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Toczyska K, Haq N, Lyu Z, Bewick G, Zhao M, Rosa H, Starikova J, Liu B, Persaud SJ. The selective serotonin reuptake inhibitors, sertraline and paroxetine, improve islet beta-cell mass and function in vitro. Diabetes Obes Metab 2024; 26:3606-3617. [PMID: 38888050 DOI: 10.1111/dom.15701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/20/2024]
Abstract
AIMS To investigate the effects of the selective serotonin reuptake inhibitors (SSRIs) sertraline and paroxetine at therapeutically relevant concentrations on beta-cell mass and function. METHODS Viability was quantified in mouse insulinoma (MIN6) beta cells and mouse islets after 48-h exposure to sertraline (1-10 μM) or paroxetine (0.01-1 μM) using the Trypan blue exclusion test. The effects of therapeutic concentrations of these SSRIs on insulin secretion were determined by static incubation and perifusion experiments, while islet apoptosis was investigated by Caspase-Glo 3/7 assay, TUNEL staining and quantitative PCR analysis. Finally, proliferation of MIN6 and mouse islet beta cells was assessed by bromodeoxyuridine (BrdU) enzyme-linked immunosorbent assay and immunofluorescence. RESULTS Sertraline (0.1-1 μM) and paroxetine (0.01-0.1 μM) were well tolerated by MIN6 beta cells and islets, whereas 10 μM sertraline and 1 μM paroxetine were cytotoxic. Exposure to 1 μM sertraline and 0.1 μM paroxetine significantly potentiated glucose-stimulated insulin secretion from mouse and human islets. Moreover, they showed protective effects against cytokine- and palmitate-induced apoptosis of islets, they downregulated cytokine-induced Stat1 and Traf1 mRNA expression, and they significantly increased proliferation of mouse beta cells. CONCLUSIONS Our data demonstrate that sertraline and paroxetine act directly on beta cells to enhance glucose-stimulated insulin secretion and stimulate beta-cell mass expansion by increasing proliferation and decreasing apoptosis. These drugs are therefore likely to be appropriate for treating depression in people with type 2 diabetes.
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Affiliation(s)
- Klaudia Toczyska
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Naila Haq
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Zekun Lyu
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Gavin Bewick
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Min Zhao
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Hannah Rosa
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Jessica Starikova
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Bo Liu
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Shanta Jean Persaud
- Department of Diabetes, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
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Salinero-Fort M, Mostaza-Prieto JM, Lahoz-Rallo C, Cárdenas-Valladolid J, Iriarte-Campo V, Estirado-Decabo E, Garcia-Iglesias F, Gonzalez-Alegre T, Fernandez-Puntero B, Cornejo-Del Rio VM, Sanchez-Arroyo V, Sabín-Rodríguez C, López-López S, Gómez-Campelo P, Taulero-Escalera B, Rodriguez-Artalejo F, San Andrés-Rebollo FJ, De Burgos-Lunar C. External validation of three diabetes prediction scores in a Spanish cohort: does adding high risk for depression improve the validation of the FINDRISC score (FINDRISC-MOOD)? BMJ Open 2024; 14:e083121. [PMID: 38844393 PMCID: PMC11163630 DOI: 10.1136/bmjopen-2023-083121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 05/17/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES To evaluate the external validity of the FINDRISC, DESIR and ADA risk scores for the prediction of diabetes in a Spanish population aged >45 years and to test the possible improvement of FINDRISC by adding a new variable of high risk of depression when Patient Health Questionnaire-9 (PHQ-9) questionnaire score ≥10 (FINDRISC-MOOD). DESIGN Prospective population-based cohort study. SETTING 10 primary healthcare centres in the north of the city of Madrid (Spain). PARTICIPANTS A total of 1242 participants without a history of diabetes and with 2-hour oral glucose tolerance test (OGTT) plasma glucose <200 mg/dL (<11.1 mmol/L) were followed up for 7.3 years (median) using their electronic health records (EHRs) and telephone contact. PRIMARY AND SECONDARY OUTCOME MEASURES Diabetes risk scores (FINDRISC, DESIR, ADA), PHQ-9 questionnaire and 2-hour-OGTT were measured at baseline. Incident diabetes was defined as treatment for diabetes, fasting plasma glucose ≥126 mg/dL (≥7.0 mmol/L), new EHR diagnosis or self-reported diagnosis. External validation was performed according to optimal cut-off, sensitivity, specificity and Youden Index. Comparison between diabetes risk scores, including FINDRISC-MOOD (original FINDRISC score plus five points if PHQ-9 ≥10), was measured by area under the receiver operating characteristic curve (AUROC). RESULTS During follow-up, 104 (8.4%; 95% CI, 6.8 to 9.9) participants developed diabetes and 185 had a PHQ-9 score ≥10. The AUROC values were 0.70 (95% CI, 0.67 to 0.72) for FINDRISC-MOOD and 0.68 (95% CI, 0.65 to 0.71) for the original FINDRISC. The AUROCs for DESIR and ADA were 0.66 (95% CI, 0.63 to 0.68) and 0.66 (95% CI, 0.63 to 0.69), respectively. There were no significant differences in AUROC between FINDRISC-MOOD and the other scores. CONCLUSIONS The results of FINDRISC-MOOD were like those of the other risk scores and do not allow it to be recommended for clinical use.
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Affiliation(s)
- Miguel Salinero-Fort
- FIIBAP, Madrid, Spain
- Frailty, patterns of multimorbidity and mortality in the community-dwelling elderly population, IdiPAZ, Madrid, Spain
| | | | | | - Juan Cárdenas-Valladolid
- Gerencia Asistencial de Atención Primaria, Comunidad de Madrid Servicio Madrileno de Salud, Madrid, Spain
- Enfermería, Universidad Alfonso X El Sabio, Villanueva de la Canada, Spain
| | | | | | | | | | | | | | | | | | | | - Paloma Gómez-Campelo
- Fundación de Investigación, La Paz University Hospital Health Research Institute, Madrid, Spain
| | - Belen Taulero-Escalera
- Foundation for Research and Biomedical Innovation of Primary Care of the Community of Madrid (FIIBAP), Madrid, Spain
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autonoma de Madrid, Madrid, Spain
- CIBERESP, Madrid, Spain
- IMDEA-Food, CEI UAM+CSIC, Madrid, Spain
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Kim H, Lee YB, Lee J, Kang D, Kim G, Jin SM, Kim JH, Hur KY, Jeon HJ. Depression, antidepressant use, and the risk of type 2 diabetes: a nationally representative cohort study. Front Psychiatry 2023; 14:1275984. [PMID: 38125283 PMCID: PMC10731300 DOI: 10.3389/fpsyt.2023.1275984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/07/2023] [Indexed: 12/23/2023] Open
Abstract
Background Previous studies have reported that depression can increase the risk of type 2 diabetes. However, they did not sufficiently consider antidepressants or comorbidity. Methods The National Health Insurance Sharing Service database was used. Among the sample population, 276,048 subjects who had been diagnosed with depression and prescribed antidepressants (DEP with antidepressants group) and 79,119 subjects who had been diagnosed with depression but not prescribed antidepressants (DEP without antidepressants group) were found to be eligible for this study. Healthy controls (HCs) were 1:1 matched with the DEP with antidepressants group for age and sex. We followed up with them for the occurrence of type 2 diabetes. Results In the group of DEP with antidepressants, although the risk of type 2 diabetes increased compared to HCs in a crude analysis, it decreased when comorbidity was adjusted for. In the group of DEP without antidepressants, the risk of type 2 diabetes decreased both in the crude model and the adjusted models. The risk varied by age group and classes or ingredients of antidepressants, with young adult patients showing an increased risk even in the fully adjusted model. Conclusion Overall, those with depression had a reduced risk of type 2 diabetes. However, the risk varied according to the age at onset, comorbidity, and type of antidepressants.
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Affiliation(s)
- Hyewon Kim
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Dongwoo Kang
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Republic of Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Department of Medical Device Management and Research, and Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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Basiri R, Seidu B, Rudich M. Exploring the Interrelationships between Diabetes, Nutrition, Anxiety, and Depression: Implications for Treatment and Prevention Strategies. Nutrients 2023; 15:4226. [PMID: 37836510 PMCID: PMC10574484 DOI: 10.3390/nu15194226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/23/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Across the world, diabetes, depression, and anxiety symptoms have gained widespread recognition as significant public health issues. Recent research has unveiled a mutually influential relationship between diabetes and these two mental health conditions, where each disorder impacts the course and outcomes of the others. The role of nutrition emerges as pivotal in preventing and treating depression, anxiety, and diabetes. A thorough literature review was undertaken to investigate the reciprocal effects between anxiety, depression, and diabetes, including their impact on the development and severity of each condition. Additionally, the effects of nutrition on the prevention and management of depression, anxiety, diabetes, and related complications in at-risk individuals were assessed. Our findings show that mental disorders, such as depression and anxiety, increase the risk of developing type 2 diabetes and are associated with poorer glycemic control, increased diabetes-related complications, and higher mortality rates. Conversely, diabetes is also linked with an increased risk of developing depression and anxiety. The biological, psychological, and social factors that contribute to the comorbidity between these two conditions are complex and multifaceted. Therefore, an integrated approach to the management of both conditions is critical for improving patient outcomes and reducing the overall burden of disease. Nutritional interventions should be utilized to reduce the risk of diabetes in patients with anxiety and depression as well as enhance mental health in patients with diabetes.
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Affiliation(s)
- Raedeh Basiri
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
| | - Blessing Seidu
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Mark Rudich
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
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Basiri R, Seidu B, Cheskin LJ. Key Nutrients for Optimal Blood Glucose Control and Mental Health in Individuals with Diabetes: A Review of the Evidence. Nutrients 2023; 15:3929. [PMID: 37764713 PMCID: PMC10536295 DOI: 10.3390/nu15183929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
Diabetes is associated with an increased risk of mental disorders, including depression, anxiety, and cognitive decline. Mental disorders can also contribute to the development of diabetes through various mechanisms including increased stress, poor self-care behaviors, and adverse effects on glucose metabolism. Consequently, individuals suffering from either of these conditions frequently experience comorbidity with the other. Nutrition plays an important role in both diabetes and mental health disorders including depression and anxiety. Deficiencies in specific nutrients such as omega-3 fatty acids, vitamin D, B vitamins, zinc, chromium, magnesium, and selenium have been implicated in the pathogenesis of both diabetes and mental disorders. While the impact of nutrition on the progression and control of diabetes and mental disorders is broadly acknowledged, there is a notable knowledge gap concerning the implications of distinct nutrients in preventing and mitigating symptoms of both conditions when they coexist. The aim of this study was to examine the role of nutrition in improving glucose homeostasis and promoting mental well-being among individuals with diabetes. Further, we evaluated the preventive or delaying effects of key nutrients on the simultaneous manifestation of these conditions when one of them is present. Our findings indicated that the use of personalized dietary interventions and targeted nutrient supplementation can improve metabolic and mental health outcomes in patients with type 2 diabetes.
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Affiliation(s)
- Raedeh Basiri
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
| | - Blessing Seidu
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
| | - Lawrence J. Cheskin
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA
- Institute for Biohealth Innovation, George Mason University, Fairfax, VA 22030, USA
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
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Karami F, Jamaati H, Coleman-Fuller N, Zeini MS, Hayes AW, Gholami M, Salehirad M, Darabi M, Motaghinejad M. Is metformin neuroprotective against diabetes mellitus-induced neurodegeneration? An updated graphical review of molecular basis. Pharmacol Rep 2023; 75:511-543. [PMID: 37093496 DOI: 10.1007/s43440-023-00469-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 02/21/2023] [Accepted: 02/23/2023] [Indexed: 04/25/2023]
Abstract
Diabetes mellitus (DM) is a metabolic disease that activates several molecular pathways involved in neurodegenerative disorders. Metformin, an anti-hyperglycemic drug used for treating DM, has the potential to exert a significant neuroprotective role against the detrimental effects of DM. This review discusses recent clinical and laboratory studies investigating the neuroprotective properties of metformin against DM-induced neurodegeneration and the roles of various molecular pathways, including mitochondrial dysfunction, oxidative stress, inflammation, apoptosis, and its related cascades. A literature search was conducted from January 2000 to December 2022 using multiple databases including Web of Science, Wiley, Springer, PubMed, Elsevier Science Direct, Google Scholar, the Core Collection, Scopus, and the Cochrane Library to collect and evaluate peer-reviewed literature regarding the neuroprotective role of metformin against DM-induced neurodegenerative events. The literature search supports the conclusion that metformin is neuroprotective against DM-induced neuronal cell degeneration in both peripheral and central nervous systems, and this effect is likely mediated via modulation of oxidative stress, inflammation, and cell death pathways.
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Affiliation(s)
- Fatemeh Karami
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamidreza Jamaati
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Natalie Coleman-Fuller
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Saint Paul, MN, 55108, USA
| | - Maryam Shokrian Zeini
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Wallace Hayes
- University of South Florida College of Public Health and Institute for Integrative Toxicology, Michigan State University, East Lansing, USA
| | - Mina Gholami
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Salehirad
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohammad Darabi
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Motaghinejad
- Chronic Respiratory Disease Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Mui JV, Li L, Chou OHI, Azfar N, Lee A, Hui J, Lee S, Tse G, Zhou J. Comparing sodium-glucose cotransporter 2 inhibitors and dipeptidyl peptidase-4 inhibitors on new-onset depression: a propensity score-matched study in Hong Kong. Acta Diabetol 2023; 60:917-927. [PMID: 37000300 DOI: 10.1007/s00592-023-02063-6] [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: 10/29/2022] [Accepted: 02/24/2023] [Indexed: 04/01/2023]
Abstract
INTRODUCTION The risk of new onset depression associated with sodium-glucose co-transporter 2 inhibitor (SGLT2I) use in patients with type 2 diabetes mellitus (T2DM) remains unclear. This study investigated the risk of new onset depression between SGLT2I and dipeptidyl peptidase 4 inhibitor (DPP4I) users. METHODS This was a population-based cohort study of T2DM patients in Hong Kong between January 1st, 2015, and December 31st, 2019. T2DM patients over 18 with either SGLT2I or DPP4I use were included. 1:1 propensity-score matching using the nearest-neighbour method was conducted based on demographics, past comorbidities and non-DPP4I/SGLT2I medication use. Cox regression analysis models were used to identify significant predictors for new onset depression. RESULTS The study cohort included a total of 18,309 SGLT2I users and 37,269 DPP4I users (55.57% male, mean age: 63.5 ± 12.9 years) with a median follow-up duration of 5.56 (IQR: 5.23-5.8) years. After propensity score matching, SGLT2I use was associated with a lower risk of new onset depression compared to DPP4I use (HR: 0.52, 95% CI: [0.35, 0.77], P = 0.0011). These findings were confirmed by Cox multivariable analysis and sensitive analyses. CONCLUSION SGLT2I use is associated with significantly lower risk of depression compared to DPP4 use in T2DM patients using propensity score matching and Cox regression analyses.
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Affiliation(s)
- Jonathan V Mui
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
| | - Lifang Li
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Oscar Hou In Chou
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Nida Azfar
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
| | - Athena Lee
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Jeremy Hui
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Sharen Lee
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China
| | - Gary Tse
- Diabetes Research Unit, Cardiovascular Analytics Group, Hong Kong, China.
- Department of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
- Kent and Medway Medical School, Canterbury, UK.
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China.
- Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin, 300211, China.
| | - Jiandong Zhou
- Nuffield Department of Medicine, University of Oxford, Oxford, UK.
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Acquah I, Hagan K, Javed Z, Taha MB, Valero-Elizondo J, Nwana N, Yahya T, Sharma G, Gulati M, Hammoud A, Shapiro MD, Blankstein R, Blaha MJ, Cainzos-Achirica M, Nasir K. Social Determinants of Cardiovascular Risk, Subclinical Cardiovascular Disease, and Cardiovascular Events. J Am Heart Assoc 2023; 12:e025581. [PMID: 36926956 PMCID: PMC10111542 DOI: 10.1161/jaha.122.025581] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background Although there is research on the impact of social determinants of health (SDOHs) on cardiovascular health, most existing evidence is based on individual SDOH components. We evaluated the impact of cumulative SDOH burden on cardiovascular risk factors, subclinical atherosclerosis, and incident cardiovascular disease events. Methods and Results We included 6479 participants from the MESA (Multi-Ethnic Study of Atherosclerosis). A weighted aggregate SDOH score representing the cumulative number of unfavorable SDOHs, identified from 14 components across 5 domains (economic stability, neighborhood and physical environment, community and social context, education, and health care system access) was calculated and divided into quartiles (quartile 4 being the least favorable). The impact of cumulative SDOH burden on cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and obesity), systemic inflammation, subclinical atherosclerosis, and incident cardiovascular disease was evaluated. Increasing social disadvantage was associated with increased odds of all cardiovascular risk factors except dyslipidemia. Smoking was the risk factor most strongly associated with worse SDOH (odds ratio [OR], 2.67 for quartile 4 versus quartile 1 [95% CI, 2.13-3.34]). Participants within SDOH quartile 4 had 33% higher odds of increased high-sensitivity C-reactive protein (OR, 1.33 [95% CI, 1.11-1.60]) and 31% higher risk of all cardiovascular disease (hazard ratio, 1.31 [95% CI, 1.03-1.67]), yet no greater burden of subclinical atherosclerosis (OR, 1.01 [95% CI, 0.79-1.29]), when compared with those in quartile 1. Conclusions Increasing social disadvantage was associated with more prevalent cardiovascular risk factors, inflammation, and incident cardiovascular disease. These findings call for better identification of SDOHs in clinical practice and stronger measures to mitigate the higher SDOH burden among the socially disadvantaged to improve cardiovascular outcomes.
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Affiliation(s)
- Isaac Acquah
- Center for Outcomes Research Houston Methodist Houston TX
| | - Kobina Hagan
- Center for Outcomes Research Houston Methodist Houston TX
| | - Zulqarnain Javed
- Division of Health Disparities and Equity Research Center for Outcomes Research, Houston Methodist Houston TX
| | - Mohamad B Taha
- Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | | | - Nwabunie Nwana
- Center for Outcomes Research Houston Methodist Houston TX
| | - Tamer Yahya
- Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | - Garima Sharma
- Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MD
| | - Martha Gulati
- Division of Cardiology University of Arizona (Phoenix) Phoenix AZ
| | | | - Michael D Shapiro
- Section of Cardiovascular Medicine Wake Forest School of Medicine Winston Salem NC
| | - Ron Blankstein
- Cardiovascular Imaging Program, Department of Medicine and Radiology Brigham and Women's Hospital Boston MA
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Cardiovascular Disease Johns Hopkins University School of Medicine Baltimore MD
| | - Miguel Cainzos-Achirica
- Center for Outcomes Research Houston Methodist Houston TX
- Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX
| | - Khurram Nasir
- Center for Outcomes Research Houston Methodist Houston TX
- Division of Cardiovascular Prevention and Wellness Houston Methodist DeBakey Heart and Vascular Center Houston TX
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del Hoyo MLL, Rodrigo MTF, Urcola-Pardo F, Monreal-Bartolomé A, Ruiz DCG, Borao MG, Alcázar ABA, Casbas JPM, Casas AA, Funcia MTA, Delgado JFR. The TELE-DD Randomised Controlled Trial on Treatment Adherence in Patients with Type 2 Diabetes and Comorbid Depression: Clinical Outcomes after 18-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:328. [PMID: 36612650 PMCID: PMC9819481 DOI: 10.3390/ijerph20010328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
UNLABELLED Clinical depression is associated with poorer adherence to hypoglycaemic medication in patients with diabetes mellitus, leading to poorer glycaemic control, diabetes management, and increased complications. The main aim of the TELE-DD trial was to demonstrate the efficacy of a proactive and psychoeducational telephonic intervention based on motivational interviewing and collaborative care to reduce nonadherence and improve prognosis in individuals with diabetes mellitus and concurrent depression. DESIGN The TELE-DD project is a three-phased prospective study including a nested randomised controlled trial. METHODS The baseline cohort included the entire population of adult patients diagnosed with type 2 diabetes and concurrent depression. A randomised controlled trial was conducted in a selection of patients from the baseline cohort, distributed into a control group (n = 192) and an intervention group (n = 192). Monthly telephonic interventions delivered by specifically trained research nurses were centred on a psychoeducational individualised monitoring protocol including motivational interviewing and collaborative care strategies. Clinical and patient-centred data were systematically collected during an 18-month follow-up including HbA1c, Patient Health Questionnaire, and the Diabetes Distress Scale. RESULTS During the trial, 18-month follow-up HbA1C levels significantly (p < 0.001) decreased in the intervention group at every follow-up from an average of 8.72 (SD:1.49) to 7.03 (SD:1.09), but slightly increased in the control group from 8.65 (SD:1.40) to 8.84 (SD:1.38). Similar positive results were obtained in depression severity and diabetes distress, LDL-cholesterol, and systolic and diastolic blood pressure, but only at the 18-month follow-up in body mass index reduction. CONCLUSIONS This is the first trial to concurrently decrease biological and psychological outcomes with a monthly brief telephonic intervention, pointing out that a combined biopsychosocial intervention and collaborative care strategy is essential for current world health challenges. CLINICALTRIALS gov Identifier: NCT04097483. Patient or Public Contribution: Diabetic patients not belonging to the TELE-DD population or trial sample were consulted during the study design to review and guarantee the clarity and understanding of the trial psychoeducational materials.
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Affiliation(s)
- María Luisa Lozano del Hoyo
- Las Fuentes Norte Health Centre, Servicio Aragonés de Salud (SALUD), 50002 Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
| | - María Teresa Fernandez Rodrigo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), 50009 Aragón, Spain
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), 50009 Aragón, Spain
| | - Alicia Monreal-Bartolomé
- Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029 Madrid, Spain
| | | | - Mercedes Gómez Borao
- Sagasta Health Center, Servicio Aragonés de Salud (SALUD), 50006 Zaragoza, Spain
| | - Ana Belén Artigas Alcázar
- University Hospital Miguel Servet, Servicio Aragonés de Salud (SALUD), University of Zaragoza, 50009 Zaragoza, Spain
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Lai TC, McDaniel CC, Chou C. Diabetes management behaviors associated with depression in the U.S. Diabetol Metab Syndr 2022; 14:178. [PMID: 36419073 PMCID: PMC9685969 DOI: 10.1186/s13098-022-00953-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/14/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is a lack of nationally representative evidence from the U.S. investigating the relationships between depression and diabetes management behaviors. Our study aimed to assess the associations between diabetes management behaviors and depression status, and to compare U.S. population-level percentages of diabetes management behaviors among patients with and without depression. METHODS A cross-sectional study was conducted using population-based survey data to assess patient-reported variables retrospectively. We used the Behavioral Risk Factor Surveillance System (BRFSS) data and included states in the U.S. that continuously adopted the diabetes optional modules in 2013, 2015, 2017, and 2019. We included U.S. adults (≥ 18 years old) with self-reported diabetes in our analysis. Main outcomes were diabetes management behaviors (i.e., self-check for blood glucose and feet sores/irritation, regular diabetes clinical visit, HbA1c check, professional feet check, and dilated eye examination) and lifestyle behaviors (i.e., exercise, smoking, and alcohol consumption). RESULTS Among the 74,011 respondents with diabetes, patients with depression had a higher likelihood of performing routine HbA1c checks (adjusted odds ratio (AOR) = 1.12; 95% CI 1.01-1.23) but had a lower likelihood to perform regular self-check for blood glucose (AOR = 0.91; 95% CI 0.84-0.99), receive professional feet checks (AOR = 0.87; 95% CI 0.79-0.95), and receive a dilated eye examination (AOR = 0.89; 95% CI 0.82-0.98). For lifestyle behaviors, patients with depression were more likely to smoke (No smoking (AOR) = 0.65; 95% CI = 0.59-0.72) and less likely to engage in sufficient exercise time (AOR = 0.69; 95% CI 0.63-0.75). There were no significant associations between depression and other behaviors, including self-check for feet sores/irritation (AOR = 0.99; 95% CI 0.92-1.08), regular diabetes clinical visit (AOR = 1.03, 95% CI 0.94-1.13), and alcohol consumption (AOR = 1.01, 95% CI 0.92-1.10). CONCLUSIONS The association between depression status and diabetes management behaviors varied. People with depression were positively associated with HbA1c checks. However, less uptake of other behaviors may indicate the needs for improvement in diabetes management.
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Affiliation(s)
- Tim C Lai
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA
| | - Cassidi C McDaniel
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA
| | - Chiahung Chou
- Department of Health Outcomes Research and Policy, Auburn University Harrison College of Pharmacy, 4306 Walker Building, Auburn, AL, 36849, USA.
- Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan.
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11
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Muacevic A, Adler JR. Relation Between Diabetes and Psychiatric Disorders. Cureus 2022; 14:e30733. [PMID: 36447711 PMCID: PMC9699801 DOI: 10.7759/cureus.30733] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 10/26/2022] [Indexed: 01/25/2023] Open
Abstract
Depression, anxiety, and schizophrenia are all things that have been found to be linked to the mental health of diabetics. When combined with particular mental health conditions, the management of diabetes might become very challenging. The management of diabetes requires the patient to be actively involved and is contingent on the patient's adherence to prescribed lifestyle modifications, self-monitoring, and medication. Patients who struggle to keep their mental health concerns under control are more likely to have trouble managing their diabetes on their own. People who have diabetes, because it is one of the most cognitively and behaviorally taxing chronic medical conditions, may be especially susceptible to developing mental health disorders. It is more prevalent in those who suffer from mental problems than it is in the general population. Diabetics frequently struggle with a variety of mental health conditions, including but not limited to schizophrenia, anxiety, and depression. Diagnosing and treating mental health disorders is an important component of diabetes treatment that can be accomplished through the collaborative efforts of members of a multidisciplinary team. Patients who fall into this category can benefit from a wide range of services provided by pharmacists who work with them, including individual assessments, joint goal-setting, skill development, ongoing monitoring, and medication management. These services are designed to help patients feel better and function better.
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12
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Speight J, Baptista S, Lee C, Sher L, Skinner TC, Brown A. The Social and Emotional Well-being of Indigenous Peoples Living With Diabetes: A Systematic Review Protocol. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:902395. [PMID: 36992776 PMCID: PMC10012064 DOI: 10.3389/fcdhc.2022.902395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022]
Abstract
IntroductionGlobally, Indigenous people have a greater incidence and earlier onset of diabetes than the general population and have higher documented rates of emotional distress and mental illness. This systematic review will provide a synthesis and critical appraisal of the evidence focused on the social and emotional well-being of Indigenous peoples living with diabetes, including prevalence, impact, moderators, and the efficacy of interventions.MethodsWe will search MEDLINE Complete, EMBASE, APA PsycINFO, and CINAHL Complete from inception until late April 2021. Search strategies will include keywords related to Indigenous peoples, diabetes, and social and emotional well-being. All abstracts will be rated independently by two researchers against specified inclusion criteria. Eligible studies will report social and emotional well-being data for Indigenous people with diabetes, and/or report on the efficacy of interventions designed to address social and emotional well-being in this population. For each eligible study, quality will be rated using standard checklists to appraise each study’s internal validity, to be determined based on study type. Any discrepancies will be resolved through discussions and consultation with other investigators as needed. We expect to present a narrative synthesis of the evidence.DiscussionThe findings of the systematic review will enable greater understanding of the impact of relationships between diabetes and emotional well-being among Indigenous peoples to inform research, policy and practice. The findings will be accessible to Indigenous people affected by diabetes through a summary published in plain language on our research centre’s website.Systematic Review RegistrationPROSPERO registration number: CRD42021246560.
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Affiliation(s)
- Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
| | - Shaira Baptista
- School of Psychology, Deakin University, Geelong, VIC, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- *Correspondence: Shaira Baptista,
| | - Christopher Lee
- First Nations Diabetes consumer and advocate, Melbourne, VIC, Australia
| | - Louisa Sher
- Library, Deakin University, Geelong, VIC, Australia
| | - Timothy C. Skinner
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia
- LaTrobe University, Melbourne, VIC, Australia
| | - Alex Brown
- College of Health & Medicine, Australian National University, Canberra, ACT, Australia
- Telethon Kids Institute, Perth, WA, Australia
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13
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Pal K, Sharma M, Mukadam NM, Petersen I. Initiation of antidepressant medication in people with type 2 diabetes living in the UK - a retrospective cohort study. Pharmacoepidemiol Drug Saf 2022; 31:892-900. [PMID: 35638365 PMCID: PMC9542279 DOI: 10.1002/pds.5484] [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: 09/22/2021] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
Introduction Depression is a common comorbidity in people with type 2 diabetes and it is associated with poorer outcomes. There is limited data on the treatments used for depression in this population. The aim of this study was to explore the rates of initiation of antidepressant prescriptions in people with type 2 diabetes in the UK and identify those most at risk of needing such treatment. Research Design and Methods This was a retrospective cohort study using data from IQVIA Medical Research Data (IMRD)‐UK data. Data from general practices in IMRD‐UK between January 2008 and December 2017 were used for this study. Results The overall rates of antidepressant prescribing were stable over the study period. The rate of initiation of antidepressant medication in people with type 2 diabetes was 22.93 per 1000 person years at risk (PYAR) with a 95%CI 22.48 to 23.39 compared to 16.89 per 1000 PYAR (95%CI 16.77 to 17.01) in an age and gender matched cohort. The risk of being prescribed antidepressant medication with age had a U‐shaped distribution with the lowest risk in the 65–69 age group. The peak age for antidepressant initiation in men and women was 40–44, with a rate in men of 32.78 per 1000 PYAR (95% CI 29.57 to 36.34) and a rate in women of 46.80 per 1000 PYAR (95% CI 41.90 to 52.26). People with type 2 diabetes with in the least deprived quintile had an initiation rate of 19.66 per 1000 PYAR (95%CI 18.67 to 20.70) compared to 27.19 per 1000 PYAR (95%CI 25.50 to 28.93) in the most deprived quintile, with a 32% increase in the risk of starting antidepressant medication (95%CI 1.22 to 1.43). Conclusions People with type 2 diabetes were 30% more likely to be started on antidepressant medication than people without type 2 diabetes. Women with type 2 diabetes were 35% more likely than men to be prescribed antidepressants and the risks increased with deprivation and in younger or older adults, with the lowest rates in the 65–69 year age band. The rates of antidepressant prescribing were broadly stable over the 10‐year period in this study. The antidepressant medications prescribed changed slightly over time with sertraline becoming more widely used and fewer prescriptions of citalopram.
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Affiliation(s)
- Kingshuk Pal
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | - Manuj Sharma
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
| | | | - Irene Petersen
- Department of Primary Care and Population Health, U3 Floor, Royal Free Campus, Rowland Hill Street, London NW3 2PF, UK
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14
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Simayi D, Guan Y. HTR1A Gene Polymorphism in Type 2 Diabetes Mellitus Comorbid with Major Depressive Disorder in a Chinese Population. Diabetes Metab Syndr Obes 2022; 15:1597-1604. [PMID: 35651901 PMCID: PMC9148918 DOI: 10.2147/dmso.s361843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/11/2022] [Indexed: 04/20/2023] Open
Abstract
Background Major depressive disorder is a frequent mental illness, which is common in patients with type 2 diabetes. Type 2 diabetes comorbid with depression has a worse prognosis. There are multiple risk factors for depression, and genetic studies have shown that gene polymorphism may play an important role in the pathogenesis of depression. Methods A total of 874 patients with type 2 diabetes were recruited for this study and divided into two groups: depressive group (DDM group, n = 234) and non-depressive group (NDDM group, n = 640). HTR1A gene polymorphisms (rs6295, rs878567, rs1800044) genotyping work was performed using a custom by design 48-Plex SNPscanTM Kit. Results The rs6295, rs878567, and rs1800044 SNPs were not associated with type 2 diabetes comorbid with depression. Female sex, age, and FBG level increased the risk of depression in patients with type 2 diabetes. Conclusion HTR1A rs6295, rs878567, and rs1800044 SNPs polymorphism is not associated with type 2 diabetes comorbid with depression. Rather, female sex, age, and FBG level are risk factors for depression among patients with type 2 diabetes. Larger studies are needed to further confirm our findings.
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Affiliation(s)
- Dilixia Simayi
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Department of Oncology, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
| | - Yaqun Guan
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
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15
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The Other Face of Insulin—Overdose and Its Effects. TOXICS 2022; 10:toxics10030123. [PMID: 35324747 PMCID: PMC8955302 DOI: 10.3390/toxics10030123] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
Insulin is the most effective glycemic-lowering drug, and for people suffering from type 1 diabetes it is a life-saving drug. Its self-dosing by patients may be associated with a higher risk of overdose, both accidental and deliberate. Insulin-induced hypoglycemia causes up to 100,000 emergency department calls per year. Cases of suicide attempts using insulin have been described in the literature since its introduction into therapy, and one of the important factors in their occurrence is the very fact of chronic disease. Up to 90% of patients who go to toxicology wards overdose insulin consciously. Patients with diabetes are burdened with a 2–3 times higher risk of developing depression compared to the general population. For this reason, it is necessary to develop an effective system for detecting a predisposition to overdose, including the assessment of the first symptoms of depression in patients with diabetes. A key role is played by a risk-conscious therapeutic team, as well as education. Further post-mortem testing is also needed for material collection and storage, as well as standardization of analytical methods and interpretation of results, which would allow for more effective detection and analysis of intentional overdose—both by the patient and for criminal purposes.
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16
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Wang T, Liu Y, Huang W. The Association between Serum Neutrophil Gelatinase-Associated Lipocalin and Depression in Patients with Type 2 Diabetes Mellitus. Exp Aging Res 2022; 48:444-454. [PMID: 35142261 DOI: 10.1080/0361073x.2022.2033591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients wtih type 2 diabetes mellitus (DM) have an increased risk of depressive symptoms. Whether serum neutrophil gelatinase-associated lipocalin (NGAL) is associated with depressive symptoms in old patients with type 2 DM is still uncertain. OBJECTIVE We aim to investigate whether serum NGAL levels were associated with elevated risk of depressive symptoms in patients with type 2 DM in an old population. METHODS Blood samples from 1012 hospitalized patients were measured for serum NGAL within the first 24 hours after admission. The Center for Epidemiological Studies Depression (CES-D) scale was performed to calculate depressive score. Cox analyses were used to examine the prognostic value of serum NGAL on detecting depressive symptoms during a median period of 5 years (range = 0.3-6.2 years). RESULTS 136 (36.6)% of all subjects have depressive symptoms during the follow-up period. Linear analysis showed that serum NGAL levels at baseline were associated with CES-D score after adjusting for clinically relevant variables in type 2 DM patients (Sβ = 0.118, 95% CI 0.106-0.171, P < .001) but not in non-DM patients (Sβ = 0.025, 95% CI, -0.047-0.083; P = .205). Cox analysis revealed that serum NGAL did have an independent prognostic value on predicting depressive symptoms (HR = 2.247, 95% CI 1.415-3.811, P-trend<0.001, Model 2) in type 2 DM patients but not in non-DM patients (HR = 1.811, 95% CI 1.209-3.292, P-trend = 0.189, Model 2) during follow-up period. CONCLUSIONS We found the first evidence that serum NGAL were strongly associated with depressive symptoms in patients with type 2 DM but not in non-DM patients. Further studies are needed to prove the underlying mechanism for the impact of type 2 DM on the association.
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Affiliation(s)
| | - Yue Liu
- School of Sports Medicine and Rehabilitation, Shandong First Medical University, Shandong, China
| | - Wenwu Huang
- Department of Clinical Psychology, The Affiliated Kangning Hospital of Wenzhou Medical University, wenzhou, China
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17
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Peng A, Qiu X, Ji S, Hu D, Dong B, Song T, Huang C, Chen L. The impact of childhood parental loss on risk for depression and anxiety in adulthood: A community-based study in Southwest China. J Affect Disord 2022; 298:104-109. [PMID: 34715182 DOI: 10.1016/j.jad.2021.10.093] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 09/14/2021] [Accepted: 10/23/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE Lack of parental raising is an important reason for parental loss in China due to urbanization. We aimed to explore the association between parental loss (including parental death, divorce, alcoholism, crime, drug addiction, bedridden, and lack of parental raising) before 17 years old and mental health disorders in adulthood in Southwest China. METHODS Childhood parental loss, age, gender, socioeconomic status, smoking, drinking, and medical history were self-reported. Patient Health Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7) were used for identifying depression and anxiety, respectively. We use logistic regression with inverse probability weighting according to the propensity score to assess the risk of childhood parental loss on mental health disorders in adulthood. RESULTS A total of 8014 adults were enrolled in this study. Childhood parental loss increased the risk of adulthood depression (OR, 1.60, 95%CI, 1.30-1.98) but not anxiety (p= 0.07) after adjustment of all covariates. Sensitivity analyses including logistic regression with original data, nearest neighbor matching, full matching, and propensity score as the only covariate all yielded similar results. LIMITATIONS Recall bias could not be fully eliminated due to the retrospective nature of study design. Our study had been conducted in a less-prosperous area in Southwest China and the results may not be representative at nation level. CONCLUSIONS Childhood parental loss was associated with depression in adulthood in Southwest China, highlighting the need for early intervention in children with parental loss, to prevent long-term negative effects on their mental health.
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Affiliation(s)
- Anjiao Peng
- Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Xiangmiao Qiu
- Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Shuming Ji
- Department of Project Design and Statistics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Dan Hu
- Department of Clinical Research Management, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Bosi Dong
- Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Tingting Song
- Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Cheng Huang
- Rehabilitation Medicine Center, West China Hospital of Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China
| | - Lei Chen
- Department of Neurology and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan 610041, China.
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18
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Burns RJ, Briner E, Schmitz N. Trajectories of Depressive Symptoms and Incident Diabetes: A Prospective Study. Ann Behav Med 2021; 56:311-316. [PMID: 34791017 DOI: 10.1093/abm/kaab094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Elevated depressive symptoms are associated with an increased risk for diabetes. Depression is a heterogeneous and chronic condition in which symptoms may remit, emerge, lessen, or intensify over time. PURPOSE The purpose of this study was to determine if trajectories of depressive symptoms measured at five time points over 8 years predicted incident diabetes over an 8-year follow-up in middle-aged and older adults. A secondary aim was to determine if trajectories of depressive symptoms predict incident diabetes, above and beyond depressive symptoms measured at a single time point. METHODS Data came from the Health and Retirement Study (n = 9,233). Depressive symptoms were measured biennially from 1998 to 2006. Self-reported incident diabetes was measured during an 8-year follow-up. RESULTS Five trajectories of depressive symptoms were identified (no depressive symptoms, low depressive symptoms, low-moderate depressive symptoms, moderate depressive symptoms, elevated and increasing depressive symptoms). Compared to the no depressive symptoms trajectory group (referent), all other trajectory groups were at higher risk of developing diabetes after adjusting for covariates. In most cases, trajectory group membership was associated with incident diabetes after controlling for depressive symptoms at a single time point. CONCLUSIONS Patterns of depressive symptoms over time were associated with incident diabetes. Patterns of depressive symptoms may be more predictive of diabetes incidence than depressive symptoms measured at a single time point.
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Affiliation(s)
- Rachel J Burns
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Esther Briner
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Norbert Schmitz
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Department of Population-Based Medicine, Institute of Health Sciences, University Hospital Tuebingen, Tübingen, Germany
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Ramírez-de Los Santos ML, López-Navarro A, Ramírez-de Los Santos S, Guzmán-Flores JM, Pereira-Suárez AL, López-Pulido EI. Relation between personality dimensions and symptomatology of depression in skin cancer patients. Biopsychosoc Med 2021; 15:18. [PMID: 34641938 PMCID: PMC8507346 DOI: 10.1186/s13030-021-00220-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Environmental psychological factors such as mood states can modify and trigger an organic response; depressive disorder is considered a risk factor for oncological development, leading to alterations both in the genesis and in the progression of the disease. Some authors have identified that personality relates to mood since a high score in neuroticism is associated with intense and long-lasting emotions of stress and therefore with the development of depressive behaviors. The objective of this study was to analyze the relationship between personality and depression in skin cancer patients. METHODS A total of forty-seven clinically and histopathologically diagnosed patients were scheduled for an hour-long interview, during which they provided informed consent and sociodemographic information. The psychological questionnaires applied were the revised Eysenck Personality Questionnaire and the clinical questionnaire for the diagnosis of the depressive syndrome. RESULTS The patient's mean age was 66.5 years (SD ± 12.4) and the majority were diagnosed with basal cell carcinoma (70.2%). The frequency of anxious/depressive symptoms was 42.5%, with an increase in depression scores in the female gender (p < 0.001). Furthermore, a difference was found in the neuroticism dimension related to gender, with higher values in women (p = 0.002). Depressive symptomatologic portraits were correlated with the dimensions of neuroticism (p < 0.001, r = 0.705), psychoticism (p = 0.003, r = 0.422) and lying (p = 0.028, r = - 0.321). CONCLUSIONS Our results support the hypothesis that personality dimensions are related to the presence of anxiety/depressive symptomatology in patients with skin cancer, especially in the female gender. Highlighting the need for future research that delves into the implications at the psychological level, the quality of life, and the biological mechanisms that link personality and depressive symptoms in the development and evolution of skin cancer.
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Affiliation(s)
- M L Ramírez-de Los Santos
- Centro Universitario de los Altos, Universidad de Guadalajara, Road to Yahualica 7.5 Km, Jalisco, 47600, Tepatitlan de Morelos, Mexico
| | - A López-Navarro
- Centro Universitario de los Altos, Universidad de Guadalajara, Road to Yahualica 7.5 Km, Jalisco, 47600, Tepatitlan de Morelos, Mexico
| | - S Ramírez-de Los Santos
- Centro Universitario de los Altos, Universidad de Guadalajara, Road to Yahualica 7.5 Km, Jalisco, 47600, Tepatitlan de Morelos, Mexico
| | - J M Guzmán-Flores
- Centro Universitario de los Altos, Universidad de Guadalajara, Road to Yahualica 7.5 Km, Jalisco, 47600, Tepatitlan de Morelos, Mexico
| | - A L Pereira-Suárez
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - E I López-Pulido
- Centro Universitario de los Altos, Universidad de Guadalajara, Road to Yahualica 7.5 Km, Jalisco, 47600, Tepatitlan de Morelos, Mexico.
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20
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Wang Y, Liu D, Li X, Liu Y, Wu Y. Antidepressants use and the risk of type 2 diabetes mellitus: A systematic review and meta-analysis. J Affect Disord 2021; 287:41-53. [PMID: 33773358 DOI: 10.1016/j.jad.2021.03.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND This study aimed at examining the effects of different antidepressants on the new onset of T2DM. METHODS Systematic literature retrieval for cohort and case-control studies was conducted in PubMed, Embase, Web of Science, Cochrane library, Clinical Trials Register of the Cochrane Collaboration and CENTRAL published from January 2000 to October 2020. Pooled estimates were calculated and subgroup analyses were conducted by a fixed or random effects model according to the heterogeneity. Funnel plots and Egger's test were performed to evaluate publication bias. Stata Version 15.1 was used for data analysis. RESULTS Thirty studies (24 cohort, 4 nested case-control and 2 case-control studies) were included covering 2,875,567 participants with the follow-up periods from 1 year to 18 years (Median=8.4 years). The pooled estimates of antidepressants use and new-onset T2DM were HR=1.24 (95% CI: 1.18, 1.31), RR=1.42 (95% CI: 0.99, 2.05) and OR=1.17 (95% CI: 1.03, 1.32), respectively. However, subgroup analyses showed that only tricyclic antidepressants (TCAs) use was positively associated with the new onset of T2DM in both cohort studies (combined RR=1.39, 95% CI: 1.17, 1.65) and case-control studies (combined OR=1.25, 95% CI: 1.05, 1.50). Moreover, the risk of T2DM was increased with the duration of antidepressants use in a linear trend (R2= 88.51%, P = 0.009). LIMITATIONS Heterogeneity might impact the results and inference. CONCLUSIONS Antidepressants use might be a risk factor for the new onset of T2DM. Patients with long-term antidepressants use should be evaluated cautiously for T2DM risk. Routine T2DM screening is necessary in antidepressants users.
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Affiliation(s)
- Yuqing Wang
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Debiao Liu
- Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Xuezhi Li
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Yan Liu
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China
| | - Yili Wu
- Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining 272013, China; Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining 272013, China; Center of Evidence-Based Medicine, Jining Medical University, Jining 272013, China.
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21
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Roy JF, Lozano Del Hoyo ML, Urcola-Pardo F, Monreal-Bartolomé A, Gracia Ruiz DC, Gómez Borao MM, Artigas Alcázar AB, Martínez Casbas JP, Aceituno Casas A, Andaluz Funcia MT, García-Campayo J, Fernández Rodrigo MT. The TELE-DD project on treatment nonadherence in the population with type 2 diabetes and comorbid depression. Sci Rep 2021; 11:8889. [PMID: 33903605 PMCID: PMC8076287 DOI: 10.1038/s41598-021-87410-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
Diabetic patients have increased depression rates, diminished quality of life, and higher death rates due to depression comorbidity or diabetes complications. Treatment adherence (TA) and the maintenance of an adequate and competent self-care are crucial factors to reach optimal glycaemic control and stable quality of life in these patients. In this report, we present the baseline population analyses in phase I of the TELE-DD project, a three-phased population-based study in 23 Health Centres from the Aragonian Health Service Sector II in Zaragoza, Spain. The objectives of the present report are: (1) to determine the point prevalence of T2D and clinical depression comorbidity and treatment nonadherence; (2) to test if HbA1c and LDL-C, as primary DM outcomes, are related to TA in this population; and (3) to test if these DM primary outcomes are associated with TA independently of shared risk factors for DM and depression, and patients' health behaviours. A population of 7,271 patients with type-2 diabetes and comorbid clinical depression was investigated for inclusion. Individuals with confirmed diagnoses and drug treatment for both illnesses (n = 3340) were included in the current phase I. A point prevalence of 1.9% was found for the T2D-depression comorbidity. The prevalence of patients nonadherent to treatment for these diseases was 35.4%. Multivariate analyses confirmed that lower diabetes duration, increased yearly PCS visits, HbA1c and LDL-C levels were independently related to treatment nonadherence. These findings informed the development of a telephonic monitoring platform for treatment of nonadherence for people with diabetes and comorbid depression and further trial, cost-effectiveness, and prognostic studies (phases II and III).
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Affiliation(s)
| | - María Luisa Lozano Del Hoyo
- Centro de Salud Las Fuentes Norte, Servicio Aragonés de Salud (SALUD), 50002, Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
| | - Fernando Urcola-Pardo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), Zaragoza, Spain
| | - Alicia Monreal-Bartolomé
- Aragon Institute for Health Research, IIS Aragon, 50009, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029, Madrid, Spain
- Department of Medicine and Psychiatry, Faculty of Medicine, University of Zaragoza, 50009, Zaragoza, Spain
| | | | | | | | | | | | | | - Javier García-Campayo
- Aragon Institute for Health Research, IIS Aragon, 50009, Zaragoza, Spain
- Primary Care Prevention and Health Promotion Research Network, RedIAPP, 28029, Madrid, Spain
- Department of Medicine and Psychiatry, Faculty of Medicine, University of Zaragoza, 50009, Zaragoza, Spain
- Miguel Servet University Hospital, Zaragoza, Spain
| | - María Teresa Fernández Rodrigo
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009, Zaragoza, Spain
- Water and Environmental Health Research Group (DGA-B43-20R), Zaragoza, Spain
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22
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Anhedonia as a Potential Risk Factor of Alzheimer's Disease in a Community-Dwelling Elderly Sample: Results from the ZARADEMP Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041370. [PMID: 33546118 PMCID: PMC7913238 DOI: 10.3390/ijerph18041370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/22/2021] [Accepted: 01/30/2021] [Indexed: 12/18/2022]
Abstract
(1) Introduction: Dementia is a major public health problem, and Alzheimer's disease (AD) is the most frequent subtype. Clarifying the potential risk factors is necessary in order to improve dementia-prevention strategies and quality of life. Here, our purpose was to investigate the role of the absence of hedonic tone; anhedonia, understood as the reduction on previous enjoyable daily activities, which occasionally is underdetected and underdiagnosed; and the risk of developing AD in a cognitively unimpaired and non-depressed population sample. (2) Method: We used data from the Zaragoza Dementia and Depression (ZARADEMP) project, a longitudinal epidemiological study on dementia and depression. After excluding subjects with dementia, a sample of 2830 dwellers aged ≥65 years was followed for 4.5 years. The geriatric mental state examination was used to identify cases of anhedonia. AD was diagnosed by a panel of research psychiatrists according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. A multivariate survival analysis and Cox proportional hazards regression model were performed, and the analysis was controlled by an analysis for the presence of clinically significant depression. (3) Results: We found a significant association between anhedonia cases and AD risk in the univariate analysis (hazard ratio (HR): 2.37; 95% CI: 1.04-5.40). This association persisted more strongly in the fully adjusted model. (4) Conclusions: Identifying cognitively intact individuals with anhedonia is a priority to implement preventive strategies that could delay the progression of cognitive and functional impairment in subjects at risk of AD.
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Antidepressants and Risk of Type 2 Diabetes Mellitus: A Population-Based Nested Case-Control Study. J Clin Psychopharmacol 2021; 40:359-365. [PMID: 32639288 DOI: 10.1097/jcp.0000000000001228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE/BACKGROUND The increased risk of type 2 diabetes mellitus (T2DM) among users of antidepressants (ADs) might be mediated by depression. We investigated whether ADs are associated with increased risk of T2DM in patients with depression. Moreover, the relationship between binding affinities of serotonin transporter (SERT) of ADs and the risk of T2DM is examined. METHODS/PROCEDURES We conducted a retrospective nested case-control study using data from Taiwan's National Health Insurance Research Database between 2000 and 2013. A total of 3038 patients with depression, 1519 cases of T2DM, and 1519 controls matched for age, sex, and index date, were included. Exposure to ADs was categorized by type and SERT. The association between AD exposure and T2DM development was assessed using conditional logistic regression analysis. FINDINGS/RESULTS No association between T2DM development and selective serotonin reuptake inhibitors (adjusted odds ratio [AOR], 1.01; 95% confidence interval [CI], 0.87-1.19; P = 0.962), serotonin-norepinephrine reuptake inhibitors (AOR, 1.13; 95% CI, 0.94-1.37; P = 1.196), tricyclic antidepressants (AOR, 1.01; 95% CI, 0.85-1.21; P = 0.906), or others (AOR, 0.88; 95% CI, 0.75-1.03; P = 0.104) was found. Alternatively, no association between individual ADs and potency of affinity to SERT and the risk of T2DM was found. IMPLICATIONS/CONCLUSIONS No association between ADs and increase risk of T2DM was found in patients with depression. However, regular metabolic evaluations are recommended for patients with depression regularly taking ADs.
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Association between Depression, Antidepression Medications, and the Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study in Taiwan. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8857230. [PMID: 33506043 PMCID: PMC7810559 DOI: 10.1155/2021/8857230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/22/2020] [Accepted: 12/26/2020] [Indexed: 11/25/2022]
Abstract
The relationship between depression, antidepressant medications (ADMs), and the risk of subsequent type 2 diabetes mellitus (T2DM) development remains controversial. Thus, we investigated this aspect by a population-based retrospective cohort study using the Longitudinal Health Insurance Database 2000 available in Taiwan. This large, observational study included 46,201 patients with depression and a 1 : 1 age- and sex-matched nondepression cohort enrolled between January 1, 2000, and December 31, 2013, and the newly diagnosed T2DM incidence rates were determined. We estimated the effects of depression on T2DM and the cumulative incidence curves by Cox proportional regression hazard models and Kaplan-Meier methods, respectively. We found that 47.97% of the patients with depression did not receive ADM. Among patients with depression who received ADM, 29.71%, 6.29%, 0.05%, 9.65%, and 6.32% received selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), heterocyclic antidepressants, and other medications, respectively. Patients without ADM treatment had a 39% higher risk of developing T2DM. However, those who received ADM treatment had a significantly lower risk of T2DM development in every treatment category. Depressive disorder treated with ADMs, especially with long-term use, was associated with an 11–48% decrease in the risk of T2DM in all ADM groups; however, heterocyclic antidepressant treatment for shorter periods (<80 days) was not significantly associated with a decreased risk of T2DM. The incidence of T2DM in Taiwan was found to be associated with an a priori history of depression and was inversely correlated with ADM treatment.
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25
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A Comparison Study of Chaihu Shugan San and Fluoxetine on Antidepression and Regulating Blood Rheology Effects with Chronic Restrained Stress Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020. [DOI: 10.1155/2020/6426383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Chaihu Shugan San (CHSGS) is a traditional Chinese herbal formula that is often used in clinical practice to treat live Qi stagnation syndrome and depression. Fluoxetine is one of the commonly used drugs for the clinical treatment of depression. This study involved a comparison of CHSGS and fluoxetine on antidepression and regulating blood rheology effects with chronic restraint stress- (CRS-) induced depression rat models. Rats were induced depression models by CRS for 4 weeks. Upon successful induction of depression in the rats, the animal was administered CHSGS at 0.6 g/kg/d, 1.2 g/kg/d, or fluoxetine 1.8 mg/kg/d to corresponding groups by gavage for 2 weeks. The changes of CRS rats were determined by behavior observations and sucrose preference test and hypothalamic-pituitary-adrenal cortex (HPA) axis functional status. The changes in monoamine neurotransmitters and related indicators of blood status were detected by enzyme-linked immunosorbent assay (ELISA), blood rheometer, and other methods. The outcome shows that CHSGS is superior to fluoxetine in regulating the appearance and HPA axis function of model rats. In addition, CHSGS and fluoxetine have similar effects in improving blood rheology, and both can alleviate the hypercoagulable state of blood via the platelet 5-hydroxytryptamine receptor 2A (5-HT2A) pathway in rats of depression. It was also observed that CHSGS can improve the blood state of depressed rats by restoring liver coagulation-anticoagulation balance and endothelium-related functions.
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26
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Carey M, Lontchi-Yimagou E, Mitchell W, Reda S, Zhang K, Kehlenbrink S, Koppaka S, Maginley SR, Aleksic S, Bhansali S, Huffman DM, Hawkins M. Central K ATP Channels Modulate Glucose Effectiveness in Humans and Rodents. Diabetes 2020; 69:1140-1148. [PMID: 32217610 PMCID: PMC7243288 DOI: 10.2337/db19-1256] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 03/20/2020] [Indexed: 12/23/2022]
Abstract
Hyperglycemia is a potent regulator of endogenous glucose production (EGP). Loss of this "glucose effectiveness" is a major contributor to elevated plasma glucose concentrations in type 2 diabetes (T2D). KATP channels in the central nervous system have been shown to regulate EGP in humans and rodents. We examined the contribution of central KATP channels to glucose effectiveness. Under fixed hormonal conditions (studies using a pancreatic clamp), hyperglycemia suppressed EGP by ∼50% in both humans without diabetes and normal Sprague-Dawley rats. By contrast, antagonism of KATP channels with glyburide significantly reduced the EGP-lowering effect of hyperglycemia in both humans and rats. Furthermore, the effects of glyburide on EGP and gluconeogenic enzymes were abolished in rats by intracerebroventricular administration of the KATP channel agonist diazoxide. These findings indicate that about half of the suppression of EGP by hyperglycemia is mediated by central KATP channels. These central mechanisms may offer a novel therapeutic target for improving glycemic control in subjects with T2D.
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Affiliation(s)
- Michelle Carey
- Albert Einstein College of Medicine, Bronx, NY
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD
| | | | | | - Sarah Reda
- Albert Einstein College of Medicine, Bronx, NY
| | - Kehao Zhang
- Albert Einstein College of Medicine, Bronx, NY
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27
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Miidera H, Enomoto M, Kitamura S, Tachimori H, Mishima K. Association Between the Use of Antidepressants and the Risk of Type 2 Diabetes: A Large, Population-Based Cohort Study in Japan. Diabetes Care 2020; 43:885-893. [PMID: 32051242 DOI: 10.2337/dc19-1175] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 01/18/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to reveal the associations between the risk of new-onset type 2 diabetes and the duration of antidepressant use and the antidepressant dose, and between antidepressant use after diabetes onset and clinical outcomes. RESEARCH DESIGN AND METHODS In this large-scale retrospective cohort study in Japan, new users of antidepressants (exposure group) and nonusers (nonexposure group), aged 20-79 years, were included between 1 April 2006 and 31 May 2015. Patients with a history of diabetes or receipt of antidiabetes treatment were excluded. Covariates were adjusted by using propensity score matching; the associations were analyzed between risk of new-onset type 2 diabetes and the duration of antidepressant use/dose of antidepressant in the exposure and nonexposure groups by using Cox proportional hazards models. Changes in glycated hemoglobin (HbA1c) level were examined in groups with continuous use, discontinuation, or a reduction in the dose of antidepressants. RESULTS Of 90,530 subjects, 45,265 were in both the exposure and the nonexposure group after propensity score matching; 5,225 patients (5.8%) developed diabetes. Antidepressant use was associated with the risk of diabetes onset in a time- and dose-dependent manner. The adjusted hazard ratio was 1.27 (95% CI 1.16-1.39) for short-term low-dose and 3.95 (95% CI 3.31-4.72) for long-term high-dose antidepressant use. HbA1c levels were lower in patients who discontinued or reduced the dose of antidepressants (F[2,49] = 8.17; P < 0.001). CONCLUSIONS Long-term antidepressant use increased the risk of type 2 diabetes onset in a time- and dose-dependent manner. Glucose tolerance improved when antidepressants were discontinued or the dose was reduced after diabetes onset.
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Affiliation(s)
- Hiroyuki Miidera
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Minori Enomoto
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan.,Department of Medical Technology, School of Health Science, Tokyo University of Technology, Tokyo, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hisateru Tachimori
- Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan.,Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuo Mishima
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan .,Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan.,International Institute for Integrative Sleep Medicine, Tsukuba, Japan
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28
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Graham EA, Deschênes SS, Khalil MN, Danna S, Filion KB, Schmitz N. Measures of depression and risk of type 2 diabetes: A systematic review and meta-analysis. J Affect Disord 2020; 265:224-232. [PMID: 32090745 DOI: 10.1016/j.jad.2020.01.053] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 11/17/2019] [Accepted: 01/13/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Depression is associated with an increased risk of type 2 diabetes. This study aimed to determine whether the association between depression and incident type 2 diabetes differs by measure of depression. METHODS Data sources included MEDLINE, EMBASE, PsycINFO, CINAHL, ProQuest Dissertations & Theses Global, Web of Science Emerging Sources Citation Index and Conference Proceedings Citation Index, Cochrane Library, the University of York Center for Reviews and Dissemination, abstracts from the PsychoSocial Aspects of Diabetes conference. INCLUSION CRITERIA comparison of participants with and without depression, depression measured at age 18 or older, longitudinal follow-up with an outcome of type 2 diabetes, effect estimate adjusted for important confounders, full-text available in English or French, and study at overall low or moderate risk of bias. Two reviewers extracted data and assessed study quality. RESULTS Twenty-one studies reporting twenty-five effect estimates were included. Depressive symptom scales, clinical interviews, physician diagnoses, and use of antidepressants were all associated with an increased risk of incident type 2 diabetes. When all measures of depression were combined, the meta-analyzed risk ratio for type 2 diabetes was 1.18 (95% CI 1.12-1.24, I2=45.4%). Results did not provide conclusive evidence that the association between depression and incident diabetes differs by measure of depression. LIMITATIONS Results showed heterogeneity and evidence of publication bias. CONCLUSIONS Results suggest that various measures of depression may be used to identify individuals at higher risk of type 2 diabetes.
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Affiliation(s)
- Eva A Graham
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada.
| | | | - Marina N Khalil
- Douglas Mental Health University Institute, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Sofia Danna
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Kristian B Filion
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada; Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada; Department of Medicine, McGill University, Montreal, QC, Canada
| | - Norbert Schmitz
- Department of Epidemiology, Biostatistics, and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada; Douglas Mental Health University Institute, Montreal, QC, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
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29
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Li X, Qiu W, Li N, Da X, Ma Q, Hou Y, Wang T, Song M, Chen J. Susceptibility to Hyperglycemia in Rats With Stress-Induced Depressive-Like Behavior: Involvement of IL-6 Mediated Glucose Homeostasis Signaling. Front Psychiatry 2020; 11:557. [PMID: 32655424 PMCID: PMC7324635 DOI: 10.3389/fpsyt.2020.00557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/01/2020] [Indexed: 11/13/2022] Open
Abstract
Depression is a common psychiatric disorder comorbid with diabetes and may lead to high morbidity, disability, and mortality. However, the underlying mechanism behind their association remains unknown. Cytokine-mediated inflammation in brain may play important roles in the pathogenesis of depression and insulin resistance. In the present study, we subjected the rats to chronic unpredictable mild stress (CUMS) for 3 to 8 weeks. The tests to ascertain depression-like behaviors including open field test (OFT) and forced swimming test (FST) were performed, and levels of morning fasting blood glucose, triglyceride (TG), total cholesterol (CHOL), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C), body weight, food intake, histopathological examinations of liver, adipose tissues and hypothalamus, hypothalamic GLUT4 as well as the IL-6-mediated glucose homeostasis signaling pathway were measured. The results showed that CUMS exposure resulted in the depression-like behavior at various time points in rats. Moreover, the rats exhibited increased peripheral glucose levels, impaired hepatocytes and hippocampal neurons, and decreased hypothalamic GLUT4 levels after 6 weeks of CUMS exposure. Meanwhile, activated IL-6 but suppressed IL-6-mediated glucose homeostasis signaling was observed in the hypothalamus. Markers of lipid metabolism including TG, CHOL, HDL-C and LDL-C were dysregulated, and body weight and food intake were decreased in the CUMS-exposed rats. Our results show that depressed rats induced by 6-week CUMS stimulation display susceptibility to hyperglycemia, which is associated with IL-6-mediated inhibition of glucose homeostasis signaling in the hypothalamus.
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Affiliation(s)
- Xiaojuan Li
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Wenqi Qiu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Nan Li
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xiaoli Da
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Qingyu Ma
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Yajing Hou
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tingye Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ming Song
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jiaxu Chen
- Formula-pattern Research Center, School of Traditional Chinese Medicine, Jinan University, Guangzhou, China.,School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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30
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Li KD, Wang QS, Zhang WW, Zhang WY, Fu SN, Xu D, Wu JR, Zhai JB, Cui YL. Gardenia fructus antidepressant formula for depression in diabetes patients: A systematic review and meta-analysis. Complement Ther Med 2020; 48:102248. [DOI: 10.1016/j.ctim.2019.102248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/26/2019] [Accepted: 11/17/2019] [Indexed: 12/30/2022] Open
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31
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Ye Z, Yue L, Shi J, Shao M, Wu T. Role of IDO and TDO in Cancers and Related Diseases and the Therapeutic Implications. J Cancer 2019; 10:2771-2782. [PMID: 31258785 PMCID: PMC6584917 DOI: 10.7150/jca.31727] [Citation(s) in RCA: 108] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/10/2019] [Indexed: 02/06/2023] Open
Abstract
Kynurenine (Kyn) pathway is a significant metabolic pathway of tryptophan (Trp). The metabolites of the Kyn pathway are closely correlated with numerous diseases. Two main enzymes, indoleamine-2,3-dioxygenase (IDO) and tryptophan-2,3-dioxygenase (TDO or TDO2), regulate the first and rate-limiting step of the Kyn pathway. These enzymes are directly or indirectly involved in various diseases, including inflammatory diseases, cancer, diabetes, and mental disorders. Presently, an increasing number of potential mechanisms have been revealed. In the present review, we depict the structure of IDO and TDO and explicate their functions in various diseases to facilitate a better understanding of them and to indicate new therapeutic plans to target them. Moreover, we summarize the inhibitors of IDO/TDO that are currently under development and their efficacy in the treatment of cancer and other diseases.
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Affiliation(s)
- Zixiang Ye
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Linxiu Yue
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Jiachen Shi
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Mingmei Shao
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Tao Wu
- Institute of Interdisciplinary Integrative Medicine Research, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
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Li HQ, Chi S, Dong Q, Yu JT. Pharmacotherapeutic strategies for managing comorbid depression and diabetes. Expert Opin Pharmacother 2019; 20:1589-1599. [PMID: 31149850 DOI: 10.1080/14656566.2019.1622090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: The increasing prevalence of comorbid depression and diabetes exerts a heavy burden on global health. Co-occurrence of depression and diabetes is common, affecting 14% to 35.8% of patients with diabetes, leading to a higher mortality and morbidity rate, more micro- and macro-vascular diseases and more cognitive decline. Areas covered: In this paper, the authors address various areas from epidemiology, the association between depression and diabetes, treatment strategies and future directions based on the currently available literature to provide novel insight into the pharmacotherapeutic management of comorbid depression and diabetes. Expert opinion: Pharmacotherapy can help patients with comorbid depression and diabetes by relieving depressive symptoms and improving glycemic control. When combined with psychological therapy, as a collaborative care effort, pharmacological therapy based on selective serotonin reuptake inhibitors (SSRIs) is recommended for comorbid depression with diabetes. Furthermore, studies with larger sample sizes that can help to define different subtypes of diabetes and severity of depression are needed so that clinicians can draw up a precise and applicable management guidelines for the personalized therapy of these diseases.
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Affiliation(s)
- Hong-Qi Li
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Song Chi
- Department of Neurology, The Affiliated Hospital of Qingdao University , Qingdao , China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University , Shanghai , China
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33
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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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Chen Y, Fang X, Shuai X, Fritzsche K, Leonhart R, Hoschar S, Li L, Ladwig KH, Ma W, Wu H. Psychometric Evaluation of the Major Depression Inventory (MDI) as a Depression Severity Scale in Chinese Patients With Coronary Artery Disease. Findings From the MEDEA FAR-EAST Study. Front Psychiatry 2019; 10:493. [PMID: 31379618 PMCID: PMC6656859 DOI: 10.3389/fpsyt.2019.00493] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/24/2019] [Indexed: 12/19/2022] Open
Abstract
Background: It is highly recommended that all patients with coronary artery disease should be screened for depression. The Major Depression Inventory (MDI) is a widely used self-rating scale for the assessment of depression but is not valid in Chinese language. The present study was designed to assess the reliability and validity of a version of the MDI translated into Chinese among patients with acute myocardial infarction (AMI). Methods: Data were derived from the "Multicenter Delay in Patients Experiencing Acute Myocardial Infarction in Shanghai" (MEDEA FAR-EAST) study. Using a cross-sectional study design, the Chinese version of the MDI was administered to a total of 267 inpatients. The internal consistency reliability of the MDI scale was evaluated based on the Cronbach's coefficient and the binary coefficient for the whole scale. Exploratory factor analysis was performed to assess the internal consistency of the MDI. To examine discriminant validity, we analyzed the correlation of the MDI score with the General Anxiety Disorder-7 (GAD-7) and World Health Organization-5 Well-Being Index (WHO-5) scale scores. Results: The Chinese version of the MDI showed high reliability (Cronbach's alpha = 0.909, split-half reliability = 0.866). We identified one factor that explained 52% of the variance, which indicated that the MDI has satisfactory structural validity. The correlations of the MDI scores with the GAD-7 scores (r = 0.425) and the WHO-5 scores (r = -0.365) were moderate, suggesting that the MDI has acceptable discriminant validity. Conclusions: The MDI was proved to be a highly reliable and satisfactory valid diagnostic screening tool to assess depression in Chinese cardiac patients.
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Affiliation(s)
- Yixiao Chen
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyan Fang
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Technical University Munich, Munich, Germany
| | - Xueqian Shuai
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Sophia Hoschar
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Faculty of Medicine, Medical Center University of Freiburg, Freiburg, Germany
| | - Li Li
- College of Electronics and Information Engineering, Tongji University, Shanghai, China
| | - Karl-Heinz Ladwig
- Institute of Epidemiology II, Mental Health Research Unit, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Technical University Munich, Munich, Germany
| | - Wenlin Ma
- Department of Cardiology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Heng Wu
- Department of Psychosomatic Medicine, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Atlantis E, Ghassem Pour S, Girosi F. Incremental predictive value of screening for anxiety and depression beyond current type 2 diabetes risk models: a prospective cohort study. BMJ Open 2018; 8:e018255. [PMID: 29362254 PMCID: PMC5786131 DOI: 10.1136/bmjopen-2017-018255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES We sought to determine whether screening for anxiety and depression, an emerging risk factor for type 2 diabetes (T2D), adds clinically meaningful information beyond current T2D risk assessment tools. DESIGN Prospective cohort. PARTICIPANTS AND SETTING The 45 and Up Study is a large-scale prospective cohort of men and women aged 45 years and over, randomly sampled from the general population of New South Wales, Australia. 51 588 participants without self-reported diabetes at baseline (2006-2009) were followed up for approximately 3 years (2010). METHODS T2D status was determined by self-reported doctor who diagnosed diabetes after the age of 30 years, and/or current use of metformin. Current symptoms of anxiety and/or depression were measured by the 10-item Kessler Psychological Distress Scale (K10). We determined the optimal cut-off point for K10 for predicting T2D using Tjur's R2 and tested risk models with and without the K10 using logistic regression. We assessed performance measures for the incremental value of the K10 using the area under the receiver operating characteristic (AROC), net reclassification improvement (NRI) and net benefit (NB) decision analytics with sensitivity analyses. RESULTS T2D developed in 1076 individuals (52.4% men). A K10 score of ≥19 (prevalence 8.97%), adjusted for age and gender, was optimal for predicting incident T2D (sensitivity 77%, specificity 53% and positive predictive value 3%; OR 1.70 (95% CI 1.41 to 2.03, P<0.001). K10 score predicted incident T2D independent of current risk models, but did not improve corresponding AROC, NRI and NB statistics. Sensitivity analyses showed that this was partially explained by the baseline model and the small effect size of the K10 that was similar compared with other risk factors. CONCLUSIONS Anxiety and depressing screening with the K10 adds no meaningful incremental value in addition to current T2D risk assessments. The clinical importance of anxiety and depression screening in preventing T2D requires ongoing consideration.
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Affiliation(s)
- Evan Atlantis
- School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Capital Markets CRC, Sydney, New South Wales, Australia
| | - Shima Ghassem Pour
- Capital Markets CRC, Sydney, New South Wales, Australia
- Translation Health Research Institute, Western Sydney University, Kingswood, New South Wales, Australia
| | - Federico Girosi
- Capital Markets CRC, Sydney, New South Wales, Australia
- Translation Health Research Institute, Western Sydney University, Kingswood, New South Wales, Australia
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Rosedale MT, Strauss SM, Kaur N, Danoff A, Malaspina D. Identification of diabetes risk in dental settings: Implications for physical and mental health. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2018; 47:64-73. [DOI: 10.1080/00207411.2017.1377803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mary T. Rosedale
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Shiela M. Strauss
- Rory Meyers College of Nursing, New York University, New York, NY, USA
- New York University Langone Medical Center, New York, NY, USA
| | - Navjot Kaur
- New York University Langone Medical Center, New York, NY, USA
| | - Ann Danoff
- New York University Langone Medical Center, New York, NY, USA
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai Medical Center, New York, NY, USA
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Akbaş-Şimşek T, Onat A, Kaya A, Tusun E, Yüksel H, Can G. Sex-dependent independent prediction of incident diabetes by depressive symptoms. Int J Geriatr Psychiatry 2017; 32:1425-1432. [PMID: 27891676 DOI: 10.1002/gps.4630] [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: 04/01/2016] [Revised: 10/22/2016] [Accepted: 10/26/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To study the predictive value of depressive symptoms (DeprSs) in a general population of Turkey for type 2 diabetes. METHODS Responses to three questions served to assess the sense of depression. Cox regression analyses were used regarding risk estimates for incident diabetes, after exclusion of prevalent cases of diabetes. Mean follow-up consisted of 5.15 (±1.4) years. RESULTS Depressive symptoms were present at baseline in 16.2% of the whole study sample, threefold in women than men. Reduced physical activity grade was the only significant covariate at baseline in men, while younger age and lower blood pressure were significantly different in women compared with those without DeprS. In men, presence of DeprS predicted incident diabetes at a significant 2.58-fold relative risk (95% confidence interval 1.03; 6.44), after adjustment for age, systolic blood pressure, and antidepressant drug usage. When further covariates were added, waist circumference remained the only significant predictor, while DepS was attenuated to a relative risk of 2.12 (95% confidence interval 0.83; 5.40). DeprS was not associated with diabetes in women, whereas antidepressant drug usage only tended to be positively associated. CONCLUSION Gender difference existed in the relationship between DeprS and incident diabetes. DeprS predicted subsequent development of diabetes in men alone, not in women. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Tuğba Akbaş-Şimşek
- Section of Internal Medicine, Bağcılar Educational Hospital, Istanbul, Turkey
| | - Altan Onat
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Adnan Kaya
- Department of Cardiology and Public Health, Suruç State Hospital, Şanlıurfa, Turkey
| | - Eyyup Tusun
- Department of Cardiology, Şanlıurfa Educational Hospital, Şanlıurfa, Turkey
| | - Hüsniye Yüksel
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Günay Can
- Department of Cardiology and Public Health, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
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Zhuang QS, Shen L, Ji HF. Quantitative assessment of the bidirectional relationships between diabetes and depression. Oncotarget 2017; 8:23389-23400. [PMID: 28177893 PMCID: PMC5410312 DOI: 10.18632/oncotarget.15051] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 01/09/2017] [Indexed: 01/07/2023] Open
Abstract
Diabetes and depression impose an enormous public health burden and the present study aimed to assess quantitatively the bidirectional relationships between the two disorders. We searched databases for eligible articles published until October 2016. A total of 51 studies were finally included in the present bidirectional meta-analysis, among which, 32 studies were about the direction of depression leading to diabetes, and 24 studies about the direction of diabetes leading to depression. Pooled results of the 32 eligible studies covering 1274337 subjects showed that depression patients were at higher risk for diabetes (odds ratio (OR) = 1.34, 95% confidence intervals (CI) = [1.23, 1.46]) than non-depressive subjects. Further gender-subgroup analysis found that the strength of this relationship was stronger in men (OR = 1.63, 95%CI = [1.48, 1.78]) than in women (OR = 1.29, 95%CI = [1.07, 1.51]). For the direction of diabetes leading to depression, pooled data of 24 articles containing 329658 subjects showed that patients with diabetes were at higher risk for diabetes (OR = 1.28, 95%CI = [1.15, 1.42]) than non-diabetic subjects. The available data supports that the relationships between diabetes and depression are bidirectional and the overall strengths are similar in both directions. More mechanistic studies are encouraged to explore the molecular mechanisms underlying the relationships between the two diseases.
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Affiliation(s)
- Qi-Shuai Zhuang
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Liang Shen
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
| | - Hong-Fang Ji
- Shandong Provincial Research Center for Bioinformatic Engineering and Technique, School of Life Sciences, Shandong University of Technology, Zibo, P. R. China
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Su WJ, Peng W, Gong H, Liu YZ, Zhang Y, Lian YJ, Cao ZY, Wu R, Liu LL, Wang B, Wang YX, Jiang CL. Antidiabetic drug glyburide modulates depressive-like behavior comorbid with insulin resistance. J Neuroinflammation 2017; 14:210. [PMID: 29084550 PMCID: PMC5663104 DOI: 10.1186/s12974-017-0985-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/23/2017] [Indexed: 12/12/2022] Open
Abstract
Background Abundant reports indicated that depression was often comorbid with type 2 diabetes and even metabolic syndrome. Considering they might share common biological origins, it was tentatively attributed to the chronic cytokine-mediated inflammatory response which was induced by dysregulation of HPA axis and overactivation of innate immunity. However, the exact mechanisms remain obscure. Herein, we mainly focused on the function of the NLRP3 inflammasome to investigate this issue. Methods Male C57BL/6 mice were subjected to 12 weeks of chronic unpredictable mild stress (CUMS), some of which were injected with glyburide or fluoxetine. After CUMS procedure, behavioral and metabolic tests were carried out. In order to evaluate the systemic inflammation associated with inflammasome activation, IL-1β and inflammasome components in hippocampi and pancreases, as well as corticosterone and IL-1β in serum were detected separately. Moreover, immunostaining was performed to assess morphologic characteristics of pancreases. Results In the present study, we found that 12 weeks’ chronic stress resulted in depressive-like behavior comorbid with insulin resistance. Furthermore, antidiabetic drug glyburide, an inhibitor of the NLRP3 inflammasome, was discovered to be effective in preventing the experimental comorbidity. In brief, it improved behavioral performance, ameliorated insulin intolerance as well as insulin signaling in the hippocampus possibly through inhibiting NLRP3 inflammasome activation by suppressing the expression of TXNIP. Conclusions All these evidence supported our hypothesis that chronic stress led to comorbidity of depressive-like behavior and insulin resistance via long-term mild inflammation. More importantly, based on the beneficial effects of blocking the activation of the NLRP3 inflammasome, we provided a potential therapeutic target for clinical comorbidity and a new strategy for management of both diabetes and depression.
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Affiliation(s)
- Wen-Jun Su
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Wei Peng
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Hong Gong
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yun-Zi Liu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yi Zhang
- Department of Psychiatry, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yong-Jie Lian
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Zhi-Yong Cao
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China.,Department of Psychiatry, The 102nd Hospital of PLA, 55 North Heping Road, Changzhou, China
| | - Ran Wu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Lin-Lin Liu
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Bo Wang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Yun-Xia Wang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China
| | - Chun-Lei Jiang
- Laboratory of Stress Medicine, Faculty of Psychology and Mental Health, Second Military Medical University, 800 Xiangyin Road, Shanghai, China.
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van de Pavert I, Sunderland M, Luijten M, Slade T, Teesson M. The general relationship between internalizing psychopathology and chronic physical health conditions: a population-based study. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1257-1265. [PMID: 28744565 DOI: 10.1007/s00127-017-1422-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 07/14/2017] [Indexed: 11/25/2022]
Abstract
Studies have consistently demonstrated a reciprocal relationship between internalizing disorders and several chronic physical health conditions. Yet, much of the extant literature fails to take into account the role of comorbidity among internalizing disorders when examining the relationship with poor physical health. The current study applied latent variable modelling to investigate the shared and specific relationships between internalizing (fear and distress factors) and a range of physical health conditions. Data comprised 8841 respondents aged 16-85 years who took part in the 2007 Australian National Survey of Mental Health and Wellbeing. Multiple indicator, multiple causes models were used to parse the shared and specific relationships between internalizing disorders and variables associated with poor physical health. The study found that several physical conditions were significantly related to mean levels of fear and distress. The results were broadly similar but minor differences emerged depending on whether lifetime or past 12 months indicators of mental disorders and physical conditions were utilized in the model. Finally, the results demonstrated that the association between individual mental disorders and physical health conditions are better accounted for by indirect relationships with broad transdiagnostic dimensions rather than including additional disorder-specific relationships. The results indicate that researchers should focus on common mechanisms across multiple internalizing disorders and poor physical health when developing prevention and treatment initiatives.
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Affiliation(s)
- Iris van de Pavert
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Matthew Sunderland
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia.
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Tim Slade
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia
| | - Maree Teesson
- Centre for Research Excellence in Mental Health and Substance Use, National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052, Australia
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of shared dysregulation of the hypothalamic-pituitary-adrenal (HPA) and brain-gut-microbiome (BGM) axes associated with depression and type 2 diabetes (T2D). Clinical implications and future research are also discussed. RECENT FINDINGS Both depression and T2D are associated with dysregulation of the HPA and BGM axes. These pathways regulate immune function, glucose metabolism, and sleep, which are altered in both illnesses. Dysregulation of homeostatic brain-body pathways may be positively influenced through different therapeutic actions, including psychotherapy, healthy eating, physical activity, sleep promotion, and certain anti-inflammatory or antidepressant medications. While the causal nature of the relationship between depression and T2D remains unclear, these conditions share dysregulation of homeostatic brain-body pathways that are central to mental and physical health. Better understanding of this dysregulation may provide opportunities for interventions that could benefit both conditions. Future research should examine the additive burden of depression and T2D on HPA and BGM dysregulation and better differentiate depression from emotional distress.
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Affiliation(s)
- Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA.
| | - Juan F Roy
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
| | - Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, 1165 Morris Park Avenue, Rousso Building, Bronx, NY, 10461, USA
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
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Salvi V, Grua I, Cerveri G, Mencacci C, Barone-Adesi F. The risk of new-onset diabetes in antidepressant users - A systematic review and meta-analysis. PLoS One 2017; 12:e0182088. [PMID: 28759599 PMCID: PMC5536271 DOI: 10.1371/journal.pone.0182088] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 07/12/2017] [Indexed: 12/02/2022] Open
Abstract
Background Antidepressant Drugs (ADs) are among the most commonly prescribed medications in developed countries. The available epidemiological evidence suggests an association between AD use and higher risk of developing type 2 diabetes mellitus. However, some methodological issues make the interpretation of these results difficult. Moreover, very recent studies provided conflicting results. Given the high prevalence of both diabetes and AD use in many countries, clarifying whether this association is causal is of extreme relevance for the public health. The aim of the present study is to provide an up-to-date evaluation of the evidence in support of a causal role of ADs in inducing diabetes. Methods and findings A systematic literature search was conducted to identify relevant studies in MEDLINE (PubMed), PsycINFO, and International Pharmaceutical Abstracts (IPA) through 31st December 2016. Only studies assessing the incidence of new-onset diabetes in subjects treated with ADs were included. Results were pooled using a random-effects meta-analysis. Moreover, we extensively reviewed the role of the different sources of bias that have been proposed to explain the association between AD and diabetes. Twenty studies met the inclusion criteria. In the meta-analysis, the association between AD use and diabetes was still evident after the inclusion of the recent negative studies [pooled relative risk = 1.27, 95% confidence interval (CI), 1.19–1.35; p<0.001]. None of the biases proposed by previous authors seemed able to fully explain the observed association. Conclusions This updated meta-analysis confirms the association between AD use and incident diabetes. It still remains a matter of debate whether single ADs exert a different effect on the risk of diabetes. Given the possible heterogeneity, we suggest that a classification of ADs according to their pharmacological profiles could be useful in better elucidating the nature of this association.
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Affiliation(s)
- Virginio Salvi
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
- * E-mail:
| | - Ilaria Grua
- Department of Pharmaceutical Sciences, University of Eastern Piedmont, Novara, Italy
| | - Giancarlo Cerveri
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Claudio Mencacci
- Department of Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
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Albertorio-Diaz JR, Eberhardt MS, Oquendo M, Mesa-Frias M, He Y, Jonas B, Kang K. Depressive states among adults with diabetes: Findings from the National Health and Nutrition Examination Survey, 2007-2012. Diabetes Res Clin Pract 2017; 127:80-88. [PMID: 28319805 PMCID: PMC5820775 DOI: 10.1016/j.diabres.2017.02.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/21/2017] [Indexed: 11/23/2022]
Abstract
AIMS To determine (1) the prevalence of SubD states among adults with diabetes, and (2) whether evidence exists of an independent association between diabetes status and SubD, controlling for selected confounders. METHODS Data from the 2007-2012 National Health and Nutrition Examination Surveys were combined to estimates of depressive states by diabetes status among the noninstitutionalized U.S. adult population, and to assess the association of diabetes status and depressive states using a polytomous logistic regression model. RESULTS An estimated 17%, or 3.7 million, of U.S. adults with diabetes (diagnosed and undiagnosed) met criteria for either mD or ssD. The majority of SubD cases with diabetes were found to be ssD (10.1%) compared with mD (6.9%). After controlling for the effects of age, sex, race and ethnicity, education, body mass index, and poverty as covariates, an independent association persists between diagnosed diabetes and each SubD grouping (ssD: OR=1.82, CIs 1.33, 2.47; mD: OR=1.95, CIs 1.39, 2.74) compared with respondents having no diabetes. No association was found between depression and undiagnosed diabetes or prediabetes compared with those having no diabetes. CONCLUSION Milder forms of depression such as ssD and mD are more extant than major depressive episodes among adults with diabetes. The odds that an adult with diagnosed diabetes meets the criteria for ssD or mD are higher by 80% and 95%, respectively, after controlling for age, sex, race and ethnicity, education, body mass index, and poverty factors when compared against adults with no diabetes.
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Affiliation(s)
| | - Mark S Eberhardt
- National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States.
| | - Maria Oquendo
- Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 200, Philadelphia, PA 19104-3309, United States.
| | - Marco Mesa-Frias
- Department of Statistical Science, University of Idaho, 875 Perimeter Drive, MS 1104, Moscow, ID 83844-1104, United States.
| | - Yulei He
- National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States.
| | - Bruce Jonas
- 8613 Undermire Ct., Bowie, MD 20720, United States.
| | - Kai Kang
- National Center for Health Statistics, 3311 Toledo Rd., Hyattsville, MD 20782, United States.
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Kokoszka A. Treatment adherence in patients with type 2 diabetes mellitus correlates with different coping styles, low perception of self-influence on disease, and depressive symptoms. Patient Prefer Adherence 2017; 11:587-595. [PMID: 28360512 PMCID: PMC5364005 DOI: 10.2147/ppa.s124605] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Insulin analogs are regarded as more convenient to use than human insulin; however, they require a different administration scheme due to their unique pharmacokinetic and pharmacodynamic properties. This study aimed to assess difficulties with adherence to treatment with insulin analogs in patients with type 2 diabetes mellitus (T2DM), who had previously been treated with human insulin. The associations between difficulties with adherence and clinical, demographic, and psychological characteristics were also evaluated. PATIENTS AND METHODS The study was conducted on 3,467 consecutively enrolled patients with T2DM (54.4% women), mean age 63.9 years (SD =9.57), who had recently undergone a physician-directed change in treatment from human insulin to insulin analogs. The questionnaires addressed difficulties with switching the therapy, coping styles, well-being, and perception of self-influence on the disease. RESULTS No adherence problems in switching therapy were reported in 56.6% of patients. Specific moderate difficulties were reported in 10.4%-22.1% of patients, major difficulties in 0.7%-6.9% of patients, and very significant difficulties in 0.03%-1.3% of patients. Overall, remembering to modify the insulin dose in the case of additional meals was the most frequently reported difficulty, and problems with identifying hypoglycemic symptoms were the least frequently reported. The increased risk of difficulties was moderately related to low perception of self-influence on diabetes and poor well-being. The intensity of problems was higher among those who were less-educated, lived in rural areas, had complications, and/or reported maladaptive coping styles. CONCLUSION Switching from human insulin to an insulin analog did not cause adherence problems in more than half of the patients. In the remaining patients, difficulties in adherence correlated with maladaptive coping styles, low perception of self-influence on disease course, and depressive symptoms.
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Affiliation(s)
- Andrzej Kokoszka
- II Department of Psychiatry, Medical University of Warsaw
- Department of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
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Correlation between hormone receptor status and depressive symptoms in patients with metastatic breast cancer. Oncotarget 2017; 8:50774-50781. [PMID: 28881602 PMCID: PMC5584203 DOI: 10.18632/oncotarget.15037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/16/2017] [Indexed: 12/17/2022] Open
Abstract
Individual differences in depressive symptoms correlate with morbidity and outcomes in breast cancer patients. We evaluated the effect of hormone receptor (HR) status on depressive symptoms in 176 women with metastatic breast cancer at diagnosis. To assess depression, the women completed Self-Rating Depression Scale (SDS) questionnaires at baseline examination (T1), after 4 chemotherapy cycles (T2) and after 6 months (T3). At baseline examination, 45/176 (25.6%) patients were found to be at high or medium risk for depression (SDS score ≥0.6). Among these, depression was both prevalent in HR-positive patients and in HR-negative patients (64.4% versus 51.4%, P = 0.001). In multivariate model, HR positivity and higher depression risk were associated with poorer overall survival (25.0 months versus 32.0 months, P < 0.05). Patients at high/medium risk of depression were treated with the antidepressant agent fluoxetine (N = 23) or no drug (N = 22). SDS scores in patients treated with fluoxetine were lower after 4 chemotherapy cycles and after 6 months than in the control group (mean scores: T2, 0.61 versus 0.67, P = 0.001; T3, 0.56 versus 0.65, P < 0.001). No difference on SDS scores was found between patients with positive or negative HR status during fluoxetine treatment. These findings suggest hormone receptor status is associated with depressive symptoms in patients with metastatic breast cancer. Fluoxetine relieves depressive symptoms in these patients, regardless of hormone receptor status.
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Impact of Muscarinic M 3 Receptor Antagonism on the Risk of Type 2 Diabetes in Antidepressant-Treated Patients: A Case-Controlled Study. CNS Drugs 2017; 31:483-493. [PMID: 28527131 PMCID: PMC5488147 DOI: 10.1007/s40263-017-0436-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND M3 muscarinic receptor antagonism has been associated with glucose intolerance and disturbance of insulin secretion. OBJECTIVE Our objective was to examine the risk of type 2 diabetes mellitus (T2DM) in patients using antidepressants with and without M3 muscarinic receptor antagonism (AD_antaM3 and AD_nonantaM3, respectively). METHODS We designed a case-control study using a pharmacy prescription database. We selected a cohort of patients who initiated antidepressant use between the ages of 20 and 40 years and who did not receive any anti-diabetic prescriptions at baseline. Cases were defined as those who developed T2DM [i.e., receiving oral anti-diabetic medication, Anatomical Therapeutic Chemical (ATC) code A10B] during the follow-up period (1994-2014), and ten random controls were picked for each case from the cohort of patients who did not develop T2DM. RESULTS A total of 530 cases with incident T2DM and 5300 controls were included. Compared with no use of antidepressants during the previous 2 years, recent (within the last 6 months) exposure to AD_antaM3 was associated with a moderately increased risk of T2DM: adjusted odds ratio 1.55 (95% confidence interval 1.18-2.02). In the stratified analyses, this association was dose dependent (>365 defined daily doses) and significant for patients who were in the younger age group (<45 years at the end of follow-up), were female and had no co-morbidity. On the other hand, recent exposure to AD_nonantaM3 was not associated with a risk for T2DM in any of our analyses. CONCLUSION Our results suggest that exposure to AD_antaM3 was associated with the development of T2DM among antidepressant users.
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Thomas JJ, Moring JC, Harvey T, Hobbs T, Lindt A. Risk of type 2 diabetes: health care provider perceptions of prevention adherence. Appl Nurs Res 2016; 32:1-6. [PMID: 27969010 PMCID: PMC5159424 DOI: 10.1016/j.apnr.2016.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/11/2016] [Accepted: 03/18/2016] [Indexed: 01/15/2023]
Abstract
The aim of the current study was to describe health care providers' perceptions as to why individuals may or may not follow recommendations for reducing risk of developing type 2 diabetes. A grounded theory research design guided data collection and analysis. Data were collected from 16 health care providers through semi-structured interviews. Results demonstrated that health care providers perceived prevention adherence as related to individual characteristics of the patient and activities of the provider. Specifically, providers described assessment of patient-based characteristics associated with behavior, context, and traits. In addition, providers discussed giving attention to the patient-provider relationship and helping the patient incorporate small lifestyle changes. Providers might utilize social cognitive theory to understand personal and socio-structural aspects of adherence. In addition, providers should focus assessment and relationship building efforts on factors that support self-efficacy.
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Affiliation(s)
- Jenifer J Thomas
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA.
| | - John C Moring
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-2994, USA.
| | - Terra Harvey
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
| | - Talisha Hobbs
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
| | - Adara Lindt
- Fay W. Whitney School of Nursing, University of Wyoming, Laramie, WY 82071-2000, USA
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Xiaoyun K, Hailong Z, Qingzhi W. Effect of community management of diabetes mellitus on patients with type 2 diabetes mellitus concomitant with depression. Int J Diabetes Dev Ctries 2016. [DOI: 10.1007/s13410-016-0525-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
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Meier SM, Mattheisen M, Mors O, Mortensen PB, Laursen TM, Penninx BW. Increased mortality among people with anxiety disorders: total population study. Br J Psychiatry 2016; 209:216-21. [PMID: 27388572 PMCID: PMC5082973 DOI: 10.1192/bjp.bp.115.171975] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 02/27/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Anxiety disorders and depression are the most common mental disorders worldwide and have a striking impact on global disease burden. Although depression has consistently been found to increase mortality; the role of anxiety disorders in predicting mortality risk is unclear. AIMS To assess mortality risk in people with anxiety disorders. METHOD We used nationwide Danish register data to conduct a prospective cohort study with over 30 million person-years of follow-up. RESULTS In total, 1066 (2.1%) people with anxiety disorders died during an average follow-up of 9.7 years. The risk of death by natural and unnatural causes was significantly higher among individuals with anxiety disorders (natural mortality rate ratio (MRR) = 1.39, 95% CI 1.28-1.51; unnatural MRR = 2.46, 95% CI 2.20-2.73) compared with the general population. Of those who died from unnatural causes, 16.5% had comorbid diagnoses of depression (MRR = 11.72, 95% CI 10.11-13.51). CONCLUSIONS Anxiety disorders significantly increased mortality risk. Comorbidity of anxiety disorders and depression played an important part in the increased mortality.
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Affiliation(s)
- Sandra M. Meier
- National Centre for Register-Based Research, Aarhus University, Aarhus, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Mental Health Centre for Child and Adolescent Psychiatry, Copenhagen Region, Denmark
| | - Manuel Mattheisen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, and Research Department P, Aarhus University Hospital, Risskov, Denmark
| | - Preben B. Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Thomas M. Laursen
- National Centre for Register-Based Research, Aarhus University, Aarhus, and The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Brenda W. Penninx
- Department of Psychiatry and EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, Netherlands
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