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Mathias L, Quagliato LA, Carta MG, Nardi AE, Cheniaux E. Challenges in the treatment of dysthymia: a narrative review. Expert Rev Neurother 2024; 24:633-642. [PMID: 38805342 DOI: 10.1080/14737175.2024.2360671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 05/23/2024] [Indexed: 05/30/2024]
Abstract
INTRODUCTION Despite its milder severity, the chronic nature of dysthymia leads to significant impairments and functional limitations. The treatment of dysthymia has received considerably less research attention compared to major depressive disorder (MDD). AREAS COVERED The authors have conducted a comprehensive review on the treatment of dysthymia. Their primary objective was to identify therapeutic options that have demonstrated genuine efficacy. To do this, they searched the PubMed database, without any time restrictions, to retrieve original studies. The samples were exclusively comprised individuals diagnosed with dysthymia according to the diagnostic criteria outlined in DSM-III, DSM-III-R, DSM-IV, or DSM-IV-TR. EXPERT OPINION Within the realm of dysthymia treatment, several antidepressants, including imipramine, sertraline, paroxetine, minaprine, moclobemide, and amineptine, in addition to the antipsychotic agent amisulpride, have demonstrated superiority over placebo. In certain studies, psychotherapeutic interventions did not distinguish themselves significantly from pharmacological treatments and failed to exhibit greater efficacy than a placebo. However, these findings remain inconclusive due to the limited number of studies and substantial methodological limitations prevalent in a significant proportion of them. Limitations include factors like small sample sizes, the absence of placebo comparisons, and a lack of study blinding.
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Affiliation(s)
- Livia Mathias
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Laiana A Quagliato
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mauro G Carta
- Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio E Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Elie Cheniaux
- Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Laboratory of Panic and Respiration, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
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Wang W, Wang Y, Wang F, Chen H, Qin X, Yang L, Yang X, Yang L. Notable dysthymia: evolving trends of major depressive disorders and dysthymia in China from 1990 to 2019, and projections until 2030. BMC Public Health 2024; 24:1585. [PMID: 38872130 PMCID: PMC11170895 DOI: 10.1186/s12889-024-18943-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 05/23/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Depressive disorders have been identified as a significant contributor to non-fatal health loss in China. Among the various subtypes of depressive disorders, dysthymia is gaining attention due to its similarity in clinical severity and disability to major depressive disorders (MDD). However, national epidemiological data on the burden of disease and risk factors of MDD and dysthymia in China are scarce. METHODS This study aimed to evaluate and compare the incidence, prevalence, and disability-adjusted life-years (DALYs) caused by MDD and dysthymia in China between 1990 and 2019. The temporal trends of the depressive disorder burden were evaluated using the average annual percentage change. The comparative risk assessment framework was used to estimate the proportion of DALYs attributed to risk factors, and a Bayesian age-period-cohort model was applied to project the burden of depressive disorders. RESULTS From 1990 to 2019, the overall age-standardized estimates of dysthymia in China remained stable, while MDD showed a decreasing trend. Since 2006, the raw prevalence of dysthymia exceeded that of MDD for the first time, and increased alternately with MDD in recent years. Moreover, while the prevalence and burden of MDD decreased in younger age groups, it increased in the aged population. In contrast, the prevalence and burden of dysthymia remained stable across different ages. In females, 11.34% of the DALYs attributable to depressive disorders in 2019 in China were caused by intimate partner violence, which has increasingly become prominent among older women. From 2020 to 2030, the age-standardized incidence, prevalence, and DALYs of dysthymia in China are projected to remain stable, while MDD is expected to continue declining. CONCLUSIONS To reduce the burden of depressive disorders in China, more attention and targeted strategies are needed for dysthymia. It's also urgent to control potential risk factors like intimate partner violence and develop intervention strategies for older women. These efforts are crucial for improving mental health outcomes in China.
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Affiliation(s)
- Wei Wang
- Department of Psychology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China
| | - Yihe Wang
- Department of Neurology, The Second Hospital of Shandong University, Jinan, China
| | - Feng Wang
- Department of Education, Guangxi Normal University, Guilin, China
| | - Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaqing Qin
- Department of Psychology, Shandong Normal University, Jinan, China
| | - Lexia Yang
- Nursing Department, The Third Hospital of Jinan, Jinan, Shandong, 250000, China
| | - Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Lejin Yang
- Department of Psychology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road, Jinan, Shandong, 250012, China.
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Liu M, Wang W, Chen Y, Guo M, Wei Y, Yang S, Xiang X. Genetically predicted processed meat, red meat intake, and risk of mental disorders: A multivariable Mendelian randomization analysis. J Affect Disord 2024; 354:603-610. [PMID: 38503356 DOI: 10.1016/j.jad.2024.03.084] [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: 11/13/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Previous observational studies have highlighted potential links between the consumption of processed meat and red meat (such as pork, mutton, and beef intake) and the occurrence of mental disorders. However, it is unclear whether a causal association exists. Therefore, we employed the Mendelian randomization (MR) study to investigate the causal effects of genetically predicted processed meat and red meat on mood disorders (MD), anxiety disorders (AD), and major depressive disorder (MDD). METHODS Genetic instruments for processed and red meat were selected from the Genome-Wide Association Study (GWAS) of the UK Biobank Study. Their associations with MD (42,746 cases 254,976), AD (35,385 cases and 254,976 controls), and MDD (38,225 cases and 299,886 controls) were obtained from the FinnGen Consortium. The inverse variance weighted (IVW) method was the primary method for two-sample MR analysis. Additionally, we employed complementary analysis to assess the robustness of our MR findings (eg, MR Egger and weighted median). We also conducted multiple sensitivity analyses to investigate horizontal pleiotropy and heterogeneity. Moreover, we performed a univariate and multivariable MR (MVMR) study to evaluate these associations. RESULTS In our univariate MR analysis, we observed that genetically predicted beef intake was associated with a reduced risk of MD [odds ratio (OR) = 0.403, 95 % confidence interval (CI) = 0.246-0.659; PIVW = 4.428 × 10-5], AD (OR = 0.443, 95 % CI = 0.267-0.734; PIVW = 1.563 × 10-3), and MDD (OR = 0.373, 95 % CI = 0.216-0.643; PIVW = 3.878 × 10-4). After adjusting for processed meat, pork, and mutton intake in the MVMR analysis, the protective association of beef intake against MD and MDD remained. However, there was no substantial evidence indicating a significant causal relationship between processed meat, pork, and mutton intake and the occurrence of mental disorders. Furthermore, our sensitivity analysis revealed no significant evidence of horizontal pleiotropy. CONCLUSION These findings support a causal relationship between genetically predicted beef intake and reducing the risk of MD and MDD.
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Affiliation(s)
- Mingkun Liu
- Department of radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai 201499, China
| | - Wenwen Wang
- Shanghai Eighth People's Hospital, No.8. Caobao Road, Xuhui District, Shanghai 200235, China
| | - Yi Chen
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China
| | - Meixiang Guo
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China
| | - Yuanhao Wei
- School of Public Health, Harbin Medical University, Harbin 150076, China
| | - Shaoling Yang
- Shanghai Eighth People's Hospital, No.8. Caobao Road, Xuhui District, Shanghai 200235, China.
| | - Xiqiao Xiang
- Department of PET-CT Imaging Center, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, No. 6600 Nanfeng Highway, Fengxian District, Shanghai 201499, China.
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Lian J, Lin Z, Li X, Chen G, Wu D. Different dosage regimens of zuranolone in the treatment of major depressive disorder: A meta-analysis of randomized controlled trials. J Affect Disord 2024; 354:206-215. [PMID: 38479510 DOI: 10.1016/j.jad.2024.03.057] [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: 11/06/2023] [Revised: 02/06/2024] [Accepted: 03/09/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE To investigate the efficacy and safety of different dosage regimens of zuranolone in the treatment of patients with major depressive disorder (MDD). METHODS PubMed, Embase, The Cochrane Library and other databases were searched from inception until July 2019. Randomized controlled trials (RCTs) related to the efficacy and safety of zuranolone in the treatment of MDD were included. The data were extracted independently by 2 investigators and assessed the study quality by the Cochrane risk-of-bias tool. The primary outcome includes the 17-item HAMILTON total score (HAMD-17) and the incidence of adverse events (AEs). RESULTS Six high-quality RCTs with 1593 patients were finally included in our analysis. Zuranolone group achieve a notable treatment effect at day15 in HAMD-17 compared with placebo group (MD = -2.69, 95 % CI: -4.45 to -0.94, P < 0.05). For safety, no significant differences existed in the proportion of patients with AEs between zuranolone with placebo (RR = 1.25, 95 % CI: 0.99 to 1.58, P = 0.06). CONCLUSION Zuranolone has a significant efficacy in improving depressive symptoms in the short term and is positively correlated with the dosage administered. However, the efficacy of zuranolone decreased significantly when the time of administration was extended. Zuranolone demonstrated a controllable safety issue. But adverse effects increased as the dose of zuranolone was gradually increased to 50 mg.
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Affiliation(s)
- Jinrong Lian
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Zhimin Lin
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xiang Li
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Gang Chen
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
| | - Depei Wu
- Department of Clinical Medicine, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
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Gao M, Song Y, Liu Y, Miao Y, Guo Y, Chai H. TNF-α/TNFR1 activated astrocytes exacerbate depression-like behavior in CUMS mice. Cell Death Discov 2024; 10:220. [PMID: 38710713 DOI: 10.1038/s41420-024-01987-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/08/2024] Open
Abstract
Neuroinflammation is considered to be a significant mechanism contributing to depression. Several studies have reported that A1 astrocytes were highly prevalent in human neuroinflammatory and neurodegenerative diseases. However, the precise mechanism by which A1 astrocytes contribute to depression remains unclear. Clinical studies have suggested a correlation between TNF-α, an activator of A1 astrocytes, and the severity of depression. Based on these findings, we hypothesized that TNF-α might worsen depression by activating A1 astrocytes. Our previous studies indicated that Rhodomyrtone (Rho) has the potential to improve depression-like behavior in mice. However, the exact mechanism for this effect has not been fully elucidated. Importantly, it was reported that Rho alleviated skin inflammation in a mouse model of psoriasis by inhibiting the expression of TNF-α. Based on this finding, we hypothesized that rhodomyrtone may exert antidepressant effects by modulating the TNF-α pathway. However, further research is required to investigate and validate these hypotheses, shedding light on the relationships between neuroinflammation, A1 astrocytes, TNF-α, and depression. By obtaining a deeper understanding of the underlying mechanisms, these findings could lead to the development of novel antidepressant strategies that target the TNF-α pathway in the context of neuroinflammation. In vivo, based on the established chronic unpredictable mild stress (CUMS) mouse depression model, we characterized the mechanism of TNF-α and Rho during depression by using several behavioral assays, adeno-associated virus(AAV) transfection, western blotting, immunofluorescence, and other experimental methods. In vitro, we characterized the effect of Rho on inflammation in TNF-α-treated primary astrocytes. TNFR1 expression was significantly increased in the hippocampus of depression-like mice, with increased astrocytes activation and neuronal apoptosis. These processes were further enhanced with increasing levels of TNF-α in the cerebrospinal fluid of mice. However, this process was attenuated by knockdown of TNFR1 and infliximab (Inf; a TNF-α antagonist). Injection of rhodomyrtone decreased the expressions of TNFR1 and TNF-α, resulting in significant improvements in mouse depression-like behaviors and reduction of astrocyte activation. TNF-α could be involved in the pathophysiological process of depression, through mediating astrocytes activation by binding to TNFR1. By blocking this pathway, Rho may be a novel antidepressant.
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Affiliation(s)
- Mengjiao Gao
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yu Song
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yaqi Liu
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China
| | - Yuqing Miao
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China
| | - Yanwu Guo
- Neurosurgery Center, Department of Functional Neurosurgery, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, Guangdong, China.
| | - Huihui Chai
- Department of Cerebrovascular Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, National Center for Neurological Disorders, National Key Laboratory for Medical Neurobiology, Institutes of Brain Science, Shanghai Key Laboratory of Brain Function and Regeneration, Institute of Neurosurgery, MOE Frontiers Center for Brain Science, Shanghai, 200040, China.
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Ma Z, Yu Y, Gao M, Chen P, Hong H, Yu D, Liang Z, Bai Y, Ye Q, Wang Y, Huang G, Tan H. Protective Effect of Hop Ethyl Acetate Extract on Corticosterone-Induced PC12 and Improvement of Depression-like Behavior in Mice. ACS Chem Neurosci 2024; 15:1893-1903. [PMID: 38613492 DOI: 10.1021/acschemneuro.4c00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2024] Open
Abstract
Depression is a common mental disorder. In recent years, more and more attention has been paid to depression and its etiology and pathogenesis. This review aims to explore the neuroprotective and antidepressant effects of hop components. By establishing an in vitro cell damage model using PC12 cells induced by corticosterone (CORT) and an in vivo depression model through the intracranial injection of lipopolysaccharide (LPS) in mice, hop ethyl acetate extract (HEA) was used to study the protective effect and mechanism of HEA on neuronal cells in vitro and the antidepression effect and mechanism in vivo. The results showed that HEA increased the survival and decreased the rate of lactate dehydrogenase (LDH) release, apoptosis, and the ROS and NO content of CORT-induced PC12 cells. HEA alleviated depressive-like behavior, neuroinflammation, reduction of norepinephrine, and dendritic spines induced by intracerebroventricular injection of LPS in mice and increases the expression levels of BDNF, SNAP 25, and TrkB proteins without any significant side effects or toxicity. Hops demonstrated significant comprehensive utilization value, and this work provided an experimental basis for the role of hops in the treatment of depression and provided a basis for the development of HEA for antidepressant drugs or dietary therapy products.
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Affiliation(s)
- Ziwei Ma
- State Key Laboratory of Chemistry and Utilization of Carbon-Based Energy Resources; College of Chemistry, Xinjiang University, Urumqi, Xinjiang 830017, P. R. China
| | - Yuming Yu
- State Key Laboratory of Chemistry and Utilization of Carbon-Based Energy Resources; College of Chemistry, Xinjiang University, Urumqi, Xinjiang 830017, P. R. China
| | - Ming Gao
- State Key Laboratory of Chemistry and Utilization of Carbon-Based Energy Resources; College of Chemistry, Xinjiang University, Urumqi, Xinjiang 830017, P. R. China
| | - Peng Chen
- State Key Laboratory of Chemistry and Utilization of Carbon-Based Energy Resources; College of Chemistry, Xinjiang University, Urumqi, Xinjiang 830017, P. R. China
| | - Huixia Hong
- State Key Laboratory of Chemistry and Utilization of Carbon-Based Energy Resources; College of Chemistry, Xinjiang University, Urumqi, Xinjiang 830017, P. R. China
| | - Dingle Yu
- Center for Child Care and Mental Health (CCCMH), Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Zhenjiang Liang
- Center for Child Care and Mental Health (CCCMH), Shenzhen Children's Hospital, Shenzhen 518038, China
| | - Yu Bai
- Center for Child Care and Mental Health, Shenzhen Pediatrics Institute of Shantou University Medical College Health, Shenzhen 518035, China
| | - Qinlian Ye
- The Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518038, China
| | - Yachao Wang
- The Institute of Translational Medicine, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen 518038, China
- Department of Neurosurgery, Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, China
| | - Guodong Huang
- Department of Neurosurgery, Shenzhen Key Laboratory of Neurosurgery, and the Institute of Translational Medicine, Shenzhen Second People's Hospital/The First Affiliated Hospital of Shenzhen University, No. 3002 Sungang Westroad, Futian District, Shenzhen 518035, China
| | - Hui Tan
- Center for Child Care and Mental Health, Shenzhen Pediatrics Institute of Shantou University Medical College Health, Shenzhen 518035, China
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Millender E, Harris RM, Bagneris JR, Marks LR, Barcelona V, Wong FY, Crusto CA, Taylor JY. The Cumulative Influence of Perceived Discrimination, Stress, and Coping Responses on Symptoms of Depression Among Young African American Mothers. J Am Psychiatr Nurses Assoc 2024; 30:322-332. [PMID: 35833679 PMCID: PMC9839894 DOI: 10.1177/10783903221105281] [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] [Indexed: 01/17/2023]
Abstract
BACKGROUND African American women have an elevated risk for experiencing depressive symptoms, and discrimination, stress, and coping contribute to symptoms of depression. AIMS We aimed to examine the associations between discrimination, stress, and coping on symptoms of depression among young African American mothers. METHODS In this retrospective study, we utilized a hierarchical linear regression to explore the effects of perceived racial discrimination, stress, and general and discrimination-related coping responses on depressive symptoms in a sample of African American mothers (N = 250). The data were drawn from the Intergenerational Impact of Genetic and Psychological Factors on Blood Pressure study (InterGEN), a study conducted between 2014 and 2019 and based in Connecticut. RESULTS After accounting for maternal age, level of education, and income, greater perceived racial discrimination (p = .03), higher levels of stress (p < .001), greater engagement in avoidance coping (p < .001), and use of passive coping responses to discrimination (p = .04) were uniquely associated with increased depressive symptoms. Other forms of coping, specifically, problem-solving and support seeking, did not appear to influence depressive symptoms in this sample. CONCLUSION The findings highlight the negative impact of discrimination, heightened stress, and maladaptive coping on the emotional health of young African American mothers.
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Affiliation(s)
- Eugenia Millender
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA
| | | | | | | | | | - Frank Y. Wong
- Center of Population Sciences for Health Equity, Florida State University, Tallahassee, FL, USA
| | | | - Jacquelyn Y. Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY, USA
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Vu QT, Harada K, Nishimura Y, Hagiya H, Tan E, Lehasa OME, Zamami Y, Koyama T. Burden of depressive disorders in Vietnam from 1990 to 2019: A secondary analysis of the Global Burden of Disease Study 2019. J Psychiatr Res 2024; 172:420-426. [PMID: 38461590 DOI: 10.1016/j.jpsychires.2024.02.041] [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: 09/04/2023] [Revised: 02/01/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
Depressive disorders are among the leading causes of disability globally. However, information on the burden of depressive disorders in Vietnam is limited. We aimed to analyse the burden of depressive disorders in Vietnam from 1990 to 2019. Using data from the Global Burden of Disease Study 2019, prevalence and disability-adjusted life-years (DALYs) were used as indicators to analyse the burden of depressive disorders by age and sex. In 2019 in Vietnam, depressive disorders comprised 2629.1 thousand (95% uncertainty interval (UI): 2233.3-3155.9) estimated cases and 380.6 thousand (95% UI: 258.9-533.8) estimated DALYs. The crude prevalence rate of depressive disorders was higher among females than among males. The DALYs of depressive disorder accounted for a higher percentage of the total all-cause DALYs in the 10-64-year age group than in other age groups. Major depressive disorder was the largest contributor to the burden of depressive disorders. From 1990 to 2019, the crude prevalence and DALY rates per 100 000 population due to depressive disorders increased significantly, whereas age-standardised rates of prevalence and DALYs decreased significantly; the respective average annual percent changes were 0.88% (95% confidence interval: 0.87 to 0.89), 0.68% (0.66 to 0.70), -0.20% (-0.21 to -0.19), and -0.27% (-0.28 to -0.25). Although the age-standardised prevalence rate was lower than that seen globally, depressive disorders were considerable mental health issues in Vietnam. This study will help governments and policymakers to establish appropriate strategies to reduce the burden of these disorders by identifying the priority areas and individuals.
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Affiliation(s)
- Quynh Thi Vu
- Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan; Faculty of Pharmacy, Haiphong University of Medicine and Pharmacy, Haiphong, Viet Nam.
| | - Ko Harada
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, USA.
| | - Yoshito Nishimura
- Department of Medicine, John A. Burns School of Medicine, University of Hawai'i, Honolulu, Hawaii, USA.
| | - Hideharu Hagiya
- Department of Infectious Diseases, Okayama University Hospital, Okayama, Japan.
| | - Elizabeth Tan
- Graduate School, Centro Escolar University Manila, Manila, Philippines; Department of Pharmacy, University of San Carlos, Cebu, Philippines.
| | | | - Yoshito Zamami
- Department of Pharmacy, Okayama University Hospital, Okayama, Japan.
| | - Toshihiro Koyama
- Department of Health Data Science, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
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Borroto-Escuela D, Serrano-Castro P, Sánchez-Pérez JA, Barbancho-Fernández MA, Fuxe K, Narváez M. Enhanced neuronal survival and BDNF elevation via long-term co-activation of galanin 2 (GALR2) and neuropeptide Y1 receptors (NPY1R): potential therapeutic targets for major depressive disorder. Expert Opin Ther Targets 2024; 28:295-308. [PMID: 38622072 DOI: 10.1080/14728222.2024.2342517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a prevalent and debilitating condition, necessitating novel therapeutic strategies due to the limited efficacy and adverse effects of current treatments. We explored how galanin receptor 2 (GALR2) and Neuropeptide Y1 Receptor (NPYY1R) agonists, working together, can boost brain cell growth and increase antidepressant-like effects in rats. This suggests new ways to treat Major Depressive Disorder (MDD). RESEARCH DESIGN AND METHODS In a controlled laboratory setting, adult naive Sprague-Dawley rats were administered directly into the brain's ventricles, a method known as intracerebroventricular (ICV) administration, with GALR2 agonist (M1145), NPYY1R agonist, both, or in combination with a GALR2 antagonist (M871). Main outcome measures included long-term neuronal survival, differentiation, and behavioral. RESULTS Co-administration of M1145 and NPYY1R agonist significantly enhanced neuronal survival and maturation in the ventral dentate gyrus, with a notable increase in Brain-Derived Neurotrophic Factor (BDNF) expression. This neurogenic effect was associated with an antidepressant-like effect, an outcome partially reversed by M871. CONCLUSIONS GALR2 and NPYY1R agonists jointly promote hippocampal neurogenesis and exert antidepressant-like effects in rats without adverse outcomes, highlighting their therapeutic potential for MDD. The study's reliance on an animal model and intracerebroventricular delivery warrants further clinical exploration to confirm these promising results.
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MESH Headings
- Animals
- Depressive Disorder, Major/drug therapy
- Depressive Disorder, Major/physiopathology
- Receptor, Galanin, Type 2/metabolism
- Rats, Sprague-Dawley
- Rats
- Brain-Derived Neurotrophic Factor/metabolism
- Male
- Receptors, Neuropeptide Y/metabolism
- Receptors, Neuropeptide Y/antagonists & inhibitors
- Neurons/drug effects
- Neurons/metabolism
- Cell Survival/drug effects
- Antidepressive Agents/pharmacology
- Antidepressive Agents/administration & dosage
- Disease Models, Animal
- Peptides
- Receptors, Neuropeptide
- Receptors, G-Protein-Coupled
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Affiliation(s)
- Dasiel Borroto-Escuela
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Receptomics and Brain Disorders Lab, Edificio Lopez-Peñalver, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Pedro Serrano-Castro
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Vithas Málaga, Vithas Málaga, Grupo Hospitalario Vithas, Málaga, Spain
| | - Jose Andrés Sánchez-Pérez
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Psychiatry, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | | | - Kjell Fuxe
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Narváez
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Vithas Málaga, Vithas Málaga, Grupo Hospitalario Vithas, Málaga, Spain
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Serbanescu I, Schramm E, Walter H, Schnell K, Zobel I, Drost S, Fangmeier T, Normann C, Schoepf D. Identifying subgroups with differential response to CBASP versus Escitalopram during the first eight weeks of treatment in outpatients with persistent depressive disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:723-737. [PMID: 37606728 PMCID: PMC10995028 DOI: 10.1007/s00406-023-01672-0] [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: 03/02/2023] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
There exists little empirical evidence helping clinicians to select the most effective treatment for individual patients with persistent depressive disorder (PDD). This study identifies and characterizes subgroups of patients with PDD who are likely to benefit more from an acute treatment with psychotherapy than from pharmacotherapy and vice versa. Non-medicated outpatients with PDD were randomized to eight weeks of acute treatment with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP; n = 29) or escitalopram plus clinical management (ESC/CM; n = 31). We combined several baseline variables to one composite moderator and identified two subgroups of patients: for 56.0%, ESC/CM was associated with a greater reduction in depression severity than CBASP, for the remaining 44.0%, it was the other way around. Patients likely to benefit more from ESC/CM were more often female, had higher rates of moderate-to-severe childhood trauma, more adverse life events and more previous suicide attempts. Patients likely to benefit more from CBASP were older, had more often an early illness onset and more previous treatments with antidepressants. Symptomatic response, remission, and reductions in symptom severity occurred more often in those patients treated with their likely more effective treatment condition. The findings suggest that the baseline phenotype of patients with PDD moderates their benefit from acute treatment with CBASP relative to ESC/CM. Once confirmed in an independent sample, these results could serve to guide the choice between primarily psychotherapeutic or pharmacological treatments for outpatients with PDD.
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Affiliation(s)
- Ilinca Serbanescu
- Institute of Psychology, Heidelberg University, Hauptstrasse 47-51, 69117, Heidelberg, Germany.
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité-University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Knut Schnell
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Rosdorfer Weg 70, 37081, Göttingen, Germany
| | - Ingo Zobel
- Psychology School at the Fresenius University of Applied Sciences Berlin, Jägerstrasse 32, 10117, Berlin, Germany
| | - Sarah Drost
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University Medical Center Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
| | - Thomas Fangmeier
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Claus Normann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Hauptstrasse 5, 79104, Freiburg, Germany
| | - Dieter Schoepf
- Department of Psychiatry and Psychotherapy, CBASP Center of Competence, University Medical Center Bonn, Sigmund-Freud-Strasse 25, 53127, Bonn, Germany
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11
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Arrabal-Gómez C, Serrano-Castro P, Sánchez-Pérez JA, Garcia-Casares N, Fuxe K, Borroto-Escuela D, Narváez M. Potentiation of antidepressant effects: NPY1R agonist and ketamine synergy enhances TrkB signaling and neurogenesis in the ventral hippocampus. Expert Opin Ther Targets 2024; 28:309-322. [PMID: 38626283 DOI: 10.1080/14728222.2024.2342524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/05/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Major Depressive Disorder (MDD) poses a significant challenge to global health, with current treatments often limited by efficacy and onset delays. This study explores the synergistic antidepressant-like effects of an NPY1R agonist and Ketamine, targeting their neurobiological interactions within the ventral hippocampus. RESEARCH DESIGN AND METHODS Utilizing a preclinical model, this study administered Neuropeptide Y receptor 1 (NPY1R) agonist and Ketamine, both separately and in combination, through intracerebroventricular (icv) and intranasal (i.n.) routes. The Forced Swimming Test (FST) was employed to assess antidepressant-like activity, while in situ Proximity Ligation Assay and immunohistochemistry were used to examine NPY1R/TrkB heteroreceptor complexes and BDNF expression in the ventral dentate gyrus (DG), along with neurogenesis markers. RESULTS The combined treatment significantly reduced immobility in the FST, indicative of enhanced antidepressant-like effects, correlated with increased formation of NPY1R/TrkB complex and brain-derived neurotrophic factor (BDNF) expression in the ventral DG. These molecular alterations were associated with increased neurogenesis. CONCLUSIONS The coadministration of an NPY1R agonist and Ketamine in a rodent model demonstrated potentiated antidepressant responses through synergistic neurobiological pathways, including TrkB signaling and hippocampal neurogenesis. This indicates a novel therapeutic strategy for MDD, warranting further clinical investigation to fully understand its implications.
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Affiliation(s)
- Carlos Arrabal-Gómez
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Vithas Málaga, Grupo Hospitalario Vithas, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Universidad de Málaga, Málaga, Spain
| | - Pedro Serrano-Castro
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Vithas Málaga, Grupo Hospitalario Vithas, Málaga, Spain
| | - Jose Andrés Sánchez-Pérez
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Psychiatry, Hospital Universitario Virgen de la Victoria, Malaga, Spain
| | - Natalia Garcia-Casares
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Kjell Fuxe
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Dasiel Borroto-Escuela
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Receptomics and Brain disorders lab, Edificio Lopez-Peñalver, Instituto de Investigación Biomédica de Málaga, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Manuel Narváez
- Instituto de Investigación Biomédica de Málaga, NeuronLab, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Unit of Neurology, Hospital Regional Universitario de Málaga, Málaga, Spain
- Vithas Málaga, Grupo Hospitalario Vithas, Málaga, Spain
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12
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Solis EC, Carlier IVE, Kamminga NGA, Giltay EJ, van Hemert AM. The clinical effectiveness of a self-management intervention for patients with persistent depressive disorder and their partners/caregivers: results from a multicenter, pragmatic randomized controlled trial. Trials 2024; 25:187. [PMID: 38481289 PMCID: PMC10938802 DOI: 10.1186/s13063-024-08033-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Persistent depressive disorder (PDD) is prevalent and debilitating. For patients with PDD, psychiatric rehabilitation using self-management interventions is advised as the next therapeutic step after multiple unsuccessful treatment attempts. The "Patient and Partner Education Program for All Chronic Diseases" (PPEP4All) is a brief, structured self-management program that focuses on functional recovery for patients and their partners/caregivers. In chronic somatic disorder populations, PPEP4All has already been shown to be clinically effective. We examined whether PPEP4All adapted for PDD (PPEP4All-PDD, nine weekly group or individual sessions) is also clinically effective for adults/elderly with PDD and their partners/caregivers compared to care-as-usual (CAU) in specialized mental healthcare. METHODS In this mixed-method multicenter pragmatic randomized controlled trial, 70 patients with PDD and 14 partners/caregivers were allocated to either PPEP4All-PDD (patients, n = 37; partners/caregivers, n = 14) or CAU (patients, n = 33; partners/caregivers, not included) and completed questionnaires at 0, 3, 6, and 12 months regarding depressive symptoms, psychopathology, psychosocial burden, mental resilience, and happiness/well-being. Qualitative data were collected regarding treatment satisfaction. Data were analyzed using mixed model analyses and an intention-to-treat (ITT) approach. RESULTS There was no statistically significant difference in any outcome regarding clinical effectiveness between PPEP4All-PDD and CAU. Subgroup analysis for depressive symptoms did not show any interaction effect for any subgroup. Although 78% of participants recommended PPEP4All-PDD, there was no difference in treatment satisfaction between PPEP4All-PDD (score = 6.6; SD = 1.7) and CAU (score = 7.6; SD = 1.2), p = 0.06. CONCLUSION Although depressive symptoms did not improve relative to CAU, this only confirmed that treatment for patients with treatment-resistant PDD should move from symptom reduction to functional recovery. Also, functional recovery may be reflected in other outcomes than psychosocial burden, such as self-empowerment, in patients with treatment-resistant PDD. Future research on PPEP4All-PDD could focus on a longer-term program and/or online program that may also be offered earlier in the treatment process as an empowerment intervention. TRIAL REGISTRATION: Netherlands Trial Register Identifier NL5818. Registered on 20 July 2016 https://clinicaltrialregister.nl/nl/trial/20302.
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Affiliation(s)
- Ericka C Solis
- Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300, RC, The Netherlands.
| | - Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300, RC, The Netherlands
| | - Noëlle G A Kamminga
- Department of Psychiatry and Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
- Faculty of Health, Medicine and Life Sciences (MHeNs), Maastricht University, Maastricht, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300, RC, The Netherlands
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300, RC, The Netherlands
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13
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Michal M, Wiltink J, Tibubos AN, Wild PS, Münzel T, Lackner K, Pfeiffer N, König J, Gieswinkel A, Beutel M, Kerahrodi JG. Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study. BMC Psychiatry 2024; 24:196. [PMID: 38459472 PMCID: PMC10924423 DOI: 10.1186/s12888-024-05658-7] [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: 04/23/2023] [Accepted: 03/04/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Symptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up. METHODS The middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms. N = 522 persons had clinically significant depression (PHQ-9 ≥ 10) and co-occurring DP/DR symptoms, and n = 599 persons had clinically significant depression (PHQ-9 ≥ 10) without DP/DR symptoms. RESULTS There were substantial health disparities between persons with and without depression. These disparities concerned a wide range of life domains, including lower quality of the recalled early life experiences with the parents, current socioeconomic status, social integration (partnership, loneliness), current social and interpersonal stressors (family, work), functional bodily complaints (e.g., tinnitus, migraine, chest pain), unhealthy lifestyle, and the prevalence of already developed physical diseases. These disparities persisted to the 5-year follow-up and were exceptionally severe for depressed persons with co-occurring DP/DR symptoms. Among the depressed persons, the co-occurrence of DP/DR symptoms more than doubled the risk for recurrence or persistence of depression. Only 6.9% of depressed persons with DP/DR symptoms achieved remission at the 5-year follow-up (PHQ-9 < 5). Depression with and without co-occurring DP/DR worsened self-rated physical health significantly. The impact of depression with co-occurring DP/DR on the worsening of the self-rated physical health status was stronger than those of age and major medical diseases (e.g., heart failure). However, only depression without DP/DR was associated with mortality in a hazard regression analysis adjusted for age, sex, and lifestyle. CONCLUSIONS The results demonstrated that DP/DR symptoms represent an important and easily assessable prognostic factor for the course of depression and health outcomes. Given the low remission rates for depression in general and depression with DP/DR in particular, efforts should be made to identify and better support this group, which is disadvantaged in many aspects of life.
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Affiliation(s)
- Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
- German Center for Cardiovascular Research (DZHK), University Medical Center Mainz, Partner site Rhine-Main, Mainz, Germany.
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Ana N Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine, Department of Medicine II, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), University Medical Center Mainz, Partner site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), University Medical Center Mainz, Partner site Rhine-Main, Mainz, Germany
| | - Karl Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany
| | - Jochem König
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander Gieswinkel
- Preventive Cardiology and Preventive Medicine, Department of Medicine II, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Jasmin Ghaemi Kerahrodi
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany
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14
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Echterhoff J, Kriston L, Klein JP, Härter M, Schramm E, Schumacher L. Symptom-specific improvement across therapies and their putative mediators: A mediation network intervention analysis. Psychother Res 2024:1-12. [PMID: 38431848 DOI: 10.1080/10503307.2024.2320349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 02/12/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVE We evaluated differential treatment effects on specific symptoms and their mediators for Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Supportive Psychotherapy (SP) in persistently depressed patients. METHOD We conducted a Bayesian mediation network intervention analysis with data from a randomized controlled trial comparing CBASP and SP. Three networks were calculated to investigate (1) differential treatment effects on specific symptoms, (2) differential treatment effects on the potential mediators interpersonal problems and social functioning, and (3) associations between change in symptoms and change in the potential mediators. RESULTS First, we found no evidence that CBASP more strongly improves most depressive symptoms specifically, except minimal evidence of symptom-specific effects on sleeping problems and self-esteem. Second, no and minimal evidence for differential treatment effects on interpersonal problems and social functioning was shown, respectively. Third, interpersonal problems and social functioning were strongly related to depressive symptoms. CONCLUSION While CBASP showed superior treatment effects for overall symptom severity, this treatment might not be superior in improving specific symptoms and the potential mediators interpersonal problems and social functioning. Still, interpersonal problems and social functioning seem to play an important role for depression symptoms. Future research needs to further investigate potential working mechanisms of CBASP.Trial registration: ClinicalTrials.gov identifier: NCT00970437.
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Affiliation(s)
- Jette Echterhoff
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jan Philipp Klein
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elisabeth Schramm
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lea Schumacher
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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15
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Silver J, Hawes M, Dougherty L, Bufferd S, Kessel E, Olino T, Carlson G, Klein D. Irritability and Temperament: Concurrent and Prospective Relationships in Childhood and Adolescence. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2024; 53:156-168. [PMID: 38100562 PMCID: PMC11043013 DOI: 10.1080/15374416.2023.2286586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
OBJECTIVE Irritability symptoms are closely associated with, and may reflect, temperament traits, particularly negative affectivity (NA). However, there are few empirical data on the relationships between child temperament and irritability symptoms. METHOD We investigated cross-sectional and longitudinal relationships between irritability symptoms and temperament traits from age 3-15 in a community sample of 609 children and their parents. Irritability symptoms were assessed through structured interviews with parents at ages 3/6, and inventories completed by parents and youth at ages 12/15. Temperament traits were assessed using parent reports at ages 3/6, and parent and child reports at ages 12/15. Path analysis and structural equation modeling were used to explore longitudinal associations from ages 3-6 and 12-15, respectively. RESULTS Higher levels of irritability symptoms at ages 3/6 were concurrently associated with higher levels of NA and lower levels of effortful control (EC). In adolescence, higher irritability symptoms were concurrently associated with higher negative temperament and disinhibition. In longitudinal analyses from age 3-6 and 12-15, irritability symptoms showed modest but significant stability after adjusting for the stability of temperament traits. However, there were significant differences in the stability paths at age 3-6, reflecting lower stability of irritability symptoms. Finally, EC at age 3 predicted increased irritability symptoms at age 6, while irritability symptoms at age 3 predicted increased NA at age 6. CONCLUSION Irritability symptoms are robustly associated with both temperamental NA and difficulty regulating attention and behavior. These findings help situate irritability symptoms within widely accepted temperament/personality taxonomies.
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Affiliation(s)
- Jamilah Silver
- Stony Brook University, Department of Psychology, Stony Brook, New York, USA
| | - Mariah Hawes
- Stony Brook University, Department of Psychology, Stony Brook, New York, USA
| | | | | | - Ellen Kessel
- Division of Child and Adolescent Psychiatry, Columbia University and New York State Psychiatric Institute, New York, NY
| | | | | | - Daniel Klein
- Stony Brook University, Department of Psychology, Stony Brook, New York, USA
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16
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Liu Z, Zhou Z, Ma J, Dong J, Sun Y, Pang M, Huang Y. Major depressive disease research in BRICS: A bibliometric analysis of publications from 2003 to 2022. Asian J Psychiatr 2024; 92:103900. [PMID: 38218004 DOI: 10.1016/j.ajp.2023.103900] [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: 10/17/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024]
Abstract
Major depressive disorder (MDD) seriously threatens human health. BRICS, known as an acronym for "Brazil, Russia, India, China, and South Africa," were also actively carrying out researches on MDD. This study aimed to conduct a bibliometric study of research on MDD conducted by the BRICS. By searching in the Web of Science and using the software Vosviewer and Citespace as analysis tools, this study analyzed the cooperation network at the country, institution, author-specific levels, the research hotspots and trends from BRICS between 2003-2022. A total of 10,911 articles were finally included. Our findings showed that researches on MDD from BRICS rapidly increased during the past two decades. China and India have shown explosive growth, while South Africa has the largest average "Usage Count" and "Time Cited". The current cooperation partners of the BRICS were mainly high-income countries and other developing countries with similar cultures, languages, and geographical locations. Institutions in high-income countries served as the main bridges for BRICS cooperation, while at the author level, some core authors in the BRICS countries serve as centers. China showed a flexible model in domestic partnership, but institutions and authors in the other four countries have gathered to cooperate within the group. BRICS research on MDD mainly focused on cognitive science, brain science, epidemiology, and disease mechanisms. The keywords"gut microbiota", "network analysis," "machine learning" and "sleep quality" showed explosive growth and might become research hotspots in the near future. This bibliometric analysis provided a science knowledge graph and references for other researchers.
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Affiliation(s)
- Zuokun Liu
- Department of Global Health, School of Public Health, Peking University, China
| | | | - Jiyan Ma
- Department of Global Health, School of Public Health, Peking University, China
| | - Jinya Dong
- Department of Global Health, School of Public Health, Peking University, China
| | - Yinuo Sun
- Department of Global Health, School of Public Health, Peking University, China
| | - Mingfan Pang
- Department of Global Health, School of Public Health, Peking University, China
| | - Yangmu Huang
- Department of Global Health, School of Public Health, Peking University, China; Institute for Global Health and Development, Peking University, China.
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17
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Wang N, Yan X, Imm K, Xu T, Li S, Gawronska J, Wang R, Smith L, Yang L, Cao C. Racial and ethnic disparities in prevalence and correlates of depressive symptoms and suicidal ideation among adults in the United States, 2017-2020 pre-pandemic. J Affect Disord 2024; 345:272-283. [PMID: 37898474 DOI: 10.1016/j.jad.2023.10.138] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/17/2023] [Accepted: 10/21/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND This study aims to estimate the pre-COVID-19 pandemic prevalence of mild, major depressive symptoms, and suicide ideation among U.S. adults and evaluate their correlates and racial/ethnic disparities. METHODS This is a cross-sectional analysis of a nationally representative sample of adults ≥20 years from the National Health and Nutrition Examination Survey study 2017-2020 Pre-Pandemic. Overall and racial/ethnic-specific weighted prevalence and 95%CI of mild and major depressive symptoms and suicidal ideation assessed by the Patient Health Questionnaire-9 were calculated. Multivariable logistic regression modelings were used to examine overall and racial/ethnic-specific correlates. RESULTS Data on 7917 US adults (Weighted N = 210,200,829; 51.8 % females) were analyzed. The prevalence of mild, major depressive symptoms, and suicidal ideation was 8.5 %, 16.5 %, and 3.2 %, respectively. Overall, consistent correlates for all three conditions included smoking, short/long sleep duration, and obesity. Females, non-Hispanic Blacks, low family-poverty-income ratio, prolonged sitting time, and a history of cardiovascular disease were consistent correlates for mild and major depressive symptoms. Younger age, never married/living without a partner, physical inactivity, drinking alcohol, and a history of diabetes were related to major depressive symptoms. Never married/living without a partner and having a low family-poverty-income ratio correlate with suicide ideation. Having cancer diagnosis was only negatively associated with major depressive symptoms in non-Hispanic Blacks. Females, current smoking, short/long sleep duration, and having cardiovascular disease were correlated with suicidal ideation among Hispanics. CONCLUSIONS The prevalence of mild, major depressive symptoms, and suicidal ideation were high among U.S. adults. Unique correlates were identified among different racial and ethnic groups.
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Affiliation(s)
- Nan Wang
- Department of Public Health Sciences, University of California, Davis, CA, USA.
| | - Xinyi Yan
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kellie Imm
- Division of Epidemiology & Genetics, Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Tianlin Xu
- Department of Biostatistics and Data Science, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shuang Li
- Department of Sociology and Criminology, Bridgewater College, Bridgewater, VA, USA
| | - Julia Gawronska
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ruixuan Wang
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, FL, USA
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Chao Cao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
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18
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Zhou Y, Zhu Y, Ye H, Jiang W, Zhang Y, Kong Y, Yuan Y. Abnormal changes of dynamic topological characteristics in patients with major depressive disorder. J Affect Disord 2024; 345:349-357. [PMID: 37884195 DOI: 10.1016/j.jad.2023.10.143] [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: 03/17/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Most studies have detected abnormalities of static topological characteristics in major depressive disorder (MDD). However, whether dynamic alternations in brain topology are influenced by MDD remains unknown. METHODS An approach was proposed to capture the dynamic topological characteristics with sliding-window and graph theory for a large data sample from the REST-meta-MDD project. RESULTS It was shown that patients with MDD were characterized by decreased nodal efficiency of the left orbitofrontal cortex. The temporal variability of topological characteristics was focused on the left opercular part of inferior frontal gyrus, and the right part of middle frontal gyrus, inferior parietal gyrus, precuneus and thalamus. LIMITATIONS Future studies need larger and diverse samples to explore the relationship between dynamic topological network characteristics and MDD symptoms. CONCLUSIONS The results support that the altered dynamic topology in cortex of frontal and parietal lobes and thalamus during resting-state activity may be involved in the neuropathological mechanism of MDD.
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Affiliation(s)
- Yue Zhou
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yihui Zhu
- Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu Province 210096, China
| | - Hongting Ye
- Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu Province 210096, China
| | - Wenhao Jiang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Yubo Zhang
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
| | - Youyong Kong
- Jiangsu Provincial Joint International Research Laboratory of Medical Information Processing, School of Computer Science and Engineering, Southeast University, Nanjing, Jiangsu Province 210096, China.
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Southeast University, Nanjing 210009, China.
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19
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Meng Y, Sun J, Zhang G. Pick fecal microbiota transplantation to enhance therapy for major depressive disorder. Prog Neuropsychopharmacol Biol Psychiatry 2024; 128:110860. [PMID: 37678703 DOI: 10.1016/j.pnpbp.2023.110860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/23/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
In recent years, fecal microbiota transplantation (FMT) has emerged as a promising therapy for major depressive disorder (MDD). The goal of the operation is to restore a healthy gut microbiota by introducing feces from a healthy donor into the recipient's digestive system. The brain-gut axis is thought to have a significant role in regulating mood, behavior, and cognition, which supports the use of FMT in the treatment of MDD. Numerous studies have shown a correlation between abnormalities of the gut microbiota and MDD, whereas FMT has demonstrated the potential to restore microbial equilibrium. While FMT has shown encouraging results, it is crucial to highlight the potential hazards and limits inherent to this therapeutic approach. Stool donor-to-recipient disease transfer is a concern of FMT. Furthermore, it still needs to be determined what effect FMT has on the gut microbiota and the brain in the long run. This literature review provides an overview of the possible efficacy of FMT as a therapeutic modality for MDD. There is hope for patients who have not reacted well to typical antidepressant therapy since FMT may become an invaluable tool in the treatment of MDD as researchers continue to examine the relationship between gut microbiota and MDD.
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Affiliation(s)
- Yiming Meng
- Department of Central Laboratory, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China.
| | - Jing Sun
- Department of Biobank, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China
| | - Guirong Zhang
- Department of Central Laboratory, Cancer Hospital of Dalian University of Technology, Liaoning Cancer Hospital & Institute, No. 44, Xiaoheyan Road, Dadong District, Shenyang 110042, China
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20
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Zhou Z, Ye Q, Ren H, Zhang Y, Han B, Yao H, Bai Y. CircDYM attenuates microglial apoptosis via CEBPB/ZC3H4 axis in LPS-induced mouse model of depression. Int J Biol Macromol 2024; 254:127922. [PMID: 37944732 DOI: 10.1016/j.ijbiomac.2023.127922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/04/2023] [Accepted: 11/04/2023] [Indexed: 11/12/2023]
Abstract
Major depressive disorder (MDD) is a highly prevalent condition and one of the most common psychiatric disorders worldwide. Circular RNA (circRNA) has been increasingly implicated in MDD. However, a comprehensive understanding of circRNA and microglial apoptosis in depression is incomplete. Here, we show that circDYM inhibits microglial apoptosis induced by LPS via CEBPB/ZC3H4 axis. CircDYM prevents the translocation of CEBPB from cytoplasm to the nucleus by binding with CEBPB. Moreover, LPS-induced CEBPB nuclear entry downregulates the expression of ZC3H4, in which promotes autophagy and apoptosis in microglia. Taken together, our findings provide new insights into the relationship between circDYM and microglial apoptosis and shed new light on the function of this novel mechanism in depression-associated complex changes in the brain.
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Affiliation(s)
- Zhongqiu Zhou
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China
| | - Qingqing Ye
- Department of Pharmacy, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Hui Ren
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China
| | - Yuan Zhang
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China
| | - Bing Han
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China
| | - Honghong Yao
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China; Institute of Life Sciences, Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China
| | - Ying Bai
- Department of Pharmacology, Jiangsu Provincial Key Laboratory of Critical Care Medicine, School of Medicine, Southeast University, Nanjing, China.
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21
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Kurkin DV, Morkovin EI, Bakulin DA, Gorbunova YV, Ivanova OV, Pavlova EV, Zvereva VI, Dzhavakhyan MA, Krysanov IS, Kolosov YA, Zaborovsky AV, Strygin AV, Petrov VI, Beliy PA, Zaslavskaya KY, Maltsev DV, Skripka MO. [Targeting NMDAR/AMPAR: a promising pharmacotherapeutic approach for depressive disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:22-30. [PMID: 38884426 DOI: 10.17116/jnevro202412405122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Depression is a leading cause of disability and reduced work capacity worldwide. The monoamine theory of the pathogenesis of depression has remained dominant for many decades, however, drugs developed on its basis have limited efficacy. Exploring alternative mechanisms underlying this pathology could illuminate new avenues for pharmacological intervention. Targeting glutamatergic pathways in the CNS, particularly through modulation of NMDA and AMPA receptors, demonstrates promising results. This review presents some existing drugs with glutamatergic activity and novel developments based on it to enhance the efficacy of pharmacotherapy for depressive disorders.
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Affiliation(s)
- D V Kurkin
- Russian University of Medicine, Moscow, Russia
- Volgograd State Medical University, Volgograd, Russia
| | - E I Morkovin
- Volgograd State Medical University, Volgograd, Russia
| | - D A Bakulin
- Russian University of Medicine, Moscow, Russia
| | | | - O V Ivanova
- Russian University of Medicine, Moscow, Russia
| | - E V Pavlova
- Russian University of Medicine, Moscow, Russia
| | - V I Zvereva
- Russian University of Medicine, Moscow, Russia
| | | | | | | | | | - A V Strygin
- Volgograd State Medical University, Volgograd, Russia
| | - V I Petrov
- Volgograd State Medical University, Volgograd, Russia
| | - P A Beliy
- Russian University of Medicine, Moscow, Russia
| | - K Y Zaslavskaya
- Ogarev National Research Mordovia State University, Saransk, Russia
| | - D V Maltsev
- Volgograd State Medical University, Volgograd, Russia
| | - M O Skripka
- Volgograd State Medical University, Volgograd, Russia
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22
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Price GD, Heinz MV, Song SH, Nemesure MD, Jacobson NC. Using digital phenotyping to capture depression symptom variability: detecting naturalistic variability in depression symptoms across one year using passively collected wearable movement and sleep data. Transl Psychiatry 2023; 13:381. [PMID: 38071317 PMCID: PMC10710399 DOI: 10.1038/s41398-023-02669-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Major Depressive Disorder (MDD) presents considerable challenges to diagnosis and management due to symptom variability across time. Only recent work has highlighted the clinical implications for interrogating depression symptom variability. Thus, the present work investigates how sociodemographic, comorbidity, movement, and sleep data is associated with long-term depression symptom variability. Participant information included (N = 939) baseline sociodemographic and comorbidity data, longitudinal, passively collected wearable data, and Patient Health Questionnaire-9 (PHQ-9) scores collected over 12 months. An ensemble machine learning approach was used to detect long-term depression symptom variability via: (i) a domain-driven feature selection approach and (ii) an exhaustive feature-inclusion approach. SHapley Additive exPlanations (SHAP) were used to interrogate variable importance and directionality. The composite domain-driven and exhaustive inclusion models were both capable of moderately detecting long-term depression symptom variability (r = 0.33 and r = 0.39, respectively). Our results indicate the incremental predictive validity of sociodemographic, comorbidity, and passively collected wearable movement and sleep data in detecting long-term depression symptom variability.
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Affiliation(s)
- George D Price
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA.
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA.
| | - Michael V Heinz
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
| | - Seo Ho Song
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Matthew D Nemesure
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA
- Digital Data Design Institute, Harvard Business School, Harvard University, Cambridge, MA, USA
| | - Nicholas C Jacobson
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Quantitative Biomedical Sciences Program, Dartmouth College, Lebanon, NH, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Lebanon, NH, USA
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23
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Wolf J, Reinhard MA, Goerigk S, Barton BB, Burkhardt G, Tang J, Eder J, Amann BL, Bertsch K, Jobst A, Musil R, Padberg F. Suicidal behaviors and adverse childhood experiences: A cross-diagnostic study in persistent depressive disorder and borderline personality disorder. Psychiatry Res 2023; 330:115562. [PMID: 37918208 DOI: 10.1016/j.psychres.2023.115562] [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: 06/13/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Adverse childhood experiences (ACE) constitute a known risk factor for suicidality. There is a research gap regarding differential patterns of associations between variants of suicidal ideations and behaviors (SIB) and characteristics of ACE in severe mental disorders. This cross-diagnostic study investigates whether SIB are related to ACE subtypes in two high-risk conditions, i.e., persistent depressive disorder (PDD) and borderline personality disorder (BPD). Inpatients with PDD (n = 117; age 40.2 years ± 12.3) and BPD (n = 74; age 26.2 ± 7.9) were assessed with the Columbia-Suicide Severity Rating Scale for suicidal ideations (SI), suicidal behaviors (SB) and actual suicide attempts (SA); ACE were recorded with the Childhood Trauma Questionnaire. In PDD, SI and SA were associated with childhood physical abuse (ORs 7.2 and 2.3, respectively). In BPD, SA were associated with severe experiences of physical abuse (OR 6.5). Weaker yet significant associations were found for childhood emotional abuse in PDD with SB (including SA), and in BPD with SA. Recall of childhood physical abuse may be clinically relevant information for identifying particular risks of SIB. Future studies should investigate these differential patterns in more depth and in terms of causality.
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Affiliation(s)
- Johannes Wolf
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany.
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany; Charlotte Fresenius Hochschule, Munich, Germany
| | - Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Jeni Tang
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Julia Eder
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Benedikt L Amann
- Centro Fórum Research Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar Medical Research Institute (IMIM), Parc de Salut Mar, Barcelona, Spain; Pompeu Fabra University Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto Carlos III, Madrid, Spain
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
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24
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Okami T, Toshishige Y, Kondo M, Okazaki J, Mizushima H, Akechi T. Interpersonal psychotherapy for comorbid prolonged grief disorder and persistent depressive disorder in a Japanese patient: A case report. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e161. [PMID: 38868732 PMCID: PMC11114255 DOI: 10.1002/pcn5.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/05/2023] [Accepted: 11/17/2023] [Indexed: 06/14/2024]
Abstract
Background Prolonged grief disorder (PGD) is a new diagnostic entity. However, treatment for PGD is not yet available. Interpersonal psychotherapy (IPT) may be effective for PGD. Case Presentation A single 27-year-old Japanese woman lost her brother to suicide. However, she did not express her grief to anyone or visit a psychiatric clinic. After experiencing strong depressive symptoms triggered by work stress, she visited a psychiatric clinic, where she was diagnosed with depression as well as PGD. Through pharmacotherapy, her depressive symptoms improved, but no improvement was noted in her PGD symptoms. She therefore began IPT for PGD at our hospital, 5 years after her brother's suicide and after 4 years of PGD symptoms. In the introductory phase of IPT, she was diagnosed with comorbid persistent depressive disorder (PDD). After this diagnosis, through psychoeducation on PDD, she could identify the symptoms that reflected her personality traits as "PDD symptoms." Furthermore, she could affirm her positive and negative feelings and share them with others. Consequently, the grieving process was facilitated, and her interests and relationships were re-established. Her PGD and PDD symptoms improved. Conclusion IPT may be effective for PGD comorbid with PDD among Japanese.
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Affiliation(s)
- Takuya Okami
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Yuko Toshishige
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Masaki Kondo
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | | | | | - Tatsuo Akechi
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
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25
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Brock J, Basu N, Schlachetzki JCM, Schett G, McInnes IB, Cavanagh J. Immune mechanisms of depression in rheumatoid arthritis. Nat Rev Rheumatol 2023; 19:790-804. [PMID: 37923863 DOI: 10.1038/s41584-023-01037-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 11/06/2023]
Abstract
Depression is a common and disabling comorbidity in rheumatoid arthritis that not only decreases the likelihood of remission and treatment adherence but also increases the risk of disability and mortality in patients with rheumatoid arthritis. Compelling data that link immune mechanisms to major depressive disorder indicate possible common mechanisms that drive the pathology of the two conditions. Preclinical evidence suggests that pro-inflammatory cytokines, which are prevalent in rheumatoid arthritis, have various effects on monoaminergic neurotransmission, neurotrophic factors and measures of synaptic plasticity. Neuroimaging studies provide insight into the consequences of inflammation on the brain (for example, on neural connectivity), and clinical trial data highlight the beneficial effects of immune modulation on comorbid depression. Major depressive disorder occurs more frequently in patients with rheumatoid arthritis than in the general population, and major depressive disorder also increases the risk of a future diagnosis of rheumatoid arthritis, further highlighting the link between rheumatoid arthritis and major depressive disorder. This Review focuses on interactions between peripheral and central immunobiological mechanisms in the context of both rheumatoid arthritis and major depressive disorder. Understanding these mechanisms will provide a basis for future therapeutic development, not least in depression.
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Affiliation(s)
- James Brock
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Neil Basu
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | | | - Georg Schett
- Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
- Universitätsklinikum Erlangen, Erlangen, Germany
| | - Iain B McInnes
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Jonathan Cavanagh
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK.
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26
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Klein JP, Schaich A, Furukawa TA. How should narcissism be treated best? Lancet Psychiatry 2023; 10:914-916. [PMID: 37844593 DOI: 10.1016/s2215-0366(23)00307-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 10/18/2023]
Affiliation(s)
- Jan Philipp Klein
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Lübeck University, Lübeck 23538, Germany; Center for Brain, Behavior, and Metabolism, Lübeck University, Lübeck, Germany.
| | - Anja Schaich
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Lübeck University, Lübeck 23538, Germany; Department of Psychiatry, Psychosomatics and Psychotherapy, Kiel University, Kiel, Germany
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan
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27
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Li M, Gao W, Zhang Y, Luo Q, Xiang Y, Bao K, Zaki N. Secular trends in the incidence of major depressive disorder and dysthymia in China from 1990 to 2019. BMC Public Health 2023; 23:2162. [PMID: 37926849 PMCID: PMC10626640 DOI: 10.1186/s12889-023-17025-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Depression is increasingly recognized as a worldwide serious, public health concern. A better understanding of depression is important for advancing its management and learning the difference between major depressive disorder (MDD) and dysthymia. Our aim is to conduct a concurrent analysis of the trends of both MDD and dysthymia in China. METHODS The data on depression from 1990 to 2019 were collected from the Global Burden of Disease Study 2019 (GBD 2019). To determine the average annual percent changes (AAPC) and relative risks (RRs), joinpoint regression and the age-period-cohort models were employed, respectively. RESULTS The incidence number of MDD and dysthymia continuously increased in China from 1990 to 2019, however, the age-standardized rates (ASR) had a decreasing trend in both men and women. The results from joinpoint regression showed that a declining trend was presented in young people (< 50 years) but an increased trend in the elderly (≥ 50 years) both in men and women, during 1990-2019. Age is the most influential factor for MDD and dysthymia. Age RRs for MDD incidence had an overall increasing trend with age. Period RR in MDD presented a U-shaped pattern, while Cohort RRs presented an inverted U-shaped pattern. On the other hand, RRs in dysthymia for period and cohort effects had no statistical significance, only the age effect presented an inverted U-shaped pattern. CONCLUSIONS The disparities in trends observed between MDD and dysthymia during the period of 1990-2019 indicated the significance of distinguishing between these two disorders. The age, period and cohort effects all had a greater impact on MDD than on dysthymia, and age effects presented different influential patterns in these two. To alleviate the burden of depressive disorders in China, proactive measures need to be implemented, with particular attention to the elderly population.
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Affiliation(s)
- Ming Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Wenlong Gao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China.
| | - Yuqi Zhang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Qiuxia Luo
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Yuanyuan Xiang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Kai Bao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
| | - Noha Zaki
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Tianshui Southern Road 222, Lanzhou, Gansu, P. R. China
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28
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Goerigk S, Reinhard MA, Barton BB, Burkhardt G, Ehring T, Bertsch K, Amann BL, Sarubin N, Seidl E, Falkai P, Musil R, Jobst A, Padberg F. Transdiagnostic analysis of adverse childhood experiences and their association with psychopathology-A TRANS-D conform study. Psychiatry Res 2023; 329:115545. [PMID: 37879200 DOI: 10.1016/j.psychres.2023.115545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/08/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023]
Abstract
Transdiagnostic approaches challenge traditional psychiatric classification systems. Adverse childhood experiences (ACE) represent a transdiagnostic risk factor for psychopathology with dose dependency. As different qualities of ACE typically co-occur, we identified ACE patterns to assess their power for predicting psychopathology compared to traditional diagnoses. Following TRANS-D guidelines, we categorized participants (N=360) with persistent depressive disorder (PDD), borderline personality disorder (BPD), or healthy control status (HC) into subcategories defined by ACE pattern, using the Childhood Trauma Questionnaire (CTQ). Improvement of the transdiagnostic vs. diagnostic approach in predicting psychopathology was evaluated in a cross-validated predictive modeling framework focusing on the clinical sample of PDD and BPD patients. Results were externally validated in another transdiagnostic sample (N=138). Seven pattern-based subcategories with distinct ACE profiles were identified in the primary sample and replicated in the validation sample. Patterns cut across diagnostic groups. Predictive modeling showed that diagnoses could not predict depressive symptoms and loneliness. Transdiagnostic constructs systematically predicted all measures. This study showcases ACE as a promising construct for transdiagnostic research. Our data-driven framework identified robust ACE subcategories mapping onto general and interpersonal psychopathology. Patterns of CTQ-based information may provide an approach to integrating information on co-occurring ACE to inform diagnostics and treatment.
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Affiliation(s)
- Stephan Goerigk
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University, Leopoldstrasse 13, Munich 80802, Germany; Charlotte Fresenius Hochschule, Infanteriestrasse 11A, Munich 80797, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany.
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Barbara B Barton
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Thomas Ehring
- DZPG (German Center for Mental Health), Partner Site, Munich, Germany; Department of Psychology, Ludwig-Maximilians-University, Leopoldstrasse 13, Munich 80802, Germany
| | - Katja Bertsch
- DZPG (German Center for Mental Health), Partner Site, Munich, Germany; Department of Psychology, Ludwig-Maximilians-University, Leopoldstrasse 13, Munich 80802, Germany
| | - Benedikt L Amann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany; Centre Fòrum Research Unit, Parc De Salut Mar, IMIM (Hospital del Mar Medical Research Institute), Pompeu Fabra University, Barcelona, Spain; Instituto Carlos III, CIBERSAM, Madrid, Spain
| | - Nina Sarubin
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; Department of Psychological Methodology and Assessment, Ludwig-Maximilians-University, Leopoldstrasse 13, Munich 80802, Germany; Charlotte Fresenius Hochschule, Infanteriestrasse 11A, Munich 80797, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Elias Seidl
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany; Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, Ludwig-Maximilians-University, Lindwurmstrasse 4, Munich 80337, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany; Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, Munich 80804, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nussbaumstrasse 7, Munich 80336, Germany; DZPG (German Center for Mental Health), Partner Site, Munich, Germany
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Fang S, Wu Z, Guo Y, Zhu W, Wan C, Yuan N, Chen J, Hao W, Mo X, Guo X, Fan L, Li X, Chen J. Roles of microglia in adult hippocampal neurogenesis in depression and their therapeutics. Front Immunol 2023; 14:1193053. [PMID: 37881439 PMCID: PMC10597707 DOI: 10.3389/fimmu.2023.1193053] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 09/20/2023] [Indexed: 10/27/2023] Open
Abstract
Adult hippocampal neurogenesis generates functional neurons from neural progenitor cells in the hippocampal dentate gyrus (DG) to complement and repair neurons and neural circuits, thus benefiting the treatment of depression. Increasing evidence has shown that aberrant microglial activity can disrupt the appropriate formation and development of functional properties of neurogenesis, which will play a crucial role in the occurrence and development of depression. However, the mechanisms of the crosstalk between microglia and adult hippocampal neurogenesis in depression are not yet fully understood. Therefore, in this review, we first introduce recent discoveries regarding the roles of microglia and adult hippocampal neurogenesis in the etiology of depression. Then, we systematically discuss the possible mechanisms of how microglia regulate adult hippocampal neurogenesis in depression according to recent studies, which involve toll-like receptors, microglial polarization, fractalkine-C-X3-C motif chemokine receptor 1, hypothalamic-pituitary-adrenal axis, cytokines, brain-derived neurotrophic factor, and the microbiota-gut-brain axis, etc. In addition, we summarize the promising drugs that could improve the adult hippocampal neurogenesis by regulating the microglia. These findings will help us understand the complicated pathological mechanisms of depression and shed light on the development of new treatment strategies for this disease.
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Affiliation(s)
- Shaoyi Fang
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhibin Wu
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Yali Guo
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Wenjun Zhu
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Chunmiao Wan
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Naijun Yuan
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Shenzhen People’s Hospital, 2Clinical Medical College, Jinan University, Shenzhen, China
| | - Jianbei Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Wenzhi Hao
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xiaowei Mo
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xiaofang Guo
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Lili Fan
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xiaojuan Li
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Jiaxu Chen
- Formula-Pattern of Traditional Chinese Medicine, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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Schefft C, Heinitz C, Guhn A, Brakemeier EL, Sterzer P, Köhler S. Efficacy and acceptability of third-wave psychotherapies in the treatment of depression: a network meta-analysis of controlled trials. Front Psychiatry 2023; 14:1189970. [PMID: 37867779 PMCID: PMC10585267 DOI: 10.3389/fpsyt.2023.1189970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 09/12/2023] [Indexed: 10/24/2023] Open
Abstract
Introduction In recent decades, various new psychotherapy approaches have been developed in an effort to overcome issues of non-response, referred to as "third-wave psychotherapies." How third-wave therapies perform in comparison to each other, to classical CBT, or other common comparators in the treatment of depression has not yet been systematically assessed. Methods We firstly determined the scope of the term "third-wave" by conducting a systematic search. The identified approaches were then used as search terms for the systematic review and network meta-analysis (NMA). We searched MEDLINE, CENTRAL, PsychINFO and Web of Science from inception until 31 July 2022. We assessed randomized controlled trials comparing third-wave psychotherapies to each other, CBT, treatment as usual (TAU), medication management, active control conditions, or waitlist (WL) in adult populations with depressive disorders. The treatments included were acceptance and commitment therapy, behavioral activation, cognitive behavioral analysis system of psychotherapy, dialectical behavioral therapy, mindfulness-based cognitive therapy, meta-cognitive therapy, positive psychotherapy and schema therapy. The primary outcome was depression severity (efficacy) at study endpoint, and the secondary outcome was all-cause discontinuation (acceptability). This review was registered in PROSPERO, identifier CRD42020147535. Results Of 7,971 search results, 55 trials were included in our NMA (5,827 patients). None of the third-wave therapies were more efficacious than CBT but most were superior to TAU [standardized mean differences (SMD) ranging between 0.42 (95% CI -0.37; 1.19) and 1.25 (0.48; 2.04)]. Meta-cognitive therapy (MCT) was more efficacious than three other third-wave therapy approaches. None of the third-wave treatments were more acceptable than WL or CBT. Twenty-seven percent of the trials were rated as low risk of bias. Confidence in the evidence was largely low according to GRADE. Inconsistency emerged for a small number of comparisons. Interpretations Third-wave therapies are largely efficacious and acceptable alternatives to CBT when compared to TAU, with few differences between them. The evidence so far does not point toward superiority or inferiority over CBT. Patient-level research may offer possibilities for tailoring individual psychotherapies to the needs of individual patients and future trials should make this data available. The evidence base needs to be broadened by sufficiently powered trials.
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Affiliation(s)
- Cora Schefft
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Berlin, Germany
| | - Christian Heinitz
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Berlin, Germany
| | - Anne Guhn
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Berlin, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Philipp Sterzer
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Berlin, Germany
| | - Stephan Köhler
- Department of Psychiatry and Neurosciences, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt—Universität zu Berlin, Berlin, Germany
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Zheng X, Zhou X, Tong L, Gu W, Wang S, Yuang W, Zhang C, Zhang C, Zhang C, Wan B. Mendelian randomization study of gastroesophageal reflux disease and major depression. PLoS One 2023; 18:e0291086. [PMID: 37768900 PMCID: PMC10538746 DOI: 10.1371/journal.pone.0291086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 08/22/2023] [Indexed: 09/30/2023] Open
Abstract
This study systematically investigated the causal relationship between gastroesophageal reflux disease (GERD) and major depression (MD). Single-nucleotide polymorphisms (SNPs) associated with disorders of interest were screened via the genome-wide association study (GWAS) enrolling individuals of European descent. Summary-level data for GERD and MD were extracted from the UK Biobank. The inverse-variance-weighted (IVW) method was utilized as the primary analysis. Sensitivity analyses were performed using the MR-Egger method, the Maximum likelihood method, the MR-pleiotropy residual sum outlier (MR-PRESSO) method, and MR-robust adjusted profile score (MR-RAPS) method. MR-Egger regression, heterogeneity tests, pleiotropy tests, and leave-one-out tests were also performed to analyze sensitivity. The MR Steiger test was used to verify the directionality of the exposure to the outcome. An available website tool (https://shiny.cnsgenomics.com/mRnd/) was used to calculate the statistical power of MR analysis. Meta-analysis was applied to test MD's average genetically predicted effect on GERD. Our MR study showed a bidirectional causal association between MD and GERD. Regarding MD to GERD, there was a positive association between them; the ORs were 1.500 (95% CI = 1.320-1.704; P = 4.91E-10) and 2.058 (95% CI = 1.868-2.267; P = 2.20E-48) in the IVW method, respectively. In addition, the meta-analysis also showed a strong positive causal association between MD and GERD. When exposure and outcome were reversed, genetic predisposition to GERD was significantly associated with the overall Risk of advanced MD (ieu-a-1187, OR = 1.982, 95% CI = 1.694-2.319, P = 1.41E-17; ieu-b-102, OR = 1.612, 95% CI = 1.530-2.700, P = 1.15E-70). Our study provides 100% power to detect the causal effect of MD on GERD and vice versa. Genetically predicted MD was positively associated with higher GERD risk, and vice versa. Our study reminds clinicians to pay attention to screening for GERD when diagnosing and treating MD and vice versa. Moreover, there may be positive feedback between MD and GERD when treating and preventing one disorder may benefit the treatment and prevention of the other.
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Affiliation(s)
- Xiaofei Zheng
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xin Zhou
- Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Li Tong
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wang Gu
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Siyu Wang
- Reproductive Medical Center, Hainan Women and Children's Medical Center, Haikou, China
| | - Wenkang Yuang
- Reproductive Medical Center, Hainan Women and Children's Medical Center, Haikou, China
| | - Chong Zhang
- Reproductive Medical Center, Hainan Women and Children's Medical Center, Haikou, China
| | - Chaoyang Zhang
- Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chao Zhang
- Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Bangbei Wan
- Reproductive Medical Center, Hainan Women and Children's Medical Center, Haikou, China
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He D, Fan Y, Qiao Y, Liu S, Zheng X, Zhu J. Depressive symptom trajectories and new-onset arthritis in a middle-aged and elderly Chinese population. J Psychosom Res 2023; 172:111422. [PMID: 37379786 DOI: 10.1016/j.jpsychores.2023.111422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/11/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE Previous studies reported that depression was associated with a high risk of arthritis. However, the effect of different long-term depressive symptom trajectory patterns on the risk of arthritis has not been evaluated. Our study aimed to explore the association between depressive symptom trajectories and the risk of arthritis. METHODS A total of 5583 participants from the China Health and Retirement Longitudinal Study from 2011 to 2018 were included in this analysis. Group-based trajectory modeling was used to identify depressive symptom trajectories, and a multivariable competitive Cox regression model was used to examine the association of depressive symptom trajectories with arthritis during follow-up. RESULTS Five depressive symptom trajectories were identified in our research: stable-high, decreasing, increasing, stable-moderate and stable-low. Compared with participants in the stable-low trajectory group, those in the stable-moderate, increasing, decreasing and stable-high trajectory groups had a higher cumulative risk of arthritis, with HRs (95% CIs) for arthritis of 1.64 (1.30, 2.07), 1.86 (1.30, 2.66), 1.99 (1.41, 2.80) and 2.19 (1.38, 3.48), respectively. Participants with the stable-high symptoms trajectory had the highest cumulative risk of arthritis. There was still a high risk of arthritis, although the depression state was reduced and remained at a level that is generally considered reasonable. CONCLUSIONS The higher depressive symptoms trajectories were significantly associated with the increased risk of arthritis, and the long-term depressive symptoms trajectories may be a strong predictor of having arthritis.
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Affiliation(s)
- Dingliu He
- Department of Clinical Nutrition, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, 224001, PR China
| | - Yayun Fan
- Department of Clinical Nutrition, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, 224001, PR China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Xiaowei Zheng
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, 1800 Lihu Road, Binhu District, Wuxi, Jiangsu Province 214122, PR China.
| | - Juanjuan Zhu
- Department of Clinical Nutrition, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, 224001, PR China.
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Tschiesner R. Infra-Low-Frequency Neurofeedback Treatment in Dysthymia: A Case Study. Behav Sci (Basel) 2023; 13:711. [PMID: 37753989 PMCID: PMC10525676 DOI: 10.3390/bs13090711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/28/2023] Open
Abstract
Depression is one of the most common mental disorders worldwide. Dysthymia, a long-lasting form of depressive disorder that is also known as persistent depressive disorder (PDD) with pure dysthymic syndrome according to the Diagnostical and Statical Manual of Mental Disorders (DSM-5), is characterised by being difficult to treat. The most prominent therapeutic approaches in treating dysthymia are pharmacotherapy and psychotherapy, but recent studies also demonstrate the success of neurofeedback in treating individuals with depressive disorders. However, infra-low-frequency (ILF) neurofeedback, the main new neurofeedback protocol, lacks empirical evidence, and there is no evidence that it can treat dysthymia. This case report investigates the ILF neurofeedback method in a male patient with dysthymia. After 45 sessions of ILF neurofeedback combined with ILF synchrony, a decrease in symptom severity was found on assessment after treatment, and these results remained consistent at a low level at a 6-month follow-up. Additionally, the patient reported benefits on interpersonal and cognitive levels and in daily life situations. This study should incentivise further investigations into using ILF neurofeedback to treat dysthymia and all variations of depressive disorders.
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Albert U, Tomasetti C, Marra C, Neviani F, Pirani A, Taddeo D, Zanetti O, Maina G. Treating depression in clinical practice: new insights on the multidisciplinary use of trazodone. Front Psychiatry 2023; 14:1207621. [PMID: 37654988 PMCID: PMC10466041 DOI: 10.3389/fpsyt.2023.1207621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/28/2023] [Indexed: 09/02/2023] Open
Abstract
Depression is estimated to be a leading contributor to the global mental health-related burden. The determinants of this huge prevalence lie in the fact that depressive symptoms may be comorbid in a wide variety of disorders, thus complicating and exacerbating their clinical framework. This makes the treatment of depressive symptoms difficult, since many pharmacological interactions should be considered by physicians planning therapy. Hence, depression still represents a challenge for both psychiatrists and other clinicians, in terms of its high rates of relapse and resistance despite well-established protocols. It is also complicated by the well-known latency in its complete response to current antidepressant treatments. In this context, the search for new strategies regarding antidepressant treatment is mandatory. Revising the use of "old" pharmacotherapies by considering their specific features may help to perfecting the treatment of depression, both in its standalone psychiatric manifestation and in the framework of other clinical conditions. Using a nominal group technique approach, the results of a consensus of expert physicians regarding the possible use of trazodone as a valuable strategy for addressing the "real world" unmet needs of depression treatment in different fields (psychiatry, primary care, neurology and geriatrics) is herein provided. This idea is based on the unique characteristics of this drug which delivers a more rapid antidepressant action as compared to other selective serotonin reuptake inhibitors. It also has pharmacodynamic malleability (i.e., the possibility of exerting different effects on depressive symptoms at different dosages) and pharmacokinetic tolerability (i.e., the possibility of being used as an add-on to other antidepressants with scarce interaction and achieving complimentary effects) when used in the milieu of other drugs in treating comorbid depressive symptoms. Moreover, the large number of formulations available permits finite dosage adjustments, and the use of trazodone for specific pathologies, such as dysphagia. Therefore, although additional studies exploring the real-world conditions of antidepressant treatment are warranted, experts agree on the idea that depressive disorder, in both its standalone and its comorbid manifestations, may surely take advantage of the particular characteristics of trazodone, thus attempting to reach the greatest effectiveness in different contexts.
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Affiliation(s)
- Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Integrata Giuliano-Isontina—ASUGI, UCO Clinica Psichiatrica, Trieste, Italy
| | - Carmine Tomasetti
- ASL Teramo, Department of Mental Health of Teramo, Alzheimer Centre of Giulianova, Teramo, Italy
| | - Camillo Marra
- Neurology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Rome, Italy
- Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesca Neviani
- Center for Cognitive Disorders and Dementia, Chair of Geriatrics, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Pirani
- Center for Cognitive Disorders and Dementia, Health County of Ferrara, Ferrara, Italy
- Alzheimer’s Association “Francesco Mazzuca”, Ferrara, Italy
| | - Daiana Taddeo
- Italian College of General Practitioners and Primary Care, Florence, Italy
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- Department of Neurosciences “Rita Levi Montalcini”, University of Turin, Turin, Italy
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Sherawat K, Mehan S. Tanshinone-IIA mediated neuroprotection by modulating neuronal pathways. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:1647-1667. [PMID: 37010572 DOI: 10.1007/s00210-023-02476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/23/2023] [Indexed: 04/04/2023]
Abstract
The progression of neurological diseases is mainly attributed to oxidative stress, apoptosis, inflammation, and trauma, making them a primary public concern. Since no drugs can stop these neurological disorders from happening, active phytochemical intervention has been suggested as a possible treatment. Among the several phytochemicals being studied for their potential health advantages, tanshinone-IIA (Tan-IIA ) stands out due to its wide range of therapeutic effects. Tan-IIA, derived from the Salvia miltiorrhiza plant, is a phenanthrenequinone. The pharmacological characteristics of Tan-IIAagainst various neurodegenerative and neuropsychiatric illnesses have led researchers to believe that the compound possesses neuroprotective potential. Tan-IIA has therapeutic potential in treating neurological diseases due to its capacity to cross the blood-brain barrier and its broad range of activities. In treating neurological disorders, Tan-IIA has been shown to have neuroprotective effects such as anti-apoptotic, anti-inflammatory, BBB protectant, and antioxidant properties. This article concisely summarises the latest scientific findings about the cellular and molecular aspects of Tan-IIA neuroprotection in relation to various neurological diseases. The results of preclinical studies on Tan-IIA provide insight into its potential application in future therapeutic development. This molecule rapidly establishes as a prominent bioactive compound for clinical research.
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Affiliation(s)
- Kajal Sherawat
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India
| | - Sidharth Mehan
- Division of Neuroscience, Department of Pharmacology, ISF College of Pharmacy, Moga, 142001, Punjab, India.
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Ye B, Yuan Y, Liu R, Zhou H, Li Y, Sheng Z, Li T, Zhang B, Xu Z, Li Y, Liu Z. Restoring Wnt signaling in a hormone-simulated postpartum depression model remediated imbalanced neurotransmission and depressive-like behaviors. Mol Med 2023; 29:101. [PMID: 37491227 PMCID: PMC10369844 DOI: 10.1186/s10020-023-00697-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/09/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a prevalent mental disorder that negatively impacts mothers and infants. The mechanisms of vulnerability to affective illness in the postpartum period remain largely unknown. Drastic fluctuations in reproductive hormones during the perinatal period generally account for triggering PPD. However, the molecular mechanism underlying the PPD-like behaviors induced by the fluctuations in hormones has rarely been reported. METHODS We utilized hormones-simulated pseudopregnancy (HSP) and hormones-simulated postpartum period (HSPP) rat models to determine how drastic fluctuations in hormone levels affect adult neurotransmission and contribute to depressive-like behaviors. The electrophysiological response of CA1 pyramidal neurons was evaluated by whole-cell patch clamping to identify the hormone-induced modulations of neurotransmission. The statistical significance of differences was assessed with One-way ANOVA and t-test (p < 0.05 was considered significant). RESULTS Reproductive hormones withdrawal induced depressive-like behaviors and disturbed the balance of excitatory and inhibitory transmission in the pyramidal neurons in the hippocampus. Molecular analyses revealed that the blunted Wnt signaling might be responsible for the deficits of synaptic transmission and behaviors. Activation of Wnt signaling increased excitatory and inhibitory synaptic transmission in the hippocampus. Reactivation of Wnt signaling alleviated the anhedonic behaviors and abnormal synaptic transmission. CONCLUSIONS Restoring Wnt signaling in the hormones-simulated postpartum period rat models remediated depression-related anhedonia symptoms and rebalanced the excitation/inhibition ratio by collectively enhancing the plasticity of GABAergic and glutamatergic synapses. The investigations carried out in this research might provide an alternative and prospective treatment strategy for PPD.
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Affiliation(s)
- Binglu Ye
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Yawei Yuan
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Rui Liu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Haitao Zhou
- State Key Laboratory of Drug Research and Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
- University of Chinese Academy of Sciences, No.9A Yuquan Road, Beijing, 100049, China
| | - Yujie Li
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Zhihao Sheng
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Tianyu Li
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
- State Key Laboratory of Drug Research and Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China
| | - Bing Zhang
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China
| | - Zhendong Xu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China.
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China.
| | - Yang Li
- State Key Laboratory of Drug Research and Key Laboratory of Receptor Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, 201203, China.
- University of Chinese Academy of Sciences, No.9A Yuquan Road, Beijing, 100049, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, 200040, China.
| | - Zhiqiang Liu
- Department of Anesthesiology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China.
- Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Clinical and Translational Research Center, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, 201204, China.
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Krzystanek M, Martyniak E, Pałasz A, Skałacka K, Chwalba A, Wierzbiński P. Amantadine in Treatment of Dysthymia-The Pilot Case Series Study. Pharmaceuticals (Basel) 2023; 16:897. [PMID: 37375844 DOI: 10.3390/ph16060897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/28/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Dysthymia is a common chronic mood disorder in which isolated symptoms of depression persist for at least 2 years. Despite the many medications recommended for the treatment of dysthymia, no recommendations have yet been made for the treatment of patients who fail to achieve clinical improvement. This justifies attempts to identify second-line drugs for the treatment of dysthymia. In an open and naturalistic case study, five patients diagnosed with dysthymia in whom at least one antidepressant treatment was ineffective were treated with amantadine. In the age- and gender-matched external control group, patients were treated with sertraline at 100 mg/day. Depressive symptoms were assessed using HDRS-17. Two men and three women were treated with 100 mg amantadine for 3 months with 3-5 months follow-up. After 1 month of treatment with amantadine, a significant reduction in the intensity of depressive symptoms was achieved in all patients, and the clinical improvement increased over the next 2 months of treatment. No deterioration in well-being was observed in any patient after discontinuation of amantadine. The effect of amantadine treatment was comparable to that of sertraline treatment in patients with dysthymia who improved with this drug. The present study indicates that amantadine is an effective and well-tolerated drug in the treatment of dysthymia. Amantadine may be associated with a quick improvement in symptoms in the treatment of dysthymia. Treatment with this drug seems to be associated with good tolerability and persistency of the therapeutic effect after the discontinuation of the treatment.
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Affiliation(s)
- Marek Krzystanek
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
| | - Ewa Martyniak
- Department and Clinic of Psychiatric Rehabilitation, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-635 Katowice, Poland
| | - Artur Pałasz
- Department of Histology, Faculty of Medical Sciences, Medical University of Silesia in Katowice, 40-752 Katowice, Poland
| | | | - Artur Chwalba
- Pharmacology Department, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-808 Zabrze Rokitnica, Poland
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Cui J, Wen J, Wang D. Cognitive manipulation of emotional and non-emotional information in working memory of patients with depression: a rigid processing style. Front Psychol 2023; 14:1183893. [PMID: 37384177 PMCID: PMC10293631 DOI: 10.3389/fpsyg.2023.1183893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Introduction Cognitive psychology is one of the important perspectives to understand depression. Compared with previous studies, recent researchers increasingly focused on the exploration of the comprehensive cognitive process of patients with depression. The cognitive operation ability of working memory is an important comprehensive cognitive process, which reflects how individuals establish representations. This is the basis for the formation of experience and schema. The purpose of this study is to explore whether there are abnormalities in cognitive manipulation in patients with depression, and to analyze its possible role in the pathogenesis and maintenance of depression. Method In this cross-sectional study, depressed patients was enrolled in the clinical psychology department of Beijing Chaoyang Hospital as the case group, while healthy individuals were recruited in the hospital and social meetings as the control group. Hamilton Depression Scale (HAMD)-17, Hamilton Anxiety Scale (HAMA) and rumination thinking scale (RRS) were adopted as measurement tools, and working memory operation tasks were adopted to test each subject, so as to measure their cognitive operation ability. Result A total of 78 depressed patients and 81 healthy individuals completed the study. The results showed that the rumination level of the case group was higher than that of the control group, and the difference was significant first; Second, in the "inconsistent" condition, the case group under different stimulus conditions when the response was significantly higher than the control group; Thirdly, the "cognitive operation consumption" value of the case group was significantly higher than that of the control group under the three stimulus conditions, among which, the operational cost value of sadness-neutral stimulus was significantly higher than that of the other two stimulus conditions. Conclusion Patients with depression had obvious difficulties in cognitive manipulation of information with different values in working memory, which reflected in the fact that it took them longer time to adjust the relationship between information and established new representations. Among them, patients with depression had a higher degree of cognitive manipulation of sad stimuli, indicating that their abnormal cognitive manipulation had certain emotion specificity. Finally, the difficulty of cognitive operation was closely related to the level of rumination.
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Affiliation(s)
- Jiacheng Cui
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong Province, China
| | - Jianglin Wen
- Department of Applied Psychology, Binzhou Medical University, Yantai, Shandong Province, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Toshishige Y, Kondo M, Watanabe T, Yamada A, Hashimoto H, Okazaki J, Tokuyama N, Kuwabara J, Mizushima H, Akechi T. Association between marital satisfaction of female patients with persistent depressive disorder, and their own and husbands' autism spectrum disorder or attention deficit/hyperactivity disorder traits. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e95. [PMID: 38868151 PMCID: PMC11114357 DOI: 10.1002/pcn5.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 04/05/2023] [Accepted: 04/22/2023] [Indexed: 06/14/2024]
Abstract
Aim Patients' and spouses' neurodevelopmental traits may influence marital relationships, which are significantly associated with depressive symptoms. However, no studies have examined marital relationships in persistent depressive disorder (PDD) in terms of neurodevelopmental traits. This study aimed to explore the association between the autism spectrum disorder (ASD) or attention-deficit/hyperactivity disorder (ADHD) traits of female PDD patients and both partners' (patient and husband) marital satisfaction. Methods A cross-sectional online survey was administered during two predetermined consecutive months at seven institutions. Participants were female outpatients who fulfilled the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for PDD and their husbands. The instruments of the study were the following validated surveys: the Quality Marriage Index (QMI), the Autism-Spectrum Quotient Japanese version-21 (AQ-J-21), and the Adult ADHD Self-Report Scale Part A (ASRS Part A). Results The patients' AQ-J-21 showed a positive significant association with their QMI in all patients who responded to this study's questionnaire, whereas among couples wherein both patient and husband responded, the ASRS Part A exhibited a positive significant association with the patients' QMI. Conversely, the husbands' ASRS Part A exhibited a negative significant association with the patients' QMI. Conclusion The patients' ASD and ADHD traits may play a positive role in the marital satisfaction of female PDD patients, while their husbands' ADHD traits may play a negative role. For female PDD patients with low marital satisfaction, it may be important to consider whether their husbands have ADHD traits; if so, it may be necessary to develop intervention strategies focused on the traits for improving the low marital satisfaction. However, our conclusions are not sufficiently convincing.
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Affiliation(s)
- Yuko Toshishige
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Masaki Kondo
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
- Present address:
Masaki KondoNational Center of Neurology and PsychiatryTokyoJapan
| | - Takafumi Watanabe
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Atsurou Yamada
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | | | | | | | | | | | - Tatsuo Akechi
- Department of Psychiatry and Cognitive‐Behavioral MedicineNagoya City University Graduate School of Medical SciencesNagoyaJapan
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40
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Alaie I, Svedberg P, Ropponen A, Narusyte J. Associations of Internalizing and Externalizing Problems in Childhood and Adolescence With Adult Labor Market Marginalization. JAMA Netw Open 2023; 6:e2317905. [PMID: 37289452 PMCID: PMC10251215 DOI: 10.1001/jamanetworkopen.2023.17905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/27/2023] [Indexed: 06/09/2023] Open
Abstract
Importance Mental health problems in early life are associated with labor market marginalization, especially in youths with persistent internalizing and externalizing problems. However, previous research has not adjusted for familial (genetic and shared environmental) factors. Objective To examine associations of early-life internalizing and externalizing problems with adulthood unemployment and work disability, adjusting for familial factors. Design, Setting, and Participants This population-based prospective cohort study included Swedish twins who were born in 1985-1986 and surveyed at 4 consecutive waves across childhood and adolescence until 2005. Through linkage to nationwide registries, participants were followed up from 2006 to 2018. Data analyses were conducted between September 2022 and April 2023. Exposures Internalizing and externalizing problems, assessed with the Child Behavior Checklist. Participants were differentiated regarding duration of internalizing and externalizing problems (persistent, episodic, and noncases). Main Outcomes and Measures Unemployment (180 days or more of being unemployed) and work disability (60 days or more of being sickness absent or disability pensioned) during follow-up. Cox proportional hazards regression models were calculated to obtain cause-specific hazard ratios (HRs) with 95% CIs in the whole cohort and exposure-discordant twin pairs. Results Of 2845 participants, 1464 (51.5%) were female. Incident unemployment was experienced by 944 (33.2%) and incident work disability by 522 (18.3%) participants. Compared with noncases, persistent internalizing problems were associated with unemployment (HR, 1.56; 95% CI, 1.27-1.92) and work disability (HR, 2.32; 95% CI, 1.80-2.99). Similarly, compared with noncases, persistent externalizing problems were associated with unemployment (HR, 1.87; 95% CI, 1.55-2.26) and work disability (HR, 2.38; 95% CI, 1.87-3.03). Persistent cases had overall higher risks of adverse outcomes than episodic cases. After adjustment for familial factors, associations with unemployment were no longer statistically significant, whereas associations with work disability remained or were only slightly reduced. Conclusions and Relevance In this cohort study of young Swedish twins, familial factors explained the associations between early-life persistent internalizing and externalizing problems and unemployment; such factors were comparatively less important for the association with work disability. This suggests nonshared environmental factors may be important for the risk of future work disability among young individuals with persistent internalizing and externalizing problems.
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Affiliation(s)
- Iman Alaie
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Division of Child and Adolescent Psychiatry, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Pia Svedberg
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Annina Ropponen
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jurgita Narusyte
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Luo A, Wu Z, Li S, McReynolds CB, Wang D, Liu H, Huang C, He T, Zhang X, Wang Y, Liu C, Hammock BD, Hashimoto K, Yang C. The soluble epoxide hydrolase inhibitor TPPU improves comorbidity of chronic pain and depression via the AHR and TSPO signaling. J Transl Med 2023; 21:71. [PMID: 36732752 PMCID: PMC9896784 DOI: 10.1186/s12967-023-03917-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/23/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Patients suffering from chronic pain often also exhibit depression symptoms. Soluble epoxide hydrolase (sEH) inhibitors can decrease blood levels of inflammatory cytokines. However, whether inhibiting sEH signaling is beneficial for the comorbidity of pain and depression is unknown. METHODS According to a sucrose preference test (SPT), spared nerve injury (SNI) mice were classified into pain with or without an anhedonia phenotype. Then, sEH protein expression and inflammatory cytokines were assessed in selected tissues. Furthermore, we used sEH inhibitor TPPU to determine the role of sEH in chronic pain and depression. Importantly, agonists and antagonists of aryl hydrocarbon receptor (AHR) and translocator protein (TSPO) were used to explore the pathogenesis of sEH signaling. RESULTS In anhedonia-susceptible mice, the tissue levels of sEH were significantly increased in the medial prefrontal cortex (mPFC), hippocampus, spinal cord, liver, kidney, and gut. Importantly, serum CYP1A1 and inflammatory cytokines, such as interleukin 1β (IL-1β) and the tumor necrosis factor α (TNF-α), were increased simultaneously. TPPU improved the scores of mechanical withdrawal threshold (MWT) and SPT, and decreased the levels of serum CYP1A1 and inflammatory cytokines. AHR antagonist relieved the anhedonia behaviors but not the algesia behaviors in anhedonia-susceptible mice, whereas an AHR agonist abolished the antidepressant-like effect of TPPU. In addition, a TSPO agonist exerted a similar therapeutic effect to that of TPPU, whereas pretreatment with a TSPO antagonist abolished the antidepressant-like and analgesic effects of TPPU. CONCLUSIONS sEH underlies the mechanisms of the comorbidity of chronic pain and depression and that TPPU exerts a beneficial effect on anhedonia behaviors in a pain model via AHR and TSPO signaling.
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Affiliation(s)
- Ailin Luo
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Zifeng Wu
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Shan Li
- grid.33199.310000 0004 0368 7223Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030 China
| | - Cindy B. McReynolds
- grid.27860.3b0000 0004 1936 9684Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA 95616 USA
| | - Di Wang
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Hanyu Liu
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Chaoli Huang
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China ,grid.41156.370000 0001 2314 964XState Key Laboratory of Pharmaceutical Biotechnology, Model Animal Research Center, Nanjing University, Nanjing, 210061 China
| | - Teng He
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Xinying Zhang
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Yuanyuan Wang
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Cunming Liu
- grid.412676.00000 0004 1799 0784Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Bruce D. Hammock
- grid.27860.3b0000 0004 1936 9684Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA 95616 USA
| | - Kenji Hashimoto
- Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, 260-8670, Japan.
| | - Chun Yang
- Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
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Konvalin F, Reinhard MA, Behr E, Weigel-Weinberger F, Nenov-Matt T, Barton BB, Zill P, Jobst A, Brakemeier EL, Buchheim A, Padberg F. Change of attachment representation after Cognitive Behavioral Analysis System of Psychotherapy. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023. [DOI: 10.1016/j.jadr.2023.100495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Beutel M, Krakau L, Kaufhold J, Bahrke U, Grabhorn A, Hautzinger M, Fiedler G, Kallenbach-Kaminski L, Ernst M, Rüger B, Leuzinger-Bohleber M. Recovery from chronic depression and structural change: 5-year outcomes after psychoanalytic and cognitive-behavioural long-term treatments (LAC depression study). Clin Psychol Psychother 2023; 30:188-201. [PMID: 36239414 DOI: 10.1002/cpp.2793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 09/07/2022] [Accepted: 10/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Psychotherapy of chronic depression has remained a challenge due to limited prognosis and high rates of recurrence. We present 5-year outcome data from a multicentre trial comparing psychoanalytic (PAT) and cognitive-behavioural (CBT) long-term treatments with randomized and preferred allocations analysing symptom (N = 227) and structural change (N = 134) trajectories. METHOD Self- and blinded expert ratings of depression symptoms were performed at yearly intervals using the Beck Depression Inventory-II (BDI-II) and Quick Inventory of Depressive Symptoms (QIDS-C). Blinded expert ratings of Operationalized Psychodynamic Diagnosis (OPD) and the Heidelberg Restructuring Scale (HRS) at baseline, 1, 3, and 5 years assessed structural change in a subsample. RESULTS Lasting and comparable symptom changes were achieved by PAT and CBT. However, compared to CBT, PAT was more successful in restructuring, a major goal of long-term psychodynamic treatments with high frequency and duration. LIMITATIONS Due to practical reasons, the time criterion for chronic depression of an acute phase had to be defined for over 1 year in the present study, which does not correspond to the DSM-5 criterion of 2 years. Therapy duration and session frequency were not incorporated into the statistical models. CONCLUSION Long-term psychotherapy helps patients with a yearlong history of depression and often multiple unsuccessful treatment attempts to achieve lasting symptom changes. Future follow-up will clarify whether restructuring promotes further sustainable improvements.
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Affiliation(s)
- Manfred Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | | | | | | | - Martin Hautzinger
- Department of Clinical Psychology, University of Tübingen, Tübingen, Germany
| | - Georg Fiedler
- Center for Suicidal Research, University Hospital Eppendorf, Hamburg, Germany
| | | | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany
| | | | - Marianne Leuzinger-Bohleber
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes-Gutenberg University Mainz, Mainz, Germany.,Department of Psychoanalysis, University of Kassel, Kassel, Germany.,IDeA Center (Center for Adaptive and Individual Development and Adaptive Education for Children-at-Risk), Frankfurt, Germany
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Brown RJ, Burton AL, Abbott MJ. The relationship between distress tolerance and symptoms of depression: Validation of the Distress Tolerance Scale (DTS) and short-form (DTS-SF). J Clin Psychol 2022; 78:2609-2630. [PMID: 35510827 PMCID: PMC9790670 DOI: 10.1002/jclp.23370] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/13/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Distress tolerance (DT) has been found to be implicated in the development and maintenance of depressive symptomatology and various other significant psychological conditions. As such, it is critical to have measures of DT that are effective and easy to administer. This study aimed to examine the factor structure, psychometric properties, and clinical utility of the Distress Tolerance Scale (DTS) and the short-form version, the Distress Tolerance Scale Short-form (DTS-SF), in a large population of individuals with varying levels of self-reported depressive symptoms. METHOD A total of 959 participants completed an online battery of questionnaires which included an assessment of depressive symptoms as well as the DTS and related measures. Results: Confirmatory factor analyses validated the four-factor structure of the DTS and the one-factor structure of the DTS-SF. Good construct validity and good internal consistency were observed across both the DTS and DTS-SF. CONCLUSION Overall, this paper provides new evidence for the validity, reliability and discriminative ability of the DTS and the brief version of the questionnaire, the DTS-SF.
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Affiliation(s)
- Ruby J. Brown
- Clinical Psychology Unit, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
| | - Amy L. Burton
- Clinical Psychology Unit, School of PsychologyThe University of SydneySydneyNew South WalesAustralia,Discipline of Clinical Psychology, Graduate School of HealthUniversity of Technology SydneySydneyAustralia
| | - Maree J. Abbott
- Clinical Psychology Unit, School of PsychologyThe University of SydneySydneyNew South WalesAustralia
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Kagee A, Saal W. Persistent depressive disorder among persons receiving an HIV test: an understudied phenomenon. AIDS Care 2022; 34:1530-1533. [PMID: 35914113 DOI: 10.1080/09540121.2022.2105797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Persistent depressive disorder is under-studied in HIV settings. We recruited 500 persons seeking an HIV test in South Africa and administered the major depression and persistent depression modules of the Structured Clinical Interview for the DSM-5, the Beck Depression Inventory (BDI), Beck Anxiety Inventory, Alcohol Use and Drug Use Disorders Identification Tests and the PTSD Symptom Scale. Of the total sample, 7.2% met the criteria for persistent depression and 14.4% had major depression; 3.6% had both Major Depression and Persistent Depression; 3.6% had Persistent Depression and no Major Depression; 10.8% had Major Depression and no Persistent Depression; and 82.0% had neither Major Depression nor Persistent Depression. We found a significant relationship between major and persistent depression (X2 (1, N = 500) = 39.89; p < .00; 95% CI). Persons with PDD were over 7 times more likely to have major depression than those without PDD (OR = 7.59; 95% CI: 3.72-15.48). Income level and BDI scores were significant predictors of persistent depression (p < 0.05), but not anxiety, traumatisation, and harmful alcohol and drug use. Many people may experience diagnosable mood disturbance prior to receipt of their HIV test results, suggesting the need to integrate mental health services with HIV testing.
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Affiliation(s)
- Ashraf Kagee
- Stellenbosch University, Stellenbosch, South Africa
| | - Wylene Saal
- Stellenbosch University, Stellenbosch, South Africa
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Eielsen M, Ulvenes PG, Røssberg JI, Høstmælingen A, Soma CS, Wampold BE. The Effectiveness of an Intensive Inpatient Psychotherapy Program for Chronic Depression: A naturalistic comparison with wait list. BMC Psychiatry 2022; 22:745. [PMID: 36451114 PMCID: PMC9710086 DOI: 10.1186/s12888-022-04381-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 11/09/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Patients with chronic depression (CD) typically have an early symptom onset, more psychiatric comorbidities, more treatment attempts, and more frequent and longer inpatient hospitalizations than patients with major depressive disorders. The main purpose of this study was to investigate the effectiveness of an intensive inpatient psychotherapy program for patients with chronic depression (CD). The primary research question was whether two intensive psychodynamic inpatient treatments, affect phobia therapy (APT) and VITA, were superior to an outpatient wait list condition, receiving treatment as usual (TAU), at completion of treatment. To investigate if a potential difference between the intensive treatment and the wait list control group was dependent on a specific psychotherapeutic model, the study contrasted two therapies with similar intensity, but different theoretical rationales. METHODS Two hundred eighty patients with CD were included in a naturalistic study. Patients were assessed at four time points; assessment, start of therapy, end of therapy and 1-year follow-up. Three comparisons were performed with patients matched across groups; Intensive inpatient treatment program (APT + VITA) vs wait list during treatment, APT vs VITA during treatment and APT vs VITA during follow-up. The outcome measure was the BDI-II. RESULTS Intensive inpatient treatment program vs. wait list showed a significant difference in favor of the intensive treatment. No significant differences were found between APT and VITA during therapy or follow-up; but both groups had large effect sizes during treatment, which were maintained during follow-up. CONCLUSIONS The intensive inpatient psychotherapy program showed superior effect on chronic depression over an outpatient wait list condition receiving treatment as usual (TAU), but no significant differences were found between the two intensive inpatient psychodynamic treatments. The results provide support for the effectiveness of an intensive inpatient psychotherapy program in treatment of chronic and severe disorders, such as CD, which could be of benefit for policymakers and the health care sector as they are allocating recourses efficiently. TRIAL REGISTRATION This study has been retrospectively registered on ClinicalTrials.gov (NCT05221567) on February 3rd, 2022.
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Affiliation(s)
- Mikkel Eielsen
- Institute of Clinical Medicine, University of Oslo, Sognsvanssveien 21, 0372, Oslo, Norway. .,Research Institute, Modum Bad Psychiatric Center, Modum Bad Research Institute, Badeveien 287, 3370, Vikersund, Norway.
| | - Pål Gunnar Ulvenes
- grid.5510.10000 0004 1936 8921Research Institute, Modum Bad Psychiatric Center, Modum Bad Research Institute, Badeveien 287, 3370 Vikersund, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Forskningsveien 3a, 0373 Oslo, Norway
| | - Jan Ivar Røssberg
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, University of Oslo, Sognsvanssveien 21, 0372 Oslo, Norway
| | - Andreas Høstmælingen
- grid.5510.10000 0004 1936 8921Department of Psychology, University of Oslo, Forskningsveien 3a, 0373 Oslo, Norway
| | - Christina S. Soma
- grid.223827.e0000 0001 2193 0096Department of Educational Psychology, University of Utah, 1721 Campus Center Dr., SAEC Room 3220, Salt Lake City, UT 84109 USA
| | - Bruce E. Wampold
- grid.5510.10000 0004 1936 8921Research Institute, Modum Bad Psychiatric Center, Modum Bad Research Institute, Badeveien 287, 3370 Vikersund, Norway ,grid.14003.360000 0001 2167 3675Department of Counseling Psychology, University of Wisconsin–Madison, 317 Education Building, 1000 Bascom Mall, Madison, WI 53706-1326 USA
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The differences in serum C1q levels between first-episode patients with bipolar disorder and major depressive disorder. J Psychosom Res 2022; 162:111042. [PMID: 36156342 DOI: 10.1016/j.jpsychores.2022.111042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed at exploring the changes of serum complement C1q levels in patients with Bipolar Disorder (BD) using a cross-sectional design, and the differences between Major Depressive Disorder (MDD) and BD. Moreover, the correlation between complement C1q and bech-rafaelsdn mania rating scales (BRMS) in patients with MDD and BD was assessed. METHODS Serum complement C1q levels were measured by ADVIA 2400 biochemical analyser in 104 patients with MDD, 71 patients with BD type I and 42 patients with BD type II diagnosed by Diagnostic and Statistical of Mental Disorder 5 (DSM-5). Then simple and multivariate linear regression analysis was conducted between the level of serum C1q and BRMS among patients with BD. RESULTS The serum complement C1q levels were higher in BD type I than BD type II (P < 0.001); Serum complement C1q levels were higher in MDD than BD type II (P < 0.001). We discovered that there was a positive correlation relationship between serum complement C1q levels and BRMS in BD type I (r = 0.756, P < 0.001). CONCLUSION We confirmed that serum complement C1q levels were higher in patients with BD type II than in MDD patients. These current results support the view that the complement C1q may play an important role in the pathophysiology of BD. Serum complement C1q was strongly associated with BD and is worth investigating in future studies.
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Reinhard MA, Popov N, Rek SV, Nenov-Matt T, Barton BB, Jobst A, Musil R, Padberg F. Loneliness is associated with maladaptive schema modes in patients with persistent depressive disorder. J Psychiatr Res 2022; 154:56-60. [PMID: 35930869 DOI: 10.1016/j.jpsychires.2022.07.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/25/2022] [Accepted: 07/21/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Though loneliness represents a public health concern, this complex unpleasant feeling is commonly neglected in psychiatric care and may constitute a new treatment target in clinical groups particularly prone to feeling lonely and socially isolated, e.g., persistent depressive disorder (PDD). Schema modes encompass a set of distinct cognitive-affective patterns that may contribute to loneliness and social isolation. Aim of this study was to examine the interplay between subjective loneliness and objective social network size with schema modes in patients with PDD as well as healthy controls (HC). METHOD Sixty-two PDD patients (DSM-5; 35 female, Mage = 40.5, SD = 12.4) and 71 HC (60 female, Mage = 28.1, SD = 10.1) were assessed cross-sectionally using the following self-report measures: UCLA Loneliness Scale, Social Network Index (SNI), and Schema-Mode-Inventory, revised version (SMI-r). Correlational and multiple linear regression analyses were performed. RESULTS PDD patients reported significantly higher scores of loneliness and maladaptive schema modes and a smaller social network than HC. Loneliness was significantly positively associated with the modes Vulnerable Child, Detached Protector, Bully and Attack, and Punitive Parent, and negatively with Contented Child and Healthy Adult in both groups. In contrast, social network size was only positively associated with the Contented Child mode. CONCLUSION Loneliness is highly prevalent in PDD and in contrast to social network size associated with maladaptive schema modes. Therapeutically addressing these schema modes with specific techniques may represent a mechanism-based intervention for patients suffering from loneliness and should be investigated in clinical trials.
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Affiliation(s)
- Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.
| | - Naomi Popov
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Stephanie V Rek
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Tabea Nenov-Matt
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Barbara B Barton
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Andrea Jobst
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
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Attachment mediates the link between childhood maltreatment and loneliness in persistent depressive disorder. J Affect Disord 2022; 312:61-68. [PMID: 35728677 DOI: 10.1016/j.jad.2022.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 05/20/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND A central concept of attachment theory is that early experiences with close attachment figures shape the way we interact with and relate to other social partners throughout life. As such, early experiences of childhood maltreatment (CM) have been suggested as a key precursor of adult insecure attachment representations. As CM has been linked to feelings of loneliness in adulthood, this study examines whether insecure attachment could explain the relationship between CM and loneliness. Also, the moderating role of a diagnosis of persistent depressive disorder (PDD) is investigated, a disorder characterized by high levels of CM and loneliness. METHOD 60 patients with PDD (DSM-5) and 60 gender- and age-matched non-clinical control participants (NC) completed self-report questionnaires measuring attachment, loneliness, and CM. Mediation analyses (PDD as a moderator) were performed. RESULTS PDD patients reported higher levels of CM, attachment anxiety, attachment avoidance, and loneliness than NC. CM was positively associated with loneliness in both groups. Mediation analyses demonstrated that the relationship between CM and loneliness was mediated by avoidant, but not anxious attachment, regardless of a diagnosis of PDD. LIMITATIONS Caution when interpreting these results is crucial as the study lacked a clinical control group, relied on self-report measures, and the cross-sectional design limits the ability to draw causal inferences. CONCLUSIONS All constructs studied were present to a greater degree in PDD. Above, findings provide initial evidence that avoidant attachment may explain the relationship between CM and loneliness. Potentially, adult avoidant attachment may lead to and maintain feelings of loneliness, regardless of PDD.
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Guhn A, Merkel L, Heim C, Klawitter H, Teich P, Betzler F, Sterzer P, Köhler S. Impaired empathic functioning in chronic depression: Behavioral evidence for the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) model. J Psychiatr Res 2022; 152:79-85. [PMID: 35716512 DOI: 10.1016/j.jpsychires.2022.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/19/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022]
Abstract
The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) model proposes preoperational functioning as a core feature of persistent depressive disorders (PDD). Empathy deficits comprise one aspect. Resulting from childhood maltreatment, empathy deficits may aggravate social isolation, a key factor in the maintenance of depression. CBASP targets empathy by teaching patients to disengage from past experiences and to engage successfully in present social interactions. However, behavioral evidence for empathy deficits in PDD has remained elusive. We reasoned that deficits become apparent only under stress and that these deficits improve after CBASP-treatment. Twenty-two patients and 21 controls performed two parallel versions of the Multifaceted Empathy Test. For stress induction, a negative autobiographical event was presented before performing the task. A neutral event served as control. Fifteen patients performed the experiment twice, before and after a 12-week inpatient CBASP-treatment. Supporting our hypotheses, patients showed reduced empathy under stress, while no group difference was found in the absence of stress. Reduced empathy correlated with the level of re-experiencing negative memories. Pre-post-treatment comparison revealed that the stress-induced empathy deficit improved in patients over time. Post-treatment empathic capacity correlated positively with clinical improvement. Our findings provide empirical support for the CBASP model, but highlight an important new aspect: Empathy is not generally deficient in PDD but becomes impaired under stress. In real-life situations, stress-induced empathy impairments may exacerbate interpersonal conflicts. CBASP's interpersonal focus improved empathy, accompanied by clinical improvement as the model predicts.
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Affiliation(s)
- Anne Guhn
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany.
| | - Lydia Merkel
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany
| | - Christine Heim
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Charitéplatz 1, 10117, Berlin, Germany
| | - Heiko Klawitter
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Charitéplatz 1, 10117, Berlin, Germany
| | - Paula Teich
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany
| | - Felix Betzler
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany
| | - Philipp Sterzer
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany
| | - Stephan Köhler
- Charité - Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charitéplatz 1, 10117, Berlin, Germany
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