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Bahrami G, Mohammadifard N, Haghighatdoost F, Emamjomeh A, Najafi F, Farshidi H, Lotfizadeh M, Kazemi T, Shafiei S, Roohafza H, Sabri M, Sarrafzadegan N. The association between soft drinks consumption and risk of mental disorders among Iranian adults: The LIPOKAP study. J Affect Disord 2024; 363:8-14. [PMID: 39019222 DOI: 10.1016/j.jad.2024.07.033] [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: 03/03/2024] [Revised: 06/11/2024] [Accepted: 07/12/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVE With rising demand for soft drinks (SDs) in low-income countries, studies examining mental disorders in relation to SDs are rather scarce. Therefore, we aimed to explore this association in a sample of Iranian adults. METHODS This cross-sectional study was carried out within the framework of the multi-centric LIPOKAP project, with 1970 Iranian healthy adults. Dietary intake and symptoms of depression and anxiety were collected using validated, Persian versions of a food frequency questionnaire and a Hospital Anxiety and Depression Scale (HADS), respectively. Artificial juices were considered fruit-flavored carbonated sugar beverages, sugar-sweetened beverages (SSB) included fruit-flavored carbonated sugar beverages and carbonated colas, and soft drinks included SSB and drinks containing non-nutritive sweeteners. RESULTS The mean age of the participants was 39.8 ± 13.9 years. Compared to lower intake, higher intake of SDs (OR = 1.30, 95 % CI: 1.01, 1.69; P = 0.041), SSBs (OR = 1.30, 95 % CI: 1.00, 1.67; P = 0.045) and artificial juice (OR = 1.63, 95 % CI: 1.24, 2.13; P < 0.001) was associated with higher risk of depression in adjusted model. These associations were sex-specific and more evident in males. No significant association was found between any of the drinks and anxiety risk except for artificial juice in men which was directly associated with anxiety risk (OR = 1.66, 95 % CI: 1.06, 2.61; P = 0.028). CONCLUSION This study found a positive association between SDs, SSBs and artificial juice and depression, but not anxiety. These associations varied between men and women. Prospective cohort studies are warranted to confirm our results and reveal the causal relationship.
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Affiliation(s)
- Ghazaleh Bahrami
- Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fahimeh Haghighatdoost
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Ali Emamjomeh
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farid Najafi
- Research Center for Environmental determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Farshidi
- Hormozgan Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran
| | - Masoud Lotfizadeh
- School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Sania Shafiei
- Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamidreza Roohafza
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammadreza Sabri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Kar N, Barreto S. Influence of Lifestyle Factors on Metabolic Syndrome in Psychiatric Patients Attending a Community Mental Health Setting: A Cross-sectional Study. Indian J Psychol Med 2024; 46:313-322. [PMID: 39056040 PMCID: PMC11268271 DOI: 10.1177/02537176231219770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024] Open
Abstract
Background Metabolic syndrome (MetS) is a concern in psychiatric patients. We aimed to study the influence of the modifiable lifestyle factors on MetS in adult psychiatric patients along with associated clinical factors and quality of life. Methods Factors such as diet (Healthy Eating Index), exercise, substance use, cardiovascular risk (QRISK), illness severity (Clinical Global Impression), medications, adverse events (Systematic Monitoring of Adverse Events Related to Treatments), and quality of life (Recovering Quality of Life Scale) were assessed along with clinical components for MetS in 323 psychiatric patients receiving routine care and monitoring in a Community Mental Health Team. Results MetS was present in 50.5% (95% CI: 45.0-55.9). It was significantly associated with higher age, duration of mental illness, body mass index (BMI), QTc, QRISK, and antipsychotic drugs. In logistic regression, age, QTc, QRISK, and BMI remained significantly linked to MetS. Patients with or without MetS were comparable in their lifestyle factors such as diet, exercise, and substance use, along with the family history of metabolic disorders, age at onset of mental illness, duration of antipsychotic medication, side effects, psychiatric diagnoses, and quality of life. However, many patients with or without MetS had poorer diet and physical inactivity, indicating scope for interventions. Conclusions Around half of the psychiatric patients had MetS, and modifiable lifestyle factors did not differentiate individuals with or without MetS. The need for further research on the prevention and management of MetS in psychiatric patients is highlighted.
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Affiliation(s)
- Nilamadhab Kar
- University of Wolverhampton, United Kingdom
- Dept. of Psychiatry, Black Country Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
| | - Socorro Barreto
- Dept. of Psychiatry, Black Country Healthcare NHS Foundation Trust, Wolverhampton, United Kingdom
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Chhabria K, Selvaraj S, Refuerzo J, Truong C, Cazaban CG. Investigating the association between metabolic syndrome conditions and perinatal mental illness: a national administrative claims study. BMC Pregnancy Childbirth 2024; 24:409. [PMID: 38849738 PMCID: PMC11157911 DOI: 10.1186/s12884-024-06542-8] [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: 03/03/2023] [Accepted: 04/25/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Although the association between mental disorder and metabolic syndrome as a bidirectional relationship has been demonstrated, there is little knowledge of the cumulative and individual effect of these conditions on peripartum mental health. This study aims to investigate the association between metabolic syndrome conditions (MetS-C) and maternal mental illness in the perinatal period, while exploring time to incident mental disorder diagnosis in postpartum women. METHODS This observational study identified perinatal women continuously enrolled 1 year prior to and 1 year post-delivery using Optum's de-identified Clinformatics® Data Mart Database (CDM) from 2014 to 2019 with MetS-C i.e. obesity, diabetes, high blood pressure, high triglycerides, or low HDL (1-year prior to delivery); perinatal comorbidities (9-months prior to and 4-month postpartum); and mental disorder (1-year prior to and 1-year post-delivery). Additionally, demographics and the number of days until mental disorder diagnosis were evaluated in this cohort. The analysis included descriptive statistics and multivariable logistic regression. MetS-C, perinatal comorbidities, and mental disorder were assessed using the International Classification of Diseases, Ninth, and Tenth Revision diagnosis codes. RESULTS 372,895 deliveries met inclusion/exclusion criteria. The prevalence of MetS-C was 13.43%. Multivariable logistic regression revealed prenatal prevalence (1.64, CI = 1.59-1.70) and postpartum incident (1.30, CI = 1.25-1.34) diagnosis of mental health disorder were significantly higher in those with at least one MetS-C. Further, the adjusted odds of having postpartum incident mental illness were 1.51 times higher (CI = 1.39-1.66) in those with 2 MetS-C and 2.12 times higher (CI = 1.21-4.01) in those with 3 or more MetS-C. Young women (under the age of 18 years) were more likely to have an incident mental health diagnosis as opposed to other age groups. Lastly, time from hospital discharge to incident mental disorder diagnosis revealed an average of 157 days (SD = 103 days). CONCLUSION The risk of mental disorder (both prenatal and incident) has a significant association with MetS-C. An incremental relationship between incident mental illness diagnosis and the number of MetS-C, a significant association with younger mothers along with a relatively long period of diagnosis mental illness highlights the need for more screening and treatment during pregnancy and postpartum.
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Affiliation(s)
- Karishma Chhabria
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA.
- Department of Public Health, Usha Kundu MD College of Health, University of West Florida 11000 University Pkwy, Pensacola, FL, 32514, USA.
| | - Sudhakar Selvaraj
- Louis Faillace, MD, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
- Clinical Development, Intra-Cellular Therapies, Inc., 430 East 29th Street, New York, NY, United States
| | - Jerrie Refuerzo
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Chau Truong
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - Cecilia Ganduglia Cazaban
- Division of Management Policy and Community Health, Center for Healthcare Data Research, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
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Carswell C, Brown JVE, Shiers D, Ajjan R, Balogun-Katung A, Bellass S, Holt RIG, Jacobs R, Kellar I, Lewisohn C, Lister J, Siddiqi N, Sidorova I, Coventry P. The Lived Experience of Informal Caregivers of People Who Have Severe Mental Illness and Coexisting Long-Term Conditions: A Qualitative Study. Health Expect 2024; 27:e14119. [PMID: 38879785 PMCID: PMC11180294 DOI: 10.1111/hex.14119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND People with severe mental illness (SMI) experience higher rates and poorer outcomes of physical long-term conditions (LTCs). The management of SMI and LTCs is highly complex and many people with SMI rely on informal carers for support, which may lead to high levels of caregiver burden, and caregiver burnout. Caregiver burnout can result in poor health outcomes for informal carers and a reduction in the quality of care they are able to provide. Therefore, it is important to understand the caring experience to identify and address factors that contribute to burden and burnout. METHODS This paper reports a secondary qualitative analysis of semistructured interviews and focus groups conducted with informal carers of people who have coexisting SMI and LTCs. We recruited 12 informal carers in England between December 2018 and April 2019. The transcripts were coded and analysed thematically. RESULTS We identified two overarching themes and five subthemes. The themes included 'Fighting on all fronts: Mounting strain between demands and resources', which described the challenge of providing care in the context of coexisting SMI and LTCs, and 'Safekeeping: The necessity of chronic hypervigilance', which captured how informal carers' roles were defined by managing high-risk situations, leading to hypervigilance and paternalistic approaches to care. CONCLUSION The experience of informal carers for people with SMI and coexisting LTCs is marked by limited access to support and the management of significant risk, which could contribute to high caregiver burden. Further primary research is needed to understand how the experiences of the caregiver role for people with SMI and LTCs influence caregiver burden. PATIENT OR PUBLIC CONTRIBUTION Our PPI panel DIAMONDS Voice provided guidance on this study from conception, design and development of interview guides and recruitment materials to final write-up. DIAMONDS Voice consists of service users and carers who have experience of SMI and LTCs. Three carer members reviewed the final manuscript, and two are credited as authors.
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Affiliation(s)
- C Carswell
- Department of Health Sciences, University of York, York, UK
| | - J V E Brown
- Department of Health Sciences, University of York, York, UK
| | - D Shiers
- Psychosis Research Unit, Greater Manchester Mental Health NHS Trust, Manchester, UK
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- School of Medicine, Keele University, Staffordshire, UK
| | - R Ajjan
- Clinical and Population Sciences Department, Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - A Balogun-Katung
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - S Bellass
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - R I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - R Jacobs
- Centre for Health Economics, University of York, York, UK
| | - I Kellar
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - C Lewisohn
- DIAMONDS Voice, DIAMONDS Programme Patient and Public Involvement Panel, York, UK
| | - J Lister
- Department of Health Sciences, University of York, York, UK
| | - N Siddiqi
- Department of Health Sciences, University of York, York, UK
- Bradford District Care NHS Foundation Trust, Bradford, UK
- Centre for Health and Population Sciences, Hull York Medical School, York, UK
| | - I Sidorova
- DIAMONDS Voice, DIAMONDS Programme Patient and Public Involvement Panel, York, UK
| | - P Coventry
- Department of Health Sciences, University of York, York, UK
- York Environmental Sustainability Institute, University of York, York, UK
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Saccaro LF, Aimo A, Panichella G, Sentissi O. Shared and unique characteristics of metabolic syndrome in psychotic disorders: a review. Front Psychiatry 2024; 15:1343427. [PMID: 38501085 PMCID: PMC10944869 DOI: 10.3389/fpsyt.2024.1343427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 02/15/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction People with psychosis spectrum disorders (PSD) face an elevated risk of metabolic syndrome (MetS), which may reduce their life expectancy by nearly 20%. Pinpointing the shared and specific characteristics and clinical implications of MetS in PSD is crucial for designing interventions to reduce this risk, but an up-to-date review on MetS across the psychosis spectrum is lacking. Methods This narrative review fills this gap by examining the clinical literature on characteristics and implications of MetS in both distinct PSD and transdiagnostically, i.e., across traditional categorical diagnoses, with a focus on psychiatric and cardio-metabolic management. Results We discuss common and specific characteristics of MetS in PSD, as well as factors contributing to MetS development in PSD patients, including unhealthy lifestyle factors, genetic predisposition, pro-inflammatory state, drugs consumption, antipsychotic medication, and psychotic symptoms. We highlight the importance of early identification and management of cardio-metabolic risk in PSD patients, as well as the existing gaps in the literature, for instance in the screening for MetS in younger PSD patients. We compare hypotheses-generating clinical associations and characteristics of MetS in different PSD, concluding by reviewing the existing recommendations and challenges in screening, monitoring, and managing MetS in PSD. Conclusion Early identification and management of MetS are crucial to mitigate the long-term cardio-metabolic toll in PSD patients. Interventions should focus on healthy lifestyle and appropriate pharmacological and behavioral interventions. Further translational and clinical research is needed to develop targeted interventions and personalized treatment approaches for this vulnerable population, aiming at improving physical health and overall well-being.
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Affiliation(s)
- Luigi F Saccaro
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Giorgia Panichella
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Othman Sentissi
- Psychiatry Department, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Psychiatry Department, Geneva University Hospital, Geneva, Switzerland
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Azfr Ali R, Jalal Z, Chandan JS, Subramanian A, Adderley NJ, Nirantharakumar K, Gokhale KM, Paudyal V. Cardiometabolic screening and monitoring in patients prescribed antipsychotic drugs in primary care: A population-based cohort study. Compr Psychiatry 2023; 127:152419. [PMID: 37717342 DOI: 10.1016/j.comppsych.2023.152419] [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: 03/27/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND This study aimed to investigate the level of guideline adherence for cardiometabolic health monitoring for patients prescribed antipsychotic medicines in UK primary care. METHODS In this population-based retrospective open cohort study, we used dataset of patients from the IQVIA Medical Research Data (IMRD) database between 1st January 2003 to 31st December 2018. Clinical Read codes were used to identify a cohort of adult patients with a diagnosis of Schizophrenia and at least four prescriptions of an anti-psychotic medication within 12 months of diagnosis. We then extracted data in relation to monitoring of cardiometabolic parameters (body compositions, lipids, and glucose outcomes) at baseline, then at six weeks, 12 weeks, and then 12 months. The frequency of outcome monitoring was described using descriptive statistics. FINDINGS A total of 11,435 patients were eligible and of them (n = 9707; 84·8%) were prescribed second-generation antipsychotics (SGAs). Only a small portion of the cohort (≈2·0%) received complete monitoring (at time points) for certain outcomes. Just over half the patients (n = 6599, 52%) had evidence of any cardiometabolic baseline testing for any of the study outcomes and the high majority had at least one abnormal lab value at baseline (n = 4627, 96·7%). INTERPRETATION In UK primary care, cardiometabolic monitoring practices among patients prescribed antipsychotics remain suboptimal. There is a need to promote guideline adherence to prevent adverse outcomes in antipsychotic users.
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Affiliation(s)
- Ruba Azfr Ali
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK; Clnical Pharmacy Department, Schoolof Pharmacy, Umm Al Qura University, Makkah, KSA
| | - Zahraa Jalal
- School of Pharmacy, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Joht Singh Chandan
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Nicola J Adderley
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | | | - Krishna M Gokhale
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Vibhu Paudyal
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
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Jawad MY, Meshkat S, Tabassum A, Mckenzie A, Di Vincenzo JD, Guo Z, Musavi NB, Phan L, Ceban F, Kwan AT, Ramachandra R, Le GH, Mansur RB, Rosenblat JD, Ho R, Rhee TG, McIntyre RS. The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia. CNS Spectr 2023; 28:541-560. [PMID: 36268655 DOI: 10.1017/s1092852922001043] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a complex metabolic-inflammatory disease associated with poor outcomes and decreased quality of life. NAFLD is overrepresented in patients with psychiatric disorders like depression, bipolar disorder, and schizophrenia; however, a comprehensive review on NAFLD and psychiatric disorders remains to be delineated. This review endeavors to investigate the association of NAFLD with psychiatric disorders, including shared pathogenesis and future clinical derivatives. Extant literature suggests that patients with psychiatric disorders (in particular, mood disorders) are more susceptible to the development of NAFLD due to multiple reasons, including but not limited to hypothalamic-pituitary-adrenal axis dysregulation, metabolic syndrome, and chronic perceived stress. Moreover, the clinical manifestations of mood disorders (e.g., anhedonia, psychomotor retardation, lifestyle modification, etc.), and potentially long-term treatment with weight-gaining agents, differentially affect these patients, making them more prone to NAFLD. Considering the increased morbidity associated with both mood disorders and NAFLD, our review recommends regular screenings for NAFLD in select patients with mood disorders exhibiting signs of increased risk (i.e., obesity, metabolic syndrome, diabetes, or family history of NAFLD) for better diagnosis and holistic care of both potentially interrelated conditions.
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Affiliation(s)
- Muhammad Youshay Jawad
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Shakila Meshkat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Aniqa Tabassum
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Andrea Mckenzie
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua D Di Vincenzo
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Ziji Guo
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | | | - Lee Phan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Felicia Ceban
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Angela Th Kwan
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Ranuk Ramachandra
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Gia Han Le
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Taeho Greg Rhee
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA
- VA New England Mental Illness, Research, Education and Clinical Center (MIRECC), VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Public Health Sciences, School of Medicine, University of Connecticut, Farmington, CT, USA
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
- Brain and Cognition Discovery Foundation, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
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Yun J, Lee Y. Comparison of Sleep Disturbance, Physical Activity, and Health-Related Quality of Life According to Depressive Symptoms in Patients with Metabolic Syndrome: A Secondary Analysis from the Korea National Health and Nutrition Examination Survey Using a Propensity Score Matching Analysis. Healthcare (Basel) 2023; 11:1802. [PMID: 37372918 DOI: 10.3390/healthcare11121802] [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: 04/15/2023] [Revised: 06/03/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Metabolic syndrome has become a global epidemic, and the age of its onset is decreasing. However, its prevalence can be reduced by lifestyle modifications. This study examined the differences in sleep disturbance, physical activity, and health-related quality of life associated with depressive symptoms in patients with metabolic syndrome aged ≥ 40 years. This cross-sectional secondary analysis of data from the 2016 and 2018 Korean National Health and Nutrition Examination Surveys. Of 1404 patients with metabolic syndrome aged ≥ 40 years, depressed and non-depressed patients (103 vs. 103) were matched 1:1 on demographic characteristics using propensity score matching. The outcome variables were then compared between the two groups. We investigated health status, including metabolic syndrome indices, health behaviors, such as sleep disturbances and physical activity, and health-related quality of life. After propensity score matching, health-related quality of life was the only variable that differed significantly between the groups; it was significantly lower in patients with depression (0.77) than in those without depression (0.88) (p = 0.001). Our results suggest that depression with metabolic syndrome is likely to cause a decrease in patients' quality of life; therefore, development of management systems and programs for early intervention to tackle at-risk groups is necessary.
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Affiliation(s)
- Jungmi Yun
- College of Nursing, Pusan National University, Yangsan 50612, Republic of Korea
- Research Institute of Nursing Science, Pusan National University, Yangsan 50612, Republic of Korea
| | - Yunji Lee
- College of Nursing, Pusan National University, Yangsan 50612, Republic of Korea
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Trigueiro AJP, Ramirez J, Hennessey E, Beqiri M. Metabolic Syndrome Identification in Patients Treated With Second-Generation Antipsychotic Medications. J Psychosoc Nurs Ment Health Serv 2022; 60:11-18. [PMID: 35316124 DOI: 10.3928/02793695-20220314-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current project was to assess missed opportunities to identify metabolic syndrome in patients treated with second-generation antipsychotic medication in a community hospital's inpatient psychiatric unit between January 1 and December 31, 2020. Data on demographics, metabolic syndrome risk factors, body mass index, medications, related diagnoses, and primary care providers (PCPs) were collected via retrospective chart review of 194 patients. This project used a nonexperimental design and heterogenous nonrandom convenience sample. Descriptive statistics, chi-square tests, one-tailed t tests, and binary logistic regression were used. The overall rate of metabolic syndrome was 47.4% (n = 92). A positive PCP status was significant for treatment with antihypertensives, statins, and antihyperglycemics (p < 0.05). Findings indicate the need to increase system-wide assessment of metabolic syndrome and integrate care coordination with PCPs. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].
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10
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Raju NN, Kumar KSVRNP, Nihal G. Management of Medication-Induced Psychiatric Disorders. Indian J Psychiatry 2022; 64:S281-S291. [PMID: 35602361 PMCID: PMC9122175 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_21_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/05/2022] Open
Affiliation(s)
- N N Raju
- Department of Psychiatry, GVP Medical College, Visakhapatnam, Andhra Pradesh, India
| | | | - Gyan Nihal
- Department of Psychiatry, Mamata Medical College, Khammam, Telangana, India E-mail:
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11
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Lu H, Qiao J, Shao Z, Wang T, Huang S, Zeng P. A comprehensive gene-centric pleiotropic association analysis for 14 psychiatric disorders with GWAS summary statistics. BMC Med 2021; 19:314. [PMID: 34895209 PMCID: PMC8667366 DOI: 10.1186/s12916-021-02186-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Recent genome-wide association studies (GWASs) have revealed the polygenic nature of psychiatric disorders and discovered a few of single-nucleotide polymorphisms (SNPs) associated with multiple psychiatric disorders. However, the extent and pattern of pleiotropy among distinct psychiatric disorders remain not completely clear. METHODS We analyzed 14 psychiatric disorders using summary statistics available from the largest GWASs by far. We first applied the cross-trait linkage disequilibrium score regression (LDSC) to estimate genetic correlation between disorders. Then, we performed a gene-based pleiotropy analysis by first aggregating a set of SNP-level associations into a single gene-level association signal using MAGMA. From a methodological perspective, we viewed the identification of pleiotropic associations across the entire genome as a high-dimensional problem of composite null hypothesis testing and utilized a novel method called PLACO for pleiotropy mapping. We ultimately implemented functional analysis for identified pleiotropic genes and used Mendelian randomization for detecting causal association between these disorders. RESULTS We confirmed extensive genetic correlation among psychiatric disorders, based on which these disorders can be grouped into three diverse categories. We detected a large number of pleiotropic genes including 5884 associations and 2424 unique genes and found that differentially expressed pleiotropic genes were significantly enriched in pancreas, liver, heart, and brain, and that the biological process of these genes was remarkably enriched in regulating neurodevelopment, neurogenesis, and neuron differentiation, offering substantial evidence supporting the validity of identified pleiotropic loci. We further demonstrated that among all the identified pleiotropic genes there were 342 unique ones linked with 6353 drugs with drug-gene interaction which can be classified into distinct types including inhibitor, agonist, blocker, antagonist, and modulator. We also revealed causal associations among psychiatric disorders, indicating that genetic overlap and causality commonly drove the observed co-existence of these disorders. CONCLUSIONS Our study is among the first large-scale effort to characterize gene-level pleiotropy among a greatly expanded set of psychiatric disorders and provides important insight into shared genetic etiology underlying these disorders. The findings would inform psychiatric nosology, identify potential neurobiological mechanisms predisposing to specific clinical presentations, and pave the way to effective drug targets for clinical treatment.
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Affiliation(s)
- Haojie Lu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Jiahao Qiao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Zhonghe Shao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Shuiping Huang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, 221004, Jiangsu, China.
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Ying J, Wan J, Sim K, Seah EJD, Subramaniam M. Perceived knowledge of psychiatry and family medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia: opportunities to refine the residency training. BMC MEDICAL EDUCATION 2021; 21:232. [PMID: 33888107 PMCID: PMC8061461 DOI: 10.1186/s12909-021-02658-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Psychiatry and Family Medicine residents frequently see patients with comorbid mental and physical disorders. Little is known about the difference in knowledge of Psychiatry residents and Family Medicine residents regarding management of common conditions they encounter. This study aimed to assess the knowledge of Psychiatry and Family Medicine residents regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia, as the findings could help to refine the training curriculum for residency training. METHODS A cross-sectional survey design was used. Psychiatry and Family Medicine residents pursuing their residency in Singapore were recruited from November 2019 to June 2020. The survey questionnaire consisted of questions which assessed the knowledge regarding medical management of schizophrenia, hypertension, diabetes mellitus, and dyslipidemia. Descriptive statistics were used to describe the demographic data; T-tests or Mann-Whitney U tests to compare the differences between groups; and multiple regression analyses to assess the factors associated with Psychiatry residents' knowledge of hypertension, diabetes mellitus, and dyslipidemia. RESULTS Fifty-seven out of 70 (81.4%) Psychiatry residents and 58 out of 61 (95.1%) Family Medicine residents participated in the study. The majority of Psychiatry residents encountered patients with hypertension (93.0%), diabetes mellitus (87.7%) and dyslipidemia (91.2%) on a daily to weekly basis. Psychiatry residents had higher scores on questions about schizophrenia versus Family Medicine residents (mean 50.70 versus 43.28, p < 0.001). However, Psychiatry residents scored lower on questions about hypertension (mean 33.86 versus 40.98, p < 0.001), diabetes mellitus (mean 45.68 versus 49.79, p = 0.005) and dyslipidemia (mean 37.04 versus 44.31, p < 0.001). Receiving undergraduate medical education locally, compared to receiving it overseas, was associated with better knowledge of hypertension (beta = 0.515, p = 0.009) and dyslipidemia (beta = 0.559, p = 0.005); while younger age (26-30 versus > 35 and 31-35 versus > 35) was associated with better knowledge of hypertension (beta = 1.361, p = 0.002 and beta = 1.225, p = 0.003). A significant proportion of Psychiatry residents (61.4%) did not agree that the training provided to manage hypertension, diabetes mellitus, and dyslipidemia was adequate. Similarly, majority of Family Medicine residents (62.1%) did not agree that they had adequate training to manage schizophrenia. CONCLUSIONS This study raises the awareness of Psychiatry residents' sense of discomfort in managing hypertension, diabetes mellitus, or dyslipidemia and conversely Family Medicine residents in management of schizophrenia, which can be further addressed during the training postings within the residency programs. Future studies are needed to look at local (such as training curriculum) and systemic factors (such as practice trends and culture) in order to better align residency selection criteria and training foci with real world practice factors over time.
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Affiliation(s)
- Jiangbo Ying
- National Psychiatry Residency Program, National Healthcare Group, Singapore, Singapore.
| | - Jinhui Wan
- Family Medicine Residency Program, National Healthcare Group, Singapore, Singapore
- National Healthcare Group Polyclinics, Singapore, Singapore
| | - Kang Sim
- National Psychiatry Residency Program, National Healthcare Group, Singapore, Singapore
- West Region, Institute of Mental Health, Singapore, Singapore
| | - Ee-Jin Darren Seah
- Family Medicine Residency Program, National Healthcare Group, Singapore, Singapore
- National Healthcare Group Polyclinics, Singapore, Singapore
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Kornetova EG, Kornetov AN, Mednova IA, Goncharova AA, Gerasimova VI, Pozhidaev IV, Boiko AS, Semke AV, Loonen AJM, Bokhan NA, Ivanova SA. Comparative Characteristics of the Metabolic Syndrome Prevalence in Patients With Schizophrenia in Three Western Siberia Psychiatric Hospitals. Front Psychiatry 2021; 12:661174. [PMID: 34276438 PMCID: PMC8282925 DOI: 10.3389/fpsyt.2021.661174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/09/2021] [Indexed: 12/13/2022] Open
Abstract
Objective: The purpose of this study was to compare the prevalence of MetS and the associated sociodemographic, clinical, and pharmacotherapeutic characteristics of patients with schizophrenia in three psychiatric hospitals in the West Siberian region. Methods: Patients with a clinical diagnosis of schizophrenia (ICD-10: F20) and an age between 18 and 60 years were included in the study after giving informed consent. Metabolic syndrome was diagnosed according to the International Diabetes Federation criteria. This research was carried out at three Western Siberian psychiatric hospitals in Kemerovo, Tomsk, and Omsk. The study population included respectively 94, 131, and 91 inpatients with schizophrenia. We carried out schizophrenia symptoms assessment by PANSS, antipsychotic therapy evaluation, anthropometry, and biochemical analysis. Statistical Analysis included the Shapiro-Wilk test, non-parametric Kruskal-Wallis H-test for independent samples, Mann-Whitney U-test for independent samples, the chi-square test, stepwise multiple regression analyses. The level of significance was p < 0.05. Results: The metabolic syndrome prevalence was higher among patients in Tomsk (36.6%), compared with Kemerovo (20.2%, p = 0.008) or Omsk (18.7%, p = 0.004), mainly due to the high prevalence of abdominal obesity, while men from Tomsk were more susceptible to this condition than men from other regions (p < 0.05). Patients from Omsk had the highest severity schizophrenia symptoms according to PANSS, and patients from Tomsk had the lowest severity of positive symptoms according to PANSS. Patients from Tomsk had the minimum duration of antipsychotic therapy compared with the patient from Kemerovo (p = 0.017) and from Omsk (p = 0.000019), but most patients from Tomsk received second-generation atypical antipsychotics, while patients from Omsk received mainly conventional antipsychotics (p = 0.0001). Multiple regression analysis showed that metabolic syndrome associated with schizophrenia duration and body mass index, although the association was not so strong (adjusted R 2 = 0.2435, p < 0.0001). Discussion: The study illustrates that in different psychiatric hospitals within the same region, the prevalence of metabolic syndrome in patients with schizophrenia can vary significantly, which dictates the need to look for opportunities to minimize the risk of its occurrence, taking into account the experience of each hospital.
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Affiliation(s)
- Elena G Kornetova
- Endogenous Disorders Department, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,University Hospital, Siberian State Medical University, Tomsk, Russia
| | - Alexander N Kornetov
- Fundamental Psychology and Behavioral Medicine Department, Siberian State Medical University, Tomsk, Russia
| | - Irina A Mednova
- Molecular Genetics and Biochemistry Laboratory, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Anastasia A Goncharova
- Endogenous Disorders Department, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Valeria I Gerasimova
- Endogenous Disorders Department, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Ivan V Pozhidaev
- Molecular Genetics and Biochemistry Laboratory, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Anastasiia S Boiko
- Molecular Genetics and Biochemistry Laboratory, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Arkadiy V Semke
- Endogenous Disorders Department, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia
| | - Anton J M Loonen
- PharmacoTherapy, -Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands
| | - Nikolay A Bokhan
- Addictive Disorders Department, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,Psychiatry, Addiction Psychiatry and Psychotherapy Department, Siberian State Medical University, Tomsk, Russia
| | - Svetlana A Ivanova
- Molecular Genetics and Biochemistry Laboratory, Mental Health Research Institute, Tomsk National Research Medical Center of the Russian Academy of Sciences, Tomsk, Russia.,Psychiatry, Addiction Psychiatry and Psychotherapy Department, Siberian State Medical University, Tomsk, Russia
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de Silva PN. Practicalities of care closer to home: seven key questions for community psychiatrists. BJPSYCH ADVANCES 2020. [DOI: 10.1192/bja.2020.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYThis article aims to clarify what ‘care closer to home’ means to a community psychiatrist. Care closer to home can be operationalised as primary care liaison and the article reviews experience across England of how a liaison service can work with the recently organised primary care networks. Key competencies needed for liaising with primary care are discussed using seven questions, including bias mitigation, reducing bed-days, consultation skills, knowledge of emerging treatments and reducing administrative overheads while improving access.
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15
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The impact of metabolic syndrome on mental health-related quality of life and depressive symptoms. Qual Life Res 2020; 29:2063-2072. [DOI: 10.1007/s11136-020-02479-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 01/10/2023]
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Roininen SM, Cheetham M, Mueller BU, Battegay E. Unmet challenges in treating hypertension in patients with borderline personality disorder: A systematic review. Medicine (Baltimore) 2019; 98:e17101. [PMID: 31517840 PMCID: PMC6750323 DOI: 10.1097/md.0000000000017101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/18/2019] [Accepted: 08/16/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Caregivers encounter serious and substantial challenges in managing hypertension in patients with subclinical or clinical borderline personality disorder (BPD). These challenges include therapeutic conflicts resulting from harmful drug-drug, and drug-disease interactions. Current guidelines provide no recommendations for concurrent psychotropic and antihypertensive treatment of hypertensive BPD patients who are at even greater cardiovascular risk. METHODS We conducted a systematic literature review to assess the extent of available evidence on prevalence rates, cardiovascular risk factors, therapeutic conflicts, and evidence-based treatment recommendations for patients with co-occurring hypertension and BPD. Search terms were combined for hypertension and BPD in PubMed, MEDLINE, EMBASE, Cochrane, and PsycINFO databases. RESULTS We included 11 articles for full-text evaluation and found a very high prevalence of hypertension and substantial cardiovascular risk in studies on co-occurring BPD and hypertension. However, we identified neither studies on harmful drug-drug and drug-disease interactions nor studies with treatment recommendations for co-occurring hypertension and BPD. CONCLUSIONS Increased prevalence of hypertension in BPD patients, and therapeutic conflicts of psychotropic agents strongly suggest careful evaluation of treatment strategies in this patient group. However, no studies or guidelines recommend specific therapies or strategies to resolve therapeutic conflicts in patients with hypertension and BPD. This evidence gap needs attention in this population at high risk for cardiovascular disease.
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Affiliation(s)
- Saara M. Roininen
- Department of Internal Medicine, University Hospital Zurich
- Center of Competence Multimorbidity
| | - Marcus Cheetham
- Department of Internal Medicine, University Hospital Zurich
- Center of Competence Multimorbidity
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
| | - Beatrice U. Mueller
- Department of Internal Medicine, University Hospital Zurich
- Center of Competence Multimorbidity
| | - Edouard Battegay
- Department of Internal Medicine, University Hospital Zurich
- Center of Competence Multimorbidity
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
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Bába LI, Kolcsár M, Kun IZ, Ulakcsai Z, Bagaméry F, Szökő É, Tábi T, Gáll Z. Effects of Cariprazine, Aripiprazole, and Olanzapine on Mouse Fibroblast Culture: Changes in Adiponectin Contents in Supernatants, Triglyceride Accumulation, and Peroxisome Proliferator-Activated Receptor-γ Expression. ACTA ACUST UNITED AC 2019; 55:medicina55050160. [PMID: 31108997 PMCID: PMC6571602 DOI: 10.3390/medicina55050160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/05/2019] [Accepted: 05/14/2019] [Indexed: 02/01/2023]
Abstract
Background and Objectives: The use of the dopamine-partial agonist subclass (also termed dopamine stabilizers) of atypical antipsychotics for the treatment of negative schizophrenia symptoms and some mood disorders has increased recently. Similar to other second-generation antipsychotics (SGAs), aripiprazole (ARI) and cariprazine (CAR) also influence food intake, but the peripheral effects of these drugs on adipose–tissue homeostasis, including adipokine secretion as well as lipo- and adipogenesis, are not fully elucidated. In this study, we explored the adipocyte-related mechanisms induced by second-generation antipsychotics (SGAs), leading to changes in peripheral signals involved in energy homeostasis. Materials and Methods: CAR, a new SGA, was compared with ARI and olanzapine (OLA), using cell cultures to study adipogenesis, and the expression levels of peroxisome proliferator-activated receptor-γ (PPAR-γ) was measured in adipocytes derived from mouse fibroblasts, by western blotting on days 7, 14, and 21 postinduction. The triglyceride (TG) content of the cells was also evaluated on day 15 using Oil Red O staining, and the adiponectin (AN) content in the cell culture supernatants was quantified on days 7 and 15 by enzyme-linked immunosorbent assay. Cells were treated with two concentrations of ARI (0.5 and 20 µg/mL), OLA (1 and 20 µg/mL), and CAR (0.1 and 2 µg/mL). Results: Both concentrations of ARI and OLA, as well as the lower concentration of CAR, significantly increased the TG contents. The AN levels in the supernatants were significantly increased by the higher concentration of ARI on days 7 and 15 (p < 0.05). Although PPAR-γ levels were not significantly affected by ARI and OLA, the lower concentration of CAR induced a significant time-dependent decrease in PPAR-γ expression (p < 0.05). Conclusions: The in vitro adipogenesis considered from TG accumulation, AN secretion, and PPAR-γ expression was differently influenced by ARI, CAR, and OLA. Understanding the adipocyte-related mechanisms of antipsychotics could contribute to understanding their weight-influencing effect.
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Affiliation(s)
- László-István Bába
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureș, 540139 Tîrgu Mureș, Romania.
| | - Melinda Kolcsár
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureș, 540139 Tîrgu Mureș, Romania.
| | - Imre Zoltán Kun
- Doctoral School, Faculty of Medicine, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureș, 540139 Tîrgu Mureș, Romania.
| | - Zsófia Ulakcsai
- Department of Pharmacodynamics, Semmelweis University, 1089 Budapest, Hungary.
| | - Fruzsina Bagaméry
- Department of Pharmacodynamics, Semmelweis University, 1089 Budapest, Hungary.
| | - Éva Szökő
- Department of Pharmacodynamics, Semmelweis University, 1089 Budapest, Hungary.
| | - Tamás Tábi
- Department of Pharmacodynamics, Semmelweis University, 1089 Budapest, Hungary.
| | - Zsolt Gáll
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, University of Medicine, Pharmacy, Sciences and Technology of Tîrgu Mureș, 540139 Tîrgu Mureș, Romania.
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Impaired Glucose Metabolism in Bipolar Patients: The Role of Psychiatrists in Its Detection and Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071132. [PMID: 30934836 PMCID: PMC6480108 DOI: 10.3390/ijerph16071132] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 12/12/2022]
Abstract
Bipolar patients have a higher risk of type 2 diabetes and obesity, which are associated with cardiovascular diseases as the leading cause of death in this group. Additionally, there is growing evidence that impaired glucose metabolism in bipolar patients is associated with rapid cycling, poor response to mood stabilizers and chronic course of illness. The aim of the study was to assess the prevalence of type 2 diabetes and other types of impaired glucose metabolism in bipolar patients along with an evaluation of the Fasting Triglycerides and Glucose Index (TyG) as a method of the insulin sensitivity assessment. The analysis of fasting glycemia, insulinemia and lipid profile in euthymic bipolar patients was performed, and the Homeostasis model assessment for insulin resistance (HOMA-IR) and TyG were computed. Type 2 diabetes was observed in 9% and insulin resistance with HOMA-IR in 48% of patients. The TyG and HOMA-IR indices were correlated (p < 0.0001), the TyG index value of 4.7 had the highest sensitivity and specificity for insulin resistance detection. The usefulness of TyG in the recognition of insulin resistance in bipolar patients was suggested. The significant role of psychiatrists in the detection and management of impaired glucose metabolism in bipolar patients was presented.
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Moreira FP, Jansen K, Cardoso TDA, Mondin TC, Vieira IS, Magalhães PVDS, Kapczinski F, Souza LDDM, da Silva RA, Oses JP, Wiener CD. Metabolic syndrome, depression and anhedonia among young adults. Psychiatry Res 2019; 271:306-310. [PMID: 30522000 DOI: 10.1016/j.psychres.2018.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 06/04/2018] [Accepted: 08/05/2018] [Indexed: 01/13/2023]
Abstract
The aim of this study was to assess the association between anhedonia and metabolic syndrome (MetS) in a well-characterized community sample of individuals with a current depressive episode. This is a cross-sectional study with young adults aged 24-30 years old. Depressive episode and the presence of anhedonia was assessed using the Mini International Neuropsychiatric Interview - Plus version (MINI Plus). The MetS was assessed using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). The sample included 931 subjects, being 22 had depression without anhedonia, whereas 55 had depression with anhedonia. MetS was more prevalent among subjects with depression and anhedonia (43.6%) when compared to individuals without anhedonia and population control group. Moreover, subjects with depression and anhedonia have a significant increase of levels of glucose, triglycerides, total-cholesterol and LDL-cholesterol, as well as significant decreased in the HDL-cholesterol level. The present study showed that individuals with depression and anhedonia present higher prevalence of MetS. Our study suggests that the use of the concept of anhedonia may contribute to a better understanding of the complex relationship between depression and metabolic syndrome.
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Affiliation(s)
- Fernanda Pedrotti Moreira
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Taiane de Azevedo Cardoso
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Thaíse Campos Mondin
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Igor Soares Vieira
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Pedro Vieira da Silva Magalhães
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Flavio Kapczinski
- Molecular Psychiatry, Department of Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil; McMaster University, Hamilton, ON, Canada
| | - Luciano Dias de Mattos Souza
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Ricardo Azevedo da Silva
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Jean Pierre Oses
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Carolina David Wiener
- Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Department of Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
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Lee Y, Subramaniapillai M, Brietzke E, Mansur RB, Ho RC, Yim SJ, McIntyre RS. Anti-cytokine agents for anhedonia: targeting inflammation and the immune system to treat dimensional disturbances in depression. Ther Adv Psychopharmacol 2018; 8:337-348. [PMID: 30524702 PMCID: PMC6278744 DOI: 10.1177/2045125318791944] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 07/11/2018] [Indexed: 12/25/2022] Open
Abstract
The etiology of mood disorders is mechanistically heterogeneous, underscoring the need for a dimensional approach to identify and develop targeted treatments in psychiatry. Accumulating evidence implicates inflammation as an important contributor to the pathophysiology of depression and presents the immune system as a viable therapeutic target that may be more proximate to the pathogenic nexus of brain-based disorders in specific subpopulations. Anhedonia is a transdiagnostic (e.g. Parkinson's disease, diabetes mellitus, rheumatic diseases), yet specific, and clinically relevant symptom dimension subserved by well-characterized neurobiological and neurophysiological substrates of the positive valence systems (PVS). Brain circuits, nodes, and networks, as well as cellular and molecular pathways (e.g. dopaminergic transmission; excitotoxicity; synaptic plasticity), subserving anhedonia are preferentially affected by inflammatory processes. To our knowledge, no published randomized, controlled clinical trial in populations with mood disorders has, to date, primarily sought to determine the effects of an anti-inflammatory agent on PVS functions or pathophysiology. Three ongoing clinical trials aim to investigate the effects of anti-TNF-alpha biologic infliximab on measures of anhedonia [ClinicalTrials.gov identifier: NCT02363738], motivational behavior and circuitry [ClinicalTrials.gov identifier: NCT03006393], and glutamatergic changes in the basal ganglia [ClinicalTrials.gov identifier: NCT03004443] in clinical populations with unipolar or bipolar depression. Positive results would further instantiate the relevance of inflammatory processes and the immune system in the pathophysiology of mood disorders and provide the impetus to develop scalable treatments targeting inflammation and the immune system to mitigate transdiagnostic, dimensional disturbances in brain-based disorders.
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Affiliation(s)
- Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Elisa Brietzke
- Department of Psychiatry, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Roger C Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Samantha J Yim
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada Brain and Cognition Discovery Foundation, Toronto, ON, Canada Institute of Medical Science, University of Toronto, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada Department of Pharmacology, University of Toronto, Toronto, ON, Canada
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Ho RCM, Chua AC, Tran BX, Choo CC, Husain SF, Vu GT, McIntyre RS, Ho CSH. Factors Associated with the Risk of Developing Coronary Artery Disease in Medicated Patients with Major Depressive Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102073. [PMID: 30248896 PMCID: PMC6210477 DOI: 10.3390/ijerph15102073] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 09/12/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022]
Abstract
Background: The aim of this study was to identify factors associated with high Framingham Risk Score (FRS) in medicated patients with major depressive disorder (MDD). Methods: We examined 61 medicated patients with MDD (mean age 37.77 ± 7.67, 90.2% women) and 43 non-depressed controls (mean age 38.26 ± 9.20, 90.7% women). We administered the Hamilton Depression Rating Scale (HAM-D) and measured systolic blood pressure (SBP), diastolic BP (DBP), mean arterial BP (MAP), pulse wave velocity (PWV), intima-media thickness (IMT), interleukin-6 (IL-6) and triglycerides. Results: We found that medicated patients with MDD had significantly higher levels of HAM-D score (p < 0.01), SBP (p = 0.015), MAP (p = 0.037), IL−6 level (p = 0.007), as compared with controls. Medicated patients who remained moderately to severely depressed showed significantly higher SBP (p = 0.049), DBP (p = 0.009), MAP (p = 0.024), IL−6 level (p = 0.019), left PWV (p = 0.004) and average PWV (p = 0.026) than those with mild depression. Multivariate regression showed that the interaction effect between HAM-D score and triglyceride level (p = 0.018) was significantly associated with FRS in medicated patients with MDD. Conclusions: This study highlights that the interaction effect of the severity of depression and the triglyceride level, was a modifiable factor positively associated with high FRS.
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Affiliation(s)
- Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
- Biomedical Global Institute of Healthcare Research & Technology (BIGHEART), National University of Singapore, Singapore 119228, Singapore.
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam.
| | - Anna C Chua
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Bach X Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam.
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
- Vietnam Young Physicians' Association, Hanoi 100000, Vietnam.
| | - Carol C Choo
- College of Healthcare Sciences, James Cook University, Singapore 387380, Singapore.
| | - Syeda Fabeha Husain
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore.
| | - Giang T Vu
- Institute for Global Health Innovations, Duy Tan University, Hanoi 73000, Vietnam.
| | - Roger S McIntyre
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada.
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON M5G 2C4, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada.
- Department of Toxicology and Pharmacology, University of Toronto, Toronto, ON M5S 1A8, Canada.
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore.
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22
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Differentiating Medicated Patients Suffering from Major Depressive Disorder from Healthy Controls by Spot Urine Measurement of Monoamines and Steroid Hormones. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050865. [PMID: 29701669 PMCID: PMC5981904 DOI: 10.3390/ijerph15050865] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/22/2018] [Accepted: 04/23/2018] [Indexed: 01/01/2023]
Abstract
Introduction: Major Depressive Disorder (MDD) is a common psychiatric disorder. Currently, there is no objective, cost-effective and non-invasive method to measure biological markers related to the pathogenesis of MDD. Previous studies primarily focused on urinary metabolite markers which are not proximal to the pathogenesis of MDD. Herein, we compare urinary monoamines, steroid hormones and the derived ratios amongst MDD when compared to healthy controls. Methods: Morning urine samples of medicated patients suffering from MDD (n = 47) and healthy controls (n = 41) were collected. Enzyme-linked immunosorbent assay (ELISA) was performed to measure five biomarkers: cortisol, dopamine, noradrenaline, serotonin and sulphate derivative of dehydroepiandrosterone (DHEAS). The mean urinary levels and derived ratios of monoamines and steroid hormones were compared between patients and controls to identify potential biomarkers. The receiver operative characteristic curve (ROC) analysis was conducted to evaluate the diagnostic performance of potential biomarkers. Results: Medicated patients with MDD showed significantly higher spot urine ratio of DHEAS/serotonin (1.56 vs. 1.19, p = 0.004) and lower ratio of serotonin/dopamine (599.71 vs. 888.60, p = 0.008) than healthy controls. A spot urine serotonin/dopamine ratio cut-off of >667.38 had a sensitivity of 73.2% and specificity of 51.1%. Conclusions: Our results suggest that spot urine serotonin/dopamine ratio can be used as an objective diagnostic method for adults with MDD.
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23
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Qin T, Liu W, Yin M, Shu C, Yan M, Zhang J, Yin P. Body mass index moderates the relationship between C-reactive protein and depressive symptoms: evidence from the China Health and Retirement Longitudinal Study. Sci Rep 2017; 7:39940. [PMID: 28128231 PMCID: PMC5269588 DOI: 10.1038/srep39940] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 11/29/2016] [Indexed: 12/17/2022] Open
Abstract
The present study aimed to investigate the role of abnormal body mass index (BMI, kg/m2) in the depression-CRP (C-reactive protein) relationship in a healthy middle-aged and elderly Chinese population. Analytical samples were drawn from the China Health and Retirement Longitudinal Study (CHARLS), and participants were categorized by different BMI levels. Depressive subtypes were evaluated both at baseline and follow-up using the Center for Epidemiology Studies Depression scale. Hs-CRP and other variables were measured at baseline. Multiple linear regression analyses were used to evaluate the cross-sectional and longitudinal relationship between depression and baseline hs-CRP. Depression was significantly negatively associated with BMI (ρ = −0.077, p < 0.0001), with underweight associated with worse depressive symptoms than other BMI groups. Both cross-sectional and longitudinal associations between serum hs-CRP and depressive subtypes were significantly positive in the underweight group (p < 0.05). However, in the other BMI groups (from normal weight to obesity), the CRP-depression relationship was no longer significant (p > 0.05). The significant relationship between CRP and depression in the underweight group suggested that not only obesity but also a low BMI could explain a substantial portion of the inflammation-depression link.
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Affiliation(s)
- Tingting Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wenhua Liu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Minghui Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Chang Shu
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Mingming Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jianyuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Marger L, Schubert C, Bertrand D. Zinc: An underappreciated modulatory factor of brain function. Biochem Pharmacol 2014; 91:426-35. [DOI: 10.1016/j.bcp.2014.08.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 07/30/2014] [Accepted: 08/08/2014] [Indexed: 02/05/2023]
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