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Peng Q, Gilder DA, Bernert RA, Karriker-Jaffe KJ, Ehlers CL. Genetic factors associated with suicidal behaviors and alcohol use disorders in an American Indian population. Mol Psychiatry 2024; 29:902-913. [PMID: 38177348 PMCID: PMC11176067 DOI: 10.1038/s41380-023-02379-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/06/2024]
Abstract
American Indians (AI) demonstrate the highest rates of both suicidal behaviors (SB) and alcohol use disorders (AUD) among all ethnic groups in the US. Rates of suicide and AUD vary substantially between tribal groups and across different geographical regions, underscoring a need to delineate more specific risk and resilience factors. Using data from over 740 AI living within eight contiguous reservations, we assessed genetic risk factors for SB by investigating: (1) possible genetic overlap with AUD, and (2) impacts of rare and low-frequency genomic variants. Suicidal behaviors included lifetime history of suicidal thoughts and acts, including verified suicide deaths, scored using a ranking variable for the SB phenotype (range 0-4). We identified five loci significantly associated with SB and AUD, two of which are intergenic and three intronic on genes AACSP1, ANK1, and FBXO11. Nonsynonymous rare and low-frequency mutations in four genes including SERPINF1 (PEDF), ZNF30, CD34, and SLC5A9, and non-intronic rare and low-frequency mutations in genes OPRD1, HSD17B3 and one lincRNA were significantly associated with SB. One identified pathway related to hypoxia-inducible factor (HIF) regulation, whose 83 nonsynonymous rare and low-frequency variants on 10 genes were significantly linked to SB as well. Four additional genes, and two pathways related to vasopressin-regulated water metabolism and cellular hexose transport, also were strongly associated with SB. This study represents the first investigation of genetic factors for SB in an American Indian population that has high risk for suicide. Our study suggests that bivariate association analysis between comorbid disorders can increase statistical power; and rare and low-frequency variant analysis in a high-risk population enabled by whole-genome sequencing has the potential to identify novel genetic factors. Although such findings may be population specific, rare functional mutations relating to PEDF and HIF regulation align with past reports and suggest a biological mechanism for suicide risk and a potential therapeutic target for intervention.
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Affiliation(s)
- Qian Peng
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA.
| | - David A Gilder
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
| | - Rebecca A Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | | | - Cindy L Ehlers
- Department of Neuroscience, The Scripps Research Institute, La Jolla, CA, USA
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2
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Ortiz A, Park Y, MacLean S, Husain MI, Sanches M, Ravindran A, Mulsant BH. A History of Suicide Attempt Is Associated with Increased Sympathetic Activation in Bipolar Disorder. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:126-137. [PMID: 37583363 PMCID: PMC10789230 DOI: 10.1177/07067437231194334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Suicide risk in bipolar disorder (BD) is estimated to be up to 20 times higher than in the general population. While there is a large body of evidence suggesting that increased sympathetic activation is associated with disease and death, there is a paucity of research on the role of autonomic nervous system (ANS) dysfunction in patients with BD who have attempted suicide. METHODS Fifty-three participants with BD used a wearable device to assess the association between history of suicide attempt, current suicidal ideation, and ANS dysfunction, including measures of heart rate variability (HRV) and respiratory rate. Data were analyzed in a series of unadjusted and adjusted bivariate models of association controlling for relevant variables. RESULTS A history of suicide attempts was significantly associated with an increase in respiratory rate (p < 0.01). These results remained significant after adjusting for age, BMI, and current mood state. There was no association between current suicidal ideation and heart rate or respiratory rate. In the frequency domain, HRV parameters suggest reduced parasympathetic (i.e., vagal) activity in participants with a history of suicide attempts and in those with current suicidality, suggesting changes in sympathicovagal balance in BD. CONCLUSIONS Our results suggest that changes in the ANS in patients with BD and a history of suicide attempt are not restricted to pure vagally mediated HRV parameters, but rather signal a general ANS dysregulation. This ANS imbalance may be contributing to illness burden and cardiovascular disease. Further research on the relationship between ANS and suicidality in BD is needed.
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Affiliation(s)
- Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Yunkyung Park
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephane MacLean
- Institute for Mental Health Research, The Royal Ottawa Hospital, Ottawa, Ontario, Canada
| | - M. Ishrat Husain
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Marcos Sanches
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Arun Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Benoit H. Mulsant
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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3
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Peltzman T, Park J, Shiner B. Development and validation of a prognostic index for mental health and substance use disorder burden. Gen Hosp Psychiatry 2023; 85:213-219. [PMID: 37988871 DOI: 10.1016/j.genhosppsych.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To develop an accessible index which quantifies MHSUD burden among patients of Veterans Affairs hospitals. METHOD We used 21 disorder categories provided by the diagnostic and statistical manual (DSM) to characterize diagnoses among primary care (PC) patients. For each patient, we generated counts of unique disorder categories present during the PC encounter or in the year prior. We used these counts to generate multiple indexes, which we compared in a 60% training sample of our population. Using model fit statistics generated from ordered multinomial logistic regressions, we identified the subset of DSM categories which, structured as index, were most predictive of MHSUD hospitalization and death. We validated and fine-tuned the form of the selected index in the full population using measures of calibration and discrimination. RESULTS In model development, the index (I-6) which best fit the data (R2 = 0.191) included the following six disorder categories: substance use, depressive, psychotic, bipolar, trauma, and personality. When applied in the full population and weighted by disorder severity, this index demonstrated good predictive discrimination for MHSUD death (C = 0.66) and hospitalization (C = 0.88) and was well calibrated in comparisons of observed versus predicted outcomes. CONCLUSIONS We recommend the I-6 as a parsimonious and effective tool for MHSUD burden risk adjustment.
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Affiliation(s)
- Talya Peltzman
- Veterans Affairs Medical Center, White River Junction, VT, USA.
| | - Jenna Park
- Veterans Affairs Medical Center, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA
| | - Brian Shiner
- Veterans Affairs Medical Center, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; National Center for Posttraumatic Stress Disorder, White River, Junction, VT, USA
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4
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Gilder D, Bernert R, Karriker-Jaffe K, Ehlers C, Peng Q. Genetic Factors Associated with Suicidal Behaviors and Alcohol Use Disorders in an American Indian Population. RESEARCH SQUARE 2023:rs.3.rs-2950284. [PMID: 37398076 PMCID: PMC10312956 DOI: 10.21203/rs.3.rs-2950284/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
American Indians (AI) demonstrate the highest rates of both suicidal behaviors (SB) and alcohol use disorders (AUD) among all ethnic groups in the US. Rates of suicide and AUD vary substantially between tribal groups and across different geographical regions, underscoring a need to delineate more specific risk and resilience factors. Using data from over 740 AI living within eight contiguous reservations, we assessed genetic risk factors for SB by investigating: (1) possible genetic overlap with AUD, and (2) impacts of rare and low frequency genomic variants. Suicidal behaviors included lifetime history of suicidal thoughts and acts, including verified suicide deaths, scored using a ranking variable for the SB phenotype (range 0-4). We identified five loci significantly associated with SB and AUD, two of which are intergenic and three intronic on genes AACSP1, ANK1, and FBXO11. Nonsynonymous rare mutations in four genes including SERPINF1 (PEDF), ZNF30, CD34, and SLC5A9, and non-intronic rare mutations in genes OPRD1, HSD17B3 and one lincRNA were significantly associated with SB. One identified pathway related to hypoxia-inducible factor (HIF) regulation, whose 83 nonsynonymous rare variants on 10 genes were significantly linked to SB as well. Four additional genes, and two pathways related to vasopressin-regulated water metabolism and cellular hexose transport, also were strongly associated with SB. This study represents the first investigation of genetic factors for SB in an American Indian population that has high risk for suicide. Our study suggests that bivariate association analysis between comorbid disorders can increase statistical power; and rare variant analysis in a high-risk population enabled by whole-genome sequencing has the potential to identify novel genetic factors. Although such findings may be population specific, rare functional mutations relating to PEDF and HIF regulation align with past reports and suggest a biological mechanism for suicide risk and a potential therapeutic target for intervention.
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5
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Chu CS, Huang KL, Bai YM, Su TP, Tsai SJ, Chen TJ, Hsu JW, Liang CS, Chen MH. Risk of suicide after a diagnosis of sleep apnea: A nationwide longitudinal study. J Psychiatr Res 2023; 161:419-425. [PMID: 37028128 DOI: 10.1016/j.jpsychires.2023.03.028] [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: 08/03/2022] [Revised: 02/15/2023] [Accepted: 03/19/2023] [Indexed: 04/09/2023]
Abstract
Previous studies have presented evidence on the association between sleep apnea and suicidal ideation and planning, but the relationship between a clinical diagnosis of sleep apnea and suicide attempts remains unknown. We investigated the risk of suicide after a diagnosis with sleep apnea using data from a nationwide community-based population database, i.e., the Taiwan National Health Insurance Research Database. We recruited 7,095 adults with sleep apnea and 28,380 age-, sex-, and comorbidity-matched controls between 1998 and 2010 and followed them up until the end of 2011. Individuals who exhibited any (once or repeated) suicide attempts were identified during the follow-up period. The E value was calculated for unmeasured bias. Sensitivity analysis was conducted. Patients with sleep apnea were more likely to carry out any suicide attempt (hazard ratio: 4.53; 95% confidence interval: 3.48-5.88) during the follow-up period than the controls after adjusting for demographic data, mental disorders, and physical comorbidities. The hazard ratio remained significant after excluding individuals with mental disorders (4.23; 3.03-5.92). The hazard ratio was 4.82 (3.55-6.56) for male patients and 3.86 (2.33-6.38) for female patients. Consistent findings of increased risk of repeated suicide attempt were found among patients with sleep apnea. No association was found between continuous positive airway pressure treatment and suicide risk. The calculated E values support suicide risk after the diagnosis of sleep apnea. The risk of suicide was 4.53-fold higher in patients diagnosed with sleep apnea than in their counterparts without sleep apnea.
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Affiliation(s)
- Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan; Non-invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Riblet NBV, Watts BV. Another Reason to Quit Smoking: Results of a Prospective Study Examining Smoking, COPD, and Suicide. Chest 2023; 163:259-261. [PMID: 36759108 PMCID: PMC9923874 DOI: 10.1016/j.chest.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/15/2022] [Accepted: 10/17/2022] [Indexed: 02/10/2023] Open
Affiliation(s)
- Natalie B V Riblet
- Veterans Affairs Medical Center, White River Junction VA Medical Center, White River Junction, VT; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH; Dartmouth Institute, Geisel School of Medicine, Dartmouth College, Hanover, NH.
| | - Bradley V Watts
- Veterans Affairs Medical Center, White River Junction VA Medical Center, White River Junction, VT; Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH; Veterans Rural Health Resource Center, White River Junction VA Medical Center, White River Junction, VT
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7
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Dahlberg K, Jaensson M, Cao Y, Näslund E, Stenberg E. Incidence of self-harm after bariatric surgery: A nationwide registry-based matched cohort study. Clin Obes 2023; 13:e12576. [PMID: 36610057 DOI: 10.1111/cob.12576] [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: 10/07/2022] [Revised: 12/02/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023]
Abstract
The aims of this study were to evaluate the longitudinal risk of self-harm and the risk factors for self-harm after bariatric surgery in patients and control subjects without prior self-harm. This observational cohort study was based on prospectively registered data. Patients 18-70 years at time of surgery, body mass index (BMI) > 30 kg/m2 , who underwent a primary Roux-en-Y gastric bypass (RYGB) procedure or a primary sleeve gastrectomy between 2007 and 2019 were considered for inclusion. All patients who met the inclusion criteria were matched 1:10 to the general population in Sweden (69 492 patients vs. 694 920 controls). After excluding patients and controls with previous self-harm, a self-harm event occurred in 1408 patients in the surgical group (incidence rate (IR) 3.54/1000 person-years, 95% confidence interval (CI) 3.36-3.73) versus in 3162 patients in the control group (IR 0.81/1000 person-years, 95% CI 0.78-0.84), with a hazard ratio (HR) of 4.38 (95% CI 4.11-4.66, p < .001). Median follow-up time was 6.1 years. Risk factors were younger age, lower BMI, cardiovascular, and chronic obstructive pulmonary disease, all aspects of psychiatric comorbidities (except neuropsychiatric disorder), lower socioeconomic status, RYGB, lower health-related quality of life, lower postoperative weight loss, and not attending postoperative follow-up visits. Self-harm is clearly higher after bariatric surgery than in the general population. A qualitative follow-up may be particularly important for patients at increased risk.
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Affiliation(s)
- Karuna Dahlberg
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Maria Jaensson
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Erik Näslund
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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8
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Brown A, Hellem T, Schreiber J, Buerhaus P, Colbert A. Suicide and altitude: A systematic review of global literature. Public Health Nurs 2022; 39:1167-1179. [PMID: 35537106 DOI: 10.1111/phn.13090] [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: 12/11/2021] [Revised: 03/11/2022] [Accepted: 04/16/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The purpose of this systematic review was to synthesize the existing global literature examining the relationship between altitude and suicide. METHOD Using the electronic databases PubMed, CINAHL, EMBASE, and PsychInfo published articles in English that addressed the relationship between altitude and suicide as a primary or secondary aim, and included human subjects, where identified. Studies were assessed for quality based on methodological approach and data relevance on a three-point scale (strong, moderate, or weak). RESULTS Of the 19 studies related to the purpose and aims, 17 reported evidence of a positive correlation between altitude and increased suicide. Vast design differences were employed within the literature, individual-level suicide data was identified as the preferred level of analysis. DISCUSSION The relationship between altitude and suicide is an evolving science with a small but growing body of literature suggesting altitude is associated with an increased risk of suicide. This review identifies the need for additional studies examining both individual-level suicide data and improving geographic precision. Public health nurses have a responsibility to carefully examine the quality of studies and the strength of the evidence when addressing variables associated with suicide.
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Affiliation(s)
- Anne Brown
- Montana State University, Bozeman, Montana, USA
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9
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Wang X, Zamora-Resendiz R, Shelley CD, Manore C, Liu X, Oslin DW, McMahon B, Beckham JC, Kimbrel NA, Crivelli S, MVP Suicide Exemplar Workgroup. An examination of the association between altitude and suicide deaths, suicide attempts, and suicidal ideation among veterans at both the patient and geospatial level. J Psychiatr Res 2022; 153:276-283. [PMID: 35868159 PMCID: PMC9462426 DOI: 10.1016/j.jpsychires.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/01/2022] [Accepted: 07/04/2022] [Indexed: 11/25/2022]
Abstract
Suicide is a major public health problem affecting US Veterans and the US in general. Many variables (e.g., demographic, clinical, biological, geographic) have been associated with risk for suicide and suicidal behavior, including altitude; however, the exact nature of the relationship between altitude and suicide remains unclear in part due to the fact that previous studies have used either geospatial data or individual-level data, but not both. Prior research has also failed to consider the full range of suicidal thoughts and behaviors, ranging from suicidal ideation to suicide deaths. Accordingly, the objective of the present research was to use both geospatial data (county and zip codes) and individual-level data to comprehensively assess the association between altitude and suicide mortality, suicide attempts, and suicidal ideation among US Veterans between 2000 and 2018. Taken together, our results demonstrate that there is a strong correlation between altitude and suicide rates at all the levels investigated and using different statistical analyses and even after controlling for significant covariates such as percent of age >50yr, percent male, percent white, percent non-Hispanic, median household income, and population density. We show that there is a positive correlation between altitude and suicide attempts especially when controlling by the covariates and a weak correlation between altitude and suicide ideation and the combination of suicide, suicide attempts and suicide ideation.
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Affiliation(s)
- Xiange Wang
- Applied Mathematics and Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.
| | - Rafael Zamora-Resendiz
- Applied Mathematics and Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Courtney D Shelley
- Departments of Mathematics and Statistics, University of California, Los Angeles, CA, USA
| | - Carrie Manore
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Xinlian Liu
- Departments of Computer Science, Hood College, Frederick, MD, USA
| | - David W Oslin
- VISN 4 Mental Illness Research, Education, and Clinical Center, Center of Excellence, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA; Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, PA, USA
| | - Benjamin McMahon
- Theoretical Biology and Biophysics, Los Alamos National Laboratory, Los Alamos, NM, USA
| | - Jean C Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC, USA
| | - Silvia Crivelli
- Applied Mathematics and Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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10
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Nguyen KT, Gates CA, Hassell JE, Foxx CL, Salazar SN, Luthens AK, Arnold AL, Elam BL, Elsayed AI, Leblanc M, Adams SC, Lowry CA, Reuter JD. Evaluation of the effects of altitude on biological signatures of inflammation and anxiety- and depressive-like behavioral responses. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110331. [PMID: 33891978 DOI: 10.1016/j.pnpbp.2021.110331] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 12/11/2022]
Abstract
Over sixteen million people suffer from a depressive episode annually in the United States, with females affected at twice the rate of males. Little is known about the effects of exposure to high altitude on the risk of development of major depressive disorder, despite reports of higher suicide rates at higher altitudes. We hypothesize that exposure to hypobaric hypoxia at high altitude increases endophenotypes of self-directed suicidal violence, including biological signatures of chronic inflammation and vulnerability to anxiety-like and depressive-like behavioral responses in a sex-specific manner. Biological signatures of inflammation, including granulocyte:lymphocyte ratios, monocyte cell counts, and monocyte:lymphocyte ratios were assessed using complete blood count data, anhedonia, and anxiety- and depressive-like behavioral responses were evaluated. We assessed biological signatures of inflammation and behavioral responses in the open-field test, sucrose preference test, and modified Porsolt forced swim test in young adult male and female Long-Evans and Sprague Dawley rats. All tests were conducted near sea level (374 ft [114 m] elevation) and at moderate-high altitude (5430 ft [1655 m] elevation) during acclimation periods of one, two, three, four, and five weeks following shipment from a sea level animal breeding facility (N = 320, n = 8 per group). Exposure to moderate-high altitude induced a biological signature of increased inflammation, as evidenced by main effects of altitude for: 1) increased granulocyte:lymphocyte ratio; 2) increased count and relative abundance of circulating monocytes; and 3) increased monocyte:lymphocyte ratios. Exposure to moderate-high altitude also increased anhedonia as assessed in the sucrose preference test in both male and female rats, when data were collapsed across strain and time. Among male and female Long Evans rats, exposure to moderate-high altitude increased immobility in the forced swim test, without changing anxiety-like behaviors in the open-field test. Finally, granulocyte:lymphocyte ratios were correlated with anhedonia in the sucrose preference test. These data are consistent with the hypothesis that hypobaric hypoxia at moderate-high altitude induces persistent endophenotypes of self-directed suicidal violence including biological signatures of inflammation, anhedonia, and depressive-like behavioral responses.
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Affiliation(s)
- Kadi T Nguyen
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Chloé A Gates
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - James E Hassell
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Christine L Foxx
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Stephanie N Salazar
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Amalia K Luthens
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Andrea L Arnold
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Brooke L Elam
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Ahmed I Elsayed
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA.
| | - Mathias Leblanc
- Animal Resources Department, Gene Expression Laboratory, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
| | - Sean C Adams
- Animal Resources Department, Gene Expression Laboratory, The Salk Institute for Biological Studies, La Jolla, CA 92037, USA.
| | - Christopher A Lowry
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Center for Microbial Exploration, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Physical Medicine & Rehabilitation and Center for Neuroscience, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA; Veterans Health Administration, Rocky Mountain Mental Illness Research Education and Clinical Center (MIRECC), Rocky Mountain Regional Veterans Affairs Medical Center (RMRVAMC), Aurora, CO 80045, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Aurora, CO 80045, USA.
| | - Jon D Reuter
- Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA; Office of Animal Resources, University of Colorado Boulder, Boulder, CO 80309, USA.
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11
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Cornelius SL, Berry T, Goodrich AJ, Shiner B, Riblet NB. The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157809. [PMID: 34360101 PMCID: PMC8345465 DOI: 10.3390/ijerph18157809] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/07/2021] [Accepted: 07/20/2021] [Indexed: 12/07/2022]
Abstract
Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.
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Affiliation(s)
- Sarah L. Cornelius
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Correspondence: ; Tel.: +1-(802)-295-9363
| | - Tara Berry
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
| | - Amanda J. Goodrich
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90033, USA;
| | - Brian Shiner
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
| | - Natalie B. Riblet
- VA Medical Center, White River Junction, VT 05009, USA; (T.B.); (B.S.); (N.B.R.)
- Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, USA
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12
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Swann AC, Graham DP, Wilkinson AV, Kosten TR. Nicotine Inhalation and Suicide: Clinical Correlates and Behavioral Mechanisms. Am J Addict 2021; 30:316-329. [PMID: 34109688 DOI: 10.1111/ajad.13171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/26/2021] [Accepted: 03/06/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Extensive evidence links smoking and suicide independently of psychiatric diagnoses, but there are questions about the pathophysiology and specificity of this relationship. We examined characteristics of this linkage to identify potential transdiagnostic mechanisms in suicide and its prevention. METHODS We reviewed literature that associated suicide with smoking and e-cigarettes, including the temporal sequence of smoking and suicide risk and their shared behavioral risk factors of sensitization and impulsivity. RESULTS Smoking is associated with increased suicide across psychiatric diagnoses and in the general population, proportionately to the number of cigarettes smoked per day. Rapid nicotine uptake into the brain through inhalation of conventional cigarettes, electronic cigarettes (e-cigarette), or even second-hand smoke can facilitate long-term sensitization and short-term impulsivity. Both impair action regulation and predispose to negative affect, continued smoking, and suicidal behavior. Intermittent hypoxia, induced by cigarettes or e-cigarettes, synergistically promotes impulsivity and sensitization, exacerbating suicidality. Two other shared behavioral risks also develop negative urgency (combined impulsivity and negative affect) and cross-sensitization to stressors or to other addictive stimuli. Finally, early smoking onset, promoted by e-cigarettes in never-smokers, increases subsequent suicide risk. CONCLUSION AND SCIENTIFIC SIGNIFICANCE Prevention or cessation of nicotine inhalation can strategically prevent suicidality and other potentially lethal behavior regardless of psychiatric diagnoses. Medications for reducing smoking and suicidality, especially in younger smokers, should consider the neurobehavioral mechanisms for acute impulsivity and longer-term sensitization, potentially modulated more effectively through glutamate antagonism rather than nicotine substitution. (Am J Addict 2021;30:316-329).
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Affiliation(s)
- Alan C Swann
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - David P Graham
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Thomas R Kosten
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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13
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Razuvaeva YG, Toropova AA, Olennikov DN, Kharzheev DV. Antihypoxic activity of the dry extract from Nepeta multifida L. Nat Prod Res 2021; 36:3105-3109. [PMID: 34085566 DOI: 10.1080/14786419.2021.1935932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The antihypoxic effect of the Nepeta multifida L. dry extract was studied in experiments on white Wistar rats. The life span of animals was determined against the background of acute hypoxias: hypercapnic, hemic, and histotoxic ones. Using the model of acute hypobaric hypoxia/reoxygenation there was evaluated the content of ATP, lactic and pyruvic acids, TBA-active products, reduced glutathione, catalase activity in brain tissue. On the model of acute hypobaric hypoxia/reoxygenation, the content of ATP, lactic and pyruvic acids, reduced glutathione and catalase activity in brain tissue The N. multifida dry extract demonstrated antihypoxic effect at the doses comprised between 100 and 300 mg/kg increasing lifespan of animals in hypercapnic, hemic and histotoxic hypoxias. N. multifida decreases the manifestation of free-radical oxidation processes, increases the activity of the endogenic antioxidant system, and promotes the efficacy of tissue respiration and oxidative phosphorylation coupling in the brain of white rats in hypoxia/reoxygenation.
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Affiliation(s)
| | - Anyuta A Toropova
- Institute of General and Experimental Biology SB RAS, Ulan-Ude, Russia
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14
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Shiner B, Peltzman T, Cornelius SL, Gui J, Jiang T, Riblet N, Gottlieb DJ, Watts BV. Influence of contextual factors on death by suicide in rural and urban settings. J Rural Health 2021; 38:336-345. [PMID: 33900641 DOI: 10.1111/jrh.12579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
PURPOSE To examine the association between contextual factors, represented by geographic and community health variables, and suicide among rural and urban Department of Veterans Affairs health care users (VA users). METHODS We performed a retrospective cohort study of 12,700,847 VA users between 2003 and 2017. We assigned contextual factors based on individuals' home address at the ZIP Code (area deprivation), county (sunlight exposure, altitude, and community health), and state level (firearm ownership), using publicly available data sources. We grouped contextual factors by quintiles or prespecified thresholds, depending on the nature of each variable. We obtained mortality data from the National Death Index. We measured the effect of living in a place with the highest versus lowest level of each contextual factor on odds of suicide using logistic regression, adjusting for individual compositional factors abstracted from VA electronic medical records data. We used random forest modeling to build prediction models for suicide based on contextual factors among rural and urban veterans. FINDINGS Almost all contextual factors we examined were significantly associated with suicide among rural and urban VA users, even after adjusting for individual compositional factors. However, no contextual variables were strong protective or risk factors (0.5<OR>2.0), and prediction models leveraging these contextual factors had poor accuracy among both rural (0.51, 95% CI: 0.48-0.54) and urban (0.53, 95% CI: 0.51-0.55) VA users. CONCLUSIONS A wide variety of contextual factors is significantly associated with suicide among rural and urban VA users. However, the factors we measured contributed very little to individual-level suicide risk.
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Affiliation(s)
- Brian Shiner
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | | | | | - Jiang Gui
- Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Tammy Jiang
- Boston University School of Public Heath, Boston, Massachusetts, USA
| | - Natalie Riblet
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Daniel J Gottlieb
- VA Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA
| | - Bradley V Watts
- Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire, USA.,Veterans Rural Health Resource Center, White River Junction, Vermont, USA.,VA Office of Systems Redesign and Improvement, Washington, DC, USA
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15
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Davoudi M, Barjasteh-Askari F, Amini H, Lester D, Mahvi AH, Ghavami V, Rezvani Ghalhari M. Association of suicide with short-term exposure to air pollution at different lag times: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 771:144882. [PMID: 33736135 DOI: 10.1016/j.scitotenv.2020.144882] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/26/2020] [Accepted: 12/26/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Suicide is a major public health problem, with some environmental risk factors. OBJECTIVES This meta-analysis study explored the association between short-term exposure to air pollution and suicide mortality, with an emphasis on different lag times. METHODS A systematic search was used to find relevant studies in databases including Scopus, Web of Knowledge, Pubmed, and Embase published up to 19 May 2020. The inclusion criteria included case-crossover or time-series studies assessing the association of criteria air pollutants with suicide mortality at different Lag Days of 0-7 (LD0 to LD7) and Cumulative Lags of 1-7 days (CL1 to CL7). Odds ratios (OR) were calculated with 95% confidence intervals (CI). RESULTS Of 1436 retrieved articles, 11 were eligible for data extraction, representing data on 283,550 suicides published between 2010 and 2019. The odds of suicide death increase with each 10 μg/m3 increase in the mean concentrations of NO2 at CL1 (1.013: 1.006-1.021), CL2 (1.028: 1.003-1.053), CL3 (1.035: 1.001-1.070), and LD2 (1.011: 1.001-1.022), SO2 at CL1 (1.024: 1.014-1.034), CL2 (1.030: 1.012-1.048), CL3 (1.029: 1.009-1.049), and CL4 (1.027: 1.005-1.049), O3 at CL6 (1.008: 1.000-1.016), PM10 at CL1 (1.004: 1.000-1.008), and PM2.5 at CL1 (1.017: 1.003-1.031). Besides, the odds of suicide death increases with each 0.5 mg/m3 increase in the mean concentration of CO at LD6 (1.005: 1.000-1.011). However, it decreased with increased O3 exposure at LD3 (0.997: 0.994-1.000). CONCLUSION The study supports a positive association between air pollution and suicide mortality. No immediate risk was elucidated but the possible effects seem to be exerted cumulatively.
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Affiliation(s)
- Mojtaba Davoudi
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Environmental Health Engineering, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fateme Barjasteh-Askari
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Homayoun Amini
- Department of Psychiatry & Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amir Hossein Mahvi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Center for Solid Waste Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
| | - Vahid Ghavami
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Rezvani Ghalhari
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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16
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Kious B, Kondo D, Renshaw P. Letter to the Editor RE: Honigman et al., Editorial Comment on: Effect of Altitude on Veteran Suicide Rates by Sabic et al. High Alt Med Biol 2020; 21:206-208. [DOI: 10.1089/ham.2019.0085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Brent Kious
- Department of Psychiatry, University of Utah Hospital, Salt Lake City, Utah, USA
| | - Douglas Kondo
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Diagnostic Neuroimaging, University of Utah, Salt Lake City, Utah, USA
| | - Perry Renshaw
- The Brain Institute, University of Utah, Salt Lake City, Utah, USA
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17
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Riblet NB, Gottlieb DJ, Hoyt JE, Watts BV, Shiner B. An analysis of the relationship between chronic obstructive pulmonary disease, smoking and depression in an integrated healthcare system. Gen Hosp Psychiatry 2020; 64:72-79. [PMID: 32279024 DOI: 10.1016/j.genhosppsych.2020.03.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Chronic Obstructive Pulmonary Disease (COPD) and smoking are highly associated with depression and hypoxia. There is limited knowledge about whether hypoxic conditions interact to cause depression. METHOD A population-based cohort study was conducted using the Veterans Affairs (VA) Corporate Data Warehouse. Patients must have accessed any healthcare at a VA facility between 2004 and 2014 and had a negative depression screen (Patient Health Questionnaire-2 (PHQ-2) score ≤ 2). Patients with COPD or a positive depression screen (PHQ-2 score: 3+) during or prior to the year with a negative depression screen were excluded. Logistic regression with annual observations was used to evaluate depression incidence based on COPD and smoking status. Models were adjusted for demographics and other comorbid conditions. A probability scale was used to examine interactions between COPD and smoking. RESULTS A total of 3,284,496 patients were included. Patients with COPD and current smokers were at increased risk for developing depression. There were minimal interaction effects between COPD and smoking. The odds of developing depression in a year varied from 1.4% among never smokers without COPD to 2.9.% among current smokers with COPD. CONCLUSION Smoking and COPD are independent risk factors for depression and interact to cause depression. Further research is needed to confirm whether hypoxia contributes to this association.
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Affiliation(s)
- Natalie B Riblet
- Veterans Affairs Medical Center, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
| | - Daniel J Gottlieb
- Veterans Affairs Medical Center, White River Junction, VT, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
| | - Jessica E Hoyt
- Veterans Affairs Medical Center, White River Junction, VT, USA.
| | - Bradley V Watts
- VA Office of Systems Redesign and Improvement, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA.
| | - Brian Shiner
- Veterans Affairs Medical Center, White River Junction, VT, USA; National Center for PTSD, White River Junction, VT, USA; Geisel School of Medicine at Dartmouth College, Hanover, NH, USA; The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA.
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18
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Hwang J, DeLisi LE, Öngür D, Riley C, Zuo C, Shi X, Sung YH, Kondo D, Kim TS, Villafuerte R, Smedberg D, Yurgelun-Todd D, Renshaw PF. Cerebral bioenergetic differences measured by phosphorus-31 magnetic resonance spectroscopy between bipolar disorder and healthy subjects living in two different regions suggesting possible effects of altitude. Psychiatry Clin Neurosci 2019; 73:581-589. [PMID: 31125152 PMCID: PMC6771782 DOI: 10.1111/pcn.12893] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 05/17/2019] [Accepted: 05/22/2019] [Indexed: 12/26/2022]
Abstract
AIM Increased oxidative stress in cerebral mitochondria may follow exposure to the systemic hypobaric hypoxia associated with residing at higher altitudes. Because mitochondrial dysfunction is implicated in bipolar disorder (BD) pathophysiology, this may impact the cerebral bioenergetics in BD. In this study, we evaluated the cerebral bioenergetics of BD and healthy control (HC) subjects at two sites, located at sea level and at moderate altitude. METHODS Forty-three veterans with BD and 33 HC veterans were recruited in Boston (n = 22) and Salt Lake City (SLC; n = 54). Levels of phosphocreatine, β nucleoside triphosphate (βNTP), inorganic phosphate, and pH over total phosphate (TP) were measured using phosphorus-31 magnetic resonance spectroscopy in the following brain regions: anterior cingulate cortex and posterior occipital cortex, as well as bilateral prefrontal and occipitoparietal (OP) white matter (WM). RESULTS A significant main effect of site was found in βNTP/TP (Boston > SLC) and phosphocreatine/TP (Boston < SLC) in most cortical and WM regions, and inorganic phosphate/TP (Boston < SLC) in OP regions. A main effect analysis of BD diagnosis demonstrated a lower pH in posterior occipital cortex and right OP WM and a lower βNTP/TP in right prefrontal WM in BD subjects, compared to HC subjects. CONCLUSION The study showed that there were cerebral bioenergetic differences in both BD and HC veteran participants at two different sites, which may be partly explained by altitude difference. Future studies are needed to replicate these results in order to elucidate the dysfunctional mitochondrial changes that occur in response to hypobaric hypoxia.
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Affiliation(s)
- Jaeuk Hwang
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Department of Psychiatry, Soonchunhyang University Hospital, Seoul, South Korea
| | - Lynn E DeLisi
- US Department of Veterans Affairs Boston Healthcare System, Brockton, USA
| | - Dost Öngür
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Colin Riley
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Chun Zuo
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Xianfeng Shi
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Young-Hoon Sung
- Department of Psychiatry, University of Utah, Salt Lake City, USA
| | - Douglas Kondo
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
| | - Tae-Suk Kim
- Department of Psychiatry, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, South Korea
| | - Rosemond Villafuerte
- Brain Imaging Center, McLean Hospital, Department of Psychiatry, Harvard Medical School, Belmont, USA
| | - Diane Smedberg
- US Department of Veterans Affairs Boston Healthcare System, Brockton, USA
| | - Deborah Yurgelun-Todd
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
| | - Perry F Renshaw
- Department of Psychiatry, University of Utah, Salt Lake City, USA.,Rocky Mountain Mental Illness Research, Education and Clinical Center, US Department of Veterans Affairs Healthcare System, Salt Lake City, USA
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19
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Kious BM, Kondo DG, Renshaw PF. Creatine for the Treatment of Depression. Biomolecules 2019; 9:E406. [PMID: 31450809 PMCID: PMC6769464 DOI: 10.3390/biom9090406] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/19/2019] [Accepted: 08/21/2019] [Indexed: 12/28/2022] Open
Abstract
Depressed mood, which can occur in the context of major depressive disorder, bipolar disorder, and other conditions, represents a serious threat to public health and wellness. Conventional treatments are not effective for a significant proportion of patients and interventions that are often beneficial for treatment-refractory depression are not widely available. There is, therefore, an immense need to identify novel antidepressant strategies, particularly strategies that target physiological pathways that are distinct from those addressed by conventional treatments. There is growing evidence from human neuroimaging, genetics, epidemiology, and animal studies that disruptions in brain energy production, storage, and utilization are implicated in the development and maintenance of depression. Creatine, a widely available nutritional supplement, has the potential to improve these disruptions in some patients, and early clinical trials indicate that it may have efficacy as an antidepressant agent.
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Affiliation(s)
- Brent M Kious
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, USA.
| | - Douglas G Kondo
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, USA
- George E. Wahlen Veterans Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
| | - Perry F Renshaw
- Diagnostic Neuroimaging, Department of Psychiatry, University of Utah, 383 Colorow Drive, Salt Lake City, UT 84108, USA
- George E. Wahlen Veterans Affairs Medical Center, 500 Foothill Drive, Salt Lake City, UT 84148, USA
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