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Zhang H, Ye Y, Zhao Y, Li S, Jiao P, Yang Y, Jin Y, Zeng L, Zhang H, Chen M, Jiang H, Zhou L, Li J, Li D, Li R. Obesity is associated with lower levels of negative emotions in polycystic ovary syndrome in clinical and animal studies. Ann Med 2024; 56:2373199. [PMID: 38956857 PMCID: PMC11225633 DOI: 10.1080/07853890.2024.2373199] [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: 04/18/2024] [Accepted: 06/20/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is one of the most common endocrine and metabolic disorders in women of reproductive age. It is frequently comorbid with obesity and negative emotions. Currently, there are few reports on the relationship between obesity and negative emotions in patients with PCOS. Here we performed both basic and clinical studies to study the relationship between obesity and negative emotions in PCOS. METHODS We performed a cross-sectional study including 608 patients with PCOS and 184 healthy participants to assess the mental health status of people with different body mass indices (BMI). Self-rated anxiety, depression, and perceived stress scales were used for subjective mood evaluations. Rat PCOS models fed 45 and 60% high-fat diets were used to confirm the results of the clinical study. Elevated plus maze and open field tests were used to assess anxiety- and depression-like behaviors in rats. RESULTS We observed overweight/obesity, increased depression, anxiety, and perceived stress in women with PCOS, and found that anxiety and depression were negatively correlated with BMI in patients with severe obesity and PCOS. Similar results were confirmed in the animal study; the elevated plus maze test and open field test demonstrated that only 60% of high fat diet-induced obesity partly reversed anxiety- and depression-like behaviors in PCOS rats. A high-fat diet also modulated rat hypothalamic and hippocampal luteinizing hormone and testosterone levels. CONCLUSION These results reveal a potential relationship between obesity and negative emotions in PCOS and prompt further investigation. The interactions between various symptoms of PCOS may be targeted to improve the overall well-being of patients.
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Affiliation(s)
- Haolin Zhang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Yang Ye
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yue Zhao
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Shi Li
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Peijie Jiao
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Yang Yang
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Yuxin Jin
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Hua Zhang
- Research Centre of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Meishuang Chen
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Hong Jiang
- Department of Neurobiology, School of Basic Medical Sciences, Neuroscience Research Institute, Peking University, Beijing, China
| | - Lifei Zhou
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Jiayi Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Dong Li
- Department of Traditional Chinese Medicine, Peking University Third Hospital, Beijing, China
| | - Rong Li
- State Key Laboratory of Female Fertility Promotion, Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction, Ministry of Education, Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
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Shell AL, Crawford CA, Cyders MA, Hirsh AT, Stewart JC. Depressive disorder subtypes, depressive symptom clusters, and risk of obesity and diabetes: A systematic review. J Affect Disord 2024; 353:70-89. [PMID: 38432462 DOI: 10.1016/j.jad.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 02/09/2024] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Overlapping but divided literatures suggest certain depression facets may pose greater obesity and diabetes risk than others. Our objectives were to integrate the major depressive disorder (MDD) subtype and depressive symptom cluster literatures and to clarify which facets are associated with the greatest cardiometabolic disease risk. METHODS We conducted a systematic review of published studies examining associations of ≥2 MDD subtypes or symptom clusters with obesity or diabetes risk outcomes. We report which facets the literature is "in favor" of (i.e., having the strongest or most consistent results). RESULTS Forty-five articles were included. Of the MDD subtype-obesity risk studies, 14 were in favor of atypical MDD, and 8 showed similar or null associations across subtypes. Of the symptom cluster-obesity risk studies, 5 were in favor of the somatic cluster, 1 was in favor of other clusters, and 5 were similar or null. Of the MDD subtype-diabetes risk studies, 7 were in favor of atypical MDD, 3 were in favor of other subtypes, and 5 were similar or null. Of the symptom cluster-diabetes risk studies, 7 were in favor of the somatic cluster, and 5 were similar or null. LIMITATIONS Limitations in study design, sample selection, variable measurement, and analytic approach in these literatures apply to this review. CONCLUSIONS Atypical MDD and the somatic cluster are most consistently associated with obesity and diabetes risk. Future research is needed to establish directionality and causality. Identifying the depression facets conferring the greatest risk could improve cardiometabolic disease risk stratification and prevention programs.
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Affiliation(s)
- Aubrey L Shell
- Department of Psychiatry, Indiana University Health, United States of America
| | | | - Melissa A Cyders
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Indianapolis, United States of America
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Indianapolis, United States of America.
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Kraus C, Kautzky A, Watzal V, Gramser A, Kadriu B, Deng ZD, Bartova L, Zarate CA, Lanzenberger R, Souery D, Montgomery S, Mendlewicz J, Zohar J, Fanelli G, Serretti A, Kasper S. Body mass index and clinical outcomes in individuals with major depressive disorder: Findings from the GSRD European Multicenter Database. J Affect Disord 2023; 335:349-357. [PMID: 37196934 PMCID: PMC10502963 DOI: 10.1016/j.jad.2023.05.042] [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: 02/10/2023] [Revised: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Individuals with major depressive disorder (MDD) are at higher risk for obesity. In turn, weight gain is a predisposing factor for depression. Although clinical data are sparse, suicide risk also appears to be elevated in obese patients. This study used data from the European Group for the Study of Resistant Depression (GSRD) to investigate clinical outcomes associated with body mass index (BMI) in MDD. METHODS Data were drawn from 892 participants with MDD over the age of 18 years (580 female, 50.5 ± 13.6 years). Response and resistance to antidepressant medication, depression rating scale scores, and further clinical and sociodemographic variables were compared using multiple logistic and linear regressions controlled for age, sex, and risk of weight gain due to psychopharmacotherapy. RESULTS Of the 892 participants, 323 were categorized as treatment-responsive and 569 as treatment-resistant. Within this cohort, 278 (31.1 %) were overweight (BMI = 25-29.9 kg/m2) and 151 (16.9 %) were obese (BMI > 30 kg/m2). Elevated BMI was significantly associated with higher suicidality, longer duration of psychiatric hospitalizations over their lifetimes, earlier age of onset of MDD, and comorbidities. There was a trend-wise association of BMI with treatment resistance. LIMITATIONS Data were analyzed in a retrospective, cross-sectional design. BMI was used as an exclusive measure of overweight and obesity. CONCLUSIONS Participants with comorbid MDD and overweight/obesity were at risk for worse clinical outcomes, suggesting that weight gain should be closely monitored in individuals with MDD in daily clinical practice. Further studies are needed to explore the neurobiological mechanisms linking elevated BMI to impaired brain health.
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Affiliation(s)
- Christoph Kraus
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna.
| | - Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
| | - Victoria Watzal
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
| | - Anna Gramser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
| | - Bashkim Kadriu
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Zhi-De Deng
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Lucie Bartova
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
| | - Carlos A Zarate
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna
| | - Daniel Souery
- Laboratoire de Psychologie Medicale, Université Libre de Bruxelles and Psy Pluriel at Epsylon Caring for Mental Health Brussels, Brussels, Belgium
| | | | | | - Joseph Zohar
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Israel
| | - Giuseppe Fanelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy; Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna; Center for Brain Research, Department of Molecular Neuroscience, Medical University of Vienna, Vienna, Austria
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Changes in T-Cell Subpopulations and Cytokine Levels in Patients with Treatment-Resistant Depression-A Preliminary Study. Int J Mol Sci 2022; 24:ijms24010479. [PMID: 36613927 PMCID: PMC9820349 DOI: 10.3390/ijms24010479] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 12/21/2022] [Accepted: 12/24/2022] [Indexed: 12/29/2022] Open
Abstract
Although there is some evidence for the involvement of cytokines and T cells in the pathophysiology of treatment-resistant depression (TRD), the nature of this relationship is not entirely clear. Therefore, we compared T-cell subpopulations and serum cytokine levels in TRD patients to find relationships between their immunological profiles, clinical presentation, and episode severity. Blood samples from TRD patients (n = 20) and healthy people (n = 13) were collected and analyzed by flow cytometry. We analyzed the percentages of helper and cytotoxic T cells according to the expression of selected activation markers, including CD28, CD69, CD25, CD95, and HLA-DR. The serum levels of inflammatory cytokines IL12p70, TNF-α, IL-10, IL-6, IL-1β, and IL-8 were also determined. TRD patients had a lower percentage of CD3+CD4+CD25+ and CD3+CD8+CD95+ cells than healthy people. They also had lower serum levels of IL-12p70 and TNF-α, whereas IL-8 levels were significantly higher. Receiver operating characteristic (ROC) analysis demonstrated that serum IL-8 values above 19.55 pg/mL were associated with a 10.26 likelihood ratio of developing TRD. No connections were found between the MADRS score and immunological parameters. These results show that TRD patients have reduced percentages of T cells expressing activation antigens (CD25 and CD95) and higher serum concentrations of proinflammatory and chemotactic IL-8. These changes may indicate reduced activity of the immune system and the important role of IL-8 in maintaining chronic inflammation in the course of depression.
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Increased telomerase activity in major depressive disorder with melancholic features: Possible role of pro-inflammatory cytokines and the brain-derived neurotrophic factor. Brain Behav Immun Health 2021; 14:100259. [PMID: 34589765 PMCID: PMC8474565 DOI: 10.1016/j.bbih.2021.100259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/11/2021] [Accepted: 04/13/2021] [Indexed: 01/10/2023] Open
Abstract
The biological mechanisms responsible for depression symptoms are not yet understood. For this reason, it is important to reveal the etiopathogenetic mechanisms in this disease. This study aims to compare the levels of pro-inflammatory cytokines, Brain-Derived Neurotrophic Factor (BDNF), and telomerase activity in patients with major depressive disorder (MDD) and healthy controls. Plasma BDNF, interleukin-6 (IL-6), IL-1beta, and Tumor Necrosis Factor-alpha (TNF-alpha) levels, and telomerase activity were measured in 39 patients with major depression and 39 healthy controls matched with patients in terms of age, gender, and education year. Plasma concentration of BDNF, IL-6 levels, and telomerase activity was significantly different between patients with MDD and healthy controls. Correlation analysis showed a positive trend between plasma BDNF levels and plasma IL-6 levels in patients with MDD with melancholic features. Furthermore, the path analysis results showed that the telomerase activity was indirectly affected by gender, IL-1β, IL-6, BDNF, and BMI, via the severity of depression and anxiety and MDD status as the mediators. Further studies are needed to examine the molecular mechanism of the telomerase activity and the role of BDNF and pro-inflammatory cytokines in the telomerase activation in MDD.
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Silva DA, Coutinho EDSF, Ferriani LO, Viana MC. Depression subtypes and obesity in adults: A systematic review and meta-analysis. Obes Rev 2020; 21:e12966. [PMID: 31724325 DOI: 10.1111/obr.12966] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/17/2019] [Accepted: 09/16/2019] [Indexed: 11/30/2022]
Abstract
Examining clinical features of depressive episodes may help elucidating the nature of association between depression and obesity, related to specific symptoms such as appetite and weight changes. This meta-analysis of observational studies evaluated whether subtypes of depression are associated with specific anthropometric profiles in adults. We searched MEDLINE, LILACS, PsycINFO, Scopus, Web of Science databases, and Grey Literature for articles published up to October 2016 that examined depressive subtypes and adiposity measures among adults. The pooled effect size was estimated with random effects models. The PRISMA guidelines were adopted to reporting results, and this review was registered in PROSPERO (CRD42016035685). A total of 22 articles were included in this systematic review, of which eight had data included in the meta-analysis, assessing 14 757 individuals with depression. Patients with atypical depression presented a 2.55 higher BMI score compared with those with melancholic depression. Subgroup analysis identified a differential distribution of anthropometric measures in studies conducted with Chinese populations. Among the remainder studies, only one reported discrepant results, possibly due to the exclusion of "weight change" in defining subtypes of depression. Atypical depression was significantly associated with elevated BMI compared with melancholic depression, deserving particular attention due to its clinical importance.
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Affiliation(s)
- Daniela Alves Silva
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.,Department of Health Integrated Education, Federal University of Espírito Santo, Vitória, Brazil
| | | | - Lara Onofre Ferriani
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Maria Carmen Viana
- Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil.,Department of Social Medicine, Federal University of Espírito Santo, Vitória, Brazil
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Hidese S, Asano S, Saito K, Sasayama D, Kunugi H. Association of depression with body mass index classification, metabolic disease, and lifestyle: A web-based survey involving 11,876 Japanese people. J Psychiatr Res 2018; 102:23-28. [PMID: 29567524 DOI: 10.1016/j.jpsychires.2018.02.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/02/2018] [Accepted: 02/09/2018] [Indexed: 12/31/2022]
Abstract
Body mass index (BMI) and lifestyle-related physical illnesses have been implicated in the pathology of depression. We aimed to investigate the association of depression wih BMI classification (i.e., underweight, normal, overweight, and obese), metabolic disease, and lifestyle using a web-based survey in a large cohort. Participants were 1000 individuals who have had depression (mean age: 41.4 ± 12.3 years, 501 men) and 10,876 population-based controls (45.1 ± 13.6 years, 5691 men). The six-item Kessler scale (K6) test was used as a psychological distress scale. Compared to in the controls, obesity and hyperlipidemia were more common and frequency of a snack or night meal consumption was higher, whereas frequencies of breakfast consumption and vigorous and moderate physical activities were lower in the patients. K6 test scores were higher for underweight or obese people compared to normal or overweight people. A logistic regression analysis showed that the K6 test cut-off score was positively associated with being underweight, hyperlipidemia, and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption in the patients. Logistic regression analyses showed that self-reported depression was positively associated with metabolic diseases and the frequency of a snack or night meal consumption, whereas it was negatively associated with the frequency of breakfast consumption. The observed associations of depression with BMI classification, metabolic disease, and lifestyle suggest that lifestyle and related physical conditions are involved in at least a portion of depressive disorders.
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Affiliation(s)
- Shinsuke Hidese
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of NCNP Brain Physiology and Pathology, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shinya Asano
- Genequest Inc, 5-22-37, Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Kenji Saito
- Genequest Inc, 5-22-37, Higashi-Gotanda, Shinagawa-ku, Tokyo, 141-0022, Japan
| | - Daimei Sasayama
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of Psychiatry, Shinshu University School of Medicine, Matsumoto, 390-8621, Japan
| | - Hiroshi Kunugi
- Department of Mental Disorder Research, National Institute of Neuroscience (NCNP), National Center of Neurology and Psychiatry, 4-1-1, Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan; Department of NCNP Brain Physiology and Pathology, Division of Cognitive and Behavioral Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Beyazyüz M, Albayrak Y, Eğilmez OB, Albayrak N, Beyazyüz E. Relationship between SSRIs and Metabolic Syndrome Abnormalities in Patients with Generalized Anxiety Disorder: A Prospective Study. Psychiatry Investig 2013; 10:148-54. [PMID: 23798963 PMCID: PMC3687049 DOI: 10.4306/pi.2013.10.2.148] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 10/12/2012] [Accepted: 12/20/2012] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE SSRIs are some of the most widely prescribed medications in the world. In addition to their effectiveness, SSRIs were reported to be associated with the side effects of weight gain, sexual dysfunction, drug interactions, extrapyramidal symptoms and discontinuation symptoms. However, the effects of SSRIs on metabolic parameters are poorly understood. METHODS This study aims to describe the effects of SSRIs on the metabolic parameters of drug-naive first episode patients with generalized anxiety disorder. Ninety-seven female patients aged 20-41 years without any metabolic or psychiatric comorbidity were included in the study. Fluoxetine, sertraline, paroxetine, citalopram and escitalopram were randomly given to the patients. Metabolic parameters, including BMI, waist circumference and the levels of fasting glucose, total cholesterol, triglyceride, HDL, LDL and blood pressure, were measured before and after 16 weeks of treatment. RESULTS In the paroxetine group, there was a significant increase in the parameters of weight, BMI, waist circumference, fasting glucose, total cholesterol, LDL and triglyceride after 16 weeks of treatment. There were significant increases in the levels of triglyceride in the citalopram and escitalopram groups. In the sertraline group, the total cholesterol level increased after treatment. In the fluoxetine group, there were significant reductions in the parameters of weight, total cholesterol and triglyceride. CONCLUSION To our knowledge, this study is the first to prospectively describe metabolic syndrome abnormalities in patients with first episode generalized anxiety disorder. Although the effectiveness of the different SSRIs is similar, clinicians should be more careful when prescribing SSRIs to patients who have cardiac risk factors. Larger and lengthier controlled clinical trials are needed to explore the associations between SSRI use and metabolic syndrome.
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Affiliation(s)
- Murat Beyazyüz
- Gölbaşı Hasvak State Hospital, Department of Psychiatry, Ankara, Turkey
| | - Yakup Albayrak
- Kırklareli State Hospital, Department of Psychiatry, Kırklareli, Turkey
| | | | - Neslihan Albayrak
- Kırklareli State Hospital, Department of Cardiology, Kırklareli, Turkey
| | - Elmas Beyazyüz
- Ankara Numune Education and Research Hospital, Department of Psychiatry, Ankara, Turkey
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Tsai AC, Chou YT, Chang TL. Usefulness of the Mini Nutritional Assessment (MNA) in predicting the nutritional status of people with mental disorders in Taiwan. J Clin Nurs 2011; 20:341-50. [DOI: 10.1111/j.1365-2702.2010.03467.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chen Y, Jiang Y, Mao Y. Association between obesity and depression in Canadians. J Womens Health (Larchmt) 2010; 18:1687-92. [PMID: 19785572 DOI: 10.1089/jwh.2008.1175] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine the age and sex variations in the associations between obesity and depression. METHODS This analysis was based on data from 59,652 adults >or=18 years of age in the provinces of Nova Scotia, Quebec, Saskatchewan, Alberta, and British Columbia, who participated in the Canadian Community Health Survey conducted in 2005. The survey included a set of 27 questions about symptoms of depression, which were taken from the Composite International Diagnostic Interview. Based on these questions, depression scores were calculated and used to define depression, which corresponds to a 90% likelihood of a positive diagnosis of major depressive episode. Body weight and height were based on self-report. RESULTS The prevalence of depression was 5.3% in adults living in the five provinces and was higher in women than in men. People with abnormal body weight tended to have an increased risk of depression. On average, obesity and being underweight were associated with approximately 30% and 40% increases in depression, respectively. Particularly in women, depression was more markedly associated with obesity in the 18-39 year age group (OR 1.67, 95% CI 1.29-2.15) and with being underweight in the 40-59 year age group (OR 2.23, 95% CI 1.45-3.42) than other age groups. CONCLUSIONS Obesity is associated with an increased risk of depression in younger women.
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Affiliation(s)
- Yue Chen
- Department of Epidemiology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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Williams LJ, Pasco JA, Henry MJ, Jacka FN, Dodd S, Nicholson GC, Kotowicz MA, Berk M. Lifetime psychiatric disorders and body composition: a population-based study. J Affect Disord 2009; 118:173-9. [PMID: 19249106 DOI: 10.1016/j.jad.2009.02.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 02/01/2009] [Accepted: 02/02/2009] [Indexed: 11/19/2022]
Abstract
BACKGROUND This study aimed to investigate the relationship between depressive and anxiety disorders and indices of adiposity, including body fat mass and percent body fat, as measured by dual energy X-ray absorptiometry. METHODS In this observational study of 979 randomly-selected women aged 20-93 years, psychiatric history was ascertained using a structured clinical interview (SCID-I/NP). Total body fat was assessed using dual-energy X-ray absorptiometry and weight, height and waist circumference were measured. Medication use and lifestyle factors were self-reported. RESULTS Those with a lifetime history of depression had increased fat mass (+7.4%) and percent body fat (+4.3%), as well as greater mean weight (+3.3%), waist circumference (+2.9%) and BMI (+3.5%) after adjustment for age, anxiety, alcohol consumption, physical activity and past smoking. Furthermore, those meeting criteria for a lifetime history of depression had a 1.7-fold increased odds of being overweight or obese (BMI>or=25), a 2.0-fold increased odds of being obese (BMI>or=30) and a 1.8-fold increased odds of having a waist circumference >or=80 cm. These patterns persisted after further adjustment for psychotropic medication use, smoking status and energy intake. No differences in any measures of adiposity were observed among those with anxiety disorders compared to controls. LIMITATIONS There is potential for unrecognised confounding, interpretations are limited to women and a temporal relationship could not be inferred. CONCLUSIONS Depression was associated with greater adiposity. The difference in body fat mass was numerically greater than differences in indirect measures of adiposity, suggesting that the latter may underestimate the extent of adiposity in this population.
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Affiliation(s)
- Lana J Williams
- Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, PO Box 281, Geelong 3220, Australia.
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Sports participation as a protective factor against depression and suicidal ideation in adolescents as mediated by self-esteem and social support. J Dev Behav Pediatr 2009; 30:376-84. [PMID: 19692930 DOI: 10.1097/dbp.0b013e3181b33659] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Participation in sports has been shown to be protective against depression and suicidal ideation, but little is known about what factors mediate these relationships. No previous studies examined potential mediators between sports participation and suicidal ideation and only one study explored possible mediators between sports participation and depression. Increased sports participation could protect against depression and suicidal ideation by increasing endogenous endorphin levels, boosting self-esteem, improving body image, increasing social support, and affecting substance abuse. METHOD Multivariate hierarchical logistic regression analyses of Add Health data to explore whether increased participation in sports (none, 1-2, 3-4, or 5 or more times per week) is associated with depression and suicidal ideation and whether exercise, self-esteem, body weight, social support, and substance abuse mediate these relationships. RESULTS As sports participation increases, the odds of suffering from depression decreases by 25% (OR: 0.75; 95% CI: 0.70-0.82) and the odds of having suicidal ideation decreases by 12% (OR: 0.88; 95% CI: 0.83-0.93) after controlling for sex, age, race/ethnicity, public assistance, and physical limitations. Substance abuse, body weight, and exercise did not mediate these associations. Consistent with self-esteem and social support acting as mediators of these relationships, the inclusion of these variables in the multivariate models attenuated the associations for depression (OR: 0.83; 95% CI: 0.75-0.91) and suicidal ideation (OR: 0.93; 95% CI: 0.88-0.99). CONCLUSION Adolescents should be offered ample opportunity and encouragement to participate in sports, which can protect against depression and suicidal ideation by boosting self-esteem and increasing social support.
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Involvement of brain dopaminergic systems in the development of an MPTP-induced depressive state in rats. ACTA ACUST UNITED AC 2008; 38:383-91. [DOI: 10.1007/s11055-008-0055-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 11/09/2006] [Indexed: 10/22/2022]
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Abstract
Eating represents a choice among many alternative behaviors. The purpose of this review is to provide an overview of how food reinforcement and behavioral choice theory are related to eating and to show how this theoretical approach may help organize research on eating from molecular genetics through treatment and prevention of obesity. Special emphasis is placed on how food reinforcement and behavioral choice theory are relevant to understanding excess energy intake and obesity and how they provide a framework for examining factors that may influence eating and are outside of those that may regulate energy homeostasis. Methods to measure food reinforcement are reviewed, along with factors that influence the reinforcing value of eating. Contributions of neuroscience and genetics to the study of food reinforcement are illustrated by using the example of dopamine. Implications of food reinforcement for obesity and positive energy balance are explored, with suggestions for novel approaches to obesity treatment based on the synthesis of behavioral and pharmacological approaches to food reinforcement.
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Affiliation(s)
- Leonard H Epstein
- Department of Pediatrics, School of Medicine and Biomedical Sciences, State University of New York, Buffalo, NY 14214-3000, USA.
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Abstract
This study presents a new theory to explain the neural origins of human mind. This is the psychomotor theory. The author briefly analyzed the historical development of the mind-brain theories. The close relations between psychological and motor systems were subjected to a rather detailed analysis, using psychiatric and neurological examples. The feedback circuits between mind, brain, and body were shown to occur within the mind-brain-body triad, in normal states, and psycho-neural diseases. It was stated that psychiatric signs and symptoms are coupled with motor disturbances; neurological diseases are coupled with psychological disturbances; changes in cortico-spinal motor-system activity may influence mind-brain-body triad, and vice versa. Accordingly, a psychomotor theory was created to explain the psychomotor coupling in health and disease, stating that, not the mind-brain duality or unity, but the mind-brain-body triad as a functional unit may be essential in health and disease, because mind does not end in the brain, but further controls movements, in a reciprocal manner; mental and motor events share the same neural substrate, cortical, and spinal motoneurons; mental events emerging from the motoneuronal system expressed by the human language may be closely coupled with the unity of the mind-brain-body triad. So, the psychomotor theory rejects the mind-brain duality and instead advances the unity of the psychomotor system, which will have important consequences in understanding and improving the human mind, brain, and body in health and disease.
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Affiliation(s)
- Uner Tan
- Department of Physics, Cukurova University, Adana, Turkey.
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Mallinckrodt CH, Watkin JG, Liu C, Wohlreich MM, Raskin J. Duloxetine in the treatment of Major Depressive Disorder: a comparison of efficacy in patients with and without melancholic features. BMC Psychiatry 2005; 5:1. [PMID: 15631624 PMCID: PMC546184 DOI: 10.1186/1471-244x-5-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Accepted: 01/04/2005] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND The most prominent feature of melancholic depression is a near-total loss of the capacity to derive pleasure from activities or other positive stimuli. Additional symptoms can include psychomotor disturbances, anorexia, excessive guilt, and early awakening from sleep. Melancholic patients may exhibit treatment responses and outcomes that differ from those of non-melancholic patients. Pooled data from double-blind, placebo-controlled studies were utilized to compare the efficacy of duloxetine in depressed patients with and without melancholic features. METHODS Efficacy data were pooled from 8 double-blind, placebo-controlled clinical trials of duloxetine. The presence of melancholic features (DSM-IV criteria) was determined using results from the Mini International Neuropsychiatric Interview (MINI). Patients (aged >or= 18 years) meeting DSM-IV criteria for major depressive disorder (MDD) received duloxetine (40-120 mg/d; melancholic, N = 759; non-melancholic, N = 379) or placebo (melancholic, N = 519; non-melancholic, N = 256) for up to 9 weeks. Efficacy measures included the 17-item Hamilton Rating Scale for Depression (HAMD17) total score, HAMD17 subscales (Maier, anxiety, retardation, sleep), the Clinical Global Impression of Severity (CGI-S) and Patient Global Impression of Improvement (PGI-I) scales, and Visual Analog Scales (VAS) for pain. RESULTS In data from all 8 studies, duloxetine's advantage over placebo did not differ significantly between melancholic and non-melancholic patients (treatment-by-melancholic status interactions were not statistically significant). Duloxetine demonstrated significantly greater improvement in depressive symptom severity, compared with placebo, within both melancholic and non-melancholic cohorts (p <or= .001 for HAMD17 total score, CGI-S and PGI-I). When analyzed by gender, the magnitude of improvement in efficacy outcomes did not differ significantly between duloxetine-treated male and female melancholic patients. In the two studies that assessed duloxetine 60 mg once-daily dosing, duloxetine-treated melancholic patients had significantly greater improvement compared with placebo on HAMD17 total score, CGI-S, PGI-I, 3 of 4 subscales of the HAMD17, and VAS overall pain severity (p < .01). Estimated probabilities of response and remission were significantly greater for melancholic patients receiving duloxetine 60 mg QD compared with placebo (response 74.7% vs. 42.2%, respectively, p < .001; remission 44.4% vs. 24.7%, respectively, p = .002. CONCLUSIONS In this analysis of pooled data, the efficacy of duloxetine in patients with melancholic features did not differ significantly from that observed in non-melancholic patients.
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Affiliation(s)
| | - John G Watkin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285
| | - Chaofeng Liu
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285
| | | | - Joel Raskin
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285
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Calikoglu M, Sahin G, Yazici AE, Yazici K, Ozişik S. Pulmonary Muscle Strength, Pulmonary Function Tests, and Dyspnea in Women with Major Depression. J Womens Health (Larchmt) 2004; 13:93-8. [PMID: 15006282 DOI: 10.1089/154099904322836500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To evaluate the subjective sensation of dyspnea compared with pulmonary function tests, pulmonary muscle strength, and chest expansion in depressed women and control subjects free of cardiorespiratory disease. METHODS Thirty female patients with major depression (MD) and 30 age-matched female control subjects were included in the study. All subjects were assessed by pulmonary function tests (spirometry) and pulmonary muscle strength measurement (maximum inspiratory and expiratory pressures [MIP and MEP]) by mouth pressure meter (MPM). Chest expansion was measured, and body mass index (kg/m(2)) (BMI) was calculated. The Health Assessment Questionnaire (HAQ) was used to evaluate the activities of daily living, and a dyspnea score was used to determine dyspnea severity. RESULTS There were no significant differences between groups regarding pulmonary function tests, pulmonary muscle strength, and chest expansion. HAQ scores were significantly lower in women, and dyspnea was higher with MD compared with controls (p < 0.05). BMI was also lower in depressed patients (p < 0.05). CONCLUSIONS The subjective sensation of dyspnea is increased in women with MD in the presence of normal lung function and is associated with the level of anxiety rather than that of depression.
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Affiliation(s)
- Mukadder Calikoglu
- Department of Chest Diseases Mersin University, Faculty of Medicine, Mersin, Turkey
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