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Jiao XA, Bai RA, Li N, Liu K. Influencing factors on the psychosomatic health of medical staff since the normalized stage of COVID-19 in mainland China. Eur J Public Health 2024; 34:600-605. [PMID: 38423544 PMCID: PMC11161144 DOI: 10.1093/eurpub/ckae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, there were under-recognized and unaddressed psychosomatic health problems among medical staff. The purpose of this study was to investigate their psychosomatic status. METHODS An online questionnaire was performed to the medical staff of major hospitals in Jinan in January 2023. In total, 1244 valid questionnaires were collected, and their psychosomatic status was assessed by the Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10). Finally, we analyzed the influencing factors for their psychosomatic status. RESULTS The psychological health of the medical staff was poor, and the level of stress perception was intense, accompanied by obvious psychosomatic symptoms. Regression analysis indicated that age, gender, frontline involvement, work experience, marriage, presence of disease history and COVID-19 infection history were risk factors for psychosomatic symptoms, while education, frontline involvement and presence of disease history were risk factors for stress feeling. CONCLUSION Medical staff often showed obvious psychosomatic symptoms and intense stress. Psychological health education and intervention should be given in order to improve their working quality.
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Affiliation(s)
- Xing-ai Jiao
- Venous Configuration Center, Qilu Hospital of Shandong University, Jinan, China
| | - Run-ai Bai
- Department of Nursing, Qingjian County People’s Hospital, Yulin, China
| | - Na Li
- Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan, China
| | - Kao Liu
- Department of Organ Transplantation, Qilu Hospital of Shandong University, Jinan, China
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2
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Guo J, Wang L, Zhao X, Wang D, Zhang X. Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder. J Psychiatr Res 2024; 172:24-33. [PMID: 38354544 DOI: 10.1016/j.jpsychires.2024.02.026] [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: 08/08/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND The relationship between suicide attempts and lipid profiles in patients with major depressive disorder (MDD) remains uncertain. The purpose of this study was to investigate sex differences in the relationship between suicide attempts and plasma lipid profiles in a large sample of first-episode and drug naive (FEDN) MDD patients. METHODS We recruited 1718 FEDN MDD patients and gathered demographic, clinical, and blood lipid data. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale were used to assess the symptoms of patients. RESULTS There was no significant difference in the prevalence of suicide attempts between male and female MDD patients. The suicide attempt group had higher levels of depression, anxiety, psychotic symptoms, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C), but lower levels of high-density lipoprotein cholesterol (HDL-C) levels than the non-suicide attempt group. Binary logistic regression showed that TC levels were significantly correlated with suicidal attempts in both male and female patients. Correlation analysis revealed that the levels of TC, HDL-C and LDL-C were significantly associated with the number of suicide attempts in both male and female patients. Further multiple linear regression revealed that TC levels were significantly associated with the number of suicide attempts in male patients only. CONCLUSIONS Lipid biomarkers, particularly high TC levels, are associated with suicide attempts in both male and female MDD patients. However, there is gender difference in association between lipid biomarkers, especially TC levels, and the number of suicide attempts in MDD patients.
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Affiliation(s)
- Junru Guo
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; Department of Psychology, Guizhou Minzu University, Guiyang, 550025, China
| | - Li Wang
- School of Psychology, Guizhou Normal University, Guiyang, 550025, China; CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China
| | - Xiaoqing Zhao
- Student Affairs Office, Guizhou University, Guiyang, 550025, China
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101, China.
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3
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Shi Y, Peng D, Zhang C, Mellor D, Wang H, Fang Y, Wu Z. Characteristics and symptomatology of major depressive disorder with atypical features from symptom to syndromal level. J Affect Disord 2023; 333:249-256. [PMID: 37086803 DOI: 10.1016/j.jad.2023.04.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE To explore clinical characteristics and symptomatology of major depressive disorder (MDD) with atypical features based on DSM criteria or only reversed vegetative symptoms. METHOD A total of 3187 patients who met DSM-IV TR criteria for MDD were enrolled. Demographics and symptomatology covering multiple symptom domains were assessed and compared between three groups of cases: those who met DSM criteria for atypical specifier (the DAD group), those who had at least one reversed vegetative symptoms (hypersomnia or hyperphagia) (the SAD group) without meeting DSM atypical specifier criteria, and those without any reversed vegetative symptoms (the NAD group). RESULTS The DAD and SAD group accounted for 4.4 % and 14.4 % of the participants, respectively. The DAD cases were characterized by a highest proportion of hospitalizations, longest duration of current episode and worst quality of life. The DAD and SAD cases were more likely to adopt unhealthy behaviors (smoking and alcohol drinking). Most depressive symptoms related to higher illness severity and treatment resistance were more frequent in the DAD cases, followed by the SAD cases, and least frequent in the NAD cases. LIMITATIONS A cross-sectional design and a non-validated questionnaire were used. CONCLUSIONS The findings support the role of DSM defined atypical depression as a valid MDD subtype and provide evidence for clinical utility of the simplified approach of defining atypical features based on only reversed vegetative symptoms. This has implications for illness screening, public health, suicide prevention and better treatment planning for depressed individuals with atypical features even below syndromal level.
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Affiliation(s)
- Yifan Shi
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - David Mellor
- School of Psychology, Deakin University, Melbourne, Australia
| | - Huaning Wang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yiru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China.
| | - Zhiguo Wu
- Shanghai Yangpu District Mental Health Center, Shanghai, China; Clinical Research Centre in Mental Health, Shanghai University of Medicine & Health Sciences, China.
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4
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Pignataro P, Dicarlo M, Suriano C, Sanesi L, Zerlotin R, Storlino G, Oranger A, Zecca C, Dell’Abate MT, Mori G, Grano M, Colucci S, Colaianni G. Once-Daily Subcutaneous Irisin Administration Mitigates Depression- and Anxiety-like Behavior in Young Mice. Int J Mol Sci 2023; 24:ijms24076715. [PMID: 37047687 PMCID: PMC10095443 DOI: 10.3390/ijms24076715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/07/2023] Open
Abstract
Major depression is one of the most common psychiatric disorders worldwide, usually associated with anxiety. The multi-etiological nature of depression has increased the search for new antidepressant molecules, including irisin, for which, in a previous study, we tested its effect in young mice when administered intraperitoneally in a long-term intermittent manner. Here, we evaluated the effect of subcutaneous short-term irisin administration (100 µg/Kg/day/5 days) in male and female mice subjected to behavioral paradigms: Tail Suspension Test (TST), Forced Swim Test (FST), Elevated Plus Maze (EPM), and Y Maze (YM). Moreover, a qRT-PCR assay was performed to analyze the impact of irisin treatment on Pgc-1α/FNDC5 expression in the brain. A significant reduction in immobility time in TST and FST was observed in irisin-treated mice. Furthermore, irisin treatment significantly increased the number of entries and time spent in open arms, demonstrating its anxiolytic effect. Memory-enhancing effects were not reported in YM. Interestingly, no gender differences were observed in all behavioral tests. Overall, these results suggest that short-term subcutaneous irisin administration can exert an antidepressant and anxiolytic role, probably due to the activation of the Pgc-1α/FNDC5 system in the brain. Further investigation could lead to the identification of irisin as a new agent for the treatment of psychiatric disorders.
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Affiliation(s)
- Patrizia Pignataro
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Manuela Dicarlo
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Clelia Suriano
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Lorenzo Sanesi
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Roberta Zerlotin
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Giuseppina Storlino
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Angela Oranger
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Chiara Zecca
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari at “Pia Fondazione Card G. Panico” Hospital, Via San Pio X, 4, 73039 Tricase, Italy
| | - Maria Teresa Dell’Abate
- Center for Neurodegenerative Diseases and the Aging Brain, Department of Clinical Research in Neurology, University of Bari at “Pia Fondazione Card G. Panico” Hospital, Via San Pio X, 4, 73039 Tricase, Italy
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Maria Grano
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Silvia Colucci
- Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Graziana Colaianni
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
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5
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Chen Y, Stewart JW, Ge J, Cheng B, Chekroud A, Hellerstein DJ. Personalized Symptom Clusters that Predict Depression Treatment Outcomes: A Replication of Machine Learning Methods. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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6
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Redei EE, Udell ME, Solberg Woods LC, Chen H. The Wistar Kyoto Rat: A Model of Depression Traits. Curr Neuropharmacol 2023; 21:1884-1905. [PMID: 36453495 PMCID: PMC10514523 DOI: 10.2174/1570159x21666221129120902] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/19/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
There is an ongoing debate about the value of animal research in psychiatry with valid lines of reasoning stating the limits of individual animal models compared to human psychiatric illnesses. Human depression is not a homogenous disorder; therefore, one cannot expect a single animal model to reflect depression heterogeneity. This limited review presents arguments that the Wistar Kyoto (WKY) rats show intrinsic depression traits. The phenotypes of WKY do not completely mirror those of human depression but clearly indicate characteristics that are common with it. WKYs present despair- like behavior, passive coping with stress, comorbid anxiety, and enhanced drug use compared to other routinely used inbred or outbred strains of rats. The commonly used tests identifying these phenotypes reflect exploratory, escape-oriented, and withdrawal-like behaviors. The WKYs consistently choose withdrawal or avoidance in novel environments and freezing behaviors in response to a challenge in these tests. The physiological response to a stressful environment is exaggerated in WKYs. Selective breeding generated two WKY substrains that are nearly isogenic but show clear behavioral differences, including that of depression-like behavior. WKY and its substrains may share characteristics of subgroups of depressed individuals with social withdrawal, low energy, weight loss, sleep disturbances, and specific cognitive dysfunction. The genomes of the WKY and WKY substrains contain variations that impact the function of many genes identified in recent human genetic studies of depression. Thus, these strains of rats share characteristics of human depression at both phenotypic and genetic levels, making them a model of depression traits.
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Affiliation(s)
- Eva E. Redei
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mallory E. Udell
- Department of Pharmacology, Addiction Science, and Toxicology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Leah C. Solberg Woods
- Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Hao Chen
- Department of Pharmacology, Addiction Science, and Toxicology, University of Tennessee Health Science Center, Memphis, TN, USA
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7
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Lu S, Shao J, Feng Q, Wu C, Fang Z, Jia L, Wang Z, Hu S, Xu Y, Huang M. Aberrant interhemispheric functional connectivity in major depressive disorder with and without anhedonia. BMC Psychiatry 2022; 22:688. [PMID: 36348342 PMCID: PMC9644581 DOI: 10.1186/s12888-022-04343-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE Anhedonia is a core feature of major depressive disorder (MDD), and as a subtype of depression, MDD with anhedonia may have exceptional neurobiological mechanisms. However, the neuropathology of anhedonia in MDD remains unclear. Thus, this study aimed to investigate the brain functional differences between MDD with and without anhedonia. METHODS A total of 62 individuals including 22 MDD patients with anhedonia, 20 MDD patients without anhedonia, and 20 healthy controls (HCs) were recruited for this study. All participants underwent 3.0-T functional magnetic resonance imaging scan. Voxel-mirrored homotopic connectivity (VMHC) was employed to quantitatively describe bilateral functional connectivity. Analyses of variance (ANOVA) were performed to obtain brain regions with significant differences among three groups and then post hoc tests were calculated for inter-group comparisons. RESULTS The ANOVA revealed significant VMHC differences among three groups in the bilateral middle temporal gyrus (MTG), superior frontal gyrus (SFG), and inferior parietal lobule (IPL) (F = 10.47 ~ 15.09, p < 0.05, AlphaSim corrected). Relative to HCs, MDD with anhedonia showed significantly decreased VMHC in the bilateral MTG (t = -5.368, p < 0.05, AlphaSim corrected), as well as increased VMHC in the bilateral SFG (t = -4.696, p < 0.05, AlphaSim corrected). Compared to MDD without anhedonia, MDD with anhedonia showed significantly decreased VMHC in the bilateral MTG and IPL (t = -5.629 ~ -4.330, p < 0.05, AlphaSim corrected), while increased VMHC in the bilateral SFG (t = 3.926, p < 0.05, AlphaSim corrected). However, no significant difference was found between MDD without anhedonia and HCs. CONCLUSION The present findings suggest that MDD with and without anhedonia exhibit different patterns of interhemispheric connectivity. Anhedonia in MDD is related to aberrant interhemispheric connectivity within brain regions involved in the frontal-temporal-parietal circuit.
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Affiliation(s)
- Shaojia Lu
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China
| | - Jiamin Shao
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China ,grid.13402.340000 0004 1759 700XFaculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Qian Feng
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China ,grid.13402.340000 0004 1759 700XFaculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Congchong Wu
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China ,grid.13402.340000 0004 1759 700XFaculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Zhe Fang
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China ,grid.13402.340000 0004 1759 700XFaculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang China
| | - Lili Jia
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China ,grid.13402.340000 0004 1759 700XFaculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang China ,Department of Clinical Psychology, The Fifth Peoples’ Hospital of Lin’an District, Hangzhou, Zhejiang China
| | - Zheng Wang
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China
| | - Shaohua Hu
- grid.13402.340000 0004 1759 700XDepartment of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder’s Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang China
| | - Yi Xu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China.
| | - Manli Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, Zhejiang, China.
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8
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Zhang L, Du J, Chen T, Sheng R, Ma J, Ji G, Yu F, Ye J, Li D, Li Z, Zhu C, Wang K. Longitudinal changes in mental health among medical students in China during the COVID-19 epidemic: depression, anxiety and stress at 1-year follow -up. PSYCHOL HEALTH MED 2022:1-11. [PMID: 36164806 DOI: 10.1080/13548506.2022.2128193] [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] [Indexed: 10/14/2022]
Abstract
This study aimed to evaluate the influence of COVID-19 on the mental health of Chinese medical students at 1-year of follow-up. From 2 February 2020 to 23 February 2021, we conducted three waves of research online (T1 = during outbreak, T2 = controlling period, T3 = 1 year after outbreak). The survey collected demographic data and several self reporting questionnaires to measure the depressive, anxiety and stress symptoms. A total of 4002 participants complete the whole research phases. The study major, grade level and gender were the main factors related to psychological distress caused by the COVID-19 crisis. Importantly, medical knowledge has a protective effect on medical students' psychological distress during the COVID-19 period.
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Affiliation(s)
- Lei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jinmei Du
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tingting Chen
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Rongrong Sheng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Juncheng Ma
- Graduate School, Anhui Medical University, Hefei, China
| | - Gongjun Ji
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Fengqiong Yu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jianguo Ye
- Graduate School, Anhui Medical University, Hefei, China
| | - Dandan Li
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zhenjing Li
- Graduate School, Anhui Medical University, Hefei, China
| | - Chunyan Zhu
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China. 230088.,Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.,Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China
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9
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Wicke FS, Ernst M, Otten D, Werner A, Dreier M, Brähler E, Tibubos AN, Reiner I, Michal M, Wiltink J, Münzel T, Lackner KJ, Pfeiffer N, König J, Wild PS, Beutel ME. The association of depression and all-cause mortality: Explanatory factors and the influence of gender. J Affect Disord 2022; 303:315-322. [PMID: 35176339 DOI: 10.1016/j.jad.2022.02.034] [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: 08/16/2021] [Revised: 12/29/2021] [Accepted: 02/13/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND The association of depression with mortality and the significance of explanatory factors, in particularly gender, have remained an issue of debate. We therefore aimed to estimate the effect of depression on all-cause mortality, to examine potential explanatory factors and to assess effect modification by gender. METHODS We used Cox regression models to estimate the effect of depression on mortality based on data from the Gutenberg Health Study, which is a prospective cohort study of the adult population in the districts of Mainz and Mainz-Bingen, Germany. Baseline assessment was between 2007 and 2012. Effect modification by gender was measured on both additive and multiplicative scales. RESULTS Out of 14,653 participants, 7.7% were depressed according to Patient Health Questionnaire 9 (PHQ-9), and 1,059 (7.2%) died during a median follow-up of 10.7 years. Depression elevated the risk of mortality in men and women in age-adjusted models (HR: 1.41, 95%-CI: 1.03-1.92; resp. HR: 1.96, 95%-CI: 1.43-2.69). Adjustment for social status, physical health and lifestyle covariates attenuated the effect and in the fully-adjusted model the hazard ratio was 0.96 (95%-CI: 0.69-1.33) in men and 1.53 (95%-CI: 1.10-2.12) in women. For effect modification by gender, the measure on multiplicative interaction was 0.68 (95%-CI 0.44-1.07) and on additive interaction was RERI=-0.47 (95%-CI -1.24-0.30). LIMITATIONS The PHQ-9 is a single self-report measure of depression reflecting symptoms of the past two weeks, limiting a more detailed assessment of depression and course of symptoms, which likely affects the association with mortality. CONCLUSIONS Depression elevates mortality by multifactorial pathways, which should be taken into account in the biopsychosocially informed treatment of depression. Effect modification by gender was not statistically significant.
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Affiliation(s)
- F S Wicke
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany.
| | - M Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - D Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Dreier
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - E Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - A N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - I Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - J Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - N Pfeiffer
- Department of Ophthalmology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany
| | - J König
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine - Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis, University Medical Center, Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Langenbeckstr. 1, Mainz 55113, Germany
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10
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Feng S, Zhang Q, Ho SMY. Fear and anxiety about COVID-19 among local and overseas Chinese university students. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e249-e258. [PMID: 33825220 PMCID: PMC8250594 DOI: 10.1111/hsc.13347] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 05/07/2023]
Abstract
This study aimed to establish a new COVID-19 Fear (Higher Education) scale to investigate the relationship between fear and generalised anxiety symptoms among Chinese students in mainland China, Hong Kong, and other countries. 219 Chinese university students studying in universities in mainland China (n = 76, 34.7%), Hong Kong (n = 66, 30.1%), and overseas (i.e., outside of China as international students, n = 77, 35.2%) participated in an online study from March 31, 2020 to April 4. Participants completed a newly developed COVID-19 Fear (Higher Education) scale to measure three domains of fear including fear of infection, fear of instability and fear of insecurity related to the COVID-19 pandemic. They also completed the Generalized Anxiety Disorder 7-item scale (GAD-7) on the severity of anxiety symptoms. About 9.6% of the participants could be classified as exhibiting high anxiety level according to the GAD-7. More students studying overseas (about 15%) were classified into the high GAD group when compared to students studying in both mainland China (6.6%) and Hong Kong (6.1%). MANOVA results showed that students studying in Hong Kong and overseas had more concerns related to preventive measures related to COVID-19 than their mainland counterparts did. We concluded that international students studying away from their home country would have higher risk to develop anxiety problems during a collective trauma such as the COVID-19 pandemic. Education institutions should provide support services including online support groups, social media groups for mutual support to alleviate the fear and anxiety of international students.
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Affiliation(s)
- Shiyin Feng
- Psychology LaboratoryDepartment of Social and Behavioural SciencesCity University of Hong KongHong Kong
| | - Qiaochu Zhang
- Psychology LaboratoryDepartment of Social and Behavioural SciencesCity University of Hong KongHong Kong
| | - Samuel M. Y. Ho
- Psychology LaboratoryDepartment of Social and Behavioural SciencesCity University of Hong KongHong Kong
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11
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Morssinkhof MWL, Lamers F, Hoogendoorn AW, de Wit AE, Riese H, Giltay EJ, van den Heuvel OA, Penninx BW, Broekman BFP. Oral contraceptives, depressive and insomnia symptoms in adult women with and without depression. Psychoneuroendocrinology 2021; 133:105390. [PMID: 34425359 DOI: 10.1016/j.psyneuen.2021.105390] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Worldwide, oral contraceptive (OC) use is a very common form of birth control, although it has been associated with symptoms of depression and insomnia. Insomnia is a risk factor for major depressive disorder (MDD) but may also be a symptom of the disorder. Despite the large number of women who use OC, it is yet unknown whether women with previous or current diagnosis of depression are more likely to experience more severe depressive and insomnia symptoms during concurrent OC use than women without diagnosis of depression. AIM This study examined associations between OC use and concurrent symptoms of depression (including atypical depression) and insomnia as well as between OC and prevalences of concurrent dysthymia and MDD. Participants were adult women with and without a history of MDD or dysthymia. We hypothesized that OC use is associated with concurrent increased severity of depressive symptoms and insomnia symptoms, as well as with an increased prevalence of concurrent diagnoses of dysthymia and MDD. We also hypothesized that a history of MDD or dysthymia moderates the relationship between OC use and depressive and insomnia symptoms. METHODS Measurements from premenopausal adult women from the Netherlands Study of Depression and Anxiety (NESDA) were grouped, based on whether participants were using OC or naturally cycling (NC). OC use, timing and regularity of the menstrual cycle were assessed with a structured interview, self-reported symptoms of depression (including atypical depression), insomnia with validated questionnaires, and MDD and dysthymia with structured diagnostic interviews. RESULTS We included a total of 1301 measurements in women who reported OC use and 1913 measurements in NC women (mean age 35.6, 49.8% and 28.9% of measurements in women with a previous depression or current depression, respectively). Linear mixed models showed that overall, OC use was neither associated with more severe depressive symptoms (including atypical depressive symptoms), nor with higher prevalence of diagnoses of MDD or dysthymia. However, by disentangling the amalgamated overall effect, within-person estimates indicated increased depressive symptoms and depressive disorder prevalence during OC use, whereas between-person estimated indicated lower depressive symptoms and prevalence of depressive disorders. OC use was consistently associated with more severe concurrent insomnia symptoms, in the overall estimates as well as in the within-person and between-person estimates. Presence of current or previous MDD or dysthymia did not moderate the associations between OC use and depressive or insomnia symptoms. DISCUSSION The study findings showed consistent associations between OC use and more severe insomnia symptoms, but no consistent associations between OC and depressive symptoms or diagnoses. Instead, post-hoc analyses showed that associations between OC and depression differed between within- and between person-estimates. This indicates that, although OC shows no associations on the overall level, some individuals might experience OC-associated mood symptoms. Our findings underscore the importance of accounting for individual differences in experiences during OC use. Furthermore, it raises new questions about mechanisms underlying associations between OC, depression and insomnia.
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Affiliation(s)
- Margot W L Morssinkhof
- OLVG Hospital, Department of Psychiatry and Medical Psychology, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Endocrinology, Department of Internal Medicine, Amsterdam, The Netherlands.
| | - Femke Lamers
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Adriaan W Hoogendoorn
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; GGZ inGeest, Department of Research and Innovation, Amsterdam, The Netherlands
| | - Anouk E de Wit
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation, Groningen, The Netherlands
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotional regulation, Groningen, The Netherlands
| | - Erik J Giltay
- Leiden University Medical Center, Department of Psychiatry, Leiden, The Netherlands
| | - Odile A van den Heuvel
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Department of Anatomy and Neuroscience, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Brenda W Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; GGZ inGeest, Department of Research and Innovation, Amsterdam, The Netherlands
| | - Birit F P Broekman
- OLVG Hospital, Department of Psychiatry and Medical Psychology, Amsterdam, The Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A⁎STAR), Singapore
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12
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Ma M, Shi Z, Wu H, Ma X. Clinical implications of panic attack in Chinese patients with somatoform disorders. J Psychosom Res 2021; 146:110509. [PMID: 33984592 DOI: 10.1016/j.jpsychores.2021.110509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Somatoform disorders are frequently accompanied by panic attack and causes many clinical symptoms. This study aimed to compare clinical features between patients with and without panic attack in somatoform disorder. METHODS In this cross-sectional study, 341 patients with somatoform disorder according to the MINI-International Neuropsychiatric Interview (M.I.N·I.) were divided into two groups depending on with or without comorbidity of a panic attack, somatoform disorder with a panic attack (SPA, n = 88) and those without panic attack (SNPA, n = 253). Patient Health Questionnaire (PHQ-15), Patient Health Questionnaire (PHQ-9) and 7-item Generalized Anxiety Disorder (GAD-7) scale was used to identify correlations between SPA group and SNPA group, respectively. Correlation analysis and multivariate regression analysis were used to determine the effects of demographic factors and psychiatric diagnoses on somatic, depressive and anxiety symptoms separately. RESULTS The SPA group's PHQ-15, PHQ-9 and GAD-7 scores were significantly higher than those of the SNPA group. Multiple linear regression analyses revealed that the associated factors for PHQ-15 were gender and panic disorder. PHQ-9 was just significantly associated with panic disorder. GAD-7 was significantly associated with education degree and panic disorder. CONCLUSIONS Our results suggest that somatoform disorder patients with panic attack suffered more severe clinical symptoms than those without a panic attack.
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Affiliation(s)
- Min Ma
- Wuhan Mental Health Center, Wuhan, China
| | - Zhidao Shi
- Shanghai Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, China
| | - Heng Wu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiquan Ma
- Department of Psychosomatic Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
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13
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Seifert J, Führmann F, Reinhard MA, Engel RR, Bernegger X, Bleich S, Stübner S, Rüther E, Toto S, Grohmann R, Sieberer M, Greil W. Sex differences in pharmacological treatment of major depressive disorder: results from the AMSP pharmacovigilance program from 2001 to 2017. J Neural Transm (Vienna) 2021; 128:827-843. [PMID: 33977402 PMCID: PMC8205885 DOI: 10.1007/s00702-021-02349-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/02/2021] [Indexed: 12/25/2022]
Abstract
Data on drug prescription for outpatients with major depressive disorder (MDD) suggest women are more likely to be treated with psychotropic drugs, while data on sex differences regarding pharmacological treatment of psychiatric inpatients are currently not available. Drug utilization data from the program "Drug Safety in Psychiatry" (German: Arzneimittelsicherheit in der Psychiatrie, AMSP) of 44,418 psychiatric inpatients with MDD were analyzed for sex differences between 2001 and 2017. Sex differences were analyzed using relative risks (RR) and 95% confidence intervals (95% CI). Time trends were analyzed by comparing the first (2001-2003) with the last time period (2015-2017). In general, men and women were equally likely to use psychotropic drugs. Monotherapy was more common in men. Women were more likely to utilize ≥ 4 psychotropic drugs. Antidepressant drugs (ADDs) were the most prescribed drug class. Men had a higher utilization of noradrenergic and specific serotonergic antidepressants (RR 1.15; 95% CI 1.12-1.19), especially mirtazapine (RR 1.16; 95% CI 1.12-1.19), but also of other ADDs such as bupropion (RR 1.50; 95% CI 1.35-1.68). Males had a slightly higher utilization of second-generation antipsychotic drugs (RR 1.06; 95% CI 1.03-1.09) and were less often treated with low-potency first-generation antipsychotic drugs (RR 0.86; 95% CI 0.83-0.90). Tranquilizing (e.g., benzodiazepines; RR 0.89; 95% CI 0.86-0.92) and hypnotic drugs (e.g., Z-drugs; RR 0.85; 95% CI 0.81-0.89) were less utilized in the treatment of male patients. Not all sex differences were stable over time. More sex differences were detectable in 2015-2017 than in 2001-2003. Findings suggest that certain psychotropic drugs are preferred in the treatment of men vs. women, however, sex differences found in this study are not as large as in ambulatory settings. To make evidence-based sex-specific recommendations in the treatment of MDD, differences in drug response and tolerability need to be further researched.
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Affiliation(s)
- Johanna Seifert
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Fabienne Führmann
- Department of Psychiatry and Psychotherapy, KRH Psychiatrie GmbH, Wunstorf, Germany
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Rolf R Engel
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Xueqiong Bernegger
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Susanne Stübner
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Department of Forensic Psychiatry, Bezirksklinikum Ansbach, Ansbach, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Prosomno, Clinic for Sleep Medicine, Munich, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Renate Grohmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Marcel Sieberer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, St. Marien-Hospital Hamm gGmbH, Hamm, Germany.,Department of Psychiatry and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Waldemar Greil
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg, Switzerland
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14
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Bitsika V, Sharpley CF. Symptom profiles and correlates of anxiety and depression among parents of autistic girls and boys. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 111:103874. [PMID: 33524737 DOI: 10.1016/j.ridd.2021.103874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 12/01/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Although it has been reported for some time that parenting an autistic child is associated with elevated anxiety and depression, no direct comparison has been published regarding the relative anxiety and depressive states of parents of an autistic son versus an autistic daughter. AIMS To investigate the presence of differences in anxiety and depression in parents of autistic girls and boys, and to identify if there were any meaningful child-based correlates of those states. METHODS AND PROCEDURES A sample of 51 parents of young autistic males (M age = 10.2 yr, SD = 2.8 yr, range to 6-17 yr) and 51 parents of autistic females (M age = 10.1 yr, SD = 2.7 yr, range to 6-17 yr) completed the GAD7 and PHQ9. Autistic children were assessed for IQ and autism severity. OUTCOMES AND RESULTS Although there were no significant differences between the two sets of parents' GAD7 or PHQ9 total scores, there were significant and meaningful differences at the individual GAD7 and PHQ9 item level. Moreover, when examined at the within-child-sex subgroup level, different aspects of the autistic sons' and daughters' age and IQ were correlated with specific items from the GAD7 and PHQ9. CONCLUSIONS AND IMPLICATIONS Because these items were somatic in nature, implications are discussed for possible treatment strategies with these parents.
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Affiliation(s)
- Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia
| | - Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, NSW, 2350, Australia.
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15
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Shi P, Yang A, Zhao Q, Chen Z, Ren X, Dai Q. A Hypothesis of Gender Differences in Self-Reporting Symptom of Depression: Implications to Solve Under-Diagnosis and Under-Treatment of Depression in Males. Front Psychiatry 2021; 12:589687. [PMID: 34759845 PMCID: PMC8572815 DOI: 10.3389/fpsyt.2021.589687] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/23/2021] [Indexed: 11/13/2022] Open
Abstract
The phenomenon of female preponderance in depression has been well-reported, which has been challenged by higher rates of suicide and addictive behaviors in males, and a longer life-span in females. We thus propose an alternative hypothesis "Gender differences in self-reporting symptom of depression," suggesting mild-moderate depression tends to be reported more often by females, and severe depression and suicide tend to be reported more often by males. Potential mechanisms that account for this difference may include three aspects: covariation between estrogen levels and the incidence peak of female depression, gender differences in coping style (e.g., comparative emotional inexpressiveness and non-help-seeking in males), and gender differences in symptom phenotypes (e.g., atypical symptoms in male depression). Our newly presented hypothesis implied the overlooked under-diagnosis and under-treatment of depression in males. For effective diagnoses and timely treatment of male depression, it is critical to incorporate symptoms of depression in males into the relevant diagnostic criteria, encourage males to express negative emotions, and increase awareness of suicidal behavior in males.
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Affiliation(s)
- Peixia Shi
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Aigang Yang
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhaohua Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Xiaomei Ren
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China
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16
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Musculoskeletal Pain during the Menopausal Transition: A Systematic Review and Meta-Analysis. Neural Plast 2020; 2020:8842110. [PMID: 33299396 PMCID: PMC7710408 DOI: 10.1155/2020/8842110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/02/2020] [Accepted: 10/11/2020] [Indexed: 11/18/2022] Open
Abstract
Musculoskeletal pain (MSP) is one of the most severe complaints in women undergoing menopause. The prevalence of MSP varied when taking the menopausal state and age factor into consideration. This study investigated the prevalence of MSP in perimenopausal women and its association with menopausal state. The MEDLINE, Embase, Web of Science, and PubMed databases were searched from inception to July 2020, and 16 studies were retrieved for the current meta-analysis. The primary outcome measure was the MSP Odds Ratio (OR). The estimated overall prevalence of MSP among perimenopausal women was 71% (4144 out of 5836, 95% confidence interval (CI): 64%-78%). Perimenopausal women demonstrated a higher risk for MSP than premenopausal ones (OR: 1.63, 95% CI: 1.35-1.96, P = 0.008, I2 = 59.7%), but similar to that in postmenopausal ones (OR: 1.07, 95% CI: 0.95–1.20, P = 0.316, I2 = 13.4%). The postmenopausal women were at a higher risk of moderate/severe MSP than the premenopausal ones (OR: 1.45, 95% CI: 1.21-1.75, P = 0.302, I2 = 16.5%) or the perimenopausal ones (OR: 1.40, 95% CI: 1.09–1.79, P = 0.106, I2 = 55.4%). In conclusion, the perimenopause is a state during which women are particularly predisposed to develop MSP. As to moderate to severe degrees of MSP, the odds increase linearly with age, from premenopause to peri- and then to postmenopause.
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17
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Hou F, Bi F, Jiao R, Luo D, Song K. Gender differences of depression and anxiety among social media users during the COVID-19 outbreak in China:a cross-sectional study. BMC Public Health 2020; 20:1648. [PMID: 33148202 PMCID: PMC7609822 DOI: 10.1186/s12889-020-09738-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 10/21/2020] [Indexed: 12/17/2022] Open
Abstract
Background Studies have shown that the outbreak of infectious diseases would result in mental health problems. Females are in greater risk for psychological problems than males. The present study investigated gender differences of depression and anxiety and explored associated factors during the COVID-19 epidemic among Chinese social media users. Methods We recruited 3088 participants through social media cross China. Participants completed sociodemographic and the COVID-19 epidemic related questions, the 2-item Patient Health Questionnaire (PHQ-2), and the 2-item Generalized Anxiety Disorder Scale (GAD-2), the Chinese version of the 10-item Connor-Davidson Resilience Scale. We applied Chi-square test and ANOVA for data description and linear regression analysis for exploring factors associated with depression and anxiety. Results Of 3063 participants eligible for analysis, the total prevalence of depression and anxiety was 14.14 and 13.25%. Females were experiencing more severe stress and anxiety symptoms, while males showed better resilience to stress. The severity of depression symptoms would decrease with the increase of age resilience, and it would increase if being unemployed, feeling less adapted, being more stressed. The severity of anxiety symptoms would decrease with higher education and better resilience, and it would increase if being female, spending over 60 min on COVID-19 related information, less adapted, and being more stressed. Conclusion The findings show the increased prevalence of depression and anxiety in Chinese population during the COVID-19 epidemic, and females are experiencing more severe anxiety symptoms than males. As social media is the current main resource of information related to COVID-19, interventions should be implemented to help users to limit the time they spend on social media and to get key information related to the epidemic from authoritative and authentic resource to avoid infodemic and prevent mental health problems.
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Affiliation(s)
- Fengsu Hou
- Department of Public Health, Shenzhen Kangning Hospital, No.1080 Cuizhu Road, Luohu District, Shenzhen, 518020, Guangdong, China
| | - Fengying Bi
- Department of Social Medicine, Xiangya School of Public Health, Central South University, No.110 Xiangya Road, Kaifu District, Changsha, 410078, Hunan, China
| | - Rong Jiao
- The First Clinical College, Hainan Medical University, No.3 Xueyuan Road, Longhua District, Haikou, 570100, Hainan, China
| | - Dan Luo
- Department of Social Medicine, Xiangya School of Public Health, Central South University, No.110 Xiangya Road, Kaifu District, Changsha, 410078, Hunan, China
| | - Kangxing Song
- Department of Cardiology, The First Medical Center of Chinese PLA General Hospital, No.51, Fucheng Road, Haidian District, Beijing, 100853, China.
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18
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Di Renzo L, Gualtieri P, Cinelli G, Bigioni G, Soldati L, Attinà A, Bianco FF, Caparello G, Camodeca V, Carrano E, Ferraro S, Giannattasio S, Leggeri C, Rampello T, Lo Presti L, Tarsitano MG, De Lorenzo A. Psychological Aspects and Eating Habits during COVID-19 Home Confinement: Results of EHLC-COVID-19 Italian Online Survey. Nutrients 2020; 12:E2152. [PMID: 32707724 PMCID: PMC7401000 DOI: 10.3390/nu12072152] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/04/2020] [Accepted: 07/16/2020] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic has had a huge impact on the population with consequences on lifestyles. The aim of the study was to analyse the relationship between eating habits, mental and emotional mood. A survey was conducted online during social isolation, from 24 April to 18 May 2020, among the Italian population. A total of 602 interviewees were included in the data analysis. A high percentage of respondents experienced a depressed mood, anxious feelings, hypochondria and insomnia (61.3%, 70.4%, 46.2% and 52.2%). Almost half of the respondents felt anxious due to the fact of their eating habits, consumed comfort food and were inclined to increase food intake to feel better. Age was inversely related to dietary control (OR = 0.971, p = 0.005). Females were more anxious and disposed to comfort food than males (p < 0.001; p < 0.001). A strength of our study was represented by the fact that the survey was conducted quickly during the most critical period of the Italian epidemic lockdown. As the COVID-19 pandemic is still ongoing, our data need to be confirmed and investigated in the future with larger population studies.
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Affiliation(s)
- Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (L.D.R.); (P.G.); (A.D.L.)
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (L.D.R.); (P.G.); (A.D.L.)
| | - Giulia Cinelli
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children’s Hospital IRCCS, 00165 Rome, Italy
| | - Giulia Bigioni
- Department of Physic, University of Rome Sapienza, P.zza Aldo Moro 5, 00185 Rome, Italy;
| | - Laura Soldati
- Department of Health Sciences, University of Milan, Via A. Di Rudinì, 8, 20142 Milan, Italy;
| | - Alda Attinà
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Francesca Fabiola Bianco
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Giovanna Caparello
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Vanessa Camodeca
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Elena Carrano
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Simona Ferraro
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Silvia Giannattasio
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Claudia Leggeri
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Tiziana Rampello
- School of Specialization in Food Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.A.); (F.F.B.); (G.C.); (V.C.); (E.C.); (S.F.); (S.G.); (C.L.); (T.R.)
| | - Laura Lo Presti
- Unitelma Sapienza, University of Rome Sapienza, Via Regina Elena, 295, 00161 Rome, Italy;
| | | | - Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (L.D.R.); (P.G.); (A.D.L.)
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Immediate psychological impact on nurses working at 42 government-designated hospitals during COVID-19 outbreak in China: A cross-sectional study. Nurs Outlook 2020; 69:6-12. [PMID: 32919788 PMCID: PMC7368912 DOI: 10.1016/j.outlook.2020.07.007] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/10/2020] [Accepted: 07/10/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND During an epidemic of a novel infectious disease, frontline nurses suffer from unprecedented psychological stress. This study aimed to assess the immediate psychological impact on frontline nurses in China. METHODS A multicenter, cross-sectional survey of frontline nurses was conducted via online questionnaires. Symptoms of depression, anxiety, somatic disorders, and suicidal ideation were evaluated. Demographic, stress, and support variables were entered into logistic regression analysis to identify the impact factors. FINDINGS Of the 4,692 nurses who completed the survey, 9.4% (n = 442) were considered to have depressive symptoms, 8.1% (n = 379) represented anxiety, and 42.7% (n = 2,005) had somatic symptom. About 6.5% (n = 306) respondents had suicidal ideation. DISCUSSION The study showed that the overall mental health of frontline nurses was generally poor during COVID-19 outbreak, and several impact factors associated with nurses' psychological health were identified. Further research is needed to ascertain whether training and support strategies are indeed able to mitigate psychological morbidities.
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20
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Heterogeneous association patterns of depressive subfactors in suicidality: The 2014 and 2016 Korea National Health and Nutrition Examination Surveys. J Affect Disord 2020; 272:183-190. [PMID: 32379614 DOI: 10.1016/j.jad.2020.04.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The heterogeneity of depressive symptoms in suicidality is poorly understood. This study examines the heterogeneous association between subfactors of depressive symptoms in suicidality. METHODS The data of 5742 participants aged 19 and older were taken from the 2014 and 2016 Korean National Health and Nutrition Examination Surveys and analyzed. Subfactors of depressive symptoms were identified utilizing factor analyses that yielded two groups (typical- and other-depressive factors). Multivariable logistic regression models were used to estimate the association between each factor and suicidality after adjusting for covariates. RESULTS Typical depressive factors included cardinal and somatic symptoms, whereas other depressive factors contained cognitive and other symptoms. The typical factors were associated with each suicidality in succession, however, others depressive factors were not. The heterogeneity of subfactors made the greatest impact on suicide attempts, controlling for all covariates, followed by suicide plans, with a robust coefficient of typical depressive factors. These differential patterns of subfactors existed especially in females and younger people, suggesting the importance of concerning typical depressive factors for those groups. LIMITATIONS Although a confirmatory factor analysis was performed, depressive subfactors need validation and reliability tests. CONCLUSIONS Our study findings may help to explain why an improved understanding of the typical depressive factors including cardinal and somatic symptoms is important to prevent suicidality, especially in females and younger people.
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21
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Deems NP, Leuner B. Pregnancy, postpartum and parity: Resilience and vulnerability in brain health and disease. Front Neuroendocrinol 2020; 57:100820. [PMID: 31987814 PMCID: PMC7225072 DOI: 10.1016/j.yfrne.2020.100820] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 11/25/2019] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
Abstract
Risk and resilience in brain health and disease can be influenced by a variety of factors. While there is a growing appreciation to consider sex as one of these factors, far less attention has been paid to sex-specific variables that may differentially impact females such as pregnancy and reproductive history. In this review, we focus on nervous system disorders which show a female bias and for which there is data from basic research and clinical studies pointing to modification in disease risk and progression during pregnancy, postpartum and/or as a result of parity: multiple sclerosis (MS), depression, stroke, and Alzheimer's disease (AD). In doing so, we join others (Shors, 2016; Galea et al., 2018a) in aiming to illustrate the importance of looking beyond sex in neuroscience research.
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Affiliation(s)
- Nicholas P Deems
- The Ohio State University, Department of Psychology, Columbus, OH, USA
| | - Benedetta Leuner
- The Ohio State University, Department of Psychology, Columbus, OH, USA.
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22
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Esposito CM, Buoli M. The biological face of melancholia: Are there any reliable biomarkers for this depression subtype? J Affect Disord 2020; 266:802-809. [PMID: 32217262 DOI: 10.1016/j.jad.2020.02.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/24/2020] [Accepted: 02/18/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Melancholic depression (MD) is a subtype of Major Depression associated with more clinical severity and poorer prognosis that non-melancholic depression (NMD). The differentiation between depression subtypes is still clinical, although the identification of specific biomarkers could be useful for diagnosis and the development of new treatments. Purpose of the present manuscript is to review the biomarkers that have been associated with MD. METHODS We performed a bibliographic research on the main databases (PubMed, Embase, PsycInfo, Isi Web of Knowledge, Medscape, The Cochrane Library), in order to find studies that proposed biological markers for melancholic depression. A total of 14 studies met our inclusion criteria. RESULTS Most of studies focused on immune dysregulation. Subjects with MD show biological abnormalities than healthy controls (HC). MD might be characterized by specific biological changes and it could be associated to more severe abnormalities with respect to NMD; however especially about this latter point the available data are preliminary. LIMITATIONS Most available data have not been replicated; the studies focused on different biomarkers. In addition, many articles report results on a limited sample size. CONCLUSIONS Melancholic depression is a subtype of major depression that seems to be associated with specific alterations of different biological systems. Future studies with larger sample can confirm the results and hypothesis presented in this review.
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Affiliation(s)
- Cecilia Maria Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy.
| | - Massimiliano Buoli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan 20122, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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23
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Agarwal P, Palin N, Walker SL, Glasper ER. Sex-dependent effects of paternal deprivation and chronic variable stress on novel object recognition in adult California mice (Peromyscus californicus). Horm Behav 2020; 117:104610. [PMID: 31669457 DOI: 10.1016/j.yhbeh.2019.104610] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/30/2019] [Accepted: 10/03/2019] [Indexed: 12/16/2022]
Abstract
Early-life stress exposure can confer vulnerability for development of psychiatric illnesses and impaired cognition in adulthood. It is well-known that early-life stress can dysregulate the hypothalamic-pituitary-adrenal (HPA) axis in a sex-dependent manner. Specifically, uniparental rodent models of prolonged disrupted mother-offspring relationships (e.g., maternal separation) have demonstrated greater alterations in stress responsivity in adult males, compared to females. Also, chronic early-life stressors (e.g., limited bedding model) impair cognitive function in males more than females. However, the sex-dependent effects of early-life stress and later-life chronic HPA axis activation on cognition have not been well-characterized. Here, we utilized the biparental California mouse (Peromyscus californicus) to model the early-life adversity of paternal deprivation (PD). Fathers either remained in the nest (biparental care) or were permanently removed (PD) on postnatal day (PND) 1. Adult offspring were exposed to daily handling (control) or chronic variable stress (CVS; three stressors for seven days). Twenty-four hours after the final stressor, the novel object recognition (NOR) task commenced, followed by serum collection for corticosterone (CORT) analysis. Independent of sex or rearing, CVS increased CORT. Exploration during acquisition for the NOR task was increased as a result of CVS and PD. During NOR testing, non-stressed females exhibited greater difference scores (i.e., increased recognition memory), compared to non-stressed males. However, the addition of CVS diminished difference scores in females - an effect not observed in CVS-exposed males. Overall, these data suggest that neonatal paternal experience, sex, and chronic stress contribute to exploratory behavior, cognition, and stress hormone concentrations in a biparental species.
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Affiliation(s)
- P Agarwal
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
| | - N Palin
- Department of Psychology, University of Maryland, College Park, MD 20742, USA
| | - S L Walker
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD 20742, USA
| | - E R Glasper
- Department of Psychology, University of Maryland, College Park, MD 20742, USA; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD 20742, USA.
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Juengst SB, Nabasny A, Terhorst L. Neurobehavioral Symptoms in Community-Dwelling Adults With and Without Chronic Traumatic Brain Injury: Differences by Age, Gender, Education, and Health Condition. Front Neurol 2019; 10:1210. [PMID: 31849805 PMCID: PMC6879460 DOI: 10.3389/fneur.2019.01210] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Accepted: 10/30/2019] [Indexed: 11/17/2022] Open
Abstract
Neurobehavioral symptoms after Traumatic Brain Injury (TBI) are prevalent, persist for many years, and negatively affect long-term health, function, and quality of life. Symptoms may differ based on age, gender, education, race, ethnicity, and injury severity. To better understand neurobehavioral functioning after TBI, we need a comprehensive picture of emotional, cognitive, and behavioral symptoms in the context of personal factors that may affect these symptoms. We also need to understand the extent to which these symptoms are specific to TBI, shared across other neurological conditions, or attributable to factors outside of the injury itself. We collected neurobehavioral symptoms via the self-reported Behavioral Assessment Screening Tool (BAST) in a National Cohort of English (n = 2,511) and Spanish speaking (n = 350) community-dwelling adults with and without chronic TBI and other neurological and mental health conditions. The primary focus of the present study was to comprehensively describe neurobehavioral symptoms in adults with and without TBI, broken down by gender and health conditions and then further by age group or educational attainment. As expected, participants with TBI reported more symptoms than Healthy Controls. Regardless of condition, women reported more fatigue, while men reported more substance abuse and impulsivity. Hispanic participants reported more neurobehavioral symptoms than non-Hispanic participants did across health conditions, though primarily Spanish-speakers reported fewer symptoms than English-speakers, suggesting that level of acculturation may contribute to symptom reporting. These data provide a comprehensive characterization of neurobehavioral symptoms in adults with TBI and adults without TBI (healthy controls, adults with other neurological conditions, and adults with mental health conditions).
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Affiliation(s)
- Shannon B Juengst
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Andrew Nabasny
- Department of Physical Medicine & Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Lauren Terhorst
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, United States
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25
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Wang Y, Wang X, Chen W, Shao Y, Zhou J, Chen Q, Lv J. BRAIN FUNCTION ALTERATIONS IN PATIENTS WITH DIABETIC NEPHROPATHY COMPLICATED BY RETINOPATHY UNDER RESTING STATE CONDITIONS ASSESSED BY VOXEL-MIRRORED HOMOTOPIC CONNECTIVITY. Endocr Pract 2019; 26:291-298. [PMID: 31682517 DOI: 10.4158/ep-2019-0355] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Objective: The voxel-mirrored homologous connection (VHMC) technique was applied to detect resting brain function alterations in patients with diabetic nephropathy and retinopathy (DNR), and their relationships with clinical manifestations in the kidneys and eyes are discussed. Methods: Twenty-two patients with DNR and 22 healthy controls (HCs) similarly matched in age, sex, and educational background were recruited. Resting-state functional magnetic resonance imaging scans were performed for all subjects. Retinal fundus photography and renal biopsy were employed to observe the clinical features of the kidney and retina. Pearson correlation analysis was used to analyze the relationship between clinical manifestations and experimental results. Results: Compared with the HCs, patients with DNR showed decreased mean VMHC values in the bilateral middle temporal gyrus, bilateral middle occipital gyrus (BMOG), and bilateral medial frontal gyrus. The receiver operating characteristic curve analysis of each brain region confirmed that the accuracy of the area under the curve was excellent. The results showed that the average VHMC value of BMOG signals was positively correlated with the urinary protein to creatinine ratio in female subjects (r = 0.626; P<.05). Nonetheless, no such correlation was noted among the male subjects. Conclusion: There were significant changes in brain function in DNR patients compared to the control group. Changes in the central nervous system in patients with DNR were mainly due to the dual negative effects of kidney function and diabetes mellitus. Abbreviations: ACR = albumin/creatinine ratio; BMFG = bilateral medial frontal gyrus; BMOG = bilateral middle occipital gyrus; BMTG = bilateral middle temporal gyrus; DN = diabetic nephropathy; DNR = diabetic nephropathy complicated by retinopathy; DR = diabetic retinopathy; fMRI = functional magnetic resonance imaging; HC = healthy control; MRI = magnetic resonance imaging; PCR = protein to creatinine ratio; ROC = receiver operating characteristic; VHMC = voxel-mirrored homologous connection.
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26
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Lytsy P, Hallqvist J, Alexanderson K, Åhs A. Gender differences in healthcare management of depression: aspects of sick leave and treatment with psychoactive drugs in a Swedish setting. Nord J Psychiatry 2019; 73:441-450. [PMID: 31403826 DOI: 10.1080/08039488.2019.1649723] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To investigate whether women and men diagnosed with depressive disorder were managed equally in terms of being sick-leave certified and being prescribed psychoactive drugs. Materials and methods: Data from all patients diagnosed with depression during 2010-2015 in Uppsala county, Sweden (n = 19 448) were used to investigate associations between gender and issued sick-leave certificate, prescriptions of anti-depressants, anxiolytics, hypnotics and sedatives, and cognitive behavioral psychotherapy referrals, at different time points up till 180 days after diagnosis. Results: At diagnosis date, 50.1% were prescribed antidepressants; 14.2% anxiolytics; 13.3% hypnotics or sedatives. Corresponding proportion regarding issue of sick-leave certificate among working aged (18-64 years) was 16.6%. Men had higher odds than women of being prescribed antidepressants (OR 1.16; 95% CI 1.09-1.24); anxiolytics (1.10; 95% CI 1.02-1.21), hypnotics and sedatives (OR 1.09; 95% CI 1.00-1.19) and lower odds (among those aged 18-64 years) of being sick-leave certified (OR 0.90; 95% CI 0.82-0.98) in adjusted regression models. There were subtle changes in ORs for outcomes at 3- and 6-month follow-up periods. Conclusions: Men had somewhat higher odds of being prescribed psychoactive drugs and slightly lower odds of being sick-leave certified as compared to women at date when diagnosed with depression. The absolute differences were, however, small and the overall conclusion is that women and men with current diagnosed depressive episode/recurrent depressive disorder are generally managed likewise regarding sick leave and psychoactive treatment.
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Affiliation(s)
- Per Lytsy
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet , Stockholm , Sweden.,Department of Public Health and Caring Sciences, University of Uppsala , Uppsala , Sweden
| | - Johan Hallqvist
- Department of Public Health and Caring Sciences, University of Uppsala , Uppsala , Sweden
| | - Kristina Alexanderson
- Department of Clinical Neuroscience, Division of Insurance Medicine, Karolinska Institutet , Stockholm , Sweden
| | - Annika Åhs
- Department of Public Health and Caring Sciences, University of Uppsala , Uppsala , Sweden
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27
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Konttinen H, van Strien T, Männistö S, Jousilahti P, Haukkala A. Depression, emotional eating and long-term weight changes: a population-based prospective study. Int J Behav Nutr Phys Act 2019; 16:28. [PMID: 30894189 PMCID: PMC6427874 DOI: 10.1186/s12966-019-0791-8] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 03/11/2019] [Indexed: 12/27/2022] Open
Abstract
Background Emotional eating (i.e. eating in response to negative emotions) has been suggested to be one mechanism linking depression and subsequent development of obesity. However, studies have rarely examined this mediation effect in a prospective setting and its dependence on other factors linked to stress and its management. We used a population-based prospective cohort of adults and aimed to examine 1) whether emotional eating mediated the associations between depression and 7-year change in body mass index (BMI) and waist circumference (WC), and 2) whether gender, age, night sleep duration or physical activity moderated these associations. Methods Participants were Finnish 25- to 74-year-olds who attended the DILGOM study at baseline in 2007 and follow-up in 2014. At baseline (n = 5024), height, weight and WC were measured in a health examination. At follow-up (n = 3735), height, weight and WC were based on measured or self-reported information. Depression (Center for Epidemiological Studies - Depression Scale), emotional eating (Three-Factor Eating Questionnaire-R18), physical activity and night sleep duration were self-reported. Age- and gender-adjusted structural equation models with full information maximum likelihood estimator were used in the analyses. Results Depression and emotional eating were positively associated and they both predicted higher 7-year increase in BMI (R2 = 0.048) and WC (R2 = 0.045). The effects of depression on change in BMI and WC were mediated by emotional eating. Night sleep duration moderated the associations of emotional eating, while age moderated the associations of depression. More specifically, emotional eating predicted higher BMI (P = 0.007 for the interaction) and WC (P = 0.026, respectively) gain in shorter sleepers (7 h or less), but not in longer sleepers (9 h or more). Depression predicted higher BMI (P < 0.001 for the interaction) and WC (P = 0.065, respectively) increase in younger participants, but not in older participants. Conclusions Our findings offer support for the hypothesis that emotional eating is one behavioural mechanism between depression and development of obesity and abdominal obesity. Moreover, adults with a combination of shorter night sleep duration and higher emotional eating may be particularly vulnerable to weight gain. Future research should examine the clinical significance of our observations by tailoring weight management programs according to these characteristics. Electronic supplementary material The online version of this article (10.1186/s12966-019-0791-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hanna Konttinen
- Department of Food and Nutrition, P.O. Box 66, 00014 University of Helsinki, Helsinki, Finland. .,Faculty of Social Sciences, P.O. Box 54, 00014 University of Helsinki, Helsinki, Finland.
| | - Tatjana van Strien
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE, Nijmegen, The Netherlands.,Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
| | - Satu Männistö
- Department of Public Health Solutions, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Pekka Jousilahti
- Department of Public Health Solutions, National Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Ari Haukkala
- Faculty of Social Sciences, P.O. Box 54, 00014 University of Helsinki, Helsinki, Finland
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28
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Rainville JR, Hodes GE. Inflaming sex differences in mood disorders. Neuropsychopharmacology 2019; 44:184-199. [PMID: 29955150 PMCID: PMC6235877 DOI: 10.1038/s41386-018-0124-7] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 06/07/2018] [Accepted: 06/11/2018] [Indexed: 02/06/2023]
Abstract
Men and women often experience different symptoms or rates of occurrence for a variety of mood disorders. Many of the symptoms of mood disorders overlap with autoimmune disorders, which also have a higher prevalence in women. There is a growing interest in exploring the immune system to provide biomarkers for diagnosis of mood disorders, along with new targets for developing treatments. This review examines known sex differences in the immune system and their relationship to mood disorders. We focus on immune alterations associated with unipolar depression, bipolar depression, and anxiety disorders. We describe work from both basic and clinical research examining potential immune mechanisms thought to contribute to stress susceptibility and associated mood disorders. We propose that sex and age are important, intertwined factors that need to be included in future experimental designs if we are going to harness the power of the immune system to develop a new wave of treatments for mood disorders.
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Affiliation(s)
- Jennifer R Rainville
- Department of Neuroscience, Virginia Polytechnic Institute and State University, 1981 Kraft Drive, Blacksburg, VA, 24060, USA
| | - Georgia E Hodes
- Department of Neuroscience, Virginia Polytechnic Institute and State University, 1981 Kraft Drive, Blacksburg, VA, 24060, USA.
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29
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Bagheri Z, Akbari M, Jafari P, Huedo-medina TB. Assessing the measurement invariance of the RCADS-25 questionnaire across gender and child–parent dyads in the presence of multilevel data. Qual Life Res 2018; 28:829-840. [DOI: 10.1007/s11136-018-2049-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2018] [Indexed: 10/27/2022]
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30
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Tyuvina NA, Voronina EO, Balabanova VV, Tyulpin YG. Clinical features of depression in women compared with men. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2018. [DOI: 10.14412/2074-2711-2018-3-48-53] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective: to study the clinical features of depression in women compared with men. Patients and methods. 120 women aged 18-65 years with recurrent depressive disorder (RDD; ICI-10 F33) (a study group) and 67 men of the same age with RDD (a control group) were clinically examined using a specially designed schedule and the Montgomery-Asberg Depression Scale. Results. The clinical picture and the course of RDD have gender differences. The earlier onset of the disease in women with a large number of depressive attacks and lower quality remissions is due to the relationship and mutual influence of menstrual and reproductive function and depression. Such typical symptoms of endogenous depression, as slow thinking, anhedony, decreased sleep duration and early morning awakenings, as well as diurnal swings of mood with its deterioration in the morning, were characteristic for most women and men. The pattern of depression in women is more commonly characterized by anxiety; ideas of self-accusation; suicidal thoughts; avoidance of contacts with others; weakness; fatigue; decreased or increased appetite; sleep onset insomnia; lack of sleep feeling. That in men is more often marked by symptoms, such as melancholy; motor retardation; decreased motivation; somatic symptoms of depression (tachycardia, constipation); comorbid panic attacks; and concomitant diseases of the cardiovascular, respiratory and genitourinary systems. Men more frequently abuse alcohol and other psychoactive substances. Conclusion. The revealed features of depression in women and men will be able to more accurately diagnose and to prescribe adequate therapy.
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Affiliation(s)
- N. A. Tyuvina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - E. O. Voronina
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - V. V. Balabanova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
| | - Yu. G. Tyulpin
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow
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Zhang J, Dong X, Wang L, Zhao L, Weng Z, Zhang T, Sui J, Go R, Huang Q, Wu J, Yan T. Gender Differences in Global Functional Connectivity During Facial Emotion Processing: A Visual MMN Study. Front Behav Neurosci 2018; 12:220. [PMID: 30319370 PMCID: PMC6167960 DOI: 10.3389/fnbeh.2018.00220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/30/2018] [Indexed: 11/21/2022] Open
Abstract
To investigate gender differences in functional connectivity during the unattended processing of facial expressions, we recorded visual mismatch negativity (vMMN) in 34 adults using a deviant-standard reverse oddball paradigm. Using wavelet analysis, we calculated the time-frequency (TF) power at each electrode associated with happy-deviant, sad-deviant, happy-standard and sad-standard conditions. We also calculated the phase lag index (PLI) between electrode pairs and analyzed the dynamic network topologies of the functional connectivity for happy and sad vMMNs in the delta (0.5-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), beta (13-30 Hz) and gamma (30-45 Hz) bands. The results showed that females induced stronger TF power and PLI values than males in only the alpha band over the whole brain regarding the vMMN. Moreover, females had a higher ratio of the number of connections between long-distance electrode pairs than males. While theoretical analysis of dynamic network topologies indicated that high node degree values were found in local brain regions of males and in almost the entire female brain, our findings suggested that female brain activation and connections between brain regions are not only stronger but also more widely distributed during the unattended processing of facial expressions than those in males.
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Affiliation(s)
- Jian Zhang
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Xiaonan Dong
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Luyao Wang
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Lun Zhao
- School of Psychological Research, Beijing Yiran Sunny Technology Co. Ltd., Beijing, China
| | - Zizheng Weng
- Engineering and Computer Science, University of Denver, Denver, CO, United States
| | | | - Junyu Sui
- Shouguang Xiandai High School, Shandong, China
| | - Ritsu Go
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Qiang Huang
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Jinglong Wu
- School of Mechatronical Engineering, Intelligent Robotics Institute, Beijing Institute of Technology, Beijing, China
| | - Tianyi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China
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Ivanets NN, Tyuvina NA, Voronina EO, Balabanova VV. Comparative evaluation of depressive disorders in women and men. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:15-19. [DOI: 10.17116/jnevro201811811115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Veltman EM, Lamers F, Comijs HC, de Waal MWM, Stek ML, van der Mast RC, Rhebergen D. Depressive subtypes in an elderly cohort identified using latent class analysis. J Affect Disord 2017; 218:123-130. [PMID: 28472702 DOI: 10.1016/j.jad.2017.04.059] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/14/2017] [Accepted: 04/24/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Clinical findings indicate heterogeneity of depressive disorders, stressing the importance of subtyping depression for research and clinical care. Subtypes of the common late life depression are however seldom studied. Data-driven methods may help provide a more empirically-based classification of late-life depression. METHODS Data were used from the Netherlands Study of Depression in Older People (NESDO) derived from 359 persons, aged 60 years or older, with a current diagnosis of major depressive disorder. Latent class analysis (LCA) was used to identify subtypes of depression, using ten CIDI-based depression items. Classes were then characterized using various sociodemographic and clinical characteristics. RESULTS The most prevalent class, as identified by LCA, was a moderate-severe class (prevalence 46.5%), followed by a severe melancholic class (prevalence 38.4%), and a severe atypical class (prevalence 15.0%). The strongest distinguishing features between the three classes were appetite and weight and, to a lesser extent, psychomotor symptoms and loss of interest. Compared with the melancholic class, the severe atypical class had the highest prevalence of females, the lowest mean age, the highest BMI, and highest prevalence of both cardiovascular disease, and metabolic syndrome. LIMITATIONS The strongest distinguishing symptoms, appetite and weight, could be correlated. Further, only longitudinal studies could demonstrate whether the identified classes are stable on the long term. DISCUSSION In older persons with depressive disorders, three distinct subtypes were identified, similar to subtypes found in younger adults. The strongest distinguishing features were appetite and weight; moreover, classes differed strongly on prevalence of metabolic syndrome and cardiovascular disease. These findings suggest differences in the involvement of metabolic pathways across classes, which should be considered when investigating the pathogenesis and (eventually) treatment of depression in older persons.
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Affiliation(s)
- E M Veltman
- Department of Psychiatry, Leiden University Medical Center, The Netherlands.
| | - F Lamers
- GGZ inGeest/Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - H C Comijs
- GGZ inGeest/Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - M W M de Waal
- Department of Public Health and Primary Care, Leiden University Medical Center, The Netherlands
| | - M L Stek
- GGZ inGeest/Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - R C van der Mast
- Department of Psychiatry, Leiden University Medical Center, The Netherlands; Department of Psychiatry, CAPRI-University of Antwerp, Belgium
| | - D Rhebergen
- GGZ inGeest/Department of Psychiatry and the EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
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Wariso BA, Guerrieri GM, Thompson K, Koziol DE, Haq N, Martinez PE, Rubinow DR, Schmidt PJ. Depression during the menopause transition: impact on quality of life, social adjustment, and disability. Arch Womens Ment Health 2017; 20:273-282. [PMID: 28000061 PMCID: PMC6309889 DOI: 10.1007/s00737-016-0701-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
The impact of depression on quality of life (QOL) and social support has neither been well characterized in clinical samples of women with perimenopausal depression (PMD) nor have the relative contributions of depression and other menopausal symptoms (e.g., hot flushes) to declining QOL been clarified. In this study, we compared QOL measures, social support, and functional disability in PMD and non-depressed perimenopausal women. We evaluated women aged 40-60 years who presented with menstrual cycle irregularity, elevated plasma FSH levels, and met criteria for perimenopause. A structured clinical interview was administered to determine the presence or absence of major and minor depression. Outcome measures included the Quality of Life Enjoyment Scale Questionnaire, the Sheehan Disability Scale, the Global Assessment of Functioning, the Social Adjustment Scale, and the Duke Social Support Index. Kruskal-Wallis tests and ANOVAs were used to compare outcome measures. Ninety women with PMD and 51 control women participated in this study. Women with PMD reported significantly decreased QOL, social support, and adjustment and increased disability compared with non-depressed perimenopausal women. Neither perimenopausal reproductive status alone nor the presence of hot flushes had a significant negative impact on QOL measures. PMD is accompanied by significant reductions in QOL, social support, and disability similar to depression in women at other stages of life. PMD may also contribute to decreased QOL in community- or clinic-based samples of perimenopausal women. It remains unclear whether the clinical characteristics we identified reflect pre-existing risk factors for depression during the perimenopause or the effects of a current depression. Future clinical and treatment studies in perimenopausal women should distinguish depressed women when outcome measures include QOL.
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Affiliation(s)
- Bathsheba A Wariso
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Gioia M Guerrieri
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Karla Thompson
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Deloris E Koziol
- Biostatistics and Clinical Epidemiology Service, Clinical Center, National Institutes of Health, Bethesda, MD, 20892-1871, USA
| | - Nazli Haq
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - Pedro E Martinez
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Peter J Schmidt
- Section on Behavioral Endocrinology, National Institute of Mental Health, NIMH, Bldg. 10CRC, Room 25330, 10 Center Drive MSC 1277, Bethesda, MD, 20892-1277, USA.
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Mental Health in Allergic Rhinitis: Depression and Suicidal Behavior. CURRENT TREATMENT OPTIONS IN ALLERGY 2017; 4:71-97. [PMID: 28966902 DOI: 10.1007/s40521-017-0110-z] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A high proportion of suicides visit their medical provider in the month prior to death, but depression, suicidal thoughts, and substance use are seldom addressed. For the clinicians routinely treating a substantial patient population with allergic diseases, there are additional concerns, as allergy has been linked with both depression and suicidal behavior. While psychotropic medications may affect diagnosis of allergies, medications used to treat allergies impact mood and behavior. Thus, we present an overview of the overlap of allergic rhinitis with depression and suicidal behavior in adults, based on clinical and epidemiological data, and our research and clinical experience. In summary, we suggest: 1) inquiring among patients with allergies about personal and family history of depression, substance use disorders, suicidal ideation and attempts 2) increased mindfulness regarding the potential effects of allergy medications on mood and behavior; and 3) for people identified with certain types of depression or increased suicide risk, a systematic multilevel collaborative approach. While for practical reasons the majority of patients with depression will continue to be treated by general or family practitioners, the allergy-treating provider should always consider integrated care for bipolar, psychotic or suicidal depression and incomplete remission, or relapsing and highly recurrent course. While awaiting results of much needed basic and clinical research to guide clinical approach for patients with comorbid allergic rhinitis and depression, the simple steps recommended here are expected to improved clinical outcomes in depression, including, on a large scale, reduced premature deaths by suicide.
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Silverstein B, Ajdacic-Gross V, Rossler W, Angst J. The gender difference in depressive prevalence is due to high prevalence of somatic depression among women who do not have depressed relatives. J Affect Disord 2017; 210:269-272. [PMID: 28068614 DOI: 10.1016/j.jad.2017.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 12/26/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Given that several studies have found the gender difference in depression to be rooted in psychosocial forces and others have shown the difference to be due to a gender difference in somatic depression, we compared the gender difference in somatic depression among respondents who reported no relative depressed with that of all other depressed respondents. METHODS Respondents in a representative sample from the Zurich study who met criteria for somatic depression and reported no relatives (first-degree, or parents, or mothers, or fathers in separate analyses) with depression were compared to other depressed respondents as to gender. RESULTS The gender difference in the prevalence of depression among respondents with somatic depression who reported no relatives with depression (whether the relatives were all first-degree, or any parent, or mothers only or fathers only) was significantly greater than the gender difference in depression among other respondents LIMITATIONS: The measure of depression among relatives was based upon reports of the respondents. CONCLUSION All or almost all of the gender difference in depression in this representative sample.is due to a gender difference in somatic depression among respondents who reported no depressed relative. Somatic depression may be a disorder distinct from depression without significant additional somatic symptomatology. If so, it is likely that it should be treated differently.
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Affiliation(s)
- Brett Silverstein
- Department of Psychology, City College of New York, New York, NY 10031, USA.
| | - Vladeta Ajdacic-Gross
- Research Unit for Social and Clinical Psychiatry, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Wulf Rossler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
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Calvó-Perxas L, Vilalta-Franch J, Turró-Garriga O, López-Pousa S, Garre-Olmo J. Gender differences in depression and pain: A two year follow-up study of the Survey of Health, Ageing and Retirement in Europe. J Affect Disord 2016; 193:157-64. [PMID: 26773909 DOI: 10.1016/j.jad.2015.12.034] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 12/18/2015] [Accepted: 12/27/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND The longitudinal association of depression and pain according to gender was investigated using a population-based sample from 13 European countries. METHODS The study population was taken from waves 4-5 of the Survey of Health, Ageing and Retirement in Europe. The sample consisted of 22,280 participants ≥50 years, who were interviewed at baseline, and after two years. Regression models for each gender were used to assess the variables associated with depression and pain incidence and persistence. RESULTS Prevalences of depression, pain, and depression-pain co-occurrence, were higher in women than in men (depression: 34.5% vs. 20.3%; OR=2.1; 95% CI=1.9-2.2; pain: 60.2% vs. 53.5%; OR=1.3; 95% CI=1.2-1.4; co-occurrence 25.3% vs. 14.0%; OR=2.3; 95% CI=2.2-2.6). Treated baseline pain in women (OR=1.6; 95% CI=1.3-2.0), and treated/untreated pain in men (untreated OR=1.3; 95% CI=1.1-1.7; treated OR=2.0; 95% CI=1.5-2.7), were associated with incident depression. Untreated baseline depression was associated with incident pain (women OR=1.3; 95% CI=1.1-1.7; men OR=1.8; 95% CI=1.3-2.6), and with persistent pain only in women (OR=1.3; 95% CI=1.1-1.6). LIMITATIONS We lack information on pain severity, and the consumption of analgesics was used as a proxy. We lack information on antidepressants and anxiolytics consumption separately. Participants were interviewed twice in two years, and pain/depression at both interviews were considered persistent although they may have relapsed and recurred. CONCLUSIONS Treated baseline pain is a risk factor for incident depression in both genders; untreated baseline pain is a risk factor only in men. Treating depression at baseline may protect from developing pain in both genders, and in women, it may also protect from pain persistence.
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Affiliation(s)
- Laia Calvó-Perxas
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain
| | - Joan Vilalta-Franch
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain; Memory and Dementia Assessment Unit, Institut d'Assistència Sanitària, Salt, Catalonia, Spain.
| | - Oriol Turró-Garriga
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain
| | - Secundino López-Pousa
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain; Memory and Dementia Assessment Unit, Institut d'Assistència Sanitària, Salt, Catalonia, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IdIBGI), IAS Research Unit, Salt, Catalonia, Spain; Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
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Kim K, Hong JP, Cho MJ, Fava M, Mischoulon D, Lee DW, Heo JY, Jeon HJ. Loss of sexual interest and premenstrual mood change in women with postpartum versus non-postpartum depression: A nationwide community sample of Korean adults. J Affect Disord 2016; 191:222-9. [PMID: 26682491 DOI: 10.1016/j.jad.2015.11.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Revised: 11/04/2015] [Accepted: 11/30/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Postpartum depression (PPD) is a type of clinical depression that can affect women after childbirth. Few previous studies have explored the association of depressive and physical symptoms among women with PPD in a nationwide community study. METHOD A total of 18,807 adults, randomly selected, completed a face-to-face interview using the Korean version of Composite International Diagnostic Interview (K-CIDI) (response rate 80.2%). PPD was defined as a major depressive episode that began within 4 weeks after delivery. RESULTS Of 679 female subjects with major depressive disorder (MDD), 14.0% (n=95) experienced PPD. Subjects with PPD were significantly more likely to have higher income, education, and reside in an urban area, compared to those with non-PPD. No significant differences were found in number of children. Multiple logistic regression revealed that the loss of sexual interest was the only symptom among 23 depressive symptoms that was significantly associated with depressive episodes among individuals with PPD (AOR=1.91, 95% CI 1.01-3.60) when compared with non-PPD. Loss of sexual interest was also significantly associated with the subjects with lifetime PPD regardless of depressive episode (AOR=1.93, 95% CI 1.12-3.31). Conversely, loss of confidence and loss of pleasure were less frequent in subjects with PPD. Premenstrual mood change (χ(2)=5.57, p=0.0036) and comorbid alcohol use disorder (χ(2)=5.11, p=0.031) showed a valid association with PPD. CONCLUSIONS Loss of sexual interest and premenstrual mood change were associated with women with PPD, whereas those with non-PPD were not, thereby suggesting the possible link between sexual hormones and PPD.
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Affiliation(s)
- Kiwon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Maeng Je Cho
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Dong-Woo Lee
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Jung-Yoon Heo
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, South Korea; Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA; Department of Health Sciences & Technology, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea; Department of Medical Device Management & Research, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea; Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, South Korea.
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Rodgers S, Vandeleur CL, Ajdacic-Gross V, Aleksandrowicz AA, Strippoli MPF, Castelao E, Glaus J, Lasserre AM, Müller M, Rössler W, Angst J, Preisig M. Tracing the associations between sex, the atypical and the combined atypical-melancholic depression subtypes: A path analysis. J Affect Disord 2016; 190:807-818. [PMID: 26625093 DOI: 10.1016/j.jad.2015.10.067] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/08/2015] [Accepted: 10/28/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Numerous studies have examined determinants leading to preponderance of women in major depressive disorder (MDD), which is particularly accentuated for the atypical depression subtype. It is thus of interest to explore the specific indirect effects influencing the association between sex and established depression subtypes. METHODS The data of 1624 subjects with a lifetime diagnosis of MDD derived from the population-based PsyCoLaus data were used. An atypical (n=256), a melancholic (n=422), a combined atypical and melancholic features subtype (n=198), and an unspecified MDD group (n=748) were constructed according to the DSM-IV specifiers. Path models with direct and indirect effects were applied to the data. RESULTS Partial mediation of the female-related atypical and combined atypical-melancholic depression subtypes was found. Early anxiety disorders and high emotion-orientated coping acted as mediating variables between sex and the atypical depression subtype. In contrast, high Body Mass Index (BMI) served as a suppression variable, also concerning the association between sex and the combined atypical-melancholic subtype. The latter association was additionally mediated by an early age of MDD onset and early/late anxiety disorders. LIMITATIONS The use of cross-sectional data does not allow causal conclusions. CONCLUSIONS This is the first study that provides evidence for a differentiation of the general mechanisms explaining sex differences of overall MDD by depression subtypes. Determinants affecting the pathways begin early in life. Since some of them are primarily of behavioral nature, the present findings could be a valuable target in mental health care.
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Affiliation(s)
- Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
| | - Caroline L Vandeleur
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Aleksandra A Aleksandrowicz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Marie-Pierre F Strippoli
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Enrique Castelao
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Jennifer Glaus
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland; Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Aurélie M Lasserre
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland; Collegium Helveticum, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland; Institute of Psychiatry, Laboratory of Neuroscience (LIM 27), University of Sao Paulo, Brazil
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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Evidence for Broadening Criteria for Atypical Depression Which May Define a Reactive Depressive Disorder. PSYCHIATRY JOURNAL 2015; 2015:575931. [PMID: 26258131 PMCID: PMC4516843 DOI: 10.1155/2015/575931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 07/05/2015] [Indexed: 11/17/2022]
Abstract
Objective. Arguing that additional symptoms should be added to the criteria for atypical depression. Method. Published research articles on atypical depression are reviewed. Results. (1) The original studies upon which the criteria for atypical depression were based cited fatigue, insomnia, pain, and loss of weight as characteristic symptoms. (2) Several studies of DSM depressive criteria found patients with atypical depression to exhibit high levels of insomnia, fatigue, and loss of appetite/weight. (3) Several studies have found atypical depression to be comorbid with headaches, bulimia, and body image issues. (4) Most probands who report atypical depression meet criteria for "somatic depression," defined as depression associated with several of disordered eating, poor body image, headaches, fatigue, and insomnia. The gender difference in prevalence of atypical depression results from its overlap with somatic depression. Somatic depression is associated with psychosocial measures related to gender, linking it with the descriptions of atypical depression as "reactive" appearing in the studies upon which the original criteria for atypical depression were based. Conclusion. Insomnia, disordered eating, poor body image, and aches/pains should be added as criteria for atypical depression matching criteria for somatic depression defining a reactive depressive disorder possibly distinct from endogenous melancholic depression.
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Kim MT, Kim KB, Han HR, Huh B, Nguyen T, Lee HB. Prevalence and Predictors of Depression in Korean American Elderly: Findings from the Memory and Aging Study of Koreans (MASK). Am J Geriatr Psychiatry 2015; 23:671-83. [PMID: 25554484 PMCID: PMC4442756 DOI: 10.1016/j.jagp.2014.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 11/16/2014] [Accepted: 11/20/2014] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To estimate the prevalence and identify the predictors of depression among community-dwelling Korean American elderly (KAE). DESIGN A cross-sectional descriptive epidemiological survey using a two-step sampling strategy to obtain a representative community sample. SETTING The authors recruited study participants at religious, service, and business establishments in the KA community (26 churches, 6 senior centers, 2 medical daycare centers, 1 supermarket). PARTICIPANTS Community-dwelling first-generation KAE (N = 1,118; mean age ± SD: 70.5 ± 7.0 years; female: 67.2%). MEASUREMENTS Trained bilingual nurses and community health workers interviewed participants face-to-face for demographic information, chronic conditions, and depression using the Korean versions of the Patient Health Questionnaire (PHQ-9K). RESULTS 30.3% of KAEs were classified as having either mild (PHQ-9K score 5-9; N = 218, 19.5%) or clinical depression (PHQ-9K score ≥10; N = 120, 10.8%), respectively. One of seven KAE (N = 164, 14.7%) endorsed thoughts of death or self-injury, but only 63 (5.7%) reported utilizing mental health services. The authors also identified several predictors of depression, including living arrangement (living alone versus living with family/spouse); having chronic conditions such as diabetes, arthritis, digestive disorders, or chronic bronchitis; years of education; and cognitive impairment. CONCLUSIONS The authors' findings reveal a high prevalence of depression among KAE and a low level of mental health service utilization. Because there are urgent needs for culturally and contextually relevant interventions, the authors also discuss the feasibility of community-based interventions to reduce the burden of depression, which should be incorporated into a management system for multiple chronic conditions.
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Affiliation(s)
- Miyong T. Kim
- School of Nursing, University of Texas at Austin, Austin, Texas
| | - Kim B. Kim
- Korean Resource Center, Ellicott City, Maryland
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Boyun Huh
- School of Nursing, University of California at San Francisco, San Francisco, California
| | - Tam Nguyen
- Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
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Rodgers S, grosse Holtforth M, Hengartner MP, Müller M, Aleksandrowicz AA, Rössler W, Ajdacic-Gross V. Serum testosterone levels and symptom-based depression subtypes in men. Front Psychiatry 2015; 6:61. [PMID: 25999864 PMCID: PMC4418274 DOI: 10.3389/fpsyt.2015.00061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 04/09/2015] [Indexed: 11/18/2022] Open
Abstract
The main objective of this preliminary study was to further clarify the association between testosterone (T) levels and depression by investigating symptom-based depression subtypes in a sample of 64 men. The data were taken from the ZInEP epidemiology survey. Gonadal hormones of a melancholic (n = 25) and an atypical (n = 14) depression subtype, derived from latent class analysis, were compared with those of healthy controls (n = 18). Serum T was assayed using an enzyme-linked immunosorbent assay procedure. Analysis of variance, analysis of covariance, non-parametrical tests, and generalized linear regression models were performed to examine group differences. The atypical depressive subtype showed significantly lower T levels compared with the melancholic depressives. While accumulative evidence indicates that, beyond psychosocial characteristics, the melancholic and atypical depressive subtypes are also distinguishable by biological correlates, the current study expanded this knowledge to include gonadal hormones. Further longitudinal research is warranted to disclose causality by linking the multiple processes in pathogenesis of depression.
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Affiliation(s)
- Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Martin grosse Holtforth
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychology, University of Bern, Bern, Switzerland
| | - Michael P. Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Mario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Aleksandra A. Aleksandrowicz
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
- Collegium Helveticum, Swiss Federal Institute of Technology, University of Zurich, Zurich, Switzerland
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Vladeta Ajdacic-Gross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, Zurich, Switzerland
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Suarez EC, Sundy JS, Erkanli A. Depressogenic vulnerability and gender-specific patterns of neuro-immune dysregulation: What the ratio of cortisol to C-reactive protein can tell us about loss of normal regulatory control. Brain Behav Immun 2015; 44:137-47. [PMID: 25241020 PMCID: PMC4275343 DOI: 10.1016/j.bbi.2014.09.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 08/26/2014] [Accepted: 09/07/2014] [Indexed: 12/27/2022] Open
Abstract
We examined whether the ratio of cortisol (CORT) to high-sensitivity C-reactive protein (hsCRP), an index that captures the integrity of homeostatic regulation between the hypothalamic-pituitary-adrenal (HPA) axis and inflammatory processes, is associated with vulnerability to depression in a gender specific manner and whether glucocorticoid receptor (GR) sensitivity plays a role in these associations. Fasting blood samples were collected between 08:45 and 09:15 and assayed for CORT, hsCRP, and leukocyte count in 213 healthy, medication-free men and women. The NEO-Personality Inventory was used to assess neuroticism, extraversion and anxiety. We used the Hamilton Depression Interview to assess depressive symptoms, the Buss-Perry anger subscale to measure anger, and the Pittsburgh Sleep Quality Index to evaluate subjective sleep quality and its components. Log-transformed CORT/CRP values were analyzed using multiple regression with Holms' adjusted p-values and age, body mass index (BMI), and race as covariates. GR sensitivity was estimated using the log-transformed ratio of neutrophils (N)-to-monocytes (M). The log-transformed ratio of CORT/CRP did not differ between men and women but was significantly and negatively associated with age and BMI. Severity of depressive symptoms, extraversion, anxiety, and sleep quality were associated with the CORT/CRP ratio in a gender-specific manner. For women, decreasing CORT/CRP ratios, suggestive of an insufficient release of CORT coupled with a heightened inflammatory state, were associated with increasing severity of depressive symptoms, decreasing quality of sleep, increasing frequency of sleep disturbance, and decreasing extraversion. For men, increasing frequency of daytime disturbance and levels of anxiety were associated with increasing CORT/CRP ratio, suggestive of an enhanced release of CORT relative to attenuated levels of hsCRP. For both genders, increasing anger was associated with decreasing CORT/CRP ratios. Although results suggested GR downregulation in women but not men, such differences did not mediate the observed associations. With the use of the CORT/CRP ratio, we showed that vulnerability factors for depression are associated with a loss of normal regulatory controls resulting in gender-specific patterns of neuro-immune dysregulation. That GR downregulation did not influence these associations suggests that the loss of regulatory controls in at risk individuals is primarily at the level of the hormone. Beyond the individual contribution of each component of the CORT/CRP ratio, disruption of normal neuroimmune regulatory feedback provides a plausible biological framework useful in understanding biobehavioral vulnerabilities to depression in a gender specific manner. The CORT/CRP ratio may be a viable biomarker not only for delineating risk for MDD but also progression and treatment responses among patients with MDD; possibilities that are testable in future studies.
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Affiliation(s)
- Edward C. Suarez
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - John S. Sundy
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Alaattin Erkanli
- Department of Biostatistics, Duke University Medical Center, Durham, NC, USA
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Silverstein B, Levin E. Differences in the developmental patterns of depression with and without additional somatic symptoms. Psychiatry Res 2014; 220:254-7. [PMID: 25128251 DOI: 10.1016/j.psychres.2014.07.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 07/15/2014] [Accepted: 07/24/2014] [Indexed: 11/17/2022]
Abstract
Depression accompanied by somatic symptoms ("somatic" depression) has been found to differ from depression without the additional symptoms ("pure" depression) in their gender ratio, their association with measures of perceived gender inequality taken from both respondents and their parents, and in their response to pharmacological treatment. Further evidence of the distinction between the two syndromes might come from differential patterns of development. Data on the annual incidence of new cases of depression exhibited by a representative sample of respondents aged 12-19 came from the National household survey on drug use and health. Between early adolescence (ages 12-14) and late adolescence (ages 15-19), female respondents exhibited a much larger increase in somatic depression than in pure depression. Males did not exhibit the same pattern. These results further support the hypothesis that somatic and pure depressions are two distinct disorders.
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Affiliation(s)
- Brett Silverstein
- Department of Psychology, City College of New York, New York, NY 10031, USA.
| | - Eitan Levin
- Department of Psychology, City College of New York, New York, NY 10031, USA
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Rodgers S, Ajdacic-Gross V, Müller M, Hengartner MP, Grosse Holtforth M, Angst J, Rössler W. The role of sex on stability and change of depression symptom subtypes over 20 years: a latent transition analysis. Eur Arch Psychiatry Clin Neurosci 2014; 264:577-88. [PMID: 24292327 DOI: 10.1007/s00406-013-0475-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 11/14/2013] [Indexed: 01/06/2023]
Abstract
Prospective studies investigating the long-term stability of depression symptom subtypes are rare. Moreover, sex has received little attention as a predictor. This study aimed to investigate the role of sex on stability and transition patterns of depressive symptom subtypes over 20 years. The data were drawn from three follow-ups (1988, 1999, and 2008) of the longitudinal Zurich Study. Latent transition analyses were fitted to the data of 322 subjects, using depressive symptoms from the face-to-face interviews. The stable classes were characterized by psychosocial correlates. Three subtypes were identified: 'severe atypical,' 'severe typical,' and 'moderate.' While stability of the severe atypical and moderate subtype was relatively high and increased over time (70-71; 45-90%), stability of the severe typical subtype was lower (45-48%). Females had a higher risk of being in the severe atypical subtype and exhibited more transitions, particularly with respect to the severe typical subtype. In contrast, males displayed more stable subtypes. The stable severe atypical subtype was associated with comorbid eating disorders as well as psychosis syndromes, whereas the stable severe typical subtype was associated only with psychosis syndromes. Our results provide first evidence for the notion that long-term stability and transition patterns differ by sex and depression subtypes. This finding has received too little attention in previous research and should be considered in treatments.
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Affiliation(s)
- Stephanie Rodgers
- Department of Psychiatry, Psychotherapy and Psychosomatics, Zurich University Hospital of Psychiatry, PO Box 1930, 8021, Zurich, Switzerland,
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Kinser PA, Lyon DE. A conceptual framework of stress vulnerability, depression, and health outcomes in women: potential uses in research on complementary therapies for depression. Brain Behav 2014; 4:665-74. [PMID: 25328843 PMCID: PMC4107381 DOI: 10.1002/brb3.249] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 05/07/2014] [Accepted: 06/09/2014] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions. AIMS AND DISCUSSION This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality. CONCLUSION The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.
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Affiliation(s)
- Patricia A Kinser
- Department of Family and Community Health Nursing, School of Nursing, Virginia Commonwealth University PO Box 980567, Richmond, Virginia, 23298-0567
| | - Debra E Lyon
- School of Nursing, University of Florida PO Box 100197, Gainesville, Florida, 32610-0197
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Henje Blom E, Duncan LG, Ho TC, Connolly CG, LeWinn KZ, Chesney M, Hecht FM, Yang TT. The development of an RDoC-based treatment program for adolescent depression: "Training for Awareness, Resilience, and Action" (TARA). Front Hum Neurosci 2014; 8:630. [PMID: 25191250 PMCID: PMC4137278 DOI: 10.3389/fnhum.2014.00630] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 07/28/2014] [Indexed: 01/08/2023] Open
Abstract
Major depressive disorder (MDD) is one of the current leading causes of disability worldwide. Adolescence is a vulnerable period for the onset of depression, with MDD affecting 8–20% of all youth. Traditional treatment methods have not been sufficiently effective to slow the increasing prevalence of adolescent depression. We therefore propose a new model for the treatment of adolescent depression – Training for Awareness, Resilience, and Action (TARA) – that is based on current understanding of developmental and depression neurobiology. The TARA model is aligned with the Research Domain Criteria (RDoC) of the National Institute of Mental Health. In this article, we first address the relevance of RDoC to adolescent depression. Second, we identify the major RDoC domains of function involved in adolescent depression and organize them in a way that gives priority to domains thought to be driving the psychopathology. Third, we select therapeutic training strategies for TARA based on current scientific evidence of efficacy for the prioritized domains of function in a manner that maximizes time, resources, and feasibility. The TARA model takes into consideration the developmental limitation in top-down cognitive control in adolescence and promotes bottom-up strategies such as vagal afference to decrease limbic hyperactivation and its secondary effects. The program has been informed by mindfulness-based therapy and yoga, as well as modern psychotherapeutic techniques. The treatment program is semi-manualized, progressive, and applied in a module-based approach designed for a group setting that is to be conducted one session per week for 12 weeks. We hope that this work may form the basis for a novel and more effective treatment strategy for adolescent depression, as well as broaden the discussion on how to address this challenge.
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Affiliation(s)
- Eva Henje Blom
- Department of Clinical Neuroscience, Karolinska Institutet Stockholm, Sweden ; Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California San Francisco San Francisco, CA, USA
| | - Larissa G Duncan
- Department of Family and Community Medicine, University of California San Francisco San Francisco, CA, USA ; Osher Center for Integrative Medicine, University of California San Francisco San Francisco, CA, USA
| | - Tiffany C Ho
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California San Francisco San Francisco, CA, USA
| | - Colm G Connolly
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California San Francisco San Francisco, CA, USA
| | - Kaja Z LeWinn
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California San Francisco San Francisco, CA, USA
| | - Margaret Chesney
- Osher Center for Integrative Medicine, University of California San Francisco San Francisco, CA, USA ; Department of Medicine, University of California San Francisco San Francisco, CA, USA
| | - Frederick M Hecht
- Osher Center for Integrative Medicine, University of California San Francisco San Francisco, CA, USA ; Department of Medicine, University of California San Francisco San Francisco, CA, USA
| | - Tony T Yang
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of California San Francisco San Francisco, CA, USA
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Chuang E, Wells R, Aarons GA. Identifying Depression in a National Sample of Caregivers Investigated in Regard to Their Child's Welfare. Psychiatr Serv 2014; 65:911-7. [PMID: 24686832 PMCID: PMC4182297 DOI: 10.1176/appi.ps.201300010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Identifying depression is the first step in provision of treatment across service settings but can be challenging for non-mental health providers. This study examined how caseworker identification of depression among parents and other caregivers during the child welfare investigation or assessment process varies as a function of agency, caseworker, and case characteristics. METHODS Data were drawn from the second National Survey of Child and Adolescent Well-Being (NSCAW II), a national probability sample of children referred to U.S. child welfare agencies between February 2008 and April 2009. The study sample comprised 889 parents and other caregivers whose children initially remained at home and whose confidential responses on the World Health Organization Composite International Diagnostic Interview Short Form indicated a major depressive episode within the past 12 months. Weighted logistic regression examined predictors of caseworker identification of caregiver depression at the agency, caseworker, and case levels. RESULTS Investigative caseworkers identified mental health needs of only 38% of caregivers. Caseworkers were more likely to identify caregiver mental health needs when child welfare agency policy specified use of a standardized mental health assessment and when the maltreatment report came from a health or mental health provider versus other sources, such as teachers or family members. Investigative caseloads were negatively associated with identifying depression. CONCLUSIONS Structured mental health assessments may help non-mental health professionals identify mental health needs among vulnerable populations.
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Cummings CM, Caporino NE, Kendall PC. Comorbidity of anxiety and depression in children and adolescents: 20 years after. Psychol Bull 2014; 140:816-45. [PMID: 24219155 PMCID: PMC4006306 DOI: 10.1037/a0034733] [Citation(s) in RCA: 510] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Brady and Kendall (1992) concluded that although anxiety and depression in youths are meaningfully linked, there are important distinctions, and additional research is needed. Since then, studies of anxiety-depression comorbidity in youths have increased exponentially. Following a discussion of comorbidity, we review existing conceptual models and propose a multiple pathways model to anxiety-depression comorbidity. Pathway 1 describes youths with a diathesis for anxiety, with subsequent comorbid depression resulting from anxiety-related impairment. Pathway 2 refers to youths with a shared diathesis for anxiety and depression, who may experience both disorders simultaneously. Pathway 3 describes youths with a diathesis for depression, with subsequent comorbid anxiety resulting from depression-related impairment. Additionally, shared and stratified risk factors contribute to the development of the comorbid disorder, either by interacting with disorder-related impairment or by predicting the simultaneous development of the disorders. Our review addresses descriptive and developmental factors, gender differences, suicidality, assessments, and treatment-outcome research as they relate to comorbid anxiety and depression and to our proposed pathways. Research since 1992 indicates that comorbidity varies depending on the specific anxiety disorder, with Pathway 1 describing youths with either social phobia or separation anxiety disorder and subsequent depression, Pathway 2 applying to youths with coprimary generalized anxiety disorder and depression, and Pathway 3 including depressed youths with subsequent social phobia. The need to test the proposed multiple pathways model and to examine (a) developmental change and (b) specific anxiety disorders is highlighted.
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