1
|
Hobden B, Bryant J, Davis R, Heard T, Rumbel J, Newman J, Rose B, Lambkin D, Sanson-Fisher R, Freund M. Co-occurring psychological distress and alcohol or other drug use among Indigenous Australians: Data from the National Aboriginal and Torres Strait Islander Health Survey. Aust N Z J Psychiatry 2024; 58:668-677. [PMID: 38581252 PMCID: PMC11308262 DOI: 10.1177/00048674241244601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
OBJECTIVES To determine the prevalence and demographic, social and health characteristics associated with co-occurring psychological distress symptoms, risky alcohol and/or substance use among a national sample of Aboriginal and Torres Strait Islander people aged 15 years or older. METHODS This study uses secondary cross-sectional data from the 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). Data were collected via face-to-face interviews with those living in private dwellings across Australia. Participants were Aboriginal and Torres Strait Islander people (n = 10,579) aged 15 years or older. Data pertaining to psychological distress, alcohol and substance use were obtained and weighted to represent the total population of Aboriginal and Torres Strait Islander people in Australia. RESULTS A total of 20.3% participants were found to have co-occurring psychological distress, risky alcohol use and/or substance use, and 4.0% reported co-occurrence of all three conditions. Female participants in a registered marriage and fully engaged in study or employment had lower rates of co-occurring conditions. Poorer self-rated health, one or more chronic conditions and increased experiences of unfair treatment and physical harm in the past 12 months were associated with increased rates of co-occurring conditions. CONCLUSION A range of potential risk and protective factors were identified for co-occurring psychological distress, risky alcohol and/or substance use among Aboriginal and Torres Strait Islander people. This information is critical for planning effective holistic strategies to decrease the burden of suffering imposed upon the individual, family and community members impacted by co-occurring conditions.
Collapse
Affiliation(s)
- Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jamie Bryant
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Robert Davis
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Todd Heard
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Wiyiliin ta CAMHS, Hunter New England Local Health District, NSW Health, Newcastle, NSW, Australia
- Systems Neuroscience Group, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Jenn Rumbel
- Systems Neuroscience Group, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
- Wollotuka Institute, Purai Global Indigenous History Centre, The University of Newcastle, Callaghan, NSW, Australia
| | - Jamie Newman
- Orange Aboriginal Medical Service, Orange, NSW, Australia
| | - Bron Rose
- Yimamulinbinkaan, Aboriginal Mental Health Service & Social Emotional Wellbeing Workforce, Hunter New England Mental Health Service, Hunter New England Local Health District, NSW Health, Newcastle, NSW, Australia
| | - David Lambkin
- Clinical Research Design and Statistics, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Megan Freund
- Health Behaviour Research Collaborative, School of Medicine and Public Health, College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- Equity in Health and Wellbeing Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| |
Collapse
|
2
|
Farré X, Blay N, Espinosa A, Castaño-Vinyals G, Carreras A, Garcia-Aymerich J, Cardis E, Kogevinas M, Goldberg X, de Cid R. Decoding depression by exploring the exposome-genome edge amidst COVID-19 lockdown. Sci Rep 2024; 14:13562. [PMID: 38866890 PMCID: PMC11169603 DOI: 10.1038/s41598-024-64200-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 06/06/2024] [Indexed: 06/14/2024] Open
Abstract
Risk of depression increased in the general population after the COVID-19 pandemic outbreak. By examining the interplay between genetics and individual environmental exposures during the COVID-19 lockdown, we have been able to gain an insight as to why some individuals are more vulnerable to depression, while others are more resilient. This study, conducted on a Spanish cohort of 9218 individuals (COVICAT), includes a comprehensive non-genetic risk analysis, the exposome, complemented by a genomics analysis in a subset of 2442 participants. Depression levels were evaluated using the Hospital Anxiety and Depression Scale. Together with Polygenic Risk Scores (PRS), we introduced a novel score; Poly-Environmental Risk Scores (PERS) for non-genetic risks to estimate the effect of each cumulative score and gene-environment interaction. We found significant positive associations for PERSSoc (Social and Household), PERSLife (Lifestyle and Behaviour), and PERSEnv (Wider Environment and Health) scores across all levels of depression severity, and for PRSB (Broad depression) only for moderate depression (OR 1.2, 95% CI 1.03-1.40). On average OR increased 1.2-fold for PERSEnv and 1.6-fold for PERLife and PERSoc from mild to severe depression level. The complete adjusted model explained 16.9% of the variance. We further observed an interaction between PERSEnv and PRSB showing a potential mitigating effect. In summary, stressors within the social and behavioral domains emerged as the primary drivers of depression risk in this population, unveiling a mitigating interaction effect that should be interpreted with caution.
Collapse
Affiliation(s)
- Xavier Farré
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Natalia Blay
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Ana Espinosa
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Castaño-Vinyals
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Anna Carreras
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisabeth Cardis
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Ximena Goldberg
- ISGlobal, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
- CIBER Salud Mental (CIBERSAM), Madrid, Spain.
| | - Rafael de Cid
- Genomes for Life-GCAT Lab, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
- Research Group on the Impact of Chronic Diseases and Their Trajectories (GRIMTra), Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain.
| |
Collapse
|
3
|
Dong X, Li Y, Wang X, Duan Y, Liu M, Wang S, He X, Yang P, Wang Y, Xie J, Cheng ASK. Bidirectional associations between dietary diversity and depressive symptoms in Chinese adult women: A retrospective cohort study. J Affect Disord 2024; 351:683-693. [PMID: 38316259 DOI: 10.1016/j.jad.2024.01.258] [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: 12/15/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE This study aimed to examine the bidirectional associations between dietary diversity and clinical depressive symptoms in adult women, and influencing factors of clinical depressive symptoms. METHODS This longitudinal study included a total of 22,385 participants, each of whom underwent at least two data collections. We used convenience sampling to recruit women from a health management center of a general hospital in southern China from April 2015 to December 2021. They completed an online self-reported health questionnaire, which included demographic characteristics, lifestyle information, the Dietary Diversity Scale (DDS), and the Patient Health Questionnaire-9. RESULTS New-onset depressive symptoms and low dietary diversity were observed in this study among 1285 and 3223 participants, respectively. Negative associations were observed between baseline low dietary diversity and new-onset depressive symptoms (P < 0.05) and between baseline depressive symptoms and low dietary diversity (P < 0.001). Cross-lagged panel analysis indicated that dietary diversity negatively and prospectively predicted depressive symptoms, but vice versa (P < 0.05). Strong evidence of a nonlinear association between DDS scores and incident depressive symptoms was found (P nonlinear < 0.05) regardless of whether the variables were adjusted. Besides, age, menarche age, physical activity, sleep duration, longer sedentary behavior and other lifestyle factors were influencing factors of depressive symptoms (P < 0.05). CONCLUSIONS The present study identified bidirectional associations between dietary diversity and depressive symptoms, and the associations were found to have a non-linear pattern. Adherence to dietary diversity and a healthy lifestyle could be effective non-pharmacological preventive measures to reduce the incidence of depressive symptoms.
Collapse
Affiliation(s)
- Xiaoqian Dong
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410000, China; Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Ying Li
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410000, China.
| | - Xingxing Wang
- Xiangya Nursing School, Central South University, Changsha, Hunan, China
| | - Yinglong Duan
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Min Liu
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sha Wang
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xue He
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410000, China
| | - Pingting Yang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410000, China
| | - Yaqin Wang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha 410000, China.
| | - Jianfei Xie
- Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Andy S K Cheng
- The Hong Kong Polytechnic University, Department of Rehabilitation Sciences, Hong Kong, China.
| |
Collapse
|
4
|
Constant A, Som M, Val-Laillet D, Moirand R, Thibault R. Exploring sub-threshold food addiction in adult patients with severe obesity: a cross-sectional analysis. J Addict Dis 2024:1-7. [PMID: 38504415 DOI: 10.1080/10550887.2024.2327721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND Most studies on Food Addiction (FA) used the strict classical diagnosis approach without quantifying sub-threshold symptoms (i.e. uncontrolled/excessive food intake, negative affect, craving, tolerance, withdrawal, and continued use despite harm) nor indicating where they stand on the "three-stage addiction cycle" modeling the transition from substance use to addiction. OBJECTIVES (1) to estimate the proportion of clinically significant episodes of distress/impairment in severely obese patients without FA, and (2) to assess their associations with FA symptoms at the subthreshold level. METHODS The modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) assesses 11 symptoms (diagnostic criteria) plus clinically significant impairment and distress (clinical significance criterion). We used this tool to diagnose FA (≥ 2 criteria plus clinical significance) in adult patients with severe obesity, but included only those below the threshold in the analyses. Demographics, clinical features, and obesity complications were collected. RESULTS Only 18% of the 192 participants (women n = 148, 77.1%; mean age: 43.0 ± 13.2) reported a total absence of FA symptoms, while one in four reported recurrent episodes of clinically significant distress (24%) or impairment (25%) in social, occupational, or other important areas of functioning. The most common recurrent symptoms were first-stage symptoms (binge/intoxication), while second- (withdrawal/negative affect) and third-stage (preoccupation/anticipation) symptoms affected nearly one patient in five for tolerance and craving, and one in ten for withdrawal. In multivariate analysis, impairment was positively related to withdrawal and tolerance, while distress was positively related to failure in role obligations. CONCLUSION Many patients with severe obesity experience recurrent episodes of FA symptoms at the subthreshold level. Prospective studies will examine whether these symptoms may play a causal role in symptoms progression toward a full-blown FA and obesity outcomes.
Collapse
Affiliation(s)
- Aymery Constant
- EHESP, School of Public Health, Rennes, France
- Inrae, Inserm, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Mickaël Som
- Department of Endocrinology-Diabetology-Nutrition, CHU Rennes, univ Rennes, Rennes, France
| | - David Val-Laillet
- Inrae, Inserm, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
| | - Romain Moirand
- Inrae, Inserm, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
- Addictology Unit, CHU Rennes, Univ Rennes, Rennes, France
| | - Ronan Thibault
- Inrae, Inserm, Univ Rennes, Nutrition Metabolisms and Cancer, NuMeCan, Rennes, France
- Department of Endocrinology-Diabetology-Nutrition, CHU Rennes, univ Rennes, Rennes, France
| |
Collapse
|
5
|
Sun X, Yuan T, Chen F, Li Y, Jiang N. Network analysis of maternal parenting practices and adolescent mental health problems: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:38. [PMID: 38504321 PMCID: PMC10953267 DOI: 10.1186/s13034-024-00728-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/06/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND An extensive literature has shown a strong connection between maternal parenting practices and adolescent mental health problems. However, it has been difficult for previous research to map a dynamic concurrent and prospective relationships within and between types of parenting practices and adolescent mental health problems. The present study addressed these issues using a network analysis approach and a longitudinal design. METHODS This study involved 591 Chinese adolescents (249 males; mean age at T1 = 13.53) and their mothers (mean age at T1 = 39.71) at two time points (T1 and T2) with eighteen months apart. Mothers reported their parenting practices including warmth, monitoring, inductive reasoning, hostility, and harshness, while adolescents reported their mental health problems including anxiety, depression, aggression, and conduct problems. Network analysis was conducted for contemporaneous networks at T1 and T2 and temporal networks from T1 to T2. RESULTS The contemporaneous networks revealed the negative association between monitoring and conduct problems served as the main pathway through which parenting practices and adolescent mental health mutually influenced each other, and further, warmth was the most influential parenting practice on adolescent mental health. The temporal network revealed that maternal hostility exerted the most influence on adolescent mental health problems, whereas adolescents' depression was most influenced by maternal parenting practices. Moreover, maternal hostility was most predicted by maternal harshness. CONCLUSIONS This study presents a novel perspective to gain a better understanding of the dynamics between and within maternal parenting practices and adolescent mental health problems. Findings highlight maternal harshness and warmth as potential prevention and intervention targets for adolescent mental health problems.
Collapse
Affiliation(s)
- Xinlu Sun
- School of Psychology, Shandong Second Medical University, 7166 Baotong West Street, Weifang, Shandong, 261053, China
| | - Ting Yuan
- School of Psychology, Shandong Second Medical University, 7166 Baotong West Street, Weifang, Shandong, 261053, China
| | - Feifei Chen
- School of Psychology, Shandong Second Medical University, 7166 Baotong West Street, Weifang, Shandong, 261053, China
| | - Yan Li
- Department of Psychology, DePaul University, 2219N Kenmore Ave, Chicago, IL, 60614, USA.
| | - Nengzhi Jiang
- School of Psychology, Shandong Second Medical University, 7166 Baotong West Street, Weifang, Shandong, 261053, China.
| |
Collapse
|
6
|
Krebs G, Clark BR, Ford TJ, Stringaris A. Epidemiology of Body Dysmorphic Disorder and Appearance Preoccupation in Youth: Prevalence, Comorbidity and Psychosocial Impairment. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00126-6. [PMID: 38508411 DOI: 10.1016/j.jaac.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 01/14/2024] [Accepted: 01/16/2024] [Indexed: 03/22/2024]
Abstract
OBJECTIVE Little is known about how common and impairing body dysmorphic disorder (BDD) is in the general population of youth. We evaluated the prevalence, comorbidity, and psychosocial impairment associated with BDD and more broadly defined appearance preoccupation in young people. METHOD Data were drawn from the 2017 Mental Health of Children and Young People in England survey. BDD and psychiatric comorbidity were assessed in individuals 5 to 19 years of age (N = 7,654) according to DSM-5 criteria, using a clinician-rated standardized diagnostic assessment. Psychosocial impairment was measured with a quantitative scale and was indexed by reported self-harm and suicide attempts, as well as service use, assessed using structured interviews. RESULTS The point prevalence of BDD was 1.0% (95% CI = 0.8%-1.3%). BDD was significantly more common among adolescents than children (1.9 vs 0.1%; OR = 22.5, p < .001), and among female than male participants (1.8% vs 0.3%; OR = 7.3, p < .001). Approximately 70% of young people with BDD had psychiatric comorbidity, most commonly internalizing disorders. BDD was associated with self- and parent-reported psychosocial impairment, self-harm and suicide attempts, and service utilization. Appearance preoccupation was more common than full-syndrome BDD, but showed similar age and sex effects, patterns of comorbidity, and associated impairment. CONCLUSION BDD and appearance preoccupation are relatively common, especially among adolescent girls, and are associated with substantial co-occurring psychopathology, impairment, and risk. Improved screening is needed to increase detection and diagnosis of BDD, and to facilitate access to evidence-based treatment. STUDY PREREGISTRATION INFORMATION The epidemiology of body dysmorphic disorder the youth: prevalence, comorbidity and psychosocial impact; https://osf.io/g83jy.
Collapse
Affiliation(s)
- Georgina Krebs
- University College London, London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
| | - Bruce R Clark
- South London and Maudsley NHS Foundation Trust, United Kingdom
| | - Tamsin J Ford
- University of Cambridge, United Kingdom, and Cambridge and Peterborough, NHS Foundation Trust, Cambridgeshire, United Kingdom
| | - Argyris Stringaris
- University College London, London, United Kingdom; National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
7
|
Jalali S, Liu L, Wang J, Kennedy SH, MacQueen G, Lebel C, Goldstein BL, Bray S, Addington J. Factors Associated with Transition to Serious Mental Illness. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2024; 69:79-88. [PMID: 37606525 PMCID: PMC10789229 DOI: 10.1177/07067437231195959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE There is increasing interest in early intervention and detection strategies for youth at-risk of developing a serious mental illness (SMI). Little is known about early factors that may be related to the later development of a SMI; thus, the aim of this study was to determine what clinical factors might relate to the development of in this study psychosis, bipolar disorder and severe or recurrent major depression in at-risk youth. METHOD The sample consisted of 162 youth aged 12-26 years at different stages of risk. Thirty-one participants developed a SMI during the study. Those who made a transition were compared on a range of baseline clinical and functional measures with those who did not make the transition. A Cox regression model was used to assess the association between measures and later development of a SMI. RESULTS Female sex, attenuated psychotic symptoms as assessed with the Scale of Psychosis-Risk Symptoms (SOPS) and ratings on the K-10 Distress Scale, were found to be significantly associated with the later transition to mental illness. Females were 2.77 times more likely to transition compared to males. For the SOPS and K-10 scales, there is a 14% increase in the transition rate relative to a one-scale increase in SOPS and a 7% increase in the transition rate relative to a one-point increase in the K-10. CONCLUSIONS Results from these longitudinal data provide further insight into the specific clinical measures that may be pertinent in early detection of mental illnesses.
Collapse
Affiliation(s)
- Sara Jalali
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - JianLi Wang
- Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sidney H. Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada
- Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Benjamin l. Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Signe Bray
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
8
|
Vandermeer MRJ, Liu P, Mohamed Ali O, Daoust AR, Joanisse MF, Barch DM, Hayden EP. Children's neural reactivity to maternal praise and criticism: Associations with early depressive symptoms and maternal depression. Dev Psychopathol 2024; 36:12-27. [PMID: 36039979 DOI: 10.1017/s0954579422000840] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Caregiving experiences are implicated in children's depression risk; however, children's neural reactivity to positive and negative feedback from mothers, a potential mediator of depression risk, is poorly understood. In a sample of 81 children (Mage = 11.12 years, SDage = 0.63), some of whom were recruited based on a maternal history of depression (n = 29), we used fMRI to characterize children's neural responses to maternal praise and criticism. Maternal history of depression was unrelated to children's brain activity during both the praise and criticism conditions; however, ROI analyses showed that children's self-reported depressive symptoms were negatively associated with functional activity in the left anterior insula and right putamen while hearing maternal criticism. Whole-brain analyses showed that children's depressive symptoms were positively associated with left inferior frontal gyrus activity while listening to maternal praise. These findings complement past work implicating these brain regions in the processing of emotionally salient stimuli, reward processing, and internal speech. Given associations between early depressive symptoms and later disorder, findings suggest that maladaptive neural processing of maternal feedback may contribute to children's early emerging risk for depression.
Collapse
Affiliation(s)
- Matthew R J Vandermeer
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Pan Liu
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Ola Mohamed Ali
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Andrew R Daoust
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Marc F Joanisse
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, 4444 Forest Park Avenue, Suite 2100, St. Louis, MO, USA
- Department of Psychology, Washington University, St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Elizabeth P Hayden
- Department of Psychology, The Brain and Mind Institute, Western University, Western Interdisciplinary Research Building, Room 3190, 1151 Richmond St., London, ON, Canada
| |
Collapse
|
9
|
Carmichael J, Ponsford J, Gould KR, Spitz G. Characterizing depression after traumatic brain injury using a symptom-oriented approach. J Affect Disord 2024; 345:455-466. [PMID: 37879410 DOI: 10.1016/j.jad.2023.10.130] [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: 06/16/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Progress in addressing depression after traumatic brain injury (TBI) has been limited. Traditional approaches to measuring depression classify individuals with diverse symptoms as having the same problem. We adopted a novel, symptom-oriented approach to characterize post-TBI depression, emphasizing specific symptoms rather than the number of symptoms. METHODS We assessed depressive symptoms cross-sectionally in 393 participants with moderate-severe TBI (range 0.4-35.4 years post-injury; M = 12.6) using the Inventory of Depression and Anxiety Symptoms - Expanded Version (IDAS-II). We analyzed symptoms of DSM-5 major depressive disorder (MDD), separating compound symptoms into sub-symptoms. We quantified depression heterogeneity across 16 specific symptoms and explored associations between each symptom and personal, injury-related, treatment, and functional/psychosocial outcome factors. RESULTS 28 % of participants self-reported a current depression diagnosis, and 35 % met DSM-5 symptom criteria for MDD. Depressed participants (according to either self-reported diagnosis or MDD symptom criteria) were more likely to endorse each specific depressive symptom, including those that overlap with TBI. Post-TBI depression was highly heterogeneous, with 84-91 % of depressed participants (depending on classification method) showing a unique symptom profile not shared with any other individual. The most common symptom profile was shared by only three individuals. This heterogeneity was meaningful, as specific depressive symptoms had distinct associations with personal, injury-related, treatment, and outcome factors. LIMITATIONS Cross-sectional design. We only analyzed DSM-5 MDD symptoms, and some symptoms were assessed using only one item. CONCLUSIONS A symptom-oriented approach to post-TBI depression captures the individual's unique profile of depressive symptoms, which relate differently to outcomes and other factors. We recommend future studies investigating post-TBI depression analyze specific symptoms alongside overall depression scores.
Collapse
Affiliation(s)
- Jai Carmichael
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.
| | - Jennie Ponsford
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Kate Rachel Gould
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
| | - Gershon Spitz
- Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia; Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| |
Collapse
|
10
|
Hodgson CG, Bonifay W, Yang W, Herman KC. Establishing the measurement precision of the patient health questionnaire in an adolescent sample. J Affect Disord 2023; 342:76-84. [PMID: 37708980 DOI: 10.1016/j.jad.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/30/2023] [Accepted: 09/08/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND Technically sound measures are necessary for accurately identifying youth at risk for depression, but many studies rely on classical test theory metrics or adult samples to evaluate measures. This study examined the use of the PHQ-8, a common and freely available pediatric depression screener, in an adolescent sample using item response theory (IRT). METHODS Secondary analyses were conducted on data from a study conducted in Midwestern middle schools in which 1224 youth completed the PHQ-8 as part of a battery of surveys. Polytomous IRT analyses (a Graded Response Model) were used to evaluate the PHQ-8. Items were examined for their ability to distinguish between respondents of different latent depression severity and for differential item functioning (DIF) across demographic categories. RESULTS All PHQ-8 items had adequate discriminative abilities. Items measuring anhedonia and psychomotor disturbances performed relatively poorly, and items measuring somatic symptoms (appetite and sleep) were most informative when respondents endorsed extreme response options ("not at all" or "nearly every day"). No DIF was found across grade level or race, but several items were flagged for DIF by gender and student income level. LIMITATIONS These results might not be generalizable to a broader youth population due to administration setting and the unique demographic characteristics of this sample (76.0 % African American). CONCLUSIONS Tools such as the PHQ-8 are appropriate to quickly screen for depression in adolescents, but further scrutiny of adolescent response patterns is warranted. Future research should examine items measuring anhedonia and psychomotor and somatic disturbances in adolescents.
Collapse
Affiliation(s)
| | - Wes Bonifay
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
| | - Wenxi Yang
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA.
| | - Keith C Herman
- University of Missouri, Department of Educational, School and Counseling Psychology, Columbia, MO, USA
| |
Collapse
|
11
|
Levy T, Dupuis A, Andrade BF, Crosbie J, Kelley E, Nicolson R, Schachar RJ. Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability. Eur Child Adolesc Psychiatry 2023; 32:2271-2280. [PMID: 36050559 DOI: 10.1007/s00787-022-02033-3] [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: 02/01/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14 years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.
Collapse
Affiliation(s)
- Tomer Levy
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Brendan F Andrade
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology and Center for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Russell James Schachar
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
12
|
Rao V, Lanni S, Yule AM, DiSalvo M, Stone M, Berger AF, Wilens TE. Diagnosing major depressive disorder and substance use disorder using the electronic health record: A preliminary validation study. JOURNAL OF MOOD AND ANXIETY DISORDERS 2023; 2:100007. [PMID: 37693103 PMCID: PMC10486184 DOI: 10.1016/j.xjmad.2023.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Background One mechanism to examine if major depressive disorder (MDD) is related to the development of substance use disorder (SUD) is by leveraging naturalistic data available in the electronic health record (EHR). Rules for data extraction and variable construction linked to psychometrics validating their use are needed to extract data accurately. Objective We propose and validate a methodologic framework for using EHR variables to identify patients with MDD and non-nicotine SUD. Methods Proxy diagnoses and index dates of MDD and/or SUD were established using billing codes, problem lists, patient-reported outcome measures, and prescriptions. Manual chart reviews were conducted for the 1-year period surrounding each index date to determine (1) if proxy diagnoses were supported by chart notes and (2) if the index dates accurately captured disorder onset. Results The results demonstrated 100% positive predictive value for proxy diagnoses of MDD. The proxy diagnoses for SUD exhibited strong agreement (Cohen's kappa of 0.84) compared to manual chart review and 92% sensitivity, specificity, positive predictive value, and negative predictive value. Sixteen percent of patients showed inaccurate SUD index dates generated by EHR extraction with discrepancies of over 6 months compared to SUD onset identified through chart review. Conclusions Our methodology was very effective in identifying patients with MDD with or without SUD and moderately effective in identifying SUD onset date. These findings support the use of EHR data to make proxy diagnoses of MDD with or without SUD.
Collapse
Affiliation(s)
- Vinod Rao
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Sylvia Lanni
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Amy M. Yule
- Department of Psychiatry, Boston Medical Center, 801 Massachusetts Avenue, Boston, MA 02118, USA
| | - Maura DiSalvo
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Mira Stone
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Amy F. Berger
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| | - Timothy E. Wilens
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
| |
Collapse
|
13
|
Nayman S, Konstantinow DT, Schricker IF, Reinhard I, Kuehner C. Associations of premenstrual symptoms with daily rumination and perceived stress and the moderating effects of mindfulness facets on symptom cyclicity in premenstrual syndrome. Arch Womens Ment Health 2023; 26:167-176. [PMID: 36899192 PMCID: PMC10063513 DOI: 10.1007/s00737-023-01304-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 03/04/2023] [Indexed: 03/12/2023]
Abstract
Subthreshold premenstrual symptoms can be impairing even if the diagnostic criteria for premenstrual dysphoric disorder (PMDD) are not reached. Previous research suggests shared psychological risk factors without a clear differentiation of premenstrual syndrome (PMS) from PMDD. This study focuses on a sample with a wide range of premenstrual symptoms not reaching PMDD-criteria and aims to investigate within-person associations of premenstrual symptoms with daily rumination and perceived stress during the late luteal phase as well as cycle-phase specific associations of habitual mindfulness including present-moment-awareness and acceptance with premenstrual symptoms and impairment. Fifty-six naturally cycling women with self-reported premenstrual symptoms completed an online diary on premenstrual symptoms, rumination and perceived stress over two consecutive menstrual cycles, and baseline questionnaires on habitual present-moment-awareness and acceptance. Multilevel analyses revealed cycle-related variations in premenstrual symptoms and impairment (all ps < .001). Higher within-person levels of core and secondary premenstrual symptoms during the late luteal phase predicted increased daily rumination and perceived stress (all ps < .001) and increased somatic symptoms predicted increased rumination (p ≤ .018). Higher habitual present-moment-awareness was linked to lower premenstrual symptom and impairment levels toward the late luteal phase whereas higher habitual acceptance was associated with lower premenstrual functional impairment (p ≤ .015). Premenstrual symptom increases during the late luteal phase in women with PMS seem to be linked to increased daily rumination and perceived stress. Trait present-moment-awareness and acceptance in turn seem to reflect protective factors against premenstrual distress and may represent useful targets for interventions.
Collapse
Affiliation(s)
- Sibel Nayman
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Desiree Tina Konstantinow
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Isabelle Florence Schricker
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany
| | - Christine Kuehner
- Research Group Longitudinal and Intervention Research, Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, Mannheim, Germany.
| |
Collapse
|
14
|
Nigg JT. Considerations toward an epigenetic and common pathways theory of mental disorder. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2023; 132:297-313. [PMID: 37126061 PMCID: PMC10153068 DOI: 10.1037/abn0000748] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Psychopathology emerges from the dynamic interplay of physiological and mental processes and ecological context. It can be seen as a failure of recursive, homeostatic processes to achieve adaptive re-equilibrium. This general statement can be actualized with consideration of polygenic liability, early exposures, and multiunit (multi-"level") analysis of the psychological action and the associated physiological and neural operations, all in the context of the developmental exposome. This article begins by identifying key principles and clarifying key terms necessary to mental disorder theory. It then ventures a sketch of a model that highlights epigenetic dynamics and proposes a common pathways hypothesis toward psychopathology. An epigenetic perspective elevates the importance of developmental context and adaptive systems, particularly in early life, while opening the door to new mechanistic discovery. The key proposal is that a finite number of homeostatic biological and psychological mechanisms are shared across most risky environments (and possibly many genetic liabilities) for psychopathology. Perturbation of these mediating mechanisms leads to development of psychopathology. A focus on dynamic changes in these homeostatic mechanisms across multiple units of analysis and time points can render the problem of explaining psychopathology tractable. Key questions include the mapping of recursive processes over time, at adequate density, as mental disorders unfold across development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Joel T Nigg
- Department of Psychiatry, Oregon Health & Science University
| |
Collapse
|
15
|
Letkiewicz AM, Spring JD, Li LY, Weinberg A, Shankman SA. Childhood trauma predicts blunted error monitoring in adulthood: An event-related potential study. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023; 23:427-439. [PMID: 36653556 PMCID: PMC10065923 DOI: 10.3758/s13415-023-01061-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/20/2023]
Abstract
Abuse and neglect have detrimental consequences on emotional and cognitive functioning during childhood and adolescence, including error monitoring, which is a critical aspect of cognition that has been implicated in certain internalizing and externalizing psychopathologies. It is unclear, however, whether (a) childhood trauma has effects on error monitoring and, furthermore whether, (b) error monitoring mediates the relation between childhood trauma and psychopathology in adulthood. To this end, in a large sample of young adults (ages 18-30) who were oversampled for psychopathology (N = 390), the present study assessed relations between childhood trauma and error-related negativity (ERN), which is a widely used neurophysiological indicator of error monitoring. Cumulative childhood trauma predicted ERN blunting, as did two specific types of traumas: sexual abuse and emotional neglect. Furthermore, the ERN partially mediated the effects of cumulative childhood trauma and emotional neglect on externalizing-related symptoms. Future studies should further examine the relations between childhood trauma and error monitoring in adulthood, which can help to inform intervention approaches.
Collapse
Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA.
| | - Justin D Spring
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Lilian Y Li
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
| | - Anna Weinberg
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, 680 N. Lakeshore Drive, Suite 1520, Chicago, IL, 60611, USA
- Department of Psychology, Northwestern University, Chicago, IL, USA
| |
Collapse
|
16
|
Associations of stressful life events with subthreshold depressive symptoms and major depressive disorder: The moderating role of gender. J Affect Disord 2023; 325:588-595. [PMID: 36657495 DOI: 10.1016/j.jad.2023.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 12/27/2022] [Accepted: 01/11/2023] [Indexed: 01/18/2023]
Abstract
BACKGROUND Stressful life events (SLEs) are high-risk factors for subthreshold depressive symptoms (SDS) and major depressive disorder (MDD). This study sought to assess the association of SLEs with SDS and MDD, with a focus on gender effects. METHODS A total of 4132 participants were recruited from 34 primary health care settings. The Stressful Life Events Screening Questionnaire (SLESQ) was used to measure SLEs that participants had experienced in the past time. The Patient Health Questionnaire 9 (PHQ-9) was used to assess SDS, and the Mini-International Neuropsychiatry Interview (MINI) depression module was used to assess the diagnosis of MDD by trained psychiatrists. RESULTS In our sample (N = 4132), exposure to any SLEs was more common in individuals with SDS and MDD than in non-depressed population, and the proportion of emotional abuse was relatively high (SDS: 10.6 %; MDD: 33.9 %). After adjusting for control variables, people who experienced SLEs were at a higher risk of SDS and MDD. For males, those experiencing only one event were not at a higher risk of SDS (P = 0.061). For individuals who had experienced multiple SLEs, the association between SLEs and SDS was stronger in females than males. However, the association between SLEs and MDD was stronger in males than females. LIMITATIONS The cross-sectional study design and self-reported SLEs. CONCLUSIONS SLEs were associated with the increased risks of SDS and MDD. The associations of SLEs with SDS were more robust for females than males. In contrast, the association between SLEs and MDD was stronger in males than females.
Collapse
|
17
|
Salazar de Pablo G, Cabras A, Pereira J, Castro Santos H, de Diego H, Catalan A, González-Pinto A, Birmaher B, Correll CU, Fusar-Poli P. Predicting bipolar disorder I/II in individuals at clinical high-risk: Results from a systematic review. J Affect Disord 2023; 325:778-786. [PMID: 36657494 DOI: 10.1016/j.jad.2023.01.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 12/30/2022] [Accepted: 01/09/2023] [Indexed: 01/19/2023]
Abstract
INTRODUCTION No systematic review has estimated the consistency and the magnitude of the risk of developing bipolar disorder I-II (BD-I/II) in individuals at clinical high risk for bipolar disorder (CHR-BD). METHODS PubMed and Web of Science databases were searched until April 2022 in this pre-registered (PROSPERO CRD42022346515) PRISMA-compliant systematic review to identify longitudinal studies in individuals meeting pre-defined CHR-BD criteria. The risk of bias was assessed using the Newcastle-Ottawa Scale, and results were systematically synthesized around CHR-BD criteria across follow-up periods and different subgroups. RESULTS Altogether, 13 studies were included reporting on nine prospective independent cohorts (n = 678 individuals at CHR-BD). The mean age of participants was 15.7 years (range 10.1-22.6 years), and 54.2 % were females. The most common CHR-BD subgroup was subthreshold mania (55.5 %), followed by BD-Not Otherwise Specified (BD-NOS: 33.3 %). Development of BD I/II ranged from 7.1 % to 23.4 % after 2 years. Development of BD-I ranged from 3.4 % at 4 years to 23 % at 8 years. Development of BD-II ranged from 10 % at 2 years to 63.8 % at 4 years. The risk of developing BD-I appeared highest in those meeting BD-NOS criteria (23 % at eight years). Predictors of development of BD were identified but remained mostly unreplicated. The quality of the included studies was moderate (NOS = 5.2 ± 1.1). CONCLUSIONS Emerging data from research studies point towards the promising utility of CHR-BD criteria. These studies may pave the way to the next generation of research, implementing detection, prognostication, and preventive interventions in individuals at CHR-BD identified and followed in clinical practice.
Collapse
Affiliation(s)
- Gonzalo Salazar de Pablo
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Child and Adolescent Mental Health Services, South London and Maudsley NHS Foundation Trust, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
| | - Anna Cabras
- Department of Neurology and Psychiatry, University of Rome La Sapienza, Rome, Italy
| | - Joana Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
| | | | - Héctor de Diego
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Ana Catalan
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Psychiatry Department, Biocruces Bizkaia Health Research Institute, OSI Bilbao-Basurto, Facultad de Medicina y Odontología, University of the Basque Country UPV/EHU, Centro de Investigación en Red de Salud Mental, (CIBERSAM), Instituto de Salud Carlos III, Plaza de Cruces 12, 48903 Barakaldo, Bizkaia, Spain
| | - Ana González-Pinto
- Departmennt of Psychiatry, Araba University Hospital, Bioaraba Research Institute, CIBER-ISCIII-Salud Mental, Vitoria, Spain; Department of Neurosciences, University of the Basque Country, Bizkaia, Spain
| | - Boris Birmaher
- Western Psychiatric Hospital, University of Pittsburgh School of Medicine, PA, USA
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience, The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
18
|
Brinkman HR, Hoyt DL, Fedorenko EJ, Mendes WB, Leyro TM. Cardiac Vagal Control Among Community Cigarette Smokers with Low to Moderate Depressive Symptoms. Appl Psychophysiol Biofeedback 2023; 48:159-169. [PMID: 36732418 DOI: 10.1007/s10484-023-09580-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 02/04/2023]
Abstract
Impairments in cardiac vagal control (CVC) have been independently linked to smoking status and depression and are implicated in self-regulatory processes that may exacerbate depressive symptoms and maintain smoking behavior. Yet, few studies have examined how depressive symptoms, even at low levels, influence CVC reactivity among individuals who smoke. Investigating these relationships may provide novel insights into how depressive symptoms exacerbate existing regulatory vulnerabilities among smokers. This study investigated how depression symptoms affect CVC reactivity as a function of changing situational demands among a community sample of 60 daily adult cigarette smokers. Participants completed a mildly demanding cognitive task while physiological data was recorded. Growth curve modeling was used to examine the main and interactive effects of self-reported depressive symptoms on CVC reactivity over the course of the task. We hypothesized that greater depressive symptoms would be associated with less CVC reactivity, characterized by smaller initial reductions in CVC values and a flatter slope over time. Participants were daily smokers with mild to moderate levels of depression. Final model results, where time was specified as linear and the slope was fixed, showed no significant main or interactive effects of time and depression symptoms on CVC reactivity. Findings suggest that at low to moderate levels, depressive symptom severity is not related to patterns of CVC reactivity among adults who smoke. This is the first study to examine this relationship in this population. Future investigations that examine patterns of CVC reactivity among smokers and non-smokers with more severe depression are needed.
Collapse
Affiliation(s)
- Hannah R Brinkman
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA.
| | - Danielle L Hoyt
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Erick J Fedorenko
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
| | - Wendy Berry Mendes
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Teresa M Leyro
- Department of Psychology, Rutgers, the State University of New Jersey, 53 Avenue E, Piscataway, NJ, 08854, USA
| |
Collapse
|
19
|
Berhe O, Höflich A, Moessnang C, Reichert M, Kremer T, Gan G, Ma R, Braun U, Reininghaus U, Ebner-Priemer U, Meyer-Lindenberg A, Tost H. Reduced Real-life Affective Well-being and Amygdala Habituation in Unmedicated Community Individuals at Risk for Depression and Anxiety. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:111-120. [PMID: 35760353 DOI: 10.1016/j.bpsc.2022.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/27/2022] [Accepted: 06/15/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Early identification of risk for depression and anxiety disorders is important for prevention, but real-life affective well-being and its biological underpinnings in the population remain understudied. Here, we combined methods from epidemiology, psychology, ecological momentary assessment, and functional magnetic resonance imaging to study real-life and neural affective functions in individuals with subclinical anxiety and depression from a population-based cohort of young adults. METHODS We examined psychological measures, real-life affective valence, functional magnetic resonance imaging amygdala habituation to negative affective stimuli, and the relevance of neural readouts for daily-life affective function in 132 non-help-seeking community individuals. We compared psychological and ecological momentary assessment measures of 61 unmedicated individuals at clinical risk for depression and anxiety (operationalized as subthreshold depression and anxiety symptoms or a former mood or anxiety disorder) with those of 48 nonrisk individuals and 23 persons with a mood or anxiety disorder. We studied risk-associated functional magnetic resonance imaging signals in subsamples with balanced sociodemographic and image quality parameters (26 nonrisk, 26 at-risk persons). RESULTS Compared with nonrisk persons, at-risk individuals showed significantly decreased real-life affective valence (p = .038), reduced amygdala habituation (familywise error-corrected p = .024, region of interest corrected), and an intermediate psychological risk profile. Amygdala habituation predicted real-life affective valence in control subjects but not in participants at risk (familywise error-corrected p = .005, region of interest corrected). CONCLUSIONS Our data suggest real-life and neural markers for affective alterations in unmedicated community individuals at risk for depression and anxiety and highlight the significance of amygdala habituation measures for the momentary affective experience in real-world environments.
Collapse
Affiliation(s)
- Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Anna Höflich
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carolin Moessnang
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany; Department of eHealth and Sports Analytics, Ruhr-University Bochum, Bochum, Germany
| | - Thomas Kremer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Gabriela Gan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom
| | - Ulrich Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Mental mHealth Lab, Department of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| |
Collapse
|
20
|
Cosentino L, Zidda F, Dukal H, Witt SH, De Filippis B, Flor H. Low levels of Methyl-CpG binding protein 2 are accompanied by an increased vulnerability to the negative outcomes of stress exposure during childhood in healthy women. Transl Psychiatry 2022; 12:506. [PMID: 36481643 PMCID: PMC9731965 DOI: 10.1038/s41398-022-02259-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Numerous mental illnesses arise following stressful events in vulnerable individuals, with females being generally more affected than males. Adverse childhood experiences are known to increase the risk of developing psychopathologies and DNA methylation was demonstrated to drive the long-lasting effects of early life stress and promote stress susceptibility. Methyl-CpG binding protein 2 (MECP2), an X-linked reader of the DNA methylome, is altered in many mental disorders of stress origin, suggesting MECP2 as a marker of stress susceptibility; previous works also suggest a link between MECP2 and early stress experiences. The present work explored whether a reduced expression of MECP2 is paralleled by an increased vulnerability to the negative outcomes of stress exposure during childhood. To this aim, blood MECP2 mRNA levels were analyzed in 63 people without history of mental disorders and traits pertaining to depressive and anxiety symptom clusters were assessed as proxies of the vulnerability to develop stress-related disorders; stress exposure during childhood was also evaluated. Using structural equation modeling, we demonstrate that reduced MECP2 expression is accompanied by symptoms of anxiety/depression in association with exposure to stress in early life, selectively in healthy women. These results suggest a gender-specific involvement of MECP2 in the maladaptive outcomes of childhood adversities, and shed new light on the complex biology underlying gender bias in stress susceptibility.
Collapse
Affiliation(s)
- Livia Cosentino
- grid.416651.10000 0000 9120 6856Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy ,grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Francesca Zidda
- grid.7700.00000 0001 2190 4373Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Helene Dukal
- grid.7700.00000 0001 2190 4373Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie H. Witt
- grid.7700.00000 0001 2190 4373Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Bianca De Filippis
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Roma, Italy.
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| |
Collapse
|
21
|
Suen YN, Yau JY, Wong PS, Li YK, Hui CLM, Chan SKW, Lee EHM, Chang WC, Chen EYH. Effect of brief, personalized feedback derived from momentary data on the mental health of women with risk of common mental disorders in Hong Kong: A randomized clinical trial. Psychiatry Res 2022; 317:114880. [PMID: 37732870 DOI: 10.1016/j.psychres.2022.114880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 10/31/2022]
Abstract
This study aimed to determine the efficacy of digitalized personalized feedback derived from experience sampling method (ESM) data for improving women's mental health and to explore its potential to become a prevention intervention. In this three-arm, randomized controlled trial, 124 adult women aged 18 to 64 years with mild to moderate depressive and anxiety symptoms were randomly assigned to ESM with personalized feedback (ESM-f, 40 women), ESM alone (ESM, 43 women), or no additional intervention (control, 41 women). The ESM-f and ESM groups received six weeks of ESM, but only the former received biweekly individualized feedback. The primary outcome measure was changes in mental well-being as measured by the 21-item Depression, Anxiety, and Stress Scale (DASS-21) from baseline to 8, 12, 16, 20, and 32 weeks and the comparison between the ESM-f and the control group. The ESM-f group experienced a significantly greater decline in DASS-21 total scores compared with the control group while the ESM and control groups had a comparable decline in DASS-21 total scores. ESM-derived personalized feedback can improve women's mental well-being. Additional research is needed to determine its cost-effectiveness, long-term consequences, and efficacy as a preventive intervention for common mental disorders.
Collapse
Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Jezreel Yeung Yau
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Pui Sze Wong
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Yee Kwan Li
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | | | - Sherry Kit Wa Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
22
|
De Stefano R, Cedro C, Iannuzzo F, Infortuna C, Lombardo C, Pandolfo G, Muscatello MRA, Bruno A. The relationship between subthreshold psychiatric symptoms and Internet Addiction in an Italian population. Psychiatry Res 2022; 317:114914. [PMID: 37732858 DOI: 10.1016/j.psychres.2022.114914] [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: 06/26/2022] [Revised: 10/07/2022] [Accepted: 10/15/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Internet addiction (IA) is an emerging psychopathological entity, often comorbid with a variety of psychiatric disorders. Subthreshold psychopathology has recently emerged as a new field of research, with solid evidence highlighting its role in causing psychological distress. AIMS The study aimed to evaluate the presence of subthreshold psychopathological symptoms and IA in Italian adults recruited from the general population, searching for possible correlations between specific subclinical psychiatric disorders and internet abuse. METHODS The study was conducted by an online survey released through social networks, web advertising, institutional and professional mailing lists, and messaging services. The General 5-Spectrum Measure (GSM-V) and the Internet Addiction Test (IAT) were chosen to assess subthreshold symptoms, and IA, respectively. RESULTS Significant positive correlations between the total score of the IAT total scores and the multiple domains of GSM-5 (p <0.0001), except for the "Mania" dimension (p = 0.717). CONCLUSIONS IA is very common in subjects unaffected by major psychiatric disorders and it is associated with subthreshold psychopathological dimensions. Further studies on larger samples and the inclusion of a dimensional framework in research settings and clinical practice are needed to better understand the nature and the reciprocal relationships between IA and subthreshold psychopathology.
Collapse
Affiliation(s)
- Rosa De Stefano
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Clemente Cedro
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Fiammetta Iannuzzo
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Carmenrita Infortuna
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Clara Lombardo
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Gianluca Pandolfo
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Maria Rosaria Anna Muscatello
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy
| | - Antonio Bruno
- Psychiatry Unit, Polyclinic Hospital of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy; Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Via Consolare Valeria 1, Contesse, Messina 98125, Italy.
| |
Collapse
|
23
|
Akıncı MA, Turan B, Esin İS, Dursun OB. Prevalence and correlates of hoarding behavior and hoarding disorder in children and adolescents. Eur Child Adolesc Psychiatry 2022; 31:1623-1634. [PMID: 34283287 DOI: 10.1007/s00787-021-01847-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/14/2021] [Indexed: 12/28/2022]
Abstract
Although hoarding symptoms are reported to begin in childhood and adolescence, the true prevalence of the disorder in this age group is unknown. This study aims to estimate the prevalence of hoarding disorder (HD) in children and adolescents. The present study was planned as a two-stage epidemiological research. In the first stage, the Children's Saving Inventory (CSI) and informed consent forms were delivered to a group of students' parents. In the second stage, one-on-one psychiatric interviews with a physician were planned with the families and children who had hoarding behavior (HB), as described by their parents. The DSM-5-based HD interview and the Development and Well-Being Assessment (DAWBA) diagnostic tool were used to detect prevalence of HD and comorbid psychiatric disorders. A total of 3249 children were included in the study, and 318 children and their parents were evaluated in the second stage. As a result of the second assessment, 32 out of 318 children met the HD diagnostic criteria. The estimated prevalence of HD was 0.98% (95% CI 0.7-1.4). Hoarding disorder was found more frequently in females (F/M = 3/1). After a logistic regression analysis, variables such as female sex and the presence of any psychopathology were identified as independent correlates of HD. More than half (56.2%) of the children diagnosed as having HD also had a comorbid psychiatric disorder. In the present study, the two-stage evaluation method was used in a large pediatric sample to determine the estimated prevalence of HD, as well as the factors associated with the disorder and comorbid psychiatric disorders.
Collapse
Affiliation(s)
- Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Dr. Ali Kemal Belviranlı Maternity and Children Hospital, Konya, Turkey.
| | - Bahadır Turan
- Autism, Mental Special Needs and Rare Diseases Department in Turkish Ministry of Health, General Directorate of Health Services, Ankara, Turkey
| | - İbrahim Selçuk Esin
- Department of Child and Adolescent Psychiatry, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Onur Burak Dursun
- Autism, Mental Special Needs and Rare Diseases Department in Turkish Ministry of Health, General Directorate of Health Services, Ankara, Turkey
| |
Collapse
|
24
|
Volz HP, Saliger J, Kasper S, Möller HJ, Seifritz E. Subsyndromal generalised anxiety disorder: operationalisation and epidemiology - a systematic literature survey. Int J Psychiatry Clin Pract 2022; 26:277-286. [PMID: 34314295 DOI: 10.1080/13651501.2021.1941120] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The diagnosis of anxiety disorders, like other psychiatric disorders also, is operationalised since the introduction of diagnostic manuals. The diagnostic criteria of Generalised Anxiety Disorder (GAD) have been tightened in the last decades. This leads to the exclusion of patients with a high level of anxiety, but not fulfilling certain of the GAD-criteria, from effective treatment. Such so-called subsyndromal, subthreshold or subclinical GAD-states, however, often exhibit a comparable burden of disease like the full syndromal disorder and often tend to develop into the full syndromal disorder. The purpose of this review is - beside systematically reporting the papers found in respective data bases from 2013 onwards - to summarise the relevant data regarding definitions, epidemiology and consequences of subsyndromal anxiety states in order to give a comprehensive review.
Collapse
Affiliation(s)
- Hans-Peter Volz
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | - Julia Saliger
- Hospital for Psychiatry, Psychotherapy and Psychosomatic Medicine Schloss Werneck, Werneck, Germany
| | | | - Hans-Jürgen Möller
- Clinic and Policlinic for Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zürich, Zürich, Switzerland
| |
Collapse
|
25
|
Connor C, Yap MBH, Warwick J, Birchwood M, De Valliere N, Madan J, Melvin GA, Padfield E, Patterson P, Petrou S, Raynes K, Stewart-Brown S, Thompson A. An online parenting intervention to prevent affective disorders in high-risk adolescents: the PIPA trial protocol. Trials 2022; 23:655. [PMID: 35971178 PMCID: PMC9376903 DOI: 10.1186/s13063-022-06563-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescent depression can place a young person at high risk of recurrence and a range of psychosocial and vocational impairments in adult life, highlighting the importance of early recognition and prevention. Parents/carers are well placed to notice changes in their child's emotional wellbeing which may indicate risk, and there is increasing evidence that modifiable factors exist within the family system that may help reduce the risk of depression and anxiety in an adolescent. A randomised controlled trial (RCT) of the online personalised 'Partners in Parenting' programme developed in Australia, focused on improving parenting skills, knowledge and awareness, showed that it helped reduce depressive symptoms in adolescents who had elevated symptom levels at baseline. We have adapted this programme and will conduct an RCT in a UK setting. METHODS In total, 433 family dyads (parents/carers and children aged 11-15) will be recruited through schools, social media and parenting/family groups in the UK. Following completion of screening measures of their adolescent's depressive symptoms, parents/carers of those with elevated scores will be randomised to receive either the online personalised parenting programme or a series of online factsheets about adolescent development and wellbeing. The primary objective will be to test whether the personalised parenting intervention reduces depressive symptoms in adolescents deemed at high risk, using the parent-reported Short Mood & Feelings Questionnaire. Follow-up assessments will be undertaken at 6 and 15 months and a process evaluation will examine context, implementation and impact of the intervention. An economic evaluation will also be incorporated with cost-effectiveness of the parenting intervention expressed in terms of incremental cost per quality-adjusted life year gained. DISCUSSION Half of mental health problems emerge before mid-adolescence and approximately three-quarters by mid-20s, highlighting the need for effective preventative strategies. However, few early interventions are family focused and delivered online. We aim to conduct a National Institute for Health and Care Research (NIHR) funded RCT of the online personalised 'Partners in Parenting' programme, proven effective in Australia, targeting adolescents at risk of depression to evaluate its effectiveness, cost-effectiveness and usability in a UK setting. TRIAL REGISTRATION {2A}: ISRCTN63358736 . Registered 18 September 2019.
Collapse
Affiliation(s)
- C Connor
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK.
| | - M B H Yap
- Monash University, Melbourne, Australia
| | - J Warwick
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - M Birchwood
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - N De Valliere
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - J Madan
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | | | - E Padfield
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - P Patterson
- Birmingham Women's & Children's NHS Foundation Trust, Birmingham, UK
| | - S Petrou
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - K Raynes
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - S Stewart-Brown
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| | - A Thompson
- University of Warwick, Gibbet Hill Road, Coventry, CV4 7AL, UK
| |
Collapse
|
26
|
Noyes BK, Munoz DP, Khalid-Khan S, Brietzke E, Booij L. Is subthreshold depression in adolescence clinically relevant? J Affect Disord 2022; 309:123-130. [PMID: 35429521 DOI: 10.1016/j.jad.2022.04.067] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/29/2022] [Accepted: 04/10/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Subthreshold depression is highly prevalent in adolescence, but compared to major depressive disorder, the clinical impact is under-researched. The aim of this review was to compare subthreshold depression and major depressive disorder in adolescents by reviewing available literature on epidemiology, risk factors, illness trajectories, brain anatomy and function, genetics, and treatment response. METHODS We conducted a scoping review of papers on subthreshold depression and major depressive disorder in adolescence published in English. Studies in adults were included when research in adolescence was not available. RESULTS We found that individuals with subthreshold depression were similar to individuals with major depressive disorder in several regards, including female/male ratio, onset, functional impairment, comorbidity, health care utilization, suicidal ideation, genetic predisposition, brain alterations, and treatment response. Further, subthreshold depression was about two times more common than major depressive disorder. LIMITATIONS The definition of subthreshold depression is highly variable across studies. Adolescent-specific data are limited in the areas of neurobiology and treatment. CONCLUSIONS The findings of the current review support the idea that subthreshold depression is of clinical importance and provide evidence for a spectrum, versus categorical model, for depressive symptomatology. Given the frequency of subthreshold depression escalating to major depressive disorder, a greater recognition and awareness of the significance of subthreshold depression in research, clinical practice and policy-making may facilitate the development and application of early prevention and intervention.
Collapse
Affiliation(s)
- Blake K Noyes
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Medicine, Queen's University, Kingston, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada
| | - Sarosh Khalid-Khan
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Psychology, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Elisa Brietzke
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Department of Medicine, Queen's University, Kingston, Canada; Department of Psychiatry, Queen's University, Kingston, Canada
| | - Linda Booij
- Department of Psychology, Queen's University, Kingston, Canada; Department of Psychology, Concordia University, Montréal, Canada; CHU Sainte-Justine Hospital Research Centre, University of Montréal, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada.
| |
Collapse
|
27
|
Crouse JJ, Ho N, Scott J, Parker R, Park SH, Couvy-Duchesne B, Mitchell BL, Byrne EM, Hermens DF, Medland SE, Martin NG, Gillespie NA, Hickie IB. Dynamic networks of psychological symptoms, impairment, substance use, and social support: The evolution of psychopathology among emerging adults. Eur Psychiatry 2022; 65:e32. [PMID: 35694845 PMCID: PMC9280922 DOI: 10.1192/j.eurpsy.2022.23] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Subthreshold/attenuated syndromes are established precursors of full-threshold mood and psychotic disorders. Less is known about the individual symptoms that may precede the development of subthreshold syndromes and associated social/functional outcomes among emerging adults. METHODS We modeled two dynamic Bayesian networks (DBN) to investigate associations among self-rated phenomenology and personal/lifestyle factors (role impairment, low social support, and alcohol and substance use) across the 19Up and 25Up waves of the Brisbane Longitudinal Twin Study. We examined whether symptoms and personal/lifestyle factors at 19Up were associated with (a) themselves or different items at 25Up, and (b) onset of a depression-like, hypo-manic-like, or psychotic-like subthreshold syndrome (STS) at 25Up. RESULTS The first DBN identified 11 items that when endorsed at 19Up were more likely to be reendorsed at 25Up (e.g., hypersomnia, impaired concentration, impaired sleep quality) and seven items that when endorsed at 19Up were associated with different items being endorsed at 25Up (e.g., earlier fatigue and later role impairment; earlier anergia and later somatic pain). In the second DBN, no arcs met our a priori threshold for inclusion. In an exploratory model with no threshold, >20 items at 19Up were associated with progression to an STS at 25Up (with lower statistical confidence); the top five arcs were: feeling threatened by others and a later psychotic-like STS; increased activity and a later hypo-manic-like STS; and anergia, impaired sleep quality, and/or hypersomnia and a later depression-like STS. CONCLUSIONS These probabilistic models identify symptoms and personal/lifestyle factors that might prove useful targets for indicated preventative strategies.
Collapse
Affiliation(s)
- Jacob J Crouse
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas Ho
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Jan Scott
- Academic Psychiatry, Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom.,Université de Paris, Paris, France.,Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Richard Parker
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Shin Ho Park
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Baptiste Couvy-Duchesne
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia.,Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Inria, Aramis Project-Team, 75013Paris, France
| | | | - Enda M Byrne
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Daniel F Hermens
- Thompson Institute, University of the Sunshine Coast, Birtinya, Queensland, Australia
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Ian B Hickie
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
28
|
Chan JH, Chen HC, Chen IM, Wang TY, Chien YL, Wu SI, Kuo PH. Personality mediates the association between juvenile conduct problems and adulthood mood disorders. Sci Rep 2022; 12:8866. [PMID: 35614306 PMCID: PMC9132998 DOI: 10.1038/s41598-022-12939-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to examine the association between conduct problems and mood disorders, and to evaluate the mediating roles of personality traits in it. Adult participants (N = 309), for which patients with major depressive disorder (MDD) or bipolar disorder (BD), and controls without major psychiatric history were recruited. Juvenile conduct problem was defined by the items in Composite International Diagnosis Interview. We assessed personality traits of extraversion and neuroticism. Multiple mediation model was performed to investigate the intervening effect of personality traits between juvenile conduct problems and adulthood mood disorders. Participants had on average 2.7 symptoms of conduct problems, and 43.4% had conduct problems. Having more symptoms of conduct problems was associated with a higher likelihood of BD (OR = 1.20). Higher neuroticism was associated with elevated risks of both MDD and BD. There was no direct effect of binary conduct problems on the risk of BD, and showed significant total indirect effect mediated by neuroticism for BD (OR = 1.49; bias-corrected and accelerated 95% CI = 1.10–2.05), but not through extraversion. Conduct problems defined as a continuous variable had a direct effect on the risk of adult MDD (OR = 1.36; bias-corrected and accelerated 95% CI = 1.05–1.76), while had an indirect effect on the risk of BD via the mediation of neuroticism (OR = 1.08; bias-corrected and accelerated 95% CI = 1.02–1.14). Neuroticism mediates between the association of juvenile conduct problems and adult BD. This finding raises our attention to assess personality traits in individuals with juvenile conduct problems for timely intervention strategies of reducing the vulnerability for developing mood disorders.
Collapse
Affiliation(s)
- Jen-Hui Chan
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Ming Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Tsung-Yang Wang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-I Wu
- Department of Medicine, Mackay Memorial Hospital, New Taipei City, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. .,Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Room 501, No. 17, Xu-Zhou Road, Taipei, 100, Taiwan.
| |
Collapse
|
29
|
Auerbach RP, Srinivasan A, Kirshenbaum JS, Mann JJ, Shankman SA. Geolocation features differentiate healthy from remitted depressed adults. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:341-349. [PMID: 35230855 PMCID: PMC9296907 DOI: 10.1037/abn0000742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Depression recurrence is debilitating, and there is a pressing need to develop clinical tools that detect the reemergence of symptoms with the aim of bridging patients to treatment before recurrences. At baseline, remitted depressed adults (n = 22) and healthy controls (n = 24) were administered clinical interviews and completed self-report symptom measures. Then, smartphone apps were installed on personal smartphones to acquire geolocation data over 21 days and ecological momentary assessment of positive and negative affect during the initial 14-day period. Compared with healthy controls, remitted depressed adults exhibited reduced circadian routine (regularity of one's daily routine) and lower average daily distance traveled. Further, reduced distance traveled associated with greater daily negative affect after controlling for depression severity; however, this effect was not more pronounced among remitted adults. A least absolute shrinkage and selection operator (LASSO) regression indicated that a linear combination of circadian routine, average distance traveled, and baseline depression severity classified remitted depressed individuals with 72% accuracy; outperforming models restricted to either geolocation or clinical measures alone. Mobile sensing approaches hold enormous promise to improve clinical care for depressive disorders. Although barriers remain, leveraging technological advancements related to real-time monitoring can improve treatment for depressed patients and potentially, reduce high rates of recurrence. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Collapse
Affiliation(s)
- Randy P. Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA
| | - Apoorva Srinivasan
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Jaclyn S. Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - J. John Mann
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | | |
Collapse
|
30
|
Maxwell AM, Harrison K, Rawls E, Zilverstand A. Gender Differences in the Psychosocial Determinants Underlying the Onset and Maintenance of Alcohol Use Disorder. Front Neurosci 2022; 16:808776. [PMID: 35360152 PMCID: PMC8964095 DOI: 10.3389/fnins.2022.808776] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 02/01/2022] [Indexed: 12/20/2022] Open
Abstract
A large number of different mechanisms have been linked to Alcohol Use Disorder (AUD), including psychosocial, neurocognitive, affective, and neurobiological factors. Gender has been shown to impact the presentation and progression of AUD; yet, little work has been done to parse the different mechanisms underlying AUD within the lens of gender differences. A review of the literature on adolescence revealed that psychosocial factors, in particular lack of family social support and interactions with peers, drive the onset of alcohol use more strongly in girls relative to boys. However, research done on gender differences in disease progression in adults remains limited. Our gender-specific analysis of the mechanisms underlying AUD in adults revealed that lack of social support was causally linked to negative affect, mental health symptoms, and AUD symptom severity in women, but not men. These novel results suggest that psychosocial factors may play a gender-specific role not only in the onset of use in adolescence, but also in the maintenance of addiction in adults. If confirmed, this suggests the need for investigating gender-specific recovery trajectories. In this perspective piece, we review the literature regarding gender differences in the onset and maintenance of AUD and present original data that support unique risk factors in women.
Collapse
Affiliation(s)
- Andrea M. Maxwell
- Medical Scientist Training Program, University of Minnesota, Minneapolis, MN, United States
- Graduate Program in Neuroscience, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Andrea M. Maxwell,
| | - Katherine Harrison
- Graduate Program in Cognitive Sciences, University of Minnesota, Minneapolis, MN, United States
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, United States
| | - Eric Rawls
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Anna Zilverstand
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
- Medical Discovery Team on Addiction, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
31
|
Ramadianto AS, Kusumadewi I, Agiananda F, Raharjanti NW. Symptoms of depression and anxiety in Indonesian medical students: association with coping strategy and resilience. BMC Psychiatry 2022; 22:92. [PMID: 35130862 PMCID: PMC8820032 DOI: 10.1186/s12888-022-03745-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/31/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Depression and anxiety are prevalent mental health issues among medical students due to the various challenges during medical education. These issues affect not only their quality of life, but also their academic and professional development. Coping strategy and resilience are two factors that may influence students' mental health outcomes. Data of medical student mental health in Indonesia is scarce, hampering efforts to systematically address the problem. Hence, this study aims to estimate the prevalence of depressive and anxiety symptoms in Indonesian medical students, and their association with coping strategy and resilience. METHODS Undergraduate medical students from each year of study (Preclinical Year 1 to 4, Clinical Year 1 and 2) in the Faculty of Medicine Universitas Indonesia were randomly selected to participate in this cross-sectional study. The study questionnaire included sociodemographic characteristics, Depression Anxiety Stress Scale (DASS) to measure symptoms of depression and anxiety, Brief COPE to measure coping strategy, and Connor-Davidson Resilience Scale (CD-RISC) to measure resilience. Scores of depression and anxiety symptoms were analyzed by comparing them between different sociodemographic groups and by measuring their correlation with coping strategies and resilience. Multiple regression analyses were conducted to identify predictors of depression and anxiety symptoms. RESULTS Among 532 respondents, 22.2% reported symptoms of depression and 48,1% reported anxiety, including 3.0% and 8.1% with extremely severe depression and anxiety, respectively. Students not living with immediate family had higher depression score; female students and those in Preclinical Year 1 and Clinical Year 1 showed higher anxiety scores. Dysfunctional coping strategies and lower resilience are predictors of higher depression and anxiety symptoms. CONCLUSIONS Students show different levels of depressive and anxiety symptoms, signifying different levels of mental health support needs from universal mental health promotion to psychiatric treatment. Prevention programs can be targeted towards students with risk factors, such as not living with immediate family, undergoing first year of preclinical studies or clinical rotations, coping with dysfunctional strategies, and having low resilience. Additionally, medical educators must be aware of other, non-student factors that may impact student mental health, such as curriculum design and learning experience.
Collapse
Affiliation(s)
- Adhitya Sigit Ramadianto
- Department of Psychiatry, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
| | - Irmia Kusumadewi
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Feranindhya Agiananda
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Natalia Widiasih Raharjanti
- grid.9581.50000000120191471Department of Psychiatry, Faculty of Medicine Universitas Indonesia – Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| |
Collapse
|
32
|
Cavicchioli M, Ogliari A, Movalli M, Maffei C. Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders. Subst Use Misuse 2022; 57:1837-1853. [PMID: 36096483 DOI: 10.1080/10826084.2022.2120358] [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] [Indexed: 10/14/2022]
Abstract
The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.
Collapse
Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| |
Collapse
|
33
|
Schreuder MJ, Wigman JTW, Groen RN, Wichers M, Hartman CA. On the transience or stability of subthreshold psychopathology. Sci Rep 2021; 11:23306. [PMID: 34857821 PMCID: PMC8640053 DOI: 10.1038/s41598-021-02711-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/18/2021] [Indexed: 12/22/2022] Open
Abstract
Symptoms of psychopathology lie on a continuum ranging from mental health to psychiatric disorders. Although much research has focused on progression along this continuum, for most individuals, subthreshold symptoms do not escalate into full-blown disorders. This study investigated how the stability of psychopathological symptoms (attractor strength) varies across severity levels (homebase). Data were retrieved from the TRAILS TRANS-ID study, where 122 at-risk young adults (mean age 23.6 years old, 57% males) monitored their mental states daily for a period of six months (± 183 observations per participant). We estimated each individual's homebase and attractor strength using generalized additive mixed models. Regression analyses showed no association between homebases and attractor strengths (linear model: B = 0.02, p = 0.47, R2 < 0.01; polynomial model: B < 0.01, p = 0.61, R2 < 0.01). Sensitivity analyses where we (1) weighed estimates according to their uncertainty and (2) removed individuals with a DSM-5 diagnosis from the analyses did not change this finding. This suggests that stability is similar across severity levels, implying that subthreshold psychopathology may resemble a stable state rather than a transient intermediate between mental health and psychiatric disorder. Our study thus provides additional support for a dimensional view on psychopathology, which implies that symptoms differ in degree rather than kind.
Collapse
Affiliation(s)
- Marieke J Schreuder
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ, Groningen, The Netherlands.
| | - Johanna T W Wigman
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ, Groningen, The Netherlands
| | - Robin N Groen
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ, Groningen, The Netherlands
| | - Marieke Wichers
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ, Groningen, The Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center for Psychopathology and Emotion regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein, 19713 GZ, Groningen, The Netherlands
| |
Collapse
|
34
|
Lee J, Lee SI. Efficacy of Omega-3 and Korean Red Ginseng in Children with Subthreshold ADHD: A Double-Blind, Randomized, Placebo-Controlled Trial. J Atten Disord 2021; 25:1977-1987. [PMID: 32847461 DOI: 10.1177/1087054720951868] [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] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of the present study was to investigate the efficacy of combined omega-3 and Korean red ginseng supplementation on ADHD symptoms and cognitive function in children with subthreshold ADHD. METHOD 120 children from 6 to 12 years with subthreshold ADHD were enrolled in this 12-week, double-blind, randomized, placebocontrolled study. The primary outcome was measured by Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS). Children Behavior Check List (CBCL), and neuropsychological tests assessing attention, memory, and executive function were included as secondary primary outcome measures. RESULTS Significant effects on the scores of ADHDRS, as well as several subscales of CBCL including ADHD and attention problem subscales were revealed. CONCLUSION The combination of omega-3 and Korean red ginseng may have beneficial effects in children with subthreshold ADHD. Increased clinical awareness of ADHD symptoms even at a subthreshold level is needed.
Collapse
Affiliation(s)
- Jeewon Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon-Si, Gyeonggi-Do, Republic of Korea
| |
Collapse
|
35
|
Moretta T, Dal Bò E, Dell'Acqua C, Messerotti Benvenuti S, Palomba D. Disentangling emotional processing in dysphoria: An ERP and cardiac deceleration study. Behav Res Ther 2021; 147:103985. [PMID: 34628258 DOI: 10.1016/j.brat.2021.103985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/13/2021] [Accepted: 10/04/2021] [Indexed: 01/13/2023]
Abstract
The present study aimed to investigate emotional processing in dysphoria. To this end, the amplitude of the Late Positive Potential (LPP) and cardiac deceleration were assessed during the passive viewing of affective (pleasant, neutral, and unpleasant) pictures in 26 individuals with dysphoria and in 25 non-depressed controls. The group with dysphoria revealed a smaller LPP amplitude than the group without dysphoria in response to pleasant and neutral, but not unpleasant, stimuli at centro-parieto-occipital sites. Interestingly, whereas both groups showed cardiac deceleration when viewing pleasant compared to neutral pictures (3-6 s time window), only individuals with dysphoria showed a prolonged cardiac deceleration in response to unpleasant stimuli as compared with neutral ones. This study suggests that dysphoria is characterized by reduced motivated attentional allocation to positive information and by sustained intake of unpleasant information. Overall, the present findings provide novel insights into the characterization of valence-specific attentional processes in dysphoria as potential vulnerability factors for clinically significant depression.
Collapse
Affiliation(s)
- Tania Moretta
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy.
| | - Elisa Dal Bò
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| | - Carola Dell'Acqua
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| | - Daniela Palomba
- Department of General Psychology, University of Padua, Via Venezia 8, 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B, 35131, Padua, Italy
| |
Collapse
|
36
|
Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910051. [PMID: 34639355 PMCID: PMC8508031 DOI: 10.3390/ijerph181910051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Mental illness and psychological distress are global concerns. This study aimed to investigate the association between having non-preferred work and the incidence of spinal pain, psychological distress, and spinal pain with concurrent psychological distress, and if associations are modified by sleep disturbance. A prospective study of 4285 participants 23-62 years old was conducted, from years 2007 to 2010. Participants reported their work situation as preferred/non-preferred regarding profession/workplace with a high/low possibility to change. Psychological distress was measured with the General Health Questionnaire 12 and spinal pain with questions about neck/back pain. Binominal regression analyses calculated relative risk (RR) with 95% confidence interval (CI). Non-preferred work with a low possibility to change was associated with a higher incidence of spinal pain (RR 1.8; 95% CI 1.2-2.6) and psychological distress (RR 1.8; 95% CI 1.4-2.4) compared to preferred work. The RR was 1.4 (95% CI 0.9-2.1) for spinal pain and 1.3 (95% CI 1.0-1.7) for psychological distress among those with a high possibility to change. Non-preferred work yielded a higher incidence of spinal pain with concurrent psychological distress (RR 1.9; 95% CI 1.0-3.7). Sleep disturbance did not modify associations. A replication based on newer data is needed to confirm the results. In conclusion, non-preferred work is associated with a higher incidence of spinal pain and psychological distress, especially if the possibility to change job is low.
Collapse
|
37
|
Myers K, Rockhill C, Cortese S. Editorial: For Adolescents With Subthreshold Depression, Is an Ounce of Prevention Worth a Pound of Cure? J Am Acad Child Adolesc Psychiatry 2021; 60:1056-1058. [PMID: 33667603 DOI: 10.1016/j.jaac.2021.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/24/2021] [Indexed: 12/31/2022]
Abstract
Globally, depression is among the leading neuropsychiatric disorders of adolescence. Conventional wisdom indicates that an "ounce of prevention is worth a pound of cure," a perspective bolstered by some studies demonstrating that psychological interventions for subthreshold depression reduce acute symptoms and prevent the onset of major depressive disorder (MDD) over short-term follow-up. However, the meta-analysis by Cuijpers et al.,1 the first to pool results from all available relevant studies in the field, provides evidence that would seem to challenge this conventional wisdom. The meta-analysis included 12 randomized controlled trials of children and adolescents. This editorial focuses on the 10 studies with adolescents (age range, 13.5-17.4 years), who were recruited from schools (n = 6), medical settings (n = 3), and mass mailings (n = 1). The youths received short-term psychotherapies ranging from 6 to 16 sessions, primarily cognitive-behavioral therapy or interpersonal therapy, or inactive control/care as usual. Results showed significant short-term benefits in reducing acute depression symptoms, even though effect size was small to medium (number needed to treat = 8.4). At 6-18 months of follow-up, however, the likelihood of meeting full criteria for MDD was not significantly different between the intervention and control conditions. We child and adolescent psychiatrists have difficulty yielding our commitment to conventional wisdom and look for evidence that this meta-analysis is not the last word on the value of early interventions for subthreshold depression to prevent MDD in adolescents.
Collapse
Affiliation(s)
| | - Carol Rockhill
- University of Washington, Seattle; Seattle Children's Hospital, Washington
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, Faculty of Environmental and Life Sciences; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, United Kingdom; Solent NHS Trust, Southampton, United Kingdom; New York University Child Study Center; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, United Kingdom
| |
Collapse
|
38
|
Onell C, Holm LW, Bohman T, Magnusson C, Lekander M, Skillgate E. Work ability and psychological distress in a working population: results from the Stockholm Public Health Cohort. Scand J Public Health 2021:14034948211033692. [PMID: 34423688 DOI: 10.1177/14034948211033692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population. METHODS Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18-60 years, with no or mild psychological distress at baseline (n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals. RESULTS At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6-2.0). CONCLUSIONS Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.
Collapse
Affiliation(s)
- Clara Onell
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sweden
| | - Lena W Holm
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Tony Bohman
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden.,School of Health and Welfare, Dalarna University, Sweden
| | | | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,Department of Psychology, Stress Research Institute, Stockholm University, Sweden
| | - Eva Skillgate
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| |
Collapse
|
39
|
Augustine L, Lygnegård F, Granlund M. Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders. Disabil Rehabil 2021; 44:1595-1608. [PMID: 34353177 DOI: 10.1080/09638288.2021.1955304] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE Having a neurodevelopmental disorder (NDD) increases the risk of mental health problems and lower participation. We investigated the trajectories of mental health problems and participation in adolescents with NDD and compared these with trajectories for peers without NDD. In addition, the relationship between participation, mental health (well-being), and mental health problems were investigated. MATERIALS AND METHODS Data from a Swedish longitudinal survey study (LoRDIA) was used and adolescents with and without self-reported NDD were followed from 12/13 to 17 years, in three waves. Mental health problems were measured using the Strength and Difficulties Questionnaire, and well-being was measured with the Mental Health Continuum short form. RESULTS Adolescents with NDD experience more mental health problems than adolescents without NDD. Hyperactivity, a key feature of NDD, remains stable, while emotional problems and psychosomatic complaints, increase over time for girls, independent of NDD. Participation is stable over time but is more related to well-being than to NDD or mental health problems. CONCLUSIONS Gender is an important factor with girls exhibiting more problems. Mental health explains more of the variation in participation than mental health problems and NDD. Probably participation intervention can enhance mental health which may protect from mental health problems.Implications for rehabilitationMental health, i.e., emotional-, social-, and psychological well-being is more strongly related to participation and to reduced levels of mental health problems than having an NDD or not, thus assessing mental health separately from measuring NDD is important.Interventions focusing on participation may lead to higher mental health and having high mental health (flourishing) may facilitate participation.Girls with self-reported NDD seem to have a higher burden of mental health problems, especially if they also are languishing, i.e., having low mental health, therefore a strong focus on this group is needed both in research and clinical practice.Half of all adolescents are flourishing, independently of NDD or not, even if they are experiencing some symptoms of mental health problems, adolescents with NDD who are also languishing, have much higher ratings of mental health problems.
Collapse
Affiliation(s)
- Lilly Augustine
- CHILD, SIDR, School of Learning and Communication, Jönköping University, Jönköping, Sweden
| | - Frida Lygnegård
- CHILD, SIDR, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mats Granlund
- CHILD, SIDR, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
40
|
Letkiewicz AM, Funkhouser CJ, Shankman SA. Childhood maltreatment predicts poorer executive functioning in adulthood beyond symptoms of internalizing psychopathology. CHILD ABUSE & NEGLECT 2021; 118:105140. [PMID: 34098377 PMCID: PMC8292220 DOI: 10.1016/j.chiabu.2021.105140] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/13/2021] [Accepted: 05/23/2021] [Indexed: 05/12/2023]
Abstract
BACKGROUND A history of childhood maltreatment predicts poorer functioning in several domains during childhood, including executive function (EF). While there is also evidence of poorer EF in adults with a history of childhood trauma, results are mixed. Notable limitations of previous research are (a) the use of single indicators of EF, and/or (b) not consistently assessing whether childhood maltreatment predicts poorer EF beyond internalizing psychopathology. OBJECTIVE We sought to overcome limitations of prior work by examining relationships between childhood maltreatment and EF in adulthood by using a latent factor of EF derived from multiple indicators and including psychopathology covariates in our analyses. PARTICIPANTS AND SETTING The present study included a large sample of community adults (n = 489) who were oversampled for internalizing psychopathology symptoms. METHODS Primary analyses examined whether childhood maltreatment (cumulative and subtypes) predicted EF using a latent factor approach and linear mixed effects models. Follow-up analyses assessed the impact of childhood maltreatment on EF beyond internalizing psychopathology symptoms and assessed whether gender moderated relationships between EF and childhood maltreatment. RESULTS Greater cumulative maltreatment predicted poorer EF (B = -0.15), and emotional neglect emerged as a unique predictor of EF (B = -0.18). These results remained after controlling for psychopathology symptoms. Gender moderated the relationship between physical abuse and EF, with physical abuse predicting poorer EF among males (B = 0.30), but not females (B = -0.04). CONCLUSIONS Overall, results indicate that general EF deficits are related to a history of childhood maltreatment, which is not accounted for by internalizing psychopathology symptoms. Potential implications and future directions are discussed.
Collapse
Affiliation(s)
- Allison M Letkiewicz
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA.
| | - Carter J Funkhouser
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Stewart A Shankman
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
41
|
Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
Collapse
Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
| |
Collapse
|
42
|
Liu H, Funkhouser CJ, Langenecker SA, Shankman SA. Set Shifting and Inhibition Deficits as Potential Endophenotypes for Depression. Psychiatry Res 2021; 300:113931. [PMID: 33894683 PMCID: PMC8141023 DOI: 10.1016/j.psychres.2021.113931] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/08/2021] [Indexed: 01/06/2023]
Abstract
The etiology of Major Depressive Disorder (MDD) is poorly understood, and identifying endophenotypes, or intermediate processes implicated in pathophysiology, for MDD may inform treatment and identification/prevention efforts. Impaired set-shifting and inhibition are commonly observed in MDD; however, few studies have examined they are endophenotypes for MDD. Thus, the present study tested whether set-shifting and/or inhibition satisfy several endophenotype criteria: specifically, whether they were (1) impaired in current MDD, (2) impaired in remitted MDD, and (3) familial (i.e., correlated within sibling pairs). Set-shifting and inhibition were assessed using subtests from the Delis-Kaplan Executive Function System. Psychopathology was assessed using the Structured Clinical Interview for DSM-5. Results indicated set-shifting deficits were familial and present in both current MDD and in remitted MDD individuals who had no current disorders, suggesting they may be state-independent. Inhibition was familial, but was generally not impaired in current nor remitted MDD (although the remitted MDD group with no current disorders exhibited impairments on one of the two inhibition tasks). These findings indicate that impaired set-shifting is a promising endophenotype candidate for MDD. Findings are limited to young adults, and further research is needed to test generalizability to other populations, evaluate longitudinal relationships, and examine other endophenotype criteria.
Collapse
Affiliation(s)
- Huiting Liu
- Evidence Based Treatment Centers of Seattle, 1200 5th Ave #800, Seattle, WA 98101, USA
| | - Carter J Funkhouser
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 North Lake Shore Drive, Chicago, IL 60611, USA
| | - Scott A Langenecker
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; University of Utah, Department of Psychiatry, 501 Chipeta Way, Salt Lake City, UT 84108, USA
| | - Stewart A Shankman
- University of Illinois at Chicago, Department of Psychology, 1007 W. Harrison Street, Chicago, IL 60607, USA; Northwestern University, Department of Psychiatry and Behavioral Sciences, 680 North Lake Shore Drive, Chicago, IL 60611, USA.
| |
Collapse
|
43
|
Zimmer-Gembeck MJ, Rudolph J, Pariz J. A cascade of rejection and appearance preoccupation: Adolescents' body dysmorphic symptoms and appearance rejection sensitivity over 4 years. BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2021; 40:17-34. [PMID: 33891314 DOI: 10.1111/bjdp.12377] [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: 11/11/2020] [Revised: 04/06/2021] [Indexed: 10/21/2022]
Abstract
Adolescence is a high-risk period for body image disturbance and appearance concerns. In a cascade model, we examined interrelations of body dysmorphic symptoms (BDS) with appearance rejection sensitivity (ARS) and tested gender moderation. Participants were 397 Australian adolescents (T1 Mage = 11.7, SD = 0.91; 56% girls) who completed six surveys over 4 years. In a random-intercept cross-lag model, two (of five possible) paths showed ARS predicted higher subsequent BDS, and three (of five possible) paths showed BDS predicted higher subsequent ARS. Girls reported more BDS and ARS than boys, and random intercepts of BDS and ARS were correlated with the correlation stronger in girls than boys. Cross-lag BDD-ARS associations over the six waves were not significantly moderated by gender. Overall, girls are at higher risk of appearance concerns than boys, but BDD-ARS cascade effects do not differ between girls and boys.
Collapse
Affiliation(s)
- Melanie J Zimmer-Gembeck
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Julia Rudolph
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Juliane Pariz
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| |
Collapse
|
44
|
Short-term longitudinal participation trajectories related to domestic life and peer relations for adolescents with and without self-reported neurodevelopmental impairments. Heliyon 2021; 7:e06784. [PMID: 33912727 PMCID: PMC8065295 DOI: 10.1016/j.heliyon.2021.e06784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/03/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022] Open
Abstract
Background With maturity and development, complexity in demands and roles change. As participation is often restricted in children with disabilities, this process might be delayed in adolescents. Investigating profiles of participation for adolescents with and without neurodevelopmental impairments could provide an understanding of which factors relate to high level of participation. The aim is to investigate trajectories of participation in everyday activities across clusters based on self-rated participation patterns in frequency of participation and perceived importance of activities related to domestic life and peer-related activities for adolescents with and without self-reported neurodevelopmental impairments. Methods and procedures A prospective person-based cohort study design. Outcomes and results Five typical trajectories were identified. Trajectories between clusters with high perceived involvement in peer relations were associated with sibling support and family communication. Self-reported neurodevelopmental impairments did not predict participation profiles at certain time points, nor movements between clusters when measuring self-reported attendance and importance in domestic life and in peer-related activities. Conclusion and implications Perceived sibling support and family communication are important for predicting typical trajectories across clusters in frequency of attendance and the perceived importance of domestic life and peer relations. Type of impairment was less important in predicting typical trajectories.
Collapse
|
45
|
Teacher Nominations of Preschool Children at Risk for Mental Health Problems: how False Is a False Positive Nomination and What Make Teachers Concerned? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09871-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractIdentification attempts in populations with a low prevalence of problems usually result in a considerable number of false positives. Thus, the aim of the current study was to investigate the false positive rate following nomination of developmental concerns by preschool teachers and the reasons for which teachers raise developmental concerns about children who display non-clinical levels of mental health problems.A total of 1430 children aged 1 to 6 years in Norwegian childcare centers were classified as true positive, false positive, true negative, or false negative by comparing preschool teachers’ nomination with their ratings on the Caregiver-Teacher Report Form, resulting in 127 (9%) false positives and 1142 (80%) true negatives.Compared to the true negative group, the false positive group received significantly higher scores on internalizing problems, externalizing problems than true negatives, conflict and significantly lower scores on closeness. Children’s internalizing and externalizing problems and age were the main factors that increased the likelihood of teachers raising concerns, while increased closeness in the teacher-child relationship reduced the likelihood of being nominated. Children’s gender and conflict level were not significant when adjusting for other factors.These findings suggest that preschool teachers’ concerns about children’s development should not be discarded as the false positive group did show elevated levels of problem behavior and poorer teacher-child relationship compared to the true negative group. Scrutinizing concerns in collaboration with parents and other mental health professionals may be beneficial to ensure healthy development for children with elevated problem levels.
Collapse
|
46
|
Dell'Acqua C, Ghiasi S, Messerotti Benvenuti S, Greco A, Gentili C, Valenza G. Increased functional connectivity within alpha and theta frequency bands in dysphoria: A resting-state EEG study. J Affect Disord 2021; 281:199-207. [PMID: 33326893 DOI: 10.1016/j.jad.2020.12.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/20/2020] [Accepted: 12/05/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The understanding of neurophysiological correlates underlying the risk of developing depression may have a significant impact on its early and objective identification. Research has identified abnormal resting-state electroencephalography (EEG) power and functional connectivity patterns in major depression. However, the entity of dysfunctional EEG dynamics in dysphoria is yet unknown. METHODS 32-channel EEG was recorded in 26 female individuals with dysphoria and in 38 age-matched, female healthy controls. EEG power spectra and alpha asymmetry in frontal and posterior channels were calculated in a 4-minute resting condition. An EEG functional connectivity analysis was conducted through phase locking values, particularly mean phase coherence. RESULTS While individuals with dysphoria did not differ from controls in EEG spectra and asymmetry, they exhibited dysfunctional brain connectivity. Particularly, in the theta band (4-8 Hz), participants with dysphoria showed increased connectivity between right frontal and central areas and right temporal and left occipital areas. Moreover, in the alpha band (8-12 Hz), dysphoria was associated with increased connectivity between right and left prefrontal cortex and between frontal and central-occipital areas bilaterally. LIMITATIONS All participants belonged to the female gender and were relatively young. Mean phase coherence did not allow to compute the causal and directional relation between brain areas. CONCLUSIONS An increased EEG functional connectivity in the theta and alpha bands characterizes dysphoria. These patterns may be associated with the excessive self-focus and ruminative thinking that typifies depressive symptoms. EEG connectivity patterns may represent a promising measure to identify individuals with a higher risk of developing depression.
Collapse
Affiliation(s)
- Carola Dell'Acqua
- Department of General Psychogy, University of Padua, Via Venezia 8 - 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B - 35131, Padua, Italy.
| | - Shadi Ghiasi
- Department of Information Engineering & Bioengineering and Robotics Research Center E. Piaggio, School of Engineering, University of Pisa, Pisa, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychogy, University of Padua, Via Venezia 8 - 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B - 35131, Padua, Italy
| | - Alberto Greco
- Department of Information Engineering & Bioengineering and Robotics Research Center E. Piaggio, School of Engineering, University of Pisa, Pisa, Italy
| | - Claudio Gentili
- Department of General Psychogy, University of Padua, Via Venezia 8 - 35131, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Orus 2/B - 35131, Padua, Italy
| | - Gaetano Valenza
- Department of Information Engineering & Bioengineering and Robotics Research Center E. Piaggio, School of Engineering, University of Pisa, Pisa, Italy
| |
Collapse
|
47
|
Fristad MA, Roley-Roberts ME, Black SR, Arnold LE. Moody kids years later: Long-term outcomes of youth from the Omega-3 and therapy (OATS) studies. J Affect Disord 2021; 281:24-32. [PMID: 33285389 PMCID: PMC7856236 DOI: 10.1016/j.jad.2020.11.115] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND This naturalistic follow-up study examines outcomes for youth with depression (n = 25) or subsyndromal bipolar disorder (n = 13) 2-5 years after participation in randomized clinical trials (RCTs) of omega-3 fatty acids (Ω3), individual family psychoeducational psychotherapy (IF-PEP), and their combination METHODS: Forty percent (38/95) of RCT families completed a follow-up assessment RESULTS: Relapse rates and conversion to bipolar disorder were consistent with published literature. Original treatment assignment did not impact current functioning. Overall, participants' mood severity, executive functioning, and global functioning continued to be better than at RCT baseline. Depressive symptoms increased significantly from end of RCT. Manic symptom severity, executive functioning, and global functioning remained comparable to end of RCT. The majority of parents and youth reported improved youth emotion regulation skills and family communication. They considered study participation beneficial, with increased understanding of mood disorders being the top reason. Half of youth commenced or continued Ω3 and 58% commenced or continued psychotherapy post-RCT, suggesting some degree of consumer satisfaction; these youth had lower depression severity than other participants. LIMITATIONS Only 40% returned to this naturalistic follow-up; they were less likely to have an African-American parent, were of higher income, and youth were more symptomatic at end of RCT than those who did not return CONCLUSIONS: Improvement from RCT baseline continued although depressive symptom severity increased from end of RCT to follow-up. Meaningful improvements in youth and family functioning persisted 2-5 years later. Interventions that prevent relapse or conversion to BPSD are still needed for these vulnerable populations.
Collapse
Affiliation(s)
- Mary A. Fristad
- Nationwide Children’s Hospital, Big Lots Behavioral Health Services and Division of Child and Family Psychiatry, Columbus, Ohio,The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, Columbus, Ohio
| | | | - Sarah R. Black
- University of New Orleans, Department of Psychology, New Orleans, Louisiana
| | - L. Eugene Arnold
- The Ohio State University Wexner Medical Center, Department of Psychiatry & Behavioral Health, Columbus, Ohio
| |
Collapse
|
48
|
Wilson S, Olino TM. A developmental perspective on personality and psychopathology across the life span. J Pers 2021; 89:915-932. [PMID: 33550639 PMCID: PMC10142293 DOI: 10.1111/jopy.12623] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 12/16/2022]
Abstract
Taking a developmental perspective, guided by core principles of developmental science and developmental psychopathology, is necessary to move the fields of personality science and psychopathology forward. Personality and psychopathology can be delineated using hierarchical models of individual differences, as evidenced by decades of converging evidence across community and psychiatric samples, countries and cultures, and ages and developmental periods. A large body of empirical research likewise documents associations between personality and various forms of psychopathology. Cross-sectional investigations of personality-psychopathology links in samples of adults now yield diminishing returns. Prospective, longitudinal investigations that assess personality, psychopathology, and their co-development across the life span are needed to determine their temporal ordering, capture dynamic associations over time and development, and elucidate causal origins and underlying mechanisms. We lay out a developmental framework that integrates across the developmental, personality, and psychopathology literatures in order to further understanding and guide future investigations of the nature of personality-psychopathology links.
Collapse
Affiliation(s)
- Sylia Wilson
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
| |
Collapse
|
49
|
Funkhouser CJ, Chacko AA, Correa KA, Kaiser AJE, Shankman SA. Unique longitudinal relationships between symptoms of psychopathology in youth: A cross-lagged panel network analysis in the ABCD study. J Child Psychol Psychiatry 2021; 62:184-194. [PMID: 32399985 PMCID: PMC7657959 DOI: 10.1111/jcpp.13256] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The network theory suggests that psychopathology may reflect causal relationships between individual symptoms. Several studies have examined cross-sectional relationships between individual symptoms in youth. However, these studies cannot address the directionality of the temporal relationships hypothesized by the network theory. Therefore, we estimated the longitudinal relationships between individual internalizing, externalizing, and attention symptoms in youth. METHODS Data from 4,093 youth participants in the Adolescent Brain Cognitive Development (ABCD) study were used. Symptoms were assessed using the Brief Problem Monitor, which was administered at three time points spaced six months apart. Unique longitudinal relationships between symptoms at T1 and T2 were estimated using cross-lagged panel network modeling. Network replicability was assessed by comparing this network to an identically estimated replication network of symptoms at T2 predicting symptoms at T3. RESULTS After controlling for all other symptoms and demographic covariates, depressed mood, inattention, and worry at T1 were most predictive of other symptoms at T2. In contrast, threats of violence and destructiveness at T2 were most prospectively predicted by other symptoms at T1. The reciprocal associations between depressed mood and worthlessness were among the strongest bivariate relationships in the network. Comparisons between the original network and the replication network (correlation between edge lists = .61; individual edge replicability = 64%-84%) suggested moderate replicability. CONCLUSIONS Although causal inferences are precluded by the observational design and methodological considerations, these findings demonstrate the directionality of relationships between individual symptoms in youth and highlight depressed mood, inattention, and worry as potential influencers of other symptoms.
Collapse
Affiliation(s)
- Carter J. Funkhouser
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Kelly A. Correa
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ariela J. E. Kaiser
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stewart A. Shankman
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
50
|
Hartmann JA, McGorry PD, Destree L, Amminger GP, Chanen AM, Davey CG, Ghieh R, Polari A, Ratheesh A, Yuen HP, Nelson B. Pluripotential Risk and Clinical Staging: Theoretical Considerations and Preliminary Data From a Transdiagnostic Risk Identification Approach. Front Psychiatry 2021; 11:553578. [PMID: 33488413 PMCID: PMC7819892 DOI: 10.3389/fpsyt.2020.553578] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 12/02/2020] [Indexed: 12/26/2022] Open
Abstract
Most psychiatric disorders develop during adolescence and young adulthood and are preceded by a phase during which attenuated or episodic symptoms and functional decline are apparent. The introduction of the ultra-high risk (UHR) criteria two decades ago created a new framework for identification of risk and for pre-emptive psychiatry, focusing on first episode psychosis as an outcome. Research in this paradigm demonstrated the comorbid, diffuse nature of emerging psychopathology and a high degree of developmental heterotopy, suggesting the need to adopt a broader, more agnostic approach to risk identification. Guided by the principles of clinical staging, we introduce the concept of a pluripotent at-risk mental state. The clinical high at risk mental state (CHARMS) approach broadens identification of risk beyond psychosis, encompassing multiple exit syndromes such as mania, severe depression, and personality disorder. It does not diagnostically differentiate the early stages of psychopathology, but adopts a "pluripotent" approach, allowing for overlapping and heterotypic trajectories and enabling the identification of both transdiagnostic and specific risk factors. As CHARMS is developed within the framework of clinical staging, clinical utility is maximized by acknowledging the dimensional nature of clinical phenotypes, while retaining thresholds for introducing specific interventions. Preliminary data from our ongoing CHARMS cohort study (N = 114) show that 34% of young people who completed the 12-month follow-up assessment (N = 78) transitioned from Stage 1b (attenuated syndrome) to Stage 2 (full disorder). While not without limitations, this broader risk identification approach might ultimately allow reliable, transdiagnostic identification of young people in the early stages of severe mental illness, presenting further opportunities for targeted early intervention and prevention strategies.
Collapse
Affiliation(s)
- Jessica A. Hartmann
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Patrick D. McGorry
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Louise Destree
- BrainPark, The Turner Institute for Brain and Mental Health, School of Psychological Sciences and Monash Biomedical Imaging Facility, Monash University, Melbourne, VIC, Australia
| | - G. Paul Amminger
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrew M. Chanen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Christopher G. Davey
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia
| | - Rachid Ghieh
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Andrea Polari
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Aswin Ratheesh
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Hok Pan Yuen
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Barnaby Nelson
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| |
Collapse
|