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Deng F, Fan X, Liao J, Tang R, Sun X, Lin J, Zhang G, Pan J. The effect of neuroendocrine abnormalities on the risk of psychiatric readmission after hospitalization for bipolar disorder: A retrospective study. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110922. [PMID: 38114056 DOI: 10.1016/j.pnpbp.2023.110922] [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: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The correlation between the endocrine system and bipolar disorder(BD) has been well recognized, yet the influence of neuroendocrine hormones on readmission risk post-hospitalization for BD remains largely unexplored. This retrospective cohort study was to scrutinize the impact of neuroendocrine functionality on the readmission of patients with BD post-hospitalization for mental disorders. METHODS The dataset was derived from the electronic medical records of the First Affiliated Hospital of Jinan University in Guangzhou, China. Both univariate and multivariate logistic regression analysis were conducted on all patients hospitalized for BD, and from 1 January 2017 to October 2022. RESULTS Of the 1110 eligible patients, 83 and 141 patients experienced psychiatric readmissions within 90 and 180 days post-discharge, respectively. Multivariate analysis revealed that high serum TSH levels (aOR = 1.079; 95%CI = 1.003-1.160) and thyroid disease comorbidities (aOR = 2.899; 95%CI = 1.303-6.452) were independently correlated with the risk of 90-day readmission; while increased serum TSH levels (aOR = 1.179; 95%CI = 1.081-1.287) represented a risk factor for 180-day readmission. These results indicate that high serum TSH levels and thyroid disease comorbidities may contribute to an elevated readmission risk in patients with BD following hospitalization. CONCLUSION Routinely evaluating and intervening in thyroid function is crucial in the treatment of BD, as it may aid in preventing re-hospitalization.
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Affiliation(s)
- Fangyi Deng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Psychiatry, Liyuan Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei 430077, China
| | - Xiaoxuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiwu Liao
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Tang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xizhe Sun
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jingjing Lin
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guimei Zhang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiyang Pan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Li Z, Wang M, Hua M, Wang Z, Ying Y, Zhang Z, Zeng S, Wang H, Xu C. Association between testosterone and cancers risk in women: a two-sample Mendelian randomization study. Discov Oncol 2023; 14:198. [PMID: 37924384 PMCID: PMC10625503 DOI: 10.1007/s12672-023-00811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023] Open
Abstract
OBJECTIVE Previous observational studies have explored the correlation between testosterone and cancer risk. However, the causal association between testosterone and various cancer types in women remains inconclusive. The objective of this Mendelian randomization study is to evaluate the causal links between total testosterone (TT) and bioavailable testosterone (BT) with cancer risk in females. METHODS Initially, a rigorous quality control process was employed to identify suitable instrumental single nucleotide polymorphisms (SNPs) associated with the exposure under investigation that exhibited a significant association. The genetic causal relationship between female testosterone levels and the risk of developing cancers was examined through a two-sample Mendelian randomization. Various analytical methods, including inverse-variance weighted (IVW), MR-Egger, weighted median, simple mode, and weighted mode, were applied in the investigation. Key findings were primarily based on the results obtained via IVW (random effects), and sensitivity analyses were conducted to assess the reliability of the obtained results. Furthermore, maximum likelihood, penalized weighted median, and IVW (fixed effects) methods were utilized to further validate the robustness of the results. RESULTS Based on the results of IVW analysis, our study indicated a positive causal relationship between BT and breast cancer (OR = 1.1407, 95%CI: 1.0627-1.2244, P = 0.0015) and endometrial cancer (OR = 1.4610, 95%CI: 1.2695-1.6813, P = 1.22E-06). Moreover, our findings also showed a positive causal association between TT and breast cancer (OR = 1.1764, 95%CI: 1.0846-1.2761, P = 0.0005), cervical cancer(OR = 1.0020, 95%CI: 1.0007-1.0032, P = 0.0077), and endometrial cancer(OR = 1.4124, 95%CI: 1.2083-1.6511, P = 0.0001). Additionally, our results demonstrated a negative causal relationship between BT and ovarian cancer (OR = 0.8649, 95%CI: 0.7750-0.9653, P = 0.0320). However, no causal relationship was found between BT, TT and other types of cancer (corrected P > 0.05). CONCLUSIONS This study elucidates the role of testosterone on the development of breast cancer, endometrial cancer, ovarian cancer, and cervical cancer. It also hints at a potential but fragile link between testosterone and bladder cancer, as well as thyroid cancer. Nonetheless, it's worth noting that no statistically significant relationship between testosterone and various other types of cancer in females was identified.
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Affiliation(s)
- Zhizhou Li
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Maoyu Wang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Meimian Hua
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Ziwei Wang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yidie Ying
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhensheng Zhang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shuxiong Zeng
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Huiqing Wang
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.
| | - Chuanliang Xu
- Department of Urology, Shanghai Changhai Hospital, Naval Medical University, Shanghai, China.
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He H, Hong L, Jin W, Xu Y, Kang W, Liu J, Song J, Zheng T, Chen H, Zhao K. Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis. BMC Psychiatry 2023; 23:301. [PMID: 37127584 PMCID: PMC10152699 DOI: 10.1186/s12888-023-04808-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/20/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) by adolescent patients with depression has become a serious public health problem. This cross-sectional study aims to identify subgroups of adolescents based on NSSI and explore the factors related to these subgroups. METHODS The study recruited 326 in- and out-patient adolescents (263 girls and 63 boys) aged 12 to 18 years (mean = 14.7, SD = 1.6) who had self-injured in the past year. Latent class indicators included 12 NSSI variables, as well as suicidal ideation. Logistic regression examined associations between identified classes and related factors. RESULTS In this study, two distinct subgroups were identified: a "high suicidal ideation NSSI group" (n = 129, 39.6%) and a "low suicidal ideation NSSI group" (n = 197, 60.4%). Depression (OR = 1.10; 95% CI, 1.05-1.16), female (OR = 2.01; 95% CI, 1.09-3.69), left-behind experience (OR = 2.08; 95% CI, 1.17-3.71), single-parent family (OR = 1.84; 95% CI, 1.11-3.04) and peer victimization (OR = 1.04; 95% CI, 1.02-1.05) increases the probability of belonging to the "high suicidal ideation NSSI group". A high level of perceived social support (OR = 0.99; 95% CI, 0.97-0.99) was a protective factor towards NSSI. CONCLUSIONS This study identifies two subgroups of NSSI and the factors associated with each subgroup. The early identification of high-risk groups for major NSSI in adolescents diagnosed with depression is possible due to the identification of correlating factors. Different treatment plans can be developed for different subtypes of NSSI to improve the effectiveness of prevention and intervention, promoting the healthy physical and mental development of adolescents with depression.
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Affiliation(s)
- He He
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Lan Hong
- The Third Hospital of QuZhou, Quzhou, 324003, China
| | - Wei Jin
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wei Kang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jingyao Song
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China.
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Zito S, Nosari G, Pigoni A, Moltrasio C, Delvecchio G. Association between testosterone levels and mood disorders: A minireview. J Affect Disord 2023; 330:48-56. [PMID: 36841309 DOI: 10.1016/j.jad.2023.02.108] [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: 08/23/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Although many studies reported the neuropsychiatric involvement of testosterone (T) levels in the development of mood disorders, its role in this disabling disorder is still not well understood. Therefore, in this review, we aim to summarize the current literature exploring serum testosterone levels in both major depressive disorder (MDD) and bipolar disorder (BD), with particular attention given to the possible causal relationship between pathological mood alterations and T levels. METHODS We selected 9 original studies from a bibliographic search on PubMed, excluding studies on hormonal therapy and other psychiatric disorders other than mood disorders. RESULTS The results reported by the reviewed studies were conflicting especially with regards to the presence of dysfunctional levels of T in patients with BD. Specifically, while MDD was found to be associated with low levels of T compared to healthy controls (HC), in BD the results were highly heterogeneous, with a mixed picture of reduced, increased or no difference in T levels in BD patients compared to HC. LIMITATIONS Studies were highly heterogeneous in terms of samples employed, psychometric scales used for assessing depressive symptoms, T assay methods and therapeutic regimens. CONCLUSIONS Overall, T levels were shown to be reduced in both MDD and BD patients, ultimately suggesting that T could be useful as a biomarker in mood disorders and provide guidance for future research.
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Affiliation(s)
- Silvana Zito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Guido Nosari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Alessandro Pigoni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Moltrasio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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5
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Sher L. Testosterone and Suicidal Behavior in Bipolar Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2502. [PMID: 36767867 PMCID: PMC9915214 DOI: 10.3390/ijerph20032502] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/26/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Bipolar disorder is associated with suicidal behavior. The risk of suicide for individuals with bipolar disorder is up to 20-30 times larger than that of the general population. Considerable evidence suggests that testosterone may play a role in the pathophysiology of suicidal behavior in both men and women with bipolar disorder and other psychiatric conditions. Testosterone has complex effects on psychological traits. It affects mood and behavior, including interactions with other people. Testosterone regulates pro-active and re-active aspects of aggression. Probably, both high and low levels of testosterone may contribute to the neurobiology of suicide in various patient populations. The effects of endogenous and exogenous testosterone on suicidality in patients with bipolar disorder need further investigation. The aim of this commentary article is to provide a commentary on the author's work on the topic, summarize the literature on testosterone, bipolar disorder, and suicide, and encourage future research on this poorly studied topic.
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Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, Bronx, NY 10468, USA; ; Tel.: +1-718-584-9000
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
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Abstract
Most suicides have a diagnosable psychiatric disorder, most frequently, a mood disorder. Psychosocial issues and neurobiological abnormalities such as dysregulation in stress response systems contribute to suicidal behavior. All psychiatric patients need to be screened for the presence of suicidal ideation. Clinicians are expected to gather information about patient's clinical features and to formulate decisions about patient's dangerousness to self and the treatment plan. As psychiatric disorders are a major risk factor for suicide their pharmacologic and psychological treatment is of utmost importance to prevent suicide. Restriction of access to lethal means is important for suicide prevention.
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Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, 130 West Kingsbridge Road, Bronx, NY 10468, USA; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY 10029, USA; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Philadelphia, PA 19104, USA
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Sher L, Sublette ME, Grunebaum MF, Mann JJ, Oquendo MA. Plasma testosterone levels and subsequent suicide attempts in males with bipolar disorder. Acta Psychiatr Scand 2022; 145:223-225. [PMID: 34735031 DOI: 10.1111/acps.13381] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Leo Sher
- James J. Peters VA Medical Center, Bronx, New York, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA
| | - M Elizabeth Sublette
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Michael F Grunebaum
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - J John Mann
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, New York, USA.,New York State Psychiatric Institute, New York, New York, USA
| | - Maria A Oquendo
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
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8
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Ho TC, Gifuni AJ, Gotlib IH. Psychobiological risk factors for suicidal thoughts and behaviors in adolescence: a consideration of the role of puberty. Mol Psychiatry 2022; 27:606-623. [PMID: 34117365 PMCID: PMC8960417 DOI: 10.1038/s41380-021-01171-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 02/05/2023]
Abstract
Suicide is the second leading cause of death among adolescents. While clinicians and researchers have begun to recognize the importance of considering multidimensional factors in understanding risk for suicidal thoughts and behaviors (STBs) during this developmental period, the role of puberty has been largely ignored. In this review, we contend that the hormonal events that occur during puberty have significant effects on the organization and development of brain systems implicated in the regulation of social stressors, including amygdala, hippocampus, striatum, medial prefrontal cortex, orbitofrontal cortex, and anterior cingulate cortex. Guided by previous experimental work in adults, we also propose that the influence of pubertal hormones and social stressors on neural systems related to risk for STBs is especially critical to consider in adolescents with a neurobiological sensitivity to hormonal changes. Furthermore, facets of the pubertal transition, such as pubertal timing, warrant deeper investigation and may help us gain a more comprehensive understanding of sex differences in the neurobiological and psychosocial mechanisms underlying adolescent STBs. Ultimately, advancing our understanding of the pubertal processes that contribute to suicide risk will improve early detection and facilitate the development of more effective, sex-specific, psychiatric interventions for adolescents.
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Affiliation(s)
- Tiffany C. Ho
- grid.168010.e0000000419368956Department of Psychology, Stanford University, Stanford, CA USA ,grid.266102.10000 0001 2297 6811Department of Psychiatry and Weill Institute for Neuroscience, University of California, San Francisco, San Francisco, CA USA
| | - Anthony J. Gifuni
- grid.168010.e0000000419368956Department of Psychology, Stanford University, Stanford, CA USA ,grid.14709.3b0000 0004 1936 8649Psychiatry Department and Douglas Mental Health University Institute, McGill University, Montréal, QC Canada
| | - Ian H. Gotlib
- grid.168010.e0000000419368956Department of Psychology, Stanford University, Stanford, CA USA
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Lombardo G. New frontiers in suicide vulnerability: immune system and sex hormones. Brain Behav Immun Health 2021; 18:100384. [PMID: 34841283 PMCID: PMC8607160 DOI: 10.1016/j.bbih.2021.100384] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/08/2021] [Accepted: 10/31/2021] [Indexed: 11/29/2022] Open
Abstract
Suicide is one of the leading causes of death worldwide and men have a higher risk of attempting and completing suicide than women. Accumulating evidence leads to a possible key role of the immune system and sex hormones in psychiatric conditions associated with suicide vulnerability (e.g., major depressive disorder). Moreover, the literature highlights a dysregulation of the immune system and altered sex hormone levels in suicidal patients. Sex hormones and the immune system may have a role in suicide risk and sex differences in suicide vulnerability. This brief review emphasises a research area focused on a possible interplay between the immune system and sex hormones that may help develop a better understanding of suicide vulnerability in the perspective of sex-specific therapeutic approaches.
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Affiliation(s)
- Giulia Lombardo
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK
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10
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Sher L, Bierer LM, Makotkine I, Yehuda R. The effect of oral dexamethasone administration on testosterone levels in combat veterans with or without a history of suicide attempt. J Psychiatr Res 2021; 143:499-503. [PMID: 33243458 DOI: 10.1016/j.jpsychires.2020.11.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 01/25/2023]
Abstract
Combat exposure has been linked to increased risk of suicidal ideation, suicide attempts, and death by suicide, and suicidality has been linked with altered testosterone levels. In this study, we examined morning baseline free and total testosterone levels and the effect of dexamethasone administration on testosterone levels in male combat veterans with or without a history of suicide attempt. Demographic and clinical parameters of the study participants were assessed and recorded. Blood samples were collected between 8:00 and 8:30 a.m. on the day prior to and following dexamethasone (0.5 mg) ingestion. Suicide attempters had higher schedule for suicidal ideation (SSI) scores in comparison to non-attempters. Baseline free and total testosterone levels were lower in suicide attempters compared to non-attempters. In the whole sample, both baseline free and total testosterone levels negatively correlated with SSI scores. Free testosterone levels decreased after dexamethasone administration among non-attempters but not among attempters. Free testosterone post-dexamethasone levels positively correlated with aggression scores among non-attempters but not among suicide attempters. Our findings indicate that there are substantial differences in the testosterone regulation between combat veterans with or without a history of suicide attempt. Studies of the relation between the testosterone function and suicidal behavior among combat veterans may lead to improvement in detection of suicidality and finding new pharmacological targets for prevention of suicide among veterans.
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Affiliation(s)
- Leo Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Linda M Bierer
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Iouri Makotkine
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lombardo G, Mondelli V, Dazzan P, Pariante CM. Sex hormones and immune system: A possible interplay in affective disorders? A systematic review. J Affect Disord 2021; 290:1-14. [PMID: 33989924 DOI: 10.1016/j.jad.2021.04.035] [Citation(s) in RCA: 13] [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: 07/08/2020] [Revised: 03/15/2021] [Accepted: 04/20/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sex hormones and the immune system may play a key role in sex differences in affective disorders. The understanding of their interplay may lead to the detection of new sex-specific tailored therapeutic approaches. The aim of this systematic review is to summarise the evidence supporting a possible association between sex hormones and inflammatory biomarkers in people with affective disorders. METHODS A systematic search of the literature published until January 2021 was conducted on PubMed database. The initial search identified a total of 1259 studies; 20 studies investigating inflammatory biomarkers and sex hormones in patients exhibiting depressive symptoms were included: 10 studies focused on patients with affective disorders, and 10 studies focused on women in menopause or in the post-partum period exhibiting depressive symptoms. RESULTS Testosterone and exogenous female sex hormones may play protective roles through their modulation of the immune system, respectively, in male patients with bipolar disorder and in peri-/post-menopausal women with depression. LIMITATIONS The main limitations are the paucity of studies investigating both sex hormones and immune biomarkers, the lack of statistical analyses exploring specifically the association between these two classes of biomarkers, and the great heterogeneity between the participants' samples in the studies. CONCLUSION This review highlights the need to investigate the interplay between sex hormones and immune system in affective disorders. The inconsistent or incomplete evidence may be improved by studies in patients with moderate-high inflammatory levels that specifically evaluate the relationship between sex hormones and the immune system.
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Affiliation(s)
- Giulia Lombardo
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK.
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK
| | - Carmine Maria Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, UK; National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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12
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Wiebenga JXM, Dickhoff J, Mérelle SYM, Eikelenboom M, Heering HD, Gilissen R, van Oppen P, Penninx BWJH. Prevalence, course, and determinants of suicide ideation and attempts in patients with a depressive and/or anxiety disorder: A review of NESDA findings. J Affect Disord 2021; 283:267-277. [PMID: 33571797 DOI: 10.1016/j.jad.2021.01.053] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/18/2020] [Accepted: 01/23/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depressive and anxiety disorders are often associated with suicide ideation (SI) and attempt (SA). However, analyses of prevalence, course, and more specific risk mechanisms are needed to improve knowledge and detection of high risk individuals with depressive and anxiety disorders. Previous studies often lacked statistical power, assessment of detailed determinants and follow-up measurements. METHODS The Netherlands Study of Depression and Anxiety (NESDA), a large cohort study, overcomes some earlier limitations. Scale for Suicide Ideation and Compositive Interview Diagnostic Instrument data were analyzed to report on prevalence of SI and SA. Additionally, important sociodemographic, clinical, psychological, environmental, and neurobiological determinants and course of SI and SA identified in depressive and/or anxiety disorder respondents in 16 NESDA articles were summarized. RESULTS Within respondents with 12-month diagnosis (n=1,783), SI and 12-month SA prevalence ranged from 17.1-20.1% and 0.8-3.0% respectively across 5 waves during 9-year follow-up and SI was highly recurrent. Both SI and SA were especially associated with comorbid depression and anxiety, higher clinical severity, sleep dysfunctions, higher aggression and hopelessness, and childhood trauma. In the (neuro)biological domain, SI was linked with immune dysregulation and SA with abnormal brain activity during emotion processing and genetic risk. LIMITATIONS Most articles were cross-sectional in nature, preventing causal inferences and no conclusions could be drawn about the overall magnitude of results. CONCLUSION SI and SA are multifactorial phenomena and especially prevalent amongst comorbid depressive and anxiety respondents. Considering many overlapping SI and SA determinants, more neurobiological determinants and use of innovative methodological techniques are desirable.
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Affiliation(s)
- Jasper X M Wiebenga
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.
| | - Justine Dickhoff
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, Groningen, The Netherlands
| | | | - Merijn Eikelenboom
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Henriette D Heering
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | | | - Patricia van Oppen
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, The Netherlands; GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
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de Wit AE, De Boer MK, Bosker FJ, van der Does AJW, Gooren LJG, Nolen WA, Penninx BWJH, Schoevers RA, Giltay EJ. Associations of plasma androgens with suicidality among men and women: A 9-year longitudinal cohort study. J Affect Disord 2020; 269:78-84. [PMID: 32217346 DOI: 10.1016/j.jad.2020.03.032] [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: 10/15/2019] [Revised: 12/30/2019] [Accepted: 03/16/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND Testosterone has been implicated in suicidality in cross-sectional studies. Stress that coincides with a suicide attempt may alter androgen levels, so prospective studies are needed to exclude reverse causation. We aimed to examine the associations of plasma androgens with concurrent and future suicidality, and if present, whether these associations were mediated by a behavioral trait like reactive aggression. METHODS Baseline plasma levels of total testosterone, 5α-dihydrotestosterone, and androstenedione were determined with liquid chromatography-tandem mass spectrometry, and dehydroepiandrosterone-sulphate with a radioimmunoassay. Suicidality was assessed using the Suicidal Ideation Scale at baseline and after 2-, 4-, 6-, and 9-year follow-up. Men and women were analyzed separately, and potential confounders were considered. RESULTS Participants (N = 2861; 66.3% women) had a mean age of 42.0 years (range 18-65) and almost half (46.9%) fulfilled criteria for a major depressive or anxiety disorder. At baseline 13.2% of men and 11.2% of women reported current suicidal ideation. In participants who were non-suicidal at baseline, slightly more men than women reported suicidal ideation during follow-up (14.7% vs. 12.5%), whereas the reverse pattern was observed for suicide attempts (3.6% vs. 4.2%). None of the associations between androgens and current and future suicidality were significant. LIMITATIONS Androgens were determined once, which may have been insufficient to predict suicidality over longer periods. DISCUSSION The lack of associations between plasma levels of androgens determined by 'gold-standard' laboratory methods with suicidality do not support previous cross-sectional and smaller studies in adult men and women with values within the physiological range.
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Affiliation(s)
- A E de Wit
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands.
| | - M K De Boer
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - F J Bosker
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - A J W van der Does
- Department of Clinical Psychology, Institute of Psychology, Leiden University, the Netherlands
| | - L J G Gooren
- Department of Endocrinology, UMC Amsterdam, the Netherlands
| | - W A Nolen
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - B W J H Penninx
- Department of psychiatry, Amsterdam UMC, VU University, the Netherlands
| | - R A Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, PO Box 30.001, Groningen, RB 9700, the Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Center, the Netherlands
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Delgado PF, Maya-Rosero E, Franco M, Montoya-Oviedo N, Guatibonza R, Mockus I. Testosterona y homicidio: aspectos neuroendocrinos de la agresión. REVISTA DE LA FACULTAD DE MEDICINA 2020. [DOI: 10.15446/revfacmed.v68n2.73237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. Las tasas de homicidio, suicidio y agresión son mayores en el sexo masculino; la testosterona podría desempeñar un papel importante en el desarrollo de estos comportamientos. Objetivo. Realizar una revisión de los aspectos endocrinos y neurobiológicos de la testosterona y su relación con comportamientos agresivos, homicidas y suicidas.Materiales y métodos. Se realizó una revisión narrativa con diferentes estrategias de búsqueda en PubMed, SpringerLink, ScienceDirect y SciELO. Se incluyeron artículos de investigación, revisiones y reportes de caso publicados en español y en inglés entre 2002 y 2018.Resultados. De los 66 estudios incluidos en la revisión, más del 50% asociaron el comportamiento agresivo u homicida con niveles elevados de testosterona, hormona que podría modular la actividad de las vías cerebrales serotoninérgicas y dopaminérgicas involucradas en el comportamiento agresivo por medio de receptores androgénicos y estrogénicos. Se encontraron relaciones entre uso de esteroides anabólicos y homicidio, y entre testosterona circulante en mujeres y rasgos de personalidad antisocial. Asimismo, se observaron cambios de concentraciones séricas de testosterona en sujetos con tendencias suicidas.
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Cansız A, İnce B. Evaluation of 2D:4D digit ratio in bipolar 1 disorder patients and its relationship with treatment response. Early Hum Dev 2020; 143:104971. [PMID: 32086117 DOI: 10.1016/j.earlhumdev.2020.104971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 01/28/2020] [Accepted: 02/04/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND The role of sex steroids in bipolar disorder (BD) has been demonstrated in adults. We aimed to evaluate the 2D:4D ratio, which indirectly reflects prenatal sex steroids, in BD. Another purpose of this study was to determine the relationship between clinical features, especially lithium response, and digit ratio. METHODS The study included 74 patients with bipolar 1 disorder and 74 healthy individuals matched according to age, gender, and educational status. The digit ratio was calculated by dividing the index finger (2D) length by the ring finger (4D) length in both hands. A lithium response scale was used to evaluate the lithium response history. RESULTS There was no difference in 2D:4D ratio between the patients and controls in either right or left hands. The digit ratio was not different between groups with and without suicide attempts. The 2D:4D ratio in the patient group was lower in individuals unresponsive to lithium therapy than in partial and good responders for both right and left hands. DISCUSSION According to the results of our study, the 2D:4D ratio in the BD group was not different from healthy controls but was lower in patients unresponsive to lithium. In this respect, the 2D:4D ratio can be considered as a biomarker for lithium response in BD. In large-sample studies, the 2D:4D ratio should be investigated for pathophysiology and treatment response of BD.
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Affiliation(s)
- Alparslan Cansız
- Harran University, Faculty of Medicine, Department of Psychiatry, Şanlıurfa-Mardin Motorway 18.km Osmanbey, 63140 Şanlıurfa, Turkey.
| | - Bahri İnce
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, 34147 Istanbul, Turkey
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Flores-Ramos M, Becerra-Palars C, Hernández González C, Chavira R, Bernal-Santamaría N, Martínez Mota L. Serum testosterone levels in bipolar and unipolar depressed female patients and the role of medication status. Int J Psychiatry Clin Pract 2020; 24:53-58. [PMID: 32096661 DOI: 10.1080/13651501.2019.1680696] [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] [Indexed: 10/24/2022]
Abstract
Objective: to compare testosterone levels between female depressed patients and female bipolar patients.Methods: Sixty-one female patients with major depressive disorder (MDD) (n = 23) or bipolar disorder (BD) (n = 38) between 18 and 45 years old were included in the study. Participants were evaluated during a depressive or manic episode with the Hamilton depression rating scale (HDRS) or Young mania rating scale (YMRS), respectively. No patients in the MDD group were taken valproate while in the BD group 14 (36.84%) were taken valproate. Total testosterone (TT) and free testosterone (FT) levels were quantified during the early follicular phase of the cycle, with radioimmunoassay or solid phase enzyme-linked immunoassay. Data were collected from May 2016 to February 2017.Results: Mean TT serum levels were significantly higher in BD patients in comparison to MDD patients. Although age and diagnosis were related to TT levels, however when we added valproate use in the analysis, only the relation between TT and valproate use remained significant.Conclusions: In this sample, TT levels were related to valproate use in patients with BD. More studies regarding the role of testosterone in affective symptoms should be conducted to clarify the relation between testosterone, affective disorders, and medication.KeypointsWe observed that testosterone levels were significant higher in bipolar women compared to women with MDD.The use of valproate could be associated with the testosterone levels in female patients with BD.Evaluation of women suffering BD should include a testosterone levels determination, particularly when they are taking valproate.
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Affiliation(s)
- Mónica Flores-Ramos
- Consejo Nacional de Ciencia y Tecnología (CONACyT), Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, México
| | - Claudia Becerra-Palars
- Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente, México City, México
| | | | - Roberto Chavira
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | - Norma Bernal-Santamaría
- Departamento de Servicio Social, Facultad de Medicina, Universidad Nacional Autónoma de México, Coyoacan, México
| | - Lucía Martínez Mota
- Laboratorio de Farmacología Conductual, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City, México
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17
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Gaynor SC, Monson ET, Gaine ME, Chimenti MS, Reichman RD, Parsons M, Oonthonpan L, Zandi PP, Potash JB, Willour VL. Male-specific association of the 2p25 region with suicide attempt in bipolar disorder. J Psychiatr Res 2020; 121:151-158. [PMID: 31830721 PMCID: PMC8344384 DOI: 10.1016/j.jpsychires.2019.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 01/20/2023]
Abstract
We previously conducted a genome-wide association study (GWAS) of attempted suicide within bipolar disorder, which implicated common variation in the 2p25 region primarily in males. The top association signal from our GWAS occurred in an intergenic region of 2p25 (p = 5.07 × 10-8) and was supported by two independent studies. In the current study, to better characterize the association of the 2p25 region with attempted suicide, we sequenced the entire 350kb 2p25 region in 476 bipolar suicide attempters and 473 bipolar non-attempters using targeted next-generation sequencing. This fine-mapping project identified 4,681 variants in the 2p25 region. We performed both gene-level and individual-variant tests on our sequencing results and identified 375 variants which were nominally significant (p < 0.05) and three common variants that were significantly associated with attempted suicide in males (corrected p = 0.035, odds ratio (OR) = 2.13). These three variants are in strong linkage disequilibrium with the top variant from our GWAS. Our top five variants are also predicted expression quantitative trait loci (eQTL) for three genes in the 2p25 region based on publicly available brain expression databases. Our sequencing and eQTL data implicate these three genes - SH3YL1, ACP1, and FAM150B - and three additional pathways - androgen receptor, Wnt signaling, and glutamatergic/GABAergic signaling - in the association of the 2p25 region with suicide. The current study provides additional support for an association of the 2p25 region with attempted suicide in males and identifies several candidate genes and pathways that warrant further investigation to understand their role in suicidal behavior.
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Affiliation(s)
- Sophia C. Gaynor
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Marie E. Gaine
- Molecular Physiology and Biophysics, Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael S. Chimenti
- Bioinformatics Division, Iowa Institute of Human Genetics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Rachel D. Reichman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Meredith Parsons
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Lalita Oonthonpan
- Department of Biochemistry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Peter P. Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Virginia L. Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
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Abstract
In the search for biomarkers and modifiable risk factors for suicide, lipid status has garnered considerable interest, although the lipid-suicide connection is not without controversy. Major categories of lipids that have been reported as germane to suicide include sterols and polyunsaturated fatty acids (PUFAs). Research concerning lipid effects on mood and suicide risk includes epidemiologic approaches, cohort studies, and clinical trials. In general, current evidence suggests that higher n-3 relative to n-6 PUFA intake may have beneficial effects on depression and suicide risk, particularly in women, while low cholesterol may be detrimental in both sexes. Additionally, low estrogen in women has been associated with suicide attempts, whereas high androgen loads may contribute to the higher suicide completion rate in men. Basic and translational research provides strong evidence for several potential mechanisms that have been implicated in depression and suicide. Firstly, PUFAs, cholesterol, and estrogen can interact to influence structure and function of membrane microdomains ("lipid rafts"), with potential regulatory effects on inflammation and signal transduction, including monoaminergic signaling. Secondly, PUFAs bind to and activate peroxisome proliferator-activated receptors (PPARs), nuclear receptors that regulate gene expression, with resultant effects on inflammation and bioenergetics. Thirdly, PUFAs are both a target for and a hormetic regulator of oxidative stress. Critical to a greater understanding of lipid status as a suicide risk predictor and treatment target will be studies that map genomic and phenotypic characteristics of individuals whose emotional state is affected most by lipid status. Also important will be a more nuanced understanding of lipid-lipid interactions and the differential roles of lipid subclasses on suicide risk.
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Affiliation(s)
- M Elizabeth Sublette
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA.
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Gogos A, Ney LJ, Seymour N, Van Rheenen TE, Felmingham KL. Sex differences in schizophrenia, bipolar disorder, and post-traumatic stress disorder: Are gonadal hormones the link? Br J Pharmacol 2019; 176:4119-4135. [PMID: 30658014 PMCID: PMC6877792 DOI: 10.1111/bph.14584] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 11/13/2018] [Accepted: 11/25/2018] [Indexed: 12/30/2022] Open
Abstract
In this review, we describe the sex differences in prevalence, onset, symptom profiles, and disease outcome that are evident in schizophrenia, bipolar disorder, and post-traumatic stress disorder. Women with schizophrenia tend to exhibit less disease impairment than men. By contrast, women with post-traumatic stress disorder are more affected than men. The most likely candidates to explain these sex differences are gonadal hormones. This review details the clinical evidence that oestradiol and progesterone are dysregulated in these psychiatric disorders. Notably, existing data on oestradiol, and to a lesser extent, progesterone, suggest that low levels of these hormones may increase the risk of disease development and worsen symptom severity. We argue that future studies require a more inclusive, considered analysis of gonadal steroid hormones and the intricacies of the interactions between them, with methodological rigour applied, to enhance our understanding of the roles of steroid hormones in psychiatric disorders. LINKED ARTICLES: This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc.
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Affiliation(s)
- Andrea Gogos
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
| | - Luke J. Ney
- School of Medicine (Psychology)University of TasmaniaSandy BayTasmaniaAustralia
| | - Natasha Seymour
- Hormones in Psychiatry LaboratoryFlorey Institute of Neuroscience and Mental HealthParkvilleVictoriaAustralia
- Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Tamsyn E. Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
- Centre for Mental Health, School of Health Sciences, Faculty of Health, Arts and DesignSwinburne UniversityMelbourneVictoriaAustralia
| | - Kim L. Felmingham
- School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
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Hou PH, Mao FC, Chang GR, Huang MW, Wang YT, Huang SS. Newly Diagnosed Bipolar Disorder and the Subsequent Risk of Erectile Dysfunction: A Nationwide Cohort Study. J Sex Med 2019; 15:183-191. [PMID: 29425665 DOI: 10.1016/j.jsxm.2017.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2017] [Revised: 11/15/2017] [Accepted: 12/13/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Although erectile dysfunction (ED) is a common problem in men with mental disorders, there are few reports in the literature on the relation between bipolar disorder (BD) and ED. AIMS To establish the incidence rate of ED in men with BD and assess the risk of ED in patients with BD according to type of treatment offered or no active treatment with medication during the 1st year of onset. METHODS We identified 5,150 men with newly diagnosed BD using Taiwan's National Health Insurance Research Database. 2 matched controls per case were selected using the propensity score and a greedy matching method to obtain a balanced control group. Multivariate Cox regression analysis was used to examine the independent risk factors for ED, including obesity and comorbidities. Hazard ratios (HRs) for ED risk were calculated for the different psychotropic therapy groups, including antidepressants, antipsychotics, and mood stabilizers. OUTCOME HRs for ED risk were calculated for the different psychotropic therapy groups, including antidepressants, antipsychotics, and mood stabilizers. Patients with BD had a significantly higher HR for an ED diagnosis than controls. RESULTS Patients with BD had a higher HR for an ED diagnosis than controls. Although some psychotropic medications can increase the risk of ED, patients with BD not actively treated with medication still showed a higher risk of ED than controls. CLINICAL IMPLICATIONS Because ED might be more prevalent in patients with BD than in the general population, clinicians should assess erectile function when selecting appropriate treatment for patients with BD to minimize the risk of ED as an annoying side effect and improve treatment compliance. STRENGTHS AND LIMITATIONS This is the first large-scale population-based study to explore the association between BD and ED. A particular strength of this study is its nationwide, population-based study design, which afforded substantial statistical power for detecting subtle differences between the 2 cohorts, thereby minimizing selection bias. There are some limitations to the present study. (i) Data on other potential risk factors is lacking. (ii) Patient compliance and dose effect between psychotropic medication and ED could not be established. (iii) We could not assess the relation between ED and the severity and phases of BD. CONCLUSION This cohort study found a temporal association between BD and subsequent ED in a large national sample of men. Clinicians should consider the risk of ED when choosing treatment for patients with BD. Hou P-H, Mao FC, Chang G-R, et al. Newly Diagnosed Bipolar Disorder and the Subsequent Risk of Erectile Dysfunction: A Nationwide Cohort Study. J Sex Med 2018;15:183-191.
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Affiliation(s)
- Po-Hsun Hou
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Social Work and Child Welfare, Providence University, Taichung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Frank Chiahung Mao
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Geng-Ruei Chang
- Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan; Department of Veterinary Medicine, National Chiayi University, Chiayi City, Taiwan
| | - Min-Wei Huang
- Department of Psychiatry, Taichung Veterans General Hospital, Chiayi Branch, Chiayi City, Taiwan
| | - Yao-Ting Wang
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shiau-Shian Huang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan; Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
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21
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Feng G, Kang C, Yuan J, Zhang Y, Wei Y, Xu L, Zhou F, Fan X, Yang J. Neuroendocrine abnormalities associated with untreated first episode patients with major depressive disorder and bipolar disorder. Psychoneuroendocrinology 2019; 107:119-123. [PMID: 31125758 DOI: 10.1016/j.psyneuen.2019.05.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/18/2019] [Accepted: 05/14/2019] [Indexed: 11/26/2022]
Abstract
There are few studies that explore simultaneously the relationship of neuroendocrine hormones of the HPA, HPT and HPG axes with major depressive disorder (MDD) and bipolar disorder (BD). The aim of this study is to examine the relationship of neuroendocrine pathways with affective disorders by comparing the differences in measures of neuroendocrine function between untreated first episode patients with MDD and BD. A cohort of 679 MDD and 83 BD patients was recruited. Thyroid stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), free thyroxin (FT4), cortisol (COR), adrenocorticotropic hormone (ACTH), estradiol (E2) and testosterone (T) were determined by chemiluminesent immunoassay for all patients. COR and ACTH were both significantly higher in the MDD group than those in BD group. The incidences of high secretion of ACTH and COR, and low thyroid hormone secretion were significantly greater in MDD patients than in BD patients. Decreased T secretion was more common in BD than MDD patients. ACTH was significantly positively correlated with HAMD total score and negatively correlated with FT3 in MDD patients. FT3 and FT4 levels were significantly negatively correlated with the somatoform factor score of HAMD in MDD patients. Untreated first episode patients with MDD have a hyperactivity of the HPA axis, lower HPT compared with BD patients. BD patients had reduced testosterone secretion. These findings indicate that ACTH, FT3 and FT4 could be used as markers for severity and symptoms of untreated first episode patients with MDD.
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Affiliation(s)
- GuoHua Feng
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - ChuanYuan Kang
- Department of Clinical Psychology, East Hospital Affiliated to Tongji University (Shanghai East Hospital), 150 Jimo Road, Pudong New District, Shanghai, 200120, China
| | - Jing Yuan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - Yan Zhang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - YuJun Wei
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - Li Xu
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - Fang Zhou
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - Xinxin Fan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China
| | - JianZhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming Yunnan 650101, China.
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Flores-Ramos M, Alcauter S, López-Titla M, Bernal-Santamaría N, Calva-Coraza E, Edden RAE. Testosterone is related to GABA+ levels in the posterior-cingulate in unmedicated depressed women during reproductive life. J Affect Disord 2019; 242:143-149. [PMID: 30195172 PMCID: PMC6484862 DOI: 10.1016/j.jad.2018.08.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/23/2018] [Accepted: 08/07/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND The role of testosterone (T) in the pathophysiology of affective disorders and anxiety is broadly supported. Evidence suggests that T has anxiolytic and antidepressant properties. One proposed route for the central effects of T is its interaction with the gamma-aminobutyric acid (GABA) system. We explored the relationship between T levels and GABA+ levels in anterior-cingulate (ACC) and the posterior-cingulate (PCC) regions in depressed women, using magnetic resonance spectroscopy (1H-MRS). METHODS Twenty-one depressed patients with regularly cycling who were not taking hormonal or psychotropic drugs were recruited. We assessed severity of depression using the Hamilton Depression Rating Scale (HDRS). Blood samples were taken for quantification of free (FT) and total testosterone (TT) on the day of the magnetic resonance (MR) scan. We evaluated GABA+ levels in the PCC and ACC, using the Hadamard Encoding and Reconstruction of MEGA-Edited Spectroscopy (HERMES) sequence. Pearson correlations were used to evaluate the association between FT, TT, GABA+ concentrations, and HDRS scores. RESULTS TT and FT levels were positively correlated with GABA+ levels in the PCC. No correlation was observed between T levels and GABA+ levels in the ACC. The HDRS total scores correlated negatively with FT levels. LIMITATIONS Limitations include the cross-sectional evaluation and the lack of a comparative healthy group. CONCLUSIONS Our findings suggest that the potential anxiolytic and antidepressant properties of T are related to increased GABA+ levels in the PCC. This observation may contribute to increased understanding of the role of T in depressive and anxiety symptoms in women.
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Affiliation(s)
- M Flores-Ramos
- Consejo Nacional de Ciencia y Tecnología, CONACyT, Avenida Insurgentes Sur 1582, Col. Crédito Constructor, Ciudad de México, México; Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, Ciudad de México, México.
| | - S Alcauter
- Instituto de Neurobiología, Universidad Nacional Autónoma de México, Boulevard Juriquilla 3001, Querétaro 76230, México
| | - M López-Titla
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, Ciudad de México, México; Universidad Veracruzana, División de estudios de Posgrado. Veracruz, Veracruz. México
| | - N Bernal-Santamaría
- Departamento de Servicio Social, Facultad de Medicina, Universidad Nacional Autónoma de México, Av. Universidad 3000. Ciudad de México, México
| | - Edgar Calva-Coraza
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Calzada México-Xochimilco 101, San Lorenzo Huipulco, Tlalpan, Ciudad de México, México
| | - R A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Center for Functional MRI, Kennedy Krieger Institute, Baltimore, MD, USA
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Mousavizadegan S, Maroufi M. Comparison of salivary testosterone levels in different phases of bipolar I disorder and control group. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2018; 23:31. [PMID: 29887899 PMCID: PMC5961281 DOI: 10.4103/jrms.jrms_1009_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 12/05/2017] [Accepted: 01/04/2018] [Indexed: 12/15/2022]
Abstract
Background: Testosterone is considered as a primary sex hormone, also known as an important anabolic steroid, that may involve in various mental disorders such as bipolar I disorder (BID). The goal of this study was to compare the testosterone salivary levels between different phases of BID and its association with the clinical features of BID. Materials and Methods: In a case–control study, 15 patients in the mania phase, 10 patients in the depression phase, and 16 in the euthymia phase were selected as patient groups. 18 healthy sex- and age-matched individuals were considered as healthy control group. Salivary samples obtained from all patients and control group and levels of testosterone were determined in saliva using an enzyme-linked immunosorbent assay. All statistical calculations were conducted with the software Statistical Package for Social Science version 20 (IBM Inc., Chicago, IL, USA). Results: The mean testosterone level in euthymia phase was 186.34 ± 182.62 pg/mL, mania phase was 239.29 ± 273.22 pg/mL, depression was 153.49 ± 222.50 pg/mL, and healthy participants was 155.73 ± 126.0 pg/mL; no significant difference was found between groups (P = 0.68.(No statistically significant differences were found between psychotic and nonpsychotic as well as between patients who attempted suicide and nonattempter patients in terms of testosterone levels (P > 0.1). Conclusion: Our findings do not reveal significant difference between different phases of BID in terms of salivary testosterone levels. However, more comprehensive studies with larger sample size are required to confirm our findings.
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Affiliation(s)
- Sabra Mousavizadegan
- Young Researchers and Elite Club, Isfahan (khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Mohsen Maroufi
- Department of Psychiatry, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Lenz B, Röther M, Bouna-Pyrrou P, Mühle C, Tektas OY, Kornhuber J. The androgen model of suicide completion. Prog Neurobiol 2018; 172:84-103. [PMID: 29886148 DOI: 10.1016/j.pneurobio.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 09/02/2017] [Accepted: 06/05/2018] [Indexed: 10/14/2022]
Abstract
Suicide is a devastating public health issue that imposes severe psychological, social, and economic burdens not only for the individuals but also for their relatives, friends, clinicians, and the general public. Among the different suicidal behaviors, suicide completion is the worst and the most relevant outcome. The knowledge of biological etiopathological mechanisms involved in suicide completion is limited. Hitherto, no objective markers, either alone or in combination, can reliably predict who will complete a suicide. However, such parameters are strongly needed to establish and optimize prediction and prevention. We introduce here a novel ideation-to-completion framework in suicide research and discuss the problems of studies aiming at identifying and validating clinically useful markers. The male gender is a specific risk factor for suicide, which suggests that androgen effects are implicated in the transition from suicidal ideation to suicide completion. We present multiple lines of direct and indirect evidence showing that both an increased prenatal androgen load (with subsequent permanent neuroadaptations) and increased adult androgen activity are involved in suicide completion. We also review data arguing that modifiable maternal behavioral traits during pregnancy contribute to the offspring's prenatal androgen load and increase the risk for suicide completion later in life. We conclude that in utero androgen exposure and adult androgen levels facilitate suicide completion in an synergistic manner. The androgen model of suicide completion provides the basis for the development of novel predictive and preventive strategies in the future.
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Affiliation(s)
- Bernd Lenz
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany.
| | - Mareike Röther
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Polyxeni Bouna-Pyrrou
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Christiane Mühle
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Ozan Y Tektas
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany
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25
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Ludwig B, Roy B, Dwivedi Y. Role of HPA and the HPG Axis Interaction in Testosterone-Mediated Learned Helpless Behavior. Mol Neurobiol 2018; 56:394-405. [PMID: 29704202 DOI: 10.1007/s12035-018-1085-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/11/2018] [Indexed: 12/25/2022]
Abstract
Affective disorders show sex-specific differences in prevalence, symptoms, and complications. One hypothesis for this discrepancy is the interaction between the hypothalamic-pituitary-adrenal (HPA) axis and hypothalamic-pituitary-gonadal (HPG) axis. The present study investigates the influence of androgen on the behavioral phenotype and explores how it interacts with HPA axis genes. Gonadectomized (GDX) and GDX rats treated with testosterone propionate (T) were tested for learned helplessness (LH) behavior and compared with tested controls (TC). Prefrontal cortex was used for analyses of HPG- axis-related genes (androgen receptor, (Ar); estrogen receptor-β (Er-β)) and HPA axis-related genes (corticotropin-releasing hormone, (Crh); glucocorticoid receptor, (Nr3c1); corticotropin-releasing hormone receptor 1, (Crhr1); corticotropin-releasing hormone receptor 2, (Crhr2); FK506 binding protein 5, (Fkbp5)). Promoter-specific CpG methylation in the Crh gene was determined by bisulfite sequencing. Chromatin immunoprecipitation (ChIP) assay was used for determining ER-β binding on the proximal promoter region of Crh gene. Serum testosterone levels confirmed a testosterone-depleted GDX group, a group with supraphysiological levels of testosterone (T) and another group with physiological levels of testosterone (control (C)). Unlike GDX rats, T group exhibited significantly higher LH score when compared with any other group. Crh and Fkbp5 genes were significantly upregulated in GDX group compared with controls, whereas Er-β showed a significant downregulation in the same group. Methylation analysis showed no significant differences in-between groups. ChIP assay was unable to determine a significant change in ER-β binding but revealed a notable contrast in Crh promoter occupancy between T and GDX groups. Altogether, the present study reveals an increased susceptibility to depression-like behavior due to chronic supraphysiological level of androgen via HPA axis inhibition.
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Affiliation(s)
- Birgit Ludwig
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, SC711 Sparks Center, 1720 7th Avenue South, Birmingham, AL, 35294, USA
| | - Bhaskar Roy
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, SC711 Sparks Center, 1720 7th Avenue South, Birmingham, AL, 35294, USA
| | - Yogesh Dwivedi
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, SC711 Sparks Center, 1720 7th Avenue South, Birmingham, AL, 35294, USA.
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26
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Affiliation(s)
- L Sher
- James J. Peters Veterans' Administration Medical Center, Bronx, NY, USA.,Icahn School of Medicine at Mount Sinai, New York, NY, USA
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27
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Sher L. Commentary: CSF and Plasma Testosterone in Attempted Suicide. Front Public Health 2017; 5:92. [PMID: 28484697 PMCID: PMC5402225 DOI: 10.3389/fpubh.2017.00092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 04/06/2017] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leo Sher
- James J. Peters Veterans' Administration Medical Center and Icahn School of Medicine at Mount Sinai, New York, NY, USA
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28
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Stefansson J, Chatzittofis A, Nordström P, Arver S, Åsberg M, Jokinen J. CSF and plasma testosterone in attempted suicide. Psychoneuroendocrinology 2016; 74:1-6. [PMID: 27567115 DOI: 10.1016/j.psyneuen.2016.08.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/08/2016] [Accepted: 08/10/2016] [Indexed: 12/22/2022]
Abstract
Very few studies have assessed testosterone levels in the cerebrospinal fluid in suicide attempters. Aggressiveness and impulsivity are common behavioural traits in suicide attempters. Dual-hormone serotonergic theory on human impulsive aggression implies high testosterone/cortisol ratio acting on the amygdala and low serotonin in the prefrontal cortex. Our aim was to examine the CSF and plasma testosterone levels in suicide attempters and in healthy volunteers. We also assessed the relationship between the testosterone/cortisol ratio, aggressiveness and impulsivity in suicide attempters. 28 medication-free suicide attempters and 19 healthy volunteers participated in the study. CSF and plasma testosterone sulfate and cortisol levels were assessed with specific radio-immunoassays. The Karolinska Scales of Personality was used to assess impulsivity and aggressiveness. All patients were followed up for cause of death. The mean follow-up period was 21 years. Male suicide attempters had higher CSF and plasma testosterone levels than age- matched male healthy volunteers. There were no significant differences in CSF testosterone levels in female suicide attempters and healthy female volunteers. Testosterone levels did not differ significantly in suicide victims compared to survivors. In male suicide attempters, the CSF testosterone/cortisol ratio showed a significant positive correlation with both impulsivity and aggressiveness. Higher CSF testosterone levels may be associated with attempted suicide in young men through association with both aggressiveness and impulsivity, a key endophenotype in young male suicide attempters.
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Affiliation(s)
- Jon Stefansson
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Chatzittofis
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Peter Nordström
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marie Åsberg
- Department of Clinical Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jussi Jokinen
- Department of Clinical Neuroscience/Psychiatry, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Sciences, Umeå University, Umeå, Sweden.
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29
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Sher L. Commentary: Exogenous Testosterone Rapidly Increases Aggressive Behavior in Dominant and Impulsive Men. Front Public Health 2016; 4:229. [PMID: 27785451 PMCID: PMC5059441 DOI: 10.3389/fpubh.2016.00229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 09/29/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Leo Sher
- James J. Peters Veterans’ Administration Medical Center, Bronx, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- *Correspondence: Leo Sher,
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30
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Sher L. Both high and low testosterone levels may play a role in suicidal behavior in adolescent, young, middle-age, and older men: a hypothesis. Int J Adolesc Med Health 2016; 30:/j/ijamh.ahead-of-print/ijamh-2016-0032/ijamh-2016-0032.xml. [PMID: 27269890 DOI: 10.1515/ijamh-2016-0032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 04/30/2016] [Indexed: 06/06/2023]
Abstract
Many studies suggest that testosterone plays a role in the regulation of mood and behavior. Most but not all investigations of the relationship between testosterone and suicidality found relations between testosterone and suicidal behavior. The balance of evidence is in favor of the view that testosterone is involved in the pathophysiology of suicidality. The author has previously proposed that suicidal behavior in adolescents and young adults is associated with high testosterone levels, whereas suicidality in older men is associated with decreased testosterone levels. However, both high and low testosterone levels can be observed in adolescent, young, middle-aged and older men. In this article, the author proposes that both high and low testosterone levels may play a role in suicidal behavior in men of any age.
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Affiliation(s)
- Leo Sher
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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31
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Shiotsuki I, Terao T, Ishii N, Takeuchi S, Kuroda Y, Kohno K, Mizokami Y, Hatano K, Tanabe S, Kanehisa M, Iwata N, Matusda S. Trace lithium is inversely associated with male suicide after adjustment of climatic factors. J Affect Disord 2016; 189:282-6. [PMID: 26454333 DOI: 10.1016/j.jad.2015.09.070] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 09/28/2015] [Accepted: 09/29/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previously, we showed the inverse association between lithium in drinking water and male suicide in Kyushu Island. The narrow variation in meteorological factors of Kyushu Island and a considerable amount of evidence regarding the role of the factors on suicide provoked the necessities of adjusting the association by the wide variation in sunshine, temperature, rain fall, and snow fall. METHODS To keep the wide variation in meteorological factors, we combined the data of Kyushu (the southernmost city is Itoman, 26°) and Hokkaido (the northernmost city is Wakkanai, 45°). Multiple regression analyses were used to predict suicide SMRs (total, male and female) by lithium levels in drinking water and meteorological factors. RESULTS After adjustment of meteorological factors, lithium levels were significantly and inversely associated with male suicide SMRs, but not with total or female suicide SMRs, across the 153 cities of Hokkaido and Kyushu Islands. Moreover, annual total sunshine and annual mean temperature were significantly and inversely associated with male suicide SMRs whereas annual total rainfall was significantly and directly associated with male suicide SMRs. LIMITATIONS The limitations of the present study include the lack of data relevant to lithium levels in food and the proportion of the population who drank tap water and their consumption habits. CONCLUSIONS The present findings suggest that trace lithium is inversely associated with male but not female suicide after adjustment of meteorological factors.
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Affiliation(s)
- Ippei Shiotsuki
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan; Advanced Emergency Medical Service Center, Oita University Faculty of Medicine, Japan
| | - Takeshi Terao
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan.
| | - Nobuyoshi Ishii
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan
| | - Shouhei Takeuchi
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Yoshiki Kuroda
- Department of Public Health, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Kentaro Kohno
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan
| | - Yoshinori Mizokami
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan
| | - Koji Hatano
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan
| | - Sanshi Tanabe
- Advanced Emergency Medical Service Center, Oita University Faculty of Medicine, Japan
| | - Masayuki Kanehisa
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Japan; Advanced Emergency Medical Service Center, Oita University Faculty of Medicine, Japan
| | - Noboru Iwata
- Department of Psychology, Hiroshima International University, Hiroshima, Japan
| | - Shinya Matusda
- Department of Public Health, University of Occupational and Environmental Health, Kitakyushu, Japan
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Wooderson SC, Gallagher P, Watson S, Young AH. An exploration of testosterone levels in patients with bipolar disorder. BJPsych Open 2015; 1:136-138. [PMID: 27703738 PMCID: PMC4995589 DOI: 10.1192/bjpo.bp.115.001008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/01/2015] [Accepted: 10/16/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Testosterone influences well-being, mood and cognition and may play a role in the pathophysiology of bipolar disorder. AIM To examine testosterone levels in patients with bipolar disorder compared with healthy controls. METHOD We examined baseline total testosterone levels and current depression scores in male and female patients with bipolar disorder and mild to moderate depression and healthy controls. RESULTS A significant interaction between diagnosis and gender was observed (F(2,97)=9.791, P=0.002). Testosterone levels were significantly lower for male patients with bipolar disorder compared with male controls (P=0.001). Women with bipolar disorder had significantly higher testosterone levels than female controls (P=0.03). CONCLUSIONS Disturbances in testosterone levels may represent an important neurobiological abnormality in bipolar disorder and may differ by gender. If these findings are confirmed, the use of gender appropriate treatment strategies for the normalisation of testosterone levels in bipolar disorder depression should be further explored. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2015. This is an open access article distributed under the terms of the Creative Commons Non-Commercial, No Derivatives (CC BY-NC-ND) licence.
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Affiliation(s)
- Sarah C Wooderson
- , MBPsS, BSc, MSc, PhD, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, UK
| | - Peter Gallagher
- , PhD, Institute of Neuroscience (Academic Psychiatry), Newcastle University, Newcastle, UK
| | - Stuart Watson
- , MBBS, MD, MRCPsych, Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Allan H Young
- , MBChB, MPhil, PhD, FRCPsych, FRCPC, Centre for Affective Disorders, IoPPN, King's College London, UK
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Neighborhood socioeconomic status during childhood versus puberty in relation to endogenous sex hormone levels in adult women. Nurs Res 2015; 64:211-20. [PMID: 25932699 DOI: 10.1097/nnr.0000000000000096] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Socioeconomic adversity in early life is related to cardiovascular risk in adulthood; however, no studies have examined whether such adversity may be related to endogenous sex hormones, which are themselves associated with cardiovascular outcomes, or whether the timing of adversity exposures (childhood vs. puberty) matters. OBJECTIVE The goal of the current study was to separately examine neighborhood socioeconomic status (SES) during periods of childhood and puberty in relation to adulthood levels of endogenous sex hormones (estradiol [E2], testosterone), sex hormone binding globulin (SHBG), and a derived index of bioavailable testosterone (free androgen index). METHODS In a sample of 143 premenopausal women (mean age = 36.8 [SD = 5.5]; 51.7% White, 32.2% African American, 5.6% Latina, 7.0% Chinese, and 3.5% Filipina), retrospective reports of residential address information in designated periods of childhood and puberty were used to derive U.S. census-based neighborhood SES composite scores characterizing the socioeconomic environments of women during these periods. RESULTS In covariate-adjusted analyses, higher neighborhood SES in puberty predicted higher levels of SHBG in adulthood, but neighborhood SES during childhood did not (standardized regression coefficient = .24, p = .01 vs. standardized regression coefficient = .04, p = .75, respectively). Neighborhood SES was not predictive of other hormones (E2, testosterone, and free androgen index). DISCUSSION The current findings suggest that puberty may be a time of particular vulnerability to the effects of neighborhood SES on SHBG levels, which have been linked to cardiovascular risk factor profiles and atherosclerotic disease progression.
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Abdoli A, Dalimi A. Are There any Relationships between Latent Toxoplasma gondii Infection, Testosterone Elevation, and Risk of Autism Spectrum Disorder? Front Behav Neurosci 2014; 8:339. [PMID: 25309376 PMCID: PMC4173877 DOI: 10.3389/fnbeh.2014.00339] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2014] [Accepted: 09/09/2014] [Indexed: 12/27/2022] Open
Affiliation(s)
- Amir Abdoli
- Faculty of Medical Sciences, Department of Parasitology, Kashan University of Medical Science , Kashan , Iran ; Faculty of Medical Sciences, Department of Parasitology, Tarbiat Modares University , Tehran , Iran
| | - Abdolhossein Dalimi
- Faculty of Medical Sciences, Department of Parasitology, Tarbiat Modares University , Tehran , Iran
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