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Ngoupaye GT, Mokgokong M, Madlala T, Mabandla MV. Alteration of the α5 GABA receptor and 5HTT lead to cognitive deficits associated with major depressive-like behaviors in a 14-day combined stress rat model. Int J Neurosci 2023; 133:959-976. [PMID: 34937496 DOI: 10.1080/00207454.2021.2019033] [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: 08/13/2020] [Revised: 07/13/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Current models used to study the pathophysiology of major depressive disorder (MDD) are laborious and time consuming. This study examined the effect of a 14-day combined stress model (CS; corticosterone injection and restraint stress) in male Sprague-Dawley rats and also compare the effect of CS versus 28-day corticosterone treatment on depressive-like behaviour and cognitive deficits. MATERIEL AND METHODS Depressive-like behaviours and cognitive deficits were assessed in the forced swim test (FST), sucrose preference (SPT), Morris water maze (MWM) and novel object recognition (NORT) tests. Real-time PCR and ELISA were respectively used to detect expression of the serotonin transporter (5-HTT), serotonin 1 A receptor (5-HT1A), α5 GABAA receptor, and the concentrations of corticosterone (plasma), GABA and acetylcholinesterase (AChE) in the hippocampus and Prefrontal cortex (PFC).Results CS group showed increased immobility time in the FST, time to reach the MWM platform, higher corticosterone level, and increased expressions of hippocampal and PFC 5-HT1A and α5 GABAA receptors, and AChE compared to their control groups. In contrast, reductions in SPT ratio, discrimination index in NORT, time in target quadrant, and hippocampal 5-HTT expression was noted relative to their control group. Compared to the 28-day corticosterone only group, PFC 5-HT1A, Hippocampal 5-HTT were reduced, while PFC 5-HTT, Hippocampal α5 GABAA receptors, and AChE concentrations were higher in the CS group. CONCLUSION Our CS model induced depressive-like behaviour with early cognitive deficits in rats affecting both hippocampus and PFC. The CS model may be useful in investigating new and comprehensive treatment strategies for MDD.
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Affiliation(s)
- Gwladys Temkou Ngoupaye
- Discipline of Human Physiology, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Makwena Mokgokong
- Discipline of Human Physiology, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Thobeka Madlala
- Discipline of Human Physiology, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Musa Vuyisile Mabandla
- Discipline of Human Physiology, School of Laboratory Medicine & Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Wang X, Cai ZD, Jiang WT, Fang YY, Sun WX, Wang X. Systematic review and meta-analysis of the effects of exercise on depression in adolescents. Child Adolesc Psychiatry Ment Health 2022; 16:16. [PMID: 35227300 PMCID: PMC8886903 DOI: 10.1186/s13034-022-00453-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 02/18/2022] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Depression is widespread among adolescents and seriously endangers their quality of life and academic performance. Developing strategies for adolescent depression has important public health implications. No systematic review on the effectiveness of physical exercise for adolescents aged 12-18 years with depression or depressive symptoms has previously been conducted. This study aims to systematically evaluate the effect of physical exercise on adolescent depression in the hope of developing optimum physical exercise programs. METHODS Nine major databases at home and abroad were searched to retrieve randomized controlled trials (RCTs) on exercise interventions among adolescents with depression or depressive symptoms. The retrieval period started from the founding date of each database to May 1, 2021. The methodological quality of the included articles was evaluated using the modified PEDro scale. A meta-analysis, subgroup analysis, sensitivity analysis, and publication bias tests were then conducted. RESULTS Fifteen articles, involving 19 comparisons, with a sample size of 1331, were included. Physical exercise significantly reduced adolescent depression (standardized mean difference [SMD] = - 0.64, 95% CI - 0.89, - 0.39, p < 0.01), with a moderate effect size, in both adolescents with depression (SMD = -0.57, 95% CI - 0.90, - 0.23, p < 0.01) and adolescents with depressive symptoms (SMD = - 0.67, 95% CI - 1.00, - 0.33, p < 0.01). In subgroups of different depression categories (depression or depressive symptoms), aerobic exercise was the main form of exercise for the treatment of adolescents with depression. For adolescents with depression, interventions lasting 6 weeks, 30 min/time, and 4 times/week had optimum results. The effects of aerobic exercise and resistance + aerobic exercise in the subgroup of adolescents with depressive symptoms were significant, while the effect of physical and mental exercise (yoga) was not significant. For adolescents with depressive symptoms, aerobic exercise lasting 8 weeks, 75-120 min/time, and 3 times/week had optimum results. Physical exercise with moderate intensity is a better choice for adolescents with depression and depressive symptoms. CONCLUSIONS Physical exercise has a positive effect on the improvement of depression in adolescents. The protocol for this study was registered with INPLASY (202170013). DOI number is 10.37766/inplasy2021.7.0013. Registration Date:2021.7.06.
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Affiliation(s)
- Xiang Wang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Zhi-dong Cai
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wan-ting Jiang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Yan-yan Fang
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Wen-xin Sun
- grid.412543.50000 0001 0033 4148School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438 China
| | - Xing Wang
- School of Physical Education and Training, Shanghai University of Sport, 650 Qingyuan Ring Road, Yangpu District, Shanghai, 200438, China.
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de Menezes Galvão AC, Almeida RN, de Sousa GM, Leocadio-Miguel MA, Palhano-Fontes F, de Araujo DB, Lobão-Soares B, Maia-de-Oliveira JP, Nunes EA, Hallak JEC, Schuch FB, Sarris J, Galvão-Coelho NL. Pathophysiology of Major Depression by Clinical Stages. Front Psychol 2021; 12:641779. [PMID: 34421705 PMCID: PMC8374436 DOI: 10.3389/fpsyg.2021.641779] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 06/23/2021] [Indexed: 01/01/2023] Open
Abstract
The comprehension of the pathophysiology of the major depressive disorder (MDD) is essential to the strengthening of precision psychiatry. In order to determine the relationship between the pathophysiology of the MDD and its clinical progression, analyzed by severity of the depressive symptoms and sleep quality, we conducted a study assessing different peripheral molecular biomarkers, including the levels of plasma C-reactive protein (CRP), serum mature brain-derived neurotrophic factor (mBDNF), serum cortisol (SC), and salivary cortisol awakening response (CAR), of patients with MDD (n = 58) and a control group of healthy volunteers (n = 62). Patients with the first episode of MDD (n = 30) had significantly higher levels of CAR and SC than controls (n = 32) and similar levels of mBDNF of controls. Patients with treatment-resistant depression (TRD, n = 28) presented significantly lower levels of SC and CAR, and higher levels of mBDNF and CRP than controls (n = 30). An increased severity of depressive symptoms and worse sleep quality were correlated with levels low of SC and CAR, and with high levels of mBDNF. These results point out a strong relationship between the stages clinical of MDD and changes in a range of relevant biological markers. This can assist in the development of precision psychiatry and future research on the biological tests for depression.
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Affiliation(s)
- Ana Cecília de Menezes Galvão
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Raíssa Nobrega Almeida
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Geovan Menezes de Sousa
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Mario André Leocadio-Miguel
- Laboratory of Neurobiology and Biological Rhythms, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | - Bruno Lobão-Soares
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - João Paulo Maia-de-Oliveira
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Clinical Medicine, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Emerson Arcoverde Nunes
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Psychiatry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Jaime Eduardo Cecilio Hallak
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Nicole Leite Galvão-Coelho
- Postgraduate Program in Psychobiology, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
- National Institute of Science and Technology in Translational Medicine, São Paulo, Brazil
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Professorial Unit, The Melbourne Clinic, Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
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Juruena MF, Gadelrab R, Cleare AJ, Young AH. Epigenetics: A missing link between early life stress and depression. Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110231. [PMID: 33383101 DOI: 10.1016/j.pnpbp.2020.110231] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/06/2020] [Accepted: 12/21/2020] [Indexed: 02/08/2023]
Abstract
Research has suggested a relationship between early life stress, and depression in particular longer episodes of depression with treatment resistant outcomes. However, the underlying mechanisms for this association remain poorly understood. Molecular studies indicate that, in general, the hereditary character of psychiatric disorders are polygenic, multifactorial and highly complex, with innumerable low-effect genetic variants interacting with each other. In addition, the importance of the environment and its interaction with genes has pointed to a fundamental role of epigenetic mechanisms in psychiatric disorders, such as methylation of deoxyribonucleic acid (DNA), alterations, histone actions and regulation of gene expression by non-coding ribonucleic acids (RNAs). This article provides an overview of the interplay of epigenetics, the HPA axis, early life stress and the development of depression. Advances in our knowledge of epigenetics in the context of early life stress and depression provide a new understanding of the genetic influence on psychopathology and could lead to the identification of new targets for clinical intervention.
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Affiliation(s)
- Mario F Juruena
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust (SLaM), UK.
| | | | - Anthony J Cleare
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust (SLaM), UK
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, Denmark Hill, London SE5 8AF, UK; South London and Maudsley NHS Foundation Trust (SLaM), UK
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Serafim AP, Durães RSS, Rocca CCA, Gonçalves PD, Saffi F, Cappellozza A, Paulino M, Dumas-Diniz R, Brissos S, Brites R, Alho L, Lotufo-Neto F. Exploratory study on the psychological impact of COVID-19 on the general Brazilian population. PLoS One 2021; 16:e0245868. [PMID: 33534820 PMCID: PMC7857630 DOI: 10.1371/journal.pone.0245868] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/10/2021] [Indexed: 12/27/2022] Open
Abstract
The COVID-19 pandemic has become one of the main international concerns regarding its impact on mental health. The present study aims to investigate the prevalence of depression, anxiety, and stress symptoms, and behavioral aspects amidst the COVID-19 pandemic in a Brazilian population. An online survey was administered from May 22 to June 5, 2020 using a questionnaire comprising of sociodemographic information, the Depression, Anxiety, and Stress Scale (DASS-21), and the Coping Strategies Inventory. Participants comprised 3,000 people from Brazil's 26 states and the Federal District, with an average age of 39.8 years, women (83%), married (50.6%), graduates (70.1%) and employees (46.7%). Some contracted the virus (6.4%) and had dead friends or relatives (22.7%). There was more consumption of drugs, tobacco, medication, and food (40.8%). Almost half of participants expressed symptoms of depression (46.4%), anxiety (39.7%), and stress (42.2%). These were higher in women, people without children, students, patients with chronic diseases, and people who had contact with others diagnosed with COVID-19. The existence of a group more vulnerable to situations with a high stress burden requires greater attention regarding mental health during and after the pandemic. That said, it should be emphasized that these findings are preliminary and portray a moment still being faced by many people amid the pandemic and quarantine measures. Therefore, we understand that the magnitude of the impacts on mental health will only be more specific with continuous studies after total relaxation of the quarantine.
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Affiliation(s)
- Antonio P Serafim
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
- Health Psychology Program, Methodist University of São Paulo, São Paulo, Brazil
| | - Ricardo S S Durães
- Health Psychology Program, Methodist University of São Paulo, São Paulo, Brazil
| | - Cristiana C A Rocca
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Priscila D Gonçalves
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fabiana Saffi
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alexandre Cappellozza
- Social and Applied Sciences Center, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Mauro Paulino
- Mind, Institute of Clinical and Forensic Psychology/Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Lisbon, Portugal
| | - Rodrigo Dumas-Diniz
- Mind, Institute of Clinical and Forensic Psychology/Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Lisbon, Portugal
| | - Sofia Brissos
- National Legal Medicine Institute, Psychiatry and Clinical and Forensic Psychology, Lisbon Psychiatric Hospital, Lisbon, Portugal
| | - Rute Brites
- Department of Psychology, Autónoma University, Lisbon, Portugal
| | - Laura Alho
- Mind, Digital Human-Environment Interaction Lab, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Francisco Lotufo-Neto
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
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Rocha BLD, Bezerra PCDL, Monteiro GTR. Prevalência de sintomas depressivos e fatores associados em idosos de Unidades de Atenção Primária à Saúde em Rio Branco, Acre. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2021. [DOI: 10.1590/1981-22562021024.210034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivo Estimar a prevalência de sintomas depressivos e fatores associados em idosos assistidos por Unidades de Atenção Primária à Saúde em Rio Branco, Acre, Brasil. Método Estudo transversal realizado com idosos cadastrados em duas unidades de Atenção Primária à Saúde de Rio Branco, Acre, entre 2016 e 2017. A prevalência de sintomas depressivos foi medida por meio da Geriatric Depression Scale (GDS-15) e as associações foram testadas com variáveis selecionadas. Foram calculadas as razões de prevalências brutas e ajustadas com intervalo de confiança de 95%, por regressão de Poisson, com variância robusta. Resultados A prevalência de sintomas depressivos foi de 74,5%. Os fatores mais fortemente associados foram: percepção de insegurança no local de moradia (RP=1,46; IC 95% 1,23-1,74), renda familiar menor que um salário mínimo (RP=1,10; IC 95% 1,01-1,20) e autopercepção da saúde insatisfatória (RP=1,25; IC 95% 1,14-1,37), ajustados por sexo, faixa etária, escolaridade, atividade laboral e fragilidade. Conclusão Evidenciou-se uma elevada prevalência de sintomas depressivos na população estudada. A identificação dos fatores associados apontou a vulnerabilidade socioeconômica e de saúde nas quais os idosos estão imersos, relacionando-se com as condições associadas à sintomatologia depressiva.
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Barroca NCB, Baes CVW, Martins-Monteverde CMS, Bosaipo NB, Santos da Silva Umeoka M, Tejada J, Antunes-Rodrigues J, de Castro M, Juruena MF, Garcia-Cairasco N, Umeoka EHDL. Evaluation of the HPA Axis' Response to Pharmacological Challenges in Experimental and Clinical Early-Life Stress-Associated Depression. eNeuro 2021; 8:ENEURO.0222-20.2020. [PMID: 33318074 PMCID: PMC7814478 DOI: 10.1523/eneuro.0222-20.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 10/27/2020] [Accepted: 11/20/2020] [Indexed: 02/08/2023] Open
Abstract
Early-life stress (ELS) is associated with a higher risk of psychopathologies in adulthood, such as depression, which may be related to persistent changes in the hypothalamic-pituitary-adrenal (HPA) axis. This study aimed to evaluate the effects of ELS on the functioning of the HPA axis in clinical and experimental situations. Clinically, patients with current depressive episodes, with and without ELS, and healthy controls, composed the sample. Subjects took a capsule containing placebo, fludrocortisone, prednisolone, dexamethasone or spironolactone followed by an assessment of plasma cortisol the morning after. Experimentally, male Wistar rats were submitted to ELS protocol based on variable, unpredictable stressors from postnatal day (PND)1 to PND21. On PND65 animals were behaviorally evaluated through the forced-swimming test (FST). At PND68, pharmacological challenges started, using mifepristone, dexamethasone, spironolactone, or fludrocortisone, and corticosterone levels were determined 3 h after injections. Cortisol response of the patients did not differ significantly from healthy subjects, regardless of their ELS history, and it was lower after fludrocortisone, prednisolone, and dexamethasone compared with placebo, indicating the suppression of plasma cortisol by all these treatments. Animals exposed to ELS presented altered phenotype as indicated by an increased immobility time in the FST when compared with control, but no significant long-lasting effects of ELS were observed on the HPA axis response. Limitations on the way the volunteers were sampled may have contributed to the lack of ELS effects on the HPA axis, pointing out the need for further research to understand these complex phenomena.
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Affiliation(s)
- Nayara Cobra Barreiro Barroca
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | - Cristiane Von Werne Baes
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | | | - Nayanne Beckmann Bosaipo
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | - Marcia Santos da Silva Umeoka
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
- Research Group on Neurobiology of Behavior, Cognition and Emotions, Faculty of Medicine, University Center Unicerrado, Goiatuba, 75600-000, Brazil
| | - Julian Tejada
- Psychology Department, Federal University of Sergipe, São Cristóvão, 49100-000, Brazil
| | - José Antunes-Rodrigues
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | - Margaret de Castro
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | - Mario Francisco Juruena
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
- Department of Psychological Medicine, Kings College London, London, SE5 8AF, United Kingdom
| | - Norberto Garcia-Cairasco
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
- Physiology Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
| | - Eduardo Henrique de Lima Umeoka
- Neuroscience and Behavioral Sciences Department, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, 14040-900, Brazil
- Research Group on Neurobiology of Behavior, Cognition and Emotions, Faculty of Medicine, University Center Unicerrado, Goiatuba, 75600-000, Brazil
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Abstract
Hormones have a crucial part in the progress and manifestation of a wide variety of different behaviors. The main influence of the neuroendocrine system on behavior is its action on the neurobiology of neuropsychiatric disorders and its relationship with the pharmacodynamics of medicines. Of all the neuroendocrine axes, the hypothalamic-pituitary-adrenal (HPA) axis has been the most extensively studied. There is evidence that disturbance in the HPA axis, the primary stress hormone system, could increase treatment resistance and relapse, worsen illness outcome, and cause cognitive deficits. Glucocorticoids mediate their actions in negative feedback binding in two different cytoplasmatic receptors described as mineralocorticoid receptors (MRs) and glucocorticoid receptors (GRs). Different psychopathologies underlying bipolar disorders are supposed to involve persistent dysfunctions in the expression and role of both MR and GR in the hippocampus. We review and analyze the evidence related to the correlation between bipolar disorders and the consequences and impact of stressful life events on the HPA axis, exploring the importance of these findings in bipolar disorders and as potential new targets for treatment.
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Affiliation(s)
- Mario F Juruena
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Anthony J Cleare
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Berk A, Yılmaz İ, Abacıoğlu N, Kaymaz MB, Karaaslan MG, Kuyumcu Savan E. Antidepressant effect of Gentiana olivieri Griseb. in male rats exposed to chronic mild stress. Libyan J Med 2020; 15:1725991. [PMID: 32048914 PMCID: PMC7034455 DOI: 10.1080/19932820.2020.1725991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: The flowering parts of Gentiana olivieri, known as ‘Afat’ in the southeastern Anatolia region of Turkey, are used as a tonic, an appetizer, and for the treatment of several mental disorders, including depression. The purpose of this study is to investigate the antidepressant effect of G. olivieri ethanol extract (GOEE) in a chronic mild stress-induced rat model, which was used to mimic a depressive state in humans, and to compare the effect with that of imipramine. Methods: Male Sprague-Dawley rats were randomly divided into six groups: control, stress, treated with imipramine (positive control) and treated with GOEE at three different (200, 500, 1000 mg/kg) doses groups. The rats in all groups, except the control group, were exposed to chronic mild stress. At the end of the 3-week experimental period, biochemical and behavioral parameters were examined. Results: The results showed that treatment with GOEE or imipramine significantly improved rats’ sucrose consumption which was diminished by chronic mild stress, restored serum levels of corticosterone and proinflammatory cytokines (interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)), prevented the increase of liver index of rats. Moreover, in the hippocampus tissue, decreased serotonin and noradrenaline levels were significantly increased by treatment with GOEE or imipramine, and antioxidant parameters (thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), and glutathione (GSH)) were significantly improved by treatment with GOEE though not with imipramine. Conclusion: The data demonstrate that G. olivieri may exert its antidepressant activity by improving monoaminergic system disorders, and by favorably affecting the antioxidant, inflammatory and the endocrine mechanisms.
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Affiliation(s)
- Ahmet Berk
- Department of Pharmacy, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - İsmet Yılmaz
- Department of Pharmacology, Faculty of Pharmacy, Inonu University, Malatya, Turkey
| | - Nurettin Abacıoğlu
- Department of Pharmacology, Faculty of Pharmacy, Near East University, Mersin, Turkey
| | | | | | - Ebru Kuyumcu Savan
- Department of Basic Pharmaceutical Sciences, Faculty of Pharmacy, İnönü University, Malatya, Turkey
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Jiang LC, Yan YJ, Jin ZS, Hu ML, Wang L, Song Y, Li NN, Su J, Wu DX, Xiao T. The Depression Anxiety Stress Scale-21 in Chinese Hospital Workers: Reliability, Latent Structure, and Measurement Invariance Across Genders. Front Psychol 2020; 11:247. [PMID: 32210869 PMCID: PMC7067921 DOI: 10.3389/fpsyg.2020.00247] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 02/03/2020] [Indexed: 01/16/2023] Open
Abstract
The Depression Anxiety Stress Scale-21 (DASS-21) is an instrument in the assessment of mental health status. The current study recruited 1,532 Chinese hospital workers [74.4% female; mean age = 31.97 (SD = 9.70) years] to examine the reliability, latent structure, and measurement invariance of the DASS-21 between genders. The Cronbach’s α values were greater than 0.90 for total score. This study examined four possible models of the DASS-21 using the confirmatory factor analysis (CFA) in Chinese hospital workers. The results from CFA revealed that the latent structure of the DASS-21 in medical staffs is best represented by a one-factor model. Then we used the one-factor model to examine measurement invariance across genders by using a multiple-group categorical CFA. All values of root mean square error approximation (RMSEA) were less than 0.08, all Comparative Fix Index (CFI) and Tucker–Lewis Index values were greater than 0.90, all ΔCFI (changes in CFI) values were less than 0.010, and ΔRMSEA (the changes in RMSEA) were less than 0.015. These findings supported the gender invariance of the DASS-21 among Chinese hospital workers.
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Affiliation(s)
- Li-Chen Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ya-Jun Yan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhi-Shuai Jin
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Mu-Li Hu
- Research Office, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Ling Wang
- Research Office, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yu Song
- Department of Rehabilitation, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, China
| | - Na-Ni Li
- Department of Science and Education, Zhuzhou 331 Hospital, Zhuzhou, China
| | - Jun Su
- Department of Science and Education, Zhuzhou 331 Hospital, Zhuzhou, China
| | - Da-Xing Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tao Xiao
- Research Office, The Second Xiangya Hospital, Central South University, Changsha, China
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Systems Approach to Identify Common Genes and Pathways Associated with Response to Selective Serotonin Reuptake Inhibitors and Major Depression Risk. Int J Mol Sci 2019; 20:ijms20081993. [PMID: 31018568 PMCID: PMC6514561 DOI: 10.3390/ijms20081993] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/17/2019] [Accepted: 04/20/2019] [Indexed: 12/27/2022] Open
Abstract
Despite numerous studies on major depressive disorder (MDD) susceptibility, the precise underlying molecular mechanism has not been elucidated which restricts the development of etiology-based disease-modifying drug. Major depressive disorder treatment is still symptomatic and is the leading cause of (~30%) failure of the current antidepressant therapy. Here we comprehended the probable genes and pathways commonly associated with antidepressant response and MDD. A systematic review was conducted, and candidate genes/pathways associated with antidepressant response and MDD were identified using an integrative genetics approach. Initially, single nucleotide polymorphisms (SNPs)/genes found to be significantly associated with antidepressant response were systematically reviewed and retrieved from the candidate studies and genome-wide association studies (GWAS). Also, significant variations concerning MDD susceptibility were extracted from GWAS only. We found 245 (Set A) and 800 (Set B) significantly associated genes with antidepressant response and MDD, respectively. Further, gene set enrichment analysis revealed the top five co-occurring molecular pathways (p ≤ 0.05) among the two sets of genes: Cushing syndrome, Axon guidance, cAMP signaling pathway, Insulin secretion, and Glutamatergic synapse, wherein all show a very close relation to synaptic plasticity. Integrative analyses of candidate gene and genome-wide association studies would enable us to investigate the putative targets for the development of disease etiology-based antidepressant that might be more promising than current ones.
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Bromis K, Calem M, Reinders AATS, Williams SCR, Kempton MJ. Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder. Am J Psychiatry 2018; 175:989-998. [PMID: 30021460 PMCID: PMC6169727 DOI: 10.1176/appi.ajp.2018.17111199] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The authors conducted a comprehensive meta-analysis of MRI region-of-interest and voxel-based morphometry (VBM) studies in posttraumatic stress disorder (PTSD). Because patients have high rates of comorbid depression, an additional objective was to compare the findings to a meta-analysis of MRI studies in depression. METHOD The MEDLINE database was searched for studies from 1985 through 2016. A total of 113 studies met inclusion criteria and were included in an online database. Of these, 66 were selected for the region-of-interest meta-analysis and 13 for the VBM meta-analysis. The region-of-interest meta-analysis was conducted and compared with a meta-analysis of major depressive disorder. Within the region-of-interest meta-analysis, three subanalyses were conducted that included control groups with and without trauma. RESULTS In the region-of-interest meta-analysis, patients with PTSD compared with all control subjects were found to have reduced brain volume, intracranial volume, and volumes of the hippocampus, insula, and anterior cingulate. PTSD patients compared with nontraumatized or traumatized control subjects showed similar changes. Traumatized compared with nontraumatized control subjects showed smaller volumes of the hippocampus bilaterally. For all regions, pooled effect sizes (Hedges' g) varied from -0.84 to 0.43, and number of studies from three to 41. The VBM meta-analysis revealed prominent volumetric reductions in the medial prefrontal cortex, including the anterior cingulate. Compared with region-of-interest data from patients with major depressive disorder, those with PTSD had reduced total brain volume, and both disorders were associated with reduced hippocampal volume. CONCLUSIONS The meta-analyses revealed structural brain abnormalities associated with PTSD and trauma and suggest that global brain volume reductions distinguish PTSD from major depression.
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Affiliation(s)
- Konstantinos Bromis
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Maria Calem
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Antje A T S Reinders
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Steven C R Williams
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Matthew J Kempton
- From the Department of Neuroimaging and the Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London; the School of Psychology, University of Sussex, Brighton, U.K.; and the School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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Oberste M, Großheinrich N, Wunram HL, Graf JL, Ziemendorff A, Meinhardt A, Fricke O, Mahabir E, Bender S. Effects of a 6-week, whole-body vibration strength-training on depression symptoms, endocrinological and neurobiological parameters in adolescent inpatients experiencing a major depressive episode (the "Balancing Vibrations Study"): study protocol for a randomized placebo-controlled trial. Trials 2018; 19:347. [PMID: 29970142 PMCID: PMC6029053 DOI: 10.1186/s13063-018-2747-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/19/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Moderate to vigorous endurance and strength-training exercise was suggested as a treatment option for major depression. However, there is little evidence to support this suggestion in adolescent patients. The present study investigates the effects of a whole-body vibration strength-training intervention on symptoms in medication-naïve adolescent inpatients experiencing a major depressive episode. Potential underlying endocrinological and neurobiological mechanisms are explored. METHODS/DESIGN A double-blinded randomized controlled trial is conducted at the University Hospital of Cologne in Germany, comparing a 6-week, whole-body vibration strength-training with a 6-week placebo-intervention, as add-on therapy to inpatient treatment as usual. Forty-one subjects (13-18 years of age) will be included in each of the two groups. The study is powered to detect (α = .05, β = .2) a medium effect size difference between the two groups (d = .5) in terms of patients' change in the Children's Depression Rating Scale raw-score, from baseline until the end of the intervention. As secondary endpoints, the effects of exercise treatment on patients' cortisol awakening response as well as on brain-derived neurotrophic factor, insulin-like growth factor 1 and inflammatory markers (tumor necrosis factor-alpha, interleukin-6 and C-reactive protein) serum levels will be assessed. DISCUSSION This study will provide evidence on the effectiveness of whole-body vibration strength-training as an add-on therapy in adolescent inpatients experiencing a major depressive episode. After completion of data collection, the present study will be the largest randomized controlled trial so far to investigate the effectiveness of an exercise intervention in inpatient adolescents suffering from a major depressive episode. Moreover, the present study may help to determine the underlying mechanisms of potential anti-depressant effects of exercise in depressed adolescent inpatients. TRIAL REGISTRATION DRKS.de, German Clinical Trials Register (DRKS), Identifier: DRKS00011772 . Registered on 20 March 2017.
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Affiliation(s)
- Max Oberste
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
| | - Nicola Großheinrich
- Department of Social Sciences, Catholic University of Applied Science of North Rhine – Westphalia, Wörthstraße 10, 50688 Cologne, Germany
| | - Heidrun-Lioba Wunram
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
| | - Johannes Levin Graf
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
| | - Alischa Ziemendorff
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
| | - Axel Meinhardt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
| | - Oliver Fricke
- Chair of Child and Adolescent Psychiatry, Witten/Herdecke University and Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
| | - Esther Mahabir
- Comparative Medicine, Center for Molecular Medicine Cologne, University of Cologne, Robert-Koch-Str. 21, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Robert-Koch-Straße 10, 50931 Cologne, Germany
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Juruena MF, Bocharova M, Agustini B, Young AH. Atypical depression and non-atypical depression: Is HPA axis function a biomarker? A systematic review. J Affect Disord 2018; 233:45-67. [PMID: 29150144 DOI: 10.1016/j.jad.2017.09.052] [Citation(s) in RCA: 189] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/11/2017] [Accepted: 09/26/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND The link between the abnormalities of the Hypothalamic-pituitary-adrenal (HPA) axis and depression has been one of the most consistently reported findings in psychiatry. At the same time, multiple studies have demonstrated a stronger association between the increased activation of HPA-axis and melancholic, or endogenous depression subtype. This association has not been confirmed for the atypical subtype, and some researchers have suggested that as an antinomic depressive subtype, it may be associated with the opposite type, i.e. hypo-function, of the HPA-axis, similarly to PTSD. The purpose of this systematic review is to summarise existing studies addressing the abnormalities of the HPA-axis in melancholic and/or atypical depression. METHOD We conducted a systematic review in the literature by searching MEDLINE, PsycINFO, OvidSP and Embase databases until June 2017. The following search items were used: "hypothalamic-pituitary-adrenal" OR "HPA" OR "cortisol" OR "corticotropin releasing hormone" OR "corticotropin releasing factor" OR "glucocorticoid*" OR "adrenocorticotropic hormone" OR "ACTH" AND "atypical depression" OR "non-atypical depression" OR "melancholic depression" OR "non-melancholic depression" OR "endogenous depression" OR "endogenomorphic depression" OR "non-endogenous depression". Search limits were set to include papers in English or German language published in peer-reviewed journals at any period. All studies were scrutinized to determine the main methodological characteristics, and particularly possible sources of bias influencing the results reported. RESULTS We selected 48 relevant studies. Detailed analysis of the methodologies used in the studies revealed significant variability especially regarding the samples' definition comparing the HPA axis activity of melancholic patients to atypical depression, including healthy controls. The results were subdivided into 4 sections: (1) 27 studies which compared melancholic OR endogenous depression vs. non-melancholic or non-endogenous depression or controls; (2) 9 studies which compared atypical depression or atypical traits vs. non-atypical depression or controls; (3) 7 studies which compared melancholic or endogenous and atypical depression subtypes and (4) 5 studies which used a longitudinal design, comparing the measures of HPA-axis across two or more time points. While the majority of studies did confirm the association between melancholic depression and increased post-challenge cortisol levels, the association with increases in basal cortisol and basal ACTH were less consistent. Some studies, particularly those focusing on reversed vegetative symptoms, demonstrated a decrease in the activity of the HPA axis in atypical depression compared to controls, but the majority did not distinguish it from healthy controls. CONCLUSIONS In conclusion, our findings indicate that there is a difference in the activity of the HPA-axis between melancholic and atypical depressive subtypes. However, these are more likely explained by hypercortisolism in melancholia; and most often normal than decreased function in atypical depression. Further research should seek to distinguish a particular subtype of depression linked to HPA-axis abnormalities, based on symptom profile, with a focus on vegetative symptoms, neuroendocrine probes, and the history of adverse childhood events. New insights into the dichotomy addressed in this review might be obtained from genetic and epigenetic studies of HPA-axis related genes in both subtypes, with an emphasis on the presence of vegetative symptoms.
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Affiliation(s)
- Mario F Juruena
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London, UK; Department of Neuroscience and Behavior, School of Medicine of Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil.
| | - Mariia Bocharova
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London, UK
| | - Bruno Agustini
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London, UK
| | - Allan H Young
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust (SLaM) and King's College London, UK
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Lacerda MS, Cirelli MA, Barros ALBLD, Lopes JDL. Anxiety, stress and depression in family members of patients with heart failure. Rev Esc Enferm USP 2017; 51:e03211. [PMID: 28327877 DOI: 10.1590/s1980-220x2016018903211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/30/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identifying the level of anxiety, stress and depression symptoms in family members of patients with heart failure; identifying the relationship between these feelings with sociodemographic and clinical variables. METHOD A cross-sectional study carried out with 100 family members. Depression, anxiety, and stress were evaluated by the Beck Depression and Anxiety Inventories and the Perceived Stress Scale - 10. The relationship between feelings and variables was performed through the t-test, Mann-Whitney or Kruskal-Wallis. RESULTS Mean depression was 8.24, anxiety was 77.95, and stress was 17.43. The correlation coefficient between depression and anxiety and depression and stress was 0.53, and it was 0.66 between anxiety and stress. Females (p=0.002, p=0.031), smoking (p=0.05, p=0.011) and sedentary lifestyle (p=0.023, p=0.001) were related to anxiety and stress, respectively. Family income lower than five minimum wages (p=0.012) was related to depression, and regular/poor self-perceived health status related to the three feelings. CONCLUSION Family members did not present high levels of these feelings. The scales were directly correlated with each one another and some variables were related to stress, anxiety and depression. OBJETIVO Identificar o nível de ansiedade, estresse e sintomas de depressão de familiares de pacientes com insuficiência cardíaca; identificar a relação entre esses sentimentos com as variáveis sociodemográficas e clínicas. MÉTODO Estudo transversal composto por 100 familiares. A depressão, a ansiedade e o estresse foram avaliados pelos Inventários de Depressão e Ansiedade de Beck e pela Escala de Estresse Percebido ‒ 10. A relação dos sentimentos com as variáveis foi realizada pelo teste t, Mann-Whitney ou Kruskal-Wallis. RESULTADOS A média de depressão foi de 8,24, ansiedade, 7,95 e estresse, 17,43. O coeficiente de correlação entre depressão e ansiedade e depressão e estresse foi de 0,53 e de 0,66 entre ansiedade e estresse. Sexo feminino (p=0,002; p=0,031), tabagismo (p=0,05; p=0,011) e sedentarismo (p=0,023; p=0,001) se relacionaram com a ansiedade e estresse respectivamente. Renda familiar menor que cinco salários mínimos (p=0,012) se relacionou com a depressão, e autoavaliação de saúde regular/ruim se relacionou com os três sentimentos. CONCLUSÃO Os familiares não apresentaram níveis elevados desses sentimentos. As escalas foram diretamente correlacionadas entre si e algumas variáveis se relacionaram com estresse, ansiedade e depressão.
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Affiliation(s)
| | - Melissa Alves Cirelli
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
| | | | - Juliana de Lima Lopes
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brazil
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Antidepressant-like effects of ginsenosides: A comparison of ginsenoside Rb3 and its four deglycosylated derivatives, Rg3, Rh2, compound K, and 20(S)-protopanaxadiol in mice models of despair. Pharmacol Biochem Behav 2015; 140:17-26. [PMID: 26528894 DOI: 10.1016/j.pbb.2015.10.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/21/2022]
Abstract
Ginsenoside Rb3 has been proved to have antidepressant-like effects, which possesses 1 xylose and 3 glucose moieties with 20(S)-protopanaxadiol (PPD) as the aglycone. However, it is commonly accepted that orally ingested ginsenosides can be deglycosylated or partially deglycosylated into active derivatives by the intestinal bacteria. To identify potential antidepressant drug candidates, we compared the antidepressant-like activities between ginsenoside Rb3 and its four deglycosylated derivatives, Rg3, Rh2, compound K (C-K), and PPD. Effects of acute (1-day), short chronic (7-days), and longer chronic treatments (14-days) with these ginsenosides (50 and 100mg/kg, p.o.) on the behavioral changes in the forced swim test (FST), tail suspension test (TST) and open field test were investigated. Serum corticosterone and adrenocorticotropic hormone (ACTH) levels and mouse brain monoamine neurotransmitters 5-HT, NA and DA levels were measured using commercially available competitive enzyme-linked immunosorbent assay (ELISA) kits. Interestingly, C-K showed antidepressant-like activities similar to that of Rb3, and Rg3 displayed antidepressant-like effects at lower dosage and faster time, indicating it has better effects than Rb3, whereas Rh2 and PPD failed to show any effect. Our results also showed, unlike the positive control fluoxetine, Rb3, Rg3 and C-K significantly increased the NA levels in the brain regions of mice exposed to FST but did not affect the 5-HT and DA levels. Moreover, treatment with Rg3 could reverse swim stress-induced increased levels of serum ACTH and corticosterone. These results suggest that C-K and Rg3 are the active deglycosylated derivatives, especially the latter compound, which is more potent than Rb3 and exerts antidepressant-like effects by regulating NA, ACTH and corticosterone levels.
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Depressive symptoms and suicidal ideation in adolescents accompanying a parent in recyclable trash collection. SPANISH JOURNAL OF PSYCHOLOGY 2015; 17:E13. [PMID: 25011630 DOI: 10.1017/sjp.2014.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The relationship between mental health and poverty has been well documented in adults. However, few studies have addressed how low socioeconomic status and psychosocial vulnerabilities may influence depressive symptoms in adolescents. The current study was carried out in a non-randomly selected sample of 239 adolescents whose parents work as ragpickers (waste collectors for recycling) in Brazil. In-person interviews were conducted, and the presence of depressive symptoms and suicidal ideation were assessed using the Children's Depression Inventory (CDI). We observed that 23% (CI ± 5.34) of the adolescents presented with depressive symptoms and 35% (CI ± 6.05) had suicidal ideation. Fatigue or loss of energy (p = .012) and irritable mood (p = .013) were significantly higher among boys than girls according to DSM-IV criteria. However, we found no gender differences in DSM-IV criteria for Major Depressive Disorders (MDD) or Dysthymic Disorder (DD) in diminished interest or pleasure, weight loss or weight gain, decreased appetite, sleep problems, feelings of worthlessness, diminished concentration or ability to think, recurrent thoughts of death, suicidal ideation, or low self-esteem. There were no significant gender differences in total CDI score, however a greater percentage of girls presented with depressed mood than boys (29.9% vs. 17.1%, p < .05).
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Mello AF, Juruena MF, Maciel MR, Cavalcante-Nobrega LP, Cividanes GC, Fossaluza V, Calsavara V, Mello MF, Cleare AJ, Mari JDJ. Factors related to the cortisol awakening response of children working on the streets and siblings, before and after 2 years of a psychosocial intervention. Psychiatry Res 2015; 225:625-30. [PMID: 25500347 DOI: 10.1016/j.psychres.2014.11.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 10/27/2014] [Accepted: 11/08/2014] [Indexed: 02/08/2023]
Abstract
The study objective was to observe the cortisol awakening response (CAR) pattern before and after a psychosocial intervention with children from dysfunctional families who had at least one child working on the streets, and to verify factors related to it. Two hundred and eleven children between 7 and 14 years old were selected and 191 were included, 178 were re-evaluated 2 years after, of whom 113 had cortisol measures completed. Besides cortisol, they were evaluated at baseline and at end point regarding: abuse/neglect, mental health symptoms, exposure to urban violence and family environment. There was no significant difference between the CAR area under the curve (AUC) before and after the intervention. Two regression analysis models were built to evaluate factors related to the CAR before and after intervention. Before the intervention, working on the streets (vs. not) was related to a greater cortisol increase after awakening, at follow-up, having suffered physical punishment (vs. not) was related to a flattened cortisol response. The intervention was not associated with changes in the magnitude of the CAR AUC, though the CAR was associated with psychosocial stressors pre- and post-intervention. Effective interventions for children at risk that might shape a physiological cortisol response are still needed.
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Affiliation(s)
- Andrea Feijo Mello
- Department of Psychiatry, Paulista Medical School, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Mario Francisco Juruena
- Department of Neurosciences and Behaviour, Faculty of Medicine Ribeirao Preto, University of Sao Paulo, Sao Paulo, Brazil; King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
| | - Mariana Rangel Maciel
- Department of Psychiatry, Paulista Medical School, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Victor Fossaluza
- Mathematics and Statistics Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Vinicius Calsavara
- Mathematics and Statistics Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Marcelo Feijo Mello
- Department of Psychiatry, Paulista Medical School, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Anthony James Cleare
- King׳s College London, Institute of Psychiatry, Department of Psychological Medicine, London, UK
| | - Jair de Jesus Mari
- Department of Psychiatry, Paulista Medical School, Federal University of Sao Paulo, Sao Paulo, Brazil
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Li YC, Shen JD, Li YY, Huang Q. Antidepressant effects of the water extract from Taraxacum officinale leaves and roots in mice. PHARMACEUTICAL BIOLOGY 2014; 52:1028-1032. [PMID: 24611722 DOI: 10.3109/13880209.2013.876432] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
CONTEXT The leaves and roots of the Taraxacum officinale F. (Asteraceae) is widely used as traditional medicinal herb in Eastern Asian countries. OBJECTIVE In the present study, the antidepressant-like effects of the water extract of T. officinale (WETO) leaves and roots were investigated in mice using forced swimming test (FST), tail suspension test (TST) and open field test (OFT). MATERIALS AND METHODS Effects of acute (1-day) and chronic treatments (14-days) with WETO (50, 100 and 200 mg/kg) on the behavioral changes in FST, TST and OFT, and the serum corticotrophin releasing factor (CRF), adrenocorticotropic hormone (ACTH) and corticosterone concentration were assessed in mice. RESULTS Chronic treatment (14-days) with WETO at the doses of 50, 100 and 200 mg/kg significantly decreased the immobility time in both FST (92.6, 85.1 and 77.4 s) and TST (84.8, 72.1 and 56.9 s). Acute treatment (1-day) with WETO at a dose of 200 mg/kg also markedly decreased the immobility time in both FST (81.7 s) and TST (73.2 s). However, all treatments did not affect the locomotor activity in the OFT. Moreover, FST induced a significant increase in serum CRF (5.8 ng/ml), ACTH (104.7 pg/ml) and corticosterone levels (37.3 ng/ml). Chronic treatment (14-days) with WETO decreased the serum CRF (200 mg/kg: 3.9 ng/ml) and corticosterone (50 mg/kg: 29.9 ng/ml; 100 mg/kg: 22.5 ng/ml; 200 mg/kg: 19.8 ng/ml) levels. DISCUSSION AND CONCLUSION These results clearly demonstrated the antidepressant effects of WETO in animal models of behavioral despair and suggested the mechanism involved in the neuroendocrine system.
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Affiliation(s)
- Yu-Cheng Li
- College of Pharmacy, Henan University of Traditional Chinese Medicine , Zhengzhou, Henan Province , PR China
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Feitosa FB. A depressão pela perspectiva biopsicossocial e a função protetora das habilidades sociais. PSICOLOGIA: CIÊNCIA E PROFISSÃO 2014. [DOI: 10.1590/1982-3703000992013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A alta prevalência da depressão na população requer que os profissionais da saúde estejam preparados para compreendê-la em seus múltiplos determinantes. O presente ensaio seguiu uma perspectiva biopsicossocial de análise da literatura, reunindo informações sobre os fatores de risco e proteção associados aos sintomas depressivos. A análise da literatura mostrou que a depressão, embora multideterminada, frequentemente está associada a problemas interpessoais que podem ser resolvidos pelo aprimoramento de habilidades sociais. As habilidades sociais contribuem para a redução dos sintomas depressivos à medida que alteram as condições do ambiente vivencial da pessoa, incluindo a construção de suporte social, o aumento da autoconfiança e autoestima nas relações interpessoais, a diminuição do estresse e o aumento nos reforçadores sociais em geral. A aplicação de programas de promoção de habilidades sociais na recuperação de pessoas com depressão, a necessidade de pesquisas mais específicas dentro da temática e algumas questões de pesquisa para novos estudos são discutidas.
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Vignola RCB, Tucci AM. Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. J Affect Disord 2014; 155:104-9. [PMID: 24238871 DOI: 10.1016/j.jad.2013.10.031] [Citation(s) in RCA: 240] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 10/22/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Depression and anxiety have been associated with a range of symptoms that often overlap. Depression, Anxiety and Stress Scale-21 (DASS-21) is a single instrument to assess symptoms of depression, anxiety and stress. This study aimed to adapt and validate the DASS-21 for use in the Brazilian Portuguese language. METHODS The DASS-21 has been adapted following the translation-back translation methodology from English to Portuguese. 242 subjects completed the following assessments: the DASS-21, the Beck Depression Index (BDI), Beck Anxiety Index (BAI) and the Inventory of Stress Symptoms of Lipp (ISSL). RESULTS The Kaiser-Meyer-Olkin (KMO) result was .949, indicating that the adequacy of the model was high. Cronbach's alpha was .92 for the depression, .90 for the stress, and .86 for the anxiety, indicating a good internal consistency for each subscale. The correlations between DASS scale and BDI scale, BAI scale and ISSL inventory were strong. The factorial analysis and distribution of factors among the subscales indicated that the structure of three distinct factors is adequate. LIMITATIONS Older subjects over 65 years of age were not largely represented in this sample. A study specific to this elderly population should be conducted. Another limitation of the study was education level. The impact of low education in its applicability should be considered. CONCLUSIONS The findings support the validity of the Brazilian Portuguese version of the DASS-21 and add to the evidence of the DASS-21 quality and ability to assess emotional states separately, eliminating the use of different instruments to assess these states.
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Baes CVW, Martins CMS, Tofoli SMDC, Juruena MF. Early Life Stress in Depressive Patients: HPA Axis Response to GR and MR Agonist. Front Psychiatry 2014; 5:2. [PMID: 24478730 PMCID: PMC3900767 DOI: 10.3389/fpsyt.2014.00002] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2013] [Accepted: 01/04/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Evidence indicates that early life stress (ELS) can induce persistent changes in the hypothalamic-pituitary-adrenal (HPA) axis to respond to stress in the adult life that leads to depression. These appear to be related to the impairment of HPA hormones through binding to glucocorticoid (GR) and mineralocorticoid receptors (MR). The aim of this study was to evaluate the impact of ELS in HPA axis response to challenges with GR and MR agonists in depressed patients. METHODS We included 30 subjects, 20 patients with current major depression (HAM-D21 ≥ 17). Patients were recruited into two groups according to ELS history assessed by the Childhood Trauma Questionnaire (CTQ). The cortisol measures in the saliva and plasma were evaluated after using (at 10:00 p.m.) placebo, fludrocortisone (MR agonist), or dexamethasone (GR agonist). RESULTS Depressed patients showed a significantly lower salivary cortisol upon waking after placebo compared with controls. Moreover, cortisol awakening responses (CAR) after MR agonist were found to be lower in depressed patients than in controls. With CTQ scores, HAM-D21, body mass index and CAR after placebo, GR agonist, MR agonist we found in a Linear Regression model that depressive patients with ELS (p = 0.028) show differences between placebo vs. MR agonist (R = 0.51; p < 0.05) but not after GR agonist; in depressive patients, without ELS the data show differences between placebo vs. MR agonist (R = 0.69; p < 0.05); but now as well placebo vs. GR agonist (R = 0.53; p < 0.05). CONCLUSION Our findings indicate that MR activity is impaired in depressed patients compared with controls. Furthermore, in spite of the previous limitations described, in depressed patients with ELS, there was suppression by MR agonist, indicating that patients with ELS are sensitive to MR agonists. In contrast with depressed patients without ELS, we find suppression after both MR and GR agonist. These data suggested that in ELS an imbalance exists between MR and GR with MR dysfunction.
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Affiliation(s)
- Cristiane von Werne Baes
- Stress and Affective Disorders – SAD Program, Mental Health Graduate Program, Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Camila Maria Severi Martins
- Stress and Affective Disorders – SAD Program, Mental Health Graduate Program, Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Sandra Márcia de Carvalho Tofoli
- Stress and Affective Disorders – SAD Program, Mental Health Graduate Program, Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Mário Francisco Juruena
- Stress and Affective Disorders – SAD Program, Mental Health Graduate Program, Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
- Institute of Psychiatry, King’s College London, London, UK
- *Correspondence: Mário Francisco Juruena, Saude Mental, University of São Paulo, Avenue Tenente Catão Roxo, 2650, Ribeirão Preto, São Paulo CEP: 14051-140, Brazil e-mail:
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Schellekens H, Finger BC, Dinan TG, Cryan JF. Ghrelin signalling and obesity: at the interface of stress, mood and food reward. Pharmacol Ther 2012; 135:316-26. [PMID: 22749794 DOI: 10.1016/j.pharmthera.2012.06.004] [Citation(s) in RCA: 147] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 06/07/2012] [Indexed: 12/14/2022]
Abstract
The neuronal circuitry underlying the complex relationship between stress, mood and food intake are slowly being unravelled and several studies suggest a key role herein for the peripherally derived hormone, ghrelin. Evidence is accumulating linking obesity as an environmental risk factor to psychiatric disorders such as stress, anxiety and depression. Ghrelin is the only known orexigenic hormone from the periphery to stimulate food intake. Plasma ghrelin levels are enhanced under conditions of physiological stress and ghrelin has recently been suggested to play an important role in stress-induced food reward behaviour. In addition, chronic stress or atypical depression has often demonstrated to correlate with an increase in ingestion of caloric dense 'comfort foods' and have been implicated as one of the major contributor to the increased prevalence of obesity. Recent evidence suggests ghrelin as a critical factor at the interface of homeostatic control of appetite and reward circuitries, modulating the hedonic aspects of food intake. Therefore, the reward-related feeding of ghrelin may reveal itself as an important factor in the development of addiction to certain foods, similar to its involvement in the dependence to drugs of abuse, including alcohol. This review will highlight the accumulating evidence demonstrating the close interaction between food, mood and stress and the development of obesity. We consider the ghrelinergic system as an effective target for the development of successful anti-obesity pharmacotherapies, which not only affects appetite but also selectively modulates the rewarding properties of food and impact on psychological well-being in conditions of stress, anxiety and depression.
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Schuhmacher A, Mössner R, Jessen F, Scheef L, Block W, Belloche AC, Lennertz L, Welper H, Höfels S, Pfeiffer U, Wagner M, Maier W, Schwab S, Zobel A. Association of amygdala volumes with cortisol secretion in unipolar depressed patients. Psychiatry Res 2012; 202:96-103. [PMID: 22698761 DOI: 10.1016/j.pscychresns.2011.09.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 09/13/2011] [Accepted: 09/14/2011] [Indexed: 01/08/2023]
Abstract
Major depressive disorder (MDD) is accompanied by morphological changes of brain structures which are of great importance in the neural circuitry mediating depression like the hippocampus and the amygdala. Hyperactivity of the hypothalamic-pituitary-adrenocortical (HPA) system resulting in enhanced glucocorticoid secretion can often be observed during depression and has been thought to play an important role in inducing these morphological changes. We used magnetic resonance imaging to investigate alterations of amygdala and hippocampal volumes in 86 in-patients with unipolar depression and 87 healthy controls, and we then correlated amygdala and hippocampal volumes of 76 in-patients with the area under the curve of cortisol secretion in the dexamethasone/corticotropin releasing hormone (Dex/CRH) test at baseline and during short-term antidepressant therapy. In line with recently published studies both left and right amygdala volumes of patients in a first depressive episode were smaller than those of healthy controls. Patients with recurrent depressive episodes showed a reduction of hippocampal volumes, while amygdala volumes were normal. Larger left and right amygdala volumes correlated with a more pronounced reduction of HPA activity, measured by the cortisol secretion in the combined DEX/CRH test, during antidepressant therapy in patients with recurrent depressive episodes.
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Affiliation(s)
- Anna Schuhmacher
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
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Valiengo LL, Soeiro-de-Souza MG, Marques AH, Moreno DH, Juruena MF, Andreazza AC, Gattaz WF, Machado-Vieira R. Plasma cortisol in first episode drug-naïve mania: differential levels in euphoric versus irritable mood. J Affect Disord 2012; 138:149-52. [PMID: 22305430 PMCID: PMC4479259 DOI: 10.1016/j.jad.2011.11.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 11/30/2011] [Indexed: 02/08/2023]
Abstract
BACKGROUND Dysregulation of HPA axis has been widely described in subjects with bipolar disorder (BD), including changes in cortisol levels during mood episodes and euthymia. However, most of the studies were done with medicated BD patients with variable length of illness, which was shown to interfere on peripheral cortisol levels. Therefore, the present study aims to evaluate plasma cortisol levels in drug-naïve BD subjects during the first manic episode, as well as investigate the relationship between plasma cortisol levels and manic symptomatology. METHODS Twenty-six drug-naïve patients were enrolled meeting criteria for a first manic episode in bipolar I disorder. Severity of mania was assessed using the Young Mania Rating Scale (YMRS). The control group included 27 healthy subjects matched by age and gender. Cortisol was quantified using a direct radioimmunoassay. RESULTS Plasma cortisol levels were decreased during first manic episode compared to healthy controls. Higher cortisol levels were positively associated with the presence of irritability (dysphoria), while elated mania showed lower cortisol levels compared to controls. LIMITATION Data including larger samples are lacking. CONCLUSION Higher cortisol in dysphoric mania compared to predominantly elated/euphoric mania may indicate a clinical and neurobiological polymorphic phenomenon, potentially involving a higher biological sensitivity to stress in the presence of irritable mood. The present findings highlight the importance to add a dimensional approach to the traditional categorical diagnosis for future neurobiological studies in BD.
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Affiliation(s)
- Leandro L. Valiengo
- Laboratory of Neuroscience, LIM-27, Institute and Department of Psychiatry, University of São Paulo, SP, Brazil
| | - Márcio G. Soeiro-de-Souza
- Mood Disorders Unit GRUDA, Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), Brazil
| | - Andrea H. Marques
- Genetic Epidemiology Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
- Department of Epidemiology, Columbia University, Mailman School of Public Health, New York, NY, USA
| | - Doris H. Moreno
- Mood Disorders Unit GRUDA, Department and Institute of Psychiatry, School of Medicine, University of Sao Paulo (HC-FMUSP), Brazil
| | - Mário F. Juruena
- Department of Neurosciences and Behavioral Sciences, USP, Ribeirão Preto, SP, Brazil
| | | | - Wagner F. Gattaz
- Laboratory of Neuroscience, LIM-27, Institute and Department of Psychiatry, University of São Paulo, SP, Brazil
| | - Rodrigo Machado-Vieira
- Laboratory of Neuroscience, LIM-27, Institute and Department of Psychiatry, University of São Paulo, SP, Brazil
- Corresponding author at: LIM-27, Institute of Psychiatry, University of Sao Paulo, Rua Ovidio Pires de Campos, 785, CEP 01060-970, Sao Paulo, SP, Brazil. Tel.: +55 11 9889 8887; fax: +55 11 30697267. (R. Machado-Vieira)
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Von Werne Baes C, de Carvalho Tofoli SM, Martins CMS, Juruena MF. Assessment of the hypothalamic-pituitary-adrenal axis activity: glucocorticoid receptor and mineralocorticoid receptor function in depression with early life stress - a systematic review. Acta Neuropsychiatr 2012; 24:4-15. [PMID: 28183380 DOI: 10.1111/j.1601-5215.2011.00610.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The mechanisms involved in the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, especially in the functioning of glucocorticoid receptor (GR) and mineralocorticoid receptor (MR) in depressed patients, are not well elucidated. The objective of this study was to conduct a systematic review of articles that assess the HPA axis activity from GR and MR in depressed patients and healthy controls with or without early life stress. METHODS We conducted a systematic review of articles in PubMed, SCOPUS and SciELO published between 2000 and 2011, using the following search terms: child abuse, depression, HPA axis, dexamethasone, prednisolone, fludrocortisone and spironolactone. Thirty-four papers were selected for this review. RESULTS Most studies identified in this review used the dexamethasone/corticotropin-releasing hormone test and dexamethasone suppression test. In these studies, hypercortisolaemia was associated with depression. We identified three studies with the Prednisolone suppression test, only one study with the use of fludrocortisone and one with spironolactone. This review found nine studies that evaluated the HPA axis in individuals with early life stress. CONCLUSIONS The majority of the studies assessed in this review show that early life stress leads to permanent changes in the HPA axis and may lead to development of depression in adults. The most consistent findings in the literature show increased activity of the HPA axis in depression associated with hypercortisolaemia and reduced inhibitory feedback. These findings suggest that this dysregulation of the HPA axis is partially attributable to an imbalance between GR and MR. Evidences have consistently showed that GR function is impaired in major depression, but few studies have assessed the activity of MR in depression and early life stress.
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Affiliation(s)
- Cristiane Von Werne Baes
- Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brasil
| | - Sandra M de Carvalho Tofoli
- Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brasil
| | - Camila Maria S Martins
- Department of Neuroscience and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brasil
| | - Mario F Juruena
- Stress and Affective Disorders Programme, Department of Neurosciences and Behaviour, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brasil
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Effects of chronic stress: A comparison between tethered and loose sows. Physiol Behav 2010; 100:154-64. [DOI: 10.1016/j.physbeh.2010.02.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2009] [Revised: 02/15/2010] [Accepted: 02/19/2010] [Indexed: 01/21/2023]
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Marques AH, Silverman MN, Sternberg EM. Glucocorticoid dysregulations and their clinical correlates. From receptors to therapeutics. Ann N Y Acad Sci 2009; 1179:1-18. [PMID: 19906229 PMCID: PMC2933142 DOI: 10.1111/j.1749-6632.2009.04987.x] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Clinicians have long known that a substantial proportion of patients treated with high-dose glucocorticoids experience a variety of serious side effects, including metabolic syndrome, bone loss, and mood shifts, such as depressive symptomatology, manic or hypomanic symptoms, and even suicide. The reason for individual variability in expression or severity of these side effects is not clear. However, recent emerging literature is beginning to shed light on possible mechanisms of these effects. As an introduction to this volume, this chapter will review the basic biology of glucocorticoid release and molecular mechanisms of glucocorticoid receptor function, and will discuss how dysregulation of glucocorticoid action at all levels could contribute to such side effects. At the molecular level, glucocorticoid receptor polymorphisms may be associated either with receptor hypofunction or hyperfunction and could thus contribute to differential individual sensitivity to the effects of glucocorticoid treatment. Numerous factors regulate hypothalamic-pituitary-adrenal (HPA) axis responsiveness, which could also contribute to individual differences in glucocorticoid side effects. One of these is sex hormone status and the influence of estrogen and progesterone on HPA axis function and mood. Another is immune system activity, in which immune molecules, such as interleukins and cytokines, activate the HPA axis and alter brain function, including memory, cognition, and mood. The effects of cytokines in inducing sickness behaviors, which overlap with depressive symptomatology, could also contribute to individual differences in such symptomatology. Taken together, this knowledge will have important relevance for identifying at-risk patients to avoid or minimize such side effects when they are treated with glucocorticoids. A framework for assessment of patients is proposed that incorporates functional, physiological, and molecular biomarkers to identify subgroups of patients at risk for depressive symptomatology associated with glucocorticoid treatment, and for prevention of side effects, which in many cases can be life-threatening.
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Affiliation(s)
- Andrea H Marques
- Section on Neuroendocrine Immunology and Behavior, Integrative Neural Immune Program, National Institute of Mental Health, National Institutes of Health, Rockville, Maryland, USA
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Polanczyk G, Caspi A, Williams B, Price TS, Danese A, Sugden K, Uher R, Poulton R, Moffitt TE. Protective effect of CRHR1 gene variants on the development of adult depression following childhood maltreatment: replication and extension. ACTA ACUST UNITED AC 2009; 66:978-85. [PMID: 19736354 DOI: 10.1001/archgenpsychiatry.2009.114] [Citation(s) in RCA: 210] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
CONTEXT A previous study reported a gene x environment interaction in which a haplotype in the corticotropin-releasing hormone receptor 1 gene (CRHR1) was associated with protection against adult depressive symptoms in individuals who were maltreated as children (as assessed by the Childhood Trauma Questionnaire [CTQ]). OBJECTIVE To replicate the interaction between childhood maltreatment and a TAT haplotype formed by rs7209436, rs110402, and rs242924 in CRHR1, predicting adult depression. DESIGN Two prospective longitudinal cohort studies. SETTING England and New Zealand. PARTICIPANTS Participants in the first sample were women in the E-Risk Study (N = 1116), followed up to age 40 years with 96% retention. Participants in the second sample were men and women in the Dunedin Study (N = 1037), followed up to age 32 years with 96% retention. Main Outcome Measure Research diagnoses of past-year and recurrent major depressive disorder. RESULTS In the E-Risk Study, the TAT haplotype was associated with a significant protective effect. In this effect, women who reported childhood maltreatment on the CTQ were protected against depression. In the Dunedin Study, which used a different type of measure of maltreatment, this finding was not replicated. CONCLUSIONS A haplotype in CRHR1 has been suggested to exert a protective effect against adult depression among research participants who reported maltreatment on the CTQ, a measure that elicits emotional memories. This suggests the hypothesis that CRHR1's protective effect may relate to its function in the consolidation of memories of emotionally arousing experiences.
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Affiliation(s)
- Guilherme Polanczyk
- Department of Psychology and Neuroscience, Institute for Genome Sciences and Policy, Duke University, 2020 W Main St, Ste 201, Durham, NC 27708, USA.
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