST, right inferior longitudinal fasciculus (ILF) and right superior longitudinal fasciculus-temporal bundle (SLFT) and mean diffusivity (MD) in the left CST, right CST, and right SLFT compared to HCs. We found that non-geriatric patients with MDD showed a significant negative correlation between the response time in the Stroop task and the AD value of the FMajor. CONCLUSION Our findings suggest that impaired structural connectivity in the FMajor may be associated with cognitive dysfunction in non-geriatric patients with MDD.
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Affiliation(s)
- Joo-Yeon Ahn
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Youbin Kang
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Aram Kim
- Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Woo-Suk Tae
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Kyu-Man Han
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
| | - Byung-Joo Ham
- Department of Psychiatry, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
- Brain Convergence Research Center, Korea University, Seoul, Republic of Korea
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Yulug B, Ayyildiz S, Sayman D, Karaca R, Ipek L, Cankaya S, Salar AB, Ayyildiz B, Mikuta C, Yagci N, Oktem EO, Ozsimsek A, Velioglu HA, Hanoglu L. The functional role of the pulvinar in discriminating between objective and subjective cognitive impairment in major depressive disorder. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2024; 10:e12450. [PMID: 38356480 PMCID: PMC10865482 DOI: 10.1002/trc2.12450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/04/2023] [Accepted: 11/09/2023] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Emotionally driven cognitive complaints represent a major diagnostic challenge for clinicians and indicate the importance of objective confirmation of the accuracy of depressive patients' descriptions of their cognitive symptoms. METHODS We compared cognitive status and structural and functional brain connectivity changes in the pulvinar and hippocampus between patients with total depression and healthy controls. The depressive group was also classified as "amnestic" or "nonamnestic," based on the members' subjective reports concerning their forgetfulness. We then sought to determine whether these patients would differ in terms of objective neuroimaging and cognitive findings. RESULTS The right pulvinar exhibited altered connectivity in individuals with depression with objective cognitive impairment, a finding which was not apparent in depressive patients with subjective cognitive impairment. DISCUSSION The pulvinar may play a role in depression-related cognitive impairments. Connectivity network changes may differ between objective and subjective cognitive impairment in depression and may play a role in the increased risk of dementia in patients with depression.
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Affiliation(s)
- Burak Yulug
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
- Department of Neurology and NeuroscienceIstanbul Medipol UniversityIstanbulTurkey
| | - Sevilay Ayyildiz
- School of MedicineDepartment of NeuroradiologyTechnical University of MunichMunichGermany
- School of MedicineTUM‐NIC Neuroimaging CenterTechnical University of MunichMunichGermany
- Anatomy PhD ProgramGraduate School of Health SciencesKocaeli UniversityIstanbulTurkey
| | - Dila Sayman
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Ramazan Karaca
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Lutfiye Ipek
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Seyda Cankaya
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Ali Behram Salar
- Functional Imaging and Cognitive‐Affective Neuroscience Lab (fINCAN)Health Sciences and Technology Research Institute (SABITA)Istanbul Medipol UniversityIstanbulTurkey
| | - Behcet Ayyildiz
- Anatomy PhD ProgramGraduate School of Health SciencesKocaeli UniversityIstanbulTurkey
| | - Christian Mikuta
- Translational Research CenterUniversity Hospital of Psychiatry and PsychotherapyUniversity of BernBernSwitzerland
- Interdisciplinary Biosciences Doctoral Training PartnershipDepartment of PhysiologyAnatomy and GeneticsUniversity of OxfordOxfordUK
| | - Nilay Yagci
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Ece Ozdemir Oktem
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Ahmet Ozsimsek
- Department of Neurology and NeuroscienceAlanya Alaaddin Keykubat UniversityAntalyaTurkey
| | - Halil Aziz Velioglu
- School of MedicineTUM‐NIC Neuroimaging CenterTechnical University of MunichMunichGermany
- Center for Psychiatric NeuroscienceFeinstein Institute for Medical ResearchManhassetNew YorkUSA
| | - Lutfu Hanoglu
- Department of Neurology and NeuroscienceIstanbul Medipol UniversityIstanbulTurkey
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Zang JCS, Hohoff C, Van Assche E, Lange P, Kraft M, Sandmann S, Varghese J, Jörgens S, Knight MJ, Baune BT. Immune gene co-expression signatures implicated in occurence and persistence of cognitive dysfunction in depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110826. [PMID: 37451594 DOI: 10.1016/j.pnpbp.2023.110826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
Cognitive dysfunction contributes significantly to the burden caused by Major Depressive Disorder (MDD). Yet, while compelling evidence suggests that different biological processes play a part in both MDD aetiology and the development of cognitive decline more generally, we only begin to understand the molecular underpinnings of depression-related cognitive impairment. Developments in psychometric assessments, molecular high-throughput methods and systems biology derived analysis strategies advance this endeavour. Here, we aim to identify gene expression signatures associated with cognitive dysfunction and cognitive improvement following therapy using RNA sequencing to analyze the whole blood-derived transcriptome of altogether 101 MDD patients who enrolled in the CERT-D study. The mRNA(Nova)Seq based transcriptome was analyzed from whole blood taken at baseline assessment, and patients' cognitive performance was measured twice at baseline and following eight weeks of therapy by means of the THINC integrated tool. Thirty-six patients showed comparatively low cognitive performance at baseline assessment, and 32 patients showed comparatively strong cognitive improvement following therapy. Differential gene expression analysis was performed using limma to a significance threshold of 0.05 and a logFC cutoff of |1.2|. Although we observed some indications for expression differences related to low cognitive performance and cognitive therapy response, signals did not withstand adjustment for multiple testing. Applying WGCNA, we retrieved altogether 25 modules of co-expressed genes and we used a combination of correlational and linear analyses to identify modules related to baseline cognitive performance and cognitive improvement following therapy. Three immune modules reflected distinct but interrelated immune processes (the yellow module: neutrophil-mediated immunity, the darkorange module: interferon signaling, the tan module: platelet activation), and higher expression of the yellow (r = -0.21, p < .05), the dark orange (r = 0.2, p < .05), and the tan (r = -0.23, p < .05) module correlated significantly negatively with patients' cognitive baseline performance. Patients' cognitive baseline performance was a significant predictor of the darkorange module (b = -0.039, p < .05) and the tan module's expression (b = 0.02, p < .05) and was close to becoming a significant predictor of the yellow module's expression (b = -0.02, p = .05). Furthermore, patients characterized by comparatively low cognitive performance at baseline showed significantly higher expression of the tan module when compared to all other patients F(1,97) = 4.32, p < .05, η= 0.04. Following eight weeks of treatment, we observed altogether significant improvement in patients' cognitive performance (b = 0.30, p < .001), and patients with comparatively high cognitive gain showed noticeably lower, but not significantly lower F(1,98) = 3.76, p = .058, expression of a dark turquoise module, which reflects complement and B-cell-associated immune processes. Noteworthy, the relation between cognitive performance and module expression remained observable after controlling for symptom severity and BMI, which partly accounted for variance in module expression. As such, our findings provide further evidence for the involvement of immune processes in MDD related cognitive dysfunction and they suggest that different immune processes contribute to the development and long-term persistence of cognitive dysfunction in the context of depression.
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Affiliation(s)
- Johannes C S Zang
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Christa Hohoff
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Evelien Van Assche
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Pia Lange
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Manuel Kraft
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Sarah Sandmann
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany.
| | - Silke Jörgens
- Department of Psychiatry, University of Münster, 48149 Münster, Germany.
| | - Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, 48149 Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, VIC 3010, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC 3010, Australia.
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Xu Z, Xie M, Wang Z, Chen H, Zhang X, Li W, Jiang W, Liu N, Zhang N. Altered brain functional network topology in Obsessive-Compulsive Disorder: A comparison of patients with varying severity of depressive symptoms and the impact on psychosocial functioning. Neuroimage Clin 2023; 40:103545. [PMID: 38006651 PMCID: PMC10755823 DOI: 10.1016/j.nicl.2023.103545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is associated with psychosocial impairment, which can be exacerbated by depressive symptoms. In this study, we employed graph theory analysis to investigate the association among neuroimaging, clinical features, and psychosocial functioning in OCD patients, with a specific focus on the differential impact of depressive symptoms. METHODS 216 OCD patients were divided into two subgroups based on depressive symptoms. Resting-state functional MRI data were acquired from a subset of 106 OCD patients along with 77 matched healthy controls (HCs). We analyzed the topological characteristics of the entire brain and the cognition-related subnetworks and performed Pearson correlation analyses to further explore the relationship with psychosocial functioning. RESULTS OCD patients with more severe depressive symptoms exhibited greater impairment across all dimensions of psychosocial functioning. Graph theory analysis revealed more pronounced reductions in network efficiency within the entire brain, the default mode network (DMN), and the cingulo-opercular network (CON) among patients with non or mild depressive symptoms. Lower nodal efficiency and degree centrality of the right superior temporal gyrus (STG) were found in OCD patients and these variables were positively correlated with psychosocial functioning impairment. CONCLUSIONS This study revealed that the presence of depressive symptoms generally exacerbated psychosocial functioning impairment in OCD patients. Abnormalities in the functional integration of the entire brain, the DMN, and the CON in OCD patients may comprise the basis of cognitive deficits, while dysfunction of the right STG may affect the psychosocial functioning through its role in emotion, intention perception, and insight.
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Affiliation(s)
- Zhihan Xu
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Minyao Xie
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Zhongqi Wang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Haochen Chen
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Xuedi Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Wangyue Li
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Wenjing Jiang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China
| | - Na Liu
- Department of Medical Psychology, The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.
| | - Ning Zhang
- The Affiliated Brain Hospital of Nanjing Medical University, 264 Guangzhou Road, Nanjing 210029, China.
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10
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Jamieson C, Canuso CM, Ionescu DF, Lane R, Qiu X, Rozjabek H, Molero P, Fu DJ. Effects of esketamine on patient-reported outcomes in major depressive disorder with active suicidal ideation and intent: a pooled analysis of two randomized phase 3 trials (ASPIRE I and ASPIRE II). Qual Life Res 2023; 32:3053-3061. [PMID: 37439961 PMCID: PMC10522733 DOI: 10.1007/s11136-023-03451-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 07/14/2023]
Abstract
PURPOSE To assess the effect of esketamine nasal spray on patient-reported outcomes (PROs) in patients with major depressive disorder having active suicidal ideation with intent (MDSI). METHODS Patient-level data from two phase 3 studies (ASPIRE I; ASPIRE II) of esketamine + standard of care (SOC) in patients (aged 18-64 years) with MDSI, were pooled. PROs were evaluated from baseline through end of the double-blind treatment phase (day 25). Outcome assessments included: Beck Hopelessness Scale (BHS), Quality of Life (QoL) in Depression Scale (QLDS), European QoL Group-5-Dimension-5-Level (EQ-5D-5L), and 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9). Changes in BHS and QLDS scores (baseline to day 25) were analyzed using a mixed-effects model for repeated measures (MMRM). RESULTS Pooled data for esketamine + SOC (n = 226; mean age: 40.5 years, 59.3% females) and placebo + SOC (n = 225; mean age: 39.6 years, 62.2% females) were analyzed. Mean ± SD change from baseline to day 25, esketamine + SOC vs placebo + SOC (least-square mean difference [95% CI] based on MMRM): BHS total score, - 7.4 ± 6.7 vs - 6.8 ± 6.5 [- 1.0 (- 2.23, 0.21)]; QLDS score, - 14.4 ± 11.5 vs - 12.2 ± 10.8 [- 3.1 (- 5.21, - 1.02)]. Relative risk (95% CI) of reporting perceived problems (slight to extreme) in EQ-5D-5L dimensions (day 25) in esketamine + SOC vs placebo + SOC: mobility [0.78 (0.50, 1.20)], self-care [0.83 (0.55, 1.27)], usual activities [0.87 (0.72, 1.05)], pain/discomfort [0.85 (0.69, 1.04)], and anxiety/depression [0.90 (0.80, 1.00)]. Mean ± SD changes from baseline in esketamine + SOC vs placebo + SOC for health status index: 0.23 ± 0.21 vs 0.19 ± 0.22; and for EQ-Visual Analogue Scale: 24.0 ± 27.2 vs 19.3 ± 24.4. At day 25, mean ± SD in domains of TSQM-9 scores in esketamine + SOC vs placebo + SOC were: effectiveness, 67.2 ± 25.3 vs 56.2 ± 26.8; global satisfaction, 69.9 ± 25.2 vs 56.3 ± 27.8; and convenience, 74.0 ± 19.4 vs 75.4 ± 18.7. CONCLUSION These PRO data support the patient perspective of the effect associated with esketamine + SOC in improving health-related QoL in patients with MDSI. TRIAL REGISTRATION ClinicalTrials.gov Identifier: ASPIRE I, NCT03039192 (Registration date: February 1, 2017); ASPIRE II, NCT03097133 (Registration date: March 31, 2017).
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Affiliation(s)
| | - Carla M Canuso
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Rosanne Lane
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - Xin Qiu
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | | | - Patricio Molero
- Department of Psychiatry, Clinica Universidad de Navarra, Pamplona, Spain
| | - Dong-Jing Fu
- Janssen Research & Development, LLC, Titusville, NJ, USA
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11
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Gryksa K, Schmidtner AK, Masís-Calvo M, Rodríguez-Villagra OA, Havasi A, Wirobski G, Maloumby R, Jägle H, Bosch OJ, Slattery DA, Neumann ID. Selective breeding of rats for high (HAB) and low (LAB) anxiety-related behaviour: A unique model for comorbid depression and social dysfunctions. Neurosci Biobehav Rev 2023; 152:105292. [PMID: 37353047 DOI: 10.1016/j.neubiorev.2023.105292] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/13/2023] [Accepted: 06/19/2023] [Indexed: 06/25/2023]
Abstract
Animal models of selective breeding for extremes in emotionality are a strong experimental approach to model psychopathologies. They became indispensable in order to increase our understanding of neurobiological, genetic, epigenetic, hormonal, and environmental mechanisms contributing to anxiety disorders and their association with depressive symptoms or social deficits. In the present review, we extensively discuss Wistar rats selectively bred for high (HAB) and low (LAB) anxiety-related behaviour on the elevated plus-maze. After 30 years of breeding, we can confirm the prominent differences between HAB and LAB rats in trait anxiety, which are accompanied by consistent differences in depressive-like, social and cognitive behaviours. We can further confirm a single nucleotide polymorphism in the vasopressin promotor of HAB rats causative for neuropeptide overexpression, and show that low (or high) anxiety and fear levels are unlikely due to visual dysfunctions. Thus, HAB and LAB rats continue to exist as a reliable tool to study the multiple facets underlying the pathology of high trait anxiety and its comorbidity with depression-like behaviour and social dysfunctions.
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Affiliation(s)
- Katharina Gryksa
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Anna K Schmidtner
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Marianella Masís-Calvo
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Odir A Rodríguez-Villagra
- Centro de Investigación en Neurosciencias, Universidad de Costa Rica, San Pedro, San José, Costa Rica.
| | - Andrea Havasi
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Gwendolyn Wirobski
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Rodrigue Maloumby
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - Herbert Jägle
- Department of Ophthalmology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany.
| | - Oliver J Bosch
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
| | - David A Slattery
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Heinrich-Hoffmann-Straße 10, 60528 Frankfurt am Main, Germany.
| | - Inga D Neumann
- Department of Behavioural and Molecular Neurobiology, Regensburg Center of Neuroscience, University of Regensburg, Universitaetsstr. 31, 93053 Regensburg, Germany.
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12
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Ogrodnik M, Karsan S, Cirone V, Heisz JJ. Exploring the Relationship between Cardiorespiratory Fitness and Executive Functioning in Adults with ADHD. Brain Sci 2023; 13:673. [PMID: 37190638 PMCID: PMC10136722 DOI: 10.3390/brainsci13040673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/04/2023] [Accepted: 04/13/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Associations between measures of executive functioning (EF) and cardiorespiratory fitness (CRF) were examined for adults with and without ADHD. METHOD Measures of executive functioning including the Stroop task, Wisconsin Card Sorting task, and Operation Span Task were completed virtually (n = 36 ADHD; n = 36 Control). Participants completed the Six-Minute Walk Test to estimate CRF. RESULTS Mean performance measures of executive function did not differ by group. However, higher estimated CRF was associated with better Stroop task performance, and the association was strongest for individuals with ADHD. CONCLUSION In adults with ADHD, higher estimated CRF was associated with better inhibitory control, but not with other measures of executive functioning.
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Affiliation(s)
- Michelle Ogrodnik
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Sameena Karsan
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Victoria Cirone
- Department of Physical Therapy, Djavad Mowafaghian Centre for Brain Health, Vancouver Coastal Health Research Institute, The Centre for Aging SMART, The University of British Columbia, Vancouver, BC V1Y 1T3, Canada
| | - Jennifer J. Heisz
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, ON L8S 4L8, Canada
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13
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Guedes PHG, Brussasco JG, Moço ACR, Moraes DD, Segatto M, Flauzino JMR, Mendes-Silva AP, Vieira CU, Madurro JM, Brito-Madurro AG. A highly reusable genosensor for late-life depression diagnosis based on microRNA 184 attomolar detection in human plasma. Talanta 2023; 258:124342. [PMID: 36940569 DOI: 10.1016/j.talanta.2023.124342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Late-Life Depression (LLD) is one of the most prevalent psychiatric disorders in elderly, causing significant functional impairments. MicroRNAs are small molecules involved in the post-transcriptional regulation of gene expression. Elderly individuals diagnosed with LLD present down regulation of miR-184 (hsa-miR-184) expression compared to healthy patients. Therefore, this miR-184 can be used as a biomarker to diagnose LLD. Current LLD diagnosis depends primarily on clinical subjective identification, based on symptoms and variable scales. This work introduces a novel and facile approach for the LLD diagnosis based on the development of an electrochemical genosensor for miR-184 detection in plasma, using differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS). DPV results presented a 2-Fold increase in current value for healthy patients, compared to individuals with LLD when monitoring ethidium bromide oxidation peak. For EIS, a 1.5-fold increase in charge transfer resistance for healthy elderly subjects was observed in comparison with depressed patients. In addition, the analytical performance of the biosensor was evaluated using DPV, obtaining a linear response ranging from 10-9 mol L-1 to 10-17 mol L-1 of miR-184 in plasma and a detection limit of 10 atomoles L-1. The biosensor presented reusability, selectivity and stability, the current response remained 72% up to 50 days of storage. Thus, the genosensor proved to be efficient in the diagnosis of LLD, as well as the accurate quantification of miR-184 in real plasma samples of healthy and depressed patients.
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Affiliation(s)
- Pedro H G Guedes
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - Jéssica G Brussasco
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - Anna C R Moço
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - Dayane D Moraes
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - Monica Segatto
- Institute of Chemistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - José M R Flauzino
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - Ana P Mendes-Silva
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil; Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Carlos U Vieira
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil
| | - João M Madurro
- Institute of Chemistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Ana G Brito-Madurro
- Institute of Biotecnology, Federal University of Uberlândia, Uberlândia, Brazil.
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14
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Di Vincenzo M, Sampogna G, Della Rocca B, Brandi C, Mancuso E, Landolfi L, Volpicelli A, Di Cerbo A, Fiorillo A, Luciano M. What influences psychological functioning in patients with mood disorders? The role of clinical, sociodemographic, and temperamental characteristics in a naturalistic study. Ann Gen Psychiatry 2022; 21:51. [PMID: 36566232 PMCID: PMC9789623 DOI: 10.1186/s12991-022-00428-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/07/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The present study aims to assess clinical and psychological correlates of psychological functioning in patients with mood disorders, in a naturalistic setting. In particular, we aimed to describe which sociodemographic, clinical, and temperamental dispositions are more frequently associated with poor psychological functioning, and to describe the association between cognitive and psychological functioning in euthymic patients with major depression and bipolar disorder. METHODS Inclusion criteria were as follows: (1) diagnosis of major depression, or bipolar disorder type I or II; (2) age between 18 and 65 years; and (3) being in a stable phase of the disorder. Patients' psychiatric symptoms, quality of life, affective temperaments, and impulsivity were investigated with validated assessment instruments. RESULTS 166 patients have been recruited, mainly female (55.4%), whose mean age was 47.1 ± 14.2 years. 42.6% of individuals reported a diagnosis of major depression. According to regression analyses, poor cognitive performance (p < 0.05), reduced perceived quality of life (p < .0001), lifetime suicide attempts (p < 0.01), and increased trait-related impulsivity (p <0 .001) strongly correlated with poor psychological functioning. Moreover, cyclothymic and irritable dispositions were also associated with poor social functioning (p < 0.01), whereas hyperthymic affective disposition was associated to a better psychological performance (p < 0.01). CONCLUSIONS Our results support the evidence that patients with mood disorders should be assessed for psychological functioning and affective dispositions, to identify patients at higher risk to develop worse long-term outcomes and to develop targeted interventions.
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Affiliation(s)
- Matteo Di Vincenzo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy.
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Bianca Della Rocca
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Carlotta Brandi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Emiliana Mancuso
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Lorenzo Landolfi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Antonio Volpicelli
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Arcangelo Di Cerbo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
| | - Mario Luciano
- Department of Psychiatry, University of Campania "L. Vanvitelli", Largo Madonna Delle Grazie, 80139, Naples, Italy
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15
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Freidl M, Wegerer M, Litvan Z, König D, Alexandrowicz RW, Portela-Millinger F, Gruber M. Determinants of quality of life improvements in anxiety and depressive disorders-A longitudinal study of inpatient psychotherapy. Front Psychiatry 2022; 13:937194. [PMID: 36590609 PMCID: PMC9798124 DOI: 10.3389/fpsyt.2022.937194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 11/21/2022] [Indexed: 12/23/2022] Open
Abstract
Background Quality of life (QoL) is substantially impaired in patients with anxiety disorders (AD) and depressive disorders (DD) and improvements in symptom burden after psychotherapy are not always paralleled by similar improvements in QoL. So far, little is known about treatment outcome in terms of QoL and predictors of QoL improvements following inpatient psychotherapy with a focus on cognitive behavior therapy (CBT). The current study aimed at investigating the relationship between changes in symptoms and QoL across different life domains. Additionally, predictors of a positive treatment outcome were evaluated. Methods 122 patients with AD and/or DD undergoing an 8-weeks inpatient CBT program completed self-report measures of psychopathological symptoms and QoL at pre- and post-treatment. Mixed effects models were used to investigate changes, a confirmatory factor analysis was applied to analyze the latent factor structure of the anxiety sensitivity index and binary logistic regression analyses were performed for predictors of QoL improvements. Results Patients showed moderate to strong decreases in anxious and depressive symptoms and moderate to strong improvements in general QoL, particularly in the psychological and physical QoL subdomains. Changes in symptom burden correlated most strongly with psychological and physical QoL. In addition, poor QoL before treatment and low levels of specific anxiety sensitivity symptoms (items 1 and 5) significantly predicted improvement in QoL. Conclusion Patients with poor QoL who are not as inhibited to openly express their anxious feelings particularly benefit from inpatient psychotherapy (individual and group) to improve their QoL. In contrast, our research suggests that patients who are too anxious to openly express their nervousness should receive additional social skills training, more focused treatment to build sufficient self-confidence to better engage in the treatment program.
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Affiliation(s)
- Marion Freidl
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Melanie Wegerer
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Zsuzsa Litvan
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Daniel König
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Filipe Portela-Millinger
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Maria Gruber
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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16
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Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. MEDICAL EDUCATION ONLINE 2022; 27:2093427. [PMID: 35747998 PMCID: PMC9245981 DOI: 10.1080/10872981.2022.2093427] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 06/15/2023]
Abstract
Depression is common worldwide, and stigmatizing attitudes toward depression have proved to be one of the major barriers to seeking professional help. The purpose of this study was to evaluate the level of personal depression stigma and identify its predictive factors among medical students in Hainan, China, as well as explore the gender difference. A total of 2,186 medical students were recruited using stratified random cluster sampling and interviewed by structured anonymous questionnaires. Personal stigma was measured by the standardized Depression Stigma Scale (DSS). Multivariate linear regression models were used to identify predictors of stigma, and the interactions between gender and each predictor were included to test its gender difference. The mean score on DSS Scale was 13.71 ± 5.35, with males significantly higher than females (14.85 vs 12.99, P < 0.0001). Compared to females, males were more likely to agree with 'I would not vote for a class cadre if I knew they had been depressed' and 'I would not make friends with him if I knew he had been depressed'. Multivariate linear regression analysis revealed that males' personal stigma was predicted by being only child (ß = 1.01, P = 0.0083), moderate-to-severe depression (ß = 1.12, P = 0.0302), and lower self-rated academic core competitiveness (Competitive: ß = 1.29, P = 0.0088, Not at all/Somewhat competitive: ß = 1.04, P = 0.0381), while females' personal stigma was only associated with moderate-to-severe depression (ß = 1.75, P < 0.0001). Significant interactions were found between gender and self-rated academic core competitiveness. Stigmatizing attitudes toward depression were prevalent among Chinese medical students, especially male students. Gender differences were found in the predictors of stigma. Effective measures must be taken to reduce the stigma of mental health among Chinese medical students.
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Affiliation(s)
- Lei Qiu
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Yawen Feng
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Jiaxin Luo
- School of Management, Hainan Medical University, Hainan, P. R. China
| | - Yinuo Zhang
- International School of Public Health and One Health, Hainan Medical University, Hainan, P. R. China
| | - Qin Yang
- Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, P. R. China
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17
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Colwell MJ, Tagomori H, Chapman S, Gillespie AL, Cowen PJ, Harmer CJ, Murphy SE. Pharmacological targeting of cognitive impairment in depression: recent developments and challenges in human clinical research. Transl Psychiatry 2022; 12:484. [PMID: 36396622 PMCID: PMC9671959 DOI: 10.1038/s41398-022-02249-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/18/2022] Open
Abstract
Impaired cognition is often overlooked in the clinical management of depression, despite its association with poor psychosocial functioning and reduced clinical engagement. There is an outstanding need for new treatments to address this unmet clinical need, highlighted by our consultations with individuals with lived experience of depression. Here we consider the evidence to support different pharmacological approaches for the treatment of impaired cognition in individuals with depression, including treatments that influence primary neurotransmission directly as well as novel targets such as neurosteroid modulation. We also consider potential methodological challenges in establishing a strong evidence base in this area, including the need to disentangle direct effects of treatment on cognition from more generalised symptomatic improvement and the identification of sensitive, reliable and objective measures of cognition.
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Affiliation(s)
- Michael J Colwell
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Hosana Tagomori
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Sarah Chapman
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Amy L Gillespie
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Philip J Cowen
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Catherine J Harmer
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
| | - Susannah E Murphy
- University Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK.
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
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18
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McIntyre RS, Lipsitz O, Rodrigues NB, Subramaniapillai M, Nasri F, Lee Y, Fehnert B, King J, Chrones L, Kratiuk K, Uddin S, Rosenblat JD, Mansur RB, McCue M. An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study. JMIR Ment Health 2022; 9:e33871. [PMID: 36301615 PMCID: PMC9650567 DOI: 10.2196/33871] [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: 10/04/2021] [Revised: 06/29/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is an impairing core symptom of depression. Among adults with major depressive disorder (MDD) treated with antidepressants, residual cognitive symptoms interfere with patient-reported outcomes. The foregoing characterization of cognitive symptoms provides the rationale for screening and assessing the severity of cognitive symptoms at point of care. However, clinical neurocognitive assessments are time-consuming and difficult, and they require specialist expertise to interpret them. A smartphone-delivered neurocognitive test may offer an effective and accessible tool that can be readily implemented into a measurement-based care framework. OBJECTIVE We aimed to evaluate the use of a smartphone-delivered app-based version of the established Cognition Kit Digit Symbol Substitution Test (DSST) neurocognitive assessment compared to a traditional paper-and-pencil version. METHODS Convergent validity and test-retest reliability of the 2 versions were evaluated. Patient satisfaction with the app was also assessed. RESULTS Assessments made using the app-based Cognition Kit DSST were highly correlated with the standard paper-and-pencil version of the test, both at the baseline visit (r=0.69, df=27; P<.001) and at the end-of-study visit (r=0.82, df=27; P<.001), and they were positively evaluated by 30 patients as being user-friendly, easy to navigate, and preferable over the paper-and-pencil version of the DSST. However, although the app-based Cognition Kit DSST was validated in patients with MDD, it still needs to be evaluated in healthy controls. CONCLUSIONS App-based DSST may facilitate a more personalized, convenient, and cost-effective method of cognitive assessment, helping to guide measurement-based care and psychotherapeutic and pharmacologic treatment options for patients with MDD. TRIAL REGISTRATION ClinicalTrials.gov NCT03999567; https://tinyurl.com/2p8pnyv7.
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Affiliation(s)
- Roger S McIntyre
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Orly Lipsitz
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Nelson B Rodrigues
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Mehala Subramaniapillai
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Flora Nasri
- Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Yena Lee
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada
| | - Ben Fehnert
- Ctrl Group, London, United Kingdom.,Cognition Kit, Cambridge, United Kingdom
| | - James King
- Cognition Kit, Cambridge, United Kingdom
| | - Lambros Chrones
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
| | - Kevin Kratiuk
- Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Sharif Uddin
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
| | - Joshua D Rosenblat
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Brain and Cognition Discovery Foundation, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada
| | - Rodrigo B Mansur
- University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maggie McCue
- Takeda Pharmaceuticals U.S.A., Inc., Lexington, MA, United States
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19
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Weller S, Schroeder PA, Plewnia C. Gamification improves antidepressant effects of cognitive control training-A pilot trial. Front Digit Health 2022; 4:994484. [PMID: 36339520 PMCID: PMC9635856 DOI: 10.3389/fdgth.2022.994484] [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: 07/14/2022] [Accepted: 10/03/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Computerised cognitive trainings have been put forward to improve control over negatively biased information processing and associated depressive symptomatology. Yet, disease-related impairments of motivation and endurance, as well as insufficient accessibility hinder use of this promising therapeutic opportunity. Here, we developed an app (de:)press© ) that utilizes a cognitive control training (paced auditory serial addition task) enriched with gamification and information elements. We compared a six-week training with de:)press© to a non-gamified version (active control group). METHODS Thirty-two depressed participants were included. Each received either de:)press© or the non-gamified version and was instructed to train three times per week for two weeks. Afterwards (four weeks) they were free to train at their own discretion. Depression severity was assessed during training and two follow-up sessions. Primary endpoint was defined as difference between groups [change of Montgomery-Åsberg Depression Rating Scale (MADRS)] four weeks after end of training. RESULTS Depression severity decreased in both groups. At primary endpoint, MADRS scores were significantly lower in the de:)press© -group compared to the control group. No differences were observed at three months' follow-up. Intervention usability was consistently rated positively. Participants who had trained with de:)press© maintained the recommended training frequency without further prompting. Besides transient fatigue or frustration, no adverse effects were observed. CONCLUSION This pilot demonstrates that gamification and information elements can substantially increase cognitive control training efficacy in alleviating depressive symptoms. Moreover, it provides first evidence for the feasibility and efficacy of de:)press© as an add-on intervention to treat depression. CLINICAL TRIAL REGISTRATION The study is registered under ClinicalTrials.gov, identifier: NCT04400162.
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Affiliation(s)
- Simone Weller
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Tuebingen, Germany
| | | | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Tuebingen Center for Mental Health, University Hospital of Tuebingen, Tuebingen, Germany,Correspondence: Christian Plewnia
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20
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Kaur H, Dhiman RK, Kulkarni AV, Premkumar M, Singh V, Duseja AK, Grover S, Grover GS, Roy A, Verma N, De A, Taneja S, Mehtani R, Mishra S, Kaur H. Improvement of chronic HCV infection-related depression, anxiety, and neurocognitive performance in persons achieving SVR-12: A real-world cohort study. J Viral Hepat 2022; 29:395-406. [PMID: 35266624 DOI: 10.1111/jvh.13668] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/14/2022] [Indexed: 02/05/2023]
Abstract
Chronic hepatitis C virus (HCV) infection is associated with neuropsychiatric changes. Also, patients with cirrhosis may develop overt or minimal hepatic encephalopathy. Sustained virological response (SVR) with direct-acting antiviral agents (DAAs) may improve the neuropsychiatric manifestations and quality of life (QoL). Consecutive patients (with and without cirrhosis, all genders and aged 18-65 years) with hepatitis C were assessed at enrolment and at 12 weeks after therapy completion for mood (Beck's Depression Inventory [BDI]), anxiety (generalized anxiety disorder [GAD-7]), QoL (SF-36 ver.2) and computer-based tests for number connection (NCT), visual memory, Stroop test and reaction times. We recruited 385 viraemic chronic HCV patients (76.1% male, 21.0% cirrhotic, mean age 39.4 ± 14.2 years, 59.3% genotype 3, mean HCV RNA load 5.8 log). Overall SVR-12 rates were 90.6%, with cure rates 87.6% and 91.4% in patients with and without cirrhosis, respectively. Patients who achieved SVR-12 had mean percentage reduction in BDI (11.3%, p = .000), GAD (8.6%, p = .001) and Stroop test (58.4%, p = .001), with improved NCT (1.7%, p = .001), visual memory (13.7%, p = .001) and digit span (23.8%, p = .002). On multivariate logistic regression, adherence (OR, 17.5 [95% CI 2.80-110.50], p = .000), high ALT (OR 1.02 [95% CI 1.00-1.05]), and BDI score (OR 1.73 [95% CI 1.42-3.26] p = .039) predicted cure. SVR-12 was associated with improved visual memory ≥5.5 (AUC-0.708; sensitivity 62.5%, specificity 63%, p = .000) and % correct Stroop test responses >26.6% (AUC-0.918, sensitivity 94.4% specificity 80.4%, p = .000). In conclusion, given the cumulative evidence of the safety of DAAs and efficacy of improving cognitive and neuropsychological and quality-of-life outcomes irrespective of age and gender, as shown in our study, future recommendations should focus on integrated universal HCV care to enable HCV elimination.
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Affiliation(s)
- Harmanpreet Kaur
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Virendra Singh
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Kumar Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gagandeep S Grover
- Programme Officer- NVHCP, Department of Health and Family Welfare, Government of Punjab, Punjab, India
| | - Akash Roy
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Nipun Verma
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arka De
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rohit Mehtani
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Saurabh Mishra
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harpreet Kaur
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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21
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Piani MC, Maggioni E, Delvecchio G, Brambilla P. Sustained attention alterations in major depressive disorder: A review of fMRI studies employing Go/No-Go and CPT tasks. J Affect Disord 2022; 303:98-113. [PMID: 35139418 DOI: 10.1016/j.jad.2022.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/23/2021] [Accepted: 02/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Major depressive disorder (MDD) is a severe psychiatric condition characterized by selective cognitive dysfunctions. In this regard, functional Magnetic Resonance Imaging (fMRI) studies showed, both at resting state and during tasks, alterations in the brain functional networks involved in cognitive processes in MDD patients compared to controls. Among those, it seems that the attention network may have a role in the disease pathophysiology. Therefore, in this review we aim at summarizing the current fMRI evidence investigating sustained attention in MDD patients. METHODS We conducted a search on PubMed on case-control studies on MDD employing fMRI acquisitions during Go/No-Go and continuous performance tasks. A total of 12 studies have been included in the review. RESULTS Overall, the majority of fMRI studies reported quantitative alterations in the response to attentive tasks in selective brain regions, including the prefrontal cortex, the cingulate cortex, the temporal and parietal lobes, the insula and the precuneus, which are key nodes of the attention, the executive, and the default mode networks. LIMITATIONS The heterogeneity in the study designs, fMRI acquisition techniques and processing methods have limited the generalizability of the results. CONCLUSIONS The results from the included studies showed the presence of alterations in the activation patterns of regions involved in sustained attention in MDD, which are in line with current evidence and seemed to explain some of the key symptoms of depression. However, given the paucity and heterogeneity of studies available, it may be worthwhile to continue investigating the attentional domain in MDD with ad-hoc study designs to retrieve more robust evidence.
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Affiliation(s)
- Maria Chiara Piani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy.
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Italy
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22
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Noto S, Wake M, Mishiro I, Hammer-Helmich L, Ren H, Moriguchi Y, Fujikawa K, Fernandez J. Health-Related Quality of Life Over 6 Months in Patients With Major Depressive Disorder Who Started Antidepressant Monotherapy. Value Health Reg Issues 2022; 30:127-133. [PMID: 35405582 DOI: 10.1016/j.vhri.2021.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/03/2021] [Accepted: 12/30/2021] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Major depressive disorder (MDD) is increasing worldwide and is associated with impaired quality of life (QOL). This study aimed to assess the QOL and its association with cognitive symptoms in patients with MDD who started antidepressant monotherapy. METHODS Data from the PERFORM (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder) study were analyzed. A descriptive epidemiological analysis on EQ-5D-5L utility score, the level of each dimension, and the EuroQoL visual analog scale value was conducted at 4 visits during 6 months' follow-up. The association between cognitive complaints and changes in QOL measures was analyzed using multivariate linear regression analysis. RESULTS The median EQ-5D-5L utility score improved from 0.67 at baseline to 0.82 at month 6. Although the proportion of patients reporting level 1 (no problem) in every dimension of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression increased over time, less than half of the patients achieved level 1 in pain/discomfort and depression/anxiety, which were closely related to depression and usual activities at month 6. Patients with no cognitive complaints or no history of MDD at baseline showed greater improvement in EQ-5D-5L utility scores and EuroQoL visual analog scale value for measuring QOL than those with these characteristics. CONCLUSIONS Treatment over 6 months improved QOL in patients with MDD although there remained room for improvement in dimensions of usual activities, pain/discomfort, and depression/anxiety. Cognitive complaints or history of MDD at baseline predicted less improvement in QOL at 6 months. Any history of MDD might delay improvement in QOL after treatment.
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Affiliation(s)
- Shinichi Noto
- Department of Rehabilitation, Niigata University of Health and Welfare, Niigata, Japan.
| | - Mayumi Wake
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | | | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Jovelle Fernandez
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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23
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Spagna A, Wang J, Rosario IE, Zhang L, Zu M, Wang K, Tian Y. Cognitive Considerations in Major Depression: Evaluating the Effects of Pharmacotherapy and ECT on Mood and Executive Control Deficits. Brain Sci 2022; 12:brainsci12030350. [PMID: 35326307 PMCID: PMC8946784 DOI: 10.3390/brainsci12030350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 02/04/2023] Open
Abstract
Deficits in the executive control of attention greatly impact the quality of life of patients diagnosed with major depressive disorder (MDD). However, attentional deficits are often underemphasized in clinical contexts compared with mood-based symptoms, and a comprehensive approach for specifically evaluating and treating them has yet to be developed. The present study evaluates the efficacy of bifrontal electroconvulsive therapy (ECT) combined with drug therapy (DT) in alleviating mood-related symptomatology and executive control deficits in drug-refractory MDD patients and compares these effects with those observed in MDD patients undergoing DT only. The Hamilton Rating Scale for Depression and the Lateralized Attentional Network Test-Revised were administered across two test sessions to assess treatment-related changes in mood-based symptoms and conflict processing, respectively, in patients undergoing ECT + DT (n = 23), patients undergoing DT (n = 33), and healthy controls (n = 40). Although both groups showed an improvement in mood-based symptoms following treatment and a deficit in conflict processing estimated on error rate, a post-treatment reduction of an executive control deficit estimated on RT was solely observed in the ECT + DT patient group. Furthermore, Bayesian correlational analyses confirmed the dissociation of mood-related symptoms and of executive control measures, supporting existing literature proposing that attentional deficits and mood symptoms are independent aspects of MDD. The cognitive profile of MDD includes executive control deficits, and while both treatments improved mood-based symptoms, only ECT + DT exerted an effect on both measures of the executive control deficit. Our findings highlight the importance of considering the improvement in both mood and cognitive deficits when determining the efficacy of therapeutic approaches for MDD.
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Affiliation(s)
- Alfredo Spagna
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
- Institute for Brain and Spinal Cord, Sorbonne University, 75013 Paris, France
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Jason Wang
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Isabella Elaine Rosario
- Department of Psychology, Columbia University in the City of New York, New York, NY 10027, USA; (J.W.); (I.E.R.)
| | - Li Zhang
- Anhui Mental Health Center, Hefei 230022, China;
| | - Meidan Zu
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
| | - Kai Wang
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230032, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei 230032, China
- Anhui Province Clinical Research Center for Neurological Disease, Hefei 230032, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
| | - Yanghua Tian
- Department of Psychology and Sleep Medicine, The Second Hospital of Anhui Medical University, Hefei 230601, China;
- Department of Neurology, The First Hospital of Anhui Medical University, Hefei 230022, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei 230031, China
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei 230601, China
- Correspondence: (A.S.); (K.W.); (Y.T.)
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24
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Piani MC, Maggioni E, Delvecchio G, Ferro A, Gritti D, Pozzoli SM, Fontana E, Enrico P, Cinnante CM, Triulzi FM, Stanley JA, Battaglioli E, Brambilla P. Sexual Dimorphism in the Brain Correlates of Adult-Onset Depression: A Pilot Structural and Functional 3T MRI Study. Front Psychiatry 2022; 12:683912. [PMID: 35069272 PMCID: PMC8766797 DOI: 10.3389/fpsyt.2021.683912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022] Open
Abstract
Major Depressive Disorder (MDD) is a disabling illness affecting more than 5% of the elderly population. Higher female prevalence and sex-specific symptomatology have been observed, suggesting that biologically-determined dimensions might affect the disease onset and outcome. Rumination and executive dysfunction characterize adult-onset MDD, but sex differences in these domains and in the related brain mechanisms are still largely unexplored. The present pilot study aimed to explore any interactions between adult-onset MDD and sex on brain morphology and brain function during a Go/No-Go paradigm. We hypothesized to detect diagnosis by sex effects on brain regions involved in self-referential processes and cognitive control. Twenty-four subjects, 12 healthy (HC) (mean age 68.7 y, 7 females and 5 males) and 12 affected by adult-onset MDD (mean age 66.5 y, 5 females and 7 males), underwent clinical evaluations and a 3T magnetic resonance imaging (MRI) session. Diagnosis and diagnosis by sex effects were assessed on regional gray matter (GM) volumes and task-related functional MRI (fMRI) activations. The GM volume analyses showed diagnosis effects in left mid frontal cortex (p < 0.01), and diagnosis by sex effects in orbitofrontal, olfactory, and calcarine regions (p < 0.05). The Go/No-Go fMRI analyses showed MDD effects on fMRI activations in left precuneus and right lingual gyrus, and diagnosis by sex effects on fMRI activations in right parahippocampal gyrus and right calcarine cortex (p < 0.001, ≥ 40 voxels). Our exploratory results suggest the presence of sex-specific brain correlates of adult-onset MDD-especially in regions involved in attention processing and in the brain default mode-potentially supporting cognitive and symptom differences between sexes.
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Affiliation(s)
- Maria Chiara Piani
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Adele Ferro
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Gritti
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara M. Pozzoli
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Fontana
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Paolo Enrico
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Claudia M. Cinnante
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Fabio M. Triulzi
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Jeffrey A. Stanley
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Elena Battaglioli
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Segrate, Italy
| | - Paolo Brambilla
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Neurosciences and Mental Health, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
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25
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Bergdolt J, Sellin P, Driessen M, Beblo T, Dehn LB. Neuropsychological predictors of vocational rehabilitation outcomes in individuals with major depression: A scoping review. Front Psychiatry 2022; 13:942161. [PMID: 36440409 PMCID: PMC9682155 DOI: 10.3389/fpsyt.2022.942161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Major depression is one of the leading causes of disability and limited capacity to work. Neuropsychological impairment is a common symptom in acute and remitted major depression and is associated with poor psychosocial functioning. This scoping review aimed to identify research on the role of neuropsychological functioning in outcomes of vocational rehabilitation programs in individuals with depression. METHODS We report on the conduct of this pre-registered (https://osf.io/5yrnf) scoping review in accordance with PRISMA-ScR guidelines. PubMed and PsychInfo were systematically searched for English or German research articles published between 1990 and September 2021 that studied objective neuropsychological tests as predictors of vocational rehabilitation interventions and included participants with depression. RESULTS The systematic literature search yielded no studies that specifically targeted subjects with major depression. However, eight articles published since 2016 were included in the review, analyzing data from five trials that evaluated the effectiveness of supported employment in North America and Europe in severe mental illnesses. An estimated 31% of the total number of participants included (n = 3,533) had major depression. Using a variety of cognitive tests and covariates, seven articles found that neuropsychological functioning - especially global cognition scores, verbal and visual learning and memory - significantly predicted vocational outcomes of rehabilitation programs. CONCLUSION Despite a lack of studies specifically targeting major depressive disorder, the identified literature suggests that higher baseline neuropsychological functioning predicts better vocational outcomes of supported employment programs in individuals with depression. In clinical practice, additional neuropsychological modules during return-to-work interventions might be helpful for vocational outcomes of such programs.
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Affiliation(s)
- Juliane Bergdolt
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Pauline Sellin
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Lorenz B Dehn
- Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, Universitätsklinikum OWL of Bielefeld University, Bielefeld, Germany.,Department of Psychology, Bielefeld University, Bielefeld, Germany
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26
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Knight MJ, Lyrtzis E, Fourrier C, Aboustate N, Sampson E, Hori H, Cearns M, Morgan J, Toben C, Baune BT. Psychological training to improve psychosocial function in patients with major depressive disorder: A randomised clinical trial. Psychiatry Res 2021; 300:113906. [PMID: 33853014 DOI: 10.1016/j.psychres.2021.113906] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/27/2021] [Indexed: 01/04/2023]
Abstract
Cognitive and emotional remediation training for depression (CERT-D): a randomised controlled trial to improve cognitive, emotional and functional outcomes in depression The aim of the current study was to evaluate an experimental treatment designed to improve psychosocial function in patients with Major Depressive Disorder (MDD) by reinforcing cognitive, emotional, and social-cognitive abilities. Participants (N = 112) with current or lifetime MDD were recruited to participate in a randomised, blinded, controlled trial. Exclusion criteria included diagnosis of a substance abuse disorder, bipolar disorder organic, eating disorders, or illness which affect cognitive function. The treatment involved repeated cognitive training designed to improve cognitive, emotional, and social-cognitive abilities. In training sessions, the principles of cognitive training were applied across cognitive, emotional, and social domains, with participants completing repeated mental exercises. Exercises included critically analysing interpretations of social interactions (e.g., body language), exploring emotional reactions to stimuli, and completing game-like cognitive training tasks. Training sessions placed great emphasis on the application of trained cognitive, emotional, and social cognitive skills to psychosocial outcomes. Outcomes demonstrated significant improvement in psychosocial function, symptom severity, self-reported cognition, and social-cognition. Our findings demonstrate the efficacy of multi-domain cognitive training to improve psychosocial functioning in individuals with MDD. We suggest that the present treatment could be deployed at a lower cost and with minimal training in comparison to established psychological therapies.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Ellen Lyrtzis
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Célia Fourrier
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Natalie Aboustate
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Emma Sampson
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Hikaru Hori
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu City, Japan
| | - Micah Cearns
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Julie Morgan
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Catherine Toben
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University Hospital Münster, University of Münster, Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The Universit y of Melbourne, Parkville, VIC, Australia.
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27
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Chen S, Gao L, Li X, Ye Y. Allopregnanolone in mood disorders: Mechanism and therapeutic development. Pharmacol Res 2021; 169:105682. [PMID: 34019980 DOI: 10.1016/j.phrs.2021.105682] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 01/23/2023]
Abstract
The neuroactive steroid allopregnanolone (ALLO) is an endogenous positive allosteric modulator of GABA type A receptor (GABAAR), and the down-regulation of its biosynthesis have been attributed to the development of mood disorders, such as depression, anxiety and post-traumatic stress disorder (PTSD). ALLO mediated depression/anxiety involves GABAergic mechanisms and appears to be related to brain-derived neurotrophic factor (BDNF), dopamine receptor, glutamate neurotransmission, and Ca2+ channel. In the clinical, brexanolone, as a newly developed intravenous ALLO preparation, has been approved for the treatment of postpartum depression (PPD). In addition, traditional antidepressants such as selective serotonin reuptake inhibitor (SSRI) could reverse ALLO decline. Recently, the translocation protein (TSPO, 18 kDa), which involves in the speed-limiting step of ALLO synthesis, and ALLO derivatization have been identified as new directions for antidepressant therapy. This review provides an overview of ALLO researches in animal model and patients, discusses its role in the development and treatment of depression/anxiety, and directs its therapeutic potential in future.
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Affiliation(s)
- Shiyi Chen
- School of Pharmacy, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Neuropsychiatric Drug Research of Zhejiang Province, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.
| | - Lijuan Gao
- School of Pharmacy, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Neuropsychiatric Drug Research of Zhejiang Province, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.
| | - Xiaoyu Li
- School of Pharmacy, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Neuropsychiatric Drug Research of Zhejiang Province, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.
| | - Yiping Ye
- School of Pharmacy, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, Zhejiang, People's Republic of China; Key Laboratory of Neuropsychiatric Drug Research of Zhejiang Province, Hangzhou Medical College, Hangzhou, Zhejiang, People's Republic of China.
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28
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Constantinescu C, Novakova L, Brandt AF, Malmeström C, Constantinescu R, Axelsson M, Lycke J. Persons with suspicious onset of multiple sclerosis but with undetermined diagnosis had persistent lower cognition and reduced quality of life. Mult Scler Relat Disord 2021; 52:102977. [PMID: 33964570 DOI: 10.1016/j.msard.2021.102977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGOUND Differential diagnosis of multiple sclerosis (MS) includes a variety of disorders and misdiagnosis is common. OBJECTIVE To follow-up persons with suspected onset of MS but in whom the diagnostic investigation was negative. METHODS In a prospective study including 271 persons with clinical features of suspected MS onset, 136 persons were diagnosed with MS or clinically isolated syndrome (PwMS), 46 had other disorders, and 89 persons had a negative diagnostic work-up, i.e. persons with undetermined diagnosis (PwUD). They underwent diagnostic reassessment, and those who remained without a diagnosis were investigated for signs of pathology including cognitive tests and assessments of quality of life (QoL). Results were compared with those of PwMS and 24 age and sex matched healthy controls (HC). RESULTS After reassement 55 (20%) persons still had undetermined diagnosis (PwUD). They had similar age and gender distribution as PwMS. In 76% of PwUD, the suspected clinical onset included sensory symptoms. PwUD and PwMS scored similarly in cognitive tests and QoL but significantly lower than HC. At 3 years follow-up, PwMS and PwUD improved in most test parameters, but PwUD scored lower than PwMS in cognition. CONCLUSION PwUD constituted the dominating differential diagnosis in persons with suspected clinical onset of MS. QoL and cognition were comparable with those of PwMS but significantly lower than in HC.
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Affiliation(s)
- Clara Constantinescu
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden
| | - Lenka Novakova
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | | | - Clas Malmeström
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Radu Constantinescu
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Markus Axelsson
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jan Lycke
- Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gotheburg, Sweden; Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
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Emery S, Häberling I, Berger G, Baumgartner N, Strumberger M, Albermann M, Nalani K, Schmeck K, Erb S, Bachmann S, Wöckel L, Müller-Knapp U, Contin-Waldvogel B, Rhiner B, Walitza S, Hersberger M, Drechsler R. Verbal Memory Performance in Depressed Children and Adolescents: Associations with EPA but Not DHA and Depression Severity. Nutrients 2020; 12:nu12123630. [PMID: 33255819 PMCID: PMC7761519 DOI: 10.3390/nu12123630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/13/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023] Open
Abstract
Omega-3 polyunsaturated fatty acids (n-3 PUFAs) have been described as positively associated with cognitive functioning. Current meta-analyses have identified eicosapentaenoic acid (EPA) as potentially more effective than docosahexaenoic acid (DHA). An especially vulnerable subgroup that might benefit from these beneficial effects are depressed youths. In this study, we examined associations between red blood cell (RBC) DHA and EPA levels and depression severity and verbal memory performance in a sample of 107 moderately (n = 63) and severely (n = 44) depressed youths. The findings showed that youths with high RBC EPA levels had steeper learning curves compared to those with moderate or low RBC EPA levels (Pillai's Trace = 0.195, p = 0.027, ηp2 = 0.097). No associations between RBC DHA levels or depression severity and verbal memory performance were observed. Our results further confirm previous findings indicating a more important role of EPA compared to DHA in relation to cognitive functioning. Future research should further investigate the differential role of EPA and DHA concerning cognitive functioning in depressed youths. Evidence supporting beneficial supplementation effects could potentially establish a recommendation for a natural and easily accessible intervention for cognitive improvement or remission.
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Affiliation(s)
- Sophie Emery
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
- Correspondence:
| | - Isabelle Häberling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
| | - Noemi Baumgartner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
| | - Michael Strumberger
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, 4002 Basel, Switzerland; (M.S.); (K.S.); (L.W.)
| | - Mona Albermann
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
| | - Kristin Nalani
- Clinic for Psychosomatic Medicine and Psychiatry, University Hospital Zurich, 8091 Zurich, Switzerland;
| | - Klaus Schmeck
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, 4002 Basel, Switzerland; (M.S.); (K.S.); (L.W.)
| | - Suzanne Erb
- Child and Adolescent Psychiatric Services St. Gallen, 9004 St. Gallen, Switzerland;
| | - Silke Bachmann
- Department of Psychiatry, University Hospitals of Geneva, 1226 Thônex, Switzerland;
- Department of Psychiatry Psychotherapy, Psychosomatic Medicine, Medical Faculty of Martin Luther University, 06112 Halle, Germany
| | - Lars Wöckel
- Research Department of Child and Adolescent Psychiatry, Psychiatric University Hospitals Basel, University of Basel, 4002 Basel, Switzerland; (M.S.); (K.S.); (L.W.)
- Clienia Littenheid AG, 9573 Littenheid, Switzerland
| | - Ulrich Müller-Knapp
- Child and Adolescent Psychiatry Klinik Sonnenhof, 9608 Ganterschwil, Switzerland;
| | | | - Bruno Rhiner
- Child and Adolescent Psychiatric Services Thurgau, 8570 Weinfelden, Switzerland;
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, 8057 Zurich, Switzerland
- Center for Integrative Human Physiology Zurich, University of Zurich, 8057 Zurich, Switzerland;
| | - Martin Hersberger
- Center for Integrative Human Physiology Zurich, University of Zurich, 8057 Zurich, Switzerland;
- Division of Clinical Chemistry and Biochemistry, University Children’s Hospital Zurich, 8032 Zurich, Switzerland
| | - Renate Drechsler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, 8032 Zurich, Switzerland; (I.H.); (G.B.); (N.B.); (M.A.); (S.W.); (R.D.)
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Crowe M, Porter R, Douglas K, Inder M, Lacey C, Jordan J, Wells H. Patients' experiences of cognitive functioning in recurrent depression: A qualitative study. J Psychiatr Ment Health Nurs 2020; 27:321-329. [PMID: 31981272 DOI: 10.1111/jpm.12603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Recurrent depressive episodes involve significant morbidity, suicide risk and recurrent hospitalizations. In both major depressive disorder and bipolar disorder, there are significant impairments in functioning following resolution of acute symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper provides an in-depth qualitative understanding of the subjective experience of cognitive impairment following a depressive episode in a recurrent mood disorder. It identifies descriptions of two types of experience (being stuck and being preoccupied with one's thoughts) that led to impairments in concentration, memory, organization and decision-making. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses need to develop an awareness of the impact of cognitive difficulties in the process of recovery from recurrent mood disorders. Mental health nurses need to provide knowledgeable reassurance, information and interventions to people who experience cognitive difficulties to provide a framework of understanding that promotes recovery. ABSTRACT: Introduction People who experience recurrent depressive episodes often have ongoing cognitive problems that impact on their functional recovery. These cognitive difficulties have been identified as impacting on social, interpersonal and occupational functioning and can result in vulnerability to relapse. Aim The aim of this qualitative study was to explore participants' subjective experiences of cognitive impairment after discharge from mental health services following treatment for recurrent depression. Methods The study was designed as a qualitative study in order to best capture participants' subjective experiences. Data were collected by semi-structured interviews and were analysed using a process of thematic analysis. Results Twenty participants took part in this study. All participants described experiences of either 1) "being stuck"; or 2) "being preoccupied with own thoughts"; however, all participants described the experiences in the third theme: "it stops you living to your potential." Implications for practice In order to promote recovery in a meaningful way, mental health nurses need to provide information about and strategies for managing cognitive difficulties associated with recurrent mood disorders.
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Affiliation(s)
- Marie Crowe
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richard Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Maree Inder
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Cameron Lacey
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Jennifer Jordan
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Hayley Wells
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Iron Aggravates the Depressive Phenotype of Stressed Mice by Compromising the Glymphatic System. Neurosci Bull 2020; 36:1542-1546. [PMID: 32578069 DOI: 10.1007/s12264-020-00539-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 04/02/2020] [Indexed: 12/11/2022] Open
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Nuggerud-Galeas S, Oliván Blázquez B, Perez Yus MC, Valle-Salazar B, Aguilar-Latorre A, Magallón Botaya R. Factors Associated With Depressive Episode Recurrences in Primary Care: A Retrospective, Descriptive Study. Front Psychol 2020; 11:1230. [PMID: 32581978 PMCID: PMC7290009 DOI: 10.3389/fpsyg.2020.01230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 05/11/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction and Objective The early identification of depressive patients having a poor evolution, with frequent relapses and/or recurrences, is one of the priority challenges in this study of high prevalence mental disorders, and specifically in depression. So, this study aims to analyze the factors that may be associated with an increased risk of recurrence of major depression episodes in patients treated in primary care. Methods A retrospective, descriptive study of cases-controls was proposed. The cases consisted of patients who had been diagnosed with major depression and who had presented recurrences (n = 101), in comparison with patients who had experienced a single major depression episode with no recurrence (n = 99). The variables of the study are age at first episode; number of episodes; perception of severity of the depression episode suffered prior to recurrence; number of residual symptoms; physical and psychiatric comorbidity; history of anxiety disorders; family psychiatric history; high incidence of stressful life events (SLEs); and experiences of physical, psychological, or sexual abuse in childhood. The differences of the variables were compared between the case subjects and the control subjects, using the Mann-Whitney, chi-square, and Fisher's U statistics. A multivariate analysis (ordinary logistic regression) was performed. Results The average age of those suffering more than one depressive episode is significantly older (5 years), and a higher percentage of subjects who have experienced more than one depressive episode have a history of anxiety disorders. In the multivariate analysis, the variables that obtained a significant value in the logistic regression analysis were age (OR: 1.03; value: 0.007) and having suffered sexual abuse during childhood (OR: 1.64; value: 0.072). Conclusion These indicators should be considered by primary care physicians when attending patients suffering from major depression.
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Affiliation(s)
- Shysset Nuggerud-Galeas
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - María Cruz Perez Yus
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Begoña Valle-Salazar
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Primary Health Care, Aragón Health Service, Zaragoza, Spain
| | | | - Rosa Magallón Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain.,Primary Health Care, Aragón Health Service, Zaragoza, Spain
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