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Onaemo VN, Chireh B, Fawehinmi TO, D'Arcy C. Comorbid substance use disorder, major depression, and associated disability in a nationally representative sample. J Affect Disord 2024; 348:8-16. [PMID: 38070745 DOI: 10.1016/j.jad.2023.12.016] [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: 05/30/2023] [Revised: 11/14/2023] [Accepted: 12/02/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND Major depressive disorders (MDD) and substance use disorders (SUDs) are commonly linked to disability, but there is a lack of research on the risk of disability among individuals who have both SUDs and MD in the general population. This study aimed to investigate the associated risk of disability in people with comorbid SUDs- specifically cannabis use disorder, alcohol use disorder, other drug (except cannabis) use disorder, and a major depressive episode using a nationally representative sample. METHODS The 2012 Canadian Community Health Survey- Mental Health (CCHS-MH) data were analyzed using multilevel logistic regression models. The survey included a nationally representative sample of Canadians aged 15 years and older (n = 25,113) residing in the ten Canadian provinces from January to December 2012. The diagnoses of major depressive episodes (MDE) and the SUDs were derived from the DSM-IV diagnostic criteria using a modified WHO-CIDI instrument, while disability was assessed using the World Health Organization Disability Assessment Score (WHODAS) 2.0. RESULTS The strongest predictor of disability was found to be comorbidity. Individuals diagnosed with both a SUD and MDE were 4 to 9 times more likely to experience disability, depending on the substance used, compared to those without either diagnosis. LIMITATIONS The study's cross-sectional design limits causal inferences. CONCLUSIONS Our research discovered that individuals who have both SUD and MDE are at a significantly higher risk of experiencing disability. This highlights the importance of integrating mental health and addiction services to mitigate the risk of disability and improve overall treatment outcomes.
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Affiliation(s)
- Vivian N Onaemo
- Division of Public Health and Preventive Medicine, Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada.
| | - Batholomew Chireh
- EPID@Work Research Institute, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada; Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada
| | | | - Carl D'Arcy
- School of Public Health, University of Saskatchewan, 104 Clinic Place, Saskatoon, Saskatchewan S7N 2Z4, Canada; Professor Emeritus (Psychiatry & Public Health), University of Saskatchewan, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 2Z4, Canada
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Guerrera CS, Boccaccio FM, Varrasi S, Platania GA, Coco M, Pirrone C, Castellano S, Caraci F, Ferri R, Lanza G. A narrative review on insomnia and hypersomnolence within Major Depressive Disorder and bipolar disorder: A proposal for a novel psychometric protocol. Neurosci Biobehav Rev 2024; 158:105575. [PMID: 38331126 DOI: 10.1016/j.neubiorev.2024.105575] [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: 07/03/2023] [Revised: 01/27/2024] [Accepted: 02/03/2024] [Indexed: 02/10/2024]
Abstract
Sleep disorders have become increasingly prevalent, with many adults worldwide reporting sleep dissatisfaction. Major Depressive Disorder (MDD) and Bipolar Disorder (BD) are common conditions associated with disrupted sleep patterns such as insomnia and hypersomnolence. These sleep disorders significantly affect the progression, severity, treatment, and outcome of unipolar and bipolar depression. While there is evidence of a connection between sleep disorders and depression, it remains unclear if sleep features differ between MDD and BD. In light of this, this narrative review aims to: (1) summarize findings on common sleep disorders like insomnia and hypersomnolence, strongly linked to MDD and BD; (2) propose a novel psychometric approach to assess sleep in individuals with depressive disorders. Despite insomnia seems to be more influent in unipolar depression, while hypersomnolence in bipolar one, there is no common agreement. So, it is essential adopting a comprehensive psychometric protocol for try to fill this gap. Understanding the relationship between sleep and MDD and BD disorders are crucial for effective management and better quality of life for those affected.
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Affiliation(s)
- Claudia Savia Guerrera
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy; Department of Biomedical and Biotechnological Sciences, University of Catania, Torre Biologica, Via Santa Sofia, 97, 95123 Catania, Italy.
| | | | - Simone Varrasi
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | | | - Marinella Coco
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Concetta Pirrone
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Sabrina Castellano
- Department of Educational Sciences, University of Catania, Via Biblioteca, 4, 95124 Catania, Italy
| | - Filippo Caraci
- Department of Drug and Health Sciences, University of Catania, Cittadella Universitaria, Via Santa Sofia, 95123 Catania, Italy; Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Department of Neurology IC, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy
| | - Giuseppe Lanza
- Unit of Neuropharmacology and Translation Neurosciences, Oasi Research Institute - IRCCS, Via Conte Ruggero 73, 94018 Troina, En, Italy; Department of Surgery and Medical-Surgical Specialties, University of Catania, A.O.U. "Policlinico - San Marco", Via Santa Sofia, 78, 95123 Catania, Italy
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3
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Zhang C, Zhang B, Xu Y, Hao W, Tang WK. The impact of depressive symptoms on cognitive impairments in chronic ketamine users. Compr Psychiatry 2024; 129:152448. [PMID: 38160647 DOI: 10.1016/j.comppsych.2023.152448] [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: 08/21/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Chronic ketamine use has been associated with cognitive impairments, while depressive symptoms are commonly observed in individuals using ketamine. However, the influence of depressive symptoms on cognitive impairments in chronic ketamine users remains unclear. This study aimed to examine the impact of depressive symptoms on cognitive function in this population. METHODS A cross-sectional study was conducted with a sample of chronic ketamine users. Participants underwent comprehensive cognitive assessments, including measures of attention, executive function, working memory, verbal and visual memory. Depressive symptoms were assessed using Beck Depression Inventory (BDI) scores. Multivariate analyses were utilized to compare the cognitive performance of individuals who use ketamine, both with and without depressive symptoms, as well as a control group, while controlling for relevant covariates. RESULTS The results revealed a significant negative impact of depressive symptoms on cognitive impairments, particularly in the domains of memory and executive function, among chronic ketamine users. The analysis of partial correlations revealed that among individuals who use ketamine and have depressive symptoms, those with higher levels of depressive symptoms demonstrated poorer cognitive performance compared to individuals with lower levels of depressive symptoms, controlling for potential confounding factors. CONCLUSIONS The findings suggest that depressive symptoms contribute to cognitive impairments, specifically in memory and executive function, in chronic ketamine users. Therefore, it is crucial to evaluate depressive symptoms when considering cognitive enhancement treatment for this population.
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Affiliation(s)
- Chenxi Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Bin Zhang
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yan Xu
- Department of Psychiatry, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China; Center of Sleep Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Hao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Wai Kwong Tang
- Department of Psychiatry, The Chinese University of Hong Kong, China.
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Giménez-Palomo A, Guitart-Mampel M, Meseguer A, Borràs R, García-García FJ, Tobías E, Valls L, Alsina-Restoy X, Roqué G, Sánchez E, Roca J, Anmella G, Valentí M, Bracco L, Andreu H, Salmerón S, Colomer L, Radua J, Verdolini N, Berk M, Vieta E, Garrabou G, Pacchiarotti I. Reduced mitochondrial respiratory capacity in patients with acute episodes of bipolar disorder: Could bipolar disorder be a state-dependent mitochondrial disease? Acta Psychiatr Scand 2024; 149:52-64. [PMID: 38030136 DOI: 10.1111/acps.13635] [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: 08/18/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic and recurrent disease characterized by acute mood episodes and periods of euthymia. The available literature postulates that a biphasic dysregulation of mitochondrial bioenergetics might underpin the neurobiology of BD. However, most studies focused on inter-subject differences rather than intra-subject variations between different mood states. To test this hypothesis, in this preliminary proof-of-concept study, we measured in vivo mitochondrial respiration in patients with BD during a mood episode and investigated differences compared to healthy controls (HC) and to the same patients upon clinical remission. METHODS This longitudinal study recruited 20 patients with BD admitted to our acute psychiatric ward with a manic (n = 15) or depressive (n = 5) episode, and 10 matched HC. We assessed manic and depressive symptoms using standardized psychometric scales. Different mitochondrial oxygen consumption rates (OCRs: Routine, Leak, electron transport chain [ETC], Rox) were assessed during the acute episode (T0) and after clinical remission (T1) using high-resolution respirometry at 37°C by polarographic oxygen sensors in a two-chamber Oxygraph-2k system in one million of peripheral blood mononuclear cells (PMBC). Specific OCRs were expressed as mean ± SD in picomoles of oxygen per million cells. Significant results were adjusted for age, sex, and body mass index. RESULTS The longitudinal analysis showed a significant increase in the maximal oxygen consumption capacity (ETC) in clinical remission (25.7 ± 16.7) compared to the acute episodes (19.1 ± 11.8, p = 0.025), and was observed separately for patients admitted with a manic episode (29.2 ± 18.9 in T1, 22.3 ± 11.9 in T0, p = 0.076), and at a trend-level for patients admitted with a depressive episode (15.4 ± 3.9 in T1 compared to 9.4 ± 3.2 in T0, p = 0.107). Compared to HC, significant differences were observed in ETC in patients with a bipolar mood episode (H = 11.7; p = 0.003). Individuals with bipolar depression showed lower ETC than those with a manic episode (t = -3.7, p = 0.001). Also, significant differences were observed in ETC rates between HC and bipolar depression (Z = 1.000, p = 0.005). CONCLUSIONS Bioenergetic and mitochondrial dysregulation could be present in both manic and depressive phases in BD and, importantly, they may restore after clinical remission. These preliminary results suggest that mitochondrial respiratory capacity could be a biomarker of illness activity and clinical response in BD. Further studies with larger samples and similar approaches are needed to confirm these results and identify potential biomarkers in different phases of the disease.
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Affiliation(s)
- Anna Giménez-Palomo
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Mariona Guitart-Mampel
- Inherited Metabolic Diseases and Muscular Disorders Research Lab, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona and CIBERER, Barcelona, Spain
| | - Ana Meseguer
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Roger Borràs
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Cardiovascular Institute, Hospital Clínic, IDIBAPS, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francesc Josep García-García
- Inherited Metabolic Diseases and Muscular Disorders Research Lab, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona and CIBERER, Barcelona, Spain
| | - Esther Tobías
- Inherited Metabolic Diseases and Muscular Disorders Research Lab, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona and CIBERER, Barcelona, Spain
| | - Laura Valls
- Inherited Metabolic Diseases and Muscular Disorders Research Lab, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona and CIBERER, Barcelona, Spain
| | | | - Gemma Roqué
- Pneumology Department, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Ester Sánchez
- Pneumology Department, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Josep Roca
- Pneumology Department, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Gerard Anmella
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Marc Valentí
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Lorenzo Bracco
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Helena Andreu
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Sergi Salmerón
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Lluc Colomer
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Joaquim Radua
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Norma Verdolini
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - Michael Berk
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
| | - Glòria Garrabou
- Inherited Metabolic Diseases and Muscular Disorders Research Lab, Cellex-IDIBAPS, Faculty of Medicine and Health Sciences-University of Barcelona, Internal Medicine Department-Hospital Clinic of Barcelona and CIBERER, Barcelona, Spain
| | - Isabella Pacchiarotti
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain
- Biomedical Research Networking Centre Consortium on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, School of Medicine and Health Sciences, Institute of Neurosciences (UBNeuro), University of Barcelona (UB), Barcelona, Spain
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