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Sipowicz K, Pietras T, Mosiołek A, Sobstyl M, Ring M, Kamecki K, Stefańczyk I, Kosmalski M. The sense of loneliness and meaning in life in post-COVID convalescents-a preliminary study. Front Psychiatry 2023; 14:1296385. [PMID: 38188044 PMCID: PMC10768000 DOI: 10.3389/fpsyt.2023.1296385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction The COVID-19 epidemic has provided opportunity to study the impact of a well-defined severe illness on the development of a depressive episode and the associated sense of loneliness and lack of meaning in life. Materials and Methods The aim of the study was to assess the occurrence of a reactive depressive episode, the severity of depression, a sense of loneliness and meaning in life in subjects who approximately a year earlier than the date of the study had suffered from a pulmonary form of SARS-CoV-2 infection with radiologically documented interstitial lesions of the lungs, requiring and not requiring hospitalization compared to people who did not develop the disease as a result of infection with that virus. The study included 63 subjects hospitalized for pulmonary lesions, 67 not hospitalized and 60 healthy controls. The severity of depressive symptoms was measured using a Polish-language standardized version of the Beck Depression Inventory, a sense of loneliness using the De Jong Gierveld Loneliness Scale, and a sense of meaning in life using the Life Attitude Profile-Revised. Results The frequency of depression and its severity were found to be the highest in hospitalized patients compared to those treated at home and healthy people. A significant difference in the frequency of depression and its severity between outpatients and healthy people was also observed. The feeling of loneliness turned out to be greatest in the group of hospitalized people. Also, the severity of loneliness was found to be higher in the outpatient compared to the control group. The sense of meaning in life reached its lowest level among hospitalized patients, was moderately reduced in the outpatient group, and typical of the Polish population in the control group. Discussion Both pulmonary SARS-CoV-2 infection and hospitalization have been shown to be a risk factor for depression, increased feeling of loneliness and a reduced sense of meaning in life. The effect of trauma and the presence of depression can be the explanation for the increased sense of loneliness after the illness and the partial breakdown of the lifeline manifested by a decrease in the sense of meaning in life.
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Affiliation(s)
- Kasper Sipowicz
- Department of Interdisciplinary Disability Studies, The Maria Grzegorzewska University in Warsaw, Warsaw, Poland
| | - Tadeusz Pietras
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
| | - Anna Mosiołek
- Department of Forensic Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
| | - Michał Sobstyl
- Neurosurgery Department, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
| | - Michał Ring
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
| | - Krystian Kamecki
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
| | - Ignacy Stefańczyk
- The Second Department of Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Warsaw, Poland
| | - Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, Lodz, Poland
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2
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Arıkan MK, İlhan R, Pogarell O, Metin B. When to stop medication in unipolar depression: A systematic review and a meta-analysis of randomized controlled trials. J Affect Disord 2023; 325:7-13. [PMID: 36623560 DOI: 10.1016/j.jad.2023.01.024] [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: 07/28/2022] [Revised: 12/26/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Currently, there is no clear answer to the question of how long antidepressants should be continued or when they can be safely discontinued. METHODS Pubmed/Medline was systematically searched from inception to Feb 20, 2021. Double-blind, randomized placebo-controlled trials (RCTs) with maintenance phase were selected to examine the relationship between relapse rate and treatment duration. Among 5351 screened records, 37 RCTs meeting inclusion criteria were selected. Odds ratios were calculated from relapse rates for each study and pooled in random-effect models. Possible predictors of effect sizes, i.e., open-label treatment duration, double-blind phase duration, age, medication type, history of recurrence, were analyzed by meta-regression. RESULTS The random-effects model showed the superiority of active medication over placebo for relapse during the follow-up phase (OR = 0.37; 95 % CI, 0.32-0.42). The meta-regression did not show a relationship between treatment duration and the effect sizes. Other clinical variables were not related with effect sizes. Subgroup analysis revealed that, for atypical ADs the effect size increased as the treatment duration increased. Further analysis showed that the relapse rate in the placebo group decreased as function of time, which reduced the absolute benefit of continued treatment. CONCLUSION The results may indicate that long term use of antidepressants may not be justified, and this strategy may expose the patients to more adverse effects.
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Affiliation(s)
| | - Reyhan İlhan
- Kemal Arıkan Psychiatry Clinic, Istanbul, Turkey
| | - Oliver Pogarell
- Department of Psychiatry, Division of Clinical Neurophysiology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Barış Metin
- Department of Neurology, Medical Faculty, Uskudar University, Istanbul, Turkey.
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3
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Sun JF, Chen LM, He JK, Wang Z, Guo CL, Ma Y, Luo Y, Gao DQ, Hong Y, Fang JL, Xu FQ. A Comparative Study of Regional Homogeneity of Resting-State fMRI Between the Early-Onset and Late-Onset Recurrent Depression in Adults. Front Psychol 2022; 13:849847. [PMID: 35465554 PMCID: PMC9021891 DOI: 10.3389/fpsyg.2022.849847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/11/2022] [Indexed: 12/24/2022] Open
Abstract
Background Neurobiological mechanisms underlying the recurrence of major depressive disorder (MDD) at different ages are unclear, and this study used the regional homogeneity (ReHo) index to compare whether there are differences between early onset recurrent depression (EORD) and late onset recurrent depression (LORD). Methods Eighteen EORD patients, 18 LORD patients, 18 young healthy controls (HCs), and 18 older HCs were included in the rs-fMRI scans. ReHo observational metrics were used for image analysis and further correlation of differential brain regions with clinical symptoms was analyzed. Results ANOVA analysis revealed significant differences between the four groups in ReHo values in the prefrontal, parietal, temporal lobes, and insula. Compared with EORD, the LORD had higher ReHo in the right fusiform gyrus/right middle temporal gyrus, left middle temporal gyrus/left angular gyrus, and right middle temporal gyrus/right angular gyrus, and lower ReHo in the right inferior frontal gyrus/right insula and left superior temporal gyrus/left insula. Compared with young HCs, the EORD had higher ReHo in the right inferior frontal gyrus/right insula, left superior temporal gyrus/left insula, and left rolandic operculum gyrus/left superior temporal gyrus, and lower ReHo in the left inferior parietal lobule, right inferior parietal lobule, and left middle temporal gyrus/left angular gyrus. Compared with old HCs, the LORD had higher ReHo in the right fusiform gyrus/right middle temporal gyrus, right middle temporal gyrus/right angular gyrus, and left rolandic operculum gyrus/left superior temporal gyrus, and lower ReHo in the right inferior frontal gyrus/right insula. ReHo in the right inferior frontal gyrus/right insula of patients with LORD was negatively correlated with the severity of 17-item Hamilton Rating Scale for Depression (HAMD-17) scores (r = −0.5778, p = 0.0120). Conclusion Adult EORD and LORD patients of different ages have abnormal neuronal functional activity in some brain regions, with differences closely related to the default mode network (DMN) and the salience network (SN), and patients of each age group exhibit ReHo abnormalities relative to matched HCs. Clinical Trial Registration [http://www.chictr.org.cn/], [ChiCTR1800014277].
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Affiliation(s)
- Ji-Fei Sun
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Li-Mei Chen
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jia-Kai He
- Graduate School of China Academy of Chinese Medical Sciences, Beijing, China.,Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhi Wang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Chun-Lei Guo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Ma
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi Luo
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.,Graduate School of China Academy of Chinese Medical Sciences, Beijing, China
| | - De-Qiang Gao
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yang Hong
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji-Liang Fang
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Feng-Quan Xu
- Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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4
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Tokariev A, Oberlander VC, Videman M, Vanhatalo S. Cortical Cross-Frequency Coupling Is Affected by in utero Exposure to Antidepressant Medication. Front Neurosci 2022; 16:803708. [PMID: 35310093 PMCID: PMC8927083 DOI: 10.3389/fnins.2022.803708] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/27/2022] [Indexed: 11/24/2022] Open
Abstract
Up to five percent of human infants are exposed to maternal antidepressant medication by serotonin reuptake inhibitors (SRI) during pregnancy, yet the SRI effects on infants’ early neurodevelopment are not fully understood. Here, we studied how maternal SRI medication affects cortical frequency-specific and cross-frequency interactions estimated, respectively, by phase-phase correlations (PPC) and phase-amplitude coupling (PAC) in electroencephalographic (EEG) recordings. We examined the cortical activity in infants after fetal exposure to SRIs relative to a control group of infants without medical history of any kind. Our findings show that the sleep-related dynamics of PPC networks are selectively affected by in utero SRI exposure, however, those alterations do not correlate to later neurocognitive development as tested by neuropsychological evaluation at two years of age. In turn, phase-amplitude coupling was found to be suppressed in SRI infants across multiple distributed cortical regions and these effects were linked to their neurocognitive outcomes. Our results are compatible with the overall notion that in utero drug exposures may cause subtle, yet measurable changes in the brain structure and function. Our present findings are based on the measures of local and inter-areal neuronal interactions in the cortex which can be readily used across species, as well as between different scales of inspection: from the whole animals to in vitro preparations. Therefore, this work opens a framework to explore the cellular and molecular mechanisms underlying neurodevelopmental SRI effects at all translational levels.
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Affiliation(s)
- Anton Tokariev
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- *Correspondence: Anton Tokariev,
| | - Victoria C. Oberlander
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Mari Videman
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Pediatric Neurology, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Sampsa Vanhatalo
- Department of Clinical Neurophysiology, BABA Center, New Children’s Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
- Department of Physiology, University of Helsinki, Helsinki, Finland
- Sampsa Vanhatalo,
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5
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Calati R. Augmentation/Combination Strategies in Psychotherapy: The Need of Clear Guidelines and Future Research. Neuropsychobiology 2022; 80:516-517. [PMID: 33857950 DOI: 10.1159/000515932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/15/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Raffaella Calati
- Department of Psychology, University of Milan-Bicocca, Milan, Italy.,Department of Adult Psychiatry, Nîmes University Hospital, Nîmes, France
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6
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Jiang X, Zhao B, Nam EW, Kong F. Assessing Knowledge, Preventive Practices, and Depression Among Chinese International Students and Local Korean Students in South Korea During the COVID-19 Pandemic: An Online Cross-Sectional Study. Front Psychiatry 2022; 13:920887. [PMID: 35815006 PMCID: PMC9258509 DOI: 10.3389/fpsyt.2022.920887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Depression among university students and international university students is an increasing problem globally. This study aimed to clarify the differences on the conditions and determinants of the knowledge, preventive practices and depression of the Chinese international students and local Korean students in South Korea during the COVID-19 pandemic. An online cross-sectional questionnaire including general demographic characteristics, COVID-19-related knowledge, preventive practice, and the Patient Health Questionnaire (PHQ-9) was applied from March 23 to April 22, 2020. A total of 533 university students (171 Chinese international students and 362 local South Korean students) were included in the study. The majority of both Chinese international students and local South Korean students had a good comprehension of COVID-19. Chinese international students in South Korea showed better preventive practice than local Korean students, while the proportion of moderate to severe depression of Chinese international students was relatively higher (28.07%) than that of local Korean students (22.38%). Determinants of depression of Chinese international students in South Korea were information satisfaction, likelihood of survival after infection, symptoms of a cough and feelings of discrimination, while for local Korean students were gender, educational level, family, suspected symptoms, self-assessed physical health status, COVID-19 detection, population contact history and online sources of information. These results could be used as a reference for decreasing the depressive symptoms among the university students.
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Affiliation(s)
- Xiaoxu Jiang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
| | - Bo Zhao
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea.,Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Eun Woo Nam
- Department of Health Administration, Graduate School, Yonsei University, Wonju, South Korea.,Yonsei Global Health Center, Yonsei University, Wonju, South Korea
| | - Fanlei Kong
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China
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7
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Wang P, Zhang N, Ma S, Kang L, Wang W, Zong X, Bai H, Li R, Liu Z. Dysfunctional Attitudes Mediate the Relationship Between Childhood Emotional Neglect and Anhedonia in Young Adult Major Depression Patients. Front Psychiatry 2022; 13:791230. [PMID: 35153876 PMCID: PMC8829348 DOI: 10.3389/fpsyt.2022.791230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Childhood traumas are well-established risk factors for major depressive disorder (MDD). However, the relationship between childhood traumas types and MDD symptoms is unclear. The present study tested the hypothesis that childhood traumas affect specific types of anhedonia in depression and the mediating role of dysfunctional attitude. METHODS Within this cross-sectional study, 310 young adult patients with MDD completed the PHQ-9, CTQ-SF, DAS, and SHAPS. The statistical analyses used the Mann-Whitney U test, Spearman's rank correlation, and multiple regression analysis. Mediation analyses were tested by the structural equation model (SEM). RESULTS Spearman's rank correlation analysis showed positive correlations between the SHAPS, CTQ-SF, and DAS total score (p < 0.05). The EA, EN, PN, and SHAPS scores were positively correlated (p < 0.05). Among the four factors of anhedonia, social interaction and interest/pastimes were positively correlated with EA, EN, and PN (p < 0.05), the sensory experience was positively correlated with EN (p < 0.01), and diet did not correlate with childhood traumas. Stepwise regression analysis showed that dysfunctional attitude and emotional neglect were the main influencing factors of sensory experience (p < 0.001) and social interaction (p < 0.001). Dysfunctional attitude and physical neglect were the main factors influencing interest/pastimes (p < 0.001). SEM analysis found that dysfunctional mediated between childhood traumas and anhedonia. CONCLUSIONS The degree of anhedonia was related to dysfunctional attitudes and childhood traumas. The childhood emotional neglect experience was the most important and was related to sensory and social anhedonia. Dysfunctional attitudes played a mediating role between childhood neglect and anhedonia. Early psychotherapy targeting young adult MDD patients with childhood emotional neglect may help decrease symptoms of anhedonia.
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Affiliation(s)
- Peilin Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Nan Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Simeng Ma
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijun Kang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaofen Zong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hanping Bai
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ruiting Li
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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8
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Qian H, Shu C, Feng L, Xiang J, Guo Y, Wang G. Childhood Maltreatment, Stressful Life Events, Cognitive Emotion Regulation Strategies, and Non-suicidal Self-Injury in Adolescents and Young Adults With First-Episode Depressive Disorder: Direct and Indirect Pathways. Front Psychiatry 2022; 13:838693. [PMID: 35492724 PMCID: PMC9039129 DOI: 10.3389/fpsyt.2022.838693] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Childhood maltreatment (CM), stressful life events (SLE), and cognitive emotion regulation strategies (CERS) have been considered crucial in the development of non-suicidal self-injury (NSSI) and major depressive disorder (MDD), but the pathways of this association are not clear. We aim to identify direct effects of CM and SLE on NSSI and depression severity and its indirect effects via CERS in adolescents and young adults with a diagnosis of MDD. METHODS A total of 114 patients (aged 14-24 years) with first episode MDD were included and further divided into the NSSI group (n = 56) and non-NSSI group (n = 58) according to the DSM-5 criteria. Diagnostic interviews and self-report measures were conducted to assess CM, SLE, CERS, and diagnose NSSI. Severity of depressive symptoms was measured using the Hamilton Rating Scale (HAMD). The structural equation model was used to assess the pathways. RESULTS MDD patients with NSSI had more frequent family history of mental illness, more experience of CM and SLE, more serious depression, less use of adaptive CERS, and more use of maladaptive CERS. In the final structural equation model (χ2 = 4.82, df = 6, p = 0.57, CFI = 1.0, TLI = 1.10, and RMSEA = 0), the experience of CM and SLE showed a significant indirect effect on NSSI through adaptive CERS. CM and SLE only had direct effects on depression severity. CONCLUSIONS NSSI are prevalent in adolescents and young adults with MDD and highly intertwined with CM, SLE, and CERS. Adaptive CERS, not maladaptive CERS may be a possible mechanism relating CM and SLE to NSSI in MDD patients.
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Affiliation(s)
- Hong Qian
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chang Shu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Feng
- Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junyi Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ying Guo
- Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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9
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Williams K, Hartley S, Langer S, Manandhar‐Richardson M, Sinha M, Taylor P. A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression. Clin Psychol Psychother 2022; 29:1494-1514. [PMID: 35912665 PMCID: PMC9805101 DOI: 10.1002/cpp.2773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Mindfulness-based Cognitive Therapy (MBCT) is a relapse-prevention intervention for people experiencing major depression. Three qualitative meta-syntheses investigating experiences of taking part in MBCT and/or Mindfulness-based Stress Reduction (MBSR) across different diagnostic populations reported themes including control, choice, group processes, relationships and struggles. As multiple studies have been published since, we aimed to update, systematically review and synthesize the experiences of participants with depression taking part in MBCT. METHODS Four databases were searched systematically (PsycInfo, Web of Science, Medline and CINAHL) up to and including 12 November 2021. Twenty-one qualitative studies met the review criteria. All papers were rated as fair using a quality appraisal tool. Meta-ethnography was applied. RESULTS Across 21 studies of participants with current or previous depression who had participated in MBCT, three overarching themes were developed: 'Becoming skilled and taking action', 'Acceptance' and 'Ambivalence and Variability'. Participants became skilled through engagement in mindfulness practices, reporting increased awareness, perspective and agency over their experiences. Participants developed acceptance towards their experiences, self and others. There was variability and ambivalence regarding participants' expectations and difficulties within mindfulness practices. LIMITATIONS Many studies were conducted in MBCT-research centres that may hold conflicts of interest. Many studies did not address the impact of the participant-researcher relationship thus potentially affecting their interpretations. Studies were skewed towards the experiences of female participants. CONCLUSIONS Our findings help to enhance participant confidence in MBCT, alongside understanding the processes of change and the potential for difficulties. MBCT is beneficial and provides meaningful change for many but remains challenging for some.
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Affiliation(s)
- Kate Williams
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK,Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | - Samantha Hartley
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK,Pennine Care NHS Foundation TrustAshton‐under‐LyneUK
| | - Susanne Langer
- Department of Psychology, Faculty of Health, Psychology, and Social CareManchester Metropolitan UniversityManchesterUK
| | | | - Melissa Sinha
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK,Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Peter Taylor
- Division of Psychology & Mental Health, School of Health SciencesUniversity of Manchester, Manchester Academic Health Sciences CentreManchesterUK
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10
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Cosci F, Fava GA. Prescribing Pharmacotherapy for Major Depressive Disorder: How Does a Clinician Decide? Biomed Hub 2021; 6:118-121. [PMID: 34950673 PMCID: PMC8647051 DOI: 10.1159/000519656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
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11
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Zhang Y, Liu X, Hou Z, Yin Y, Xie C, Zhang H, Zhang H, Kong Y, Gao S, Zhang Z, Yuan Y. Global topology alteration of the brain functional network affects the 8-week antidepressant response in major depressive disorder. J Affect Disord 2021; 294:491-496. [PMID: 34330044 DOI: 10.1016/j.jad.2021.07.078] [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: 03/01/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Previous studies have indicated that the global topology of the brain functional network in patients with major depressive disorder (MDD) differs from that of those with normal controls (NCs). However, the relationship between an altered global topology and the response to antidepressants remains unclear. Here, we investigated whether differences in global topology affect the efficacy of antidepressants in MDD patients. METHODS 108 MDD patients and 61 NCs were recruited. A magnetic resonance imaging (MRI) scan was performed at the baseline, and the Hamilton Depression Scale-24 (HAMD-24) was assessed at baseline and after 2 and 8 weeks of antidepressant treatment. Seven global topological parameters of the brain functional network were measured and compared between groups. A correlation analysis was performed to identify the relationships between global topological parameters and antidepressant efficacy. RESULTS The brain networks of MDD patients and NCs were both small-world networks. The clustering coefficient (Cp) and local efficiency (Eloc) were significantly smaller in MDD patients compared with those in NCs. The characteristic path length (Lp) were negatively correlated with the 8-week reductive rate of HAMD-24 in the MDD group. CONCLUSION The present research found that the brain functional network of MDD patients still had a small-world organization but with a lower Cp and Eloc than the NCs. In addition, the brain network global topology might have an impact on the antidepressant response and thus had the potential to become a treatment predictor of MDD.
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Affiliation(s)
- Yanran Zhang
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xiaoyun Liu
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, School of Medicine, ZhongDa Hospital, Southeast University, Nanjing, China
| | - Haisan Zhang
- Department of Clinical Magnetic Resonance Imaging, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Hongxing Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Youyong Kong
- Lab of Image Science and Technology, School of Computer Science and Engineering, Key Laboratory of Computer Network and Information Integration, Ministry of Education, Southeast University, Nanjing, China
| | - Shuwen Gao
- Lab of Image Science and Technology, School of Computer Science and Engineering, Key Laboratory of Computer Network and Information Integration, Ministry of Education, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, School of Medicine, ZhongDa Hospital, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics and Psychiatry, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, China.
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Wang J, Cosci F. Neonatal Withdrawal Syndrome following Late in utero Exposure to Selective Serotonin Reuptake Inhibitors: A Systematic Review and Meta-Analysis of Observational Studies. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:299-307. [PMID: 33971648 DOI: 10.1159/000516031] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/20/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION A clear picture of neonatal withdrawal signs due to in utero selective serotonin reuptake inhibitor (SSRI) exposure and its consequences is still missing. OBJECTIVE A systematic review and a meta-analysis were performed to provide an overview of neonatal withdrawal signs following late in utero exposure to SSRIs and to quantify the corresponding risks. METHODS MEDLINE, Web of Science, and Embase were searched from inception to January 2021. The Meta-Analysis of Observational Studies in Epidemiology (MOOSE) guidelines were followed. English-language observational studies reporting on acute postpartum outcomes following late in utero exposure to SSRIs or SSRIs/venlafaxine were evaluated. RESULTS Of 2,269 citations reviewed, 79 studies were assessed for eligibility; 13 were included in the qualitative analysis of the literature, which allowed us to identify 26 signs. A meta-analysis was run separately for studies on SSRI exposure (n = 3) and those on SSRI/venlafaxine exposure (n = 6). Hypoglycemia was identified as a withdrawal sign based on the SSRI studies. Tremors, hypotonia, tachycardia, rapid breathing, respiratory distress, and hypertonia were identified as withdrawal signs based on the SSRI/venlafaxine studies. CONCLUSIONS The present work provides a framework for the identification of neonatal SSRI withdrawal syndrome. Tapering and discontinuation of antidepressant drugs before and during the early phase of pregnancy are worth attempting to prevent the occurrence of this syndrome.
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Affiliation(s)
- Jianjun Wang
- Department of Neurology and Psychology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Clinical Pharmacopsychology Laboratory, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Cosci F, Fava GA. When Anxiety and Depression Coexist: The Role of Differential Diagnosis Using Clinimetric Criteria. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 90:308-317. [PMID: 34344013 DOI: 10.1159/000517518] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 05/31/2021] [Indexed: 11/19/2022]
Abstract
Depressive and anxiety disorders are frequently associated. Depression may be a complication of anxiety and anxiety can complicate depression. The nature of their relationship has been a source of controversy. Reviews generally base their conclusions on randomized controlled trials and meta-analyses that refer to the average patient and often clash with the variety of clinical presentations that may occur when anxiety and depression coexist. The aim of this review was to examine the literature according to profiling of subgroups of patients based on clinimetric criteria, in line with the recently developed concept of medicine-based evidence. We critically reviewed the literature pertaining to the specific presentations of anxiety and depression, outlining the advantages and disadvantages of each treatment approach. The following prototypic cases were presented: depression secondary to an active anxiety disorder, depression in patients with anxiety disorders under treatment, anxious depression, anxiety as a residual component of depression, and demoralization secondary to anxiety disorder. We argue that the selection of treatment when anxiety and depression coexist should take into account the modalities of presentation and be filtered by clinical judgment. Very different indications may ensue when the literature is examined according to this perspective.
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Affiliation(s)
- Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, New York, New York, USA
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