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Jansen R, Milaneschi Y, Schranner D, Kastenmuller G, Arnold M, Han X, Dunlop BW, Rush AJ, Kaddurah-Daouk R, Penninx BWJH. The metabolome-wide signature of major depressive disorder. Mol Psychiatry 2024:10.1038/s41380-024-02613-6. [PMID: 38849517 DOI: 10.1038/s41380-024-02613-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 04/25/2024] [Accepted: 05/15/2024] [Indexed: 06/09/2024]
Abstract
Major Depressive Disorder (MDD) is a common, frequently chronic condition characterized by substantial molecular alterations and pathway dysregulations. Single metabolite and targeted metabolomics platforms have revealed several metabolic alterations in depression, including energy metabolism, neurotransmission, and lipid metabolism. More comprehensive coverage of the metabolome is needed to further specify metabolic dysregulations in depression and reveal previously untargeted mechanisms. Here, we measured 820 metabolites using the metabolome-wide Metabolon platform in 2770 subjects from a large Dutch clinical cohort with extensive clinical phenotyping (1101 current MDD, 868 remitted MDD, 801 healthy controls) at baseline, which were repeated in 1805 subjects at 6-year follow up (327 current MDD, 1045 remitted MDD, 433 healthy controls). MDD diagnosis was based on DSM-IV psychiatric interviews. Depression severity was measured with the Inventory of Depressive Symptomatology Self-report. Associations between metabolites and MDD status and depression severity were assessed at baseline and at 6-year follow-up. At baseline, 139 and 126 metabolites were associated with current MDD status and depression severity, respectively, with 79 overlapping metabolites. Adding body mass index and lipid-lowering medication to the models changed results only marginally. Among the overlapping metabolites, 34 were confirmed in internal replication analyses using 6-year follow-up data. Downregulated metabolites were enriched with long-chain monounsaturated (P = 6.7e-07) and saturated (P = 3.2e-05) fatty acids; upregulated metabolites were enriched with lysophospholipids (P = 3.4e-4). Mendelian randomization analyses using genetic instruments for metabolites (N = 14,000) and MDD (N = 800,000) showed that genetically predicted higher levels of the lysophospholipid 1-linoleoyl-GPE (18:2) were associated with greater risk of depression. The identified metabolome-wide profile of depression indicated altered lipid metabolism with downregulation of long-chain fatty acids and upregulation of lysophospholipids, for which causal involvement was suggested using genetic tools. This metabolomics signature offers a window on depression pathophysiology and a potential access point for the development of novel therapeutic approaches.
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Affiliation(s)
- Rick Jansen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands.
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands.
| | - Yuri Milaneschi
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
| | - Daniela Schranner
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Gabi Kastenmuller
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Matthias Arnold
- Institute of Computational Biology, Helmholtz Zentrum München, Neuherberg, Germany
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Xianlin Han
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Boadie W Dunlop
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - A John Rush
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke National University of Singapore, Singapore, Singapore
| | - Rima Kaddurah-Daouk
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
- Department of Medicine, Duke University, Durham, NC, USA.
- Duke Institute of Brain Sciences, Duke University, Durham, NC, USA.
| | - Brenda W J H Penninx
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam, the Netherlands
- Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands
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2
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Triolo F, Vetrano DL, Sjöberg L, Calderón-Larrañaga A, Belvederi Murri M, Fratiglioni L, Dekhtyar S. Somatic disease burden and depression risk in late life: a community-based study. Epidemiol Psychiatr Sci 2024; 33:e6. [PMID: 38327092 PMCID: PMC10894701 DOI: 10.1017/s2045796024000064] [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: 09/19/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 02/09/2024] Open
Abstract
AIMS Co-occurring somatic diseases exhibit complex clinical profiles, which can differentially impact the development of late-life depression. Within a community-based cohort, we aimed to explore the association between somatic disease burden, both in terms of the number of diseases and their patterns, and the incidence of depression in older people. METHODS We analysed longitudinal data of depression- and dementia-free individuals aged 60+ years from the population-based Swedish National Study on Aging and Care in Kungsholmen. Depression diagnoses were clinically ascertained following the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision over a 15-year follow-up. Somatic disease burden was assessed at baseline through a comprehensive list of chronic diseases obtained by combining information from clinical examinations, medication reviews and national registers and operationalized as (i) disease count and (ii) patterns of co-occurring diseases from latent class analysis. The association of somatic disease burden with depression incidence was investigated using Cox models, accounting for sociodemographic, lifestyle and clinical factors. RESULTS The analytical sample comprised 2904 people (mean age, 73.2 [standard deviation (SD), 10.5]; female, 63.1%). Over the follow-up (mean length, 9.6 years [SD, 4 years]), 225 depression cases were detected. Each additional disease was associated with the occurrence of any depression in a dose-response manner (hazard ratio [HR], 1.16; 95% confidence interval [CI]: 1.08, 1.24). As for disease patterns, individuals presenting with sensory/anaemia (HR, 1.91; 95% CI: 1.03, 3.53), thyroid/musculoskeletal (HR, 1.90; 95% CI: 1.06, 3.39) and cardiometabolic (HR, 2.77; 95% CI: 1.40, 5.46) patterns exhibited with higher depression hazards, compared to those without 2+ diseases (multimorbidity). In the subsample of multimorbid individuals (85%), only the cardiometabolic pattern remained associated with a higher depression hazard compared to the unspecific pattern (HR, 1.71; 95% CI: 1.02, 2.84). CONCLUSIONS Both number and patterns of co-occurring somatic diseases are associated with an increased risk of late-life depression. Mental health should be closely monitored among older adults with high somatic burden, especially if affected by cardiometabolic multimorbidity.
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Affiliation(s)
- Federico Triolo
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Linnea Sjöberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Martino Belvederi Murri
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Mohd Safien A, Ibrahim N, Subramaniam P, Singh DKA, Mat Ludin AF, Chin AV, Shahar S. Prevalence of depression and clinical depressive symptoms in community-dwelling older adults with cognitive frailty. Geriatr Gerontol Int 2024; 24:225-233. [PMID: 38199952 DOI: 10.1111/ggi.14801] [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: 06/26/2023] [Revised: 11/17/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024]
Abstract
AIM The present study determines the prevalence of depression and the extent of clinical depression symptoms among community-dwelling older adults with cognitive frailty and its associated factors. METHODS A total of 755 older adults aged ≥60 years were recruited. Their cognitive performance was determined using the Clinical Dementia Rating. Fried's criteria was applied to identify physical frailty, and the Beck Depression Inventory assessed their mental states. RESULTS A total of 39.2% (n = 304) of the participants were classified as cognitive frail. In this cognitive frail subpopulation, 8.6% (n = 26) had clinical depressive symptoms, which were mostly somatic such as disturbance in sleep pattern, work difficulty, fatigue, and lack of appetite. Older adults with cognitive frailty also showed significantly higher depression levels as compared with the noncognitive frail participants (t (622.06) = -3.38; P = 0.001). There are significant associations between depression among older adults with cognitive frailty and multimorbidity (P = 0.009), polypharmacy (P = 0.009), vision problems (P = 0.046), and hearing problems (P = 0.047). The likelihood of older adults with cognitive frailty who experience impairments to their vision and hearing, polypharmacy, and multimorbidity to be depressed also increased by 2, 3, 5, and 7-fold. CONCLUSIONS The majority of the Malaysian community-dwelling older adults were in a good mental state. However, older adults with cognitive frailty are more susceptible to depression due to impairments to their hearing and vision, multimorbidity, and polypharmacy. As common clinical depressive symptoms among older adults with cognitive frailty are mostly somatic, it is crucial for health professionals to recognize these and not to disregard them as only physical illness. Geriatr Gerontol Int 2024; 24: 225-233.
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Affiliation(s)
- A'isyah Mohd Safien
- Clinical Psychology and Behavioral Health Programme & Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Clinical Psychology and Behavioral Health Programme & Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ponnusamy Subramaniam
- Clinical Psychology and Behavioral Health Programme & Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ai-Vyrn Chin
- Division of Geriatric Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Center for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Basal and LPS-stimulated inflammatory markers and the course of anxiety symptoms. Brain Behav Immun 2021; 98:378-387. [PMID: 34509625 DOI: 10.1016/j.bbi.2021.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 08/23/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023] Open
Abstract
A cross-sectional relationship between low-grade inflammation -characterized by increased blood levels of C-reactive protein (CRP) and pro-inflammatory cytokines- and anxiety has been reported, but the potential longitudinal relationship has been less well studied. We aimed to examine whether basal and lipopolysaccharide (LPS-)induced levels of inflammatory markers are associated with anxiety symptom severity over the course of nine years. We tested the association between basal and LPS-induced inflammatory markers with anxiety symptoms (measured with the Beck's Anxiety Inventory; BAI, Fear Questionnaire; FQ and Penn's State Worry Questionnaire; PSWQ) at 5 assessment waves over a period up nine years. We used multivariate-adjusted mixed models in up to 2867 participants of the Netherlands Study of Depression and Anxiety (NESDA). At baseline, 43.6% of the participants had a current anxiety disorder, of which social phobia (18.5%) was most prevalent. Our results demonstrated that baseline inflammatory markers were significantly associated with several outcomes of anxiety at baseline over nine subsequent years. BAI subscale of somatic (arousal) symptoms of anxiety, and FQ subscale of agoraphobia demonstrated the strongest effects with standardized beta-coefficients of up to 0.14. The associations were attenuated by 25%-30% after adjusting for the presence of (comorbid) major depressive disorder (MDD), but remained statistically significant. In conclusion, we found that participants with high levels of inflammatory markers have on average high levels of anxiety consisting of physical arousal and agoraphobia, which tended to persist over a period of nine years, albeit with small effect sizes. These associations were partly driven by co-morbid depression.
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5
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Ronaldson A, Arias de la Torre J, Prina M, Armstrong D, Das-Munshi J, Hatch S, Stewart R, Hotopf M, Dregan A. Associations between physical multimorbidity patterns and common mental health disorders in middle-aged adults: A prospective analysis using data from the UK Biobank. LANCET REGIONAL HEALTH-EUROPE 2021; 8:100149. [PMID: 34557851 PMCID: PMC8447568 DOI: 10.1016/j.lanepe.2021.100149] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background We aimed to identify specific patterns of physical multimorbidity, defined as the presence of two or more physical long-term conditions, and to examine the extent to which these specific patterns could predict future incident and persistent common mental health disorders (CMDs) in middle-aged adults enrolled in the UK Biobank. Methods We assessed prospective associations between physical multimorbidity status at the baseline assessment (2006–2010) and depression and anxiety ‘caseness’ according to the Patient Health Questionnaire (PHQ)-9 and the Generalised Anxiety Disorder Assessment (GAD)-7 at the follow-up assessment (2016) in 154,367 middle-aged adults enrolled in the UK Biobank (median age: 57 years, interquartile range = 50–62 years, 56.5% female, mean duration of follow-up: 7.6 years, standard deviation = 0.87). Patterns of physical multimorbidity were identified using exploratory factor analysis. Logistic regression was used to assess prospective associations between physical multimorbidity patterns at baseline and both incident and persistent depression and anxiety at follow-up. Findings Compared to those with no physical multimorbidity, having two (adjusted odds ratio (aOR) =1.41, 95%CI 1.32 to 1.53), three (aOR = 1.94, 95%CI 1.76 to 2.14), four (aOR = 2.38, 95%CI 2.07 to 2.74), and five or more (aOR = 2.89, 95%CI 2.42 to 3.45) physical conditions was prospectively associated with incident depression at follow-up in a dose response manner. Similar trends emerged for incident anxiety, persistent depression, and persistent anxiety, but associations were strongest for incident CMDs. Regarding specific patterns of physical MM, the respiratory pattern (aOR = 3.23, 95%CI 2.44 to 4.27) and the pain/gastrointestinal pattern (aOR = 2.19, 95%CI 1.92 to 2.50) emerged as the strongest predictors of incident depression. Similar results emerged for incident anxiety. Interpretation These findings highlight patterns of physical multimorbidity with the poorest prognosis for both emerging and persisting depression and anxiety. These findings might have significant implications for the implementation of integrated mental and physical healthcare and facilitate the development of targeted preventative interventions and treatment for those with physical multimorbidity. Funding AR is supported by Guy's Charity grant number EIC180702; JAT is funded by Medical Research Council (MRC) number MR/SO28188/1; AD is funded by Guy's Charity grant number EIC180702 and MRC grant number MR/SO28188/1. JD is part supported by the ESRC Centre for Society and Mental Health at King's College London (ES/S012567/1), grants from the ESRC (ES/S002715/1), by the Health Foundation working together with the Academy of Medical Sciences, for a Clinician Scientist Fellowship, and by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London and the National Institute for Health Research (NIHR) Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust. The views expressed are those of the author[s] and not necessarily those of the ESRC, NIHR, the Department of Health and Social Care or King's College London.
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Affiliation(s)
- Amy Ronaldson
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Jorge Arias de la Torre
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Matthew Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David Armstrong
- Department of Primary Care and Public Health Sciences, King's College London, London, UK
| | - Jayati Das-Munshi
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,ESRC Centre for Society and Mental Health, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Stephani Hatch
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,ESRC Centre for Society and Mental Health, King's College London, London, UK
| | - Rob Stewart
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Alexandru Dregan
- Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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6
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Dolsen EA, Prather AA, Lamers F, Penninx BWJH. Suicidal ideation and suicide attempts: associations with sleep duration, insomnia, and inflammation. Psychol Med 2021; 51:2094-2103. [PMID: 32321599 DOI: 10.1017/s0033291720000860] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Sleep disturbance has been consistently identified as an independent contributor to suicide risk. Inflammation has emerged as a potential mechanism linked to both sleep disturbance and suicide risk. This study tested associations between sleep duration, insomnia, and inflammation on suicidal ideation (SI) and history of a suicide attempt (SA). METHODS Participants included 2329 adults with current or remitted depression and/or anxiety enrolled in the Netherlands Study of Depression and Anxiety. Sleep duration, insomnia, past week SI, and SA were assessed with self-report measures. Plasma levels of C-reactive protein, interleukin-6, and tumor necrosis factor-α were obtained. RESULTS Short sleep duration (⩽6 h) compared to normal sleep duration (7-9 h) was associated with reporting a prior SA, adjusting for covariates [adjusted odds ratio (AOR) 1.68, 95% CI 1.13-2.51]. A higher likelihood of SI during the past week was observed for participants with long sleep duration (⩾10 h) compared to normal sleep duration (AOR 2.22, 95% CI 1.02-4.82), more insomnia symptoms (AOR 1.44, 95% CI 1.14-1.83), and higher IL-6 (AOR 1.31, 95% CI 1.02-1.68). Mediation analyses indicated that the association between long sleep duration and SI was partially explained by IL-6 (AOR 1.02, 95% CI 1.00-1.05). CONCLUSIONS These findings from a large sample of adults with depression and/or anxiety provide evidence that both short and long sleep duration, insomnia symptoms, and IL-6 are associated with the indicators of suicide risk. Furthermore, the association between long sleep duration and SI may operate through IL-6.
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Affiliation(s)
- Emily A Dolsen
- Department of Psychology, University of California, Berkeley, 2121 Berkeley Way, Berkeley, CA94720, USA
| | - Aric A Prather
- Department of Psychiatry, University of California San Francisco, San Francisco, CA94118, USA
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institutes, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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7
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Jin W, Liu Z, Zhang Y, Che Z, Gao M. The Effect of Individual Musculoskeletal Conditions on Depression: Updated Insights From an Irish Longitudinal Study on Aging. Front Med (Lausanne) 2021; 8:697649. [PMID: 34513871 PMCID: PMC8426633 DOI: 10.3389/fmed.2021.697649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Few longitudinal studies have systematically investigated whether or how individual musculoskeletal conditions (IMCs) convey risks for negative psychological health outcomes, and approaches to assess such risk in the older population are lacking. In this Irish nationally representative longitudinal prospective study of 6,715 individuals aged 50 and above, machine learning algorithms and various models, including mediation models, were employed to elaborate the underlying mechanisms of IMCs leading to depression and to develop an IMC-induced negative psychological risk (IMCPR) classification approach. Resultantly, arthritis [odds ratio (95% confidence interval): 2.233 (1.700-2.927)], osteoporosis [1.681 (1.133-2.421)], and musculoskeletal chronic pain [MCP, 2.404 (1.838-3.151)] were found to increase the risk of depression after 2 years, while fracture and joint replacement did not. Interestingly, mediation models further demonstrated that arthritis per se did not increase the risk of depression; such risk was augmented only when arthritis-induced restrictions of activities (ARA) existed [proportion of mediation: 316.3% (ARA of usual), 213.3% (ARA of social and leisure), and 251.3% (ARA of sleep)]. The random forest algorithm attested that osteoarthritis, not rheumatoid arthritis, contributed the most to depressive symptoms. Moreover, bone mineral density was negatively associated with depressive symptoms. Systemic pain contributed the most to the increased risk of depression, followed by back, knee, hip, and foot pain (mean Gini-Index: 3.778, 2.442, 1.980, 1.438, and 0.879, respectively). Based on the aforementioned findings, the IMCPR classification approach was developed using an interpretable machine learning model, which stratifies participants into three grades. Among the IMCPR grades, patients with a grade of "severe" had higher odds of depression than those with a "mild" [odds ratio (95% confidence interval): 4.055 (2.907-5.498)] or "moderate" [3.584 (2.101-5.883)] grade. Females with a "severe" grade had higher odds of depression by 334.0% relative to those with a "mild" grade, while males had a relative risk of 258.4%. In conclusion, the present data provide systematic insights into the IMC-induced depression risk and updated the related clinical knowledge. Furthermore, the IMCPR classification approach could be used as an effective tool to evaluate this risk.
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Affiliation(s)
- Wenyi Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zilin Liu
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yubiao Zhang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhifei Che
- Department of Urology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Mingyong Gao
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
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8
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Ten Have M, Tuithof M, van Dorsselaer S, Kleinjan M, Penninx BWJH, Batelaan NM, de Graaf R. Duration of anxiety disorder and its associated risk indicators: Results of a longitudinal study of the general population. Depress Anxiety 2021; 38:328-336. [PMID: 33107675 DOI: 10.1002/da.23103] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/10/2020] [Accepted: 09/30/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Data on episode duration of anxiety disorders are required for informing patients and for disease management, but such data from population studies are lacking. METHODS Three-year longitudinal data were used from the Netherlands Mental Health Survey and Incidence Study-2, a psychiatric epidemiological cohort study among the general adult population (N = 6646). Respondents with a new (first or recurrent) anxiety disorder were selected (n = 158). DSM-IV diagnoses were assessed with the Composite International Diagnostic Interview; the Life Chart Interview assessed episode duration and recovery rates. RESULTS Among those with anxiety disorder, median episode duration was 7.5 months and mean duration was 15.2 months. 38.8% had not recovered at 12 months and 30.1% not at 36 months. Longer duration was associated with older age, not having a paid job, higher neuroticism, more physical disorders, and worse physical functioning. CONCLUSIONS Also, in the general population, anxiety disorder has a rather chronic course. After 12 months the cumulative recovery rate flattened. To prevent and manage chronicity, timely treatment, and chronic disease management are required. The risk indicators found may help to identify individuals with an anxiety disorder at risk for chronicity.
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Affiliation(s)
- Margreet Ten Have
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marlous Tuithof
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Saskia van Dorsselaer
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Marloes Kleinjan
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands.,Department of Interdisciplinary Social Sciences, Youth Studies, Utrecht University, Utrecht, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Psychiatry, GGZ inGeest, Amsterdam, The Netherlands
| | - Ron de Graaf
- Department of Epidemiology, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
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9
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Jansen R, Han LK, Verhoeven JE, Aberg KA, van den Oord EC, Milaneschi Y, Penninx BW. An integrative study of five biological clocks in somatic and mental health. eLife 2021; 10:59479. [PMID: 33558008 PMCID: PMC7872513 DOI: 10.7554/elife.59479] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023] Open
Abstract
Biological clocks have been developed at different molecular levels and were found to be more advanced in the presence of somatic illness and mental disorders. However, it is unclear whether different biological clocks reflect similar aging processes and determinants. In ~3000 subjects, we examined whether five biological clocks (telomere length, epigenetic, transcriptomic, proteomic, and metabolomic clocks) were interrelated and associated to somatic and mental health determinants. Correlations between biological aging indicators were small (all r < 0.2), indicating little overlap. The most consistent associations of advanced biological aging were found for male sex, higher body mass index (BMI), metabolic syndrome, smoking, and depression. As compared to the individual clocks, a composite index of all five clocks showed most pronounced associations with health determinants. The large effect sizes of the composite index and the low correlation between biological aging indicators suggest that one's biological age is best reflected by combining aging measures from multiple cellular levels.
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Affiliation(s)
- Rick Jansen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Laura Km Han
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Josine E Verhoeven
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Karolina A Aberg
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, United States
| | - Edwin Cgj van den Oord
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, United States
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Brenda Wjh Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute and Amsterdam Neuroscience, Amsterdam, Netherlands
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10
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Triolo F, Harber-Aschan L, Belvederi Murri M, Calderón-Larrañaga A, Vetrano DL, Sjöberg L, Marengoni A, Dekhtyar S. The complex interplay between depression and multimorbidity in late life: risks and pathways. Mech Ageing Dev 2020; 192:111383. [DOI: 10.1016/j.mad.2020.111383] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/14/2020] [Accepted: 10/05/2020] [Indexed: 12/20/2022]
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11
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Verhoeven JE, Verduijn J, van Oppen P, van Schaik A, Vinkers CH, Penninx BWJH. Getting under the skin: Does biology help predict chronicity of depression? J Affect Disord 2020; 274:1013-1021. [PMID: 32663927 DOI: 10.1016/j.jad.2020.05.098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/08/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Depressed patients are at risk of an unfavourable course including chronic episodes. Various psychiatric characteristics have shown to be predictive of depression's course trajectory, but whether indicators of somatic health further contribute to course prediction remains unclear. This study aimed to identify somatic health indicators (i.e. biomarkers, health status and lifestyle) that predict 2-year chronicity above and beyond an extensive list of sociodemographic and psychiatric characteristics. METHODS Data are from patients with current depression at baseline (n = 903) and available 2-year follow-up participating in a longitudinal cohort study. Baseline demographic, psychiatric and somatic health indicators were associated with 2-year course trajectories, classified as non-chronic versus chronic RESULTS: At 2-year follow up, 40% of the patients showed a chronic course. Of the twenty tested somatic health indicators, short sleep and high interleukin-6 improved the regression model predicting chronicity with a significant, but modest, effect (ROC = 0.78; p = 0.03). LIMITATIONS Due to the observational design we did not have the ability to reliably consider the impact of psychiatric treatment. More elaborate information on somatic health such as dietary patterns would strengthen the study. CONCLUSIONS This study showed that short sleep duration and high interleukin-6 contributed significantly to the regression model as independent predictors, suggestive of clinical implications for patients with sleep disturbances and elevated inflammation levels. Other somatic health indicators did not add to the model. Overall, somatic health indicators showed modest additive value for predicting chronic course above and beyond sociodemographic and psychiatric indicators.
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Affiliation(s)
- Josine E Verhoeven
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands.
| | - Judith Verduijn
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Anneke van Schaik
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Christiaan H Vinkers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute & Amsterdam Neuroscience, Oldenaller 1, 1081 HJ Amsterdam, The Netherlands
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12
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Abstract
PURPOSE OF REVIEW Despite of the heightened risks and burdens of physical comorbidities across the entire spectrum of mental disorders, relatively little is known about physical multimorbidity in this population. The aim of this narrative review is to present recent data regarding the onset and accumulation of physical multimorbidity and to assess its impact on the onset, course, treatment, and outcomes of mental disorders. RECENT FINDINGS A substantial body of literature shows increased risk of physical multimorbidity among people with mental disorders. The disparity in physical multimorbidity occurs even before the diagnosis of mental disorder, and the younger age group appears to be at particular risk. Numerous patterns of association between mental disorders and medical disorders involving multiple organ systems have been identified. Physical multimorbidity affects people with mental disorders across their life spans, is associated with a wide range of unfavorable outcomes and presents significant clinical and public health concerns. SUMMARY To address physical health inequalities among people with mental disorders compared with the general population, we must focus on the physical health from the very first point of contact with a mental health service. Treatment of mental disorders must be customized to meet the needs of patients with different physical multimorbidity patterns. Future work is needed to clarify how physical multimorbidity influences mental disorder treatment outcomes.
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13
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van Eeden WA, van Hemert AM, Carlier IVE, Penninx BWJH, Lamers F, Fried EI, Schoevers R, Giltay EJ. Basal and LPS-stimulated inflammatory markers and the course of individual symptoms of depression. Transl Psychiatry 2020; 10:235. [PMID: 32669537 PMCID: PMC7363825 DOI: 10.1038/s41398-020-00920-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/22/2020] [Accepted: 07/03/2020] [Indexed: 12/04/2022] Open
Abstract
Multiple studies show an association between inflammatory markers and major depressive disorder (MDD). People with chronic low-grade inflammation may be at an increased risk of MDD, often in the form of sickness behaviors. We hypothesized that inflammation is predictive of the severity and the course of a subset of MDD symptoms, especially symptoms that overlap with sickness behavior, such as anhedonia, anorexia, low concentration, low energy, loss of libido, psychomotor slowness, irritability, and malaise. We tested the association between basal and lipopolysaccharide (LPS)-induced inflammatory markers with individual MDD symptoms (measured using the Inventory of Depressive Symptomatology Self-Report) over a period of up to 9 years using multivariate-adjusted mixed models in 1147-2872 Netherlands Study of Depression and Anxiety (NESDA) participants. At baseline, participants were on average 42.2 years old, 66.5% were women and 53.9% had a current mood or anxiety disorder. We found that basal and LPS-stimulated inflammatory markers were more strongly associated with sickness behavior symptoms at up to 9-year follow-up compared with non-sickness behavior symptoms of depression. However, we also found significant associations with some symptoms that are not typical of sickness behavior (e.g., sympathetic arousal among others). Inflammation was not related to depression as a unified syndrome but rather to the presence and the course of specific MDD symptoms, of which the majority were related to sickness behavior. Anti-inflammatory strategies should be tested in the subgroup of MDD patients who report depressive symptoms related to sickness behavior.
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Affiliation(s)
- Wessel A van Eeden
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
| | - Albert M van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Ingrid V E Carlier
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Research and Innovation, GGZ inGeest, Amsterdam, The Netherlands
| | - Eiko I Fried
- Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - Robert Schoevers
- Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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14
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Corallo F, De Salvo S, Cannistraci C, Lo Buono V, Di Cara M, Floridia D, Cerra F, Romeo L, Pria D, Bramanti P, Marino S, Bonanno L. Chronic pain and spinal cord stimulation. Medicine (Baltimore) 2020; 99:e20490. [PMID: 32481461 DOI: 10.1097/md.0000000000020490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Chronic pain can have a devastating impact and lead to patient isolation. Many people with chronic pain are predisposed to anxiety-depressant symptoms, due to a lower quality life. The aim of the study is to demonstrate how neuromodulation methods, can encourage the reduction of chronic pain and an improvement in the quality of life, therefore advancing the restoration of psychological well-being.We involved 50 patients with a diagnosis of pain that not respond to traditional pharmacological therapies. Interventions: All subject had depression and anxiety symptoms and a low-quality life. We used the spinal cord stimulation treatment and a psychological evaluation for assessment of depression-anxiety symptomatology and the level of quality life.We observed a significant difference in physical functioning, role limitations due to physical health, general health perceptions, vitality, social functioning, role limitations due to emotional problems and mental health.Our study affirms that the perception of chronic pain has a great impact on the perception of psychological well-being, quality of life, and the performance of normal daily social and professional activities.
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Affiliation(s)
- Francesco Corallo
- IRCCS Centro Neurolesi "Bonino Pulejo," S.S. 113 C.da Casazza, Messina, Italy
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15
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Harber-Aschan L, Hotopf M, Brown JSL, Henderson M, Hatch SL. Longitudinal patterns of mental health service utilisation by those with mental-physical comorbidity in the community. J Psychosom Res 2019; 117:10-19. [PMID: 30665590 DOI: 10.1016/j.jpsychores.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/06/2018] [Accepted: 11/10/2018] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Successful healthcare integration demands an understanding of current service utilisation by people with comorbidity. Physical illness may impact on mental health service use (MHSU), but longitudinal studies of comorbidity and MHSU are rare. This study 1) estimated associations between mental-physical comorbidity and longitudinal MHSU patterns; 2) tested whether associations between comorbidity and continuous MHSU are driven by "need". METHODS Survey data from a South East London community cohort were used (N = 1052). Common mental disorder symptoms (CMDS) were measured using the Clinical Interview Schedule Revised and self-report of long-standing disorders. A checklist of common conditions measured chronic physical conditions. MHSU captured self-reported use of mental health services in the past year at two time points. "Need" indicators included CMDS at follow-up, suicidal ideation, somatic symptom severity, self-rated health, daily functioning problems and perceived functioning limitations due to emotional health. Analyses used logistic and multinomial regression. RESULTS Continuous MHSU (at both time-points) was twice as commonly reported by those with comorbidity than those without physical comorbidity (30.9% vs 12.3%). CMDS at follow-up, suicidal ideation, and perceived functioning limitations due to emotional health only partially explained the association between CMDS-physical comorbidity and continuous MHSU. In the adjusted model, comorbidity remained associated with continuous MHSU (RRR = 3.23, 95% CI: 1.39-7.51; p = .002), while the association for non-comorbid CMDS was fully attenuated (RRR = 1.08, 95% CI: 0.40-2.93; p = .85). CONCLUSION CMDS-physical comorbidity was strongly associated with continuous MHSU, and "need" did not account for this association, suggesting that comorbidity itself represents a "need" indicator.
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Affiliation(s)
- L Harber-Aschan
- Psychological Medicine, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health at the South London, Maudsley NHS Foundation Trust, King's College London, London, UK.
| | - M Hotopf
- Psychological Medicine, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK; NIHR Biomedical Research Centre for Mental Health at the South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - J S L Brown
- Psychology Department, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - M Henderson
- NIHR Biomedical Research Centre for Mental Health at the South London, Maudsley NHS Foundation Trust, King's College London, London, UK
| | - S L Hatch
- Psychological Medicine, Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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16
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The effect of chronic physical illnesses on psychiatric hospital admission in patients with recurrent major depression. Psychiatry Res 2019; 272:602-608. [PMID: 30616130 DOI: 10.1016/j.psychres.2018.12.178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 11/26/2018] [Accepted: 12/31/2018] [Indexed: 12/19/2022]
Abstract
People with major depressive disorder (MDD) have an increased burden of chronic physical illnesses (CPI). However, information about the effect of CPIs on recurrent MDD treatment outcome is limited. The objective of this study was to explore whether the number of CPIs in patients with recurrent MDD was associated with higher rate of psychiatric admissions. Data were collected for a consecutive sample of 190 patients diagnosed with recurrent MDD. The key outcome was the number of psychiatric admissions following psychiatric diagnosis. The independent variable was the number of CPIs. The effects of different clinical, sociodemographic, and lifestyle confounding factors were controlled using robust regression. The patients with CPI had significantly more psychiatric admissions than the patients without CPI, and the number of CPIs was significantly associated with the number of psychiatric admissions. The results of our study largely confirmed that more than two CPIs in patients diagnosed with recurrent MDD are associated with higher rates of psychiatric admission, independent of psychiatric comorbidities and other clinical and sociodemographic factors. These findings indicate that to improve treatment outcome and to reduce recurrence, it is crucial to enhance early recognition and treatment of physical comorbidity.
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17
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Thunander Sundbom L, Hedborg K. Association between prescribed antidepressants and other prescribed drugs differ by gender: a nationwide register-based study in Sweden. Nord J Psychiatry 2019; 73:73-79. [PMID: 30661437 DOI: 10.1080/08039488.2018.1536766] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND People with depression are prescribed more drugs than people in general, partly due to comorbidity with other conditions. However, little research has been done on depression-related drug use from a gender perspective. AIM Examine the association between antidepressants, other types of prescribed drugs, and polypharmacy, by gender. METHODS Data on drugs dispensed October to December 2016 to all Swedish citizens aged 18-84 years were collected from the Swedish prescribed drug register. Logistic regression analyses were performed to examine the associations between antidepressants and other drugs, by gender. RESULTS For both men and women, associations were found between antidepressants and drugs for alimentary tract problems, respiratory problems, blood, nervous system, analgesics, and polypharmacy. However, for women, but not men, associations were also found for drugs for diabetes, musculoskeletal problems, dermatological problems, and systemic hormones. CONCLUSIONS Associations were found between antidepressants and many other types of drugs for both men and women; indicating comorbidity between depression and other conditions. Further, some of the associations between antidepressants and other drugs were found to be specific among women. Whether this indicates that men and women differ in comorbidity between depression and other conditions cannot be concluded based on this cross-sectional study. However, comorbidity impairs the possibility of recovery; in the somatic condition as well as the depression. Thus, physicians need to be aware that the association between antidepressants and other types of drugs are more common among women than men.
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Affiliation(s)
- Lena Thunander Sundbom
- a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gävle , Gävle , Sweden.,b Pharmacoepidemiology and Pharmacoeconomics, Department of Pharmacy , Uppsala University , Uppsala , Sweden
| | - Kerstin Hedborg
- a Faculty of Health and Occupational Studies, Department of Health and Caring Sciences , University of Gävle , Gävle , Sweden
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18
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Gaspersz R, Lamers F, Beekman AT, van Hemert AM, Schoevers RA, Penninx BW. The Impact of Depressive Disorder Symptoms and Subtypes on 6-Year Incidence of Somatic Diseases. PSYCHOTHERAPY AND PSYCHOSOMATICS 2018; 87:308-310. [PMID: 30114682 PMCID: PMC6219696 DOI: 10.1159/000491933] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 07/07/2018] [Indexed: 11/19/2022]
Affiliation(s)
- Roxanne Gaspersz
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands,*Roxanne Gaspersz, MD, Department of Psychiatry, VU University Medical Center, Postbus 74077, NL–1070 BB Amsterdam (The Netherlands), E-Mail
| | - Femke Lamers
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Aartjan T.F. Beekman
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Albert M. van Hemert
- Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands
| | - Robert A. Schoevers
- Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Brenda W.J.H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands,Department of Psychiatry, Leiden University Medical Center, Leiden, the Netherlands,Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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19
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van Loo HM, Aggen SH, Gardner CO, Kendler KS. Sex similarities and differences in risk factors for recurrence of major depression. Psychol Med 2018; 48:1685-1693. [PMID: 29173194 DOI: 10.1017/s0033291717003178] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Major depression (MD) occurs about twice as often in women as in men, but it is unclear whether sex differences subsist after disease onset. This study aims to elucidate potential sex differences in rates and risk factors for MD recurrence, in order to improve prediction of course of illness and understanding of its underlying mechanisms. METHODS We used prospective data from a general population sample (n = 653) that experienced a recent episode of MD. A diverse set of potential risk factors for recurrence of MD was analyzed using Cox models subject to elastic net regularization for males and females separately. Accuracy of the prediction models was tested in same-sex and opposite-sex test data. Additionally, interactions between sex and each of the risk factors were investigated to identify potential sex differences. RESULTS Recurrence rates and the impact of most risk factors were similar for men and women. For both sexes, prediction models were highly multifactorial including risk factors such as comorbid anxiety, early traumas, and family history. Some subtle sex differences were detected: for men, prediction models included more risk factors concerning characteristics of the depressive episode and family history of MD and generalized anxiety, whereas for women, models included more risk factors concerning early and recent adverse life events and socioeconomic problems. CONCLUSIONS No prominent sex differences in risk factors for recurrence of MD were found, potentially indicating similar disease maintaining mechanisms for both sexes. Course of MD is a multifactorial phenomenon for both males and females.
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Affiliation(s)
- Hanna M van Loo
- Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond,VA,USA
| | - Steven H Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond,VA,USA
| | - Charles O Gardner
- Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond,VA,USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics,Virginia Commonwealth University,Richmond,VA,USA
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20
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Hegeman JM, van Fenema EM, Comijs HC, Kok RM, van der Mast RC, de Waal MWM. Effect of chronic somatic diseases on the course of late-life depression. Int J Geriatr Psychiatry 2017; 32:779-787. [PMID: 27273023 DOI: 10.1002/gps.4523] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/14/2016] [Accepted: 05/16/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine the influence of specific chronic somatic diseases and overall somatic diseases burden on the course of depression in older persons. METHODS This was a prospective cohort study with a 2-year follow-up. Participants were depressed persons (n = 285) from the Netherlands Study of Depression in Older Persons. The presence of chronic somatic diseases was based on self-report. Diagnosis of depression was assessed with the Composite International Diagnostic Interview, and severity of depression was measured with the Inventory of Depressive Symptomatology Self-report. RESULTS Cardiovascular diseases (odds ratio [OR] = 1.67, 95% confidence interval [CI] = 1.02-2.72, p = 0.041), musculoskeletal diseases (OR = 1.71, 95% CI = 1.04-2.80, p = 0.034), and the number of chronic somatic diseases (OR = 1.37, 95% CI = 1.16-1.63, p < 0.001) were associated with having a depressive disorder at 2-year follow-up. Furthermore, chronic non-specific lung diseases, cardiovascular diseases, musculoskeletal diseases, cancer, or cumulative somatic disease burden were associated with a chronic course of depression. CONCLUSIONS Somatic disease burden is associated with a poor course of late-life depression. The course of late-life depression is particularly unfavorable in the presence of chronic non-specific lung diseases, cardiovascular diseases, musculoskeletal diseases, and cancer. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Johanna M Hegeman
- Department of Psychiatry, St. Antonius Ziekenhuis, Utrecht, The Netherlands.,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Esther M van Fenema
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, EMGO Institute of Health and Care Research, VU Medical Center, Amsterdam, The Netherlands
| | - Rob M Kok
- Department of Old Age Psychiatry, Parnassia, Den Haag, The Netherlands
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.,Department of Psychiatry, CAPRI--University of Antwerp, Antwerp, Belgium
| | - Margot W M de Waal
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
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21
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Bokma WA, Batelaan NM, van Balkom AJLM, Penninx BWJH. Impact of Anxiety and/or Depressive Disorders and Chronic Somatic Diseases on disability and work impairment. J Psychosom Res 2017; 94:10-16. [PMID: 28183397 DOI: 10.1016/j.jpsychores.2017.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 01/02/2017] [Accepted: 01/06/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Anxiety and/or Depressive Disorders (ADDs) and Chronic Somatic Diseases (CSDs) are associated with substantial levels of health-related disability and work impairment. However, it is unclear whether comorbid ADDs and CSDs additively affect functional outcomes. This paper examines the impact of ADDs, CSDs, and their comorbidity on disability, work absenteeism and presenteeism. METHODS Baseline data from the Netherlands Study of Depression and Anxiety (n=2371) were used. We assessed presence of current ADDs (using psychiatric interviews, CIDI) and presence of self-reported CSDs. Outcome measures were disability scores (WHO-DAS II questionnaire, overall and domain-specific), work absenteeism (≤2weeks and >2weeks; TiC-P) and presenteeism (reduced and impaired work performance; TiC-P). We conducted multivariate regression analyses adjusted for socio-demographics. RESULTS Both ADDs and CSDs significantly and independently impact total disability, but the impact was substantially larger for ADDs (main effect unstandardized β=20.1, p<.001) than for CSDs (main effect unstandardized β=3.88, p<.001). There was a positive interaction between ADDs and CSDs on disability (unstandardized β interaction=4.06, p=.004). Although CSDs also induce absenteeism (OR for extended absenteeism=1.42, p=.015) and presenteeism (OR for impaired work performance=1.42, p=.013), associations with ADDs were stronger (OR for extended absenteeism=6.64, p<.001; OR for impaired work performance=7.51, p<.001). CONCLUSION Both CSDs and ADDs cause substantial disability, work absenteeism and presenteeism, but the impact of ADDs far exceeds that of CSDs. CSDs and ADDs interact synergistically on disability, thereby bolstering the current view that patients with physical mental comorbidity (PM-comorbidity) form a severe subgroup with an unfavourable prognosis.
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Affiliation(s)
- Wicher A Bokma
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands.
| | - Neeltje M Batelaan
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Anton J L M van Balkom
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center and GGZ inGeest, De Boelelaan 1117, 1081 HZ Amsterdam, The Netherlands
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Ivey SL, Kealey M, Kurtovich E, Hunter RH, Prohaska TR, Bayles CM, Satariano WA. Neighborhood characteristics and depressive symptoms in an older population. Aging Ment Health 2016; 19:713-22. [PMID: 25316114 DOI: 10.1080/13607863.2014.962006] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES We explored relationships between depressive symptoms and neighborhood environment measures including traffic safety, crime, social capital, and density of businesses in community-dwelling older adults from four different regions of the United States. METHOD The Healthy Aging Research Network walking study is a cross-sectional study of 884 adults aged 65+, which included a 10-item Center for Epidemiologic Studies Depression scale of depressive symptoms, demographics, self-reported neighborhood perceptions, and objective neighborhood data. RESULTS After adjusting for individual covariates, reports of neighborhood crime, unsafe traffic, and unwillingness of neighbors to help each other were significantly positively associated with depressive symptoms among participants. CONCLUSION This research suggests an association between self-reported depressive symptoms and the social and built environment; examining causal association requires additional longitudinal research in diverse populations of older adults.
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Affiliation(s)
- Susan L Ivey
- a Community Health and Human Development, School of Public Health , University of California , Berkeley , CA , USA
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23
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Nakao M, Takeuchi T. Clinical Characteristics and Referral Patterns of Outpatients Visiting a Japanese Psychosomatic Medicine Clinic. Int J Behav Med 2015; 23:580-8. [DOI: 10.1007/s12529-015-9520-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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24
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Chen C, Si TM, Xiang YT, Ungvari GS, Wang CY, He YL, Kua EH, Fujii S, Sim K, Trivedi JK, Chung EK, Udomratn P, Chee KY, Sartorius N, Tan CH, Shinfuku N. Prevalence and prescription of antidepressants in depression with somatic comorbidity in Asia: the Research on East Asian Psychotropic Prescription Patterns study. Chin Med J (Engl) 2015; 128:853-8. [PMID: 25836602 PMCID: PMC4833998 DOI: 10.4103/0366-6999.154272] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background: Depression is often comorbid with chronic somatic diseases. Few previous studies have investigated the prevalence of somatic diseases in depression or the prescription pattern of antidepressants in comorbidly depressed patients in Asia. This study aimed to investigate the prevalence of somatic comorbidity (SC) in depression and compared the prescriptions of antidepressants in depressed patients with and without SC. Methods: A total of 2320 patients treated with antidepressants in 8 Asian countries were examined, and a diagnosis was based on the International Classification of Disease, 10th revision. We listed 17 common chronic somatic diseases. Patients’ socio-demographic and clinical characteristics and psychotropic drug prescriptions were recorded using a standardized protocol and data collection procedure. Results: Of the patients examined, 1240 were diagnosed with depression and 30% of them (n = 375) had SC. The most common comorbid condition was diabetes (23.7%). The patients with SC were more likely to seek help at a general hospital (74.7% vs. 47.2%), and had a higher incidence of symptoms involving sadness, disturbed sleep, and poor appetite. Noradrenergic and specific serotonergic antidepressant was prescribed more for patients with SC than for those without SC (30.4% vs. 22.9%). Conclusions: SC is common in depressed Asian patients. It is important to strengthen the recognition of depression, especially in general hospitals and when patients report some somatic discomfort. It is also a matter of urgency to establish evidence-based guidelines for the use of new antidepressants in depressed patients with SC.
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Affiliation(s)
| | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Mental Health and Peking University Institute of Mental Health, Beijing 100083, China
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van Loo HM, Aggen SH, Gardner CO, Kendler KS. Multiple risk factors predict recurrence of major depressive disorder in women. J Affect Disord 2015; 180:52-61. [PMID: 25881281 PMCID: PMC4504430 DOI: 10.1016/j.jad.2015.03.045] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 03/12/2015] [Accepted: 03/25/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND It is difficult to predict recurrence of depressive episodes in patients with major depression (MD): evidence for many risk factors is inconsistent and general prediction algorithms are lacking. The aim of this study was to develop a prediction model for recurrence of depressive episodes in women using improved methodology. METHODS We used prospective data from a general population sample of female twins with a last-year MD episode (n=194). A rich set of baseline predictors was analyzed with Cox proportional hazards regression subject to elastic net regularization to find a model predicting recurrence of depressive episodes. Prediction accuracy of the model was assessed in an independent test sample (n=133), which was limited by the unavailability of a number of key predictors. RESULTS A wide variety of risk factors predicted recurrence of depressive episodes in women: depressive and anxiety symptoms during the index episode, the level of symptoms at the moment of interview, psychiatric and family history, early and recent adverse life events, being unmarried, and problems with friends and finances. Kaplan Meier estimated survival curves showed that the model differentiated between patients at higher and lower risk for recurrence; estimated areas under the curve were in the range of 0.61-0.79. LIMITATIONS Despite our rich set of predictors, certain potentially relevant variables were not available, such as biological measures, chronic somatic diseases, and treatment status. CONCLUSIONS Recurrence of episodes of MD in women is highly multifactorial. Future studies should take this into account for the development of clinically useful prediction algorithms.
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Affiliation(s)
- Hanna M. van Loo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Address for correspondence: H.M. van Loo, MD, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, PO box 30.001, 9700 RB Groningen, The Netherlands, , Phone: 0031 50 361 1242, Fax: 0031 50 361 9722
| | - Steven H. Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Charles O. Gardner
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA,Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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Nakao M, Takeuchi T, Fricchione G. Definition of psychosomatic medicine and the applicability of DSM-IV-TR to outpatients visiting a Japanese psychosomatic clinic. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 83:120-1. [PMID: 24457266 DOI: 10.1159/000354182] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Accepted: 07/01/2013] [Indexed: 11/19/2022]
Affiliation(s)
- Mutsuhiro Nakao
- Department of Psychosomatic Medicine, Teikyo University Hospital, Tokyo, Japan
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27
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Gerrits MMJG, van Oppen P, Leone SS, van Marwijk HWJ, van der Horst HE, Penninx BW. Pain, not chronic disease, is associated with the recurrence of depressive and anxiety disorders. BMC Psychiatry 2014; 14:187. [PMID: 24965597 PMCID: PMC4090396 DOI: 10.1186/1471-244x-14-187] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/18/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Studies suggest that poor physical health might be associated with increased depression and anxiety recurrence. The objectives of this study were to determine whether specific chronic diseases and pain characteristics are associated with depression and anxiety recurrence and to examine whether such associations are mediated by subthreshold depressive or anxiety symptoms. METHODS 1122 individuals with remitted depressive or anxiety disorder (Netherlands Study of Depression and Anxiety) were followed up for a period of four years. The impact of specific chronic diseases and pain characteristics on recurrence was assessed using Cox regression and mediation analyses. RESULTS Chronic diseases were not associated with recurrence. Neck (HR 1.45, p < .01), chest (HR 1.65, p < .01), abdominal (HR 1.52, p < .01) pain, an increase in the number of pain locations (HR 1.10, p < .01) and pain severity (HR 1.18, p = .01) were associated with an increased risk of depression recurrence but not anxiety. Subthreshold depressive symptoms mediated the associations between pain and depression recurrence. CONCLUSIONS Pain, not chronic disease, increases the likelihood of depression recurrence, largely through its association with aggravated subthreshold depressive symptoms. These findings support the idea of the existence of a mutually reinforcing mechanism between pain and depression and are indicative of the importance of shedding light on neurobiological links in order to optimize pain and depression management.
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Affiliation(s)
- Marloes MJG Gerrits
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands,Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands,Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Stephanie S Leone
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Harm WJ van Marwijk
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Henriëtte E van der Horst
- Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Brenda W Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands,Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands,Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
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28
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Gerrits MM, van Oppen P, van Marwijk HW, Penninx BW, van der Horst HE. Pain and the onset of depressive and anxiety disorders. Pain 2014; 155:53-59. [DOI: 10.1016/j.pain.2013.09.005] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 08/23/2013] [Accepted: 09/03/2013] [Indexed: 11/24/2022]
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Gerrits MMJG, van Marwijk HWJ, van Oppen P, van der Horst H, Penninx BWJH. The role of somatic health problems in the recognition of depressive and anxiety disorders by general practitioners. J Affect Disord 2013; 151:1025-32. [PMID: 24119920 DOI: 10.1016/j.jad.2013.08.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/07/2013] [Accepted: 08/29/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recognition of depression and anxiety by general practitioners (GPs) is suboptimal and there is uncertainty as to whether particular somatic health problems hinder or facilitate GP recognition. The objective of this study was to investigate the associations between somatic health problems and GP recognition of depression and anxiety. METHODS We studied primary care patients with a DSM-IV based psychiatric diagnosis of depressive or anxiety disorder during a face-to-face interview (n=778). GPs' registrations of depression and anxiety diagnoses, based on medical file extractions, were compared with the DSM-IV based psychiatric diagnoses as reference standard. Somatic health problems were based on self-report of several chronic somatic diseases and pain symptoms, using the Chronic Pain Grade (CPG), during the interview. RESULTS Depression and anxiety was recognized in sixty percent of the patients. None of the health problems were negatively associated with recognition. Greater severity of pain symptoms (OR=1.18, p=.02), and chest pain (OR=1.56, p=.02), in particular, were associated with more GP recognition of depression and anxiety. Mediation analyses showed that depression and anxiety in these patients were better recognized through the presence of more severe psychiatric symptoms. LIMITATIONS Some specific chronic diseases had low prevalence. CONCLUSIONS This study shows that the presence of particular chronic diseases does not influence GP recognition of depression and anxiety. GPs tend to recognize depression and anxiety better in patients with pain symptoms, partly due to more severe psychiatric symptoms among those with pain.
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Affiliation(s)
- Marloes M J G Gerrits
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, GGZ inGeest, Amsterdam, The Netherlands; Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
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Kok GD, Bockting CLH, Burger H, Hannig W, Pijnenborg GHM, Cuijpers P, Hollon SD. Double trouble: does co-morbid chronic somatic illness increase risk for recurrence in depression? A systematic review. PLoS One 2013; 8:e57510. [PMID: 23472087 PMCID: PMC3589395 DOI: 10.1371/journal.pone.0057510] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 01/22/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To perform a systematic review, and if possible a meta-analysis, to establish whether depressed patients with co-morbid chronic somatic illnesses are a high risk "double trouble" group for depressive recurrence. METHOD The databases PubMed, EMbase and PsycINFO were systematically searched until the 4(th) of December 2012 by using MeSH and free text terms. Additionally, reference lists of retrieved publications and treatment guidelines were reviewed, and experts were consulted. Inclusion criteria were: depression had to be measured at least twice during the study with qualified instruments and the chronic somatic illness had to be assessed by self-report or by a medical professional. Information on depressive recurrence was extracted and additionally risk ratios of recurrence were calculated. RESULTS The search generated four articles that fulfilled our inclusion criteria. These studies showed no differences in recurrence over one- two- three- and 6.5 years of follow-up for a total of 2010 depressed patients of which 694 patients with a co-morbid chronic somatic illness versus 1316 patients without (Study 1: RR = 0.49, 95% CI, 0.17-1.41 at one year follow-up and RR = 1.37, 95% CI, 0.78-2.41 at two year follow-up; Study 2: RR = 0.94, 95% CI, 0.65-1.36 at two year follow-up; Study 3: RR = 1.15, 95% CI, 0.40-3.27 at one year follow-up; RR = 1.07, 95% CI, 0.48-2.42 at two year follow-up and RR = 0.99, 95% CI,0.55-1.77 at 6.5 years follow-up; Study 4: RR = 1.16, 95% CI, 0.86-1.57 at three year follow-up). CONCLUSION We found no association between a heightened risk for depressive recurrence and co-morbid chronic somatic illnesses. There is a need for more longitudinal studies to justify the current specific treatment advice such as long-term pharmacological maintenance treatment for this presumed "double trouble" group.
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Affiliation(s)
- Gemma D. Kok
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Claudi L. H. Bockting
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Huibert Burger
- Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wiebke Hannig
- Department of Clinical Psychology and Psychotherapy, Marburg University, Marburg, Germany
| | - Gerdina H. M. Pijnenborg
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
- Department of Psychotic Disorders, GGZ Drenthe, Assen, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology and EMGO+ Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands
- Leuphana University, Lüneburg, Germany
| | - Steven D. Hollon
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
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