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Bannert U, Siewert-Markus U, Klinger-König J, Grabe HJ, Stracke S, Dörr M, Völzke H, Markus MRP, Töpfer P, Ittermann T. Major depression recurrence is associated with differences in obesity-related traits in women, but not in men. Eur Psychiatry 2024; 67:e55. [PMID: 39301585 DOI: 10.1192/j.eurpsy.2024.1764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Obesity-related cardiometabolic comorbidity is common in major depressive disorder (MDD). However, sex differences and MDD recurrence may modify the MDD-obesity-link. METHODS Sex-specific associations of MDD recurrence (single [MDDS] or recurrent episodes [MDDR]) and obesity-related traits were analyzed in 4.100 adults (51.6% women) from a cross-sectional population-based cohort in Germany (SHIP-Trend-0). DSM-IV-based lifetime MDD diagnoses and MDD recurrence status were obtained through diagnostic interviews. Obesity-related outcomes included anthropometrics (weight, body mass index, waist- and hip-circumference, waist-to-hip ratio, waist-to-height ratio), bioelectrical impedance analysis of body fat mass and fat-free mass, and subcutaneous (SAT) and visceral adipose tissue (VAT) from abdominal magnetic resonance imaging. Sex-stratified linear regression models predicting obesity-related traits from MDD recurrence status were adjusted for age, education, and current depressive symptoms. RESULTS 790 participants (19.3%) fulfilled lifetime MDD criteria (23.8% women vs. 14.5% men, p<0.001). In women, MDDS was inversely associated with anthropometric indicators of general and central obesity, while MDDR was positively associated with all obesity-related traits, except waist-to-hip ratio and fat-free mass. In women, MDDR versus MDDS was associated with higher levels of obesity across all outcomes except fat-free mass. In men, MDD was positively associated with SAT regardless of MDD recurrence. Additionally, lifetime MDD was positively associated with VAT in men. Results remained significant in sensitivity analyses after exclusion of participants with current use of antidepressants. CONCLUSIONS The MDD-obesity association is modified by MDD recurrence and sex independent of current depressive symptoms. Accounting for sex and MDD recurrence may identify individuals with MDD at increased cardiometabolic risk.
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Affiliation(s)
- Urs Bannert
- University Medicine Greifswald, Greifswald, Germany
| | - Ulrike Siewert-Markus
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site, Rostock/Greifswald, Germany
| | - Sylvia Stracke
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
| | - Henry Völzke
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- German Center for Diabetes Research (DZD), Partner Site Greifswald, Greifswald, Germany
| | - Philipp Töpfer
- Department of Internal Medicine A, University Medicine Greifswald, Greifswald, Germany
| | - Till Ittermann
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, Greifswald, Germany
- Department of Study of Health in Pomerania/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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Badulescu S, Tabassum A, Le GH, Wong S, Phan L, Gill H, Llach CD, McIntyre RS, Rosenblat J, Mansur R. Glucagon-like peptide 1 agonist and effects on reward behaviour: A systematic review. Physiol Behav 2024; 283:114622. [PMID: 38945189 DOI: 10.1016/j.physbeh.2024.114622] [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: 04/11/2024] [Revised: 06/17/2024] [Accepted: 06/25/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION The roles of metabolic signals, including Glucagon-like peptide 1 (GLP-1), have been implicated in multiple domains outside metabolic regulation. There is a growing interest in repurposing Glucagon-like peptide 1 receptor agonists (GLP-1RAs) as therapeutics for motivation and reward-related behavioural disturbances. Herein, we aim to systematically review the extant evidence on the potential effects of GLP-1RAs on the reward system. METHODS The study followed PRISMA guidelines using databases such as OVID, PubMed, Scopus, and Google Scholar. The search focused on "Reward Behavior" and "Glucagon Like Peptide 1 Receptor Agonists" and was restricted to human studies. Quality assessment achieved by the NIH's Quality Assessment of Controlled Intervention Studies RESULTS: GLP-1RAs consistently reduced energy intake and influenced reward-related behaviour. These agents have been associated with decreased neurocortical activation in response to higher rewards and food cues, particularly high-calorie foods, and lowered caloric intake and hunger levels. DISCUSSION GLP-1RAs show promise in addressing reward dysfunction linked to food stimuli, obesity, and T2DM. They normalize insulin resistance, and might also modulate dopaminergic signalling and reduce anhedonia. Their effects on glycemic variability and cravings suggest potential applications in addiction disorders.
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Affiliation(s)
- Sebastian Badulescu
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.
| | - Aniqa Tabassum
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Gia Han Le
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Sabrina Wong
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Hartej Gill
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Cristian-Daniel Llach
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Joshua Rosenblat
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Rodrigo Mansur
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
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Tsang RSM, Stow D, Kwong ASF, Donnelly NA, Fraser H, Barroso IA, Holmans PA, Owen MJ, Wood ML, van den Bree MBM, Timpson NJ, Khandaker GM. Immunometabolic Blood Biomarkers of Developmental Trajectories of Depressive Symptoms: Findings From the ALSPAC Birth Cohort. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.12.24310330. [PMID: 39040209 PMCID: PMC11261916 DOI: 10.1101/2024.07.12.24310330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
Studies of longitudinal trends of depressive symptoms in young people could provide insight into aetiologic mechanism, heterogeneity and origin of common cardiometabolic comorbidities for depression. Depression is associated with immunological and metabolic alterations, but immunometabolic characteristics of developmental trajectories of depressive symptoms remain unclear. Using depressive symptoms scores measured on 10 occasions between ages 10 and 25 years in the Avon Longitudinal Study of Parents and Children (n=7302), we identified four distinct trajectories: low-stable (70% of the sample), adolescent-limited (13%), adulthood-onset (10%) and adolescent-persistent (7%). We examined associations of these trajectories with: i) anthropometric, cardiometabolic and psychiatric phenotypes using multivariable regression (n=1709-3410); ii) 67 blood immunological proteins and 57 metabolomic features using empirical Bayes moderated linear models (n=2059 and n=2240 respectively); and iii) 28 blood cell counts and biochemical measures using multivariable regression (n=2256). Relative to the low-stable group, risk of depression and anxiety in adulthood was higher for all other groups, especially in the adolescent-persistent (ORdepression=22.80, 95% CI 15.25-34.37; ORGAD=19.32, 95% CI 12.86-29.22) and adulthood-onset (ORdepression=7.68, 95% CI 5.31-11.17; ORGAD=5.39, 95% CI 3.65-7.94) groups. The three depression-related trajectories vary in their immunometabolic profile, with evidence of little or no alterations in the adolescent-limited group. The adulthood-onset group shows widespread classical immunometabolic changes (e.g., increased immune cell counts and insulin resistance), while the adolescent-persistent group is characterised by higher BMI both in childhood and adulthood with few other immunometabolic changes. These findings point to distinct mechanisms and intervention opportunities for adverse cardiometabolic profile in different groups of young people with depression.
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Affiliation(s)
- Ruby S M Tsang
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
| | - Daniel Stow
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Alex S F Kwong
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Nicholas A Donnelly
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Avon and Wiltshire NHS Mental Health Partnership NHS Trust, Bristol, UK
| | - Holly Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
| | - Inês A Barroso
- Exeter Centre of Excellence for Diabetes Research, University of Exeter, UK
| | - Peter A Holmans
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Michael J Owen
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Neuroscience and Mental Health Innovation Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Megan L Wood
- School of Psychology, University of Leeds, Leeds, UK
| | - Marianne B M van den Bree
- Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Neuroscience and Mental Health Innovation Institute, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Nicholas J Timpson
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Golam M Khandaker
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
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Zhu X, Yue Y, Li L, Zhu L, Cai Y, Shu Y. The relationship between depression and relative fat mass (RFM): A population-based study. J Affect Disord 2024; 356:323-328. [PMID: 38614443 DOI: 10.1016/j.jad.2024.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Relative fat mass (RFM) is a novel indicator for measuring body fat. The relationship between RFM and depression was explored using National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2018. METHODS A general statistical description of the population included in the study was performed, and logistic analyses were used to explore the association between body mass index (BMI), waist circumference (WC), RFM and depression. Sensitivity analyses and restricted cubic spline (RCS) were also conducted to investigate the association between RFM and depression. RESULTS A total of 28,836 participants were included in the study. In multivariate models, all obesity indices were associated with depression (P < 0.001). An increase of 1 SD in BMI, WC, and RFM was associated with a respective increased risk of depression of 2.3 %, 1.0 %, and 3.3 %. Excluding those taking antidepressants, the risk of depression was OR 1.88 (95 % CI: 1.26-2.79) for those with RFM in the highest quartile compared with those in the lowest quartile. After Inverse probability of weighting (IPW), the risk of depression in individuals with RFM in the highest quartile compared with individuals in the lowest quartile was 2.62 (95 % CI: 2.21-3.09). The RCS showed a possible nonlinear relationship between RFM and depression. CONCLUSIONS RFM is associated with depression, suggesting that attention to RFM may be helpful for depression research.
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Affiliation(s)
- Xianlin Zhu
- Department of Clinical Psychology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ya Yue
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, China
| | - Lin Li
- Department of Clinical Psychology, Deyang City mental Health Center, Deyang, China
| | - Liying Zhu
- Medical Section, The Second People's Hospital of Huizhou, Huizhou, China
| | - Yuexi Cai
- Department of Psychiatry, Changzhou Dean Hospital, Changzhou, China
| | - Yanping Shu
- Department of Psychiatry of Women and Children, The Second People's Hospital of Guizhou Province, Guiyang, China.
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Zhu Y, Huang T, Li R, Yang Q, Zhao C, Yang M, Lin B, Li X. Distinct resting-state effective connectivity of large-scale networks in first-episode and recurrent major depression disorder: evidence from the REST-meta-MDD consortium. Front Neurosci 2023; 17:1308551. [PMID: 38148946 PMCID: PMC10750394 DOI: 10.3389/fnins.2023.1308551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Previous studies have shown disrupted effective connectivity in the large-scale brain networks of individuals with major depressive disorder (MDD). However, it is unclear whether these changes differ between first-episode drug-naive MDD (FEDN-MDD) and recurrent MDD (R-MDD). Methods This study utilized resting-state fMRI data from 17 sites in the Chinese REST-meta-MDD project, consisting of 839 patients with MDD and 788 normal controls (NCs). All data was preprocessed using a standardized protocol. Then, we performed a granger causality analysis to calculate the effectivity connectivity (EC) within and between brain networks for each participant, and compared the differences between the groups. Results Our findings revealed that R-MDD exhibited increased EC in the fronto-parietal network (FPN) and decreased EC in the cerebellum network, while FEDN-MDD demonstrated increased EC from the sensorimotor network (SMN) to the FPN compared with the NCs. Importantly, the two MDD subgroups displayed significant differences in EC within the FPN and between the SMN and visual network. Moreover, the EC from the cingulo-opercular network to the SMN showed a significant negative correlation with the Hamilton Rating Scale for Depression (HAMD) score in the FEDN-MDD group. Conclusion These findings suggest that first-episode and recurrent MDD have distinct effects on the effective connectivity in large-scale brain networks, which could be potential neural mechanisms underlying their different clinical manifestations.
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Affiliation(s)
- Yao Zhu
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Tianming Huang
- Department of General Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China
| | - Ruolin Li
- Department of Radiology, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Qianrong Yang
- Department of General Psychiatry, Shanghai Changning Mental Health Center, Shanghai, China
| | - Chaoyue Zhao
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ming Yang
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Bin Lin
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | | | - Xuzhou Li
- Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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Nour MO, Hafiz TA, Alharbi KK. Measuring the relationship between body mass index and depression among Saudi adult population: A nationwide cross-sectional study. PLoS One 2023; 18:e0293799. [PMID: 37972096 PMCID: PMC10653455 DOI: 10.1371/journal.pone.0293799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The prevalence of obesity and depression shows an accelerating trend with increased risk of morbidity and disability. The exact underlying relationship between them is unclear. We aimed to evaluate the prevalence of body mass index (BMI) and depression and their associations in a large sample of Saudi adults. METHODS We administered a nationwide cross-sectional web-based survey using a snowball sampling method among Saudi adults aged 18-60 years. We used a validated Arabic version of Beck's Depression Inventory-II (BDI-II) for depression assessment. We classified BMI into underweight, normal weight, overweight, and obesity. We used logistic regression analysis to determine the factors associated with depression. RESULTS Among 4,683 Saudi adults, different grades of depression were present in 43.3%, most (25.2%) with a mild condition. Overweight and obesity were present in 26.4% and 21%, respectively. We found a positive association between BMI and BDI-II score (ρ = 0.14, p = 0.006). BMI was significantly higher among those who were older, males, married, living in the Eastern region of Saudi Arabia, educated at a pre-university level, employed, at high family-income levels, smokers, and people with chronic diseases. Depression score was significantly higher among married, non-employees, non-smokers, people with chronic diseases, and those with BMI ≥ 25 kg/m2. Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. CONCLUSIONS Saudi adults were suffering from different grades of depression, overweight, and obesity. A positive association between BMI and BDI-II score was observed. Depression score did not differ by age, sex, geographical region, educational level, or family income. Non-smoking, presence of chronic diseases, and being overweight or obese were significantly associated with depression. Further longitudinal research is required to understand the factors underpinning causal relationships between BMI and depression, the subgroups' variation, and mediating strategies.
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Affiliation(s)
- Mohamed O. Nour
- Department of Health Promotion and Education, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
- Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Tamara Abdulrahman Hafiz
- Department of Health Promotion and Education, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Khulud K. Alharbi
- Department of Health Services Management, Faculty of Public Health & Health Informatics, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
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Ervin C, Norcross L, Mallya UG, Fehnel S, Mittleman RS, Webster M, Haqq AM, Haws RM. Interview-Based Patient- and Caregiver-Reported Experiences of Hunger and Improved Quality of Life with Setmelanotide Treatment in Bardet-Biedl Syndrome. Adv Ther 2023; 40:2394-2411. [PMID: 36961653 PMCID: PMC10036981 DOI: 10.1007/s12325-023-02443-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 01/25/2023] [Indexed: 03/25/2023]
Abstract
INTRODUCTION Bardet-Biedl syndrome (BBS) is a rare genetic disease associated with hyperphagia, a pathologic insatiable hunger, due to impaired signaling in the melanocortin-4 receptor (MC4R) pathway. The impact of hyperphagia on the lives of patients with BBS and their families has not been fully characterized. METHODS Patients with BBS or their caregivers who participated in clinical trials of the MC4R agonist setmelanotide (NCT03013543 and NCT03746522) were included in this qualitative study. Telephone interviews were conducted using a semistructured interview guide to explore patient experience and caregiver observations of hyperphagia before and during setmelanotide treatment. RESULTS Nineteen interviews (8 patients, 11 caregivers) were conducted. The term "hunger" (rather than "hyperphagia") was used in interviews to ensure common terminology. Before setmelanotide treatment, all participants described their (or their child's) hunger as all-consuming, leading to an obsessive focus on food. Nine participants recalled intense, continuous hunger, and most participants (5 patients, 10 caregivers) reported lack of control with eating. Negative impacts on patients' lives included difficulties with concentration, emotional and physical manifestations, and impaired relationships. All participants experienced or observed improvements in hunger and health outcomes during treatment, the most meaningful of which included weight loss and decrease in obsessive focus on food and food-seeking behaviors. All participants reported improvements in either physical and/or emotional well-being and being satisfied with setmelanotide. CONCLUSIONS Hyperphagia and resulting food-seeking behaviors have notable negative impacts on quality of life in patients with BBS and caregivers. Setmelanotide improved hyperphagia, reduced body weight and obsessive focus on food, and facilitated improvements in physical and emotional well-being for both patients and caregivers. TRIAL REGISTRATION NCT03013543 and NCT03746522.
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Affiliation(s)
- Claire Ervin
- RTI Health Solutions, 3040 E Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Lindsey Norcross
- RTI Health Solutions, 3040 E Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Usha G. Mallya
- Rhythm Pharmaceuticals, Inc., 222 Berkeley Street, 12th Floor, Boston, MA 02116 USA
| | - Sheri Fehnel
- RTI Health Solutions, 3040 E Cornwallis Rd, PO Box 12194, Research Triangle Park, NC 27709-2194 USA
| | - Robert S. Mittleman
- Rhythm Pharmaceuticals, Inc., 222 Berkeley Street, 12th Floor, Boston, MA 02116 USA
| | - Matthew Webster
- Rhythm Pharmaceuticals, Inc., 222 Berkeley Street, 12th Floor, Boston, MA 02116 USA
| | - Andrea M. Haqq
- University of Alberta, 6-002E Li Ka Shing Centre for Health Research Innovation, Edmonton, AB T6G 2E1 Canada
| | - Robert M. Haws
- Marshfield Clinic Research Institute, 1000 North Oak Avenue, Marshfield, WI 54449 USA
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Treviño-Alvarez AM, Sánchez-Ruiz JA, Barrera FJ, Rodríguez-Bautista M, Romo-Nava F, McElroy SL, Cuéllar-Barboza AB. Weight changes in adults with major depressive disorder: A systematic review and meta-analysis of prospective studies. J Affect Disord 2023; 332:1-8. [PMID: 36963517 DOI: 10.1016/j.jad.2023.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/04/2023] [Accepted: 03/18/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Major Depressive Disorder (MDD) and obesity are bidirectionally related, but the amount of weight-gain secondary to MDD is unknown. We aimed to estimate the adjusted effect of MDD on weight-change in prospective studies compared to individuals without MDD. METHODS Scopus/MEDLINE, PsycInfo, Web of Science and Cochrane were systematically searched for prospective observational studies of participants with a diagnosis of MDD. We included studies that conducted regression analyses on weight-variables. We searched for weight-variables reported at baseline, follow-up, and regression analyses. A meta-analysis of the odds ratios reported in logistic regression models was performed using the generic inverse weight variance method. RESULTS Eight studies were included with a total of 60,443 subjects; 56.8 % with MDD. Weight-variables included weight, BMI, waist circumference, fat mass, and obesity incidence. In three follow-up reports, weight-variables increased more in participants with MDD and its subphenotypes than in control subjects, except for one MDD subphenotype. Meta-analysis of three eligible studies (n = 21,935) showed a significantly greater likelihood of incident obesity in participants with MDD (OR:1.48, 95%CI 1.03-2.13). MDD subphenotype reports might suggest a greater risk for atypical MDD. LIMITATIONS Heterogeneity in weight related variables, follow-ups, and regression models; scarcity of follow-up data; and limited studies eligible for meta-analysis. CONCLUSIONS Despite previous associations between MDD and obesity, current prospective evidence on MDD related weight-change is scarce and heterogeneous. Our findings suggest a need to standardize weight-change assessment in MDD trials. Moreover, careful weight tracking and management should be incorporated in clinical settings. PROSPERO registration CRD42020214427.
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Affiliation(s)
- Andrés Marcelo Treviño-Alvarez
- Department of Psychiatry, University Hospital and School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | | | - Francisco J Barrera
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Mario Rodríguez-Bautista
- Plataforma INVEST UANL - KER Unit Mayo Clinic (KER Unit Mexico), School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
| | - Francisco Romo-Nava
- Lindner Center of Hope, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Susan L McElroy
- Lindner Center of Hope, Mason, OH, USA; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Alfredo Bernardo Cuéllar-Barboza
- Department of Psychiatry, University Hospital and School of Medicine, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
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Considerations for Optimizing Warfighter Psychological Health with a Research-Based Flavonoid Approach: A Review. Nutrients 2023; 15:nu15051204. [PMID: 36904203 PMCID: PMC10005237 DOI: 10.3390/nu15051204] [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: 01/16/2023] [Revised: 02/13/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023] Open
Abstract
Optimal nutrition is imperative for psychological health. Oxidative stress and inflammation are underlying etiologies for alterations in psychological health. Warfighters are at risk of health concerns such as depression due to increased stress in austere environments and family separation while deployed. Over the last decade, research has demonstrated the health benefits of flavonoids found in fruits and berries. Berry flavonoids have potent antioxidant and anti-inflammatory properties by inhibiting oxidative stress and inflammation. In this review, the promising effects of various berries rich in bioactive flavonoids are examined. By inhibiting oxidative stress, berry flavonoids have the potential to modulate brain, cardiovascular, and intestinal health. There is a critical need for targeted interventions to address psychological health concerns within the warfighter population, and a berry flavonoid-rich diet and/or berry flavonoid dietary supplement intervention may prove beneficial as an adjunctive therapy. Structured searches of the literature were performed in the PubMed, CINAHL, and EMBASE databases using predetermined keywords. This review focuses on berry flavonoids' critical and fundamental bioactive properties and their potential effects on psychological health in investigations utilizing cell, animal, and human model systems.
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Liu T, Wu B, Yao Y, Chen Y, Zhou J, Xu K, Wang N, Fu C. Associations between depression and the incident risk of obesity in southwest China: A community population prospective cohort study. Front Public Health 2023; 11:1103953. [PMID: 36741957 PMCID: PMC9893117 DOI: 10.3389/fpubh.2023.1103953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023] Open
Abstract
Objective This study aimed to describe the incidence of obesity and investigate associations between depression and the risk of incident obesity among residents in Southwest China. Methods A 10-year prospective cohort study of 4,745 non-obese adults was conducted in Guizhou, southwest China from 2010 to 2020. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9) while the obesity was identified by waist circumference (WC) and/or body mass index (BMI). Cox proportional hazard models were used to estimate hazard ratios (HR), and 95% confidence intervals (CIs) of depression and incident obesity. Results A total of 1,115 incident obesity were identified over an average follow-up of 7.19 years, with an incidence of 32.66 per 1,000 PYs for any obesity, 31.14 per 1,000 PYs and 9.40 per 1,000 PYs for abdominal obesity and general obesity, respectively. After adjustment for potential confounding factors, risks of incident abdominal obesity for subjects with minimal (aHR: 1.22, 95% CI: 1.05, 1.43), and mild or more advanced depression (aHR: 1.27, 95% CI: 1.01, 1.62) were statistically higher than those not depressed, while there was no significant association with incident general obesity. The risks of any incident obesity among subjects with minimal (aHR: 1.21, 95% CI: 1.04, 1.40), mild or more advanced depression (aHR: 1.30, 95% CI: 1.03, 1.64) were significantly higher than those not depressed and positive association was found for PHQ score per SD increase (aHR: 1.07, 95%CI: 1.01, 1.13), too. The association was stronger significantly in Han Chinese (minimal: aHR: 1.27, 95% CI: 1.05, 1.52; mild or more advanced: aHR: 1.70, 95% CI: 1.30, 2.21) and farmers (minimal: aHR: 1.64, 95% CI: 1.35, 2.01; mild or more advanced: aHR: 1.82, 95% CI: 1.32, 2.51). Conclusion Depression increased the risk of incident obesity among adults in Southwest China, especially among Han Chinese and farmers. This finding suggests that preventing and controlling depression may benefit the control of incident obesity.
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Affiliation(s)
- Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Bo Wu
- School of Public Health, Fudan University, Shanghai, China,National Health Commission of People's Republic of China (NHC) Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yuntong Yao
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Yun Chen
- School of Public Health, Fudan University, Shanghai, China,National Health Commission of People's Republic of China (NHC) Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jie Zhou
- Guizhou Center for Disease Control and Prevention, Guiyang, China
| | - Kelin Xu
- School of Public Health, Fudan University, Shanghai, China,National Health Commission of People's Republic of China (NHC) Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Na Wang
- School of Public Health, Fudan University, Shanghai, China,National Health Commission of People's Republic of China (NHC) Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Chaowei Fu
- School of Public Health, Fudan University, Shanghai, China,National Health Commission of People's Republic of China (NHC) Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China,*Correspondence: Chaowei Fu ✉
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11
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Alreshidi SM. Correlation Between Symptoms of Depression and Obesity in Caregivers of Patients With Chronic Illness: A Gender Difference Analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231219590. [PMID: 38102847 PMCID: PMC10725106 DOI: 10.1177/00469580231219590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/23/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
This study involved gender-stratified analysis and total-sample analysis to assess the extent to which symptoms of depression correlate with the body mass index (BMI) of a population of 112 people responsible for caring for others diagnosed with a chronic illness. The majority of the participants (caregivers) of this study were female (57.1%). All participants were recruited from an urban medical city hospital. The Patient Health Questionnaire-9 (PHQ-9) was employed to assess the extent to which caregivers exhibited symptoms of depression, and BMI was calculated by the researcher using the subject's height and weight. Regressions were executed on the entire dataset spanning male and female participants to generate insights into demographic factors, after which the PHQ-9 was administered. After taking into account the possible confounding factors, the findings of the regression showed that there was a significant correlation between the BMI and PHQ-9 scores (β = .25, P = .042). The correlation between BMI and PHQ-9 persisted among females (β = .37, P = .023). Furthermore, there is a noteworthy correlation among the participants who were morbidly obese (BMI > 30 kg/m2). The correlation between BMI and PHQ-9 caregivers of patients with chronic illness remained after taking demographic factors into account. These findings could be utilized to enhance the outcomes for caregivers of patients with chronic illness. They may be particularly pertinent for caregivers who are experiencing depression or are overweight.
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12
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McLaughlin AP, Nikkheslat N, Hastings C, Nettis MA, Kose M, Worrell C, Zajkowska Z, Mariani N, Enache D, Lombardo G, Pointon L, Cowen P, Cavanagh J, Harrison N, Bullmore E, Pariante CM, Mondelli V. The influence of comorbid depression and overweight status on peripheral inflammation and cortisol levels. Psychol Med 2022; 52:3289-3296. [PMID: 33731235 PMCID: PMC9693673 DOI: 10.1017/s0033291721000088] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/26/2020] [Accepted: 01/15/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Depression and overweight are each associated with abnormal immune system activation. We sought to disentangle the extent to which depressive symptoms and overweight status contributed to increased inflammation and abnormal cortisol levels. METHODS Participants were recruited through the Wellcome Trust NIMA Consortium. The sample of 216 participants consisted of 69 overweight patients with depression; 35 overweight controls; 55 normal-weight patients with depression and 57 normal-weight controls. Peripheral inflammation was measured as high-sensitivity C-Reactive Protein (hsCRP) in serum. Salivary cortisol was collected at multiple points throughout the day to measure cortisol awakening response and diurnal cortisol levels. RESULTS Overweight patients with depression had significantly higher hsCRP compared with overweight controls (p = 0.042), normal-weight depressed patients (p < 0.001) and normal-weight controls (p < 0.001), after controlling for age and gender. Multivariable logistic regression showed that comorbid depression and overweight significantly increased the risk of clinically elevated hsCRP levels ⩾3 mg/L (OR 2.44, 1.28-3.94). In a separate multivariable logistic regression model, overweight status contributed most to the risk of having hsCRP levels ⩾3 mg/L (OR 1.52, 0.7-2.41), while depression also contributed a significant risk (OR 1.09, 0.27-2). There were no significant differences between groups in cortisol awakening response and diurnal cortisol levels. CONCLUSION Comorbid depression and overweight status are associated with increased hsCRP, and the coexistence of these conditions amplified the risk of clinically elevated hsCRP levels. Overweight status contributed most to the risk of clinically elevated hsCRP levels, but depression also contributed to a significant risk. We observed no differences in cortisol levels between groups.
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Affiliation(s)
- Anna P. McLaughlin
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Naghmeh Nikkheslat
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Caitlin Hastings
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Maria A. Nettis
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Melisa Kose
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Courtney Worrell
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Zuzanna Zajkowska
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Nicole Mariani
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Daniela Enache
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Giulia Lombardo
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Linda Pointon
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - NIMA Consortium
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Philip Cowen
- University Department of Psychiatry, Warneford Hospital, Oxford, UK
| | - Jonathan Cavanagh
- Mental Health and Wellbeing, Sackler Institute, Neurology block, Queen Elizabeth University hospital, Glasgow, UK
| | - Neil Harrison
- Division of Psychological Medicine and Clinical Sciences, Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff, UK
| | - Edward Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Carmine M. Pariante
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King's College London, London, UK
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13
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Understanding the Patient Experience of Hunger and Improved Quality of Life with Setmelanotide Treatment in POMC and LEPR Deficiencies. Adv Ther 2022; 39:1772-1783. [PMID: 35192151 PMCID: PMC8862005 DOI: 10.1007/s12325-022-02059-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/26/2022] [Indexed: 01/09/2023]
Abstract
INTRODUCTION In patients with pro-opiomelanocortin (POMC) or leptin receptor (LEPR) deficiency, managing obesity and hyperphagia can be burdensome for patients and caretakers. The impacts on health-related quality of life are under-recognized and are not well characterized. METHODS We conducted in-depth qualitative interviews in patients with POMC (n = 3) and LEPR (n = 2) deficiencies participating in an ongoing open-label extension of phase 3 clinical trials with the melanocortin receptor 4 agonist setmelanotide to describe the patient experience of hyperphagia and characterize changes following treatment with setmelanotide. RESULTS Prior to setmelanotide treatment, all five patients described abnormal sensations of hunger with none indicating feeling satiated after meals and also reported that the burden of hyperphagia impacted their families, emotions, and work and/or school functioning. Following setmelanotide treatment, all five patients reported consistent reductions in hunger and weight, decreased eating, and feeling satiated after meals in addition to substantial improvements in each area of functioning they had previously reported. All five patients indicated they were very satisfied with the impact of setmelanotide on their quality of life and would be upset if treatment was discontinued. CONCLUSIONS In patients with POMC or LEPR deficiency, hyperphagia and the inability to feel satiety negatively impacted quality of life. By reducing hunger and improving satiety, setmelanotide facilitated important changes in the lives of these patients. This qualitative research study suggests that the impact of setmelanotide goes beyond favorable clinical changes (e.g., weight and hunger) to also include quality of life improvements that are highly meaningful to patients.
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14
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Fiedorowicz JG, Brown L, Li J, Parikh SV, Dunlop BW, Forester BP, Shelton RC, Thase ME, Macaluso M, Yu K, Greden JF. Obesogenic Medications and Weight Gain Over 24 Weeks in Patients with Depression: Results from the GUIDED Study. PSYCHOPHARMACOLOGY BULLETIN 2021; 51:8-30. [PMID: 34887596 PMCID: PMC8601756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Weight gain is a common side-effect of medications used to treat major depressive disorder (MDD). We sought to estimate the frequency of weight gain for obesogenic medications prescribed for MDD and to evaluate if bupropion mitigated risk for weight gain. We analyzed a prospective cohort of patients with weight available at baseline and 12 weeks (n = 1,032) or 24 weeks (n = 871) in a post hoc analysis of the Genomics Used to Improve DEpression Decisions (GUIDED) study of patients with MDD who failed at least one medication trial. We compared weight gain between those on versus not on medications with high risk for weight gain, including a subgroup receiving combination treatment with bupropion. A second analysis evaluated weight gain across traditional medication classes, adjusting for potential confounding variables. Those on medications identified as high risk for weight gain were significantly more likely to experience clinically significant weight gain (≥3%) at 12 weeks (29.3% vs. 16.3%, p < .001) and 24 weeks (33.5% vs. 23.5%, p = .015). No protection from clinically significant weight gain was observed among patients treated with a high-risk medication concomitantly with bupropion (N = 31, 35% and 52% with clinically significant weight gain at 12 and 24 weeks). Antipsychotic medications and tricyclic antidepressants were most often associated with clinically significant weight gain. This study helps quantify the real-world risk of weight gain for patients with MDD on medications with high risk for weight gain, especially for patients taking antipsychotics. Concurrent treatment with bupropion does not appear to mitigate the weight gain risk.
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Affiliation(s)
- Jess G Fiedorowicz
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Lisa Brown
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - James Li
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Sagar V Parikh
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Boadie W Dunlop
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Brent P Forester
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Richard C Shelton
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Michael E Thase
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Matthew Macaluso
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - Kunbo Yu
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
| | - John F Greden
- Fiedorowicz, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute; Brown, Li, Yu, Myriad Genetics, Inc.; Parikh, Greden, University of Michigan; Dunlop, Emory University School of Medicine; Forester, McLean Hospital and Harvard Medical School; Shelton, University of Alabama at Birmingham; Thase, University of Pennsylvania, Macaluso, UAB
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Sen ZD, Danyeli LV, Woelfer M, Lamers F, Wagner G, Sobanski T, Walter M. Linking atypical depression and insulin resistance-related disorders via low-grade chronic inflammation: Integrating the phenotypic, molecular and neuroanatomical dimensions. Brain Behav Immun 2021; 93:335-352. [PMID: 33359233 DOI: 10.1016/j.bbi.2020.12.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 12/13/2022] Open
Abstract
Insulin resistance (IR) and related disorders, such as T2DM, increase the risk of major depressive disorder (MDD) and vice versa. Current evidence indicates that psychological stress and overeating can induce chronic low-grade inflammation that can interfere with glutamate metabolism in MDD as well as insulin signaling, particularly in the atypical subtype. Here we first review the interactive role of inflammatory processes in the development of MDD, IR and related metabolic disorders. Next, we describe the role of the anterior cingulate cortex in the pathophysiology of MDD and IR-related disorders. Furthermore, we outline how specific clinical features of atypical depression, such as hyperphagia, are more associated with inflammation and IR-related disorders. Finally, we examine the regional specificity of the effects of inflammation on the brain that show an overlap with the functional and morphometric brain patterns activated in MDD and IR-related disorders.
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Affiliation(s)
- Zümrüt Duygu Sen
- Department of Psychiatry and Psychotherapy, University Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Lena Vera Danyeli
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany; Leibniz Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - Marie Woelfer
- Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany; Leibniz Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany
| | - Femke Lamers
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit, Oldenaller 1, 1081 HJ Amsterdam, the Netherlands
| | - Gerd Wagner
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany
| | - Thomas Sobanski
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Thueringen-Kliniken "Georgius Agricola" GmbH, Rainweg 68, 07318 Saalfeld, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University Tuebingen, Calwerstraße 14, 72076 Tuebingen, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital, Philosophenweg 3, 07743 Jena, Germany; Clinical Affective Neuroimaging Laboratory (CANLAB), Leipziger Str. 44, Building 65, 39120 Magdeburg, Germany; Leibniz Institute for Neurobiology, Brenneckestr. 6, 39118 Magdeburg, Germany.
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16
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Depression is associated with increased adiposity in a 4-year follow-up: results from the ELSA-Brasil. J Affect Disord 2021; 282:179-186. [PMID: 33418365 DOI: 10.1016/j.jad.2020.12.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/30/2020] [Accepted: 12/22/2020] [Indexed: 11/21/2022]
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Blasco BV, García-Jiménez J, Bodoano I, Gutiérrez-Rojas L. Obesity and Depression: Its Prevalence and Influence as a Prognostic Factor: A Systematic Review. Psychiatry Investig 2020; 17:715-724. [PMID: 32777922 PMCID: PMC7449839 DOI: 10.30773/pi.2020.0099] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 05/09/2020] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Depression and obesity are two conditions with great impact over global health. This is mainly due to their high prevalence and the morbidity and mortality associated to both. The main aim of the present systematic review is to study the association between obesity and depression and the prognostic implications derived from it. METHODS A literature review was performed in the PUBMED database. 18 articles were found (9 cross-sectional studies, 6 longitudinal studies and 3 clinical trials), which were reviewed by critical reading after which a summary of the main conclusions was written. RESULTS These selected articles confirmed that there is indeed a link between depression and obesity, although there are doubts as to the significance of this relationship. Depression is a risk factor for obesity, especially atypical depression and in African-American adolescent males. Obesity is a risk factor for depression, especially in women and for recurrent depressive disorder. The comorbidity between obesity and depression is a risk factor for a bad prognosis illness. CONCLUSION The relationship between both disorders has been analysed in scientific literature, obtaining significant associations but also contradictory results. The most current data demonstrates that there is a relationship between both entities, although there is no unanimity when it comes to establishing the meaning of this association.
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Affiliation(s)
| | | | - Isabel Bodoano
- Psychiatry Service, Virgen de las Nieves Hospital, Granada, Spain
| | - Luis Gutiérrez-Rojas
- Department of Psychiatry, University of Granada, Granada, Spain.,CTS-549 Research Group, Institute of Neurosciences, University of Granada, Granada, Spain.,Psychiatry Service, San Cecilio University Hospital, Granada, Spain
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Lasselin J, Benson S, Hebebrand J, Boy K, Weskamp V, Handke A, Hasenberg T, Remy M, Föcker M, Unteroberdörster M, Brinkhoff A, Engler H, Schedlowski M. Immunological and behavioral responses to in vivo lipopolysaccharide administration in young and healthy obese and normal-weight humans. Brain Behav Immun 2020; 88:283-293. [PMID: 32485294 DOI: 10.1016/j.bbi.2020.05.071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Obesity is associated with an increase prevalence of neuropsychiatric symptoms and diseases, such as depression. Based on the facts that pro-inflammatory cytokines are able to modulate behavior, and that obesity is characterized by a chronic low-grade inflammatory state, inflammation has been hypothesized to contribute to the neuropsychiatric comorbidity in obese individuals. However, a causal link between inflammation and the development of neuropsychiatric symptoms is hard to establish in humans. Here, we used an inflammatory stimulus, i.e. the intravenous injection of lipopolysaccharide (LPS), in a double-blind placebo-controlled design, to determine the vulnerability of obese individuals to inflammation-induced behavioral changes. The hypothesis was that obese individuals would show heightened behavioral response compared to normal-weight subjects for the same inflammatory stimulus, reflecting an increased sensitivity to the behavioral effects of pro-inflammatory cytokines. LPS (dose 0.8 ng/kg body weight, adjusted for estimated blood volume in obese subjects) and placebo (saline) were intravenously injected in 14 obese healthy subjects and 23 normal-weight healthy subjects in a within-subject, randomized, crossover design. LPS administration induced, in both groups, an acute increase in blood concentrations of cytokines (interleukin-6, tumor necrosis factor-α, and IL-10), as well as in body temperature, cortisol, norepinephrine, sickness symptoms, fatigue, negative mood, and state anxiety. There were little differences in the immune and behavioral responses to LPS between obese and normal-weight subjects, but the cortisol response to LPS was strongly attenuated in obese individuals. Higher percentage of body fat was related to a lower cortisol response to LPS. Taken together, the population of young and healthy obese individuals in this study did not exhibit an increased behavioral sensitivity to cytokines, but an attenuated cortisol response to the immune challenge. Future studies will need to determine whether additional physiological and psychological factors interact with the state of obesity to increase the risk for inflammation-induced neuropsychiatric symptoms.
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Affiliation(s)
- Julie Lasselin
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Stress Research Institute, Stockholm University, 10691 Stockholm, Sweden; Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Nobels väg 9, 17177 Stockholm, Sweden.
| | - Sven Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Karoline Boy
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Vera Weskamp
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Analena Handke
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Till Hasenberg
- Helios Adipositas Zentrum West, Helios St. Elisabeth Klinik Oberhausen, Witten/Herdecke University, Josefstr. 3, 46045 Oberhausen, Germany
| | - Miriam Remy
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Manuel Föcker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Duisburg-Essen, Germany
| | - Meike Unteroberdörster
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Alexandra Brinkhoff
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany; Department of Nephrology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Harald Engler
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
| | - Manfred Schedlowski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, Hufelandstrasse 55, 45122 Essen, Germany
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Canheta ABDS, Santos ASEADC, Souza JDD, Silveira EA. Traditional Brazilian diet and extra virgin olive oil reduce symptoms of anxiety and depression in individuals with severe obesity: Randomized clinical trial. Clin Nutr 2020; 40:404-411. [PMID: 32675019 DOI: 10.1016/j.clnu.2020.05.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
RATIONAL & OBJECTIVE Although the relationship between obesity, anxiety and depression is known, the clinical benefits of nutrition therapy in individuals with obesity have been scarcely studied. This study assessed the effectiveness of a traditional Brazilian diet (DieTBra) and extra virgin olive oil (EVOO) on the symptoms of anxiety and depression in severe obese participants. METHOD This was a parallel randomized clinical trial in adults with severe obesity (Body Mass Index - BMI ≥ 35 kg/m2), DietBra Trial. Participants were randomized into three intervention groups in a ratio of 1: 1: 1 and followed up for 12 weeks. The three intervention groups were: 1) DieTBra, 2) 52 mL/day EVOO, and 3) DieTBra +52 mL/day EVOO. The symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. The outcome variables were: anxiety, depression and simultaneous anxiety and depression in the same individual. RESULTS 149 severe obese individuals were randomized. The mean BMI was 46.3 ± 6.5 kg/m2 with a mean age of 38.9 ± 8.7 years. After randomization, individuals on medication for depression and anxiety were excluded, totaling 129 at baseline, with 44:43:42 per group. At the end of 12 weeks 113 individuals completed the study. There was a significant reduction of symptoms for the three groups: EVOO, DieTBra and DieTBra + EVOO, respectively: anxiety 38.23% (p = 0.019), 45.83% (p=<0.014), 33.33% (p < 0.013) depression 55.17% (p=<0.001), 50.00% (p=<0.007), 34.61% (p=<0.035), and anxiety/depression 57.69% (p=<0.001), 66.67% (p=<0.014), 27.78% (p=<0.013). CONCLUSIONS Both DieTBra and olive oil interventions were effective in reducing symptoms of anxiety and depression in severe obese adults. These interventions can be integrated with clinical protocols for treatment of symptoms of anxiety and depression in severe obese individuals. TRIAL REGISTRATION Clinicaltrials.gov NCT02463435.
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Affiliation(s)
- Andrea Batista de Sousa Canheta
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás (UFG), Brazil; Faculty of Education, Federal University of Goiás (UFG), Brazil
| | | | - Jacqueline Danésio de Souza
- Course of Nutrition, University of North Paraná (UNOPAR - Londrina/PR), Brazil; Faculty of Education, Federal University of Goiás (UFG), Brazil
| | - Erika Aparecida Silveira
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás (UFG), Brazil.
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Abdel Wahed WY, Hassan SK. Prevalence and associated factors of stress, anxiety and depression among medical Fayoum University students. ALEXANDRIA JOURNAL OF MEDICINE 2019. [DOI: 10.1016/j.ajme.2016.01.005] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Wafaa Yousif Abdel Wahed
- Department of Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Egypt
| | - Safaa Khamis Hassan
- Department of Public Health and Community Medicine, Faculty of Medicine, Fayoum University, Egypt
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Rao WW, Zhang JW, Zong QQ, An FR, Ungvari GS, Balbuena L, Yang FY, Xiang YT. Prevalence of depressive symptoms in overweight and obese children and adolescents in mainland China: A meta-analysis of comparative studies and epidemiological surveys. J Affect Disord 2019; 250:26-34. [PMID: 30826491 DOI: 10.1016/j.jad.2019.02.045] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/13/2019] [Accepted: 02/16/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Obesity is associated with a higher risk of depression in children and adolescents. This is a meta-analysis of studies examining depressive symptoms in overweight and obese children and adolescents in China. METHODS A systematic literature search was performed independently in both English (PubMed, EMBASE, Web of Science and Medline Complete) and Chinese (China National Knowledge Internet, WANFANG Data and WeiPu VIP) databases from their commencement date to December 31, 2018. The pooled prevalence of depressive symptoms was calculated using a random-effects model. Data analyses were performed with STATA Version 12.0, R Version 3.3.0 and R Studio Version 0.99.903. RESULTS Twenty-two epidemiological and 18 comparative studies were included in the meta-analysis. The overall prevalence of depressive symptoms was 24.02% (95% CI: 15.92%-33.16%) in obese children and adolescents and 22.61% (95% CI: 14.87%-31.34%) in overweigh children and adolescents. Obese children and adolescents were more likely to suffer from depressive symptoms (OR = 1.877, 95% CI: 1.459-2.415, P < 0.001) than their non-obese counterparts. The use of different screening scales for depressive symptoms was significantly associated with the prevalence of depressive symptoms. CONCLUSIONS Depressive symptoms are common in overweight and obese children and adolescents in China. Obese, but not overweight children and adolescents had higher risk of depressive symptoms. In order to lessen the risk of depressive symptoms, regular screening and effective interventions should be implemented to reduce obesity and overweight in this population.
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Affiliation(s)
- Wen-Wang Rao
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Ji-Wen Zhang
- School of Nursing, Capital Medical University, Beijing, China
| | - Qian-Qian Zong
- School of Nursing, Capital Medical University, Beijing, China; The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Feng-Rong An
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, Capital Medical University, School of Mental Health, Beijing, China
| | - Gabor S Ungvari
- The University of Notre Dame Australia, Fremantle, Australia; Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Lloyd Balbuena
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Fang-Yu Yang
- School of Nursing, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China.
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Amiri S, Behnezhad S, Nadinlui KB. Body Mass Index (BMI) and risk of depression in adults: A systematic review and meta-analysis of longitudinal studies. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.obmed.2018.10.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Abstract
We assessed the effect of body weight and BMI on plasma concentrations of venlafaxine (VEN), O-desmethylvenlafaxine (ODVEN), active moiety (AM=VEN+ODVEN), and dose-corrected plasma concentrations (C/D). A database containing concentrations of VEN and ODVEN including 737 of 1594 eligible patients was analyzed. Analyses included sex, body weight, and BMI as well as concentrations of VEN, ODVEN, AM, and C/D. A positive correlation was detected between body weight and daily dosage (rs=0.168, P<0.001). A negative correlation was found between body weight and AM (rs=-0.124, P=0.001) and ODVEN (rs=-0.137, P<0.001). Negative correlations were also found between body weight and C/D ratios (C/D VEN: rs=-0.134, P<0.001, C/D ODVEN: rs=-0.239, P<0.001, C/D AM: rs=-0.256, P<0.001). No correlations were detected between BMI and concentrations for VEN, ODVEN, and AM. Comparing low-BMI (<20 kg/m²), medium-BMI (20-29.9 kg/m²), and high-BMI (≥30 kg/m²) groups, higher values of some pharmacokinetic variables in the lower BMI group did not remain significant after controlling for sex. Women had higher VEN, ODVEN, AM, and C/D values for AM, VEN, and ODVEN than men (P<0.001 for all comparisons). Our results highlight the role of different pharmacokinetically relevant parameters and foremost of sex as mediators for the effect of BMI on VEN metabolism.
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Alvarez-Galvez J, Gomez-Baya D. Socioeconomic Context as a Moderator in the Relationship between Body Mass Index and Depression in Europe. Appl Psychol Health Well Being 2017; 9:410-428. [PMID: 29171197 DOI: 10.1111/aphw.12104] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Obesity and depression are two major health issues in contemporary societies. This study aims to address two fundamental questions: (1) what is the impact of macro-level adverse socioeconomic circumstances on depression? and (2) how do macro-level variations in the socioeconomic context affect the relationship between body mass index (BMI) and depression? METHODS Data from the 7th round of the European Social Survey were used, collected from a sample size of 37,623 participants and aggregated around a total of 20 countries. A random intercept multilevel model was constructed to study the variations in the relationship between depression and BMI. The contextual effect of risk of poverty, unemployment rate, and gross domestic product per capita were studied at the country level. RESULTS First, both unemployment and poverty risk were found to be positively associated with depressive disorders. Second, the results show that a higher risk of poverty at the macro level may increase the effect of BMI on depression in European countries. CONCLUSION The present study provides new evidence suggesting that the obesity-depression relationship will be, on average, stronger in countries with poor socioeconomic conditions. Therefore, adverse socioeconomic contextual conditions may increase depression associated with obesity.
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Panduro A, Rivera-Iñiguez I, Sepulveda-Villegas M, Roman S. Genes, emotions and gut microbiota: The next frontier for the gastroenterologist. World J Gastroenterol 2017; 23:3030-3042. [PMID: 28533660 PMCID: PMC5423040 DOI: 10.3748/wjg.v23.i17.3030] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/10/2017] [Accepted: 04/12/2017] [Indexed: 02/06/2023] Open
Abstract
Most medical specialties including the field of gastroenterology are mainly aimed at treating diseases rather than preventing them. Genomic medicine studies the health/disease process based on the interaction of the human genes with the environment. The gastrointestinal (GI) system is an ideal model to analyze the interaction between our genes, emotions and the gut microbiota. Based on the current knowledge, this mini-review aims to provide an integrated synopsis of this interaction to achieve a better understanding of the GI disorders related to bad eating habits and stress-related disease. Since human beings are the result of an evolutionary process, many biological processes such as instincts, emotions and behavior are interconnected to guarantee survival. Nourishment is a physiological need triggered by the instinct of survival to satisfy the body’s energy demands. The brain-gut axis comprises a tightly connected neural-neuroendocrine circuitry between the hunger-satiety center, the dopaminergic reward system involved in the pleasure of eating and the gut microbiota that regulates which food we eat and emotions. However, genetic variations and the consumption of high-sugar and high-fat diets have overridden this energy/pleasure neurocircuitry to the point of addiction of several foodstuffs. Consequently, a gut dysbiosis generates inflammation and a negative emotional state may lead to chronic diseases. Balancing this altered processes to regain health may involve personalized-medicine and genome-based strategies. Thus, an integrated approach based on the understanding of the gene-emotions-gut microbiota interaction is the next frontier that awaits the gastroenterologist to prevent and treat GI disorders associated with obesity and negative emotions.
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Physical exercise ameliorates mood disorder-like behavior on high fat diet-induced obesity in mice. Psychiatry Res 2017; 250:71-77. [PMID: 28142069 DOI: 10.1016/j.psychres.2017.01.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/05/2016] [Accepted: 01/03/2017] [Indexed: 01/17/2023]
Abstract
Obesity is associated with mood disorders such as depression and anxiety. The aim of this study was to investigate whether treadmill exercise had any benefits on mood disorder by high fat diet (HFD) induced obesity. Mice were randomly divided into four groups: control, control and exercise, high fat diet (HFD), and HFD and exercise. Obesity was induced by a 20-week HFD (60%). In the exercise groups, exercise was performed 6 times a week for 12 weeks, with the exercise duration and intensity gradually increasing at 4-week intervals. Mice were tested in tail suspension and elevated plus maze tasks in order to verify the mood disorder like behavior such as depression and anxiety on obesity. In the present study, the number of 5-HT- and TPH-positive cells, and expression of 5-HT1A and 5-HTT protein decreased in dorsal raphe, and depression and anxiety like behavior increased in HFD group compared with the CON group. In contrast, treadmill exercise ameliorated mood disorder like behavior by HFD induced obesity and enhanced expression of the serotonergic system in the dorsal raphe. We concluded that exercise increases the capacity of the serotonergic system in the dorsal raphe, which improves the mood disorders associated with HFD-induced obesity.
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Capuron L, Lasselin J, Castanon N. Role of Adiposity-Driven Inflammation in Depressive Morbidity. Neuropsychopharmacology 2017; 42:115-128. [PMID: 27402495 PMCID: PMC5143483 DOI: 10.1038/npp.2016.123] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/27/2016] [Accepted: 07/01/2016] [Indexed: 02/07/2023]
Abstract
Depression and metabolic disorders, including overweight and obesity, appear tightly interrelated. The prevalence of these conditions is concurrently growing worldwide, and both depression and overweight/obesity represent substantial risk factors for multiple medical complications. Moreover, there is now multiple evidence for a bidirectional relationship between depression and increased adiposity, with overweight/obesity being associated with an increased prevalence of depression, and in turn, depression augmenting the risk of weight gain and obesity. Although the reasons for this intricate link between depression and increased adiposity remain unclear, converging clinical and preclinical evidence points to a critical role for inflammatory processes and related alterations of brain functions. In support of this notion, increased adiposity leads to a chronic low-grade activation of inflammatory processes, which have been shown elsewhere to have a potent role in the pathophysiology of depression. It is therefore highly possible that adiposity-driven inflammation contributes to the development of depressive disorders and their growing prevalence worldwide. This review will present recent evidence in support of this hypothesis and will discuss the underlying mechanisms and potential therapeutic targets. Altogether, findings presented here should help to better understand the mechanisms linking adiposity to depression and facilitate the identification of new preventive and/or therapeutic strategies.
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Affiliation(s)
- Lucile Capuron
- Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- University of Bordeaux, Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux, France
| | - Julie Lasselin
- Institute of Medical Psychology and Behavioral Immunobiology, Universitäts Klinikum Essen, Essen, Germany
- Department of Clinical Neuroscience, Division for Psychology, Karolinska Institutet, Stockholm, Sweden
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Nathalie Castanon
- Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, Bordeaux, France
- University of Bordeaux, Nutrition and Integrative Neurobiology (NutriNeuro), Bordeaux, France
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Abstract
Macrophages and their counterparts in the central nervous system, the microglia, detect and subsequently clear microbial pathogens and injured tissue. These phagocytic cells alter and adapt their phenotype depending on their prime activity, i.e., whether they participate in acute defence against pathogenic organisms ('M1'-phenotype) or in clearing damaged tissues and performing repair activities ('M2'-phenotype). Stimulation of pattern recognition receptors by viruses (vaccines), bacterial membrane components (e.g., LPS), alcohol, or long-chain saturated fatty acids promotes M1-polarization. Vaccine or LPS administration to healthy human subjects can result in sickness symptoms and low mood. Alcohol abuse and abdominal obesity are recognized as risk factors for depression. In the M1-polarized form, microglia and macrophages generate reactive oxygen and nitrogen radicals to eradicate microbial pathogens. Inadvertently, also tetrahydrobiopterin (BH4) may become oxidized. This is an irreversible reaction that generates neopterin, a recognized biomarker for depression. BH4 is a critical cofactor for the synthesis of dopamine, noradrenaline, and serotonin, and its loss could explain some of the symptoms of depression. Based on these aspects, the suppression of M1-polarization would limit the inadvertent catabolism of BH4. In the current review, we evaluate the evidence that antidepressant treatments (monoamine reuptake inhibitors, PDE4 inhibitors, lithium, valproate, agomelatine, tianeptine, electroconvulsive shock, and vagus nerve stimulation) inhibit LPS-induced microglia/macrophage M1-polarization. Consequently, we propose that supplementation with BH4 could limit the reduction in central monoamine synthesis and might represent an effective treatment for depressed mood.
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Affiliation(s)
- Hans O Kalkman
- Neuroscience Research, NIBR, Fabrikstrasse 22-3.001.02, Basel 4002, Switzerland.
| | - Dominik Feuerbach
- Neuroscience Research, NIBR, Fabrikstrasse 22-3.001.02, Basel 4002, Switzerland
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The Combined Effects of Obesity, Abdominal Obesity and Major Depression/Anxiety on Health-Related Quality of Life: the LifeLines Cohort Study. PLoS One 2016; 11:e0148871. [PMID: 26866920 PMCID: PMC4750966 DOI: 10.1371/journal.pone.0148871] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 01/24/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Obesity and major depressive disorder (MDD)/anxiety disorders often co-occur and aggravate each other resulting in adverse health-related outcomes. As little is known about the potential effects of interaction between obesity and MDD and/or anxiety disorders on health-related quality of life (HR-QoL), this study was aimed at examining these combined effects. METHODS We collected data among N = 89,332 participants from the LifeLines cohort study. We categorized body weight using body mass index (kg/m2) as normal weight (18.5-24.99), overweight (25-29.9), mild obesity (30-34.9) and moderate/severe obesity (≥ 35); we measured abdominal obesity using a waist circumference of ≥102 and ≥ 88 cm for males and females, respectively. MDD and anxiety disorders were diagnosed with the Mini-International Neuropsychiatric Interview. HR-QoL was assessed using the RAND-36 questionnaire to compute physical and mental quality of life scores. We used binary logistic and linear regression analyses. RESULTS The combined effect of obesity and MDD and/or anxiety disorders on physical QoL was larger than the sum of their separate effects; regression coefficients, B (95%-confidence interval, 95%-CI) were: - 1.32 (-1.75; -0.90). However, the combined effect of obesity and major depression alone on mental QoL was less than the additive effect. With increasing body weight participants report poorer physical QoL; when they also have MDD and/or anxiety disorders participants report even poorer physical QoL. In persons without MDD and/or anxiety disorders, obesity was associated with a better mental QoL. CONCLUSIONS Obesity and MDD and/or anxiety disorders act synergistically on physical and mental QoL. The management of MDD and/or anxiety disorders and weight loss may be important routes to improve HR-QoL.
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