1
|
Hüfner K, Vedova S, Tymoszuk P, Nelles P, Bruckner T, Deisenhammer EA, Egeter J, Galffy M, Giesinger JM, Lehmann J, Oberhammer M, Rockenschaub J, Sacher M, Holzner B, Gostner JM, Sperner-Unterweger B. The effect of inflammation, SARS-CoV-2 infection, age and mental health on serotonin, and kynurenine and catecholamine pathway metabolites. Psychoneuroendocrinology 2023; 156:106334. [PMID: 37481962 DOI: 10.1016/j.psyneuen.2023.106334] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/12/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND A high prevalence of mental disorders following COVID-19 has been described. It is therefore essential to elucidate underlying biological mechanisms linking SARS-CoV-2 infection and mental health. The kynurenine and catecholamine metabolic pathways are modulated by inflammation and can affect systemic levels of serotonin and dopamine. Their activity may hence link physical disorders with mental health. We investigated factors that affect kynurenine and catecholamine pathway activity in SARS-CoV-2 infection and recovery. METHODS The cross-sectional SIMMUN (n = 165) and longitudinal INCOV cohort (n = 167, Su et al. 2022) were analyzed. Demographic and clinical characteristic, inflammatory markers, SARS-CoV-2 infection, symptoms of depression and anxiety (HADS), and mental stress (PSS-4) served as explanatory variables. Blood serotonin and markers of kynurenine (kynurenine/tryptophan ratio), and catecholamine pathway activity (dopamine 3-O-sulfate, phenylalanine/tyrosine ratio) were modeled by multi-parameter linear regression. RESULTS In the SIMMUN cohort, the inflammatory marker neopterin (β = 0.47 [95% CI: 0.34-0.61]), SARS-CoV-2-positivity (0.42 [0.16-0.68]), mental stress (0.18 [0.055-0.31]), and age (0.26 [0.12-0.39]) were positively associated with the kynurenine/tryptophan ratio. The phenylalanine/tyrosine ratio was lower in SARS-CoV-2-positive than uninfected participants (-0.38 [-0.68 to -0.08]). In the INCOV cohort, markers of inflammation were associated with lower serotonin (IL6: -0.22 [-0.38 to -0.053]) and dopamine 3-O-sulfate levels (interferon-gamma: -0.15 [-0.26 to -0.036]). Serotonin (0.76 [0.34-1.2]) and dopamine 3-O-sulfate levels (0.63 [0.28-0.99]) were higher during recovery than in acute SARS-CoV-2 infection. CONCLUSION SARS-CoV-2 infection, inflammation, age and mental stress are key independent predictors of kynurenine pathway activity, which may influence serotonin availability. The catecholamine pathway was also affected in SARS-CoV-2 infection. Altered activity of these pathways may contribute to impaired mental health following COVID-19.
Collapse
Affiliation(s)
- Katharina Hüfner
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria.
| | - Sophia Vedova
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Philipp Nelles
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Tobias Bruckner
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Eberhard A Deisenhammer
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria; University Hospital of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Jonas Egeter
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Matyas Galffy
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes M Giesinger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Jens Lehmann
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Maria Oberhammer
- University Hospital of Psychiatry I, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Joachim Rockenschaub
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Magdalena Sacher
- Department of Visceral, Transplant and Thoracic Surgery (VTT), Medical University Innsbruck, Innsbruck, Austria
| | - Bernhard Holzner
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| | - Johanna M Gostner
- Institute of Medical Biochemistry, Medical University Innsbruck, Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Hospital of Psychiatry II, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
2
|
Cavaleri D, Bartoli F, Capogrosso CA, Guzzi P, Moretti F, Riboldi I, Misiak B, Kishi T, Rubin RT, Fuchs D, Crocamo C, Carrà G. Blood concentrations of neopterin and biopterin in subjects with depression: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2023; 120:110633. [PMID: 36089162 DOI: 10.1016/j.pnpbp.2022.110633] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Pteridines, such as neopterin, biopterin, and tetrahydrobiopterin (BH4), may be involved in depression pathophysiology owing to their links to immune-inflammatory response, oxidative and nitrosative stress, and monoaminergic transmission. Nonetheless, studies assessing pteridines in depression are inconsistent. We conducted a systematic review and meta-analysis of observational studies comparing blood pteridine concentrations between subjects with depression and healthy controls (HCs). METHODS We searched Embase, MEDLINE, and PsycInfo for articles indexed through November 2021. Study quality was appraised, evaluating age and gender comparability between groups, sample representativeness, and methods to assess depression. Random-effects meta-analyses were carried out, generating pooled standardized mean differences (SMDs). Heterogeneity across studies was estimated using the I2 statistic. RESULTS Twenty-four studies, involving 3075 subjects, were included. Individuals with depression showed blood neopterin concentrations higher than HCs (k = 19; SMD = 0.36; p < 0.001) with moderate heterogeneity across studies (I2 = 58.2%). No moderating role of age, gender, or type of blood sample was found. Sensitivity analyses showed no impact of inconsistency and quality of studies on findings. Neopterin concentrations were higher among individuals with major depressive disorder compared to HCs (SMD = 0.44; p < 0.001). This held true also when considering only drug-free subjects (SMD = 0.68; p = 0.003). No differences in biopterin concentrations were found between subjects with depression and HCs (k = 5; SMD = -0.35; p = 0.086), though this result was limited by inconsistency of findings (I2 = 77.9%) and quality of studies. Finally, no sufficient data were available for a meta-analysis on BH4. CONCLUSIONS As a whole, our work partly supports the hypothesis of an imbalance of pteridine metabolism in depression.
Collapse
Affiliation(s)
- Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy.
| | - Chiara A Capogrosso
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Pierluca Guzzi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Federico Moretti
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Błażej Misiak
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland
| | - Taro Kishi
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi 470-1192, Japan
| | - Robert T Rubin
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, United States; Community Memorial Health System, Ventura County Medical Center, 147 N Brent St, Ventura, CA 93003, United States
| | - Dietmar Fuchs
- Institute of Biological Chemistry, Biocentre, Medical University of Innsbruck, Innrain 80-82, A-6020 Innsbruck, Austria
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, Italy; Division of Psychiatry, University College London, Maple House 149, London W1T 7BN, United Kingdom
| |
Collapse
|
3
|
Jiang H, Deng S, Zhang J, Chen J, Li B, Zhu W, Zhang M, Zhang C, Meng Z. Acupuncture treatment for post-stroke depression: Intestinal microbiota and its role. Front Neurosci 2023; 17:1146946. [PMID: 37025378 PMCID: PMC10070763 DOI: 10.3389/fnins.2023.1146946] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
Stroke-induced depression is a common complication and an important risk factor for disability. Besides psychiatric symptoms, depressed patients may also exhibit a variety of gastrointestinal symptoms, and even take gastrointestinal symptoms as the primary reason for medical treatment. It is well documented that stress may disrupt the balance of the gut microbiome in patients suffering from post-stroke depression (PSD), and that disruption of the gut microbiome is closely related to the severity of the condition in depressed patients. Therefore, maintaining the balance of intestinal microbiota can be the focus of research on the mechanism of acupuncture in the treatment of PSD. Furthermore, stroke can be effectively treated with acupuncture at all stages and it may act as a special microecological regulator by regulating intestinal microbiota as well. In this article, we reviewed the studies on changing intestinal microbiota after acupuncture treatment and examined the existing problems and development prospects of acupuncture, microbiome, and poststroke depression, in order to provide new ideas for future acupuncture research.
Collapse
Affiliation(s)
- Hailun Jiang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shizhe Deng
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jieying Zhang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junjie Chen
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Boxuan Li
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Weiming Zhu
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Menglong Zhang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Graduate School, Tianjin University of Traditional Chinese Medicine, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Chao Zhang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Chao Zhang,
| | - Zhihong Meng
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Zhihong Meng,
| |
Collapse
|
4
|
Abdulkadir H, Girma M, Gebru Z, Sidamo NB, Temesgen G, Jemal K. Anxiety and its associated factors among inmates in ARBA Minch and JINKA town, southern Ethiopia. BMC Psychiatry 2022; 22:582. [PMID: 36050698 PMCID: PMC9434509 DOI: 10.1186/s12888-022-04230-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prison populations are more affected by mental illness than the general population but little attention is given to this population. And there is a limitation of study on the magnitude of anxiety and its associated factors. So this study aimed to assess the magnitude of anxiety and its associated factors among prisoners in Arba Minch and Jinka town, Ethiopia. METHODS An institution-based cross-sectional study was conducted among 650 randomly selected prisoners at Arba Minch and Jinka town. Data was collected by using open data kit then converted to excel and exported to SPSS version 25 for analysis. Descriptive statistics including frequency, means, and proportion were performed. Binary logistic regression was used to identify the associated variables. P < 0.05 was used to declare statistical significance. RESULTS The proportion of Anxiety among prisoners was 28% [N = 174, (95%CI, 25-32%)]. Age ≥ 48 (AOR = 4.21, 95%CI 1.99-8.93), age 38-47 (3.95, 1.94-8.07), being an urban resident (2.48, 1.56-3.95), not doing physical exercise (2.71, 1.53-4.79), having a chronic disease (1.63, 1.07-2.47), having 1-2 stressful life events (2.92, 1.59-5.35), duration of punishment > 5 years (2.92, 1.59-5.35) and lack of income-generating job in prison (2.54, 1.48-4.35) were significantly associated with anxiety. CONCLUSION The magnitude of anxiety among prisoners was high. Age ≥ 48 and 38-47, urban residence, not doing physical exercise, having a chronic disease, having 1-2 stressful life events, duration of punishment > 5 years, and lack of income-generating job in prison were significantly associated with anxiety. Giving special attention and being supportive to older age and those who have a chronic disease, facilitating physical exercise, creating job opportunity in the prison, and giving training for prisoners on stress coping mechanism and anxiety is recommended.
Collapse
Affiliation(s)
- Hanan Abdulkadir
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Meseret Girma
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Zeleke Gebru
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Negussie Boti Sidamo
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gebremaryam Temesgen
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kiyar Jemal
- Departement of laboratory, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
5
|
Remes O, Mendes JF, Templeton P. Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature. Brain Sci 2021; 11:1633. [PMID: 34942936 PMCID: PMC8699555 DOI: 10.3390/brainsci11121633] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/08/2021] [Accepted: 11/12/2021] [Indexed: 12/15/2022] Open
Abstract
Depression is one of the leading causes of disability, and, if left unmanaged, it can increase the risk for suicide. The evidence base on the determinants of depression is fragmented, which makes the interpretation of the results across studies difficult. The objective of this study is to conduct a thorough synthesis of the literature assessing the biological, psychological, and social determinants of depression in order to piece together the puzzle of the key factors that are related to this condition. Titles and abstracts published between 2017 and 2020 were identified in PubMed, as well as Medline, Scopus, and PsycInfo. Key words relating to biological, social, and psychological determinants as well as depression were applied to the databases, and the screening and data charting of the documents took place. We included 470 documents in this literature review. The findings showed that there are a plethora of risk and protective factors (relating to biological, psychological, and social determinants) that are related to depression; these determinants are interlinked and influence depression outcomes through a web of causation. In this paper, we describe and present the vast, fragmented, and complex literature related to this topic. This review may be used to guide practice, public health efforts, policy, and research related to mental health and, specifically, depression.
Collapse
Affiliation(s)
- Olivia Remes
- Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK
| | | | - Peter Templeton
- IfM Engage Limited, Institute for Manufacturing, University of Cambridge, Cambridge CB3 0FS, UK;
- The William Templeton Foundation for Young People’s Mental Health (YPMH), Cambridge CB2 0AH, UK
| |
Collapse
|
6
|
Mindus C, van Staaveren N, Fuchs D, Gostner JM, Kjaer JB, Kunze W, Mian MF, Shoveller AK, Forsythe P, Harlander-Matauschek A. L. rhamnosus improves the immune response and tryptophan catabolism in laying hen pullets. Sci Rep 2021; 11:19538. [PMID: 34599202 PMCID: PMC8486881 DOI: 10.1038/s41598-021-98459-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/30/2021] [Indexed: 02/08/2023] Open
Abstract
In mammals, early-life probiotic supplementation is a promising tool for preventing unfavourable, gut microbiome-related behavioural, immunological, and aromatic amino acid alterations later in life. In laying hens, feather-pecking behaviour is proposed to be a consequence of gut-brain axis dysregulation. Lactobacillus rhamnosus decreases stress-induced severe feather pecking in adult hens, but whether its effect in pullets is more robust is unknown. Consequently, we investigated whether early-life, oral supplementation with a single Lactobacillus rhamnosus strain can prevent stress-induced feather-pecking behaviour in chickens. To this end, we monitored both the short- and long-term effects of the probiotic supplement on behaviour and related physiological parameters. We hypothesized that L. rhamnosus would reduce pecking behaviour by modulating the biological pathways associated with this detrimental behaviour, namely aromatic amino acid turnover linked to neurotransmitter production and stress-related immune responses. We report that stress decreased the proportion of cytotoxic T cells in the tonsils (P = 0.047). Counteracting this T cell depression, birds receiving the L. rhamnosus supplementation significantly increased all T lymphocyte subset proportions (P < 0.05). Both phenotypic and genotypic feather peckers had lower plasma tryptophan concentrations compared to their non-pecking counterparts. The probiotic supplement caused a short-term increase in plasma tryptophan (P < 0.001) and the TRP:(PHE + TYR) ratio (P < 0.001). The administration of stressors did not significantly increase feather pecking in pullets, an observation consistent with the age-dependent onset of pecking behaviour. Despite minimal changes to behaviour, our data demonstrate the impact of L. rhamnosus supplementation on the immune system and the turnover of the serotonin precursor tryptophan. Our findings indicate that L. rhamnosus exerts a transient, beneficial effect on the immune response and tryptophan catabolism in pullets.
Collapse
Affiliation(s)
- Claire Mindus
- grid.34429.380000 0004 1936 8198Department of Animal Biosciences, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Nienke van Staaveren
- grid.34429.380000 0004 1936 8198Department of Animal Biosciences, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Dietmar Fuchs
- grid.5361.10000 0000 8853 2677Institute of Biological Chemistry, Biocenter, Center for Chemistry and Biomedicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Johanna M. Gostner
- grid.5361.10000 0000 8853 2677Institute of Medical Biochemistry, Biocenter, Center for Chemistry and Biomedicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Joergen B. Kjaer
- grid.417834.dInstitute of Animal Welfare and Animal Husbandry, Friedrich-Loeffler-Institut, Celle, Germany
| | - Wolfgang Kunze
- grid.25073.330000 0004 1936 8227Brain-Body Institute, St. Joseph’s Healthcare, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1 Canada
| | - M. Firoz Mian
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada
| | - Anna K. Shoveller
- grid.34429.380000 0004 1936 8198Department of Animal Biosciences, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Paul Forsythe
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, 50 Charlton Avenue East, Hamilton, ON L8N 4A6 Canada
| | - Alexandra Harlander-Matauschek
- grid.34429.380000 0004 1936 8198Department of Animal Biosciences, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| |
Collapse
|
7
|
Hüfner K, Giesinger JM, Gostner JM, Egeter J, Koudouovoh-Tripp P, Vill T, Fuchs D, Sperner-Unterweger B. Neurotransmitter Precursor Amino Acid Ratios Show Differential, Inverse Correlations with Depression Severity in the Low and High Depression Score Range. Int J Tryptophan Res 2021; 14:11786469211039220. [PMID: 34483668 PMCID: PMC8414612 DOI: 10.1177/11786469211039220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/20/2021] [Indexed: 12/28/2022] Open
Abstract
The immunomodulatory capacity of mental stress is one of the basic concepts of
psychoneuroimmunology. The current prospective longitudinal study was designed
to evaluate the effect of acute mental stress on neurotransmitter precursor
amino acid levels in individuals with depression at 2 time points. Ten
physically healthy patients with a diagnosis of major depressive episode and
Montgomery–Åsberg Depression Rating Scale scores (MADRAS) ⩾20 points at
inclusion were assessed on 2 study days (once with higher MADRAS scores, once
with lower MADRAS scores; median 34.5 days apart) and subjected to a
standardized acute mental stress test on each study day. Blood was collected at
4 time points: once prior to and at 3 time points (0, 30 minutes, 60 minutes)
following mental stress. Neurotransmitter precursor amino acid levels, that is
kynurenine/tryptophan (KYN/TRP) and phenylalanine/tyrosine (PHE/TYR), as well as
neopterin and nitrite were analyzed in a total of 80 individual blood samples.
Regression and correlation analyses were performed. Regression analyses of
PHE/TYR (R2 = .547) and KYN/TRP
(R2 = .440) in relation to MADRAS depression
severity showed a quadratic curve fit. This was reflected by a negative linear
correlation between MADRAS scores and PHE/TYR as well as KYN/TRP in the lower
score range (r = −.805, P < .001 and
r = −.586, P < .001 respectively) and a
positive correlation in the higher MADRAS score range
(r = .713, P < .001 and
r = .379, P = .016 respectively). No effect of
acute mental stress was found. This analysis exemplifies the implications of
sampling as well as data distributions on results. The crosstalk of biological
mechanisms that orchestrate metabolic and immunological signaling may vary
depending on depression severity resulting in non-linear associations that may
explain the heterogeneity of results found in the literature.
Collapse
Affiliation(s)
- Katharina Hüfner
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
- Katharina Hüfner, University Clinic for
Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics,
Medical University of Innsbruck, Anichstr. 35, Innsbruck 6020, Austria.
| | - Johannes M Giesinger
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Johanna M Gostner
- Institute of Medical Biochemistry,
Biocenter, Medical University of Innsbruck, Austria
| | - Jonas Egeter
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Pia Koudouovoh-Tripp
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
- Division of Psychiatry and
Psychotherapeutic Medicine, Hospital St. Vinzenz Zams, Austria
| | - Theresa Vill
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| | - Dietmar Fuchs
- Institute of Biological Chemistry,
Biocenter, Medical University of Innsbruck, Austria
| | - Barbara Sperner-Unterweger
- University Clinic for Psychiatry II,
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of
Innsbruck, Austria
| |
Collapse
|
8
|
Zhou Y, Xie Z, Zhang Z, Yang J, Chen M, Chen F, Ma Y, Chen C, Peng Q, Zou L, Gao J, Xu Y, Kuang Y, Zhu M, You D, Yu J, Wang K. Plasma metabolites changes in male heroin addicts during acute and protracted withdrawal. Aging (Albany NY) 2021; 13:18669-18688. [PMID: 34282053 PMCID: PMC8351709 DOI: 10.18632/aging.203311] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Heroin addiction and withdrawal have been associated with an increased risk for infectious diseases and psychological complications. However, the changes of metabolites in heroin addicts during withdrawal remain largely unknown. METHODS A total of 50 participants including 20 heroin addicts with acute abstinence stage, 15 with protracted abstinence stage and 15 healthy controls, were recruited. We performed metabolic profiling of plasma samples based on ultraperformance liquid chromatography coupled to tandem mass spectrometry to explore the potential biomarkers and mechanisms of heroin withdrawal. RESULTS Among the metabolites analyzed, omega-6 polyunsaturated fatty acids (linoleic acid, dihomo-gamma-linolenic acid, arachidonic acid, n-6 docosapentaenoic acid), omega-3 polyunsaturated fatty acids (docosahexaenoic acid, docosapentaenoic acid), aromatic amino acids (phenylalanine, tyrosine, tryptophan), and intermediates of the tricarboxylic acid cycle (oxoglutaric acid, isocitric acid) were significantly reduced during acute heroin withdrawal. Although majority of the metabolite changes could recover after months of withdrawal, the levels of alpha-aminobutyric acid, alloisoleucine, ketoleucine, and oxalic acid do not recover. CONCLUSIONS In conclusion, the plasma metabolites undergo tremendous changes during heroin withdrawal. Through metabolomic analysis, we have identified links between a framework of metabolic perturbations and withdrawal stages in heroin addicts.
Collapse
Affiliation(s)
- Yong Zhou
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Zhenrong Xie
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Zunyue Zhang
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Jiqing Yang
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Minghui Chen
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Medical School, Kunming University of Science and Technology, Kunming 650032, Yunnan, China
| | - Fengrong Chen
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Yuru Ma
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Cheng Chen
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Yunnan Institute of Digestive Disease, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Qingyan Peng
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Lei Zou
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Jianyuan Gao
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Yu Xu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Yunnan Institute of Digestive Disease, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Yiqun Kuang
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Mei Zhu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Dingyun You
- School of Public Health, Kunming Medical University, Kunming 650032, Yunnan, China
| | - Juehua Yu
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Centre for Experimental Studies and Research, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China
| | - Kunhua Wang
- NHC Key Laboratory of Drug Addiction Medicine, Kunming Medical University, First Affiliated Hospital of Kunming Medical University, Kunming 650032, Yunnan, China.,Yunnan University, Kunming 650032, Yunnan, China
| |
Collapse
|
9
|
Gong H, Zhang SX, Nawaser K, Afshar Jahanshahi A, Xu X, Li J, Bagheri A. The Mental Health of Healthcare Staff Working During the COVID-19 Crisis: Their Working Hours as a Boundary Condition. J Multidiscip Healthc 2021; 14:1073-1081. [PMID: 34007182 PMCID: PMC8122682 DOI: 10.2147/jmdh.s297503] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/30/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose Healthcare staff operate at the forefront of the fight against COVID-19 and hence face enormous physical and mental pressures. We aim to investigate healthcare staff's mental health issues and the associated predictors during the COVID-19 pandemic. Specifically, this paper aims to identify some unique predictors of healthcare staff's mental health issues in Iran, the second country after China to experience a major COVID-19 crisis. Methods An online survey of 280 healthcare staff in all 31 provinces of Iran assessed staff's mental distress (K6), depression, and anxiety (PHQ-4) during April 5-20, 2020 during the COVID-19 crisis. Results Nearly a third of healthcare staff surpassed the cutoff for distress, depression, and anxiety symptoms. Females or more educated healthcare staff were more likely to experience distress. Those who were unsure whether they had COVID-19 were more likely to experience distress and depression symptoms. The number of COVID-19 cases among a healthcare worker's colleagues or friends positively predicted the worker's anxiety symptoms. Amongst healthcare staff, doctors were less likely than radiology technologists to experience distress and anxiety symptoms. Technicians and obstetrics staff experienced fewer anxiety symptoms. The age and the weekly working days of healthcare staff interacted such that age is asignificant predictor of mental health issues among younger but not older healthcare staff. Conclusion The identification of the predictors of mental health issues can guide healthcare organizations to screen healthcare workers who are more likely to be mentally vulnerable in the ongoing COVID-19 pandemic.
Collapse
Affiliation(s)
- Haitong Gong
- Collegue of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Stephen X Zhang
- Faculty of Professions, University of Adelaide, Adelaide, SA, Australia
| | - Khaled Nawaser
- Universidad Católica Los Ángeles de Chimbote, Instituto de Investigación, Chimbote, Peru
| | - Asghar Afshar Jahanshahi
- CENTRUM Católica Graduate Business School (CCGBS), Lima, Peru.,Pontificia Universidad Católica del Perú (PUCP), Lima, Peru
| | - Xingzi Xu
- School of Economics and Management, Tsinghua University, Beijing, People's Republic of China
| | - Jizhen Li
- School of Economics and Management, Tsinghua University, Beijing, People's Republic of China
| | - Afsaneh Bagheri
- Faculty of Entrepreneurship, University of Tehran, Tehran, Iran
| |
Collapse
|
10
|
Liu X, Cao H, Zhu H, Zhang H, Niu K, Tang N, Cui Z, Pan L, Yao C, Gao Q, Wang Z, Sun J, He H, Guo M, Guo C, Liu K, Peng H, Peng W, Sun Y, Xie Y, Li B, Shan G, Zhang L. Association of chronic diseases with depression, anxiety and stress in Chinese general population: The CHCN-BTH cohort study. J Affect Disord 2021; 282:1278-1287. [PMID: 33601707 DOI: 10.1016/j.jad.2021.01.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/09/2021] [Accepted: 01/12/2021] [Indexed: 01/26/2023]
Abstract
Background Large-scale epidemiological surveys focusing on characteristic differences in psychological and physical health conditions in Chinese adults are lacking. Objective To investigate the association of noncommunicable chronic diseases (NCDs) with depression, anxiety and stress in the Chinese general population. Methods A total of 13784 participants were recruited from the baseline survey of the Cohort Study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) from 2017 to 2019. Sociodemographic characteristics, lifestyle and NCDs were assessed via questionnaire. Stress, anxiety and depression were assessed by the Depression-Anxiety-Stress Scale (DASS-21). The relationship of NCDs with psychological symptoms was determined through logistic regression analysis. Results Multivariate logistic regression analysis revealed that the prevalence of stress (OR = 1.640; 95% CI: 1.381-1.949), anxiety (OR = 1.654; 95% CI: 1.490-1.837) and depression (OR = 1.460; 95% CI: 1.286-1.658) symptoms were all significantly higher in patients with NCDs. Multimorbidities were associated with a higher risk of stress (OR = 2.310; 95% CI: 1.820-2.931), anxiety (OR = 2.119; 95% CI: 1.844-2.436) and depression (OR = 2.785; 95% CI: 1.499-2.126) than single NCDs. A course of disease within 1 year or more than 5 years also was associated with a higher risk. Limitations The cross-sectional design could not examine the causal link between psychological symptoms and NCDs. Conclusion Psychological symptoms were more prevalent among individuals with NCDs in the Chinese general population. This study suggests that more attention should be paid to the mental health problems of patients with NCDs.
Collapse
Affiliation(s)
- Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Han Zhang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, 300070, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, and Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Tianjin 300070, China
| | - Ze Cui
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Li Pan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Changqiang Yao
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Zhengfang Wang
- Health Management Center, Beijing Aerospace General Hospital, Beijing, 100076, China
| | - Jixin Sun
- Department of Chronic and Noncommunicable Disease Prevention and Control, Hebei Provincial Center for Disease Prevention and Control, Shijiazhuang, Hebei Province, 050021, China
| | - Huijing He
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ming Guo
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Kuo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Hai Peng
- Department of Disease Prevention and Control, Dingzhou Center for Disease Prevention and Control, Baoding, Hebei Province, 073099, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China
| | - Guangliang Shan
- Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing 100730, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University and Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, 100069, China..
| |
Collapse
|
11
|
Ebrahimi H, Namdar H, Soheili A, Gharaei LHH. Workplace Ostracism in Nurses and Its Determining Factors. Res Theory Nurs Pract 2020; 34:237-252. [PMID: 32817278 DOI: 10.1891/rtnp-d-19-00124] [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: 11/25/2022]
Abstract
AIM AND OBJECTIVES This study attempted to identify workplace ostracism in nurses and its determining factors. BACKGROUND Ostracism, which is a form of mistreatment in the nursing workplace, is neglected in the nursing profession although it can affect the quality of healthcare services. DESIGN The present study was a descriptive correlational study. METHODS Nurses in healthcare centers (n = 340) that had at least 12 months of clinical care experience were selected through proportionate stratified random sampling for the period from 2018 to 2019. The study instruments were a modified questionnaire based on the workplace ostracism scale and a questionnaire that assessed personal-social factors. To analyze the data, descriptive and inferential statistics were used. RESULTS Participants' average ostracism score was 9.03 ± 36.63, and there were statistically significant relationships between ostracism and employment status, university of education, a record of getting an incentive, nurses' current physical disorders, and feelings of colleagues' envy and managers' discrimination. CONCLUSIONS Applying some approaches to educate nurses about interpersonal relationships and clearly communicating mutual expectations between the staff and nursing management could help solve this problem. IMPLICATIONS FOR PRACTICE The study results will serve to guide legislators and managers in developing interventions to create supportive and safe work environments, both for nurses and patients.
Collapse
Affiliation(s)
- Hossein Ebrahimi
- Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Namdar
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Soheili
- Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | | |
Collapse
|
12
|
Stute P, Spyropoulou A, Karageorgiou V, Cano A, Bitzer J, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Lindén Hirschberg A, Kiesel L, Lopes P, Pines A, Rees M, van Trotsenburg M, Zervas I, Lambrinoudaki I. Management of depressive symptoms in peri- and postmenopausal women: EMAS position statement. Maturitas 2019; 131:91-101. [PMID: 31740049 DOI: 10.1016/j.maturitas.2019.11.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Globally, the total number of people with depression exceeds 300 million, and the incidence rate is 70 % greater in women. The perimenopause is considered to be a time of increased risk for the development of depressive symptoms and major depressive episodes. AIM The aim of this position statement is to provide a comprehensive model of care for the management of depressive symptoms in perimenopausal and early menopausal women, including diagnosis, treatment and follow-up. The model integrates the care provided by all those involved in the management of mild or moderate depression in midlife women. MATERIALS AND METHODS Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS Awareness of depressive symptoms, early detection, standardized diagnostic procedures, personalized treatment and a suitable follow-up schedule need to be integrated into healthcare systems worldwide. Recommended treatment comprises antidepressants, psychosocial therapies and lifestyle changes. Alternative and complementary therapies, although widely used, may help with depression, but a stronger evidence base is needed. Although not approved for this indication, menopausal hormone therapy may improve depressive symptoms in peri- but not in postmenopausal women, especially in those with vasomotor symptoms.
Collapse
Affiliation(s)
- Petra Stute
- Department of Obstetrics and Gynecology, University Women's Hospital, Bern, Switzerland.
| | - Areti Spyropoulou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Vasilios Karageorgiou
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital, Basel, Switzerland
| | - Iuliana Ceausu
- Department of Obstetrics and Gynecology I, "Dr. I. Cantacuzino" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Peter Chedraui
- Instituto de Investigación e Innovación de Salud Integral (ISAIN), Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Fatih Durmusoglu
- İstanbul Medipol International School of Medicine, Istanbul, Turkey
| | - Risto Erkkola
- Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University of Münster, Münster, Germany
| | - Patrice Lopes
- Nantes, France Polyclinique de l'Atlantique Saint Herblain. F 44819 St Herblain France, Université de Nantes F 44093 Nantes Cedex, France
| | - Amos Pines
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Mick van Trotsenburg
- Department of Obstetrics and Gynaecology, University Hospital St. Poelten-Lilienfeld, Austria
| | - Iannis Zervas
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| |
Collapse
|