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Yang H, Chen Y, Tao Q, Shi W, Tian Y, Wei Y, Li S, Zhang Y, Han S, Cheng J. Integrative molecular and structural neuroimaging analyses of the interaction between depression and age of onset: A multimodal magnetic resonance imaging study. Prog Neuropsychopharmacol Biol Psychiatry 2024; 134:111052. [PMID: 38871019 DOI: 10.1016/j.pnpbp.2024.111052] [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: 04/08/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/15/2024]
Abstract
Depression is a neurodevelopmental disorder that exhibits progressive gray matter volume (GMV) atrophy. Research indicates that brain development is influential in depression-induced GMV alterations. However, the interaction between depression and age of onset is not well understood by the underlying molecular and neuropathological mechanisms. Thus, 152 first-episode depression individuals and matched 130 healthy controls (HCs) were recruited to undergo T1-weighted high-resolution magnetic resonance imaging for this study. By two-way ANOVA, age and diagnosis were used as factors when analyzing the interaction of GMV in the participants. Then, spatial correlations between neurotransmitter maps and factor-related volume maps are established. Results illustrate a pronounced antagonistic interaction between depression and age of onset in the right insula, superior temporal gyrus, anterior cingulate gyrus, and orbitofrontal gyrus. Depression-caused reductions in GMV are mainly distributed in thalamic-limbic-cortical regions, regardless of age. For the main effect of age, adults exhibit brain atrophy in frontal, cerebellum, parietal, and temporal lobe structures. Cross-modal correlations showed that GMV changes in the interactive regions were linked with the serotonergic system and dopaminergic systems. Summarily, our results reveal the interaction between depression and age of onset in neurobiological mechanisms, which provide hints for future treatment of different ages of depression.
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Affiliation(s)
- Huiting Yang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Qiuying Tao
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Wenqing Shi
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Ya Tian
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
| | - Shaoqiang Han
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China; Zhengzhou Key Laboratory of brain function and cognitive magnetic resonance imaging, Zhengzhou, China; Henan Engineering Technology Research Center for detection and application of brain function, Zhengzhou, China; Henan Engineering Research Center of medical imaging intelligent diagnosis and treatment, Zhengzhou, China; Henan key laboratory of imaging intelligence research, Zhengzhou, China; Henan Engineering Research Center of Brain Function Development and Application, Zhengzhou, China.
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Li Y, Wang D, Fang J, Zu S, Xiao L, Zhu X, Wang G, Hu Y. Factors influencing the tendency of residual symptoms in patients with depressive disorders: a longitudinal study. BMC Psychiatry 2024; 24:557. [PMID: 39138456 PMCID: PMC11323663 DOI: 10.1186/s12888-024-05915-9] [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: 06/17/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Residual symptoms of depressive disorders are serious health problems. However, the progression process is hardly predictable due to high heterogeneity of the disease. This study aims to: (1) classify the patterns of changes in residual symptoms based on homogeneous data, and (2) identify potential predictors for these patterns. METHODS In this study, we conducted a data-driven Latent Class Growth Analysis (LCGA) to identify distinct tendencies of changes in residual symptoms, which were longitudinally quantified using the QIDS-SR16 at baseline and 1/3/6 months post-baseline for depressed patients. The association between baseline characteristics (e.g. clinical features and cognitive functions) and different progression tendencies were also identified. RESULTS The tendency of changes in residual symptoms was categorized into four classes: "light residual symptom decline (15.4%)", "residual symptom disappears (39.3%)", "steady residual symptom (6.3%)" and "severe residual symptom decline (39.0%)". We observed that the second class displayed more favorable recuperation outcomes than the rest of patients. The severity, recurrence, polypharmacy, and medication adherence of symptoms are intricately linked to the duration of residual symptoms' persistence. Additionally, clinical characteristics including sleep disturbances, depressive moods, alterations in appetite or weight, and difficulties with concentration have been identified as significant factors in the recovery process. CONCLUSIONS Our research findings indicate that certain clinical characteristics in patients with depressive disorders are associated with poor recovery from residual symptoms following acute treatment. This revelation holds significant value in the targeted attention to specific patients and the development of early intervention strategies for residual symptoms accordingly.
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Affiliation(s)
- Yuwei Li
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Dong Wang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Jiexin Fang
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Si Zu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xuequan Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Yongdong Hu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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Ren FF, Hillman CH, Wang WG, Li RH, Zhou WS, Liang WM, Yang Y, Chen FT, Chang YK. Effects of aerobic exercise on cognitive function in adults with major depressive disorder: A systematic review and meta-analysis. Int J Clin Health Psychol 2024; 24:100447. [PMID: 38371396 PMCID: PMC10869919 DOI: 10.1016/j.ijchp.2024.100447] [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: 08/07/2023] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
Background Major Depressive Disorder (MDD) is a highly prevalent psychiatric disorder that impairs the cognitive function of individuals. Aerobic exercise stands out as a promising non-pharmacological intervention for enhancing cognitive function and promoting brain health.While positive impacts of aerobic exercise on executive function in adults with depression have been documented, a comprehensive understanding of its benefits on overall cognitive function, including memory, attention, and processing speed, along with key moderating factors in adults with MDD, remains unexplored. The purpose of the systematic review and meta-analysis was to investigate the effects of aerobic exercise on overall cognitive function in adults with MDD, and to explore whether cognitive sub-domains, aerobic exercise characteristics, and study and sample variables modify the effects of aerobic exercise on cognition. Methods Six English electronic databases (Embase, Cochrane Central, Scopus, APA PsycInfo, PubMed, Web of Science) were searched from inception to 2 April 2023. Randomized trials, including adults aged 18 years or above with a diagnosis of clinical depression, of the effects of aerobic exercise on cognitive function in adults with MDD compared to non-aerobic exercise groups were included. A three-level meta-analysis was conducted utilizing a random-effects model in R. The quality of the studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. The PROSPERO registration number is CRD42022367350. Results Twelve randomized trials including 945 adults with MDD were included. Results indicated that aerobic exercise significantly improved overall cognitive function (g = 0.21; 95 % confidence intervals [CI] = 0.07, 0.34), and the sub-domains of memory (g = 0.25; 95 % CI = 0.06, 0.44) and executive function (g = 0.12; 95 % CI = 0.04, 0.20). Significant benefits in cognitive function were found from moderate-to-vigorous (mixed) intensity (g = 0.19; 95 % CI = 0.02, 0.37), aerobic exercise conducted 3 times per week (g = 0.23; 95 % CI = 0.10, 0.38), in sessions < 45 min (g = 0.59; 95 % CI = 0.28, 0.90), and 45-60 min (g = 0.16; 95 % CI = 0.07, 0.26), in aerobic exercise intervention ≤ 12 weeks (g = 0. 26; 95 % CI = 0.08, 0.44). Limitations This review only included peer-reviewed English-language studies, which may lead to a language bias. The results of the Egger's test suggested a potential publication bias. Conclusions Aerobic exercise is efficacious in improving overall cognitive function and the sub-domains of memory and executive function in adults with major depressive disorder.
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Affiliation(s)
- Fei-Fei Ren
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston, MA, USA
- Department of Physical Therapy, Movement, and Rehabilitation, Northeastern University, Boston, MA, USA
| | - Wei-Guang Wang
- Department of Physical Education, Beijing Language and Culture University, Beijing, China
| | - Ruei-Hong Li
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
| | - Wen-Sheng Zhou
- Department of Physical Education, Jiangsu Second Normal University, Jiangsu, China
| | - Wen-Ming Liang
- Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | - Yong Yang
- Laboratory of Kinesiology and Rehabilitation, School of Physical Education and Sport, Chaohu University, Anhui, China
| | - Feng-Tzu Chen
- Department of Kinesiology, National Tsing Hua University, Hsinchu, Taiwan
| | - Yu-Kai Chang
- Department of Physical Education and Sport Sciences, National Taiwan Normal University, Taipei, Taiwan
- Social Emotional Education and Development Center, National Taiwan Normal University, Taipei, Taiwan
- Institute for Research Excellence in Learning Science, National Taiwan Normal University, Taipei, Taiwan
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Long Y, Li X, Cao H, Zhang M, Lu B, Huang Y, Liu M, Xu M, Liu Z, Yan C, Sui J, Ouyang X, Zhou X. Common and distinct functional brain network abnormalities in adolescent, early-middle adult, and late adult major depressive disorders. Psychol Med 2024; 54:582-591. [PMID: 37553976 DOI: 10.1017/s0033291723002234] [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: 08/10/2023]
Abstract
BACKGROUND The age-related heterogeneity in major depressive disorder (MDD) has received significant attention. However, the neural mechanisms underlying such heterogeneity still need further investigation. This study aimed to explore the common and distinct functional brain abnormalities across different age groups of MDD patients from a large-sample, multicenter analysis. METHODS The analyzed sample consisted of a total of 1238 individuals including 617 MDD patients (108 adolescents, 12-17 years old; 411 early-middle adults, 18-54 years old; and 98 late adults, > = 55 years old) and 621 demographically matched healthy controls (60 adolescents, 449 early-middle adults, and 112 late adults). MDD-related abnormalities in brain functional connectivity (FC) patterns were investigated in each age group separately and using the whole pooled sample, respectively. RESULTS We found shared FC reductions among the sensorimotor, visual, and auditory networks across all three age groups of MDD patients. Furthermore, adolescent patients uniquely exhibited increased sensorimotor-subcortical FC; early-middle adult patients uniquely exhibited decreased visual-subcortical FC; and late adult patients uniquely exhibited wide FC reductions within the subcortical, default-mode, cingulo-opercular, and attention networks. Analysis of covariance models using the whole pooled sample further revealed: (1) significant main effects of age group on FCs within most brain networks, suggesting that they are decreased with aging; and (2) a significant age group × MDD diagnosis interaction on FC within the default-mode network, which may be reflective of an accelerated aging-related decline in default-mode FCs. CONCLUSIONS To summarize, these findings may deepen our understanding of the age-related biological and clinical heterogeneity in MDD.
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Affiliation(s)
- Yicheng Long
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xuemei Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Manqi Zhang
- Center for Studies of Psychological Application, South China Normal University, Guangzhou, China
| | - Bing Lu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Huang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengqi Liu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Xu
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Brainnetome Center and National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Zhening Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Chaogan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jing Sui
- IDG/McGovern Institute for Brain Research, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Xuan Ouyang
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Evanger LN, Flo-Groeneboom E, Sørensen L, Schanche E. Mindfulness-based cognitive therapy improves insomnia symptoms in individuals with recurrent depression: secondary analyses from a randomized controlled trial. Front Psychiatry 2024; 14:1231040. [PMID: 38312915 PMCID: PMC10834689 DOI: 10.3389/fpsyt.2023.1231040] [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: 05/29/2023] [Accepted: 12/27/2023] [Indexed: 02/06/2024] Open
Abstract
Background Embedded within a randomized efficacy trial, the present study aimed to investigate whether mindfulness-based cognitive therapy (MBCT) for recurrent depression improved symptoms of insomnia. Methods Sixty-eight remitted participants with at least three prior episodes of depression were randomized to 8 weeks of MBCT (n = 33) or a waitlist control condition (n = 35). The Bergen Insomnia Scale was used to screen for insomnia symptoms before and after the intervention. The analyses were conducted using one-way between-groups analyses of covariance. Results Twenty-five MBCT participants and 30 waitlist controls completed the study (74.5% females; mean age 40.7 ± 12.9 years). At baseline, 83.6% screened positive for the insomnia diagnosis. Following the intervention and after controlling for corresponding insomnia parameters at baseline, MBCT completers reported significantly less severe insomnia symptoms (p = 0.017), as well as less problems with prolonged sleep onset (p = 0.047) and nocturnal awakenings (p = 0.023), relative to controls. No group differences were found on early morning awakening, daytime impairment, or dissatisfaction with sleep. Conclusion The results suggest that MBCT improves certain insomnia symptoms. However, additional sleep-specific interventions may be needed to further improve this population's sleep.Clinical Trial Registration: ISRCTN, ISRCTN18001392, registered 22/11/2018. URL: 10.1186/ISRCTN18001392.
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Affiliation(s)
- Linn Nyjordet Evanger
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | | | - Lin Sørensen
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Elisabeth Schanche
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
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Gafarov VV, Gromova EA, Gubina MA, Gagulin IV, Maksimov VN, Gafarova AV. [The association of polymorphisms of the serotonin transporter gene SLC6A4 with depression]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:135-139. [PMID: 38465822 DOI: 10.17116/jnevro2024124021135] [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: 03/12/2024]
Abstract
OBJECTIVE To study the relationship of polymorphic variants of the SLC6A4 gene with depression among people aged 25-44 years in Novosibirsk. MATERIAL AND METHODS Under the WHO program «MONICA-psychosocial (MOPSY)», a random representative sample of people aged 25-44 years from the population of the Oktyabrsky district of Novosibirsk (men n=725, mean age 43.4±0.4 years, response - 71.3%, women n=710, mean age 44.8±0.4 years, response - 72%). Depression was assessed using the MONICA-MOPSY psychosocial questionnaire. Every fourth respondent was examined for polymorphic variants of 5HTTLPR-VNTR SNP rs25531 A>G of the SLC6A4 gene. The study was carried out within the framework of the budget topic Reg. No. 122031700094-5. RESULTS The high level of depression among people aged 25-44 was 12.8% (for men 9.1%, for women - 15.92%); the average level of depression occurred in 24.5% of the population (among men in 21.24%, among women in 26.76%) (χ2=17.071, df=2, p<0.001). The most common genotype of the SLC6A4 gene, among people aged 25--4 years old in Novosibirsk, was SLA - 43.29%, LALA - 26.53% - in second place, SS - 17.87% - third, LALG - 6 genotypes were less represented genotypes. 74%, SLG - 4.18%, LGLG - 1.39%. Carrying the SLA genotype (53.3% and 63.6%) increased the chance of developing both the average level of depression by 2.359 (95% CI 1.278-4.355) times, and depression in general by 1.933 (95% CI 1.142-3.271) times, compared with persons carrying the LALA genotype (32.0% and 46.9%), (χ2=7.674, df=1, p<0.01 and χ2=6.095, df=1, p<0.05). Persons carrying the LALG genotype (54.5%) also had a higher chance of developing a mean level of depression RR=2.929 (95% CI 1.039-8.261), compared with carriers of the LALA genotype (32.0%) (χ2=4.326, df =1, p<0.05) (p<0.05). CONCLUSION Associative links between polymorphic variants of the SLC6A4 gene and depression have been established.
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Affiliation(s)
- V V Gafarov
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - E A Gromova
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - M A Gubina
- Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - I V Gagulin
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - V N Maksimov
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A V Gafarova
- Research Institute of Therapy and Preventive Medicine - branch of the Institute of Cytology and Genetics Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
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Dorfman NJ, Blumenthal-Barby J, Ubel PA, Moore B, Nelson R, Kious BM. What Do Psychiatrists Think About Caring for Patients Who Have Extremely Treatment-Refractory Illness? AJOB Neurosci 2024; 15:51-58. [PMID: 37379054 DOI: 10.1080/21507740.2023.2225467] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
Questions about when to limit unhelpful treatments are often raised in general medicine but are less commonly considered in psychiatry. Here we describe a survey of U.S. psychiatrists intended to characterize their attitudes about the management of suicidal ideation in patients with severely treatment-refractory illness. Respondents (n = 212) received one of two cases describing a patient with suicidal ideation due to either borderline personality disorder or major depressive disorder. Both patients were described as receiving all guideline-based and plausible emerging treatments. Respondents rated the expected helpfulness and likelihood of recommending each of four types of intervention: hospitalization, additional medication changes, additional neurostimulation, and additional psychotherapy. Across both cases, most respondents said they were likely to provide each intervention, except for additional neurostimulation in borderline personality disorder, while fewer thought each intervention would be helpful. Substantial minorities of respondents indicated that they would provide an intervention they did not think was likely to be helpful. Our results suggest that while most psychiatrists recognize the possibility that some patients are unlikely to be helped by available treatments, many would continue to offer such treatments.
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Pavlova I, Ruda-Kucerova J. Brain metabolic derangements examined using 1H MRS and their (in)consistency among different rodent models of depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110808. [PMID: 37301420 DOI: 10.1016/j.pnpbp.2023.110808] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/01/2023] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
Major depressive disorder (MDD) is underlined by neurochemical changes in the brain. Proton magnetic resonance spectroscopy (1H MRS) is a useful tool for their examination as it provides information about the levels of metabolites. This review summarises the current knowledge of 1H MRS findings from rodent models of MDD, assesses the results from both a biological and a technical perspective, and identifies the main sources of bias. From a technical point of view, bias-introducing factors are the diversity of the measured volumes and their positioning in the brain, the data processing, and the metabolite concentration expression. The biological variables are strain, sex, and species, as well as the model itself, and in vivo vs. ex vivo exploration. This review identified some consistency in the 1H MRS findings in the models of MDD: lower levels of glutamine, glutamate + glutamine, and higher levels of myo-inositol and taurine in most of the brain regions of MDD models. This may suggest changes in regional metabolism, neuronal dysregulation, inflammation, and a compensatory effect reaction in the MDD rodent models.
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Affiliation(s)
- Iveta Pavlova
- Institute of Scientific Instruments of the Czech Academy of Sciences, Královopolská 147, 612 00 Brno, Czech Republic; Department of Condensed Matter Physics, Faculty of Science, Masaryk University, Kotlářská 2, 602 00 Brno, Czech Republic.
| | - Jana Ruda-Kucerova
- Department of Pharmacology, Faculty of Medicine, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic.
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He Z, Zheng Y, Ni J, Huang J, Pang Q, Chen T, Muhlert N, Elliott R. Loneliness is related to smaller gray matter volumes in ACC and right VLPFC in people with major depression: a UK biobank study. Cereb Cortex 2023; 33:11656-11667. [PMID: 37874025 DOI: 10.1093/cercor/bhad399] [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: 09/01/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
The anterior cingulate cortex (ACC) and right ventrolateral prefrontal cortex (VLPFC) are thought to have important roles in loneliness (feeling of social isolation/exclusion) experience or regulation and in the pathophysiology of their disturbance in major depressive disorder (MDD). However, the structural abnormalities of these regions and the correlates with loneliness in MDD across the healthy population have not fully been clarified. The study analyzed the link between loneliness and gray matter volumes (GMVs) in the ACC and right VLPFC among 1,005 patients with MDD and 7,247 healthy controls (HCs) using UK Biobank data. Significant reductions in GMV in the right VLPFC were found in MDD males compared to HCs. MDD males also showed a higher association between loneliness and reduced GMVs in the right VLPFC and bilateral ACC than HCs. No such associations were found in MDD females. The findings suggest that loneliness may influence brain structures crucial for emotion experience and regulation, particularly in middle-older aged men with MDD. This highlights the potential adverse effects of loneliness on brain structure in MDD and suggests that social engagement could have a positive impact.
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Affiliation(s)
- Zhenhong He
- School of Psychology, Shenzhen University, Shenzhen 518060, China
- Division of Neuroscience and Experimental Psychology, School of Biological Science, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Youcun Zheng
- School of Science and Engineering, Chinese University of Hong Kong, Shenzhen 518172, China
| | - Jingxuan Ni
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Jin Huang
- School of Mathematical Sciences, Shenzhen University, Shenzhen 518060, China
| | - Qingqing Pang
- School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Tongtong Chen
- School of Humanities, Shenzhen University, Shenzhen 518060, China
| | - Nils Muhlert
- Division of Neuroscience and Experimental Psychology, School of Biological Science, University of Manchester, Manchester M13 9PL, United Kingdom
| | - Rebecca Elliott
- Division of Neuroscience and Experimental Psychology, School of Biological Science, University of Manchester, Manchester M13 9PL, United Kingdom
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10
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Fischer IC, Schnurr PP, Pietrzak RH. Employment status among US military veterans with a history of posttraumatic stress disorder: Results from the National Health and Resilience in Veterans Study. J Trauma Stress 2023; 36:1167-1175. [PMID: 37821772 DOI: 10.1002/jts.22977] [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: 07/28/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/13/2023]
Abstract
The current study examined the prevalence and correlates of employment status in a nationally representative sample of U.S. military veterans with a probable lifetime history of posttraumatic stress disorder. Participants were 4,609 veterans from National Health and Resilience in Veterans Study (NHRVS) Bivariate analyses compared the employment status of veterans with regard to sociodemographic, military, health, and psychiatric characteristics. A multinomial regression analysis was conducted to determine the effect of lifetime PTSD status on employment and identify variables that differentiated employment status among veterans with a history of PTSD. In the total sample, 450 (weighted 12.5%) screened positive for lifetime PTSD. Veterans with PTSD were more than twice as likely to be unemployed, OR = 2.41, and retired, OR = 2.26, and nearly 4 times as likely to be disabled, OR = 3.84, relative to those without PTSD. Among veterans with PTSD, 203 (54.0%) were employed, 178 were retired (28.2%), 31 (7.3%) were unemployed, and 38 (10.5%) were disabled. Relative to employed veterans, retired veterans were older and reported more medical conditions; unemployed veterans were almost 5 times as likely to be female; disabled veterans reported lower income, more medical conditions, and more severe symptoms of current major depressive disorder but less severe symptoms of alcohol use disorder, ORs = 0.88-4.88. This study provides an up-to-date characterization of employment status in a nationally representative sample of U.S. military veterans with a history of PTSD. Results may inform efforts to provide sustainable employment in this segment of the population.
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Affiliation(s)
- Ian C Fischer
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Paula P Schnurr
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, White River Junction, Vermont, USA
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
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11
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Ruitenberg GM, Booij SHS, Batelaan NMN, Hoogendoorn AWA, Visser HAH. Transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and depressive disorders. BMC Psychiatry 2023; 23:443. [PMID: 37328822 PMCID: PMC10273546 DOI: 10.1186/s12888-023-04919-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 05/31/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Both anxiety and depressive disorders are associated with significant long-term disability. Since experienced impairments vary between patients independent of diagnosis and disease severity, identifying transdiagnostic factors that predict the course of disability may provide new targets to reduce disability. This study examines transdiagnostic factors predicting the 2-year disability outcome in patients with anxiety and/or depressive disorders (ADD), focusing on potentially malleable factors. METHODS Six hundred fifteen participants with a current diagnosis of ADD from the Netherlands Study of Depression and Anxiety (NESDA) were included. Disability was assessed at baseline and after 2 years of follow-up, using the 32-item WHODAS II questionnaire. Transdiagnostic predictors of 2-year disability outcome were identified using linear regression analysis. RESULTS In univariable analyses, transdiagnostic factors associated with the 2-year disability outcome were locus of control (standardized β = -0.116, p = 0.011), extraversion (standardized β = -0.123 p = 0.004) and experiential avoidance (standardized β = 0.139, p = 0.001). In multivariable analysis, extraversion had a unique predictive value (standardized β = -0.143 p = 0.003). A combination of sociodemographic, clinical and transdiagnostic variables resulted in an explained variance (R2) of 0.090). The explained variance of a combination of transdiagnostic factors was 0.050. CONCLUSION The studied transdiagnostic variables explain a small but unique part of variability in the 2-year disability outcome. Extraversion is the only malleable transdiagnostic factor predictive of the course of disability independent of other variables. Due to the small contribution to the variance in the disability outcome, the clinical relevance of targeting extraversion seems limited. However, its predictive value is comparable to that of accepted disease severity measures, supporting the importance of looking beyond using disease severity measures as predictors. Furthermore, studies including extraversion in combination with other transdiagnostic and environmental factors may elucidate the unexplained part of variability of the course of disability in patients with ADD.
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Affiliation(s)
| | - S H Sanne Booij
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Huispostcode CC72, Postbus 30.001, 9700 RB, Groningen, The Netherlands.
- Center for Integrative Psychiatry, Lentis, Groningen, the Netherlands.
| | - N M Neeltje Batelaan
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Specialized Mental Health Care, GGZ InGeest, Amsterdam, The Netherlands
| | - A W Adriaan Hoogendoorn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - H A Henny Visser
- Mental Health Care Institute GGZ Centraal, Ermelo, The Netherlands
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12
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Zheng Y, Zhang L, He S, Xie Z, Zhang J, Ge C, Sun G, Huang J, Li H. Integrated Module of Multidimensional Omics for Peripheral Biomarkers (iMORE) in patients with major depressive disorder: rationale and design of a prospective multicentre cohort study. BMJ Open 2022; 12:e067447. [PMID: 36418119 PMCID: PMC9685190 DOI: 10.1136/bmjopen-2022-067447] [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: 11/24/2022] Open
Abstract
INTRODUCTION Major depressive disorder (MDD) represents a worldwide burden on healthcare and the response to antidepressants remains limited. Systems biology approaches have been used to explore the precision therapy. However, no reliable biomarker clinically exists for prognostic prediction at present. The objectives of the Integrated Module of Multidimensional Omics for Peripheral Biomarkers (iMORE) study are to predict the efficacy of antidepressants by integrating multidimensional omics and performing validation in a real-world setting. As secondary aims, a series of potential biomarkers are explored for biological subtypes. METHODS AND ANALYSIS iMore is an observational cohort study in patients with MDD with a multistage design in China. The study is performed by three mental health centres comprising an observation phase and a validation phase. A total of 200 patients with MDD and 100 healthy controls were enrolled. The protocol-specified antidepressants are selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Clinical visits (baseline, 4 and 8 weeks) include psychiatric rating scales for symptom assessment and biospecimen collection for multiomics analysis. Participants are divided into responders and non-responders based on treatment response (>50% reduction in Montgomery-Asberg Depression Rating Scale). Antidepressants' responses are predicted and biomarkers are explored using supervised learning approach by integration of metabolites, cytokines, gut microbiomes and immunophenotypic cells. The accuracy of the prediction models constructed is verified in an independent validation phase. ETHICS AND DISSEMINATION The study was approved by the ethics committee of Shanghai Mental Health Center (approval number 2020-87). All participants need to sign a written consent for the study entry. Study findings will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04518592.
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Affiliation(s)
- Yuzhen Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Linna Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shen He
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zuoquan Xie
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Jing Zhang
- Shanghai Green Valley Pharmaceutical Co Ltd, Shanghai, China
| | - Changrong Ge
- Shanghai Green Valley Pharmaceutical Co Ltd, Shanghai, China
| | - Guangqiang Sun
- Shanghai Green Valley Pharmaceutical Co Ltd, Shanghai, China
| | - Jingjing Huang
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center for Mental Health, Shanghai Mental Health Center, Shanghai, China
| | - Huafang Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center for Mental Health, Shanghai Mental Health Center, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Long-term disability in common mental disorders in Chinese community: evidence from a five-year follow-up study. BMC Psychiatry 2022; 22:727. [PMID: 36419029 PMCID: PMC9682650 DOI: 10.1186/s12888-022-04382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/10/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Common mental disorders are general term for mental disorders with high disability rates and significant social burden. The purpose of this study was to determine the degree of long-term disability associated with common mental disorders and to interpret the relationship between common mental disorders and long-term disability. METHODS Participants in the 2013 China Mental Health Survey were followed up by telephone between April and June 2018. This study evaluated long-term disability over a five-year period using the World Health Organization's Disability Assessment Schedule 2.0. Poisson regression was used to analyze the relationship between common mental disorders and long-term disability. RESULTS A total of 6269 patients were followed up by telephone. In patients with common mental disorders, the prevalence of disability ranged from 7.62% to 43.94%. The long-term disabilities were significantly associated with dysthymic disorder (DD, RR:2.40; 95% CI:1.87-3.03), major depressive disorder (MDD, RR:1.63; 95% CI:1.34-1.98), generalized anxiety disorder (GAD, RR:1.95; 95% CI:1.15-3.09), obsessive-compulsive disorder (OCD, RR:1.68; 95% CI:1.24-2.22) and alcohol use disorder (AUD, RR: 1.42; 95% CI:0.99-1.96). CONCLUSIONS In China, common mental disorders raise the risk of long-term disability, and there is a critical need for monitoring patients with DD, MDD, GAD, OCD, and AUD. For improved quality of life and reduced disability levels, more resources need to be dedicated to mental health in the future.
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Samalin L, Rothärmel M, Mekaoui L, Gaudré-Wattinne E, Codet MA, Bouju S, Sauvaget A. Esketamine nasal spray in patients with treatment-resistant depression: the real-world experience in the French cohort early-access programme. Int J Psychiatry Clin Pract 2022; 26:352-362. [PMID: 35174754 DOI: 10.1080/13651501.2022.2030757] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To present the first real-world data of patients with treatment-resistant depression (TRD) treated with esketamine through a French cohort Temporary Authorisation for Use (ATUc) programme. METHODS In 2019, the French Health Authorities exceptionally granted the first ATUc in psychiatry for TRD patients. Clinical characteristics, safety and efficacy data were reported by physicians. The ATUc ended ∼6 months after initiation. RESULTS The cohort (n = 66; median age 53.0 years; 62.1% female; 78.8% with severe major depressive episodes; resistance to a mean of 4.2 previous antidepressants) received esketamine treatment for a median of 30 days. Among 46 analysed patients, 22 (47.8%) achieved response (Montgomery-Åsberg Depression Rating Scale [MADRS] total score reduction ≥50.0%) and 17 (37.0%) achieved remission (MADRS total score of ≤12) at least once at a median of 18.5 (2.0-77.0) and 21.0 (2.0-46.0) days after initiation, respectively. By Week 4, patients had a 31.6% probability of achieving remission (Kaplan-Meier method). Sedation, somnolence, dizziness, hypertension, anxiety and dissociation were the most frequently reported (>10.0%) adverse events. No new safety signals were identified. CONCLUSIONS Patient characteristics of this cohort demonstrate high-level treatment resistance. The safety and efficacy of esketamine in patients with TRD in real-world clinical practice were consistent with Phase 3 trials.Key pointsPatients with treatment-resistant depression (TRD) exceptionally received esketamine nasal spray ahead of its launch through a French cohort Temporary Authorisation for Use (ATUc) programme.The clinical characteristics of 66 adult patients with TRD included in this cohort demonstrated a high-level of resistance to conventional treatments at the time of treatment request prior to esketamine initiation.No new safety signals were observed with esketamine initiation during the ATUc period compared with the Phase 3 clinical trials.The safety and efficacy of esketamine in the real world remain consistent with that established in Phase 3 clinical trials.The data collected during this ATUc also provide the first real-world data on the management and practical use of esketamine in a hospital setting in France.
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Affiliation(s)
- Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Maud Rothärmel
- University Department of Psychiatry, Therapeutic Centre of Excellence, Institute of Psychiatry - Rouvray Hospital Centre, Sotteville-lès-Rouen, France
| | - Lila Mekaoui
- Mental and Brain Illness Clinic, Sainte-Anne Hospital, GHU Paris - Psychiatry and Neurosciences, Paris, France
| | | | | | - Sophie Bouju
- Medical Affairs, Janssen-Cilag, Issy-les-Moulineaux, France
| | - Anne Sauvaget
- Nantes Université, CHU Nantes, Movement, Interactions, Performance (MIP), EA 4334, Nantes, France
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15
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Ouyang X, Long Y, Wu Z, Liu D, Liu Z, Huang X. Temporal Stability of Dynamic Default Mode Network Connectivity Negatively Correlates with Suicidality in Major Depressive Disorder. Brain Sci 2022; 12:1263. [PMID: 36138998 PMCID: PMC9496878 DOI: 10.3390/brainsci12091263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/26/2022] Open
Abstract
Previous studies have demonstrated that the suicidality in patients with major depressive disorder (MDD) is related to abnormal brain functional connectivity (FC) patterns. However, little is known about its relationship with dynamic functional connectivity (dFC) based on the assumption that brain FCs fluctuate over time. Temporal stabilities of dFCs within the whole brain and nine key networks were compared between 52 MDD patients and 21 age, sex-matched healthy controls (HCs) using resting-state functional magnetic resonance imaging and temporal correlation coefficients. The alterations in MDD were further correlated with the scores of suicidality item in the Hamilton Rating Scale for Depression (HAMD). Compared with HCs, the MDD patients showed a decreased temporal stability of dFC as indicated by a significantly decreased temporal correlation coefficient at the global level, as well as within the default mode network (DMN) and subcortical network. In addition, temporal correlation coefficients of the DMN were found to be significantly negatively correlated with the HAMD suicidality item scores in MDD patients. These results suggest that MDD may be characterized by excessive temporal fluctuations of dFCs within the DMN and subcortical network, and that decreased stability of DMN connectivity may be particularly associated with the suicidality in MDD.
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Affiliation(s)
- Xuan Ouyang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Yicheng Long
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zhipeng Wu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Dayi Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Zhening Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha 410011, China
| | - Xiaojun Huang
- Department of Psychiatry, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, China
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Liang X, Tang J, Qi YQ, Luo YM, Yang CM, Dou XY, Jiang L, Xiao Q, Zhang L, Chao FL, Zhou CN, Tang Y. Exercise more efficiently regulates the maturation of newborn neurons and synaptic plasticity than fluoxetine in a CUS-induced depression mouse model. Exp Neurol 2022; 354:114103. [PMID: 35525307 DOI: 10.1016/j.expneurol.2022.114103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/28/2022] [Accepted: 04/30/2022] [Indexed: 11/24/2022]
Abstract
Depression, a common and important cause of morbidity and mortality worldwide, is commonly treated with antidepressants, electric shock and psychotherapy. Recently, increasing evidence has shown that exercise can effectively alleviate depression. To determine the difference in efficacy between exercise and the classic antidepressant fluoxetine in treating depression, we established four groups: the Control, chronic unpredictable stress (CUS/STD), running (CUS/RUN) and fluoxetine (CUS/FLX) groups. The sucrose preference test (SPT), the forced swimming test (FST), the tail suspension test (TST), immunohistochemistry, immunofluorescence and stereological analyses were used to clarify the difference in therapeutic efficacy and mechanism between exercise and fluoxetine in the treatment of depression. In the seventh week, the sucrose preference of the CUS/RUN group was significantly higher than that of the CUS/STD group, while the sucrose preference of the CUS/FLX group did not differ from that of the CUS/STD group until the eighth week. Exercise reduced the immobility time in the FST and TST, while fluoxetine only reduced immobility time in the TST. Hippocampal structure analysis showed that the CUS/STD group exhibited an increase in immature neurons and a decrease in mature neurons. Exercise reduced the number of immature neurons and increased the number of mature neurons, but no increase in the number of mature neurons was observed after fluoxetine treatment. In addition, both running and fluoxetine reversed the decrease in the number of MAP2+ dendrites in depressed mice. Exercise increased the number of spinophilin-positive (Sp+) dendritic spines in the hippocampal CA1, CA3, and dentate gyrus (DG) regions, whereas fluoxetine only increased the number of SP+ spines in the DG. In summary, exercise promoted newborn neuron maturation in the DG and regulated neuronal plasticity in three hippocampal subregions, which might explain why running exerts earlier and more comprehensive antidepressant effects than fluoxetine.
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Affiliation(s)
- Xin Liang
- Department of Pathophysiology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Jing Tang
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Ying-Qiang Qi
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, PR China
| | - Yan-Min Luo
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Physiology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Chun-Mao Yang
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Xiao-Yun Dou
- Institute of Life Science, Chongqing Medical University, Chongqing 400016, PR China
| | - Lin Jiang
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Lab Teaching & Management Center, Chongqing Medical University, Chongqing 400016, PR China
| | - Qian Xiao
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Radioactive Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Lei Zhang
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Feng-Lei Chao
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Chun-Ni Zhou
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China
| | - Yong Tang
- Laboratory of Stem Cells and Tissue Engineering, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China; Department of Histology and Embryology, Faculty of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, PR China.
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17
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Jaeger S, Uhlmann C, Bichescu-Burian D, Flammer E, Steinert T, Schmid P. One-year follow-up of functional impairment in inpatients with mood and anxiety disorders - Potentials of the Mini-ICF-APP. BMC Psychiatry 2022; 22:334. [PMID: 35570275 PMCID: PMC9107757 DOI: 10.1186/s12888-022-03977-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 05/05/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The aim of the study was to investigate functional impairment and its relationship to illness severity in a sample of patients with a diagnosis of mood or anxiety disorder during inpatient treatment and 1 year after discharge. METHODS Two hundred thirty-nine inpatients with primary diagnoses of mood or anxiety disorders were assessed at baseline and at follow-up by a range of validated instruments. Mini-ICF-APP was used for the assessment of functional impairment, BDI-II for the assessment of clinical symptoms and remission. Sample characteristics and measures of impairment at baseline and at follow-up were analysed descriptively. Symptomatically remitted and non-remitted patients were compared with regard to capacity limitations. RESULTS Initially, the sample showed considerable impairment in many capacities, particularly endurance, spontaneous activities, structuring of tasks, competency and flexibility. After 1 year, all capacities significantly improved. The level of impairment was correlated with employment status and severity of clinical symptoms. About 50% of the patients remitted in clinical symptomatology. Retrospectively, the remitted and the unremitted did not differ in functional impairment at baseline but there were considerable differences at follow-up. CONCLUSIONS Mini-ICF-APP is a useful instrument to monitor functional status and change in psychiatric samples, complementing the usual focus on symptom reduction.
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Affiliation(s)
- Susanne Jaeger
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany.
| | - Carmen Uhlmann
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Dana Bichescu-Burian
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Erich Flammer
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Tilman Steinert
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
| | - Petra Schmid
- Department of Psychiatry and Psychotherapy I, Ulm University, ZfP Südwürttemberg, Weingartshofer Str. 2, D-88214, Ravensburg, Germany
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18
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Del Casale A, Pomes LM, Bonanni L, Fiaschè F, Zocchi C, Padovano A, De Luca O, Angeletti G, Brugnoli R, Girardi P, Preissner R, Borro M, Gentile G, Pompili M, Simmaco M. Pharmacogenomics-Guided Pharmacotherapy in Patients with Major Depressive Disorder or Bipolar Disorder Affected by Treatment-Resistant Depressive Episodes: A Long-Term Follow-up Study. J Pers Med 2022; 12:jpm12020316. [PMID: 35207804 PMCID: PMC8874425 DOI: 10.3390/jpm12020316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/27/2022] [Accepted: 02/15/2022] [Indexed: 01/25/2023] Open
Abstract
Treatment-resistant depression (TRD) reduces affected patients’ quality of life and leads to important social health care costs. Pharmacogenomics-guided treatment (PGT) may be effective in the cure of TRD. The main aim of this study was to evaluate the clinical changes after PGT in patients with TRD (two or more recent failed psychopharmacological trials) affected by bipolar disorder (BD) or major depressive disorder (MDD) compared to a control group with treatment as usual (TAU). We based the PGT on assessing different gene polymorphisms involved in the pharmacodynamics and pharmacokinetics of drugs. We analyzed, with a repeated-measure ANOVA, the changes between the baseline and a 6 month follow-up of the efficacy index assessed through the Clinical Global Impression (CGI) scale, and depressive symptoms through the Hamilton Depression Rating Scale (HDRS). The PGT sample included 53 patients (26 BD and 27 MDD), and the TAU group included 52 patients (31 BD and 21 MDD). We found a significant within-subject effect of treatment time on symptoms and efficacy index for the whole sample, with significant improvements in the efficacy index (F = 8.544; partial η² = 0.077, p < 0.004) and clinical global impression of severity of illness (F = 6.818; partial η² = 0.062, p < 0.01) in the PGT vs. the TAU group. We also found a significantly better follow-up response (χ² = 5.479; p = 0.019) and remission (χ² = 10.351; p = 0.001) rates in the PGT vs. the TAU group. PGT may be an important option for the long-term treatment of patients with TRD affected by mood disorders, providing information that can better define drug treatment strategies and increase therapeutic improvement.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (A.D.C.); (P.G.)
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Luca Bonanni
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Federica Fiaschè
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Clarissa Zocchi
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Alessio Padovano
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Ottavia De Luca
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Gloria Angeletti
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Roberto Brugnoli
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Paolo Girardi
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (A.D.C.); (P.G.)
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
| | - Robert Preissner
- Structural Bioinformatics Group, Institute for Physiology, Charité—University Medicine Berlin, 10115 Berlin, Germany;
| | - Marina Borro
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Maurizio Pompili
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy; (L.B.); (F.F.); (C.Z.); (A.P.); (G.A.); (R.B.); (M.P.)
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00189 Rome, Italy; (L.M.P.); (O.D.L.); (M.B.); (G.G.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
- Correspondence:
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19
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White EJ, Nacke M, Akeman E, Cannon MJ, Mayeli A, Touthang J, Zoubi OA, McDermott TJ, Kirlic N, Santiago J, Kuplicki R, Bodurka J, Paulus MP, Craske MG, Wolitzky-Taylor K, Abelson J, Martell C, Clausen A, Stewart JL, Aupperle RL. P300 amplitude during a monetary incentive delay task predicts future therapy completion in individuals with major depressive disorder. J Affect Disord 2021; 295:873-882. [PMID: 34706458 PMCID: PMC8554135 DOI: 10.1016/j.jad.2021.08.106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/24/2021] [Accepted: 08/28/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Treatment effectiveness for major depressive disorder (MDD) is often affected by client non-adherence, dropout, and non-response. Identification of client characteristics predicting successful treatment completion and/or response (i.e., symptom reduction) may be an important tool to increase intervention effectiveness. It is unclear whether neural attenuations in reward processing associated with MDD predict behavioral treatment outcome. METHODS This study aimed to determine whether blunted neural responses to reward at baseline differentiate MDD (n = 60; 41 with comorbid anxiety) and healthy control (HC; n = 40) groups; and predict MDD completion of and response to 7-10 sessions of behavior therapy. Participants completed a monetary incentive delay (MID) task. The N200, P300, contingent negative variation (CNV) event related potentials (ERPs) and behavioral responses (reaction time [RT], correct hits) were quantified and extracted for cross-sectional group analyses. ERPs and behavioral responses demonstrating group differences were then used to predict therapy completion and response within MDD. RESULTS MDD exhibited faster RT and smaller P300 amplitudes than HC across conditions. Within the MDD group, treatment completers (n = 37) exhibited larger P300 amplitudes than non-completers (n = 21). LIMITATIONS This study comprises secondary analyses of EEG data; thus task parameters are not optimized to examine feedback ERPs from the paradigm. We did not examine heterogenous presentations of MDD; however, severity and comorbidity did not influence findings. CONCLUSIONS Previous studies suggest that P300 is an index of motivational salience and stimulus resource allocation. In sum, individuals who deploy greater neural resources to task demands are more likely to persevere in behavioral therapy.
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Affiliation(s)
- Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, United States.
| | - Mariah Nacke
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | | | | | - Ahmad Mayeli
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - James Touthang
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Obada Al Zoubi
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Psychiatry, Harvard Medical School/McLean Hospital, Boston MA, United States
| | - Timothy J McDermott
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Psychology, University of Tulsa, Tulsa, OK, United States
| | - Namik Kirlic
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | | | - Rayus Kuplicki
- Laureate Institute for Brain Research, Tulsa, OK, United States
| | - Jerzy Bodurka
- Laureate Institute for Brain Research, Tulsa, OK, United States; Stephenson School of Biomedical Engineering, University of Oklahoma, Tulsa, OK, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Michelle G Craske
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral science, University of California Los Angeles, Los Angeles, CA, United States
| | - Kate Wolitzky-Taylor
- Department of Psychiatry and Biobehavioral science, University of California Los Angeles, Los Angeles, CA, United States
| | - James Abelson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Christopher Martell
- Department of Psychological and Brain Sciences, University of Massachusetts- Amherst, Amherst, MA United States
| | - Ashley Clausen
- Kansas City VA Medical Center, Kansas City, MO, United States; Department of Psychiatry and Behavioral Science, University of Kansas Medical Center, Kansas City, Kansas United States
| | - Jennifer L Stewart
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States; Department of Community Medicine, University of Tulsa, Tulsa, OK, United States
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20
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van der Wal JM, van Borkulo CD, Deserno MK, Breedvelt JJF, Lees M, Lokman JC, Borsboom D, Denys D, van Holst RJ, Smidt MP, Stronks K, Lucassen PJ, van Weert JCM, Sloot PMA, Bockting CL, Wiers RW. Advancing urban mental health research: from complexity science to actionable targets for intervention. Lancet Psychiatry 2021; 8:991-1000. [PMID: 34627532 DOI: 10.1016/s2215-0366(21)00047-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/30/2022]
Abstract
Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urbanicity and CMD burden in 191 countries. We found a positive, non-linear relationship with a higher CMD prevalence in more urbanised countries, particularly for anxiety disorders. We also did a review of meta-analytic studies on the association between urban factors and CMD risk. We identified factors relating to the ambient, physical, and social urban environment and showed differences per diagnosis of CMDs. We argue that factors in the urban environment are likely to operate as a complex system and interact with each other and with individual city inhabitants (including their psychological and neurobiological characteristics) to shape mental health in an urban context. These interactions operate on various timescales and show feedback loop mechanisms, rendering system behaviour characterised by non-linearity that is hard to predict over time. We present a conceptual framework for future urban mental health research that uses a complexity science approach. We conclude by discussing how complexity science methodology (eg, network analyses, system-dynamic modelling, and agent-based modelling) could enable identification of actionable targets for treatment and policy, aimed at decreasing CMD burdens in an urban context.
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Affiliation(s)
- Junus M van der Wal
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands; Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Claudia D van Borkulo
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Marie K Deserno
- Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands; Centre for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
| | - Josefien J F Breedvelt
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; National Centre for Social Research, London, UK; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Mike Lees
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Informatics Institute, University of Amsterdam, Amsterdam, Netherlands
| | - John C Lokman
- Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Denny Borsboom
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychological Methods, University of Amsterdam, Amsterdam, Netherlands
| | - Damiaan Denys
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ruth J van Holst
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Marten P Smidt
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Karien Stronks
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Public Health, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands
| | - Paul J Lucassen
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Julia C M van Weert
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, Netherlands
| | - Peter M A Sloot
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Institute for Advanced Study, University of Amsterdam, Amsterdam, Netherlands; National Centre for Cognitive Science, ITMO University, St Petersburg, Russia
| | - Claudi L Bockting
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Psychiatry, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, Netherlands.
| | - Reinout W Wiers
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, Netherlands; Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
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21
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Atagun Mİ, Atay OC, Balaban OD, Ipekcioglu D, Alpugan B, Yalcin S, Senat A, Karamustafalioglu N, Ilnem MC, Erel O. Serum nitric oxide levels are depleted in depressed patients treated with electroconvulsive therapy. Indian J Psychiatry 2021; 63:456-461. [PMID: 34789933 PMCID: PMC8522622 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1441_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/05/2021] [Accepted: 06/30/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Nitric oxide (NO) is an endogenous substance which has several endocrine functions and may act as neurotransmitter in the brain. High levels of NO may provoke nitrosative stress. AIM It was aimed to examine serum levels of NO in patients with depressive episodes who were treated with electroconvulsive therapy (ECT) in this study. METHODS The design was a case-control, follow-up study. Patients with depressive episodes (n = 23) and a healthy control group (n = 21) were enrolled. Three serum samples were obtained from the patient group (before ECT, after first and seventh sessions). NO, nitrite, and nitrate levels were examined. STATISTICAL ANALYSIS Differences between groups were examined with t-test or Mann-Whitney U-test. Longitudinal data were evaluated with Panel Regression Analysis and Kruskal-Wallis Test. RESULTS Serum levels of NO and nitrite decreased significantly after the seventh session of ECT administration compared to the baseline and first session. Nitrate levels did not differ between the assessments. CONCLUSIONS Reduction of the serum NO and nitrite levels might be a contributing factor for hypertension during the sessions. These findings are reflect the circulating NO levels. Further studies may dissect NO physiology in the brain in mental disorders and potential external effects.
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Affiliation(s)
- Murat İlhan Atagun
- Department of Psychiatry, Izmir Bakircay University Faculty of Medicine, Izmir, Turkey
| | - Ozge Canbek Atay
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Ozlem D Balaban
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Derya Ipekcioglu
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Baris Alpugan
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Suat Yalcin
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Almila Senat
- Department of Biochemistry, Ankara Yildirim Beyazit University Medical Faculty, Ankara, Turkey
| | - Nesrin Karamustafalioglu
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Mehmet C Ilnem
- Department of Psychiatry, Istanbul Bakirkoy Research and Training Hospital for Psychiatry, Istanbul, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Ankara Yildirim Beyazit University Medical Faculty, Ankara, Turkey
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Ter Meulen WG, Draisma S, van Hemert AM, Schoevers RA, Kupka RW, Beekman ATF, Penninx BWJH. Depressive and anxiety disorders in concert-A synthesis of findings on comorbidity in the NESDA study. J Affect Disord 2021; 284:85-97. [PMID: 33588240 DOI: 10.1016/j.jad.2021.02.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Comorbidity of depressive and anxiety disorders is common and remains incompletely comprehended. This paper summarizes findings from the Netherlands Study of Depression and Anxiety (NESDA) regarding prevalence, temporal sequence, course and longitudinal patterns; sociodemographic, vulnerability and neurobiological indicators; and functional, somatic and mental health indicators of comorbidity. METHODS Narrative synthesis of earlier NESDA based papers on comorbidity (n=76). RESULTS Comorbidity was the rule in over three-quarter of subjects with depressive and/or anxiety disorders, most often preceded by an anxiety disorder. Higher severity and chronicity characterized a poorer comorbidity course. Over time, transitions between depressive and anxiety disorders were common. Consistent comorbidity risk indicators in subjects with depressive and anxiety disorders were childhood trauma, neuroticism and early age of onset. Psychological vulnerabilities, such as trait avoidance tendencies, were more pronounced in comorbid than in single disorders. In general, there were few differences in biological markers and neuroimaging findings between persons with comorbid versus single disorders. Most functional, somatic, and other mental health indicators, ranging from disability to cardiovascular and psychiatric multimorbidity, were highest in comorbid disorders. LIMITATIONS The observational design of NESDA limits causal inference. Attrition was higher in comorbid relative to single disorders. CONCLUSIONS As compared to single disorders, persons with comorbid depressive and anxiety disorders were characterized by more psychosocial risk determinants, more somatic and other psychiatric morbidities, more functional impairments, and poorer outcome. These results justify specific attention for comorbidity of depressive and anxiety disorders, particularly in treatment settings.
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Affiliation(s)
- Wendela G Ter Meulen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Stasja Draisma
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Albert M van Hemert
- Leiden University, Leiden University Medical Centre, Department of Psychiatry, Leiden, the Netherlands.
| | - Robert A Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioral and Cognitive Neurosciences (BCN), Groningen, the Netherlands.
| | - Ralph W Kupka
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Aartjan T F Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
| | - Brenda W J H Penninx
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, the Netherlands; GGZ inGeest Specialized Mental Health Care, Research and Innovation, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands.
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23
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Schmid M, Hammar Å. First-Episode Patients Report Cognitive Difficulties in Executive Functioning 1 Year After Initial Episode of Major Depressive Disorder. Front Psychiatry 2021; 12:667238. [PMID: 34135786 PMCID: PMC8200526 DOI: 10.3389/fpsyt.2021.667238] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/26/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Major Depressive Disorder (MDD) is associated with cognitive impairment in general, and Executive Functioning (EF) in particular, even in remitted phase of the disorder, suggesting residual cognitive symptoms. The aim of the present study was to investigate self-reported EF 1 year after the first episode of MDD and to explore this in relation to depressive mood symptoms, remission and relapse. Method: The study included data from 24 patients and 23 healthy control subjects 1 year after the patients' initial first episode of MDD. All participants completed the Behavior Rating Inventory of Executive Functioning-Adult version (BRIEF-A), a standardized self-report measure of perceived EF in everyday life, measuring nine different EF. Total index scores for metacognitive functions, behavior/emotional regulation functions and a global EF score is also calculated. Results: The patient group in total, independent of symptom status, reported significantly lower EF in all indexes compared to the healthy controls 1 year after the initial episode. However, higher depressive mood symptom load correlated with self-reported difficulties in metacognitive functions and poor global EF scores. Regulatory control of behavior and emotional responses did not show such strong association with mood symptoms, but low self-report scores on this measure was associated with relapse during the first year after the initial episode. Conclusion: First-episode patients report significant lower executive functioning in everyday life compared to individually matched healthy controls, 1 year after onset, independent of symptom load. Residual cognitive symptoms seem to be evident and associated with risk of relapse and should be targeted in treatment and prevention of recurrence in MDD.
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Affiliation(s)
- Marit Schmid
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway
| | - Åsa Hammar
- Division of Psychiatry, Haukeland University Hospital, University of Bergen, Bergen, Norway.,Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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24
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Fratelli C, Siqueira J, Silva C, Ferreira E, Silva I. 5HTTLPR Genetic Variant and Major Depressive Disorder: A Review. Genes (Basel) 2020; 11:E1260. [PMID: 33114535 PMCID: PMC7692865 DOI: 10.3390/genes11111260] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 02/06/2023] Open
Abstract
Major Depressive Disorder (MDD) is a disease that involves biological, psychological, and social interactions. Studies have shown the importance of genetics contribution to MDD development. The SCL6A4 protein (5HTTLPR) functions transporting serotonin, a neurotransmitter linked to mood and emotion, to the synaptic cleft. Hence, this study seeks, through a literature review, a better comprehension of the 5HTTLPR genetic variant association with MDD. For this purpose, a search was performed on the Virtual Health Library Portal for articles that related 5HTTLPR to MDD. Most of the articles found were conducted in the American continent, with one (1) study implemented in Brazil. 5HTTLPR associations were found regarding changes in the nervous system, pharmacology, and risk factors seen in MDD patients. When verifying the allelic distribution, the S allele had a higher frequency in most of the studies analyzed. Despite not finding a commonality in the different studies, the tremendous genetic variation found demonstrates the MDD complexity. For this reason, further studies in diverse populations should be conducted to assist in the understanding and treatment of the disease.
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Affiliation(s)
- Caroline Fratelli
- Postgraduate Program in Health Sciences and Technologies, Campus Faculty of Ceilandia, University of Brasilia, Brasilia 72220-275, Brazil;
| | - Jhon Siqueira
- Department of Pharmacy, Campus Faculty of Ceilandia, University of Brasilia, Brasilia 72220-275, Brazil; (J.S.); (C.S.); (E.F.)
| | - Calliandra Silva
- Department of Pharmacy, Campus Faculty of Ceilandia, University of Brasilia, Brasilia 72220-275, Brazil; (J.S.); (C.S.); (E.F.)
| | - Eduardo Ferreira
- Department of Pharmacy, Campus Faculty of Ceilandia, University of Brasilia, Brasilia 72220-275, Brazil; (J.S.); (C.S.); (E.F.)
| | - Izabel Silva
- Department of Pharmacy, Campus Faculty of Ceilandia, University of Brasilia, Brasilia 72220-275, Brazil; (J.S.); (C.S.); (E.F.)
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25
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Breedvelt JJF, Warren FC, Brouwer ME, Karyotaki E, Kuyken W, Cuijpers P, van Oppen P, Gilbody S, Bockting CLH. Individual participant data (IPD) meta-analysis of psychological relapse prevention interventions versus control for patients in remission from depression: a protocol. BMJ Open 2020; 10:e034158. [PMID: 32060157 PMCID: PMC7044815 DOI: 10.1136/bmjopen-2019-034158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Psychological interventions and antidepressant medication can be effective interventions to prevent depressive relapse for patients currently in remission of depression. Less is known about overall factors that predict or moderate treatment response for patients receiving a psychological intervention for recurrent depression. This is a protocol for an individual participant data (IPD) meta-analysis which aims to assess predictors and moderators of relapse or recurrence for patients currently in remission from depression. METHODS AND ANALYSIS Searches of PubMed, PsycINFO, Embase and Cochrane Central Register of Controlled Trials were completed on 13 October 2019. Study extractions and risk of bias assessments have been completed. Study authors will be asked to contribute IPD. Standard aggregate meta-analysis and IPD analysis will be conducted, and the outcomes will be compared with assess whether results differ between studies supplying data and those that did not. IPD files of individual data will be merged and variables homogenised where possible for consistency. IPD will be analysed via Cox regression and one and two-stage analyses will be conducted. ETHICS AND DISSEMINATION The results will be published in peer review journals and shared in a policy briefing as well as accessible formats and shared with a range of stakeholders. The results will inform patients and clinicians and researchers about our current understanding of more personalised ways to prevent a depressive relapse. No local ethics approval was necessary following consultation with the legal department. Guidance on patient data storage and management will be adhered to. PROSPERO REGISTRATION NUMBER CRD42019127844.
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Affiliation(s)
- Josefien J F Breedvelt
- Department of Psychiatry and Amsterdam Public Health research institute, Amsterdam University Medical Centre - Location AMC, Amsterdam, The Netherlands
| | - Fiona C Warren
- Institute of Health Research, College of Medicine & Health, University of Exeter, Exeter, UK
| | - Marlies E Brouwer
- Department of Psychiatry and Amsterdam Public Health research institute, Amsterdam University Medical Centre - Location AMC, Amsterdam, The Netherlands
| | - Eirini Karyotaki
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Willem Kuyken
- Department of Psychiatry, University of Oxford, Oxford, Oxfordshire, UK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam University Medical Centre, location VUmc and GGZ InGeest, Amsterdam, Netherlands
| | - Simon Gilbody
- Mental Health and Addictions Research Group - Department of Health Sciences, The University of York, York, UK
| | - Claudi L H Bockting
- Department of Psychiatry and Amsterdam Public Health research institute, Amsterdam University Medical Centre - Location AMC, Amsterdam, The Netherlands
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