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Wang W, Lu K, Du Q, Li C, Wang J, Wei Y, Yao M, Li S, Li X, Tian X, Zhang T, Yin F, Ma Y. Association between depressive duration and cognitive decline in middle-aged and older adults: Evidence from the Health and Retirement Study 2010-2018. J Affect Disord 2024; 364:286-294. [PMID: 39142592 DOI: 10.1016/j.jad.2024.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 07/01/2024] [Accepted: 08/09/2024] [Indexed: 08/16/2024]
Abstract
BACKGROUND Depression has been found to be associated with cognitive decline, but whether longer depressive durations lead to more severe cognitive declines has not been investigated. We aimed to estimate the association between depressive duration and cognitive decline in middle-aged and older Americans based on a large-scale representative population study. METHODS We included 27,886 participants from the Health and Retirement Study (HRS) in 2010-2018. Four datasets with 2-, 4-, 6-, and 8-year consecutive interviews were further derived which involving persistent depressed and persistent depression-free individuals. Multiple linear regressions were constructed to estimate the effects of each depressive duration on the decline in global cognition, memory and mental status. Meta-regressions were performed to test the linear trends and to explore the heterogeneity between sex, age and baseline cognitive function along with subgroup analyses. RESULTS Depressive durations of 2, 4, 6, and 8 years were associated with reductions in global cognitive scores of 0.62 points (95% CI: 0.51-0.73), 0.77 points (95% CI: 0.60-0.94), 0.83 points (95% CI: 0.55-1.10), and 1.09 points (95% CI: 0.63-1.55), respectively, indicating a linear trend (P = 0.016). More pronounced associations were observed in middle-aged adults and females. Similar patterns were found in the associations between depressive duration and two subdomains, i.e., memory and mental health. LIMITATIONS This study is essentially a cross-sectional study and therefore cannot provide causal associations. CONCLUSIONS Longer depressive durations were linearly related to more severe cognitive declines. Timely intervention for depression targeted middle-aged adults can more effectively alleviate cognition-related burdens.
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Affiliation(s)
- Wei Wang
- Department of Gastroenterology, Xinqiao Hospital, Third Military Medical University, Chongqing, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Kai Lu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Qianqian Du
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Chen Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Junyu Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yuxin Wei
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Menghan Yao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Sheng Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Xuelin Li
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Xinyue Tian
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Tao Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Fei Yin
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China
| | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Sichuan, Chengdu, China.
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Gautron MA, Clergue-Duval V, Chantre J, Lejoyeux M, Geoffroy PA. Predictive factors of cognitive impairment in alcohol use disorder inpatients. Addict Behav 2024; 158:108132. [PMID: 39146925 DOI: 10.1016/j.addbeh.2024.108132] [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: 04/29/2024] [Revised: 07/03/2024] [Accepted: 08/12/2024] [Indexed: 08/17/2024]
Abstract
BACKGROUND Cognitive impairments are common in patients with AUD and worsen the prognosis of addiction management. There are no clear guidelines for screening cognitive impairments in hospitalized patients with AUD. METHODS Fifty-seven patients with an AUD history who were admitted to an acute hospital and assessed by the addiction care team were included. Those patients were screened for cognitive impairments using the Montreal Cognitive Assessment (MoCA) test. We collected clinical information regarding addiction history, comorbidities, and current treatments. Chi-square tests, t-tests, and Mann-Whitney tests were performed to determine factors associated with a pathological MoCA score (<26). RESULTS A pathological MoCA score was positively associated with spatial-temporal disorientation, difficulty in recalling addiction history, patient underreporting of AUD and a date of last alcohol consumption lower than 11 days ago, and negatively associated with a reason for hospitalization due to alcohol-related health issues. No medication was associated with cognitive impairments. CONCLUSIONS Clinical elements from assessment by the addiction care team allow for relevant indication for screening cognitive impairments.
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Affiliation(s)
- Marie-Astrid Gautron
- Unité de Traitement Ambulatoire des Maladies Addictives, Département d'Addictologie et de Psychiatrie, Hôpital Beaujon, APHP GHU Nord, 100 bd du général Leclerc, 92110 Clichy, France; ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France.
| | - Virgile Clergue-Duval
- ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France; Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, APHP GHU Nord, 200 rue du faubourg Saint-Denis, 75010 Paris, France; UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; UMRS-1144 Optimisation thérapeutique en neuropsychopharmacologie, Inserm, Université Paris Cité, 4 avenue de l'Observatoire, 75006 Paris, France; FHU Network of Research in Substance Use Disorders (NOR-SUD), 4 avenue de l'Observatoire, 75006 Paris , France
| | - Janice Chantre
- Unité de Traitement Ambulatoire des Maladies Addictives, Département d'Addictologie et de Psychiatrie, Hôpital Beaujon, APHP GHU Nord, 100 bd du général Leclerc, 92110 Clichy, France; ResAlCog (Réseau pour la prise en charge des troubles cognitifs liés à l'alcool), 51 bis Rue des Epinettes, 75017 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France
| | - Michel Lejoyeux
- UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France; 22ème secteur de psychiatrie parisienne GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France
| | - Pierre A Geoffroy
- UFR de Médecine, Université Paris Cité, 85 boulevard Saint-Germain, 75006 Paris, France; Département de psychiatrie et d'addictologie, AP-HP, DMU Neurosciences, Hôpital Bichat - Claude Bernard, APHP GHU Nord, 46 rue Henri Huchard, 75018 Paris, France; Centre ChronoS, GHU Paris - Psychiatry & Neurosciences, 1 rue Cabanis, 75014 Paris, France; CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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Francia L, De Giorgi R, Lara E, del Castellar BD, Castelletti C, Rodríguez-Prada C, Domènech-Abella J, Olaya B, Haro JM, Ayuso Mateos JL. Treatment coverage for depression in the general Spanish population and the impact of the Covid-19 pandemic. Heliyon 2024; 10:e32594. [PMID: 38961986 PMCID: PMC11219982 DOI: 10.1016/j.heliyon.2024.e32594] [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] [Received: 01/16/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 07/05/2024] Open
Abstract
Background Despite the availability of effective antidepressant strategies, numerous people with depressive disorders remain untreated. The Covid-19 pandemic has affected healthcare services, especially the mental health sector. This study aims to explore the coverage of depression treatments in the general Spanish population and the impact of the Covid-19 pandemic. Methods We used longitudinal data (2018 and 2022) from the general Spanish population: pre-pandemic n = 1512; mean age = 65.43 years ± 14.90; 56 % females; post-pandemic n = 909; mean age = 68.00 years ± 14.24; 54 % women. The International Classification of Disease 10th edition was used to diagnose lifetime depressive episodes and severity. We explored psychological and pharmacological treatment coverage via multiple logistic regressions adjusted for 4 covariates (sex assigned at birth, education level, age, Covid-19 pandemic) for participants with a diagnosis of depression. Results Treatment coverage for depression in the pre-pandemic and post-pandemic samples was, respectively, 53.3 % and 51.9 %. We observed an association between severe depression and treatment coverage (OR = 2.77, 95%CI 1.05 to 7.75). We found no association between the COVID-19 pandemic and treatment coverage. Conclusions The pharmacological treatment coverage was associated with severe types of depression. The prevalence rates of treatment coverage were similar in the pre- and post-COVID-19 pandemic attesting to the resilience of the mental health system in Spain.
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Affiliation(s)
- Lea Francia
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Riccardo De Giorgi
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, X3 7JX, United Kingdom
- Oxford Health NHS Foundation Trust, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - Elvira Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Department of Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Blanca Dolz del Castellar
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Chiara Castelletti
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Cristina Rodríguez-Prada
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Joan Domènech-Abella
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Beatriz Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - Josep Maria Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
- Unitat de Recerca Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
| | - José Luis Ayuso Mateos
- Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa, IIS Princesa, Spain
- Department of Psychiatry, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
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Jian YL, Jia S, Shi S, Shi Z, Zhao Y. A nomogram to predict the risk of cognitive impairment in patients with depressive disorder. Res Nurs Health 2024; 47:302-311. [PMID: 38149849 DOI: 10.1002/nur.22364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
This study was to describe the cognitive function status in patients with depressive disorder and to construct a nomogram model to predict the risk factors of cognitive impairment in these patients. From October 2019 to February 2021, a total of 141 patients with depressive disorder completed the survey in two hospitals. The Montreal cognitive assessment (MoCA) was used with a cutoff score of 26 to differentiate cognitive impairment. Univariable and multivariable logistic regression analyses were conducted to identify independent risk factors. A nomogram was then constructed based on the results of the multivariable logistic regression analysis. The patients had an average MoCA score of 23.99 ± 3.02. The multivariable logistic regression analysis revealed that age (OR: 1.096, 95% CI: 1.042-1.153, p < 0.001), education (OR: 0.065, 95% CI: 0.016-0.263, p < 0.001), depression severity (OR: 1.878, 95% CI: 1.021-3.456, p = 0.043), and sleep quality (OR: 2.454, 95% CI: 1.400-4.301, p = 0.002) were independent risk factors for cognitive impairment in patients with depressive disorder. The area under receiver operating characteristic (ROC) curves was 0.868 (95% CI: 0.807-0.929), indicating good discriminability of the model. The calibration curve of the model and the Hosmer-Lemeshow test (p = 0.571) demonstrated a well-fitted model with high calibration. Age, education, depression severity, and sleep quality were found to be significant predictors of cognitive function. A nomogram model was developed to predict cognitive impairment in patients with depressive disorder, providing a solid foundation for clinical interventions.
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Affiliation(s)
| | - Shoumei Jia
- School of Nursing, Fudan University, Shanghai, China
| | - Shenxun Shi
- Department of Psychiatry, Fudan University Huashan Hospital, Shanghai, China
| | | | - Ying Zhao
- School of Nursing, Fudan University, Shanghai, China
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Meng TJ, Qian Y, Wang YL, Gao BL, Liu JJ, Yue JL, Tang DH. The effect of systematic couple group therapy on families with depressed juveniles: a pilot trial. Front Psychiatry 2024; 15:1283519. [PMID: 38863609 PMCID: PMC11165141 DOI: 10.3389/fpsyt.2024.1283519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 05/07/2024] [Indexed: 06/13/2024] Open
Abstract
Background Depression is a primary cause of illness and disability among teenagers, and the incidence of depression and the number of untreated young people have increased in recent years. Effective intervention for those youths could decrease the disease burden and suicide or self-harm risk during preadolescence and adolescence. Objective To verify the short efficacy of the systemic couple group therapy (SCGT) on youths' depression changes and families with depressed adolescents. Methods The study was a self-control trial; only within-group changes were evaluated. Participants were couples with a depressed child who was resistant to psychotherapy; they were recruited non-randomly through convenient sampling. The paired-sample t-test and Wilcoxon signed-rank test were used to compare differences before and after interventions. The effect sizes were also estimated using Cohen's d. Spearman's correlation analysis was used to examine associations between changes. Results A downward trend was seen in depressive symptoms after treatment, and Cohen's d was 0.33 (p = 0.258). The adolescents perceived fewer interparental conflicts, and the effect sizes were medium for perceived conflict frequency (0.66, p = 0.043), conflict intensity (0.73, p = 0.028), conflict solutions (0.75, p = 0.025), coping efficacy (0.68, p = 0.038), and perceived threat (0.57, p = 0.072). For parents, global communication quality, constructive communication patterns, and subjective marital satisfaction significantly improved after interventions, with large effect sizes (1.11, 0.85, and 1.03, respectively; all p < 0.001). Other destructive communication patterns such as demand/withdraw (p = 0.003) and mutual avoidance (p = 0.018) and communication strategies like verbal aggression (p = 0.012), stonewalling (p = 0.002), avoidance-capitulation (p = 0.036), and child involvement (p = 0.001) also reduced, with medium effect sizes (0.69, 0.52, 0.55, 0.71, 0.46, and 0.79, respectively). Meanwhile, the associations between depression changes and changes in interparental conflicts (p < 0.001) and marital satisfaction (p = 0.001) were significant. Conclusions and clinical relevance The SCGT offers the possibility for the treatment of families with depressed children who are unwilling to seek treatment. Helping parents improve communication and marital quality may have benefits on children's depressive symptoms.
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Affiliation(s)
- Tian-Jiao Meng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Ying Qian
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yu-Lu Wang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Bing-Ling Gao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jia-Jia Liu
- School of Nursing, Peking University, Beijing, China
| | - Jing-Li Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Deng-Hua Tang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Coello K, Stanislaus C, Stanislaus S, Sletved KSO, Kjærstad HL, Miskowiak KW, Faurholt-Jepsen M, Pagsberg AK, Vinberg M, Kessing LV. Socio-economic status, functioning and cognition in young versus adult patients newly diagnosed with bipolar disorder and their unaffected relatives; results from a cross-sectional study. J Affect Disord 2024; 351:458-471. [PMID: 38266931 DOI: 10.1016/j.jad.2024.01.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 01/07/2024] [Accepted: 01/17/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Bipolar disorders (BD) figures on top of the World Health Organization classification of disabling disorders. It is unclear if there are socioeconomic, functioning, and cognition differences in young patients newly diagnosed with BD and whether these are different for young and adult patients newly diagnosed with BD. Understanding these differences is important for tailored treatment and support. METHODS Participant groups included 401 patients newly diagnosed with BD, 145 of their unaffected first-degree relatives (UR) and 209 healthy control individuals (HC). First, we compared socio-economic status, functioning and cognition between young patients newly diagnosed with BD (150), UR (61) and HC (92) (15-25 years) and adult patients newly diagnosed with BD (251), UR (84) and HC (117) (>25 years), respectively. Second, within patients, we compared functioning and cognition between young and adult patients newly diagnosed with BD. RESULTS In both participant groups, patients newly diagnosed with BD, and to a lesser degree UR, had lower socio-economic status and impaired functioning and cognition compared with HC. Further, young patients newly diagnosed with BD were less functionally impaired, than adults newly diagnosed with BD, whereas cognition did not differ between groups. LIMITATIONS Applied tools for assessments of functioning and cognition are not validated below age 18. CONCLUSIONS Overall, lower socio-economic status and impaired functioning and cognition were found both in young and adult patients newly diagnosed with BD and their UR compared with young and adult HC, respectively. Young patients were less functionally impaired than adults, but cognition was similarly impaired.
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Affiliation(s)
- Klara Coello
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark.
| | - Christoffer Stanislaus
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark
| | - Sharleny Stanislaus
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark
| | | | - Hanne Lie Kjærstad
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark
| | - Kamilla Woznika Miskowiak
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark; Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Mental Health Services, Capital Region of Denmark, Denmark; Department of Psychology, University of Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark; Child and Adolescent Mental Health Center, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Maj Vinberg
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark; The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen University Hospital, Mental Health Services CPH, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, Frederiksberg, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Denmark
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Liu W, Jiang X, Deng Z, Xie Y, Guo Y, Wu Y, Sun Q, Kong L, Wu F, Tang Y. Functional and structural alterations in different durations of untreated illness in the frontal and parietal lobe in major depressive disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:629-642. [PMID: 37542558 PMCID: PMC10995069 DOI: 10.1007/s00406-023-01625-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/22/2023] [Indexed: 08/07/2023]
Abstract
Major depressive disorder (MDD) is one of the most disabling illnesses that profoundly restricts psychosocial functions and impairs quality of life. However, the treatment rate of MDD is surprisingly low because the availability and acceptability of appropriate treatments are limited. Therefore, identifying whether and how treatment delay affects the brain and the initial time point of the alterations is imperative, but these changes have not been thoroughly explored. We investigated the functional and structural alterations of MDD for different durations of untreated illness (DUI) using regional homogeneity (ReHo) and voxel-based morphometry (VBM) with a sample of 125 treatment-naïve MDD patients and 100 healthy controls (HCs). The MDD patients were subgrouped based on the DUI, namely, DUI ≤ 1 M, 1 < DUI ≤ 6 M, 6 < DUI ≤ 12 M, and 12 < DUI ≤ 48 M. Subgroup comparison (MDD with different DUIs) was applied to compare ReHo and grey matter volume (GMV) extracted from clusters of regions with significant differences (the pooled MDD patients relative to HCs). Correlations and mediation effects were analysed to estimate the relationships between the functional and structural neuroimaging changes and clinical characteristics. MDD patients exhibited decreased ReHo in the left postcentral gyrus and precentral gyrus and reduced GMV in the left middle frontal gyrus and superior frontal gyrus relative to HCs. The initial functional abnormalities were detected after being untreated for 1 month, whereas this duration was 3 months for GMV reduction. Nevertheless, a transient increase in ReHo was observed after being untreated for 3 months. No significant differences were discovered between HCs and MDD patients with a DUI less than 1 month or among MDD patients with different DUIs in either ReHo or GMV. Longer DUI was related to reduced ReHo with GMV as mediator in MDD patients. We identified disassociated functional and anatomical alterations in treatment-naïve MDD patients at different time points in distinct brain regions at the early stage of the disease. Additionally, we also discovered that GMV mediated the relationship between a longer DUI and diminished ReHo in MDD patients, disclosing the latent deleterious and neuro-progressive implications of DUI on both the structure and function of the brain and indicating the necessity of early treatment of MDD.
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Affiliation(s)
- Wen Liu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Xiaowei Jiang
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Radiology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Zijing Deng
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yu Xie
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yingrui Guo
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yifan Wu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Qikun Sun
- Department of Radiation Oncology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Lingtao Kong
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Feng Wu
- Brain Function Research Section, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
| | - Yanqing Tang
- Department of Psychiatry, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
- Department of Gerontology, The First Hospital of China Medical University, Shenyang, 110001, Liaoning, People's Republic of China.
- Department of Psychiatry and Geriatric Medicine, The First Hospital of China Medical University, 155 Nanjing North Street, Shenyang, 110001, Liaoning, People's Republic of China.
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Li R, Wang W, Guo J, Liu W, Huang X, Qiao Y, Jia S, Tian L, Zhou J, Wang G. Efficacy and acceptability of supervised group exercise for mild to moderate major depressive disorder: A feasibility study. J Affect Disord 2023; 329:96-104. [PMID: 36841307 DOI: 10.1016/j.jad.2023.02.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 02/11/2023] [Accepted: 02/19/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Exercise can efficiently reduce the symptoms of major depression disorder (MDD). This study aims to examine the efficacy and acceptability of supervised group exercise intervention among patients in an acute phase of mild to moderate MDD. METHODS We enrolled patients in the psychiatric clinic of Beijing Anding Hospital affiliated to Capital Medical University in a prospective, single-arm objective performance criteria (OPC) trial. A total of 40 adults aged 18-50 who had a diagnosis of an episode of depression and the 17-item Hamilton Rating Scale for Depression (HRSD-17) score of 7-20 were recruited. Supervised exercise group intervention was applied on participants with a new episode of mild to moderate depression 3 times a week for 8 weeks without any other treatment. Every exercise session should meet the standard of moderate intensity, defined as approximately equal to 50 %-80 % of the maximal heart rate for 150 min every week. The primary end point was the clinical response at week 8, defined as a 50 % reduction in the baseline HRSD-17 score. Meanwhile, the secondary end points included the acceptability of the supervised group exercise intervention for both patients and investigators, remission rate (defined as an HRSD-17 score of 7 or less), the change of Patient Health Questionnaire (PHQ-9) and the Quality of Life, Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). RESULTS Among the 46 screened patients, 40 were enrolled. Of them, 4 people dropped out, while 36 received all the planned sessions of the supervised group exercise therapy and completed the week-8 assessment. At week 8, the response rate was 89 % (95 % confidence interval [CI] 74 % to 97 %) and the remission rate was 83 % (95%CI 67 % to 94 %). The overall acceptance of the supervised group exercise based on the VAS score (range 0-10) was 9.19 ± 1.27 for patients and 9.67 ± 0.62 for investigators. The least-squares mean (±SE) change from baseline at week 8 was-9.99 in the PHQ-9 score and 25.15 in the Q-LES-Q-SF score. No serious adverse events were reported during this trial. The percentage of any adverse event was 5 %. CONCLUSION Supervised group exercise intervention is effective in patients with acute mild to moderate MDD and has good acceptance rate among both patients and investigators.
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Affiliation(s)
- Ruinan Li
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Weiwei Wang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Jianjun Guo
- Capital University of Physical Education And Sports, Beijing 100192, China
| | - Wenyang Liu
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Xiaohan Huang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Yu Qiao
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Shengtao Jia
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Lu Tian
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China
| | - Jingjing Zhou
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China.
| | - Gang Wang
- National Clinical Research Center for Mental Disorders, Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing 100069, China.
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Liu X, Wang G, Cao Y. The effectiveness of exercise on global cognitive function, balance, depression symptoms, and sleep quality in patients with mild cognitive impairment: A systematic review and meta-analysis. Geriatr Nurs 2023; 51:182-193. [PMID: 37011490 DOI: 10.1016/j.gerinurse.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 04/04/2023]
Abstract
This review aimed to examine the effectiveness of exercise on global cognitive function, balance, depression symptoms, and sleep quality in patients with mild cognitive impairment. And systematically retrieved five electronic databases, including the Cochrane library, PubMed, Embase, Web of Science, and PsycINFO, from inception to May 2022. Of 1102 studies, twenty-one studies were included in this meta-analysis. The polled results revealed that exercise could significantly improve global cognitive function (SMD = 0.64, 95%CI: 0.36 to 0.91, Z = 4.56, P < 0.00001), balance (SMD = 0.62, 95%CI: 0.30 to 0.95, Z = 4.56, P = 0.0001) and depression symptoms (SMD = -0.37, 95%CI: -0.64 to -0.10, Z = 2.70, P = 0.007). The exercise was a promising intervention with the potential to be applied in people with mild cognitive impairment.
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Di Salvo G, Porceddu G, Albert U, Maina G, Rosso G. Correlates of long duration of untreated illness (DUI) in patients with bipolar disorder: results of an observational study. Ann Gen Psychiatry 2023; 22:12. [PMID: 36959643 PMCID: PMC10035162 DOI: 10.1186/s12991-023-00442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Despite a high number of studies investigating the correlation between long Duration of Untreated Illness (DUI) and poor course of Bipolar Disorder (BD), the results concerning the impact of DUI on some specific factors, such as suicidality and medical comorbidities, are still inconsistent. This cross-sectional observational study aimed at analyzing potential socio-demographic and clinical correlates of long DUI in a large cohort of real-world, well-characterized BD patients. METHODS The socio-demographic and clinical characteristics of 897 patients with BD were collected. The sample was divided for analysis in two groups (short DUI vs long DUI) according to a DUI cutoff of 2 years. Comparisons were performed using χ2 tests for categorical variables and the Kruskal-Wallis test for continuous variables. Logistic regression (LogReg) was used to identify explanatory variables associated with DUI (dependent variable). RESULTS Six-hundred and sixty patients (75.5%) presented long DUI (> 2 years) and mean DUI was 15.7 years. The LogReg analysis confirmed the association of long DUI with bipolar II disorder (p: 0.016), lower age at onset (p < 0.001), depressive predominant polarity (p: 0.018), depressive polarity onset (p < 0.001), longer duration of illness (p < 0.001), lifetime suicide attempts (p: 0.045) and current medical comorbidities (p: 0.019). CONCLUSIONS The present study confirms the association between long DUI and higher risk of suicide attempts in patients with BD. Moreover, an association between long DUI and higher rates of medical conditions has been found.
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Affiliation(s)
- Gabriele Di Salvo
- San Luigi Gonzaga University Hospital, Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Giorgia Porceddu
- Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
- UCO Clinica Psichiatrica, Azienda Sanitaria Universitaria Giuliano Isontina, ASUGI, Trieste, Italy
| | - Giuseppe Maina
- San Luigi Gonzaga University Hospital, Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy
| | - Gianluca Rosso
- San Luigi Gonzaga University Hospital, Department of Neurosciences 'Rita Levi Montalcini', University of Turin, Turin, Italy.
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lv Q, Li X, Zhang Y, Lu D, Lu J, Xie Q, Li H, Wu Y, Wang C, Yi Z. Sex differences in subjective cognitive impairment and clinical correlates in Chinese patients with subthreshold depression. Biol Sex Differ 2023; 14:6. [PMID: 36782299 PMCID: PMC9926784 DOI: 10.1186/s13293-023-00488-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/23/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE Subthreshold depression (SD) is a global mental health problem given its high prevalence, comorbidity, functional impairment, and its association with increased service utilization. However, currently little is known about sex differences of SD in cognitive impairment with clinical correlates. This study aims to explore sex differences in subjective cognitive impairment and clinically associated risk factors in Chinese patients with subthreshold depression (SD). METHODS A total of 126 patients with SD, 40 males and 86 females, aged 18-45 years, were included in this cross-sectional observational study. Their general information, psychological assessments, and psychiatric symptom assessments were collected online. The Patient Health Questionnaire depression-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Perceived Deficits Questionnaire-Depression (PDQ-D), and Toronto Alexithymia Scale (TAS-20) with 3 subdomains were used. The obtained scores were analyzed with partial correlation and multiple linear regression analysis models. RESULTS Our results showed that females had significantly higher PDQ-D-20 total score than males. However, the differences in TAS-20 and subdomain score according to sex were not significant. Notably, TAS-20 and DDF (difficulty describing feelings) subdomain contributed to cognitive impairment in males, whereas both PHQ-9 total score and TAS-20 or DDF subdomain contributed to cognitive impairment in females. CONCLUSION These findings revealed significant sex differences in cognitive impairment and clinical correlates in SD, which should be further followed-up in the future.
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Affiliation(s)
- Qinyu lv
- grid.16821.3c0000 0004 0368 8293Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030 China ,grid.8547.e0000 0001 0125 2443Institute of Mental Health, Fudan University, Shanghai, 200040 China ,grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Xin Li
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Yao Zhang
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Daofeng Lu
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Jiajing Lu
- grid.8547.e0000 0001 0125 2443Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040 People’s Republic of China
| | - Qingfang Xie
- Shanghai Baoshan Mental Health Center, Shanghai, 201900 China
| | - Hong Li
- Shanghai Baoshan Mental Health Center, Shanghai, 201900 China
| | - Yiming Wu
- Shanghai Yangpu Mental Health Center, Shanghai, 200093 China
| | - Chongze Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
| | - Zhenghui Yi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China. .,Institute of Mental Health, Fudan University, Shanghai, 200040, China. .,Department of Psychiatry, Huashan Hospital, School of Medicine, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040, People's Republic of China.
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12
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Luo G, Li Y, Yao C, Li M, Li J, Zhang X. Duration of untreated illness and clinical correlates in first-episode and drug-naïve patients with major depressive disorder. Psychiatry Res 2023; 320:115056. [PMID: 36680911 DOI: 10.1016/j.psychres.2023.115056] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUNDS The notion that a prolonged duration of untreated illness (DUI) leads to poorer outcomes has contributed to extensive changes in mental health services worldwide. However, most studies on DUI have focused on schizophrenia and related psychosis. This study aimed to assess the possible relationship between DUI and certain clinical correlates in first-episode and drug-naïve patients with major depressive disorder (MDD). METHODS This cross-sectional study recruited 1718 first-episode and drug-naïve MDD outpatients. All participants were scored on the Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Positive and Negative Syndrome Scale, and thyroid hormone and metabolic parameters were measured. We used the Structure Clinical Interview for DSM-IV for clinical diagnosis and investigated suicide attempts through face-to-face interviews. RESULTS A total of 171 (10%) of MDD patients had co-morbid psychiatric symptoms. Participants who were older, with lower education level, and married were less likely to seek a timely treatment compared to the counterparts. One-month longer untreated duration was associated with 2% to 9% higher odds of being with most of the investigated clinical conditions. For those with the longest DUI, the risk was increased for most of the investigated clinical conditions, with absolute risk differences ranging from 5.19% to 29.48%. CONCLUSIONS These findings suggest that longer DUI may be negatively associated with clinical correlates in MDD. Further long-term follow-up studies are warranted to confirm these preliminary results.
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Affiliation(s)
- Guoshuai Luo
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Yaxi Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 3210 Humin Rd, Shanghai 201108, China
| | - Cong Yao
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Meijuan Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China
| | - Jie Li
- Laboratory of Biological Psychiatry, Institute of Mental Health, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Tianjin 300222, China.
| | - Xiangyang Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, 16 Lincui Road, Beijing 100101, China.
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13
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Latency to selective serotonin reuptake inhibitor vs benzodiazepine treatment in patients with panic disorder: a naturalistic study. CNS Spectr 2023; 28:46-52. [PMID: 34736545 DOI: 10.1017/s1092852921000869] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Panic disorder (PD) is a prevalent and impairing anxiety disorder with previous reports suggesting that the longer the condition remains untreated, the greater the likelihood of nonresponse. However, patients with PD may wait for years before receiving a guideline-recommended pharmacological treatment. The widespread prescription of benzodiazepines (BDZ) for managing anxiety symptoms and disorders might delay the administration of pharmacotherapy according to guidelines (eg, selective serotonin reuptake inhibitors, SSRIs). The present study aimed to determine the mean duration of untreated illness (DUI) in a sample of PD patients, to quantify and compare DUI-SSRI to DUI-BDZ, and to compare findings with those from previous investigations. METHODS Three hundred and fourteen patients with a Diagnostic and Statistical Manual of Mental Disorders, fifth edition diagnosis of PD were recruited from an Italian outpatient psychotherapy unit, and epidemiological and clinical variables were retrieved from medical records. Descriptive statistical analyses were undertaken for sociodemographic and clinical variables, Wilcoxon matched-pair signed rank test was applied to compare the distribution of DUI-SSRI vs DUI-BDZ, and Welch's t test was performed to compare findings with those from previous studies. RESULTS The mean DUI-SSRI of the total sample was 64.25 ± 112.74 months, while the mean DUI-BDZ was significantly shorter (35.09 ± 78.62 months; P < 0.0001). A significantly longer DUI-SSRI, compared to findings from previous studies, was also observed. CONCLUSIONS The present results confirm a substantial delay in implementing adequate pharmacological treatments in patients with PD, and highlight the discrepancy between recommendations from international treatment guidelines and common clinical practice in relation to BDZ prescription.
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14
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Cui L, Wang Y, Cao L, Wu Z, Peng D, Chen J, Yang H, Rong H, Liu T, Fang Y. Age of onset for major depressive disorder and its association with symptomatology. J Affect Disord 2023; 320:682-690. [PMID: 36183820 DOI: 10.1016/j.jad.2022.09.096] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/31/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The age of onset (AOO) is a key factor for heterogeneity in major depressive disorder (MDD). Looking at the effect of AOO on symptomatology may improve clinical outcomes. This study aims to examine whether and how AOO affects symptomatology using a machine learning approach and latent profile analysis (LPA). METHODS The study enrolled 915 participants diagnosed with MDD from eight hospitals across China. Depressive symptoms were assessed using the 17-item Hamilton Depression Rating Scale. The relationship between symptom profiles and AOO was explored using Random Forest. The effect of AOO on symptom clusters and subtypes was investigated using multiple linear regression and LPA. A continuous AOO indicator was used to conduct the analyses. RESULTS Based on the Random Forest, symptom profiles were closely associated with AOO. The regression model showed that the severity of neurovegetative symptoms was positively associated with AOO (β = 0.18, p < 0.001), and the severity of cognitive-behavioral symptoms was negatively associated with AOO (β = -0.12, p < 0.001). LPA demonstrated that the subgroups characterized by suicide and guilt had earlier onset of depression. The subgroup with the lowest global severity of depression had the latest onset. LIMITATIONS AOO was recalled retrospectively. The relative scarcity of participants with childhood and adolescence onset depression. CONCLUSIONS AOO has an important impact on symptomatology. The findings may enhance clinical evaluations for MDD and assist clinicians in promoting earlier detection and individualized care in vulnerable individuals.
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Affiliation(s)
- Lvchun Cui
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Yun Wang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Lan Cao
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zhiguo Wu
- Department of Psychiatry and Psychology, Shanghai Deji Hospital affiliated to Qingdao University, Shanghai 200331, China
| | - Daihui Peng
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Jun Chen
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haichen Yang
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Han Rong
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Tiebang Liu
- Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen 518020, China
| | - Yiru Fang
- Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China.
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Omelchenko M, Migalina V, Kaleda V. The Effect of Untreated Illness in Youth Depression: A Cross-Sectional Study. CONSORTIUM PSYCHIATRICUM 2022; 3:8-17. [PMID: 39045583 PMCID: PMC11262081 DOI: 10.17816/cp206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/25/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The existing research has mainly focused on exploring how the duration of untreated psychosis effects the further course of the disease. By contrast, the duration of an untreated illness (DUI) in youth depression and its impact on the further course of the disease has remained scarcely investigated. AIM The current study aims to determine how the duration of untreated illness affects the severity of the symptoms during the first depressive episode and the degree to which the symptoms are reduced after treatment. METHODS Fifty-two young male patients (15-29 years old) were examined. First, they were hospitalized with a severe without psychotic symptoms (F32.2) and moderate (F32.1) depressive episode. The Hamilton Depression Rating Scale (HDRS), the Scale of Prodromal Symptoms (SOPS), and the Scale for Assessment of Negative Symptoms (SANS) were used to achieve the research goals. The examination was conducted twice at the time of patient admission to the hospital and before discharge. Our statistical analysis was carried out with the Statistica 12 software. The Mann-Whitney U test was used to compare the differences between two independent groups. The Spearman's rank correlation coefficient was used to uncover any correlation between how long the illness has remained untreated and the severity of its clinical symptoms. RESULTS All patients were hospitalized at the first depressive episode. The average duration of an untreated illness was 35.8±17.0 months. The patients were divided into two groups: the first group (59.6%, n=31), with a duration of the untreated illness of more than 36 months, and the second group (40.4%, n=21), with a duration of the untreated illness of less than 36 months. A cross-group comparison between the participants showed that the reduction of HDRS scores was significantly higher in the second group (p=0.019) at the time of discharge, with no differences in the severity of depressive symptoms (p=0.544) at the time of admission. Comorbidity was detected in 83.9% of the patients in the first group and in 42.9% of the patients in the second group. A greater therapy effectiveness was found to exist in the second group, as the depressive symptoms score on the HDRS scale (p=0.016; U=196.0) and prodromal symptoms score on the SOPS disorganization subscale (p=0.046; U=218.0) were found to have been reduced significantly. CONCLUSION The study showed that DUI has an impact on the reduction of depressive, negative symptoms and symptoms of disorganization in youth patients at the first depressive episode. A high level of comorbidity has been uncovered, confirming that a variety of non-psychotic and psychotic disorders in youth manifest themselves in depression at a prodromal stage, causing difficulties in establishing diagnoses and requiring subsequent verification. Future research might need to focus on exploring depressive symptoms as predictors of mental disorders in youth patients.
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Jiang W, Tian Y, Fan F, Fu F, Wei D, Tang S, Chen J, Li Y, Zhu R, Wang L, Shi Z, Wang D, Zhang XY. Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110611. [PMID: 35907518 DOI: 10.1016/j.pnpbp.2022.110611] [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: 05/22/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Cognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. METHODS We analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. RESULTS Compared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. CONCLUSIONS Our results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.
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Affiliation(s)
- Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhanbiao Shi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Clinical and psychopathological correlates of duration of untreated illness (DUI) in affective spectrum disorders. Eur Neuropsychopharmacol 2022; 61:60-70. [PMID: 35810585 DOI: 10.1016/j.euroneuro.2022.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022]
Abstract
Affective disorders represent psychopathological entities lying on a continuum, characterized by high prevalence and functional impairment. A delay in treatment initiation might increase the burden associated with affective spectrum disorders. The present study was aimed at analyzing the correlates of a long duration of untreated illness (DUI) in these conditions. We recruited subjects diagnosed with affective disorders, both in- and outpatients, and collected information concerning socio-demographic, clinical, and psychopathological characteristics. Long DUI was defined according to previous research criteria as >2 years for Bipolar Disorders or >1 year for Depressive Disorders. Bivariate analyses were performed to compare subjects with a long and short DUI (p<0.05). A logistic regression was operated to evaluate the correlates of long DUI. In the present sample (n=135), 34.1% (n=46) subjects showed a long DUI. This subgroup presented with more physical comorbidities (p=0.003), higher body mass index (BMI) (p<0.001), more frequent anxiety onset (p=0.018), younger onset age (p=0.042), and more severe depressive symptoms (Hamilton Depression Rating Scale item 1-depressed mood (p=0.032) and item 2-guilt feelings (p=0.018)). At the logistic regression, higher severity of depressed mood (OR 1.568), higher BMI (OR 1.264), and younger age at onset (OR 0.935) were associated with long DUI. The present study confirmed a possible role of DUI as a construct underpinning higher clinical severity in affective spectrum disorders, possibly linked to worse illness course and unfavorable outcomes. Intervention strategies targeting physical comorbidities and depressive symptoms severity may decrease disease burden in subjects with a long DUI.
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Bashir MI, Abdul Aziz NHK, Noor DAM. Antidepressant-like Effects of Polygonum minus Aqueous Extract in Chronic Ultra-Mild Stress-Induced Depressive Mice Model. Behav Sci (Basel) 2022; 12:bs12060196. [PMID: 35735406 PMCID: PMC9220072 DOI: 10.3390/bs12060196] [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] [Received: 05/12/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022] Open
Abstract
Depression is the most common behavior disorder that leads to many disabilities. The main aim of this study was to evaluate the effects of a Polygonum minus (P. minus) aqueous extract on chronic ultra-mild stress (CUMS)-induced depressive mice model. Chronic ultra-mild stress can disturb the neurotransmitters levels and plasticity of the hippocampus. Balb/c male mice were used in this study, which consisted of six groups (n = 14). Treatment was given for eight weeks, and chronic ultra-mild stress was applied for six weeks. Commercially available P. minus extract (BioKesum®) was used in this study. The behavior and neurochemical parameters were investigated through behavioral Tests and ELISA assays. P. minus administration significantly (p < 0.05) restored CUMS-induced behavior abnormalities, decreased the immobility time, and increased the sucrose preference and increased the spatial memory. P. minus treatment also showed the decreased level of serum corticosterone and increased the level of hippocampal neurotransmitters (Serotonin and Norepinephrine) significantly (p < 0.05). The brain-derived neurotrophic factor (BDNF) level also increased significantly in both the prefrontal cortex and hippocampus (p < 0.05). P. minus treatment exhibited significant (p < 0.05) reduction of Monoamine Oxidase-A (MAO-A) in the hippocampus. These findings indicate that P. minus aqueous extract exhibits antidepressant effects, including decreased immobility time, increased spatial memory, reduced corticosterone, increased BDNF level, and reduced MAO-A enzyme level with increasing the monoamines (serotonin and norepinephrine) in the hippocampus.
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Affiliation(s)
- Muhammad Irfan Bashir
- Discipline of Pharmacology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
- Correspondence: or (M.I.B.); (N.H.K.A.A.)
| | - Nur Hidayah Kaz Abdul Aziz
- Discipline of Pharmacology, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia
- Correspondence: or (M.I.B.); (N.H.K.A.A.)
| | - Dzul Azri Mohamed Noor
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden 11800, Penang, Malaysia;
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Wang M, Yin D, Liu L, Zhou S, Liu Q, Tian H, Wei J, Zhang K, Wang G, Chen Q, Zhu G, Wang X, Si T, Yu X, Lv X, Zhang N. Features of cognitive impairment and related risk factors in patients with major depressive disorder: A case-control study. J Affect Disord 2022; 307:29-36. [PMID: 35358550 DOI: 10.1016/j.jad.2022.03.063] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/11/2022] [Accepted: 03/24/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Cognitive impairment (CI) is a common symptom contributing to functional loss in major depressive disorder (MDD). However, the features of CI and its related risk factors in young and middle-aged MDD patients remain unclear. METHODS In this case-control study, 18- to 55-year-old acute-onset MDD patients and healthy controls (HCs) were recruited from nine centers in China. MDD patients were diagnosed based on the DSM-IV, the Mini-International Neuropsychiatric Interview, and a 17-item Hamilton Rating Scale for Depression score ≥ 14. Cognitive function, including attention/vigilance, learning, memory, processing speed and executive function, was assessed with a neuropsychological battery and compared between MDD patients and HCs. MDD patients scoring 1.5 SDs below the mean HC score in at least 2 domains were defined as having CI. Logistic regression analysis was used to identify risk factors for CI in MDD patients. RESULTS Compared with HCs (n = 302), MDD patients (n = 631) showed significant impairment in all cognitive domains (P < 0.001); 168 MDD patients (26.6%) had CI. Male sex (OR: 1.712; 95% CI: 1.165-2.514; P < 0.01) was positively correlated with CI; age of first onset (OR: 0.974; 95% CI: 0.957-0.991; P < 0.05) and comorbid anxiety disorders (OR: 0.514; 95% CI: 0.332-0.797; P < 0.01) were negatively correlated with CI. LIMITATIONS Biomarkers and neuroimaging were not used to investigate the possible biological mechanism and neural basis of CI in MDD. CONCLUSIONS CI was prominent in adults with acute-onset MDD; male sex and younger age of first onset were independent risk factors, and comorbid anxiety disorders were a protective factor.
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Affiliation(s)
- Meisheng Wang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Deju Yin
- Department of Neurology, Taizhou People's Hospital, Taizhou, China
| | - Lijun Liu
- Department of Psychological Medicine, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Shuzhe Zhou
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Qi Liu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Hongjun Tian
- Nankai University Affiliated Anding Hospital, Tianjin Mental Health Center, Tianjin, China
| | - Jing Wei
- Department of Psychological Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Gang Wang
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qiaoling Chen
- Department of Psychiatry, Dalian Seventh People's Hospital, Dalian, China
| | - Gang Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Xueyi Wang
- Department of Psychiatry, The First Hospital of Hebei Medical University, Mental Health Institute of Hebei Medical University, Shijiazhuang, China
| | - Tianmei Si
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xin Yu
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
| | - Xiaozhen Lv
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), National Health Commission Key Laboratory of Mental Health, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China.
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.
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Shin J, Cho E. Trajectories of depressive symptoms among community-dwelling Korean older adults: findings from the Korean longitudinal study of aging (2006-2016). BMC Psychiatry 2022; 22:246. [PMID: 35395760 PMCID: PMC8991942 DOI: 10.1186/s12888-022-03905-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression among older adults is an important public health concern associated with increased risk of suicide and decreased physical, cognitive, and social functioning. This study identified trajectories of depressive symptoms and investigated predictive variables of group-based trajectory modeling among Korean community-dwelling older adults. METHODS Participants comprised 2016 community-dwelling Korean adults over 65 years. Data from the years 2006-2016 of the Korean Longitudinal Study of Aging, a nationally representative panel survey that has been conducted every two years since 2006, were used. We employed a group-based trajectory modeling analysis to identify depressive symptom trajectories. Multinomial logistic regression analysis was conducted to identify predictors of each class of depressive symptoms. RESULTS Five depressive symptom trajectory groups were identified: Group 1, "None" (28.9%); Group 2, "Slowly worsening" (24.3%); Group 3, "Rapidly worsening" (17.5%); Group 4 "Improving" (12.4%); and Group 5, "Persistently severe" (16.9%). Older adults followed five distinct depressive symptom trajectories over 10 years. Mini-Mental State Examination scores, number of chronic diseases, educational level, and social activity were predictors associated with increasing depressive symptoms. CONCLUSIONS This study showed that many older adults living in the community have depressive symptoms. To prevent and treat depression and aid successful mental health aging among older adults, the development of interventions should be tailored to target specific needs for each symptom trajectory. It is necessary to develop community-based interventions and strategies to identify and prevent depressive symptom trajectories among older adults.
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Affiliation(s)
- Jinhee Shin
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, Republic of Korea
| | - Eunhee Cho
- Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, 606 Nursing Education Building, 50-1 Yonsei-ro, Seodaemoon-Gu, Seoul, 03722, Republic of Korea.
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Yen YC, Chiu NY, Hwang TJ, Su TP, Yang YK, Chen CS, Li CT, Su KP, Lai TJ, Chang CM. A Multi-Center Study for the Development of the Taiwan Cognition Questionnaire (TCQ) in Major Depressive Disorder. J Pers Med 2022; 12:jpm12030359. [PMID: 35330360 PMCID: PMC8949511 DOI: 10.3390/jpm12030359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
Cognitive dysfunction is associated with functional impairment of patients with Major Depressive Disorder (MDD). The goals were to explore the associated factors of cognitive impairment in MDD and to develop and validate a brief and culture-relevant questionnaire, the Taiwan Cognition Questionnaire (TCQ), among patients with MDD. This was a cross-sectional, multi-center observational study of MDD patients in Taiwan. Participants of Group 1 from 10 centers contributed to the validation of the TCQ by their response and sociodemographics. The participants of Group 2 from one center received an objective cognitive assessment for clarification of the relationship between the TCQ score and its associated factors. In Group 1, 493 participants were recruited. As for Group 2, an extra 100 participants were recruited. The global Cronbach’s alpha for the TCQ was 0.908. According to the coordinates of the ROC curve, 9/10 was the ideal cut-off point. With the criteria, the sensitivity/specificity of the TCQ was 0.610/0.689. The TCQ score was positively associated with a history of being admitted to acute psychiatric care and the severity of depression and negatively associated with objective cognitive measures. The TCQ provides a reliable, valid, and convenient measure of subjective cognitive dysfunction in patients with MDD.
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Affiliation(s)
- Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; or
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Nan-Ying Chiu
- Center for Sleep Medicine, Department of Psychiatry, Chang-Hua Christian Medical System, Chang-Hua 500, Taiwan;
- Lukang Christian Hospital, Chang-Hua 505, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei 100, Taiwan;
- School of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan;
- Institute of Philosophy of Mind and Cognition, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei 112, Taiwan
| | - Yen-Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, Tainan 701, Taiwan;
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Psychiatry, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan
| | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan;
- School of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Cheng-Ta Li
- Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei 112, Taiwan;
- Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan;
| | - Kuan-Pin Su
- Mind-Body Interface Laboratory (MBI-Lab), Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
- An-Nan Hospital, China Medical University, Tainan 709, Taiwan
| | - Te-Jen Lai
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan;
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Chia-Ming Chang
- Department of Psychiatry, Chang Gung Memorial Hospital at Linko, Taoyuan 333, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence:
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Amsalem D, Martin A. Reducing depression-related stigma and increasing treatment seeking among adolescents: randomized controlled trial of a brief video intervention. J Child Psychol Psychiatry 2022; 63:210-217. [PMID: 33821507 DOI: 10.1111/jcpp.13427] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Confronting stigma early in life could enhance receptivity to seeking treatment. We evaluated the efficacy of social contact interventions to reduce stigma toward depression and to enhance treatment-seeking intentions among adolescents. We hypothesized that the brief video-based interventions would be more effective than their matched controls. METHOD Using crowdsourcing, we recruited and randomly assigned 1,183 participants aged 14-18 to one of four video-based stimuli on a 4:4:1:1 ratio: (a) adolescent girl with depression; (b) adolescent boy with depression; (c) same girl, without depression; or (d) same boy, without depression. In each of the ~100-second-long videos, two simulated patients (SPs) depicted empowered presenters sharing their personal stories. In the depression conditions, SPs described how social support from family, friends, and professionals helped them overcome their symptoms and recover. RESULTS We found a significant effect for the Depression Stigma Scale (DSS) between active and control groups (F = 27.4, p < .001). We found a significant increase in treatment-seeking intentions, as measured by the General Help-Seeking Questionnaire (GHSQ; p < .001). Secondary analyses revealed that racial (but not gender) congruence between protagonists and participants resulted in greater stigma reduction and treatment seeking, as compared to racially incongruent pairings (t = 2.9, p = .004). CONCLUSION A brief video-based intervention effectively reduced stigma toward depression and increased treatment seeking among adolescents. Favorable changes were greater when race (but not gender) was congruent between protagonists and participants. Future studies should explore how to optimize brief contact-based interventions according to adolescents' race and ethnicity and how to scale such interventions to novel online platforms of dissemination.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Andrés Martin
- Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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23
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Association between abnormal glycolipid level and cognitive dysfunction in drug-naïve patients with bipolar disorder. J Affect Disord 2022; 297:477-485. [PMID: 34715186 DOI: 10.1016/j.jad.2021.10.100] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/13/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Cognitive impairment and abnormal glycolipid metabolism are common clinical features of bipolar disorder (BD). The purpose of this study was to investigate the relationship between conventional glycolipid metabolism indicators and cognitive impairment in patients with BD. METHODS A total of 132 drug-naïve patients with BD and 129 healthy controls (HC) were recruited in the study. Five serum glycolipid metabolism indicators were measured and cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test) for each participant. RESULTS The scores of immediate memory, attention, language and delayed memory in BD group were significantly lower than those in HC group (P < 0.05). The triglyceride (TG) level in BD group was higher than that in HC group (P = 0.011), and the total cholesterol and high-density lipoprotein cholesterol (HDL) levels were lower than those in HC group (P = 0.026; P = 0.001). Regression analysis showed that TG level was significantly correlated with RBANS total score (β = 0.245, P = 0.008), attention (β = 0.289, P = 0.03) and delayed memory (β = 0.221, P = 0.023). Fasting blood glucose (FBG) level was significantly correlated with language subscale score (β = -0.187, P = 0.046) in BD. LIMITATIONS Cross-sectional design and limited control variables. CONCLUSIONS Elevated FBG and TG levels may be associated with cognitive dysfunction in BD patients. Improving glycolipid metabolism in patients with BD may help to improve certain domain-specific cognitive functions.
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24
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Miranda-Olivos R, Testa G, Lucas I, Sánchez I, Sánchez-González J, Granero R, Jiménez-Murcia S, Fernández-Aranda F. Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration. J Psychiatr Res 2021; 144:87-95. [PMID: 34601380 DOI: 10.1016/j.jpsychires.2021.09.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/30/2023]
Abstract
Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jessica Sánchez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Youn H, Hyung WSW, Kim J, Lee ES, Eo JS, Han CE, Han C, Kim SH, Jeong HG. Brain amyloid accumulation possibly exacerbates concurrent mild cognitive impairment with subthreshold depression in older adults: A 1-year follow-up study. J Affect Disord 2021; 295:93-100. [PMID: 34418779 DOI: 10.1016/j.jad.2021.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND This study aimed to investigate the 1-year changes in neuropsychological test results in older adults with concomitant late-life depression (LLD) and mild cognitive impairment (MCI) according to the presence or absence of brain amyloidopathy. METHODS All subjects underwent 18F-florbetaben-positron emission tomography and a standardized neuropsychological battery. The subjects were divided based on brain amyloidopathy and severity of depressive symptoms into the following groups: LLD-MCI-A(+), subthreshold depression (STD)-MCI-A(+), major depressive disorder (MDD)-MCI-A(+), LLD-MCI-A(-), STD-MCI-A(-), and MDD-MCI-A(-). After one year, follow-up neurocognitive tests were conducted. Fifty-nine participants completed both the baseline and 1-year follow-up neurocognitive tests. RESULTS In the LLD-MCI-A(+) group, the word list recall and word list recognition scores decreased during the follow-up period. The STD-MCI-A(+) group also showed a significant decrease in word list recall score and the score/Z-score of word list recognition. On the other hand, the word list recall Z-score improved at the 1-year follow-up in the LLD-MCI-A(-) group. In particular, the MDD-MCI-A(-) group showed significant increases in word list memory score/Z-score and word list recall Z-score during the follow-up period. LIMITATIONS Considering that AD progresses slowly, a longer follow-up period may be required. CONCLUSIONS Our findings showed differences in the extent of change of neuropsychological test results depending on the severity of depressive symptoms and presence or absence of brain amyloidopathy. Our results suggest that clinicians might explore the underlying neuropathology when assessing older adults with concomitant depression and cognitive impairment, even if the symptoms of depression are not severe.
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Affiliation(s)
- HyunChul Youn
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Won Seok William Hyung
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Junhyung Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eun Seong Lee
- Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Cheol E Han
- Department of Electronics and Information Engineering, Korea University, Sejong, Republic of Korea
| | - Changsu Han
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea; Korea University Research Institute of Mental Health, Seoul, Republic of Korea
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26
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Fico G, Anmella G, Gomez-Ramiro M, de Miquel C, Hidalgo-Mazzei D, Manchia M, Alda M, Gonzalez-Pinto A, Carvalho AF, Vieta E, Murru A. Duration of untreated illness and bipolar disorder: time for a new definition? Results from a cross-sectional study. J Affect Disord 2021; 294:513-520. [PMID: 34330047 DOI: 10.1016/j.jad.2021.07.062] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND We primarily aimed to explore the associations between duration of untreated illness (DUI), treatment response, and functioning in a cohort of patients with bipolar disorder (BD). METHODS 261 participants with BD were recruited. DUI was defined as months from the first affective episode to the start of a mood-stabilizer. The functioning assessment short test (FAST) scores and treatment response scores for lithium, valproate, or lamotrigine according to the Alda Scale Total Score (TS) were compared between patients with short (<24 months) or long DUI. Differences in FAST scores among good (GR; TS≥7), poor (PR; TS=2-6), or non-responders (NR; TS<2) to each mood-stabilizer were analyzed. Linear regression was computed using the FAST global score as the dependent variable. RESULTS DUI and FAST scores showed no statistically significant correlation. Patients with a longer DUI showed poorer response to lithium (Z=-3.196; p<0.001), but not to valproate or lamotrigine. Response to lithium (β=-1.814; p<0.001), number of hospitalizations (β=0.237; p<0.001), and illness duration (β=0.160; p=0.028) were associated with FAST total scores. GR to lithium was associated with better global functioning compared to PR or NR [H=27.631; p<0.001]. LIMITATIONS The retrospective design could expose our data to a recall bias. Also, only few patients were on valproate or lamotrigine treatment. CONCLUSIONS Poor functioning in BD could be the result of multiple affective relapses, rather than a direct effect of DUI. A timely diagnosis with subsequent effective prophylactic treatment, such as lithium, may prevent poor functional outcomes in real-world patients with BD.
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Affiliation(s)
- Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Gerard Anmella
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Marta Gomez-Ramiro
- Barcelona Clínic Schizophrenia Unit, Hospital Clínic of Barcelona, Department of Medicine, Neuroscience Institute, Universitat de Barcelona, CIBERSAM, IDIBAPS, Barcelona, Catalonia, Spain
| | - Carlota de Miquel
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Diego Hidalgo-Mazzei
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | | | - Andre F Carvalho
- IMPACT (Innovation in Mental and Physical Health and Clinical Treatment) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain.
| | - Andrea Murru
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, 170 Villarroel st, 12-0, 08036, Barcelona, Catalonia, Spain
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Prevention of Depression in Children, Adolescents, and Young Adults: The Role of Teachers and Parents. PSYCHIATRY INTERNATIONAL 2021. [DOI: 10.3390/psychiatryint2030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Major depressive disorder (MDD) and other affective disorders may surreptitiously arise in children and adolescents during their school period and impair their social and educational functioning. Besides the social and personal burden, which are increased during the SARS-CoV-2 pandemic, the onset of depression may compromise the future of the growing person with chronicity and recurrence. In this context, educators’ training is essential to detect early the onset of a depressive disorder, to spare later consequences through the timely establishment of adequate treatment. The educational staff should receive adequate training to be able to work closely with healthcare providers and parents, thus directing the young person with an affective disorder to the right psychological and pharmacological treatment provider, i.e., a specialized psychologist or psychiatrist. The first approach should be to establish a trustful relationship with the adolescent and his/her classmates, to reduce social and self-stigma and inform about mental illness. If symptoms do not subside and the suffering child or adolescent fails to reintegrate within his/her school environment, cognitive–behavioral interventions are recommended that are individual, group, or computer-based. When needed, these should be implemented with individualized pharmacotherapy.
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Broomfield C, Stedal K, Touyz S. The Neuropsychological Profile of Severe and Enduring Anorexia Nervosa: A Systematic Review. Front Psychol 2021; 12:708536. [PMID: 34408714 PMCID: PMC8365190 DOI: 10.3389/fpsyg.2021.708536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 06/30/2021] [Indexed: 11/13/2022] Open
Abstract
Characteristics of Severe and Enduring Anorexia Nervosa (SE-AN) are being investigated to differentiate the patients experiencing SE-AN from those at earlier stages of the AN disease. The current systematic review was the first step in exploring neuropsychological functioning as a potentially identifying characteristic for long-term presentations. With a subgroup of AN patients reflecting a unique neuropsychological profile that is proportionate to the quantity of patients that go on to develop SE-AN, it was the aim of this review to assess neuropsychological functioning in the later stage of the disease. In accordance with PRISMA guidelines, a literature search was conducted using four electronic databases (PsycINFO, MEDLINE, Web of Science, and Scopus) for neuropsychological research on AN participants with a seven or more year illness duration. Datasets that met inclusion criteria were screened for SE-AN participants (N = 166) and neuropsychological data extracted together with potentially confounding variables and information required to conduct a quality assessment. In research investigating decision-making, participants with a SE-AN presentation demonstrated significantly lower functioning compared to healthy controls. There was conflicting evidence for differences in intellectual functioning and set-shifting abilities with no variability indicated in central coherence, memory, attention, reasoning, or processing speed. If findings from this preliminary analysis are confirmed through empirical research, implications include earlier identification of SE-AN patients and more effective treatment development.
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Affiliation(s)
| | - Kristin Stedal
- Regional Department for Eating Disorders, Oslo University Hospital, Ullevål, Norway
| | - Stephen Touyz
- Inside Out Institute, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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Menculini G, Verdolini N, Brufani F, Pierotti V, Cirimbilli F, Di Buò A, Spollon G, De Giorgi F, Sciarma T, Tortorella A, Moretti P. Comorbidities, Depression Severity, and Circadian Rhythms Disturbances as Clinical Correlates of Duration of Untreated Illness in Affective Disorders. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:459. [PMID: 34066782 PMCID: PMC8150538 DOI: 10.3390/medicina57050459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 12/20/2022]
Abstract
Background and Objectives: Affective disorders, namely bipolar (BDs) and depressive disorders (DDs) are characterized by high prevalence and functional impairment. From a dimensional point of view, BDs and DDs can be considered as psychopathological entities lying on a continuum. A delay in treatment initiation might increase the burden associated with affective disorders. The aim of this study is to analyze the correlates of a long duration of untreated illness (DUI) in these conditions. Materials and Methods: Subjects with BDs and DDs, both in- and outpatients, were recruited. Long DUI was defined according to previous research criteria as >2 years for BDs or >1 year for DDs. Socio-demographic, clinical and psychopathological characteristics of the recruited subjects were collected. Bivariate analyses were performed to compare subjects with a long and short DUI (p < 0.05). Results: In our sample (n = 61), 34.4% of subjects presented a long DUI. A long DUI was significantly associated with longer overall illness duration (p = 0.022) and a higher rate of psychiatric (p = 0.048) and physical comorbidities (p = 0.023). As for psychopathological features, depressive symptoms were more severe in the long DUI subgroup, as demonstrated by a higher score at the Clinical Global Impression-severity of depression (p = 0.012) item and at the anxiety/depression factor of the Positive and Negative Syndrome Scale (p = 0.041). Furthermore, subjects with a long DUI displayed more severe disruption of circadian rhythms, as evaluated by the Biological Rhythms Interview for Assessment in Neuropsychiatry total (p = 0.044) and social domain (p = 0.005) scores and by the Hamilton Depression Rating Scale diurnal variation items (18a: p = 0.029, 18b: p = 0.047). Conclusions: A long DUI may underpin higher clinical severity, as well as worse illness course and unfavorable prognosis in affective disorders. Intervention strategies targeting comorbidities, depressive symptoms and circadian rhythms may decrease disease burden in subjects with a long DUI.
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Affiliation(s)
- Giulia Menculini
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Institute of Neuroscience, 08036 Barcelona, Spain;
| | - Francesca Brufani
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Valentina Pierotti
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Federica Cirimbilli
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Santa Maria Della Misericordia Hospital, 06132 Perugia, Italy; (F.C.); (F.D.G.)
| | - Agata Di Buò
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Giulio Spollon
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Filippo De Giorgi
- Section of Psychiatry, Clinical Psychology and Rehabilitation, Santa Maria Della Misericordia Hospital, 06132 Perugia, Italy; (F.C.); (F.D.G.)
| | - Tiziana Sciarma
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Alfonso Tortorella
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
| | - Patrizia Moretti
- Department of Psychiatry, University of Perugia, 06132 Perugia, Italy; (G.M.); (F.B.); (V.P.); (A.D.B.); (G.S.); (T.S.); (A.T.)
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Adamo D, Pecoraro G, Coppola N, Calabria E, Aria M, Mignogna M. Vortioxetine versus other antidepressants in the treatment of burning mouth syndrome: An open-label randomized trial. Oral Dis 2020; 27:1022-1041. [PMID: 32790904 DOI: 10.1111/odi.13602] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES This randomized open-label trial compared the efficacy and tolerability of vortioxetine (15 mg/daily) with different antidepressants in the treatment of patients with burning mouth syndrome (BMS). METHODS One and hundred fifty BMS patients were randomized into five groups and treated with either vortioxetine, paroxetine (20 mg/daily), sertraline (50 mg/daily), escitalopram (10 mg/daily) or duloxetine (60 mg/daily). The Visual Analogue Scale (VAS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A), and Clinical Global Impression Improvement (CGI-I) and Efficacy scales (CGI-E) were performed at baseline and after 2, 4, 6, and 12 months of treatment. Any adverse events (AEs) were tabulated for each group. Descriptive statistics, including the Kruskal-Wallis non-parametric test and the Friedman non-parametric test for median comparisons between different times, were used. RESULTS All the antidepressants (AD) were associated with a significant decrease in the VAS, T-PRI, HAM-A, HAM-D, CGI-I, and CGI-E scores in the long-term (p < .001). However, the response rate of the vortioxetine group showed a significant reduction after six months. The medians, after 6 months, were as follows: VAS 0.0; T-PRI 2.0; HAM-A 7.0; HAM-D 7.0; CGI-I 1.0; and CGI-E 1.0 with a lower incidence of AEs (p < .019). CONCLUSION Vortioxetine was efficacious with a shorter latency of action and fewer AEs compared with other ADs.
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Affiliation(s)
- Daniela Adamo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Giuseppe Pecoraro
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Noemi Coppola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Elena Calabria
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Michele Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
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