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Fiorillo A, Albert U, Dell'Osso B, Pompili M, Sani G, Sampogna G. The clinical utility and relevance in clinical practice of DSM-5 specifiers for major depressive disorder: A Delphi expert consensus study. Compr Psychiatry 2024; 133:152502. [PMID: 38810371 DOI: 10.1016/j.comppsych.2024.152502] [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: 12/29/2023] [Revised: 05/06/2024] [Accepted: 05/18/2024] [Indexed: 05/31/2024] Open
Abstract
Major depressive disorder (MDD) is a heterogeneous syndrome, associated with different levels of severity and impairment on the personal functioning for each patient. Classification systems in psychiatry, including ICD-11 and DSM-5, are used by clinicians in order to simplify the complexity of clinical manifestations. In particular, the DSM-5 introduced specifiers, subtypes, severity ratings, and cross-cutting symptom assessments allowing clinicians to better describe the specific clinical features of each patient. However, the use of DSM-5 specifiers for major depressive disorder in ordinary clinical practice is quite heterogeneous. The present study, using a Delphi method, aims to evaluate the consensus of a representative group of expert psychiatrists on a series of statements regarding the clinical utility and relevance of DSM-5 specifiers for major depressive disorder in ordinary clinical practice. Experts reached an almost perfect agreement on statements related to the use and clinical utility of DSM-5 specifiers in ordinary clinical practice. In particular, a complete consensus was found regarding the clinical utility for ordinary clinical practice of using DSM-5 specifiers. The use of specifiers is considered a first step toward a "dimensional" approach to the diagnosis of mental disorders.
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Affiliation(s)
- Andrea Fiorillo
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste and Department of Mental Health, Azienda Sanitaria Universitaria Giuliano Isontina - ASUGI, Italy
| | - Bernardo Dell'Osso
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy; Department of Psychiatry and Behavioural Sciences, Stanford University, USA
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, University Cattolica del Sacro Cuore, Rome, Italy; Department of Neuroscience, Sensory organs and Thorax, Department of Psychiatry, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
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Pelizza L, Leuci E, Maestri D, Quattrone E, Azzali S, Paulillo G, Pellegrini P. Disorganization in first episode affective psychosis: Treatment response and clinical considerations from a 2-year follow-up study in a "real world" setting. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:151-158. [PMID: 38520114 DOI: 10.1016/j.rpsm.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Disorganization is a crucial domain in affective psychoses. However, it has received poor research attention, especially at the illness onset. The aims of this study were: (a) to monitor the longitudinal course of disorganization in young people with first episode affective psychosis (FEAP) across 2 years of follow-up, and (b) to investigate any relevant correlation of disorganized symptoms with psychopathology, functioning and the specific treatment elements of an "Early Intervention in Psychosis" (EIP) protocol along the follow-up period. MATERIALS AND METHODS Seventy-five FEAP participants (aged 12-35 years) completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF). Spearman's rank correlation coefficients were calculated. RESULTS During the follow-up, disorganized symptoms showed significant enduring positive correlations with PANSS items representing delusional thought content and uncooperativeness, as well as a persistent negative association with the GAF score. Across the 2-year follow-up period, FEAP individuals also had a relevant reduction in disorganization levels. This symptom decrease was specifically related with the combination of antipsychotic medication with the specific psychosocial components of our EIP intervention offered to FEAP patients during the first 12 months of treatment. CONCLUSIONS Disorganization is relevant in FEAP subjects already at their enrollment in specialized EIP protocols. However, it decreases over time, together with the delivery of specific, combined (person-tailored) EIP interventions.
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Affiliation(s)
- Lorenzo Pelizza
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy.
| | - Emanuela Leuci
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy
| | - Davide Maestri
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy
| | - Emanuela Quattrone
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy
| | - Silvia Azzali
- Department of Mental Health and Pathological Addiction, Azienda USL-IRCCS di Reggio Emilia, Via Amendola n.2, 43100 Reggio Emilia, Italy
| | - Giuseppina Paulillo
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy
| | - Pietro Pellegrini
- Department of Mental Health and Pathological Addiction, Azienda USL di Parma, Largo Palli n. 1/A, 43100 Parma, Italy
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Demchenko I, Desai N, Iwasa SN, Gholamali Nezhad F, Zariffa J, Kennedy SH, Rule NO, Cohn JF, Popovic MR, Mulsant BH, Bhat V. Manipulating facial musculature with functional electrical stimulation as an intervention for major depressive disorder: a focused search of literature for a proposal. J Neuroeng Rehabil 2023; 20:64. [PMID: 37193985 DOI: 10.1186/s12984-023-01187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 05/02/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Major Depressive Disorder (MDD) is associated with interoceptive deficits expressed throughout the body, particularly the facial musculature. According to the facial feedback hypothesis, afferent feedback from the facial muscles suffices to alter the emotional experience. Thus, manipulating the facial muscles could provide a new "mind-body" intervention for MDD. This article provides a conceptual overview of functional electrical stimulation (FES), a novel neuromodulation-based treatment modality that can be potentially used in the treatment of disorders of disrupted brain connectivity, such as MDD. METHODS A focused literature search was performed for clinical studies of FES as a modulatory treatment for mood symptoms. The literature is reviewed in a narrative format, integrating theories of emotion, facial expression, and MDD. RESULTS A rich body of literature on FES supports the notion that peripheral muscle manipulation in patients with stroke or spinal cord injury may enhance central neuroplasticity, restoring lost sensorimotor function. These neuroplastic effects suggest that FES may be a promising innovative intervention for psychiatric disorders of disrupted brain connectivity, such as MDD. Recent pilot data on repetitive FES applied to the facial muscles in healthy participants and patients with MDD show early promise, suggesting that FES may attenuate the negative interoceptive bias associated with MDD by enhancing positive facial feedback. Neurobiologically, the amygdala and nodes of the emotion-to-motor transformation loop may serve as potential neural targets for facial FES in MDD, as they integrate proprioceptive and interoceptive inputs from muscles of facial expression and fine-tune their motor output in line with socio-emotional context. CONCLUSIONS Manipulating facial muscles may represent a mechanistically novel treatment strategy for MDD and other disorders of disrupted brain connectivity that is worthy of investigation in phase II/III trials.
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Affiliation(s)
- Ilya Demchenko
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital - Unity Health Toronto, Toronto, ON, M5B 1M4, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Naaz Desai
- Krembil Research Institute - University Health Network, Toronto, ON, M5T 0S8, Canada
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, M5G 2A2, Canada
| | - Stephanie N Iwasa
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, M5G 2A2, Canada
- CRANIA, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Fatemeh Gholamali Nezhad
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital - Unity Health Toronto, Toronto, ON, M5B 1M4, Canada
| | - José Zariffa
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, M5G 2A2, Canada
- CRANIA, University Health Network, Toronto, ON, M5G 2C4, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5G 1V7, Canada
- Institute of Biomedical Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, M5S 3E2, Canada
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, M5S 3G8, Canada
| | - Sidney H Kennedy
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital - Unity Health Toronto, Toronto, ON, M5B 1M4, Canada
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada
| | - Nicholas O Rule
- Department of Psychology, Faculty of Arts & Science , University of Toronto, Toronto, ON, M5S 3G3, Canada
| | - Jeffrey F Cohn
- Department of Psychology, Kenneth P. Dietrich School of Arts & Sciences, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Milos R Popovic
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, M5G 2A2, Canada
- CRANIA, University Health Network, Toronto, ON, M5G 2C4, Canada
- Institute of Biomedical Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, M5S 3E2, Canada
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering, Faculty of Applied Science & Engineering, University of Toronto, Toronto, ON, M5S 3G8, Canada
| | - Benoit H Mulsant
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, M6J 1H4, Canada
| | - Venkat Bhat
- Interventional Psychiatry Program, Mental Health and Addictions Service, St. Michael's Hospital - Unity Health Toronto, Toronto, ON, M5B 1M4, Canada.
- Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Krembil Research Institute - University Health Network, Toronto, ON, M5T 0S8, Canada.
- KITE, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, M5G 2A2, Canada.
- CRANIA, University Health Network, Toronto, ON, M5G 2C4, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada.
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Martinotti G, Dell'Osso B, Di Lorenzo G, Maina G, Bertolino A, Clerici M, Barlati S, Rosso G, Di Nicola M, Marcatili M, d'Andrea G, Cavallotto C, Chiappini S, De Filippis S, Nicolò G, De Fazio P, Andriola I, Zanardi R, Nucifora D, Di Mauro S, Bassetti R, Pettorruso M, McIntyre RS, Sensi SL, di Giannantonio M, Vita A. Treating bipolar depression with esketamine: Safety and effectiveness data from a naturalistic multicentric study on esketamine in bipolar versus unipolar treatment-resistant depression. Bipolar Disord 2023; 25:233-244. [PMID: 36636839 DOI: 10.1111/bdi.13296] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Bipolar depression accounts for most of the disease duration in type I and type II bipolar disorder (BD), with few treatment options, often poorly tolerated. Many individuals do not respond to first-line therapeutic options, resulting in treatment-resistant bipolar depression (B-TRD). Esketamine, the S-enantiomer of ketamine, has recently been approved for treatment-resistant depression (TRD), but no data are available on its use in B-TRD. OBJECTIVES To compare the efficacy of esketamine in two samples of unipolar and bipolar TRD, providing preliminary indications of its effectiveness in B-TRD. Secondary outcomes included the evaluation of the safety and tolerability of esketamine in B-TRD, focusing on the average risk of an affective switch. METHODS Thirty-five B-TRD subjects treated with esketamine nasal spray were enrolled and compared with 35 TRD patients. Anamnestic data and psychometric assessments (Montgomery-Asberg Depression Rating Scale/MADRS, Hamilton-depression scale/HAM-D, Hamilton-anxiety scale/HAM-A) were collected at baseline (T0), at one month (T1), and three months (T2) follow up. RESULTS A significant reduction in depressive symptoms was found at T1 and T2 compared to T0, with no significant differences in response or remission rates between subjects with B-TRD and TRD. Esketamine showed a greater anxiolytic action in subjects with B-TRD than in those with TRD. Improvement in depressive symptoms was not associated with treatment-emergent affective switch. CONCLUSIONS Our results supported the effectiveness and tolerability of esketamine in a real-world population of subjects with B-TRD. The low risk of manic switch in B-TRD patients confirmed the safety of this treatment.
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Affiliation(s)
- Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Bernardo Dell'Osso
- Department of Biomedical and Clinical Sciences Luigi Sacco and Aldo Ravelli Center for Neurotechnology and Brain Therapeutic, University of Milan, Milano, Italy
| | - Giorgio Di Lorenzo
- Chair of Psychiatry, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giuseppe Maina
- Department of Neurosciences Rita Levi Montalcini, University of Torino, Turin, Italy
| | | | - Massimo Clerici
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Stefano Barlati
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Italy
| | - Gianluca Rosso
- Department of Neurosciences Rita Levi Montalcini, University of Torino, Turin, Italy
| | - Marco Di Nicola
- Section of Psychiatry, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Matteo Marcatili
- Department of Mental Health and Addiction, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Giacomo d'Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Clara Cavallotto
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Stefania Chiappini
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - Giuseppe Nicolò
- Department of Mental Health and Addiction, ASL Roma 5, Rome, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Raffaella Zanardi
- Mood Disorder Unit, Department of Clinical Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Clinical Neurosciences, University Vita-Salute San Raffaele, Milan, Italy
| | | | | | - Roberta Bassetti
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Italy
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University Health Network, ON, Toronto, Canada
- Department of Pharmacology and Toxicology, University of Toronto, ON, Toronto, Canada
- Canadian Rapid Treatment Center of Excellence, ON, Mississauga, Canada
- Brain and Cognition Discovery Foundation, ON, Toronto, Canada
- Department of Psychiatry, University of Toronto, ON, Toronto, Canada
| | - Stefano L Sensi
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Massimo di Giannantonio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D'Annunzio, Chieti, Italy
| | - Antonio Vita
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Italy
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Shaw DB, Carreira DS. The Impacts of Anxiety and Depression on Outcomes in Foot and Ankle Surgery. Foot Ankle Int 2022; 43:1606-1613. [PMID: 36367127 DOI: 10.1177/10711007221132277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Mineo L, Rodolico A, Spedicato GA, Aguglia A, Bolognesi S, Concerto C, Cuomo A, Goracci A, Maina G, Fagiolini A, Amore M, Aguglia E. Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity-Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients. Eur Psychiatry 2022; 65:e30. [PMID: 35638732 PMCID: PMC9158398 DOI: 10.1192/j.eurpsy.2022.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients. Methods A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables. Results Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder. Conclusions In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.
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Affiliation(s)
- Ludovico Mineo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alessandro Rodolico
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, Italy
| | - Simone Bolognesi
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Carmen Concerto
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Arianna Goracci
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Turin, University Hospital San Luigi Gonzaga, Turin, Italy
| | - Andrea Fagiolini
- Department of Molecular Medicine, University of Siena, Siena, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Department of Neurosciences, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Baicalin Attenuates Continuous Activation of β-Catenin Induced by Lipopolysaccharide (LPS) and Depression Complicated by Infertility in Male Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2112359. [PMID: 35432561 PMCID: PMC9010181 DOI: 10.1155/2022/2112359] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 03/08/2022] [Indexed: 11/18/2022]
Abstract
Background Baicalin (BA) is a potential candidate drug to inhibit depressive behavior. However, the mechanism of BA's role on depression complicated with male infertility (DCMI) is still unclear. This study aimed to investigate the role of BA in alleviating inflammatory factor-induced DCMI by regulating β-catenin. Methods Firstly, we performed sucrose preference test (SPT), open field test (OFT), tail suspension test (TST), and forced swim test (FST) in the chronic unpredictable mild stress (CUMS) + lipopolysaccharide (LPS) model rats to study the effect of BA on depressive behavior. The levels of neuropeptide Y (NPY), testosterone (T), and IL-1β, IL-6, TNF-α, IL-10, and IL-4 in the peripheral blood plasma of normal people, patients with depression, and patients with DCMI were measured. Then, the levels of IL-1β, IL-6, TNF-α, IL-10, IL-4, β-catenin in rat testis and peripheral blood and ANXA2, APP, SEMG1, and SEMG2 in seminal plasma proteins were examined. Moreover, the level of β-catenin in the testicular tissue was detected. LPS was used to treat Sertoli cells, and the level of β-catenin was detected. Finally, we evaluated the reproductive phenotype and sperm motility of rats. Results BA (especially 100 mg/kg) could notably ameliorate depression-like behavior induced by CUMS + LPS. The levels of IL-4, IL-10, T, and NPY in depression patients, DCMI patients, and CUMS + LPS model rats elevated, while the levels of IL-1β, IL-6, and TNF-α were reduced. However, BA alleviated the changes in these factors. Moreover, BA alleviated male rat depression induced by CUMS + LPS. LPS upregulated β-catenin (NP) but could not adjust β-catenin (TP) level in rat Sertoli cells. BA relieved the symptoms of DCMI by regulating β-catenin. Furthermore, BA ameliorated the reproductive ability of depressed rats. Conclusion BA modulated β-catenin in the relief of inflammatory factor-induced DCMI.
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Chronic mild stress paradigm as a rat model of depression: facts, artifacts, and future perspectives. Psychopharmacology (Berl) 2022; 239:663-693. [PMID: 35072761 PMCID: PMC8785013 DOI: 10.1007/s00213-021-05982-w] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/15/2021] [Indexed: 02/06/2023]
Abstract
RATIONALE The chronic mild stress (CMS) paradigm was first described almost 40 years ago and has become a widely used model in the search for antidepressant drugs for major depression disorder (MDD). It has resulted in the publication of almost 1700 studies in rats alone. Under the original CMS procedure, the expression of an anhedonic response, a key symptom of depression, was seen as an essential feature of both the model and a depressive state. The prolonged exposure of rodents to unpredictable/uncontrollable mild stressors leads to a reduction in the intake of palatable liquids, behavioral despair, locomotor inhibition, anxiety-like changes, and vegetative (somatic) abnormalities. Many of the CMS studies do not report these patterns of behaviors, and they often fail to include consistent molecular, neuroanatomical, and physiological phenotypes of CMS-exposed animals. OBJECTIVES To critically review the CMS studies in rats so that conceptual and methodological flaws can be avoided in future studies. RESULTS Analysis of the literature supports the validity of the CMS model and its impact on the field. However, further improvements could be achieved by (i) the stratification of animals into 'resilient' and 'susceptible' cohorts within the CMS animals, (ii) the use of more refined protocols in the sucrose test to mitigate physiological and physical artifacts, and (iii) the systematic evaluation of the non-specific effects of CMS and implementation of appropriate adjustments within the behavioral tests. CONCLUSIONS We propose methodological revisions and the use of more advanced behavioral tests to refine the rat CMS paradigm, which offers a valuable tool for developing new antidepressant medications.
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9
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Ma M, Zhang Y, Zhang X, Yan H, Zhang D, Yue W. Common and Distinct Alterations of Cognitive Function and Brain Structure in Schizophrenia and Major Depressive Disorder: A Pilot Study. Front Psychiatry 2021; 12:705998. [PMID: 34354618 PMCID: PMC8329352 DOI: 10.3389/fpsyt.2021.705998] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/03/2021] [Indexed: 01/10/2023] Open
Abstract
Objective: Numerous studies indicate that schizophrenia (SCZ) and major depressive disorder (MDD) share pathophysiological characteristics. Investigating the neurobiological features of psychiatric-affective disorders may facilitate the diagnosis of psychiatric disorders. Hence, we aimed to explore whether patients with SCZ and patients with MDD had the similar or distinct cognitive impairments and GMV alterations to further understand their underlying pathophysiological mechanisms. Methods: We recruited a total of 52 MDD patients, 64 SCZ patients, and 65 healthy controls (HCs). The Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery was used to assess cognitive functions. In addition, voxel-based morphometry (VBM) analysis was used to evaluate the gray matter volume (GMV) by using MRI scanning. One-way ANOVA and post-hoc tests were used to find the differences among the MDD, SCZ, and HCs. Finally, we explored the correlation between structural alterations and cognitive functions. Results: Compared with that of HCs, processing speed was impaired in both patients with SCZ and patients with MDD (F = 49.505, p < 0.001). SCZ patients displayed impaired cognitive performance in all dimensions of cognitive functions compared with HCs (p < 0.001, except social cognition, p = 0.043, Bonferroni corrected). Whole-brain VBM analysis showed that both SCZ and MDD groups had reductions of GMV in the medial superior frontal cortex (cluster-level FWE p < 0.05). Patients with SCZ exhibited declining GMV in the anterior cingulate cortex and right middle frontal cortex (MFC) compared with HCs and MDD patients (cluster-level FWE p < 0.05). The mean values of GMV in the right MFC had a positive correlation with the attention/vigilance function in patients with MDD (p = 0.014, partial. r = 0.349, without Bonferroni correction). Conclusions: In total, our study found that MDD and SCZ groups had common cognitive impairments and brain structural alterations, but the SCZ group exhibited more severe impairment than the MDD group in both fields. The above findings may provide a potential support for recognizing the convergent and divergent brain neural pathophysiological mechanisms between MDD and SCZ.
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Affiliation(s)
- Mengying Ma
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Yuyanan Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Xiao Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Hao Yan
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Dai Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Weihua Yue
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
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10
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Steardo L, Luciano M, Sampogna G, Carbone EA, Caivano V, Di Cerbo A, Giallonardo V, Palummo C, Vece A, Del Vecchio V, De Fazio P, Fiorillo A. Clinical Severity and Calcium Metabolism in Patients with Bipolar Disorder. Brain Sci 2020; 10:brainsci10070417. [PMID: 32630307 PMCID: PMC7408522 DOI: 10.3390/brainsci10070417] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/26/2020] [Accepted: 06/29/2020] [Indexed: 02/07/2023] Open
Abstract
Parathyroid hormone (PTH), vitamin D and serum calcium play a key role in several physiological and pathological conditions. Vitamin D and PTH receptors are largely expressed in the central nervous system and are involved in the modulation of inflammatory responses. Few studies investigated the association between calcium homeostasis imbalance and psychiatric disorders. This study aims to assess calcium homeostasis imbalance in patients with bipolar disorder (BD) and its impact on clinical outcome. We recruited 199 patients with BD, who were administered with validated assessment instruments to investigate depressive, manic and anxiety symptoms, affective temperaments, childhood trauma and global functioning. Serum calcium, vitamin D and PTH levels were assessed in all patients. Levels of PTH correlated with several clinical characteristics, including the diagnosis of bipolar disorder type I (BD-I), the presence of psychotic symptoms, lithium treatment, suicidality, total number of acute episodes and of hospitalizations (p < 0.0001) and seasonality (p < 0.05). At the regression analyses, higher levels of PTH were predicted by early age at onset, number of hospitalizations, aggressive behaviors (p < 0.05), higher Childhood Trauma Questionnaire total score (CTQ) (p < 0.001) and treatment with lithium (p = 0.01). Our findings suggest that the calcium homeostasis could play a role in BD patients, and that PTH levels are correlated with the clinical severity of the disorder.
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Affiliation(s)
- Luca Steardo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
- Correspondence: ; Tel.: +39-0961712801 or +39-3208612071
| | - Mario Luciano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Gaia Sampogna
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Elvira Anna Carbone
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
| | - Vito Caivano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Arcangelo Di Cerbo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Vincenzo Giallonardo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Carmela Palummo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Alfonso Vece
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Valeria Del Vecchio
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
| | - Pasquale De Fazio
- Psychiatric Unit, Department of Health Sciences, University Magna Graecia, 88100 Catanzaro, Italy; (E.A.C.); (P.D.F.)
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (M.L.); (G.S.); (V.C.); (A.D.C.); (V.G.); (C.P.); (A.V.); (V.D.V.); (A.F.)
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11
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Kaur A, Garg S, Shiekh BA, Singh N, Singh P, Bhatti R. In Silico Studies and In Vivo MAO A Inhibitory Activity of Coumarins Isolated from Angelica archangelica Extract: An Approach toward Antidepressant Activity. ACS OMEGA 2020; 5:15069-15076. [PMID: 32637779 PMCID: PMC7330908 DOI: 10.1021/acsomega.0c00887] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/02/2020] [Indexed: 05/08/2023]
Abstract
The current investigation was aimed at in vivo MAOA inhibitory activity of coumarins angelicin, bergapten, and scopoletin isolated from the roots of Angelica archangelica. The isolated compounds were screened for MAOA (pdb ID 2Z5y) binding through molecular docking studies. The molecular docking results displayed that bergapten has a maximum affinity for MAOA, followed by angelicin and scopoletin. In silico prediction of physicochemical parameters indicated that maximum blood-brain barrier (BBB) permeability was observed with angelicin (2.3), followed by bergapten (2.0) and least with scopoletin (0.644). In consonance to the results of molecular docking studies, appreciable in vivo antidepressant activity of angelicin and bergaptan was observed over the mouse model of reserpine-induced depression. The modulation of MAOA in the antidepressant effect of extract and its isolated fractions was also determined. Biochemical examination of the brain tissue indicated that bergapten has maximum MAOA inhibitory activity while scopoletin fails to inhibit brain MAOA.
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Affiliation(s)
- Anudeep Kaur
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Saweta Garg
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
| | - Bilal Ahmad Shiekh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Nirmal Singh
- Department
of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala 147002, India
| | - Palwinder Singh
- Department
of Chemistry, Guru Nanak Dev University, Amritsar 143005, India
| | - Rajbir Bhatti
- Department
of Pharmaceutical Sciences, Guru Nanak Dev
University, Amritsar 143005, India
- . Phone: 0183-2258802-9, ext. 3543. Cell: 09417278858
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