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Stojanović Z, Simić K, Tepšić Ostojić V, Gojković Z, Petković-Ćurčin A. Electroconvulsive therapy in the Fourth Industrial Revolution (Review). Biomed Rep 2024; 21:129. [PMID: 39070111 PMCID: PMC11273193 DOI: 10.3892/br.2024.1817] [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: 04/22/2024] [Accepted: 06/21/2024] [Indexed: 07/30/2024] Open
Abstract
There are very few treatments in psychiatry, even in medicine, that have experienced longevity and effectiveness such as electroconvulsive therapy (ECT), despite the controversies and stigma that accompany it. The experience of the COVID-19 pandemic has highlighted the need to strengthen mental health systems in most countries, given that depression is one of the leading health problems and that there is an evident shortage of psychiatrists worldwide. The Fourth Industrial Revolution, has witnessed great progress in artificial intelligence (AI) technology, which opens up the possibility of its application both in the diagnosis and in the therapy of mental disorders. It is no exaggeration to suggest that tools such as AI, neuroimaging and blood tests will bring significant change to psychiatry in the coming years, but even so, treating severe mental disorders remains a challenge. The present review summarized the development of ECT over time, its application in clinical practice, neurobiological correlates and mechanisms of action and sheds light on the important place of ECT in the era of technological development, considering that ECT is still the most effective therapy for the treatment of severe mental disorders, especially depressive disorder.
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Affiliation(s)
- Zvezdana Stojanović
- Clinic for Psychiatry, Military Medical Academy, 11000 Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
| | - Katarina Simić
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Vesna Tepšić Ostojić
- Clinic for Psychiatry, Military Medical Academy, 11000 Belgrade, Serbia
- Medical Faculty of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
| | - Zagorka Gojković
- Clinic for Psychiatry, Military Medical Academy, 11000 Belgrade, Serbia
| | - Aleksandra Petković-Ćurčin
- Medical Faculty of the Military Medical Academy, University of Defence, 11000 Belgrade, Serbia
- Institute for Medical Research, Military Medical Academy, 11000 Belgrade, Serbia
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Jarkas DA, Villeneuve AH, Daneshmend AZB, Villeneuve PJ, McQuaid RJ. Sex differences in the inflammation-depression link: A systematic review and meta-analysis. Brain Behav Immun 2024; 121:257-268. [PMID: 39089535 DOI: 10.1016/j.bbi.2024.07.037] [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: 02/11/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024] Open
Abstract
Major Depressive Disorder (MDD) is a heterogeneous disorder that affects twice as many women than men. Precluding advances in more tailored and efficacious treatments for depression is the lack of reliable biomarkers. While depression is linked to elevations in inflammatory immune system functioning, this relationship is not evident among all individuals with depression and may vary based on symptom subtypes and/or sex. This systematic review and meta-analysis examined whether inflammatory immune peripheral markers of depression are sex-specific. PRISMA guidelines were followed for the systematic review, and a comprehensive search strategy that identified studies from PubMed and PsycInfo was applied. Studies were included if they reported C-reactive protein (CRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α and/or IL-1β for males and/or females among depressed and healthy adults. We identified 23 studies that satisfied these inclusion criteria. Random-effects meta-analysis models were fit, and measures of association were summarized between levels of circulating markers of inflammation in depressed and healthy males and females. Sex-based analyses revealed elevated levels of CRP among females with depression (Cohen's d = 0.19) relative to their healthy counterparts (p = 0.02), an effect not apparent among males (Cohen's d = -0.01). Similarly, levels of IL-6 were increased among females with depression compared to healthy controls (Cohen's d = 0.51; p = 0.04), but once again this was not found among males (Cohen's d = 0.16). While TNF-α levels were elevated among individuals with depression compared to controls (p = 0.01), no statistically significant sex differences were found. The meta-analysis for IL-1β resulted in only three articles, and thus, results are presented in the supplemental section. This meta-analysis advances our understanding of the unique involvement of inflammatory biomarkers in depression among men and women, which may help inform more tailored sex-specific treatment approaches in the future.
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Affiliation(s)
- Dana A Jarkas
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada.
| | - Ally H Villeneuve
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Ayeila Z B Daneshmend
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Paul J Villeneuve
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Robyn J McQuaid
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, Ontario, Canada
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Meier TB, Huber DL, Goeckner BD, Gill JM, Pasquina P, Broglio SP, McAllister TW, Harezlak J, McCrea MA. Research Letter: Relationship of Blood Biomarkers of Inflammation With Acute Concussion Symptoms and Recovery in the CARE Consortium. J Head Trauma Rehabil 2024:00001199-990000000-00163. [PMID: 38833710 DOI: 10.1097/htr.0000000000000956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Determine the association of inflammatory biomarkers with clinical measures and recovery in participants with concussion. SETTING Multicenter study in National Collegiate Athletic Association member institutions including military service academies. PARTICIPANTS Four hundred twenty-two participants with acute concussion. DESIGN Clinical visits and blood draws were completed preinjury and at multiple visits postconcussion (0-12 hours, 12-36 hours, and 36-60 hours postinjury). Clinical measures included Sport Concussion Assessment Tool (SCAT) symptom severity, Balance Error Scoring System, Standardized Assessment of Concussion (SAC), Brief Symptom Inventory-18 (BSI-18) scores, time to initiation of graduated return-to-play (RTP) protocol, and time to RTP. Interleukin (IL)-6, IL-10, IL-8, IL-1 receptor antagonist (RA), tumor necrosis factor (TNF), c-reactive protein, and vascular endothelial growth factor (VEGF) were measured in serum. Prespecified analyses focused on IL-6 and IL-1RA at 0 to 12 hours; exploratory analyses were conducted with false discovery rate correction. RESULTS For prespecified analyses, IL-1RA at 0 to 12 hours in female participants was positively associated with more errors on the SAC (B(standard error, SE) = 0.58(0.27), P < .05) and worse SCAT symptom severity (B(SE) = 0.96(0.44), P < .05). For exploratory analyses, higher levels of IL-1RA at 12 to 36 hours were associated with higher global (B(SE) = 0.55(0.14), q < 0.01), depression (B(SE) = 0.45(0.10), q < 0.005), and somatization scores on the BSI (B(SE) = 0.46(0.12), q < 0.01) in participants with concussion; Higher TNF at 12 to 36 hours was associated with fewer errors on the SAC (B(SE) = - 0.46(0.14), q < 0.05). Subanalyses showed similar results for male participants and participants who were athletes. No associations were discovered in nonathlete cadets. Higher IL-8 at 0 to 12 hours was associated with slower RTP in female participants (OR = 14.47; 95% confidence interval, 2.96-70.66, q < 0.05); no other associations with recovery were observed. CONCLUSIONS Peripheral inflammatory markers are associated with clinical symptoms following concussion and potentially represent one mechanism for psychological symptoms observed postinjury. Current results do not provide strong support for a potential prognostic role for these markers.
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Affiliation(s)
- Timothy B Meier
- Author Affiliations: Department of Neurosurgery (Dr Meier, Mr Huber, and Dr McCrea), Department of Biomedical Engineering (Dr Meier), Department of Biophysics (Ms Goeckner), Department of Cell Biology, Neurobiology and Anatomy (Dr Meier), Department of Neurology (Dr McCrea), Medical College of Wisconsin, Milwaukee, Wisconsin; National Institute of Nursing Research (Dr Gill), National Institutes of Health, Bethesda, Maryland, USA; Johns Hopkins School of Nursing and Medicine (Dr Gill), Baltimore, MD; Department of Physical Medicine and Rehabilitation (Dr Pasquina), Uniformed Services University of the Health Sciences, Bethesda, Maryland; Michigan Concussion Center (Dr Broglio), University of Michigan, Ann Arbor, Michigan; Department of Psychiatry (Dr McAllister), Indiana University School of Medicine, Indianapolis, IN; and Department of Epidemiology and Biostatistics (Dr Harezlak), School of Public Health-Bloomington, Indiana University, Bloomington, Indiana
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Takada A, Dan-Glauser E. Decoding the complexities of emotion socialization: cultures, individual features and shared information. Sci Rep 2024; 14:3536. [PMID: 38346987 PMCID: PMC10861512 DOI: 10.1038/s41598-024-52885-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Affiliation(s)
- Akira Takada
- Division of African Area Studies, Graduate School of Asian and African Area Studies (ASAFAS), Kyoto University, 46 Yoshida-Shimoadachi-cho, Sakyo Ward, Kyoto, 606-8304, Japan
| | - Elise Dan-Glauser
- Institute of Psychology, Faculty of Social and Political Sciences, Unil-Mouline, University of Lausanne, 1015, Lausanne, Switzerland.
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Moilanen P, Liukkonen T, Jokelainen J, Keinänen-Kiukaanniemi S, Puukka K, Timonen M, Auvinen J, Eskola P. Cross-sectional analysis of depressive symptom profiles and serum C-reactive protein levels: data from the Northern Finland 1966 birth cohort. Nord J Psychiatry 2024; 78:95-102. [PMID: 37905346 DOI: 10.1080/08039488.2023.2274341] [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: 05/23/2023] [Accepted: 10/15/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Individuals with depression exhibit significantly higher levels of systemic inflammation than those without depression, particularly among those with atypical depression. However, this association has been less convincing at the population level among individuals without a formal depression diagnosis but with suggestive symptoms. Our aim was to clarify this association. MATERIALS AND METHODS In a large birth cohort sample of the Finnish general population, we examined the cross-sectional association between high-sensitivity C-reactive protein (hsCRP) levels in venous blood samples and atypical/non-atypical depressive symptoms using the Beck Depression Inventory-II to screen 5443 middle-aged participants. RESULTS As expected, depressive symptoms associated to elevated hsCRP-levels compared to non-depressed. Participants with the atypical subtype of depressive symptoms (n = 84) had an odds ratio (OR) of 2.59 (95% CI 1.40-4.81) for elevated hsCRP levels compared to the non-depressed group. Similarly, our findings indicate that participants with non-atypical symptoms (n = 440) also showed an OR of 1.42 (95% CI 1.05-1.92) when compared to the non-depressed group (n = 4919). CONCLUSIONS These results provide additional support for previous research linking depression and inflammation and add to the field with a unique and sizeable study population. Furthermore, the current results support the notion that different types of depressive symptoms may be associated with inflammatory markers in slightly different ways.
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Affiliation(s)
- Pauli Moilanen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Timo Liukkonen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Department of Psychiatry, Savonlinna Central Hospital, Savonlinna, Finland
| | - Jari Jokelainen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | - Sirkka Keinänen-Kiukaanniemi
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- The Wellbeing Services County of North Ostrobothnia (Pohde), Oulu, Finland
| | - Katri Puukka
- NordLab Oulu, Medical Research Center Oulu, Oulu University Hospital and Department of Clinical Chemistry, University of Oulu, Oulu, Finland
| | - Markku Timonen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
- The Wellbeing Services County of North Ostrobothnia (Pohde), Oulu, Finland
| | - Juha Auvinen
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- The Wellbeing Services County of North Ostrobothnia (Pohde), Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Pasi Eskola
- Research Unit of Population Health, University of Oulu, Oulu, Finland
- The Wellbeing Services County of North Ostrobothnia (Pohde), Oulu, Finland
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Witkin JM, Golani LK, Smith JL. Clinical pharmacological innovation in the treatment of depression. Expert Rev Clin Pharmacol 2023; 16:349-362. [PMID: 37000975 DOI: 10.1080/17512433.2023.2198703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
INTRODUCTION Deficiencies in standard of care antidepressants are driving novel drug discovery. A new age of antidepressant medications has emerged with the introduction of rapid-acting antidepressants with efficacy in treatment-resistant patients. AREAS COVERED The newly approved medicines and those in clinical development for major depressive disorder (MDD) are documented in this scoping review of newly approved and emerging antidepressants. Compounds are evaluated for clinical efficacy, tolerability, and safety and compared to those of standard of care medicines. EXPERT OPINION A new age of antidepressant discovery relies heavily on glutamatergic mechanisms. New medicines based upon the model of ketamine have been delivered and are in clinical development. Rapid onset and the ability to impact treatment-resistant depression, raises the question of the best first-line medicines for patients. Drugs with improvements in tolerability are being investigated (e.g. mGlu2/3 receptor antagonists, AMPA receptor potentiators, and novel NMDA receptor modulators). Multiple companies are working toward the identification of novel psychedelic drugs where the requirement for psychedelic activity is not fully known. Gaps still exist - methods for matching patients with specific medicines are needed, and medicines for the prevention of MDD and its disease progression need research attention.
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Affiliation(s)
- Jeffrey M Witkin
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA
- Departments of Neuroscience and Trauma Research, Ascension St. Vincent Hospital, Indianapolis, IN USA
| | - Lalit K Golani
- Department of Chemistry and Chemical Biology, Northeastern University, Boston, MA, USA
| | - Jodi L Smith
- Laboratory of Antiepileptic Drug Discovery, Ascension St. Vincent Hospital, Indianapolis, IN, USA
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