Double screening for dual disorder, alcoholism and depression

Lavender essential oil alleviates depressive-like behavior in alcohol-withdrawn rats: Insights from gut metabolites and hippocampal transcriptome analysis

Lavender, an aromatic plant with a history dating back to ancient Egypt and Greece, is consumed because of its diverse pharmacological properties, including sedation, sleep aid, and antidepressant effects. However, the mechanisms underlying these antidepressant properties remain unclear. In this study, we explored the impact of lavender essential oil (LEO) inhalation on the diversity of gut microbiota, metabolites, and differential gene expression in the hippocampus of alcohol-withdrawn depressive rats. Additionally, we examined alterations in the hippocampal transient receptor potential (TRP) channel-mediated inflammatory regulation within the brain-gut axis of depressive rats. The results demonstrated a significant decrease in sucrose preference, diminished activity in the central zone of the open field test, and prolonged immobility time in the forced swim test in alcohol-withdrawn depressive rats, indicating the amelioration of depressive states following lavender essential oil inhalation. 16 S rDNA sequencing analysis revealed a significant reduction in Bacteroidota and Muribaculaceae in the gut of alcohol-withdrawn depressive rats, whereas lavender essential oil significantly increased the relative abundance of Muribaculaceae and other bacterial species. Metabolomic analysis identified 646 distinct metabolites as highly correlated biomarkers between the model and lavender essential oil groups. Furthermore, lavender essential oil inhalation significantly attenuated hippocampal inflammatory factors IL-2, IL-6, IL-1β, and TNF-α. This study identified elevated expression of Trpv4 and Calml4 in the hippocampal region of alcohol-withdrawn depressed rats and showed that lavender essential oil inhalation regulated aberrantly expressed genes. Our research suggests that lavender essential oil downregulates Trpv4, modulates inflammatory factors, and alleviates depressive-like behavior in alcohol withdrawal rats.

Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students

The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017-2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.

Association of Computer Vision Syndrome with Depression/Anxiety among Lebanese Young Adults: The Mediating Effect of Stress

Computers have become indispensable in daily activities. With this excess use of electronics, computer vision syndrome (CVS), a highly prevalent condition, is associated with various symptoms. Although understanding the relationship between CVS and mental health has been reported, the impact of CVS has not been explored on more than one psychological aspect. We hypothesize that higher CVS symptoms could be associated with higher levels of anxiety and depression, mediated by higher stress. Therefore, the objective of this study was to determine the association between CVS and depression and anxiety among a sample of Lebanese young adults, along with evaluating the mediating effect of stress on these associations. Between August 2020 and April 2021, 749 participants completed an online questionnaire for this cross-sectional study. Females compared to males (Beta = 3.73) and those with CVS compared to those who did not (Beta = 3.14) were significantly associated with more anxiety, whereas having a university level of education compared to secondary or less (Beta = -3.02) was significantly associated with less anxiety. Females compared to males (Beta = 2.55) and those with CVS compared to those without (Beta = 2.61) were significantly associated with more depression, whereas being of an older age (Beta = -0.18) was significantly associated with less depression. Stress partially mediated the association between CVS and anxiety and between CVS and depression. More CVS was significantly associated with more stress (Beta = 3.05). Higher stress was significantly associated with more anxiety (Beta = 0.70) and depression (Beta = 0.71), whereas more CVS was significantly and directly associated with more anxiety (Beta = 3.14) and depression (Beta = 2.61). This study is the first worldwide to evaluate an association between CVS and mental health. Our results serve as a starting point for healthcare providers (psychiatrists and psychologists, most importantly) to look deeper into CVS when looking for reasons behind mental health issues. Further studies are warranted to confirm our results and look for more factors and mediators in such associations.

Neuropsychological functioning of patients with major depression or bipolar disorder comorbid to substance use disorders: A systematic review

Major depression disorder (MDD) and bipolar disorder (BD) are usual comorbidities in patients with substance use disorders (SUD), a condition known as dual disorder (DD). MDD, BD and SUD are associated with cognitive impairment, potentially leading to a greater functional impairment in the context of DD.

OBJECTIVES

To review the existing data on the cognitive impairment in DD patients with comorbid MDD or BD, considering the influence of the depressive symptomatology.

METHODS

Following the PRISMA protocol 19 studies were selected from the last 17 years, 13 of which focused on BD, five on MDD and one included both diagnoses.

RESULTS

Studies based in BD+SUD showed that the most affected cognitive domains were attention and executive functions, but not all of them found a greater impairment due to the comorbidity. While fewer studies were found for depression, MDD+SUD works point to a similar impairment cognitive pattern. Furthermore, depression improvement could be associated to better cognitive performance.

LIMITATIONS

More standardized research is needed regarding the influence of depression on cognitive performance of DD patients, especially on those with comorbid MDD. Factors such as main substance, abstinence, or MDD/BD-related variables should be considered. Unstudied factors, like gender or circadian rhythms, are proposed to improve knowledge in this area.

CONCLUSIONS

Current studies suggest that DD could potentiate cognitive impairment in BD, MDD and SUD. However, additional research is needed to improve the understanding of comorbidity to apply more individualized therapies in the treatment of these patients, considering the interference of their neurocognitive functioning.

Prevalence and Correlates of Unmet Mental Health Services Need in Adolescents With Major Depressive Episode in 2019: An Analysis of National Survey on Drug Use and Health Data

PURPOSE

Mental health (MH) crises in adolescence can derail development, possibly leading to poorer health outcomes in young adulthood. According to recent estimates, approximately half of US children have unmet MH need, with increased odds when uninsured or Hispanic. The aims of this study were to update estimates of MH services need and use in the US adolescent (12- 17 years) and to reassess previously identified associations between insurance status, demographic characteristics, MH need and use, and unmet need, using data from the National Survey of Drug Use and Health (NSDUH; 2019).

METHODS

Adolescents aged 12-17 years were included from the NSDUH. Logistic regressions were performed to assess associations of race and insurance with outcomes of past-year major depressive episode (MDE) and unmet MH need. Adjustments were made for age, sex, and income.

RESULTS

Individuals of multiple races, females, and users of alcohol, marijuana, and illicit drugs had increased odds of MDE, while Black adolescents and the privately insured had decreased odds. Hispanic adolescents, people of multiple races, and users of alcohol and illicit drug had increased odds for unmet need.

DISCUSSION

We estimate that 15.8% of all US adolescents had an MDE and that 45.8% of these adolescents with MDE went without MH care in 2019. We found very limited support for associations of race and insurance status with past-year MDE or unmet MH need, although this may be due to the small number of uninsured adolescents sampled in 2019. Longitudinal data are needed to assess severity of MH needs and appropriateness of care.

Advances in the mechanisms of polysaccharides in alleviating depression and its complications

BACKGROUND

Depression is one of the most serious mental illnesses worldwide that endangers the health of people. The pathogenesis of depression is complex and is associated with abnormal neurotransmitter levels, activation of the hypothalamic-pituitary-adrenal (HPA) axis, inflammation, and gut flora-related disorders. However, most of the current pharmacological therapies used to manage depression are inconsistent and are associated with side effects. Owing to their low toxicity and wide availability in nature, polysaccharides are gradually attracting attention and are being discovered to exert direct or indirect antidepressant effects.

PURPOSE

In this review, we have summarized the classification, dosage, and experimental models to study polysaccharides with antidepressant effects obtained from different sources. We have also reviewed the protective effects and underlying mechanisms of these polysaccharides in depression by modulating inflammation, the HPA axis, and intestinal flora.

METHODS

We searched the PubMed, Web of Science, and Google scholar databases and included studies that reported the use of polysaccharides in treating depression.

RESULTS

The unique benefits of natural polysaccharides as antidepressants lie in their potential to modulate inflammation, regulate the HPA axis, and regulate intestinal flora, giving full play to their antidepressant effects via multiple pathways and targets.

CONCLUSION

Natural polysaccharides may be a promising resource for use as adjuvant antidepressant therapy. Our study might therefore provide evidence for the development of polysaccharide resources as antidepressants.

What are the socioeconomic determinants of mental disorders?

PURPOSE

This study examines the influence of socioeconomic factors on the prevalence of depression and anxiety and on the number of years lived with disability (YLD) of depression and anxiety.

DESIGN AND METHODS

This is an exploratory study. The study analyzed data from 160 member countries of the World Health Organization (WHO).

FINDINGS

Except for alcohol consumption and unemployment rate, Gini coefficient, age dependency, rural population, and population aged 65 and above have statistically significant effects on both depression and anxiety prevalence. Also, Gini coefficient and rural population have significant effects on YLD of depression and anxiety.

PRACTICE IMPLICATIONS

The study results will allow psychiatrists, psychologists, and other mental health professionals to focus on policy reforms that address the social determinants of mental health.

A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing

BACKGROUND

Studies often evaluate mental health and well-being in association with individual health behaviours although evaluating multiple health behaviours that co-occur in real life may reveal important insights into the overall association. Also, the underlying pathways of how lifestyle might affect our health are still under debate. Here, we studied the mediation of different health behaviours or lifestyle factors on mental health and its effect on core markers of ageing: telomere length (TL) and mitochondrial DNA content (mtDNAc).

METHODS

In this study, 6054 adults from the 2018 Belgian Health Interview Survey (BHIS) were included. Mental health and well-being outcomes included psychological and severe psychological distress, vitality, life satisfaction, self-perceived health, depressive and generalised anxiety disorder and suicidal ideation. A lifestyle score integrating diet, physical activity, smoking status, alcohol consumption and BMI was created and validated. On a subset of 739 participants, leucocyte TL and mtDNAc were assessed using qPCR. Generalised linear mixed models were used while adjusting for a priori chosen covariates.

RESULTS

The average age (SD) of the study population was 49.9 (17.5) years, and 48.8% were men. A one-point increment in the lifestyle score was associated with lower odds (ranging from 0.56 to 0.74) for all studied mental health outcomes and with a 1.74% (95% CI: 0.11, 3.40%) longer TL and 4.07% (95% CI: 2.01, 6.17%) higher mtDNAc. Psychological distress and suicidal ideation were associated with a lower mtDNAc of - 4.62% (95% CI: - 8.85, - 0.20%) and - 7.83% (95% CI: - 14.77, - 0.34%), respectively. No associations were found between mental health and TL.

CONCLUSIONS

In this large-scale study, we showed the positive association between a healthy lifestyle and both biological ageing and different dimensions of mental health and well-being. We also indicated that living a healthy lifestyle contributes to more favourable biological ageing.

Opioid and Benzodiazepine Substitutes: Impact on Drug Overdose Mortality in Medicare Population

INTRODUCTION

Gabapentinoids (GABAs) and serotonergic drugs (selective serotonin reuptake inhibitors [SSRIs]/serotonin and norepinephrine reuptake inhibitors [SNRIs]) are increasingly being prescribed as potential substitutes to opioids and benzodiazepines (benzos), respectively, to treat co-occurring pain and anxiety disorders. The toxicities of these drug classes and their combinations are not well understood.

METHODS

We conducted a matched case-control study using 2013-2016 Medicare files linked to the National Death Index. Cases were enrollees who died from drug overdose. Controls were enrollees who died from other causes. Cases and controls were matched on patient characteristics and prior chronic conditions. Possession of any opioids, GABAs, benzos, and SSRIs/SNRIs in the month prior to death was defined as drug use. Combination drug use was defined as possessing at least 2 types of these prescriptions for an overlapping period of at least 7 days in the month prior to death.

RESULTS

Among 4323 matches, benzo possession was associated with twice the risk for drug overdose death in cases vs controls. Compared with opioid-benzo co-prescribing, combinations involving SSRIs/SNRIs and opioids (or GABAs) were associated with decreased risk (adjusted odds ratio 0.55; 95% confidence interval, 0.44-0.69 for opioids and SSRIs/SNRIs; adjusted odds ratio 0.59; 95% confidence interval, 0.44-0.79 for GABAs and SSRIs/SNRIs). Fatal drug overdose risk was similar in users of GABA-opioid, GABA-benzo, and opioid-benzo combinations.

CONCLUSIONS

Benzodiazepines, prescribed alone or in combination, were associated with an increased risk of drug overdose death. SSRIs/SNRIs were associated with lower risk of overdose death vs benzodiazepines. GABAs were not associated with decreased risk compared with opioids, raising concerns for GABAs' perceived relative safety.

Rewarding and Antidepressant Properties of Ketamine and Ethanol: Effects on the Brain-Derived Neurotrophic Factor and TrkB and p75NTR Receptors

There is a high level of comorbidity between depression and alcohol use disorder. Subanesthetic doses of ketamine induce short-acting and enduring antidepressant effects after a single or a few administrations. Considering such comorbidity, we assessed, in Swiss male mice, if ketamine-induced antidepressant-like effects would alter ethanol's rewarding effects; and, if ethanol pretreatment would alter the rewarding and antidepressant effects of ketamine. The role of the brain-derived neurotrophic factor (BDNF) and its high and low affinity receptors TrkB and p75NTR, respectively, in both reward and depression-related behaviors is well established. The present study assessed, in outbred Swiss male mice, the expression of these proteins in the prefrontal cortex and hippocampus. Ketamine did not alter the development of ethanol-induced conditioned place preference (CPP), yet ethanol inhibited the expression of CPP induced by 50 mg/kg ketamine. The antidepressant action of 50 mg/kg ketamine was attenuated after repeated treatment (i.e., developed tolerance), an effect blocked by ethanol preexposure; ethanol also inhibited the antidepressant effect of 30 mg/kg ketamine. Ketamine (50 mg/kg) and Ethanol-Ketamine (50 mg/kg) groups showed lower levels of 145 kDa TrkB in the hippocampus than Saline-treated group. Ethanol-Ketamine (50 mg/kg) decreased the hippocampal expression of p75NTR compared to Saline-Saline and Saline-Ethanol groups. Ketamine (50 mg/kg) induced hippocampal downregulation of 145 kDa TrkB may contribute to ketamine-induced antidepressant tolerance. Likewise, a relationship between low hippocampal levels of p75NTR in the Ethanol-Ketamine (50 mg/kg) and ketamine-induced CPP blockade may be considered. The findings underscore potential ethanol-ketamine interactions likely to undermine ketamine putative antidepressant effects.

Risk of depression in patients with oral cancer: a nationwide cohort study in Taiwan

This study investigates an association between oral cancers and the risk of developing depression. We conducted a total of 3031 patients with newly diagnosed oral cancers and 9093 age-, sex-, and index year-matched controls (1:3) from 2000 to 2013 were selected from the National Health Insurance Research Database (NHIRD) of Taiwan. After adjusting for confounding factors, multivariate Cox proportional hazards analysis was used to compare the risk of depression over a 13-year follow-up. Of the patients with oral cancer, 69 (2.28%, or 288.57 per 105 person-years) developed depression compared to 150 (1.65%, 135.64 per 105 person-years) in the control group. The Cox proportional hazards regression analysis showed that the adjustment hazard ratio (HR) for subsequent depression in patients with oral cancer diagnosed was 2.224 (95% Confidence Interval [CI] 1.641–3.013, p < 0.001). It is noteworthy that in the sensitivity analysis is the adjusted HR in the group with depression diagnosis was 3.392 and in the oral cancer subgroup of “Tongue” was 2.539. This study shows oral cancer was associated with a significantly increased risk for developing subsequent depression and early identification and treatment of depression in oral cancer patients is crucial.

Understanding low treatment seeking rates for alcohol use disorder: A narrative review of the literature and opportunities for improvement

Despite a well-documented global burden of disease attributable to alcohol use disorder (AUD), treatment seeking rates remain low. In this qualitative literature review, we address treatment seeking for AUD from a host of perspectives and summarize the literature on key factors. First, we summarize the rates of alcohol treatment seeking across various epidemiological surveys, spanning decades. Second, we discuss the definition of treatment seeking and 'what' is typically considered formal treatment. Third, we consider timing and discuss 'when' individuals are most likely to seek treatment. Fourth, we review the literature on 'who' is most likely to seek treatment, including demographic and clinical correlates. Fifth, we address the critical question of 'why' so few people receive clinical services for AUD, relative to the number of individuals affected by the disorder, and review barriers to treatment seeking at the treatment- and person-levels of analysis. Finally, we identify opportunities to improve treatment seeking rates by focusing on tangible points of intervention. Specifically, we recommend a host of adaptations to models of care including efforts to make treatment more appealing across stages of AUD severity, accept a range of health-enhancing drinking goals as opposed to an abstinence-only model, educate providers and consumers about evidence-based behavioral and pharmacological treatments, and incentivize the delivery of evidence-based services.

Preliminary study of alcohol problem severity and response to brief intervention

Background

Findings have been mixed as to whether brief intervention (BI) is appropriate and effective for individuals with more severe alcohol use problems. Motivation to change drinking has been supported as a mechanism of behavior change for BI. This exploratory study examined aspects of motivation as mechanisms of clinical response to BI and alcohol problem severity as a moderator of treatment effects.

Methods

Non-treatment-seeking heavy drinkers (average age = 35 years; 57% male) were randomized to receive BI (n = 27) or attention-matched control (n = 24). Three indices of motivation to change were assessed at baseline and post-intervention: importance, confidence, and readiness. Moderated mediation analyses were implemented with treatment condition as the focal predictor, changes in motivation as mediator, 1-month follow-up drinks per day as the outcome, and an alcohol severity factor as second-stage moderator.

Results

Analysis of importance displayed a significant effect of intervention condition on importance (p < 0.003) and yielded a significant index of moderated mediation (CI − 0.79, − 0.02), indicating that the conditional indirect effect of treatment condition on drinking through importance was stronger for those with higher alcohol severity. For all motivation indices, alcohol severity moderated the effect of post-intervention motivation levels on drinking (p’s < 0.05). The direct effect of treatment condition on drinking was not significant in any model.

Conclusions

Findings highlight the relevance of considering one’s degree of alcohol problem severity in BI and alcohol screening efforts among non-treatment seeking heavy drinkers. These nuanced effects elucidate both potential mechanisms and moderators of BI response.

Trial registration Clinicaltrials.gov: NCT04710095. Registered January 14, 2021—retrospectively registered, https://clinicaltrials.gov/ct2/show/study/NCT04710095.

Who is asked about alcohol consumption? A retrospective cohort study using a national repository of Electronic Medical Records

Documentation of alcohol use in electronic medical record (EMR) informs interventions to reduce alcohol-related morbidity and mortality. This retrospective cohort study explored EMR data from 960 primary care providers participating in the Canadian Primary Care Sentinel Surveillance Network to describe documentation of alcohol use (e.g. none, current or past use) in the EMR. Included providers represented 700,620 adult patients from across Canada with an encounter between 2015 and 2018. Bivariate comparisons characterized the patients with, and without, documentation of alcohol use. Multivariate generalized estimating equation models with logit function assessed patient and provider characteristics associated with (1) documentation of alcohol and (2) patients with heightened risk for alcohol-related problems. Forty percent of patients had alcohol use documentation in the EMR. Light alcohol consumption was recorded for 43.6% of these patients. Male patients (OR1.09, CI 1.07-1.12), who were older (OR1.26, CI 1.23-1.30), had more frequent visits to their provider (OR1.11, CI 1.09-1.13) and had hypertension (OR1.07, CI 1.06-1.09) or depression (OR1.07, CI 1.09-1.14) had higher odds of alcohol documentation. There were 4.7% of patients with a record indicating heightened risk for alcohol-related problems. Male patients (OR3.27 CI 3.14-3.4), patients with depression (OR2.01 CI1.93-2.1) and rural residency (OR1.35 CI1.29-1.42) was associated with risk for alcohol-related problems. Heavy alcohol consumption is associated with an increased risk of negative health outcomes, particularly for patients with certain chronic conditions. However, these patients do not have alcohol use consistently documented in the EMR. Strategies should be designed and implemented to support more consistent alcohol-screening among high-risk patients.

Alcohol and melatonin

Investigation of the pathogenesis of alcoholism in humans using different methodological approaches has facilitated detection of important biological factors of consequent metabolic diseases, endocrine disorders, and other medical conditions, such as alcoholic cardiomyopathy, alcoholic hypertension, heart and vascular lesions, alcoholic liver disease, alcoholic pancreatitis, etc. Alcohol abuse leads to damage to the nervous system, which can result in neurological and mental disorders, including alcoholic polyneuropathy, psychosis, and alcohol dementia. The complexity and versatility of the harmful effects of regular alcohol consumption on the human body can be considered in the perspective of a chronobiological approach, because alcohol is chronotoxic to biological processes. As a rhythm regulator, melatonin exerts a wide range of different effects: circadian rhythm regulation, thermoregulation, sleep induction, antioxidant, immunomodulatory, and anti-stress ones. This review presents from a chronobiological perspective the impact of melatonin on alcohol intoxication in terms of mental disorders, sleep and inflammation, hepatic injury, and mitochondrial function. It discusses the main clinical effects of melatonin on alcohol injury and the main targets as a therapy for alcohol disorders. Chronobiological effects of ethanol are related to melatonin suppression that has been associated with, among others, cancer risk. Exogenous melatonin seems to be a promising hepato- and immune-protector due to its antioxidant and anti-inflammatory properties, which in combination with other medicines makes it useful to prevent alcoholic organ damage. The reason for the scientific interest in melatonin as a treatment for alcoholism is obvious; the number of cases of this pathology that gives rise to metabolic syndrome, and its subsequent transformation into steatohepatitis, liver fibrosis, and cirrhosis, is increasing worldwide. Melatonin not only exerts antioxidant effects but it exerts various other effects contributing to the management of liver conditions. This review discusses the interaction between normal and pathological processes caused by alcohol consumption and the relationship between alcohol and melatonin in these conditions.

Neurocognitive performance in alcohol use disorder using the NIH toolbox: Role of severity and sex differences

AIMS

Sustained heavy alcohol consumption is associated with a range of neurocognitive deficits. Yet, past research centers on a severe profile of alcohol use disorder (AUD), with persons recruited from in-patient settings. The current project aims to compare neurocognitive performance between individuals seeking AUD outpatient treatment with healthy comparisons while considering the association between performance, disorder severity, and sex.

METHODS

Enrollment included two matched groups (N = 125; 34 % female): 77 treatment-seeking individuals with AUD; 48 healthy comparison individuals with low drinking patterns. Neurocognitive performance on NIH Toolbox subtests measuring attention, inhibition, episodic memory, working memory, language, and processing speed were compared across groups. Within the AUD group, analyses examined the relationship between performance, disorder severity, recent alcohol consumption, and sex.

RESULTS

AUD group did not perform significantly lower than healthy comparisons on neurocognition subtests assessed. Within AUD group, females displayed significantly higher processing speeds than males (p = .007). Disorder severity and alcohol consumption were not significantly related to performance. However, a significant interaction between disorder severity and sex emerged (p = .010), with higher severity associated with poorer performance in males but not females, on a subtest measuring attention and inhibition.

CONCLUSIONS

Effect of heavy alcohol use on neurocognitive performance was not detected in this outpatient AUD sample. Weaknesses in domains of attention and inhibition may be correlated with AUD severity among males, but not females. Further research on AUD severity and sex in understanding individual differences in neurocognition is warranted, particularly using novel tools for large scale phenotyping, such as the NIH Toolbox.

Changes in the global burden of depression from 1990 to 2017: Findings from the Global Burden of Disease study

OBJECTIVE

Depression is the most common mental illness worldwide. It has become an important public health problem. This study aimed to determine the global burden of depression and how it has changed between 1990 and 2017.

METHODS

We used information on depression obtained by the Global Burden of Disease (GBD) study from 1990 to 2017. The age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were used to assess the global burden of depression.

RESULTS

The number of incident cases of depression worldwide increased from 172 million in 1990 to 25,8 million in 2017, representing an increase of 49.86%. The ASR of depression varied widely between the 195 analyzed countries and regions in 2017, being highest in Lesotho (6.59 per 1000) and lowest in Myanmar (1.28 per 1000). The ASR increased the most between 1990 and 2017 in Belgium (EAPC = 0.88, 95% confidence interval [CI] = 0.78 to 0.97), and decreased the most in Cuba (EAPC = -1.26, 95% CI = -1.36 to -1.14). The ASR increased in regions with a high sociodemographic index, such as high-income North America (EAPC = 0.41, 95% CI = 0.31 to 0.51), and decreased significantly in South Asia (EAPC = -0.63, 95% CI = -0.85 to -0.41). The proportions of the population with major depressive disorder and dysthymia were essentially stable both globally and in various countries, with a much larger proportion having major depressive disorder.

CONCLUSION

Depression remains a major public health issue, and governments should support the research necessary to develop better prevention and treatment interventions.

Screening for alcohol use disorder among individuals with comorbid psychiatric disorders: Diagnostic accuracy in a sample of young Swiss men

Alcohol use disorder (AUD) is frequently comorbid with other psychiatric disorders. However, few studies investigated the psychometric properties of AUD screening tools in presence of co-occurring disorders. This study examined the diagnostic accuracy of a short AUD screening tool among young adults, in the presence of high vs. low or moderate symptomatology of other common psychiatric disorders. Data were collected among young Swiss men (n = 233) between 2016 and 2018. Measures included a diagnostic interview for AUD and screening tools for AUD and other psychiatric disorders (attention deficit hyperactivity disorder, antisocial personality disorder, bipolar disorder, borderline personality disorder, major depressive disorder, and social anxiety disorder). We computed receiver operating characteristic curves to test whether the AUD screening tool was an accurate indicator of AUD for groups with high vs. low or moderate symptomatology of each psychiatric disorder. The results showed that the optimal cut-off score was ≥3 (the original cut-off of the scale) for participants with a low or moderate symptomatology and ≥4 for participants with a high symptomatology. Our findings highlighted the urgent need for an integrated approach to screening. Psychiatric comorbidities should be included in the screen for AUD to obtain accurate results.

Pre-clinical models of reward deficiency syndrome: A behavioral octopus

Individuals with mood disorders or with addiction, impulsivity and some personality disorders can share in common a dysfunction in how the brain perceives reward, where processing of natural endorphins or the response to exogenous dopamine stimulants is impaired. Reward Deficiency Syndrome (RDS) is a polygenic trait with implications that suggest cross-talk between different neurological systems that include the known reward pathway, neuroendocrine systems, and motivational systems. In this review we evaluate well-characterized animal models for their construct validity and as potential models for RDS. Animal models used to study substance use disorder, major depressive disorder (MDD), early life stress, immune dysregulation, attention deficit hyperactivity disorder (ADHD), post traumatic stress disorder (PTSD), compulsive gambling and compulsive eating disorders are discussed. These disorders recruit underlying reward deficiency mechanisms in multiple brain centers. Because of the widespread and remarkable array of associated/overlapping behavioral manifestations with a common root of hypodopaminergia, the basic endophenotype recognized as RDS is indeed likened to a behavioral octopus. We conclude this review with a look ahead on how these models can be used to investigate potential therapeutics that target the underlying common deficiency.

Inhibitory influence of agmatine in ethanol withdrawal-induced depression in rats: Behavioral and neurochemical evidence

Although ethanol withdrawal depression is one of the prominent reasons for ethanol consumption reinstatement and ethanol dependence, its neurochemical basis is not clearly understood. The present study investigated the role of the agmatinergic system in ethanol withdrawal-induced depression using the forced swim test (FST) in rats. Chronic exposure of animals to ethanol for 21 days and its abrupt withdrawal produced depression-like behavior, as evidenced by increased immobility time in the FST, compared to the pair-fed control animals. The ethanol withdrawal-induced depression was significantly attenuated by agmatine (20-40 μg/rat, i.c.v. [intracerebroventricularly]), moxonidine (50 μg/rat, i.c.v.), 2-BFI (20 μg/rat, i.c.v.), L-arginine (80 μg/rat, i.c.v.), amino-guanidine (25 μg/rat, i.c.v.), and arcaine (50 μg/rat, i.c.v.) by their once-daily administration during the withdrawal phase (Days 21, 22, and 23). The antidepressant effect of agmatine in ethanol-withdrawn rats was potentiated by the imidazoline receptor I₁ agonist moxonidine (25 μg/rat, i.c.v.) and the imidazoline receptor I₂ agonist, 2-BFI (10 μg/rat, i.c.v.) at their sub-effective doses. On the other hand, it was completely blocked by the imidazoline receptor I₁ antagonist, efaroxan (10 μg/rat, i.c.v.) and the imidazoline receptor I₂ antagonist, idazoxan (4 μg/rat, i.c.v.). In addition, agmatine levels were significantly reduced in brain samples of ethanol-withdrawn rats as compared to the pair-fed control animals. In conclusion, the present study suggests the importance of the endogenous agmatinergic system and the imidazoline receptors system in ethanol withdrawal-induced depression. The data project agmatine as a potential therapeutic target for the alcohol withdrawal-induced depression.

Administration of a putative pro-dopamine regulator, a neuronutrient, mitigates alcohol intake in alcohol-preferring rats

BACKGROUND

Excessive alcohol intake is a serious but preventable public health problem in the United States and worldwide. Alcohol and other substance use disorders occur co-morbid with more generalized reward deficiency disorders, characterized by a reduction in dopamine (DA) signaling within the reward pathway, and classically associated with increased impulsivity, risk taking and subsequent drug seeking behavior. It is postulated that increasing dopamine availability and thus restoring DA homeostasis in the mesocorticolimbic system could reduce the motivation to seek and consume ethanol. Here, we treated animals with a neuro-nutrient, KB220Z also known as Synaptamine, designed to augment DA signaling.

METHOD

KB220Z was administered to genetically alcohol-preferring (P) adult male and female rats by oral gavage (PO), intraperioneally (IP), or subcutaneously (SQ) for 4 consecutive days at a 3.4 mL/Kg rat equivalent dose and compared to saline (SQ, IP) or water (PO) controls. Subsequent to treatment, lever pressing and consumption of 10 % ethanol or control 3% sucrose during operant responding was assessed using a drinking in the dark multiple scheduled access (DIDMSA) binge drinking protocol. Locomotor and elevated zero maze activity, and DRD2 mRNA expression via in situ hybridization (ISH) were assessed independently following 4 days of a SQ regimen of KB220Z.

RESULTS

KB220Z administered via IP and SQ markedly and immediately reduced binge drinking of 10 % ethanol in both male and female rats whereas PO administration took at least 3 days to decrease lever pressing for ethanol in both male and female rats. There was no effect of SQ KB220Z on 3% sucrose drinking. Elevated activity in the open field was significantly decreased, and time spent in the open arm of the EZM was moderately reduced. The regimen of SQ KB220Z did not impact the number of DRD2 punctae in neurons of the NAc, but the NAc shell expressed more DRD2 mRNA/cell than NAc core independent of KB220Z.

CONCLUSION

KB220Z attenuates ethanol drinking and other RDS behaviors in P rats possibly by acting on the dopaminergic system, but not by effecting an increase in NAc DRD2 mRNA expression.

Prevalence, Demographic, and Clinical Correlates of Comorbid Depressive Symptoms in Chinese Psychiatric Patients With Alcohol Dependence

BACKGROUND

Depressive symptoms are common among psychiatric patients with alcohol dependence (AD). However, the prevalence and clinical correlates of comorbid depressive symptoms are less well studied in Chinese Han patients.

METHODS

In this hospital-based survey, we recruited 378 psychiatric patients diagnosed with AD according to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV). All patients completed the Beck Depression Inventory (BDI) to evaluate depressive symptoms and the Alcohol Use Disorders Identification Test (AUDIT) to assess the severity of drinking.

RESULTS

Compared to patients without depressive symptoms, 48.9% (185/378) of the patients with comorbid depressive symptoms were younger, had a more unstable marital status, had a higher AUDIT total score, and had a higher adverse consequences subscore (all P < 0.05). Further logistic regression analysis showed that unstable marital status (Odds ratios [OR] = 2.20, 95% confidence interval [CI] 1.21-3.99) and AUDIT total score (OR=1.07, 95% CI 1.03-1.11) were significantly associated with depressive symptoms.

CONCLUSIONS

Our findings indicate high comorbidity between AD and depressive symptoms in Chinese psychiatric patients. Moreover, some variables are correlates of comorbid depressive symptoms. Particular attention should be paid to the early detection and intervention for this comorbid condition and its risk factors.