1
|
Blanco J, Quimbaya P, Mena M, Dodd S, Bustos RH. Profiling the combination of bupropion and dextromethorphan as a treatment option for major depressive disorder. Expert Rev Neurother 2024; 24:837-848. [PMID: 39039791 DOI: 10.1080/14737175.2024.2374024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/25/2024] [Indexed: 07/24/2024]
Abstract
INTRODUCTION Major Depressive Disorder (MDD) is a common mental health disorder marked by sadness, hopelessness, and anhedonia. Various therapies exist, but their effectiveness is limited. Dextromethorphan hydrobromide combined with bupropion hydrochloride (Auvelity®) is a recently approved alternative for treating this condition in adults. AREAS COVERED This review summarizes the neurobiology of major depression and delves into the pharmacology, efficacy, safety, and tolerability of dextromethorphan plus bupropion in adult patients. It is based on observational studies, clinical trials, and other secondary studies obtained through systematic literature searches. EXPERT OPINION The combination of bupropion and dextromethorphan as a new pharmacotherapy for mental health is an interesting addition to the treatment options that can be used for MDD. The combination can be used in a range of scenarios, including as a first line therapy, as a second option when a patient has failed to achieve remission with a serotonin targeting agent, and for treatment resistant depression. Further research for other indications, including addiction disorders, may provide exciting results. Although a new combination, clinicians will be very familiar with both agents, increasing their acceptability. This pharmacotherapy also may bring increased impetus for discovering other combinations that may have beneficial synergistic effects.
Collapse
Affiliation(s)
- Joseph Blanco
- Department of Clinical Pharmacology, Evidence-Based Therapeutics Group, Faculty of Medicine, Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Cundinamarca, Colombia
| | - Pamela Quimbaya
- Department of Clinical Pharmacology, Evidence-Based Therapeutics Group, Faculty of Medicine, Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Cundinamarca, Colombia
| | - Manuel Mena
- Department of Clinical Pharmacology, Evidence-Based Therapeutics Group, Faculty of Medicine, Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Cundinamarca, Colombia
| | - Seetal Dodd
- Faculty of Medicine, Universidad de La Sabana, Chía, Colombia
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Barwon Health, Geelong, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, Australia
| | - Rosa-Helena Bustos
- Department of Clinical Pharmacology, Evidence-Based Therapeutics Group, Faculty of Medicine, Universidad de La Sabana and Clínica Universidad de La Sabana, Chía, Cundinamarca, Colombia
| |
Collapse
|
2
|
Nelson KM, Wilson S. Depressive disorders in children: recent prevalence and future directions. Evid Based Nurs 2024:ebnurs-2023-103932. [PMID: 38724092 DOI: 10.1136/ebnurs-2023-103932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2024] [Indexed: 05/26/2024]
Affiliation(s)
- Kayla M Nelson
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Sylia Wilson
- Institute of Child Development, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| |
Collapse
|
3
|
Cao C, Chen M, Yang S, Xu Y, Gu J. Childhood maltreatment, multilocus HPA-axis genetic variation and adolescent comorbidity profiles of depressive and anxiety symptoms. CHILD ABUSE & NEGLECT 2024; 149:106683. [PMID: 38335561 DOI: 10.1016/j.chiabu.2024.106683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 01/21/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Despite a growing body of evidence showing both genetic and environmental influences on adolescent depression and anxiety, the involved comorbid mechanisms regarding gene-by-environment (G × E) interaction remain unclear. OBJECTIVE The current study was the first to investigate the extent to which multilocus hypothalamic-pituitary-adrenal (HPA)-axis genetic variants moderated the association between childhood maltreatment and adolescent comorbid depression and anxiety. METHODS The participants were 827 Chinese Han adolescents (Mage = 16.45 ± 1.37 years; 50.2 % girls). A theory-driven multilocus genetic profile score (MGPS) was computed by calculating alleles of core HPA-axis genes (CRHR1, NR3C1, NR3C2, and FKBP5) associated with heightened stress reactivity. Childhood maltreatment was retrospectively collected using Childhood Trauma Questionnaire. Comorbidity profiles of self-reported adolescent depressive and anxiety symptoms were constructed via person-centered latent profile analysis. RESULTS Three heterogeneous comorbidity profiles of depressive and anxiety symptoms were identified: comorbid severe symptoms (9.7 %), comorbid moderate symptoms (46.4 %) and comorbid mild symptoms (43.9 %). The HPA-axis related MGPS significantly interacted with childhood maltreatment, especially emotional maltreatment (emotional abuse: OR = 1.14, 95 % CI [1.03, 1.26], p < .01; emotional neglect: OR = 1.07, 95 % CI [1.01, 1.13], p < .05), to distinguish the comorbid severe symptoms profile from the comorbid mild symptoms profile (OR = 1.03, 95 % CI [1.01, 1.06], p < .05). CONCLUSION The HPA-axis related genes showed an additive polygenic sensitivity toward childhood maltreatment, which might be one of the polygenic G × E mechanisms underlying adolescent comorbid depression and anxiety.
Collapse
Affiliation(s)
- Cong Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.
| | - Meijing Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shan Yang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yajing Xu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Junlian Gu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
| |
Collapse
|
4
|
Klein DN, Perlman G, Feltman SM, Kotov R. Preonset predictors of chronic-intermittent depression from early adolescence to early adulthood. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:694-703. [PMID: 37276087 PMCID: PMC10524144 DOI: 10.1037/abn0000826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Individuals with prolonged or frequent episodes account for a disproportionate share of the burden of depression. However, there are surprisingly few data on whether individuals at risk for developing chronic-intermittent depression (CID) as opposed to briefer, infrequent depressive episodes (time-limited depression [TLD]) can be distinguished before their first depressive episode. We followed a community sample of 465 never-depressed females on five occasions from age 14 to 20 years and examined whether 18 preonset clinical and psychosocial variables prospectively predicted CID. The CID group accounted for 40% of depressed cases but 84% of the cumulative time depressed in the sample. Participants with CID (n = 60) exhibited significantly higher preonset levels of 16 of the 18 risk factors than the never-depressed group (n = 315). The TLD group (n = 90) had significantly higher preonset levels of nine risk factors than never-depressed participants. Finally, the CID group had significantly higher levels of nine risk factors than the TLD group, five of which were similar in TLD and never-depressed participants. These findings indicate that differences between CID and TLD are evident before onset and suggest that the liability to CID may be both greater than, and somewhat different from, the liability to TLD. Moreover, they suggest that individuals at risk for a malignant course of depression can be targeted for prevention and early intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Greg Perlman
- Department of Psychiatry and Behavioral Health, Stony Brook University
| | - Scott M. Feltman
- Department of Psychiatry and Behavioral Health, Stony Brook University
| | - Roman Kotov
- Department of Psychiatry and Behavioral Health, Stony Brook University
| |
Collapse
|
5
|
Prizeman K, Weinstein N, McCabe C. Effects of mental health stigma on loneliness, social isolation, and relationships in young people with depression symptoms. BMC Psychiatry 2023; 23:527. [PMID: 37479975 PMCID: PMC10362624 DOI: 10.1186/s12888-023-04991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is the most prevalent affective disorder and the leading cause of illness and disability among young people worldwide. Besides being more susceptible to the onset of depression, young people have a higher risk of loneliness, and their personal and social development is impacted by social relationships during this time. It is thought that mental health stigma can undermine both help-seeking and longer-term outcomes for disorders like depression in young people. However, how stigma (i.e., related to depression) might affect young people's feelings of loneliness, social isolation, and relationships is unclear. Using qualitative research methods, this study aimed to explore the subjective experiences of public and internalized stigma and its effects on loneliness, social isolation, and relationship quality in young people with depression symptoms. METHODS We carried out in-depth, semi-structured interviews with N = 22 young people aged 17-25 (Mage = 22 years) who reported high symptoms of depression (Mood and Feelings Questionnaire (MFQ) score > 27) (i.e., community sample, N = 9) or had been previously diagnosed with depression by a medical professional (i.e., clinical sample, N = 13). Data were analysed using thematic analysis. We explored the subjective effects of depression stigma on loneliness, social isolation, and relationships. RESULTS Participants described both public stigma (i.e., initiated by others) and internalized stigma (i.e., self-imposed) as disrupting social relationships and eliciting loneliness, isolation, and depressive symptomology. Four main themes about young people's subjective experiences of stigma were identified: 1) Others' Misunderstanding of Mental Health Disorders and the Impact Misunderstanding has on Relationships; 2) Effects of Stigma on the Self and Wellbeing; 3) Stigma Fosters Secrecy Versus Disclosure; and 4) Stigma Increases Loneliness Driven by Avoidance of Social Contexts. CONCLUSIONS Young people's accounts revealed a wide range of consequences beyond their depression diagnosis. Participants often felt discriminated against, misunderstood, and judged by others as a result of public stigma; they discussed internalizing these attitudes. They suggested that a lack of understanding from others, for example from their partners, family, and peers, and unreliable and/or absent support systems resulted in increased feelings of loneliness and social isolation and reduced the quality and quantity of relationship formation, social bonds, and interactions. Stigma also reduced their self-esteem and confidence, which in turn fostered secrecy and a reluctance to disclose their depression. Despite depression's stigma, most participants reported having long-term goals and aspirations to reconnect with others. These goals stood in contrast to feeling hopeless and unmotivated during periods of depression. Overall, we reveal how stigma can impact feelings of loneliness, social isolation, and relationships among young people with depression, which could lead to targeted interventions to lessen the impact of stigma in this population.
Collapse
|
6
|
Mu W, Li K, Tian Y, Perlman G, Michelini G, Watson D, Ormel H, Klein DN, Kotov R. Dynamic risk for first onset of depressive disorders in adolescence: does change matter? Psychol Med 2023; 53:2352-2360. [PMID: 34802476 DOI: 10.1017/s0033291721004190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Risk factors for depressive disorders (DD) change substantially over time, but the prognostic value of these changes remains unclear. Two basic types of dynamic effects are possible. The 'Risk Escalation hypothesis' posits that worsening of risk levels predicts DD onset above average level of risk factors. Alternatively, the 'Chronic Risk hypothesis' posits that the average level rather than change predicts first-onset DD. METHODS We utilized data from the ADEPT project, a cohort of 496 girls (baseline age 13.5-15.5 years) from the community followed for 3 years. Participants underwent five waves of assessments for risk factors and diagnostic interviews for DD. For illustration purposes, we selected 16 well-established dynamic risk factors for adolescent depression, such as depressive and anxiety symptoms, personality traits, clinical traits, and social risk factors. We conducted Cox regression analyses with time-varying covariates to predict first DD onset. RESULTS Consistently elevated risk factors (i.e. the mean of multiple waves), but not recent escalation, predicted first-onset DD, consistent with the Chronic Risk hypothesis. This hypothesis was supported across all 16 risk factors. CONCLUSIONS Across a range of risk factors, girls who had first-onset DD generally did not experience a sharp increase in risk level shortly before the onset of disorder; rather, for years before onset, they exhibited elevated levels of risk. Our findings suggest that chronicity of risk should be a particular focus in screening high-risk populations to prevent the onset of DDs. In particular, regular monitoring of risk factors in school settings is highly informative.
Collapse
Affiliation(s)
- Wenting Mu
- Department of Psychology, Tsinghua University, Beijing, China
| | - Kaiqiao Li
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Yuan Tian
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Giorgia Michelini
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
- Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - David Watson
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Hans Ormel
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Daniel N Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
- Semel Institute for Neuroscience & Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
7
|
Pitanupong J, Sa-i A. Personality traits among major depressive disorder in southern Thailand: a hospital-based case-control study. BMC Psychol 2023; 11:18. [PMID: 36694215 PMCID: PMC9875388 DOI: 10.1186/s40359-023-01057-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Residual depression can cause functional impairment. This study aimed to assess personality traits among individuals with depression, to compare the results with personality traits found in outpatients without psychiatric disorders recruited from general practitioner settings, and to study the association between personality traits and the age-onset of depression, duration of treatment, and the presence of depressive residual symptoms. METHODS A case-control study surveyed Thai individuals with depression and outpatients without psychiatric disorders recruited from general practitioner settings at an outpatient clinic of Songklanagarind hospital, in 2022. The questionnaires were: (1) demographic data, (2) the PHQ-9 Thai version, and (3) the International Personality Item Pool-NEO (IPIP-NEO) Thai version. The difference between personality traits and the assigned clinical group were analyzed using the Student's t-test and the Wilcoxon rank sum test. A generalized linear model was performed to examine differences of personality traits between the assigned clinical group (case-control), and the presence of depressive residual symptoms. The association between personality traits and treatment profiles was assessed by using an analysis of the variance test and the Kruskal-Wallis test. RESULTS In regards to 73 individuals with depression in the case group, and 73 gender-and age-matched outpatients without psychiatric disorders recruited from general practitioner settings in the control group; 78.1% of cases and 82.2% of controls were female. Thirty-eight (52.1%) cases had depressive residual symptoms. Regarding the IPIP-NEO Thai version, there was a statistically significant difference in Neuroticism, Extraversion, and Conscientiousness domains between the case and the control groups. In comparison to the control group, the case group scored higher on the Neuroticism domain, and lower on the Extraversion and Conscientiousness domains. Every 0.18-point reduction in the Neuroticism score and every 0.09-point increment in regards to the Openness score were associated with a 1-year increment of age-onset of depression. This study found an association between a higher score of Neuroticism and a lower score of Conscientiousness with the presence of depressive residual symptoms. CONCLUSION Different personality profiles were found between individuals with depression and outpatients without psychiatric disorders recruited from general practitioner settings. Individuals with depressive residual symptoms featured a higher score of Neuroticism and a lower score of Conscientiousness. A higher score of Neuroticism and a lower score of Openness were associated with age-onset of depression, but no personality traits were associated with treatment duration.
Collapse
Affiliation(s)
- Jarurin Pitanupong
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| | - Adchara Sa-i
- grid.7130.50000 0004 0470 1162Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110 Thailand
| |
Collapse
|
8
|
Sapsford TP, Johnson SR, Headrick JP, Branjerdporn G, Adhikary S, Sarfaraz M, Stapelberg NJC. Forgetful, sad and old: Do vascular cognitive impairment and depression share a common pre-disease network and how is it impacted by ageing? J Psychiatr Res 2022; 156:611-627. [PMID: 36372004 DOI: 10.1016/j.jpsychires.2022.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/07/2022]
Abstract
Vascular cognitive impairment (VCI) and depression frequently coexist in geriatric populations and reciprocally increase disease risks. We assert that a shared pre-disease state of the psycho-immune-neuroendocrine (PINE) network model mechanistically explains bidirectional associations between VCI and depression. Five pathophysiological sub-networks are identified that are shared by VCI and depression: neuroinflammation, kynurenine pathway imbalance, hypothalamic-pituitary-adrenal (HPA) axis overactivity, impaired neurotrophic support and cerebrovascular dysfunction. These do not act independently, and their complex interactions necessitate a systems biology approach to better define disease pathogenesis. The PINE network is already established in the context of non-communicable diseases (NCDs) such as depression, hypertension, atherosclerosis, coronary heart disease and type 2 diabetes mellitus. We build on previous literature to specifically explore mechanistic links between MDD and VCI in the context of PINE pathways and discuss key mechanistic commonalities linking these comorbid conditions and identify a common pre-disease state which precedes transition to VCI and MDD. We expand the model to incorporate bidirectional interactions with biological ageing. Diathesis factors for both VCI and depression feed into this network and the culmination of shared mechanisms (on an ageing substrate) lead to a critical network transition to one or both disease states. A common pre-disease state underlying VCI and depression can provide clinicians a unique opportunity for early risk assessment and intervention in disease development. Establishing the mechanistic elements and systems biology of this network can reveal early warning or predictive biomarkers together with novel therapeutic targets. Integrative studies are recommended to elucidate the dynamic networked biology of VCI and depression over time.
Collapse
Affiliation(s)
- Timothy P Sapsford
- Griffith University School of Medicine, Gold Coast, Queensland, Australia; Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Susannah R Johnson
- Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - John P Headrick
- Griffith University School of Medicine, Gold Coast, Queensland, Australia
| | - Grace Branjerdporn
- Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia.
| | - Sam Adhikary
- Mater Young Adult Health Centre, Mater Hospital, Brisbane, Queensland, Australia
| | - Muhammad Sarfaraz
- Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia
| | - Nicolas J C Stapelberg
- Gold Coast Hospital and Health Service, Gold Coast, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| |
Collapse
|
9
|
Moulin F, Gholam M, Strippoli MPF, Castelao E, Merikangas KR, Stapp EK, Marquet P, Aubry JM, Plessen KJ, Di Giacomo F, Glaus J, Pistis G, Lavigne B, Elowe J, Ranjbar S, Preisig M, Vandeleur CL. Environmental factors in offspring of parents with mood disorders and their role in parent-child transmission: findings from a 14-year prospective high-risk study. Int J Bipolar Disord 2022; 10:11. [PMID: 35386056 PMCID: PMC8986929 DOI: 10.1186/s40345-022-00257-5] [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: 10/26/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background The factors involved in the transmission of mood disorders are only partially elucidated. Aside from genes, the family environment might play a crucial role in parent–child transmission. Our goals were to (1) assess the associations of parental bipolar disorder (BPD) and Major Depressive Disorder (MDD) with individual or shared family environmental factors, including traumatic events in offspring, parental separation, family cohesion and parental attitudes; and 2) test whether these factors were mediators of the association between exposure to parental mood disorders and the onset of these disorders in offspring. Methods The sample stems from an ongoing family high-risk study of mood disorders conducted in the French-speaking part of Switzerland. Given the strong impact of the age of onset of parental disorders on their transmission to children, parental disorders were dichotomized according to the onset (cut-off 21 years). Probands with early-onset (n = 30) and later-onset BPD (n = 51), early-onset (n = 21) and later-onset MDD (n = 47) and controls (n = 65), along with their spouses (n = 193) and offspring (n = 388; < 18 years on study inclusion), were assessed over a mean follow-up duration of 14 years (s.d: 4.6). The environmental measures were based on reports by offspring collected before the onset of their first mood episode. Results Offspring of probands with later-onset BPD and offspring of probands with both early-onset and later-onset MDD reported traumatic events more frequently than comparison offspring, whereas exposure to parental separation was more frequent in all groups of high-risk offspring. Moreover, several familial environment scores including parenting attitudes differed between offspring of probands with BPD and comparison offspring. However, none of these factors were mediators of the parent–child transmission of BPD. Among the environmental factors, traumatic events were shown to be modest mediators of the transmission of early-onset MDD. Conclusions Our data do not support the implication of the assessed environmental factors in the parent–child transmission of BPD. In contrast to BPD, traumatic events partially mediate the parent–child transmission of early-onset MDD, which has important implications for intervention and prevention. Early therapeutic efforts in offspring exposed to these events are likely to reduce their deleterious impact on the risk of subsequent MDD.
Collapse
Affiliation(s)
- Flore Moulin
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland.,INSERM U 1219, Bordeaux Population Health Research Center, Bordeaux, France
| | - Mehdi Gholam
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Enrique Castelao
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Emma K Stapp
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Pierre Marquet
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,International Research Unit in Neurodevelopment and Child Psychiatry, Laval University, Quebec, Canada
| | - Jean-Michel Aubry
- Department of Psychiatry, University Hospital of Geneva, Geneva, Switzerland
| | - Kerstin J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Francesca Di Giacomo
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, North Sector, Canton of Vaud, Yverdon, Switzerland
| | - Jennifer Glaus
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Giorgio Pistis
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Benjamin Lavigne
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, West Sector, Canton of Vaud, Prangins, Switzerland
| | - Julien Elowe
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, North and West Sectors, Canton of Vaud, Yverdon and Prangins, Switzerland
| | - Setareh Ranjbar
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland
| | - Caroline L Vandeleur
- Department of Psychiatry, Centre for Research in Psychiatric Epidemiology and Psychopathology, Lausanne University Hospital and University of Lausanne, Route de Cery 25, Prilly, Switzerland.
| |
Collapse
|
10
|
Halonen J, Hakko H, Riala K, Riipinen P. Familial Risk Factors in Relation to Recurrent Depression Among Former Adolescent Psychiatric Inpatients. Child Psychiatry Hum Dev 2022; 53:515-525. [PMID: 33651209 PMCID: PMC9107395 DOI: 10.1007/s10578-021-01146-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 02/02/2023]
Abstract
Treating recurrent depression is a challenge for clinical practitioners. We investigated which family environmental factors contribute to differences between recurrent and non-recurrent depression by the young adulthood of the former adolescent inpatients. The initial sample covered 237 adolescent psychiatric inpatients with depression, of which 35.4% had later diagnosed with recurrent depression. Recurrence in depression was associated to distant maternal relationships in both male (p = 0.022) and female patients (p = 0.042). In females, the likelihood for recurrent depression was also related to psychiatric problems of the father (p = 0.013) and siblings (OR = 3.7, p = 0.032), and having a grand multiparous mother (p = 0.005). Our results emphasise the need for effective family-centred approaches in treatment of adolescents with depression.
Collapse
Affiliation(s)
- Joonas Halonen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O.BOX 5000, 90014 Oulu, Finland
| | - Helinä Hakko
- Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029, Oulu, Finland.
| | - Kaisa Riala
- grid.412326.00000 0004 4685 4917Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029 Oulu, Finland
| | - Pirkko Riipinen
- grid.10858.340000 0001 0941 4873Research Unit of Clinical Neuroscience, Psychiatry, University of Oulu, P.O.BOX 5000, 90014 Oulu, Finland ,grid.412326.00000 0004 4685 4917Department of Psychiatry, Oulu University Hospital, Oulu, P.O.BOX 26, 90029 Oulu, Finland
| |
Collapse
|
11
|
Myofascial Tissue and Depression. COGNITIVE THERAPY AND RESEARCH 2021; 46:560-572. [PMID: 34955570 PMCID: PMC8688142 DOI: 10.1007/s10608-021-10282-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/06/2022]
Abstract
Background The myofascial system plays a fundamental role in the mechanics of the body, in body tension regulation and the etiology of pathological states like chronic pain. Moreover, it contains contractile elements and preliminary evidence suggests that its properties are linked to psychological factors. The aim of the present research was to investigate characteristics of the myofascial tissue in patients with Major Depressive Disorder (MDD) and to examine whether the state of the myofascial tissue causally affects pathopsychological processes in MDD. Methods In Study 1, stiffness and elasticity of the myofascial tissue of 40 inpatients suffering from MDD measured with a tissue compliance meter were compared with those of 40 matched never-depressed participants. In Study 2, 69 MDD patients were randomly assigned to single-session self-myofascial release intervention (SMRI) or a placebo intervention. Effects on memory bias and affect were investigated. Results Results showed that MDD patients displayed heightened stiffness and reduced elasticity of the myofascial tissue and that patients in the SMRI group showed a reduced negative memory bias and more positive affect compared to patients in the placebo condition. Conclusions The preliminary results of our studies indicate that the myofascial tissue might be part of a dysfunctional body-mind dynamic that maintains MDD. Supplementary Information The online version contains supplementary material available at 10.1007/s10608-021-10282-w.
Collapse
|
12
|
Derakhshanian S, Zhou M, Rath A, Barlow R, Bertrand S, DeGraw C, Lee C, Hasoon J, Kaye AD. Role of Ketamine in the Treatment of Psychiatric Disorders. Health Psychol Res 2021; 9:25091. [PMID: 35106397 PMCID: PMC8801551 DOI: 10.52965/001c.25091] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/17/2021] [Indexed: 09/02/2023] Open
Abstract
PURPOSE OF REVIEW This is a comprehensive review of the literature regarding the use of ketamine as a treatment for treatment-resistant depression (TRD). It covers the epidemiology, risk factors, pathophysiology, and current treatment modalities regarding Major Depressive Disorder (MDD) and TRD. It provides background on the mechanism of action of ketamine, its history, current approved and off-label indications in the field of psychiatry, and then provides an overview of the existing evidence for the use of ketamine in the treatment of TRD. RECENT FINDINGS MDD is a mental illness that puts an enormous strain on the affected and a high socio-economic burden on society. The illness is complex and combines genetic, pathophysiologic, and environmental factors that combine to negatively affect neurotransmitter balance in the brain. Additional evidence suggests dysregulation of the hypothalamic-pituitary (HPA) axis, brain-derived neurotrophic factor (BDNF), vitamin D levels, and involvement of pro-inflammatory markers. Core symptoms include depressed mood or anhedonia, combined with neurovegetative symptoms such as sleep impairment, changes in appetite, feelings of worthlessness and guilt, and psychomotor retardation. Current first-line treatment options are antidepressants of the selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) class. Failure to respond to two adequate trials of treatment meets the criteria for TRD. Esketamine (Spravato) is an NMDA-receptor antagonist with additional AMPA-receptor agonist properties, which the FDA approved in 2019 to treat adult TRD in conjunction with an oral antidepressant. It can be administered intranasally, providing a rapid response and proven effective and safe. Additional research suggests that oral ketamine might be effective for PTSD and anxiety disorders. Intravenous administration of ketamine has also shown benefits for acute suicidal ideation and depression and substance use to reduce relapse rates. SUMMARY TRD is associated with huge costs on individual and societal levels. Underlying disease processes are multifactorial and not well understood. Adjunctive therapies for TRD with proven benefits exist, but acutely depressed and suicidal patients often require prolonged inpatient stabilization. Intranasal esketamine is a new FDA-approved alternative with rapid benefit for TRD, which has also shown a rapid reduction in suicidal ideation while maintaining a favorable side-effect profile. Additional potential off-label uses for ketamine in psychiatric disorders have been studied, including PTSD, anxiety disorders, bipolar depression, and substance use disorders.
Collapse
Affiliation(s)
| | - Maxine Zhou
- Department of Psychiatry, Louisiana State University Shreveport, LA
| | - Alexander Rath
- Department of Psychiatry, Louisiana State University Shreveport, LA
| | - Rachel Barlow
- Louisiana State University Health Sciences Center Shreveport School of Medicine, LA
| | - Sarah Bertrand
- Louisiana State University Health Sciences Center Shreveport School of Medicine, LA
| | - Caroline DeGraw
- Louisiana State University Health Sciences Center Shreveport School of Medicine, LA
| | - Christopher Lee
- Department of Internal Medicine, Creighton University School of Medicine-Phoenix Regional Campus, Phoenix, AZ
| | - Jamal Hasoon
- Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Shreveport, LA
| |
Collapse
|
13
|
Multiple domains of risk factors for first onset of depression in adolescent girls. J Affect Disord 2021; 283:20-29. [PMID: 33516083 PMCID: PMC7954924 DOI: 10.1016/j.jad.2021.01.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 12/26/2020] [Accepted: 01/09/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND First onsets of depression are especially common in adolescent females and often develop into chronic/recurrent illness. Surprisingly few studies have comprehensively evaluated multiple domains of etiologically-informative risk factors for first onset in adolescents from the community. We investigated whether clinical, cognitive, personality, interpersonal, and biological risk factors prospectively predict a first onset of depressive disorder (DD), and of DD with a chronic/recurrent course, in a community sample of adolescent girls. METHODS 479 girls (13.5-15.5 years) with no history of DD completed baseline assessments of risk factors and five diagnostic assessments over 3 years. Baseline measures were analyzed separately and jointly to prospectively predict first-onset DD and first-onset chronic/recurrent DD. RESULTS Most risk factors predicted first-onset DD (n = 93), including depressive symptoms, anxiety disorders, rumination, personality traits, blunted neural response (late positive potential [LPP]) to unpleasant pictures, peer victimization, parental criticism, and parental mood disorder. Depressive symptoms, rumination, parental mood disorder, and parental criticism were independently associated with first onsets. Nearly all measures, including a blunted neural response to rewards (reward positivity [RewP]), also predicted first-onset chronic/recurrent DD (n = 52), with depressive symptoms, low extraversion, poor peer relationships, and blunted RewP emerging as independent risk factors. LIMITATIONS This study focused on adolescent females and therefore does not provide information on males. CONCLUSIONS Multiple domains of risk factors in early adolescence are prospectively associated with first-onset DD and chronic/recurrent DD. A smaller subset of risk factors uniquely contributing to first onsets may represent core vulnerabilities for adolescent-onset depression and promising prevention targets.
Collapse
|
14
|
Mikkelsen S, Coggon D, Andersen JH, Casey P, Flachs EM, Kolstad HA, Mors O, Bonde JP. Are depressive disorders caused by psychosocial stressors at work? A systematic review with metaanalysis. Eur J Epidemiol 2021; 36:479-496. [PMID: 33580479 PMCID: PMC8159794 DOI: 10.1007/s10654-021-00725-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 01/25/2021] [Indexed: 11/25/2022]
Abstract
In the last decade, many studies have examined associations between poor psychosocial work environment and depression. We aimed to assess the evidence for a causal association between psychosocial factors at work and depressive disorders. We conducted a systematic literature search from 1980 to March 2019. For all exposures other than night and shift work and long working hours, we limited our selection of studies to those with a longitudinal design. We extracted available risk estimates for each of 19 psychosocial exposures, from which we calculated summary risk estimates with 95% confidence intervals (PROSPERO, identifier CRD42019130266). 54 studies were included, addressing 19 exposures and 11 different measures of depression. Only data on depressive episodes were sufficient for evaluation. Heterogeneity of exposure definitions and ascertainment, outcome measures, risk parameterization and effect contrasts limited the validity of meta-analyses. Summary risk estimates were above unity for all but one exposure, and below 1.60 for all but another. Outcome measures were liable to high rates of false positives, control of relevant confounding was mostly inadequate, and common method bias was likely in a large proportion of studies. The combination of resulting biases is likely to have inflated observed effect estimates. When statistical uncertainties and the potential for bias and confounding are taken into account, it is not possible to conclude with confidence that any of the psychosocial exposures at work included in this review is either likely or unlikely to cause depressive episodes or recurrent depressive disorders.
Collapse
Affiliation(s)
- Sigurd Mikkelsen
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark.
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark
| | - Patricia Casey
- Department of Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- Department of Psychosis, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
15
|
Sahin Z, Ozkurkculer A, Kalkan OF, Ozkaya A, Koc A, Ozen Koca R, Solak H, Solak Gormus ZI, Kutlu S. Investigation of Effects of Two Chronic Stress Protocols on Depression-Like Behaviors and Brain Mineral Levels in Female Rats: an Evaluation of 7-Day Immobilization Stress. Biol Trace Elem Res 2021; 199:660-667. [PMID: 32328969 DOI: 10.1007/s12011-020-02160-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/15/2020] [Indexed: 12/17/2022]
Abstract
We aimed to investigate the effects of two different chronic immobilization stress protocols on depression-related behaviors and brain mineral levels. Adult female Wistar albino rats were divided into 3 groups as follows (n = 10/group): control, immobilization stress-1 (45 min daily for 7 days), and immobilization stress-2 (45 min twice a day for 7 day). Stress-related behavior was evaluated by means of the forced swimming test (FST) and open field test (OFT). Minerals were analyzed using an inductively coupled plasma mass spectrometer. In the FST, swimming and immobility were significantly lower in the immobilization stress-1 and immobilization stress-2 groups. The climbing duration of the immobilization stress-2 group was higher than the control group. In the OFT, percentage of time spent in the central area was significantly lower in the immobilization stress-1 and immobilization stress-2 groups. Values of latency to center area, rearing, and grooming did not significantly differ between groups. In the immobilization stress-1 group, zinc was lower, and iron, copper, and manganese were higher than the control group. In the immobilization stress-2 group, copper and manganese were higher, and phosphate was lower than the control group. Our results showed that depression-related behaviors were more dominant in the immobilization stress-1 group. A decrease in the brain zinc level was valid only for the immobilization stress-1 group. These results point to the role of low brain zinc levels in the pathophysiology of depression.
Collapse
Affiliation(s)
- Z Sahin
- Department of Physiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
| | - A Ozkurkculer
- Department of Physiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - O F Kalkan
- Department of Physiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - A Ozkaya
- Department of Chemistry, Faculty of Science and Art, Adiyaman University, Adiyaman, Turkey
| | - A Koc
- Department of Physiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - R Ozen Koca
- Department of Physiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - H Solak
- Department of Physiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Z I Solak Gormus
- Department of Physiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - S Kutlu
- Department of Physiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| |
Collapse
|
16
|
Precision Psychiatry: Biomarker-Guided Tailored Therapy for Effective Treatment and Prevention in Major Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1305:535-563. [PMID: 33834417 DOI: 10.1007/978-981-33-6044-0_27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Depression contributes greatly to global disability and is a leading cause of suicide. It has multiple etiologies and therefore response to treatment can vary significantly. By applying the concepts of personalized medicine, precision psychiatry attempts to optimize psychiatric patient care by better predicting which individuals will develop an illness, by giving a more accurate biologically based diagnosis, and by utilizing more effective treatments based on an individual's biological characteristics (biomarkers). In this chapter, we discuss the basic principles underlying the role of biomarkers in psychiatric pathology and then explore multiple biomarkers that are specific to depression. These include endophenotypes, gene variants/polymorphisms, epigenetic factors such as methylation, biochemical measures, circadian rhythm dysregulation, and neuroimaging findings. We also examine the role of early childhood trauma in the development of, and treatment response to, depression. In addition, we review how new developments in technology may play a greater role in the determination of new biomarkers for depression.
Collapse
|
17
|
Rapp AM, Chavira DA, Sugar CA, Asarnow JR. Incorporating family factors into treatment planning for adolescent depression: Perceived parental criticism predicts longitudinal symptom trajectory in the Youth Partners in Care trial. J Affect Disord 2021; 278:46-53. [PMID: 32949872 PMCID: PMC7704900 DOI: 10.1016/j.jad.2020.09.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/03/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND This study aimed to clarify the predictive significance of youth perceptions of parental criticism assessed using a brief measure designed to enhance clinical utility. We hypothesized that high perceived parental criticism would be associated with more severe depression over 18-months of follow-up. METHODS The study involved secondary analyses from the Youth Partners in Care trial, which demonstrated that a quality improvement intervention aimed at increasing access to evidence-based depression treatment in primary care led to improved depression outcomes at post-treatment compared to usual care enhanced by provider education regarding depression evaluation/management. Patients (N = 418; ages 13-21) were assessed at four time points: baseline; post-treatment (six-month follow-up); 12- and 18-month follow-ups. The primary analysis estimated the effect of perceived parental criticism on likelihood of severe depression (i.e., Center for Epidemiological Studies-Depression Scale ≥ 24) over post-intervention follow-ups using a repeated-measures logistic regression model. Secondarily, a linear mixed-effects growth model examined symptom trajectories from baseline through 18-months using the Mental Health Index-5, a measure of emotional distress available at all time-points. RESULTS High perceived parental criticism emerged as a robust predictor of clinically-elevated depression (OR=1.66, p=.02) and a more pernicious symptom trajectory over 18-months (β =-1.89, p<.0001). LIMITATIONS The association between the self-report perceived criticism and traditional expressed emotion measures derived from verbal and nonverbal parental behaviors was not evaluated. CONCLUSIONS Results support perceived parental criticism as a predictor of youth depression outcomes over 18-months. This brief measure can be feasibly integrated within clinical assessment to assist clinicians in optimizing treatment benefits.
Collapse
Affiliation(s)
- Amy M Rapp
- Department of Psychology, University of California, Los Angeles; Department of Psychiatry, Columbia University; New York State Psychiatric Institute
| | | | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Biostatistics, University of California, Los Angeles
| | - Joan R Asarnow
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles.
| |
Collapse
|
18
|
Ma M, Zhang X, Zhang Y, Su Y, Yan H, Tan H, Zhang D, Yue W. Childhood Maltreatment Was Correlated With the Decreased Cortical Function in Depressed Patients Under Social Stress in a Working Memory Task: A Pilot Study. Front Psychiatry 2021; 12:671574. [PMID: 34305677 PMCID: PMC8295536 DOI: 10.3389/fpsyt.2021.671574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/25/2021] [Indexed: 01/30/2023] Open
Abstract
Background: Major depressive disorder (MDD) is a common psychiatric disorder associated with working memory (WM) impairment. Neuroimaging studies showed divergent results of the WM process in MDD patients. Stress could affect the occurrence and development of depression, in which childhood maltreatment played an important role. Methods: Thirty-seven MDD patients and 54 healthy control subjects were enrolled and completed a WM functional magnetic resonance imaging task with maintenance and manipulation conditions under stress and non-stress settings. We collected demographical and clinical data, using 17-item Hamilton Depression Scale (HAMD-17) and Childhood Trauma Questionnaire (CTQ) in MDD patients. In the WM task, we analyzed the main diagnosis effect and explored the correlation of impaired brain regions in MDD patients with CTQ and HAMD-17. Results: No group differences were found in the accuracy rate and reaction time between the two groups. MDD patients had lower brain activation in following regions (P FWE < 0.05). The left fusiform gyrus showed less activation in all conditions. The right supplementary motor area (SMA) exhibited decreased activation under non-stress. The anterior prefrontal cortex showed reduced activation during manipulation under stress, with the β estimations of the peak voxel showing significant group difference negatively correlated with childhood sex abuse (P Bonferroni < 0.05). Conclusions: In our pilot study, MDD patients had reduced brain activation, affecting emotional stimuli processing function, executive function, and cognitive control function. Childhood maltreatment might affect brain function in MDD. This work might provide some information for future studies on MDD.
Collapse
Affiliation(s)
- Mengying Ma
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Xiao Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Yuyanan Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Yi Su
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Hao Yan
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China
| | - Haoyang Tan
- Lieber Institute for Brain Development, Baltimore, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dai Zhang
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,Lieber Institute for Brain Development, Baltimore, MD, United States
| | - Weihua Yue
- Institute of Mental Health, The Sixth Hospital, Peking University, Beijing, China.,Key Laboratory of Mental Health, Ministry of Health & National Clinical Research Center for Mental Disorders, Peking University, Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| |
Collapse
|
19
|
Hamlat EJ, McCormick KC, Young JF, Hankin BL. Early pubertal timing predicts onset and recurrence of depressive episodes in boys and girls. J Child Psychol Psychiatry 2020; 61:1266-1274. [PMID: 32017111 PMCID: PMC7396277 DOI: 10.1111/jcpp.13198] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/24/2019] [Accepted: 12/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recurrent depressive episodes during adolescence result in significant impairment and increased risk for subsequent adverse outcomes throughout the life span. Evidence suggests that early pubertal timing predicts the onset of depressive episodes (particularly for girls); however, it is not known if pubertal timing prospectively predicts recurrent depressive episodes in youth. METHODS At baseline, 603 youth (56% female, at baseline: Mage = 12.09, SD = 2.35) reported on their pubertal development. Youth and their parents completed a semistructured diagnostic interview to assess depressive episodes at baseline and then evaluated for onset repeatedly every 6 months for a period of 36 months. RESULTS Controlling for past history of depression, Cox proportional hazards models examined whether earlier pubertal timing predicted (a) days to first depressive episode from baseline and (b) days to a second (recurrent) depressive episode from the end of the first episode. Early pubertal timing predicted the onset of the first depressive episode after baseline (b = .19, Wald = 5.36, p = .02, HR = 1.21), as well as a recurrent episode during course of study follow-up episode (b = .32, Wald = 6.16, p = .01, HR = 1.38). CONCLUSIONS Findings reinforce the importance of considering the impact of early pubertal timing on depression risk. Investigation on how pubertal timing interacts with other risk factors to predict depression recurrence is needed.
Collapse
Affiliation(s)
| | | | - Jami F. Young
- Children's Hospital of Philadelphia University of Pennsylvania Perelman School of Medicine Philadelphia PA USA
| | | |
Collapse
|
20
|
Frey M, Obermeier V, von Kries R, Schulte-Körne G. Age and sex specific incidence for depression from early childhood to adolescence: A 13-year longitudinal analysis of German health insurance data. J Psychiatr Res 2020; 129:17-23. [PMID: 32554228 DOI: 10.1016/j.jpsychires.2020.06.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/08/2020] [Accepted: 06/01/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Epidemiological studies indicate a disproportionate increase of depression incidence among adolescent girls, compared with boys. Since results regarding the age of onset of this sex difference are heterogeneous, this study aimed to investigate this difference on a large and representative sample. A second investigation sought to clarify whether there is a relevant sex difference in prepubertal onset of depression regarding the further course. METHODS Health insurance data of 6-18-year-old Barmer insured patients, representing a 7.9% sample of the German population born in 1999 (N = 61.199), were analyzed. The incidence of depression episodes (ICD-10 F32.x) was evaluated. Subsequently, the absolute and relative risk of a depression diagnosis (F32.x/F33.x) in early/late adolescence was analyzed based on the diagnosis of depression in primary school age in unstratified and stratified univariate analyses performed in SAS. RESULTS From 13 years of age, we found a significantly higher incidence of depressive disorders in girls than in boys. More than a fifth of the children with a depression diagnoses in primary school age had a depression relapse in early or late adolescence (early: 23.2%; 95% CI 19.6-26.9/late: 22.9%; 95% CI 19.3-26.5). Boys with depression in primary school age have a significantly higher relative risk for a depression relapse in late adolescence than girls (boys RR 4.2, 95% CI 3.3-5.2, girls RR: 2.1, 95% CI 1.7-2.7). LIMITATIONS The analysis is based on administrative data. Low sensitivity for depression in primary care setting and low service utilization leads to an underestimation of the incidence. CONCLUSIONS During puberty the risk for a first depressive episode increases more steeply in girls than in boys. Childhood depression has a high risk of relapse for both sexes, but is much more pronounced for boys.
Collapse
Affiliation(s)
- Michael Frey
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
| | - Viola Obermeier
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Rüdiger von Kries
- Institute for Social Paediatrics and Adolescent Medicine, Ludwig Maximilians University, Haydnstraße 5, D-80336, Munich, Germany.
| | - Gerd Schulte-Körne
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, LMU Munich, Nussbaumstrasse 5a, D-80336, Munich, Germany.
| |
Collapse
|
21
|
Atypical communication characteristics among clinic-referred youth with and without autism spectrum disorder: Stability and associations with clinical correlates. Dev Psychopathol 2020; 32:1240-1253. [PMID: 32938518 DOI: 10.1017/s095457942000070x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Atypical communication characteristics (ACCs), such as speech delay, odd pitch, and pragmatic difficulties, are common features of autism spectrum disorder (ASD) as are the symptoms of a wide range of psychiatric disorders. Using a simple retrospective method, this study aimed to better understand the relation and stability of ACCs with a broad range of psychiatric symptoms among large, well-characterized samples of clinic-referred children and adolescents with and without ASD. Youth with ASD had higher rates and a more variable pattern of developmental change in ACCs than the non-ASD diagnostic group. Latent class analysis yielded three ACC stability subgroups within ASD: Stable ACCs, Mostly Current-Only ACCs, and Little Professors. Subgroups exhibited differences in severity of ASD symptomatology, co-occurring psychiatric symptoms, and other correlates. Our findings provide support for the clinical utility of characterizing caregiver-perceived changes in ACCs in identifying children at risk for co-occurring psychopathology and other clinically relevant variables.
Collapse
|
22
|
Berger T, Lee H, Young AH, Aarsland D, Thuret S. Adult Hippocampal Neurogenesis in Major Depressive Disorder and Alzheimer's Disease. Trends Mol Med 2020; 26:803-818. [PMID: 32418723 DOI: 10.1016/j.molmed.2020.03.010] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/16/2020] [Accepted: 03/31/2020] [Indexed: 12/25/2022]
Abstract
Depression and dementia are major public health problems. Major depressive disorder (MDD) and Alzheimer's disease (AD) reciprocally elevate the risk for one another. No effective drug is available to treat AD and about one-third of depressive patients show treatment resistance. The biological connection between MDD and AD is still unclear. Uncovering this link might open novel ways of treatment and prevention to improve patient healthcare. Here, we discuss recent studies specifically on the role of human adult hippocampal neurogenesis (AHN) in MDD and AD. We compare diverse approaches to analyse the effect of MDD and AD on human AHN and analyse different studies implicating the role of human AHN as a potential converging mechanism in MDD and AD.
Collapse
Affiliation(s)
- Thomas Berger
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Hyunah Lee
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London and South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
| |
Collapse
|
23
|
Van Alsten SC, Duncan AE. Lifetime patterns of comorbidity in eating disorders: An approach using sequence analysis. EUROPEAN EATING DISORDERS REVIEW 2020; 28:709-723. [PMID: 32748537 DOI: 10.1002/erv.2767] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/05/2020] [Accepted: 06/29/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Eating disorders (EDs) have high rates of psychiatric comorbidity. This study aimed to characterize longitudinal patterns of comorbidities in adults with EDs. METHODS Sequence analysis and hierarchical clustering were applied to ages of onset and recency for select eating, substance, mood, and anxiety disorders from the 479 participants in the Collaborative Psychiatric Epidemiology Surveys with lifetime DSM-IV bulimia nervosa, binge eating disorder, or anorexia nervosa. External validators were compared across clusters using chi-square tests. RESULTS Five clusters were identified among individuals with any lifetime ED based on longitudinal sequence of psychiatric disorder onset and remission, characterized as: (1) multi-comorbid with early onset of comorbid disorder (46%); (2) moderate preeminent anxiety with moderate comorbidity and low ED persistence (20%); (3) late ED onset with low comorbidity (15%); (4) early onset, persistent ED with low comorbidity (14%); and (5) chronic, early onset depression (5%). Clusters were well differentiated by significant differences in age, body mass index, race, and psychiatric indicators. CONCLUSIONS This study demonstrates a new method to assess clustering of comorbidity among individuals with lifetime EDs. Having a psychiatric diagnosis prior to an ED was associated with greater psychopathology and illness duration. Information on timing of diagnoses may allow for more refined comorbidity classification.
Collapse
Affiliation(s)
- Sarah C Van Alsten
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Alexis E Duncan
- Brown School, Washington University in St. Louis, St. Louis, Missouri, USA
| |
Collapse
|
24
|
LeMoult J, Humphreys KL, Tracy A, Hoffmeister JA, Ip E, Gotlib IH. Meta-analysis: Exposure to Early Life Stress and Risk for Depression in Childhood and Adolescence. J Am Acad Child Adolesc Psychiatry 2020; 59:842-855. [PMID: 31676392 DOI: 10.1016/j.jaac.2019.10.011] [Citation(s) in RCA: 257] [Impact Index Per Article: 64.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/21/2019] [Accepted: 10/22/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Early life stress (ELS) is associated with increased risk for the development of major depressive disorder (MDD) in adulthood; however, the degree to which ELS is associated with an early onset of MDD (ie, during childhood or adolescence) is not known. In this meta-analysis, we estimated the associations between ELS and the risk for onset of MDD before age 18 years. In addition, we examined the associations between eight specific forms of ELS (ie, sexual abuse, physical abuse, poverty, physical illness/injury, death of a family member, domestic violence, natural disaster, and emotional abuse) and risk for youth-onset MDD. METHOD We conducted a systematic search in scientific databases for studies that assessed both ELS and the presence or absence of MDD before age 18 years. We identified 62 journal articles with a total of 44,066 unique participants. We assessed study quality using the Newcastle-Ottawa Scale. When heterogeneous effect sizes were detected, we tested whether demographic and/or methodological factors moderated the association between ELS and MDD. RESULTS Using a random-effects meta-analysis, we found that individuals who experienced ELS were more likely to develop MDD before the age of 18 years than were individuals without a history of ELS (odds ratio = 2.50; 95% confidence interval 2.08, 3.00). Separate meta-analyses revealed a range of associations with MDD: whereas some types of ELS (eg, poverty) were not associated with MDD, other types (eg, emotional abuse) were associated more strongly with MDD than was ELS considered more broadly. CONCLUSION These findings provide important evidence that the adverse effect of ELS on MDD risk manifests early in development, prior to adulthood, and varies by type of ELS.
Collapse
Affiliation(s)
| | | | | | | | - Eunice Ip
- University of British Columbia, Vancouver
| | | |
Collapse
|
25
|
Severe J, Greden JF, Reddy P. Consequences of Recurrence of Major Depressive Disorder: Is Stopping Effective Antidepressant Medications Ever Safe? FOCUS (AMERICAN PSYCHIATRIC PUBLISHING) 2020; 18:120-128. [PMID: 33162849 PMCID: PMC7587881 DOI: 10.1176/appi.focus.20200008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
According to the World Health Organization, major depressive disorder is the world's leading cause of disability. If clinical remission is not attained and sustained, episodes tend to recur with greater severity and with lessening responsivity to conventional treatments. Reasonably well-established clues and guidelines are presented about the high risk and profound consequences of recurrence of major depressive disorder if successful antidepressant treatments are discontinued. The authors describe actions required to achieve a "lifetime wellness" focus for treatment. Current approaches would need to be transformed from attainment of clinical remission to attainment and maintenance of lifetime wellness, with the knowledge that some individuals may need continuous treatment. Risk factors would need to be assessed and used to formulate clinical treatment guidelines for risk of recurrence. Clinical trials would need to be greatly lengthened. Measurement-based care and precision medicine would be the foundation for informing clinical decisions. The authors provide guidance in determining how to discontinue antidepressants if that decision is made despite risks.
Collapse
Affiliation(s)
| | - John F Greden
- Department of Psychiatry, University of Michigan, Ann Arbor
| | - Priyanka Reddy
- Department of Psychiatry, University of Michigan, Ann Arbor
| |
Collapse
|
26
|
Kang SG, Cho SE. Neuroimaging Biomarkers for Predicting Treatment Response and Recurrence of Major Depressive Disorder. Int J Mol Sci 2020; 21:ijms21062148. [PMID: 32245086 PMCID: PMC7139562 DOI: 10.3390/ijms21062148] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 03/19/2020] [Indexed: 12/26/2022] Open
Abstract
The acute treatment duration for major depressive disorder (MDD) is 8 weeks or more. Treatment of patients with MDD without predictors of treatment response and future recurrence presents challenges and clinical problems to patients and physicians. Recently, many neuroimaging studies have been published on biomarkers for treatment response and recurrence of MDD using various methods such as brain volumetric magnetic resonance imaging (MRI), functional MRI (resting-state and affective tasks), diffusion tensor imaging, magnetic resonance spectroscopy, near-infrared spectroscopy, and molecular imaging (i.e., positron emission tomography and single photon emission computed tomography). The results have been inconsistent, and we hypothesize that this could be due to small sample size; different study design, including eligibility criteria; and differences in the imaging and analysis techniques. In the future, we suggest a more sophisticated research design, larger sample size, and a more comprehensive integration including genetics to establish biomarkers for the prediction of treatment response and recurrence of MDD.
Collapse
|
27
|
Musa ZA, Kim Lam S, Binti Mamat @ Mukhtar F, Kwong Yan S, Tajudeen Olalekan O, Kim Geok S. Effectiveness of mindfulness-based cognitive therapy on the management of depressive disorder: Systematic review. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
|
28
|
Thielecke J, Buntrock C, Titzler I, Braun L, Freund J, Berking M, Baumeister H, Ebert DD. Clinical and Cost-Effectiveness of Personalized Tele-Based Coaching for Farmers, Foresters and Gardeners to Prevent Depression: Study Protocol of an 18-Month Follow-Up Pragmatic Randomized Controlled Trial (TEC-A). Front Psychiatry 2020; 11:125. [PMID: 32194458 PMCID: PMC7064472 DOI: 10.3389/fpsyt.2020.00125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 02/13/2020] [Indexed: 12/30/2022] Open
Abstract
Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters, and gardeners (SVLFG) to implement internet- and tele-based services among others to improve mental health in this population. The aim of the present study is to evaluate the (cost-)effectiveness of personalized tele-based coaching for reducing depressive symptom severity and preventing the onset of clinical depression, compared to enhanced treatment as usual. Methods: In a two-armed, pragmatic randomized controlled trial (N = 312) with follow-ups at post-treatment (6 months), 12 and 18 months, insured farmers, foresters, and gardeners, collaborating family members and pensioners with elevated depressive symptoms (PHQ-9 ≥ 5) will be randomly allocated to personalized tele-based coaching or enhanced treatment as usual. The coaching is provided by psychologists and consists of up to 34 tele-based sessions for 25-50 min delivered over 6 months. Primary outcome is depressive symptom severity at post-treatment. Secondary outcomes include depression onset, anxiety, stress, and quality of life. A health-economic evaluation will be conducted from a societal perspective. Discussion: This study is the first pragmatic randomized controlled trial evaluating the (cost-)effectiveness of a nationwide tele-based preventive service for farmers. If proven effective, the implementation of personalized tele-based coaching has the potential to reduce disease burden and health care costs both at an individual and societal level. Clinical Trial Registration: German Clinical Trial Registration: DRKS00015655.
Collapse
Affiliation(s)
- Janika Thielecke
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Claudia Buntrock
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Lina Braun
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Johanna Freund
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Berking
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - David D Ebert
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.,Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,GET.ON Institute, Hamburg, Germany
| |
Collapse
|
29
|
Schweizer S, Leung JT, Kievit R, Speekenbrink M, Trender W, Hampshire A, Blakemore SJ. Protocol for an app-based affective control training for adolescents: proof-of-principle double-blind randomized controlled trial. Wellcome Open Res 2019; 4:91. [PMID: 31289755 PMCID: PMC6600858 DOI: 10.12688/wellcomeopenres.15229.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 03/30/2024] Open
Abstract
Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents' affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AffeCT) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AffeCT will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AffeCT successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032).
Collapse
Affiliation(s)
- Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jovita T. Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - William Trender
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | - Adam Hampshire
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | | |
Collapse
|
30
|
Schweizer S, Leung JT, Kievit R, Speekenbrink M, Trender W, Hampshire A, Blakemore SJ. Protocol for an app-based affective control training for adolescents: proof-of-principle double-blind randomized controlled trial. Wellcome Open Res 2019; 4:91. [PMID: 31289755 PMCID: PMC6600858 DOI: 10.12688/wellcomeopenres.15229.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 12/17/2022] Open
Abstract
Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AffeCT) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AffeCT will include three different
n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AffeCT successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number:
ISRCTN17213032).
Collapse
Affiliation(s)
- Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jovita T Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - William Trender
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | - Adam Hampshire
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | | |
Collapse
|
31
|
Goodman RJ, Samek DR, Wilson S, Iacono WG, McGue M. Close relationships and depression: A developmental cascade approach. Dev Psychopathol 2019; 31:1451-1465. [PMID: 30370876 PMCID: PMC6488448 DOI: 10.1017/s0954579418001037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Previous research has shown that problematic parent-child, peer, and romantic partner relationships are associated with an increased likelihood for major depressive disorder (MDD). Less research has evaluated the developmental unfolding of how these interpersonal relationship features are both an antecedent versus a consequence of MDD symptoms from adolescence through young adulthood. These gaps were evaluated using a large community sample (N = 1,127; 54% female, 96% white) via a developmental cascade model. Results showed support for significant antecedent effects, as greater parent-child relationship problems at ages 11 and 17 predicted rank-order increases in MDD symptoms at ages 14 and 20. Supporting a developmental cascade of problematic social relationships, greater parent-child relationship problems at ages 11 and 14 also predicted greater subsequent rank-order increases in antisocial peer affiliation at ages 14 and 17. Greater affiliation to antisocial peers at age 20 predicted greater rank-order increases in romantic relationship problems at age 24, which in turn predicted greater MDD symptoms at age 29. Cross-effects were generally small (βs ≤ .16), illustrating other factors may be relevant to the development or consequences of MDD. Nonetheless, findings support the importance of efforts to strengthen social support networks to offset risk as well as potentially treat depression.
Collapse
Affiliation(s)
- Rebecca J. Goodman
- DepartmentofHuman Developmentand FamilyStudies,AuburnUniversity,Auburn,AL, USA
| | - Diana R. Samek
- DepartmentofHuman Developmentand FamilyStudies,AuburnUniversity,Auburn,AL, USA
| | - Sylia Wilson
- DepartmentofPsychology, UniversityofMinnesota,Minneapolis, MN, USA
| | | | - Matt McGue
- DepartmentofPsychology, UniversityofMinnesota,Minneapolis, MN, USA
| |
Collapse
|
32
|
Stevanovic D, Zalsman G. Changes in cognitive distortions and affectivity levels in adolescent depression after acute phase fluoxetine treatment. Cogn Neuropsychiatry 2019; 24:4-13. [PMID: 30306831 DOI: 10.1080/13546805.2018.1532284] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION It is supposed that both antidepressants and psychotherapies work in a manner consistent with cognitive theories of depression when changing negative affective and cognitive distortions. This study evaluated changes in cognitive distortions (i.e. systematic misinterpretations of new information) and affectivity in adolescent major depressive disorder (MDD) after acute phase treatment with fluoxetine. METHODS Twenty-five adolescents (mean age 15.10 years (SD = 1.19); 17 (68%) females) with MDD receiving fluoxetine were followed for 8 weeks. Clinician rating scales of MDD and self-reports of cognitive distortions and affectivity were completed before and after the treatment. RESULTS Seven (28%) adolescents showed significant improvement in cognitive distortions, 11 (44%) showed a significant decrease in negative affect, and 15 (60%) showed a significant increase in positive affect. The responders to fluoxetine had significantly decreased level of negative affect (62.5%) and an increased level in positive affect (81.2%) compared to non-responders, whereas there were no differences between the two regarding changes in cognitive distortions. CONCLUSIONS Treatment with fluoxetine over 8 weeks led to reductions in cognitive distortions, with decreased negative and increased positive affect in adolescents with MDD. Improvements in affectivity levels closely corresponded to reductions in depressive symptoms and were greater than improvements in cognitive distortions.
Collapse
Affiliation(s)
- Dejan Stevanovic
- a Clinic for Neurology and Psychiatry for Children and Youth , Belgrade , Serbia
| | - Gil Zalsman
- b Division of Child and Adolescent Psychiatry , Geha Mental Health Center , Petah Tikva , Israel.,c Israel Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel
| |
Collapse
|
33
|
Cañete-Massé C, Peró-Cebollero M, Gudayol-Ferré E, Guàrdia-Olmos J. Longitudinal Estimation of the Clinically Significant Change in the Treatment of Major Depression Disorder. Front Psychol 2018; 9:1406. [PMID: 30127761 PMCID: PMC6088288 DOI: 10.3389/fpsyg.2018.01406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Although major depressive disorder is usually treated with antidepressants, only 50-70% of the patients respond to this treatment. This study applied Jacobson and Truax's (1991) methodology (reliable change index, RCI) to a sample of depressive patients being treated with one of two antidepressants to evaluate their functioning and the effect of certain variables such as severity and age. Method: Seventy-three depressive patients medicated with Escitalopram (n = 37) or Duloxetine (n = 36) were assessed using the Hamilton depression rating scale over a 24-week period. Results: They indicate that the RCI stabilizes in an absolute way starting in week 16, and it is not until week 24 that all of the patients become part of the functional population. We found limited statistical significance with respect to the RCI and the external variables. Conclusion: Our study suggests the need to accompany the traditional statistical methodology with some other clinical estimation systems capable of going beyond a simple subtraction between pre and posttreatment values. Hence, it is concluded that RCI estimations could be stronger and more stable than the classical statistical techniques.
Collapse
Affiliation(s)
| | - Maribel Peró-Cebollero
- Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience (UB), The UB Institute of Complex Systems (UBICS), Barcelona, Spain
| | - Esteve Gudayol-Ferré
- Facultad de Psicología, Universidad Michoacana de San Nicolás de Hidalgo, Michoacan, Mexico
| | - Joan Guàrdia-Olmos
- Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience (UB), The UB Institute of Complex Systems (UBICS), Barcelona, Spain
| |
Collapse
|
34
|
Articulation and testing of a personality-centred model of psychopathology: evidence from a longitudinal community study over 30 years. Eur Arch Psychiatry Clin Neurosci 2018; 268:443-454. [PMID: 28389890 DOI: 10.1007/s00406-017-0796-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/31/2017] [Indexed: 10/19/2022]
Abstract
Advances in psychopathological research advocate a personality-centred model of common mental disorders (CMD). We tested four hypotheses to test such a model. First, personality relates to critical life events; second, both personality and critical life events relate to CMD; third, interaction effects between personality and critical life events relate to CMD; fourth, neuroticism explains the majority of variance in psychopathology. We analysed data (n = 453) based on seven semi-structured interviews from a longitudinal epidemiologic cohort study over 30 years spanning years 1979 (age 20) to 2008 (age 50). CMD and critical life events were assessed seven times between 1979 and 2008 and personality domains of neuroticism, extraversion and aggressiveness in 1988 and 1993. Aggressiveness and neuroticism related to partnership rupture and job loss. Neuroticism related significantly to major depression, anxiety disorders, substance-use disorders (SUD) and severity of psychopathology. Both partnership rupture and job loss related to major depression and severity of psychopathology, but not to anxiety disorder or SUD. An interaction effect between neuroticism and partnership rupture pointed towards significantly increased SUD prevalence. All associations held when additionally adjusted for childhood adversity and familial socio-economic status. According to a pseudo-R 2, neuroticism explained 51% of total variance in severity of psychopathology over time, while all three personality domains along with both partnership rupture and job loss explained 59% of total variance. In conclusion, personality, especially neuroticism, relates consistently to repeated measures of psychopathology. These associations are independent of and more pervasive than the effects of partnership rupture and job loss. Partnership rupture in interaction with neuroticism may further increase the risk for SUD. We conclude that neuroticism is a fundamental aetiological factor for severe psychopathology, but further testing of this model in other longitudinal studies is required.
Collapse
|
35
|
Suicidal thoughts and attempts in First Nations communities: links to parental Indian residential school attendance across development. J Dev Orig Health Dis 2018; 10:123-131. [PMID: 29923477 DOI: 10.1017/s2040174418000405] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The Indian residential school (IRS) system in Canada ran for over a century until the last school closed in 1996. Conditions in the IRSs resulted in generations of Indigenous children being exposed to chronic childhood adversity. The current investigation used data from the 2008-2010 First Nations Regional Health Survey to explore whether parental IRS attendance was associated with suicidal thoughts and attempts in childhood, adolescence and in adulthood among a representative sample of First Nations peoples living on-reserve across Canada. Analyses of the adult sample in Study 1 (unweighted n=7716; weighted n=186,830) revealed that having a parent who attended IRS was linked with increased risk for suicidal thoughts and attempts in adolescence and adulthood. Although females were negatively affected by having a parent who attended IRS, the link with suicidal ideation in adulthood was greater for males. Analyses of the youth sample in Study 2 (unweighted n=2883; weighted n=30,190) confirmed that parental IRS attendance was associated with an increased risk for suicidal ideation and attempts. In contrast to the adult sample, parental IRS attendance had a significantly greater relation with suicidal ideation among female youth. A significant interaction also emerged between parental IRS attendance and age in the youth sample, with the influence of parental attendance being particularly strong among youth ages 12-14, compared with those 15-17 years. These results underscore the need for culturally relevant early interventions for the large proportions of Indigenous children and youth intergenerationally affected by IRSs and other collective traumas.
Collapse
|
36
|
Goldstein BL, Kotov R, Perlman G, Watson D, Klein DN. Trait and facet-level predictors of first-onset depressive and anxiety disorders in a community sample of adolescent girls. Psychol Med 2018; 48:1282-1290. [PMID: 28929975 DOI: 10.1017/s0033291717002719] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Individual differences in neuroticism, extraversion, and conscientiousness are associated with, and may predict onset of, internalizing disorders. These general traits can be parsed into facets, but there is a surprising paucity of research on facet risk for internalizing disorders. We examined general traits and facets of neuroticism, extraversion, and conscientiousness in predicting first onsets of depressive and anxiety disorders. METHODS A community sample of 550 adolescent females completed general and facet-level personality measures and diagnostic interviews. Interviews were re-administered 18 months later. RESULTS First onsets of depressive disorders were predicted by neuroticism, extraversion, and conscientiousness. Facets predicting first onset of depression included depressivity (neuroticism facet) and lower positive emotionality and sociability (extraversion facets). First onsets of generalized anxiety disorder (GAD) were predicted by neuroticism, and particularly the facet of anxiousness. First onsets of social phobia were predicted at the facet level by anxiousness. First onsets of specific phobia were predicted by neuroticism, low conscientiousness, and all neuroticism facets. In multivariate analyses, first onsets of depression were uniquely predicted by depressivity, and onsets of GAD and social phobia were uniquely predicted by anxiousness over and above the general trait of neuroticism. CONCLUSIONS General traits predict first onsets of depressive and anxiety disorders. In addition, more specific associations are evident at the facet level. Facets can refine our understanding of the links between personality and psychopathology risk, and provide finer-grained targets for personality-informed interventions.
Collapse
Affiliation(s)
| | - Roman Kotov
- Department of Psychiatry,Stony Brook University,Stony Brook, NY,USA
| | - Greg Perlman
- Department of Psychiatry,Stony Brook University,Stony Brook, NY,USA
| | - David Watson
- Department of Psychology,University of Notre Dame,Notre Dame, IN,USA
| | - Daniel N Klein
- Department of Psychology,Stony Brook University,Stony Brook,NY,USA
| |
Collapse
|
37
|
Islam MR, Islam MR, Shalahuddin Qusar MMA, Islam MS, Kabir MH, Mustafizur Rahman GKM, Islam MS, Hasnat A. Alterations of serum macro-minerals and trace elements are associated with major depressive disorder: a case-control study. BMC Psychiatry 2018; 18:94. [PMID: 29631563 PMCID: PMC5891975 DOI: 10.1186/s12888-018-1685-z] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 04/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is a mixed disorder with the highly irregular course, inconsistent response to treatment and has no well-known mechanism for the pathophysiology. Major causes of depression are genetic, neurobiological, and environmental. However, over the past few years, altered serum levels of macro-minerals (MM) and trace elements (TE) have been recognized as major causative factors to the pathogenesis of many mental disorders. The purpose of this study was to determine the serum levels of MM (calcium and magnesium) and TE (copper, iron, manganese, selenium, and zinc) in MDD patients and find out their associations with depression risk. METHODS This prospective case-control study recruited 247 patients and 248 healthy volunteers matched by age and sex. The serum levels of MM and TE were analyzed by atomic absorption spectroscopy (AAS). Statistical analysis was performed with independent sample t-tests and Pearson's correlation test. RESULTS We found significantly decreased concentrations of calcium and magnesium, iron, manganese, selenium, and zinc in MDD patients compared with control subjects (p < 0.05). But the concentration of copper was significantly increased in the patients than control subjects (p < 0.05). Data obtained from different inter-element relations in MDD patients and control subjects strongly suggest that there is a disturbance in the element homeostasis. CONCLUSION Our study suggests that altered serum concentrations of MM and TE are major contributing factors for the pathogenesis of MDD. Alterations of these elements in serum levels of MDD patients arise independently and they may provide a prognostic tool for the assessment of depression risk.
Collapse
Affiliation(s)
- Md Rabiul Islam
- Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000, Bangladesh.
| | - Md Reazul Islam
- 0000 0001 1498 6059grid.8198.8Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000 Bangladesh
| | - M. M. A. Shalahuddin Qusar
- 0000 0001 2034 9320grid.411509.8Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka, 1000 Bangladesh
| | - Mohammad Safiqul Islam
- grid.449503.fDepartment of Pharmacy, Noakhali Science and Technology University, Sonapur, Noakhali, 3814 Bangladesh
| | - Md Humayun Kabir
- grid.443108.aDepartment of Soil Science, Faculty of Agriculture, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Salna, Gazipur, 1706 Bangladesh
| | - G. K. M. Mustafizur Rahman
- grid.443108.aDepartment of Soil Science, Faculty of Agriculture, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Salna, Gazipur, 1706 Bangladesh
| | - Md Saiful Islam
- 0000 0001 1498 6059grid.8198.8Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Abul Hasnat
- 0000 0001 1498 6059grid.8198.8Department of Clinical Pharmacy and Pharmacology, Faculty of Pharmacy, University of Dhaka, Dhaka, 1000 Bangladesh
| |
Collapse
|
38
|
Hengartner MP. Developmental course of child personality traits and their associations with externalizing psychopathology: Results from a longitudinal multi-informant study in a representative cohort. JOURNAL OF RESEARCH IN PERSONALITY 2018. [DOI: 10.1016/j.jrp.2017.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
39
|
Schmaal L, Hibar DP, Sämann PG, Hall GB, Baune BT, Jahanshad N, Cheung JW, van Erp TGM, Bos D, Ikram MA, Vernooij MW, Niessen WJ, Tiemeier H, Hofman A, Wittfeld K, Grabe HJ, Janowitz D, Bülow R, Selonke M, Völzke H, Grotegerd D, Dannlowski U, Arolt V, Opel N, Heindel W, Kugel H, Hoehn D, Czisch M, Couvy-Duchesne B, Rentería ME, Strike LT, Wright MJ, Mills NT, de Zubicaray GI, McMahon KL, Medland SE, Martin NG, Gillespie NA, Goya-Maldonado R, Gruber O, Krämer B, Hatton SN, Lagopoulos J, Hickie IB, Frodl T, Carballedo A, Frey EM, van Velzen LS, Penninx BWJH, van Tol MJ, van der Wee NJ, Davey CG, Harrison BJ, Mwangi B, Cao B, Soares JC, Veer IM, Walter H, Schoepf D, Zurowski B, Konrad C, Schramm E, Normann C, Schnell K, Sacchet MD, Gotlib IH, MacQueen GM, Godlewska BR, Nickson T, McIntosh AM, Papmeyer M, Whalley HC, Hall J, Sussmann JE, Li M, Walter M, Aftanas L, Brack I, Bokhan NA, Thompson PM, Veltman DJ. Cortical abnormalities in adults and adolescents with major depression based on brain scans from 20 cohorts worldwide in the ENIGMA Major Depressive Disorder Working Group. Mol Psychiatry 2017; 22:900-909. [PMID: 27137745 PMCID: PMC5444023 DOI: 10.1038/mp.2016.60] [Citation(s) in RCA: 713] [Impact Index Per Article: 101.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 02/25/2016] [Accepted: 03/17/2016] [Indexed: 12/20/2022]
Abstract
The neuro-anatomical substrates of major depressive disorder (MDD) are still not well understood, despite many neuroimaging studies over the past few decades. Here we present the largest ever worldwide study by the ENIGMA (Enhancing Neuro Imaging Genetics through Meta-Analysis) Major Depressive Disorder Working Group on cortical structural alterations in MDD. Structural T1-weighted brain magnetic resonance imaging (MRI) scans from 2148 MDD patients and 7957 healthy controls were analysed with harmonized protocols at 20 sites around the world. To detect consistent effects of MDD and its modulators on cortical thickness and surface area estimates derived from MRI, statistical effects from sites were meta-analysed separately for adults and adolescents. Adults with MDD had thinner cortical gray matter than controls in the orbitofrontal cortex (OFC), anterior and posterior cingulate, insula and temporal lobes (Cohen's d effect sizes: -0.10 to -0.14). These effects were most pronounced in first episode and adult-onset patients (>21 years). Compared to matched controls, adolescents with MDD had lower total surface area (but no differences in cortical thickness) and regional reductions in frontal regions (medial OFC and superior frontal gyrus) and primary and higher-order visual, somatosensory and motor areas (d: -0.26 to -0.57). The strongest effects were found in recurrent adolescent patients. This highly powered global effort to identify consistent brain abnormalities showed widespread cortical alterations in MDD patients as compared to controls and suggests that MDD may impact brain structure in a highly dynamic way, with different patterns of alterations at different stages of life.
Collapse
Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - D P Hibar
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - P G Sämann
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - N Jahanshad
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - J W Cheung
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - D Bos
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M W Vernooij
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - D Janowitz
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - R Bülow
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - M Selonke
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- German Center for Cardiovascular Research (DZHK), partner site Griefswald, Greifswald, Germany
- German Center for Diabetes Research (DZD), partner site Griefswald, Greifswald, Germany
| | - D Grotegerd
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - U Dannlowski
- Department of Psychiatry, University of Muenster, Muenster, Germany
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - V Arolt
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - N Opel
- Department of Psychiatry, University of Muenster, Muenster, Germany
| | - W Heindel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - H Kugel
- Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - D Hoehn
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - M Czisch
- Neuroimaging Core Unit, Max Planck Institute of Psychiatry, Munich, Germany
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - M E Rentería
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - L T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - M J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - N T Mills
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N G Martin
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N A Gillespie
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
| | - R Goya-Maldonado
- Centre for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Krämer
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - A Carballedo
- Department of Psychiatry and Institute of Neuroscience, Trinity College, Dublin, Ireland
| | - E M Frey
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M-J van Tol
- Neuroimaging Center, Section of Cognitive Neuropsychiatry, Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry and Leiden Institute for Brain and Cognition, Leiden University Medical Center, Leiden, The Netherlands
| | - C G Davey
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - B Mwangi
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - B Cao
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J C Soares
- UT Center of Excellence on Mood Disoders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - I M Veer
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D Schoepf
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - C Konrad
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - K Schnell
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - M D Sacchet
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - I H Gotlib
- Neurosciences Program and Department of Psychology, Stanford University, Stanford, CA, USA
| | - G M MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - B R Godlewska
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - T Nickson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Centre for Cogntive Ageing and Cogntive Epidemiology, University of Edinburgh, Edinburg, UK
| | - M Papmeyer
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Division of Systems Neuroscience of Psychopathology, Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - J Hall
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
- Department of Psychiatry, NHS Borders, Melrose, UK
| | - M Li
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - M Walter
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Psychiatry, University Tübingen, Tübingen, Germany
| | - L Aftanas
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - I Brack
- Department of Experimental and Clinical Neuroscience, Scientific Research Institute of Physiology and Basic Medicine, Novosibirsk, Russia
| | - N A Bokhan
- Mental Health Research Institute, Tomsk, Russia
- Faculty of Psychology, National Research Tomsk State University, Tomsk, Russia
- Department of General Medicine, Siberian State Medical University, Tomsk, Russia
| | - P M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Marina del Rey, CA, USA
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
40
|
Sex differences in recent first-onset depression in an epidemiological sample of adolescents. Transl Psychiatry 2017; 7:e1139. [PMID: 28556831 PMCID: PMC5534940 DOI: 10.1038/tp.2017.105] [Citation(s) in RCA: 170] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/10/2017] [Indexed: 12/22/2022] Open
Abstract
Prior studies provide limited and contradictory evidence regarding sex differences in the incidence of depression during adolescence, a critical period for development of the disorder. Data from six consecutive years (2009-2014) of a national survey of US adolescents aged 12-17 (N=101 685) are used to characterize sex differences in the incidence of depression by age and to compare recent first-onset and persistent depression with respect to impairment, suicide attempts, conduct problems and academic functioning. Projecting from age-specific incidence proportions, the cumulative incidence of depression between the ages of 12 and 17 is 13.6% among male and 36.1% among female subjects. The sex difference in incidence is significant at the age of 12 years (5.2% in female versus 2.0% in male subjects, P<0.0001), and it is significantly larger at ages of 13 through 17 years than at the age of 12 years (P-values<0.05). Depression-related impairment is lower in recent first-onset than in persistent depression among female but not among male subjects. The prevalence of conduct problems and poor academic functioning is higher in both recent first-onset and persistent depression relative to those with no depression for both male and female subjects. The incidence of depression during adolescence is higher than that suggested by prior studies based on retrospective recall. Contrary to prior studies, evidence suggests that the sex difference in depression originates during childhood and grows in magnitude during adolescence. High levels of impairment, suicide attempts, conduct problems and poor academic functioning argue against a 'wait and see' approach to clinical treatment of recent first-onset depression.
Collapse
|
41
|
Hengartner MP, Lehmann SN. Why Psychiatric Research Must Abandon Traditional Diagnostic Classification and Adopt a Fully Dimensional Scope: Two Solutions to a Persistent Problem. Front Psychiatry 2017; 8:101. [PMID: 28638352 PMCID: PMC5461269 DOI: 10.3389/fpsyt.2017.00101] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Michael P Hengartner
- Department of Applied Psychology, Zurich University of Applied Sciences, Zurich, Switzerland
| | - Sandrine N Lehmann
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry, Zurich, Switzerland
| |
Collapse
|
42
|
Liberali R. Mindfulness-Based Cognitive Therapy in Major depressive disorder - systematic review and metanalysis. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.s01.ar03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: MBCT practices increases the ability of concentration and attention, as well is particularly effective for people with current and treatment-resistant depression. Objective: To analyze the effects of the application of MBCT in symptoms of MDD. Methods: systematic review and meta-analysis. To find suitable studies, we searched PubMed/MEDLINE's database using the keywords mindfulness and major depressive disorder. Studies in English published between 2003 and 2015 were selected. The studies were evaluated according to their methodological quality by PEDro scale (score greater than 3), studies that showed empirical evidence, had an experimental study design (randomized and non-randomized), and whose full text was available. For the meta-analysis, we used a random-effects model with standardized mean differences and 95% confidence intervals. Results: Fourteen es were included, of which three were non-randomized, with only one group with intervention of MBCT, and 11 were randomized studies, divided into two-group samples and three-group samples. The non-randomized studies showed a PEDro score of 5, while the two-group and three-group randomized studies showed PEDro scores of 5-10 and 6-9, respectively. In the meta-analysis, the four randomized studies selected revealed a moderate effect of MBCT on the outcome of depression symptoms, with a mean difference of -0.52 (95% CI: -1.050 to -0.002; p = 0.04). Conclusion: The MBCT presented as a promising alternative for the treatment of this disorder.
Collapse
|
43
|
Shackman AJ, Tromp DPM, Stockbridge MD, Kaplan CM, Tillman RM, Fox AS. Dispositional negativity: An integrative psychological and neurobiological perspective. Psychol Bull 2016; 142:1275-1314. [PMID: 27732016 PMCID: PMC5118170 DOI: 10.1037/bul0000073] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dispositional negativity-the propensity to experience and express more frequent, intense, or enduring negative affect-is a fundamental dimension of childhood temperament and adult personality. Elevated levels of dispositional negativity can have profound consequences for health, wealth, and happiness, drawing the attention of clinicians, researchers, and policymakers. Here, we highlight recent advances in our understanding of the psychological and neurobiological processes linking stable individual differences in dispositional negativity to momentary emotional states. Self-report data suggest that 3 key pathways-increased stressor reactivity, tonic increases in negative affect, and increased stressor exposure-explain most of the heightened negative affect that characterizes individuals with a more negative disposition. Of these 3 pathways, tonically elevated, indiscriminate negative affect appears to be most central to daily life and most relevant to the development of psychopathology. New behavioral and biological data provide insights into the neural systems underlying these 3 pathways and motivate the hypothesis that seemingly "tonic" increases in negative affect may actually reflect increased reactivity to stressors that are remote, uncertain, or diffuse. Research focused on humans, monkeys, and rodents suggests that this indiscriminate negative affect reflects trait-like variation in the activity and connectivity of several key brain regions, including the central extended amygdala and parts of the prefrontal cortex. Collectively, these observations provide an integrative psychobiological framework for understanding the dynamic cascade of processes that bind emotional traits to emotional states and, ultimately, to emotional disorders and other kinds of adverse outcomes. (PsycINFO Database Record
Collapse
Affiliation(s)
- Alexander J. Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
- Department of Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742 USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742 USA
| | - Do P. M. Tromp
- Department of Psychology, University of California, Davis, CA 95616 USA
| | - Melissa D. Stockbridge
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742 USA
| | - Claire M. Kaplan
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Rachael M. Tillman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA 95616 USA
- California National Primate Research Center, University of California, Davis, CA 95616 USA
| |
Collapse
|
44
|
Dennison MJ, Sheridan MA, Busso DS, Jenness JL, Peverill M, Rosen ML, McLaughlin KA. Neurobehavioral markers of resilience to depression amongst adolescents exposed to child abuse. JOURNAL OF ABNORMAL PSYCHOLOGY 2016; 125:1201-1212. [PMID: 27819477 PMCID: PMC5119749 DOI: 10.1037/abn0000215] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Childhood maltreatment is strongly associated with depression, which is characterized by reduced reactivity to reward. Identifying factors that mitigate risk for depression in maltreated children is important for understanding etiological links between maltreatment and depression as well as improving early intervention and prevention. We examine whether high reward reactivity at behavioral and neurobiological levels is a marker of resilience to depressive symptomology in adolescence following childhood maltreatment. A sample of 59 adolescents (21 with a history of maltreatment; Mean Age = 16.95 years, SD = 1.44) completed an fMRI task involving passive viewing of emotional stimuli. BOLD signal changes to positive relative to neutral images were extracted in basal ganglia regions of interest. Participants also completed a behavioral reward-processing task outside the scanner. Depression symptoms were assessed at the time of the MRI and again 2 years later. Greater reward reactivity across behavioral and neurobiological measures moderated the association of maltreatment with baseline depression. Specifically, faster reaction time (RT) to cues paired with monetary reward relative to those unpaired with reward and greater BOLD signal in the left pallidum was associated with lower depression symptoms in maltreated youth. Longitudinally, greater BOLD signal in the left putamen moderated change in depression scores over time, such that higher levels of reward response were associated with lower increases in depression over time among maltreated youths. Reactivity to monetary reward and positive social images, at both behavioral and neurobiological levels, is a potential marker of resilience to depression among adolescents exposed to maltreatment. These findings add to a growing body of work highlighting individual differences in reactivity to reward as a core neurodevelopmental mechanism in the etiology of depression. (PsycINFO Database Record
Collapse
|
45
|
Kovacs M, Obrosky S, George C. The course of major depressive disorder from childhood to young adulthood: Recovery and recurrence in a longitudinal observational study. J Affect Disord 2016; 203:374-381. [PMID: 27347807 PMCID: PMC4975998 DOI: 10.1016/j.jad.2016.05.042] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/22/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND The episodic nature of major depressive disorder (MDD) in clinically referred adults has been well-characterized, particularly by the NIMH Collaborative Depression Study. Previous work has established that MDD also is episodic prior to adulthood, but no study has yet provided comprehensive information on the actual course of MDD in clinically referred juveniles. Thus, the present investigation sought to characterize recovery, recurrence, and their predictors across multiple episodes of MDD in initially 8- to 13-year-old outpatients (N=102), and to estimate freedom from morbidity ("well-time") across the years. METHOD Clinically referred youngsters with MDD were repeatedly assessed in an observational study across two decades (median follow up length: 15 years). Survival analytic techniques served to model recovery from the 1st, 2nd and 3rd lifetime episodes of MDD, the risk of developing the 2nd, 3rd, and 4th episodes, and the effects of traditional psychosocial and clinical predictors of outcomes. "Well-time" across the follow-up and its predictors also were examined. RESULTS Recovery rates ranged from 96% to 100% across MDD episodes; episode lengths ranged from 6 to 7 months. Up to 72% of those recovered from the first episode of MDD had a further episode; median inter-episode intervals were about 3-5 years. No single demographic, social, or clinical variable, nor treatment, consistently predicted recovery/recurrence. Psychiatric morbidity over time derived mostly from non-affective disorders, which, however, did not alter the course of MDD. LIMITATIONS The sample was relatively small and power to detect small effects further declined with each MDD episode recurrence. CONCLUSIONS Echoing findings on adults, the course of pediatric-onset MDD in this clinical sample was unequivocally episodic. Traditional course predictors had limited temporal stability, highlighting the need to examine novel predictor variables. The ongoing risk of depression episodes into the second and third decades of life suggests that prevention efforts should start in late childhood.
Collapse
Affiliation(s)
- Maria Kovacs
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
| | | | | |
Collapse
|
46
|
Schmaal L, Veltman DJ, van Erp TGM, Sämann PG, Frodl T, Jahanshad N, Loehrer E, Vernooij MW, Niessen WJ, Ikram MA, Wittfeld K, Grabe HJ, Block A, Hegenscheid K, Hoehn D, Czisch M, Lagopoulos J, Hatton SN, Hickie IB, Goya-Maldonado R, Krämer B, Gruber O, Couvy-Duchesne B, Rentería ME, Strike LT, Wright MJ, de Zubicaray GI, McMahon KL, Medland SE, Gillespie NA, Hall GB, van Velzen LS, van Tol MJ, van der Wee NJ, Veer IM, Walter H, Schramm E, Normann C, Schoepf D, Konrad C, Zurowski B, McIntosh AM, Whalley HC, Sussmann JE, Godlewska BR, Fischer FH, Penninx BWJH, Thompson PM, Hibar DP. Response to Dr Fried & Dr Kievit, and Dr Malhi et al. Mol Psychiatry 2016; 21:726-8. [PMID: 26903270 PMCID: PMC4876636 DOI: 10.1038/mp.2016.9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- L Schmaal
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - D J Veltman
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - T G M van Erp
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - P G Sämann
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - T Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University of Magdeburg, Magdeburg, Germany
- Department of Psychiatry, Trinity College, University of Dublin, Dublin, Ireland
| | - N Jahanshad
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - E Loehrer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MS, USA
| | - M W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - W J Niessen
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Medical Informatics, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - K Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - H J Grabe
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- Helios Hospital Stralsund, Stralsund, Germany
| | - A Block
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - K Hegenscheid
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - D Hoehn
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - M Czisch
- Max Planck Institute of Psychiatry, Neuroimaging Research Group, Munich, Germany
| | - J Lagopoulos
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - S N Hatton
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - I B Hickie
- Clinical Research Unit, Brain and Mind Centre, University of Sydney, Camperdown, NSW, Australia
| | - R Goya-Maldonado
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Gerog-August-University, Goettingen, Germany
| | - B Krämer
- Center for Translational Research in Systems Neuroscience and Psychiatry, Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Gerog-August-University, Goettingen, Germany
| | - O Gruber
- Section for Experimental Psychopathology and Neuroimaging, Department of General Psychiatry, Heidelberg University Hospital, Heidelberg, Germany
| | - B Couvy-Duchesne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
- Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - M E Rentería
- Department of Genetic Epidemiology, Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - L T Strike
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - M J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - G I de Zubicaray
- Faculty of Health, The Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Brisbane, QLD, Australia
| | - K L McMahon
- Center for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - S E Medland
- Department of Quantitative Genetics, Queensland Institute of Medical Research Berghofer, Brisbane, QLD, Australia
| | - N A Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - G B Hall
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- Imaging Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - L S van Velzen
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - M-J van Tol
- University of Groningen, University Medical Center Groningen, Department of Neuroscience, Neuroimaging Center, Groningen, The Netherlands
| | - N J van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - I M Veer
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - H Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - E Schramm
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
- Psychiatric University Clinic, Basel, Switzerland
| | - C Normann
- Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany
| | - D Schoepf
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | - C Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakoniklinikum, Rotenburg, Germany
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - B Zurowski
- Center for Integrative Psychiatry, University of Lübeck, Lübeck, Germany
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | - H C Whalley
- Division of Psychiatry, University of Edinburgh, UK
| | - J E Sussmann
- Division of Psychiatry, University of Edinburgh, UK
| | - B R Godlewska
- Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - F H Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité Universitätsmedizin, Berlin, Germany
- Institute for Social Medicine, Epidemology and Health Economics, Charité Universitätsmedizin, Berlin, Germany
| | - B W J H Penninx
- Department of Psychiatry and Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - P M Thompson
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| | - D P Hibar
- Imaging Genetics Center, Department of Neurology, Keck School of Medicine, University of Southern California, Marina del Rey, CA, USA
| |
Collapse
|
47
|
Gender Moderation of the Intergenerational Transmission and Stability of Depressive Symptoms from Early Adolescence to Early Adulthood. J Youth Adolesc 2016; 46:248-260. [PMID: 27055682 DOI: 10.1007/s10964-016-0480-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 04/02/2016] [Indexed: 10/22/2022]
Abstract
Factors that might exacerbate or mitigate the transmission of depressive symptoms from parents to adolescents and the continuity of depressive symptoms into early adulthood are poorly understood. This study tested the hypothesis that the intergenerational transmission and stability of depressive symptoms would be stronger for girls than boys over adolescence and into early adulthood, while considering the possibility that the pattern of gender moderation might vary depending on parent gender and developmental timing. The participants were 667 rural Midwestern adolescents (52 % female) and their parents. Survey data on maternal and paternal depressive symptoms (at youth age 11) and on adolescent and young adult depressive symptoms (at youth ages 11, 18, and 21) were analyzed via multiple group structural equation modeling. Maternal depressive symptoms predicted increased late adolescent depressive symptoms for girls but not boys, and adolescent depressive symptoms were more stable in girls. Paternal depressive symptoms predicted increased late adolescent depressive symptoms for all youth. The findings suggest the need for early, tailored interventions.
Collapse
|
48
|
Shackman AJ, Stockbridge MD, Tillman RM, Kaplan CM, Tromp DPM, Fox AS, Gamer M. The neurobiology of dispositional negativity and attentional biases to threat: Implications for understanding anxiety disorders in adults and youth. J Exp Psychopathol 2016; 7:311-342. [PMID: 27917284 PMCID: PMC5130287 DOI: 10.5127/jep.054015] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
When extreme, anxiety can become debilitating. Anxiety disorders, which often first emerge early in development, are common and challenging to treat, yet the neurocognitive mechanisms that confer increased risk have only recently begun to come into focus. Here we review recent work highlighting the importance of neural circuits centered on the amygdala. We begin by describing dispositional negativity, a core dimension of childhood temperament and adult personality and an important risk factor for the development of anxiety disorders and other kinds of stress-sensitive psychopathology. Converging lines of epidemiological, neurophysiological, and mechanistic evidence indicate that the amygdala supports stable individual differences in dispositional negativity across the lifespan and contributes to the etiology of anxiety disorders in adults and youth. Hyper-vigilance and attentional biases to threat are prominent features of the anxious phenotype and there is growing evidence that they contribute to the development of psychopathology. Anatomical studies show that the amygdala is a hub, poised to govern attention to threat via projections to sensory cortex and ascending neuromodulatory systems. Imaging and lesion studies demonstrate that the amygdala plays a key role in selecting and prioritizing the processing of threat-related cues. Collectively, these observations provide a neurobiologically-grounded framework for understanding the development and maintenance of anxiety disorders in adults and youth and set the stage for developing improved intervention strategies.
Collapse
Affiliation(s)
- Alexander J. Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742 USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742 USA
| | - Melissa D. Stockbridge
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD 20742 USA
| | - Rachael M. Tillman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Claire M. Kaplan
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
| | - Do P. M. Tromp
- Department of Psychiatry, University of Wisconsin, Madison, WI 53719 USA
- HealthEmotions Research Institute, University of Wisconsin, Madison, WI 53719 USA
- Lane Neuroimaging Laboratory, University of Wisconsin, Madison, WI 53719 USA
- Neuroscience Training Program, University of Wisconsin, Madison, WI 53719 USA
| | - Andrew S. Fox
- Department of Psychology, University of California, Davis, CA 95616 USA
- California National Primate Research Center, University of California, Davis, CA 95616 USA
| | - Matthias Gamer
- Department of Psychology, Julius Maximilian University of Würzburg, Würzburg, Germany
| |
Collapse
|
49
|
Liang Y, Zhao G, Sun R, Mao Y, Li G, Chen X, Gao L, Hu Z. Genetic variants in the promoters of let-7 family are associated with an increased risk of major depressive disorder. J Affect Disord 2015; 183:295-9. [PMID: 26047307 DOI: 10.1016/j.jad.2015.04.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2015] [Revised: 04/21/2015] [Accepted: 04/21/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Let-7 family plays a critical role in the pathogenesis of major depressive disorder (MDD). Genetic polymorphisms in the promoters of miRNA may influence individual׳s susceptibility to diseases. The purpose of this study was to investigate the association between rs10877887 and rs13293512 polymorphisms in the promoters of let-7 family and the risk of MDD. METHOD Polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing assays were used to analyze the rs10877887 and rs13293512 polymorphisms in 237 MDD patients and 296 controls. RESULTS We found that the rs10877887 CC genotype was associated with an increased risk of MDD (CC vs. TT: OR=1.73, 95% CI, 1.04-2.86, P=0.03, and CC vs. TT/TC OR=1.74, 95% CI, 1.08-2.80, P=0.02, respectively). Similarly increased risk was also observed for the rs13293512 (CC vs. TT: OR=1.83, 95% CI, 1.12-2.99, P=0.015; CC vs. TT/TC OR=1.84, 95% CI, 1.20-2.81, P=0.005; and C vs. T: OR=1.32, 95% CI, 1.03-1.68, P=0.03, respectively). Stratification analysis showed that patients with the rs13293512 TC and CC genotypes had a 2.29 and 2.56-fold increased risk of MDD recurrence after treatment (TC vs. TT: 95% CI, 1.23-4.25, P=0.008; CC vs. TT: 95% CI, 1.25-5.23, P=0.009, respectively). LIMITATIONS Relatively small sample size and hospital-based study design may influence the results. CONCLUSIONS Our findings suggest that the rs10877887 and rs13293512 polymorphisms may be related to the development of MDD.
Collapse
Affiliation(s)
- Yundan Liang
- Department of Forensic Psychiatry, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Gaofeng Zhao
- Mental Health Hospital of Jining, Jining, Shandong 272051, PR China
| | - Ruifen Sun
- Central Laboratory, Yunnan University of Chinese Traditional Medicine, Kunming, Yunnan 650500, PR China
| | - Yuanyi Mao
- Criminal Detachment of Chengdu Public Security Bureau, Chengdu, Sichuan 610017, PR China
| | - Gangqin Li
- Department of Forensic Psychiatry, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Xueyan Chen
- Department of Forensic Psychiatry, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Linbo Gao
- Laboratory of Molecular and Translational Medicine, West China Institute of Women and Children׳s Health; West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
| | - Zeqing Hu
- Department of Forensic Psychiatry, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, Sichuan 610041, PR China.
| |
Collapse
|
50
|
Klein DN, Hajcak G. Heterogeneity of Depression: Clinical Considerations and Psychophysiological Measures. PSYCHOLOGICAL INQUIRY 2015. [DOI: 10.1080/1047840x.2015.1032873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|