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Zapater-Fajarí M, Crespo-Sanmiguel I, Perez V, Hidalgo V, Salvador A. Subjective memory complaints in young people: the role of resilience. Psychol Health 2024; 39:1243-1262. [PMID: 36368933 DOI: 10.1080/08870446.2022.2141240] [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: 05/04/2021] [Revised: 04/25/2022] [Accepted: 10/21/2022] [Indexed: 11/14/2022]
Abstract
OBJECTIVE Little is known about the origin and associated factors of subjective memory complaints (SMCs) in the young population, although they might be closely related to the psychophysiological states produced by stress exposure, such as anxiety and depression. In this regard, resilience has been related to a reduction in these negative states, as well as to more adaptive hypothalamic-pituitary-adrenal (HPA) axis functioning. We aimed to investigate the importance of depression, anxiety, and HPA axis activity in SMCs in the young population. We also analysed the relationship between resilience and SMCs through the mediation of depression, anxiety, and the cortisol awakening response (CAR). DESIGN To do so, we measured SMCs, depression and anxiety states, resilience, and the CAR in 77 healthy young people. RESULTS Both depression and anxiety were associated with SMCs. In addition, greater resilience was related to fewer SMCs through depression and anxiety. However, the CAR was not related to SMCs, and it did not mediate the relationship between resilience and SMCs. CONCLUSION These results suggest that negative affective states have greater importance in SMCs than HPA functioning in this age group, and they also highlight the importance of resilience in the psychological adjustment to stressful situations.
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Affiliation(s)
- Mariola Zapater-Fajarí
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Isabel Crespo-Sanmiguel
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Perez
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
- IIS Aragón, Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain
| | - Alicia Salvador
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
- Spanish National Network for Research in Mental Health CIBERSAM, Madrid, Spain
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Pachimsawat P, Ratanachamnong P, Jantaratnotai N. Exogenous melatonin's effect on salivary cortisol and amylase: A randomized controlled trial. Pharmacol Res Perspect 2024; 12:e1205. [PMID: 38764237 PMCID: PMC11103136 DOI: 10.1002/prp2.1205] [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: 10/30/2023] [Revised: 03/07/2024] [Accepted: 04/20/2024] [Indexed: 05/21/2024] Open
Abstract
This study aimed to examine the effect of acute exogenous melatonin administration on salivary cortisol and alpha-amylase (sCort and sAA) as representatives of the HPA axis and the sympathetic nervous system, respectively. A single-dose prolonged-release melatonin (2 mg) or a placebo tablet was given to healthy volunteers (n = 64) at 20:00 h in a crossover design. The saliva was collected at six time points (20:00, 21:00, awakening, 30 min after awakening, 10:00, and 12:00 h) and was measured for sCort, sAA, and salivary melatonin (sMT) levels. Pulse rates and sleep parameters were also collected. Melatonin was effective in improving sleep onset latency by 7:04 min (p = .037) and increasing total sleep time by 24 min (p = .006). Participants with poor baseline sleep quality responded more strongly to melatonin than participants with normal baseline sleep quality as they reported more satisfaction in having adequate sleep (p = .017). Melatonin administration resulted in higher sCort levels at awakening time point (p = .023) and a tendency of lower sAA levels but these were not significant. Melatonin ingestion at 20:00 h resulted in a marked increase in sMT levels at 21:00 h and remained higher than baseline up to at least 10:00 h (p < .001). Melatonin increases sCort levels at certain time point with a tendency to lower sAA levels. These opposing effects of melatonin suggested a complex interplay between melatonin and these biomarkers. Also, the results confirmed the positive acute effect of a single-dose melatonin on sleep quality.
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Affiliation(s)
- Praewpat Pachimsawat
- Department of Advanced General Dentistry, Faculty of DentistryMahidol UniversityBangkokThailand
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Weiss SJ, Xu L. Postpartum symptoms of anxiety, depression and stress: differential relationships to women's cortisol profiles. Arch Womens Ment Health 2024; 27:435-445. [PMID: 38214755 PMCID: PMC11116185 DOI: 10.1007/s00737-024-01421-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
PURPOSE Women are at high risk of stress, anxiety, and depression during the postpartum but the ways in which these different types of psychological distress are related to cortisol regulation is not clear. We examined the distinct association of each type of distress with women's average cortisol level, cortisol awakening response (CAR), cortisol decline across the day (diurnal slope), and overall amount of cortisol secretion across the day (AUCG). METHODS At 6 months postpartum, a diverse group of 58 women completed measures of depression, anxiety, perceived stress, and life stressors. Each woman provided 4 salivary samples for cortisol assay from waking to bedtime on each of 2 consecutive days. Linear regressions were used to examine associations of stress, anxiety and depression to each of the 4 cortisol measures, controlling for number of stressful life events. RESULTS Depressive symptoms were associated with less of a rise in the CAR (β = -.46, p = 0.01), steeper diurnal slope (β = .51, p = 0.006), and higher average cortisol level (β = .42, p = .01). Women who met the clinical cutoff for an anxiety disorder had lower overall cortisol output (β = -.29, p = 0.03). Stress was not related to any cortisol metric. CONCLUSIONS Findings suggest that stress is less associated with cortisol alterations in the postpartum than are more severe types of psychological distress. Anxiety and depression may have distinct and opposite profiles of cortisol dysregulation. Results indicate that mental health assessment is critical even in the later postpartum so that interventions can be initiated to reduce emotional suffering and the risk of impaired cortisol regulation.
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Affiliation(s)
- Sandra J Weiss
- Department of Community Health Systems, University of California, San Francisco, CA, USA.
| | - Ling Xu
- Department of Community Health Systems, University of California, San Francisco, CA, USA
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Kukucka T, Ferencova N, Visnovcova Z, Ondrejka I, Hrtanek I, Kovacova V, Macejova A, Mlyncekova Z, Tonhajzerova I. Mechanisms Involved in the Link between Depression, Antidepressant Treatment, and Associated Weight Change. Int J Mol Sci 2024; 25:4511. [PMID: 38674096 PMCID: PMC11050075 DOI: 10.3390/ijms25084511] [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: 03/29/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Major depressive disorder is a severe mood disorder associated with a marked decrease in quality of life and social functioning, accompanied by a risk of suicidal behavior. Therefore, seeking out and adhering to effective treatment is of great personal and society-wide importance. Weight changes associated with antidepressant therapy are often cited as the reason for treatment withdrawal and thus are an important topic of interest. There indeed exists a significant mechanistic overlap between depression, antidepressant treatment, and the regulation of appetite and body weight. The suggested pathomechanisms include the abnormal functioning of the homeostatic (mostly humoral) and hedonic (mostly dopaminergic) circuits of appetite regulation, as well as causing neuromorphological and neurophysiological changes underlying the development of depressive disorder. However, this issue is still extensively discussed. This review aims to summarize mechanisms linked to depression and antidepressant therapy in the context of weight change.
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Affiliation(s)
- Tomas Kukucka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (N.F.); (Z.V.)
| | - Igor Ondrejka
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Igor Hrtanek
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Veronika Kovacova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Andrea Macejova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Zuzana Mlyncekova
- Clinic of Psychiatry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (T.K.); (I.O.); (I.H.); (V.K.); (A.M.); (Z.M.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia
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Mao B, Xie Z, Liu M, Gong Y, Wang H, Yang S, Liao M, Xiao T, Tang S, Wang Y, Yang YD. Associations of chronotype with anxiety, depression and insomnia among general adult population: A cross-sectional study in Hubei, China. J Affect Disord 2024; 351:250-258. [PMID: 38280566 DOI: 10.1016/j.jad.2024.01.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 01/06/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND The relationship between chronotype and anxiety, depression, and insomnia was inconsistent. We aimed to assess the association between chronotype and mental health and the potential moderating effect of age and socioeconomic status (SES). METHODS A multi-stage sampling cross-sectional study with 12,544 adults was conducted. Chronotype, anxiety, depression, and insomnia were investigated by 5-item Morning and Evening, 7-item Generalized Anxiety Disorder, 9-item Patient Health, and the 7-item Insomnia Severity Index Questionnaires. Logistic regression was conducted. RESULTS The predominant chronotype was morning chronotype (69.2 %), followed by 27.6 % intermediate and 3.2 % evening chronotype. The prevalence of anxiety, depression, and insomnia was 0.7 %, 1.9 %, and 9.6 %, respectively. Compared with intermediate chronotype, morning chronotype participants had a lower risk of anxiety (OR = 0.28,95%CI:0.18-0.44), depression (OR = 0.54,95%CI:0.41-0.72) and insomnia (OR = 0.67,95%CI:0.58-0.77), while evening chronotype participants had a higher risk of depression (OR = 1.98,95%CI:1.06-3.71) but not anxiety or insomnia. Interactions between chronotype with age and SES on insomnia (Pinteraction < 0.05) were found. A more profound association between morning chronotype and insomnia was observed in <65 years participants (OR = 0.59,95%CI:0.50-0.71) and those with monthly household income ≥10,000yuan (OR = 0.21,95%CI:0.12-0.35), compared with their counterparts. LIMITATIONS The cross-sectional design limited causal conclusions. Only adults were included; the findings could not be generalized to children. CONCLUSIONS The morning chronotype might be protective for anxiety, depression, and insomnia, while the evening chronotype might be a risk factor for depression. Future studies are needed to assess the efficacy of chronotype-focused intervention for mental health. Insomnia prevention efforts should pay more attention to the elderly and those with lower incomes.
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Affiliation(s)
- Bin Mao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Zhongliang Xie
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Mengjiao Liu
- School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang 330006, China; Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330006, China
| | - Yue Gong
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Huicai Wang
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Shuwang Yang
- Institute of Chronic Non-Communicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan 430079, China
| | - Ming Liao
- Department of Psychiatry, Honghu Mental Health Center, Shimatou Street 126, Honghu, Jingzhou 434021, China
| | - Tianli Xiao
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China
| | - Shiming Tang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ying Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha 410081, China..
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Jang S, Kim IY, Choi SW, Lee A, Lee JY, Shin H, Lee J, Lee M, Lee KR, Jung S, Ryu JS, Oh J, Kwon M, Kim J, Ahn R, Jung YC, Seok JH. Exploratory Clinical Trial of a Depression Diagnostic Software That Integrates Stress Biomarkers and Composite Psychometrics. Psychiatry Investig 2024; 21:230-241. [PMID: 38569581 PMCID: PMC10990624 DOI: 10.30773/pi.2023.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/09/2023] [Accepted: 11/30/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE This study evaluated the clinical effectiveness of Minds.NAVI, a depression screening kit combining psychometric measures and stress hormone biomarkers, in a prospective clinical trial. The objective was to assess its potential as a depression screening tool and investigate the associations between psychological assessments, salivary hormone staging, and depression severity. METHODS Thirty-five participants with major depressive disorder and 12 healthy controls (HCs) were included. The Minds.NAVI software, utilizing the PROtective and Vulnerable factors battEry Test (PROVE) and salivary cortisol/dehydroepiandrosterone (DHEA) analysis, was employed. The PROVE test is a comprehensive self-report questionnaire that assesses depressive symptoms, suicide risk, attachment style, adverse childhood experiences, mentalization capacity, and resilience. In addition, salivary cortisol and DHEA levels were measured to evaluate the functional stage of the hypothalamic-pituitary-adrenal (HPA) axis. RESULTS Minds.NAVI exhibited 100% sensitivity, 91.7% specificity, and 97.9% accuracy in distinguishing depression from HCs within an exploratory small group. Salivary stress hormone phases showed changes with depression stage (p=0.030), and the proportion of patients with "adrenal exhaustion stage" was higher in the moderate/severe depression group (p=0.038). Protective/vulnerable factors differed significantly between controls and depressed groups (p<0.001). Cortisol awakening response inversely correlated with depressive symptom severity (r=-0.31, p=0.034). CONCLUSION This study suggested possible clinical effectiveness of Minds.NAVI, a depression screening tool that integrates psychometric measures and stress hormone biomarkers. The findings support the potential association between depression, chronic stress, and HPA axis hyporesponsiveness.
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Affiliation(s)
- Sooah Jang
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Sun-Woo Choi
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Anna Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Ju-Yeal Lee
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Hyunkyung Shin
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junwoo Lee
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Mikyeong Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Kyoung-Ryul Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yongin, Republic of Korea
| | - Saeeun Jung
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Jin Sun Ryu
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea
| | - Jihee Oh
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Manjae Kwon
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Joohan Kim
- Department of Communication, Yonsei University, Seoul, Republic of Korea
| | - Ryunsup Ahn
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Hormone Analysis Center, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Chul Jung
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institue of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
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Stańczykiewicz B, Bogudzińska B, Kowalski K, Misiak B. The association between depression and the cortisol awakening response is moderated by loneliness in men from a non-clinical sample. Psychoneuroendocrinology 2024; 160:106924. [PMID: 38086318 DOI: 10.1016/j.psyneuen.2023.106924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/02/2024]
Abstract
Previous studies investigating cortisol levels in people with depression or depressive symptoms have provided mixed findings. It has been suggested that the difficulty to generalize findings across studies in this field might be related to interindividual variability in experiencing depressive symptoms in terms of clinical and social contexts. Therefore, in the present study we aimed to test the association of morning cortisol levels and depressive symptoms in a non-clinical sample of young men taking into consideration the level of perceived loneliness. We hypothesized that the level of loneliness might moderate the association between morning cortisol levels and depressive symptoms. A total of 102 participants (aged 29.9 ± 5.0 years) completed questionnaires measuring the levels of depressive and anxiety symptoms, perceived stress, and loneliness. Cortisol levels were determined in four morning samples of saliva. There were significant positive correlations of the cortisol awakening response (CAR) and the mean increase in cortisol levels during the measurement period (MnInc) with the levels of depressive symptoms and loneliness. Moreover, a significant association of the depressive symptoms by loneliness interaction with the CAR and the MnInc was found. Specifically, the correlation of depressive symptoms with the CAR and the MnInc appeared to be significant and negative at high levels of loneliness. No significant association between depressive symptoms and the CAR was observed in men with low levels of loneliness. There were no significant associations of depressive symptoms, loneliness and the depressive symptoms by loneliness interaction with cortisol levels at awakening. In conclusion, findings from the present study indicate the importance of social contexts in understanding the association between altered activity of the hypothalamic-pituitary-adrenal axis and depressive symptoms in men.
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Affiliation(s)
- Bartłomiej Stańczykiewicz
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland.
| | - Bogna Bogudzińska
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kowalski
- Department of Psychiatry, Division of Consultation Psychiatry and Neuroscience, Wroclaw Medical University, Wroclaw, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Jha P, Dangi N, Sharma S. Probiotics Show Promise as a Novel Natural Treatment for Neurological Disorders. Curr Pharm Biotechnol 2024; 25:799-806. [PMID: 37877144 DOI: 10.2174/0113892010261604230919170143] [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: 05/26/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 10/26/2023]
Abstract
Probiotics are beneficial microorganisms shown to improve human health when consumed regularly and in sufficient quantities. Numerous health benefits can be attained by possessing important metabolites with nutritional and medicinal qualities. It has been shown through scientific research that these living microbial consortiums can influence a variety of mental health outcomes, including but not limited to anxiety, depression, cognitive processes, stress responses, and behavioral patterns. Selected strains of bacteria and yeasts control how the central nervous system (CNS) communicates with the gut-brain axis (GBA) through neuronal, humoral, and metabolic pathways to ease mood. Psychobiotics are substances that can affect the digestive system as well as mood and anxiety. There is scant evidence to validate the beneficial effects of psychiatric drugs in treating neurological diseases or disorders. The therapeutic method of research into psychobiotics opens exciting prospects for the future of the field of development. This review compiles the current evidence available in the scientific literature on the use of probiotics to influence neurological disorders.
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Affiliation(s)
- Preeti Jha
- Department of Biotechnology, Amity Institute of Biotechnology, Amity University, Jaipur, 303002, Rajasthan, India
| | - Neha Dangi
- Department of Pharmaceutical Sciences, Alwar Pharmacy College, M.I.A., Alwar, 301030, Rajasthan, India
| | - Shikha Sharma
- Department of Pharmaceutical Science, Lords University, Alwar, 301028, Rajasthan, India
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9
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Wang R, Kogler L, Derntl B. Sex differences in cortisol levels in depression: A systematic review and meta-analysis. Front Neuroendocrinol 2024; 72:101118. [PMID: 38176541 DOI: 10.1016/j.yfrne.2023.101118] [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: 04/04/2023] [Revised: 12/11/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.
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Affiliation(s)
- Rui Wang
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany.
| | - Lydia Kogler
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany; LEAD Graduate School and Research Network, University of Tübingen, Germany
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10
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Sendi S, Fischer S, Papadopoulos A, Poon L, Rane LJ, Fekadu A, Mondelli V, Cleare AJ. Childhood trauma associated with increased post-awakening cortisol in major depressive disorder. Psychol Med 2023; 53:6397-6402. [PMID: 36792953 PMCID: PMC10520594 DOI: 10.1017/s0033291723000053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 11/23/2022] [Accepted: 01/05/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND Enhanced post-awakening cortisol may serve as a biological marker for individuals with major depressive disorder. However, studies comparing post-awakening cortisol between patients with major depressive disorder (MDD) and healthy controls have produced conflicting findings. The aim of this study was to investigate whether this inconsistency could be due to the effects of childhood trauma. METHODS A total of N = 112 patients with MDD and healthy controls were divided into four groups according to the presence of childhood trauma. Saliva samples were collected at awakening and 15, 30, 45, and 60 min later. The total cortisol output and the cortisol awakening response (CAR) were calculated. RESULTS The total post-awakening cortisol output was significantly higher in patients with MDD as compared to healthy controls, but only in those individuals reporting childhood trauma. The four groups did not differ regarding the CAR. CONCLUSIONS Elevated post-awakening cortisol in MDD may be confined to those with a history of early life stress. Tailoring and/or augmenting of currently available treatments may be required to meet the specific needs of this population.
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Affiliation(s)
- Shabaz Sendi
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychiatry, Austin Health, University of Melbourne, Melbourne, Australia
| | - Susanne Fischer
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Institute of Psychology, Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Andrew Papadopoulos
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucia Poon
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lena J. Rane
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Abebaw Fekadu
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
- Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Global Health & Infection Department, Brighton and Sussex Medical School, Brighton, UK
| | - Valeria Mondelli
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Anthony J. Cleare
- Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
- National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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11
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Ceballos N, Perrotte J, Sharma S, Awofisayo O, Callaway D, Gordon A, Graham R. Women who pre-game: A study of stress and alcohol use in female collegiate predrinkers. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-9. [PMID: 37581956 PMCID: PMC10867280 DOI: 10.1080/07448481.2023.2245499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 07/17/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
Introduction: This study examined the relationship between stress and pre-gaming (i.e., drinking prior to going out to an event) in female college students. Methods: Thirty-four female college students were grouped as pre-gamers or non-pre-gamers based on self-reported drinking patterns. They completed surveys about alcohol use and mental health and provided a set of salivary cortisol samples upon waking, 30 min later, and at 10am on the same day. Results: Pre-gamers and non-pre-gamers did not differ on demographics or psychosocial variables. Pre-gamers reported riskier drinking overall and had greater endorsement of social, coping, and enhancement drinking motives. Pre-gamers also had lower cortisol levels 30 min after waking and exhibited attenuated CAR. Conclusions: Female collegiate pre-gamers may differ from their peers not only in terms of alcohol consumption and drinking motives, but also on attenuated CAR, a physiological biomarker associated with stress dysregulation and vulnerability to addictive behaviors.
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Affiliation(s)
- Natalie Ceballos
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Jessica Perrotte
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Shobhit Sharma
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | | | - Danielle Callaway
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Amanda Gordon
- Department of Psychology, Texas State University, San Marcos, Texas, USA
| | - Reiko Graham
- Department of Psychology, Texas State University, San Marcos, Texas, USA
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12
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Aker A, Serghides L, Cotnam J, Jackson R, Robinson M, Gauvin H, Mushquash C, Gesink D, Amirault M, Benoit AC. The impact of a stress management intervention including cultural components on stress biomarker levels and mental health indicators among indigenous women. J Behav Med 2023; 46:594-608. [PMID: 36652086 PMCID: PMC10344996 DOI: 10.1007/s10865-023-00391-0] [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: 06/17/2022] [Accepted: 01/03/2023] [Indexed: 01/19/2023]
Abstract
We examined the effectiveness of a 26-week culture-inclusive intervention on reducing salivary stress biomarker levels, and perceived stress, depressive, and post-traumatic stress disorder (PTSD) symptoms measured using scales in 53 Indigenous women in Ontario, Canada. Statistical analyses compared the average biomarker levels, and the area under the curve (AUC) of biomarkers. Differences in biomarkers and mental health scale scores pre- and post-intervention were compared using mixed models with a random intercept. Interaction terms were included between the intervention and age, education, disability, and HIV status, individually, to test for sub-group differences. Cortisol AUC post-intervention was decreased compared to pre-intervention (β -1.29 µg/dL; 95%CI -2.35, -0.23). There was a slight decrease in perceived stress levels (aOR: -2.80; 95%CI -5.09, -0.50). The associations were stronger among women of younger age, higher education, and no disabilities. These interventions can be effective, but future interventions should target Indigenous population sub-groups to address individual needs.
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Affiliation(s)
- Amira Aker
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Lena Serghides
- Toronto General Hospital Research Institute, University Health Network, Toronto, Canada
- Department of Immunology, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Jasmine Cotnam
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Randy Jackson
- McMaster Indigenous Research Institute, McMaster University, Hamilton, ON, Canada
| | - Margaret Robinson
- Department of Sociology and Social Anthropology, Dalhousie University, Nova Scotia, Canada
| | | | - Christopher Mushquash
- Centre for Rural and Northern Health Research, Lakehead University, Thunder Bay, ON, Canada
- Department of Psychology, Northern Ontario School of Medicine, Lakehead University, Thunder Bay, ON, Canada
- Dilico Anishinabek Family Care, Fort William First Nation, Thunder Bay, ON, Canada
| | - Dionne Gesink
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | | | - Anita C Benoit
- Department of Health & Society, University of Toronto Scarborough, Toronto, ON, Canada.
- Women's College Hospital, Women's College Research Institute, University of Toronto, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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13
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Euteneuer F, Neuert M, Salzmann S, Fischer S, Ehlert U, Rief W. Does psychological treatment of major depression reduce cardiac risk biomarkers? An exploratory randomized controlled trial. Psychol Med 2023; 53:3735-3749. [PMID: 35232509 PMCID: PMC10277774 DOI: 10.1017/s0033291722000447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/31/2021] [Accepted: 02/07/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Depression is associated with an increased risk for cardiovascular disease (CVD). Biological cardiac risk factors are already elevated in depressed patients without existing CVD. The purpose of this exploratory trial was to examine whether treating Major Depression (MD) with cognitive behavioral therapy (CBT) is associated with improvements in cardiac risk biomarkers and whether depressive symptom severity at baseline moderates treatment effects. METHODS Eighty antidepressant-free patients with MD were randomly assigned to CBT or waiting list (WL). Biological outcomes included long-term recordings (24-h, daytime, nighttime) of heart rate, heart rate variability (HRV), and blood pressure, as well as inflammatory markers such as C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor (TNF)-α. A sample of 40 age- and sex-matched non-clinical controls was also involved to verify biological alterations in MD at study entry. RESULTS Compared to WL, CBT was associated with a significant increase in overall HRV, as indexed by the 24-h and daytime HRV triangular index, as well as trend improvements in 24-h low-frequency HRV and daytime systolic blood pressure. Self-rated depressive symptom severity moderated (or tended to moderate) improvements in CBT for 24-h and daytime heart rate and several indices of HRV (especially daytime measures). Inflammatory treatment effects were not observed. CONCLUSIONS CBT increased overall HRV in patients with MD. Initially more depressed patients showed the most pronounced cardiovascular improvements through CBT. These exploratory findings may provide new insights into the biological effects of psychological treatment against depression and must be confirmed through future research.
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Affiliation(s)
- Frank Euteneuer
- Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Berlin, Berlin, Germany
- Division of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Marie Neuert
- Division of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
| | - Susanne Fischer
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Ulrike Ehlert
- Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Winfried Rief
- Division of Clinical Psychology and Psychotherapy, University of Marburg, Marburg, Germany
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14
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Neri L, Oberdier MT, van Abeelen KCJ, Menghini L, Tumarkin E, Tripathi H, Jaipalli S, Orro A, Paolocci N, Gallelli I, Dall’Olio M, Beker A, Carrick RT, Borghi C, Halperin HR. Electrocardiogram Monitoring Wearable Devices and Artificial-Intelligence-Enabled Diagnostic Capabilities: A Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:4805. [PMID: 37430719 PMCID: PMC10223364 DOI: 10.3390/s23104805] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/09/2023] [Accepted: 05/12/2023] [Indexed: 07/12/2023]
Abstract
Worldwide, population aging and unhealthy lifestyles have increased the incidence of high-risk health conditions such as cardiovascular diseases, sleep apnea, and other conditions. Recently, to facilitate early identification and diagnosis, efforts have been made in the research and development of new wearable devices to make them smaller, more comfortable, more accurate, and increasingly compatible with artificial intelligence technologies. These efforts can pave the way to the longer and continuous health monitoring of different biosignals, including the real-time detection of diseases, thus providing more timely and accurate predictions of health events that can drastically improve the healthcare management of patients. Most recent reviews focus on a specific category of disease, the use of artificial intelligence in 12-lead electrocardiograms, or on wearable technology. However, we present recent advances in the use of electrocardiogram signals acquired with wearable devices or from publicly available databases and the analysis of such signals with artificial intelligence methods to detect and predict diseases. As expected, most of the available research focuses on heart diseases, sleep apnea, and other emerging areas, such as mental stress. From a methodological point of view, although traditional statistical methods and machine learning are still widely used, we observe an increasing use of more advanced deep learning methods, specifically architectures that can handle the complexity of biosignal data. These deep learning methods typically include convolutional and recurrent neural networks. Moreover, when proposing new artificial intelligence methods, we observe that the prevalent choice is to use publicly available databases rather than collecting new data.
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Affiliation(s)
- Luca Neri
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Matt T. Oberdier
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Kirsten C. J. van Abeelen
- Department of Informatics, Systems, and Communication, University of Milano-Bicocca, 20126 Milan, Italy
- Department of Internal Medicine, Radboud University Medical Center, 6525 AJ Nijmegen, The Netherlands
| | - Luca Menghini
- Department of Psychology and Cognitive Science, University of Trento, 38068 Rovereto, Italy
| | - Ethan Tumarkin
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Hemantkumar Tripathi
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Sujai Jaipalli
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Alessandro Orro
- Institute of Biomedical Technologies, National Research Council, 20054 Segrate, Italy
| | - Nazareno Paolocci
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Ilaria Gallelli
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Massimo Dall’Olio
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Amir Beker
- AccYouRate Group S.p.A., 67100 L’Aquila, Italy
| | - Richard T. Carrick
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
| | - Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy
| | - Henry R. Halperin
- Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, USA; (L.N.)
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
- Department of Radiology, Johns Hopkins University, Baltimore, MD 21205, USA
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15
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Schumacher MM, Santambrogio J. Cortisol and the Dexamethasone Suppression Test as a Biomarker for Melancholic Depression: A Narrative Review. J Pers Med 2023; 13:jpm13050837. [PMID: 37241007 DOI: 10.3390/jpm13050837] [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: 04/14/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
The dexamethasone suppression test (DST) assesses the functionality of the HPA axis and can be regarded as the first potential biomarker in psychiatry. In 1981, a group of researchers at the University of Michigan published a groundbreaking paper regarding its use for diagnosing melancholic depression, reporting a diagnostic sensitivity of 67% and a specificity of 95%. While this study generated much enthusiasm and high expectations in the field of biological psychiatry, subsequent studies produced equivocal results, leading to the test being rejected by the American Psychiatric Association. The scientific reasons leading to the rise and fall of the DST are assessed in this review, suggestions are provided as to how the original test can be improved, and its potential applications in clinical psychiatry are discussed. An improved, standardized, and validated version of the DST would be a biologically meaningful and useful biomarker in psychiatry, providing a tool for clinicians caring for depressed patients in the areas of diagnosis, treatment, and prognosis, and predicting the risk of suicide. Additionally, such a test could be a crucial part in the generation of biologically homogenous patient cohorts, necessary for the successful development of new psychotropic medications.
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Affiliation(s)
| | - Jacopo Santambrogio
- Adele Bonolis AS.FRA. Onlus Foundation, 20854 Vedano al Lambro, Italy
- Presidio Corberi, ASST Brianza, 20812 Limbiate, Italy
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Determinants of hair cortisol in preschool children and their mothers: A Brazilian birth cohort study. Psychoneuroendocrinology 2023; 150:106027. [PMID: 36702042 DOI: 10.1016/j.psyneuen.2023.106027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Few large-scale studies have provided population-based estimates of hair cortisol levels and its determinants. Hair cortisol and potential determinants were measured in children and their mothers in a population-based sample in a Brazilian city with large variations in socioeconomic conditions. METHODS We used data from the 4-year follow-up of the 2015 Pelotas (Brazil) Birth Cohort Study. Hair samples were collected by trained fieldworkers to analyze average levels of cortisol over a 3-month period. Four groups of variables were tested as potential determinants: hair characteristics (natural color, treatment, type, and frequency of wash), use of corticosteroids and oral contraceptives, sociodemographic factors (sex, age, skin color, socioeconomic level, maternal relationship, pregnancy, daycare enrollment), maternal perceived stress, and substance exposure (smoking and illicit drug use). Linear regression with log transformation was used to test associations. RESULTS 3235 children and 3102 mothers were analyzed (80.7% and 77.4% of those interviewed when children were 4 years of age, respectively), for whom sufficient hair was collected for cortisol analysis. The median of hair cortisol concentration was 7.8 pg/mg (IQR = 5.6 - 11.0) for children, and 5.6 pg/mg (IQR = 4.2 - 7.8) for mothers. In adjusted models, sex and socioeconomic level were associated with child cortisol levels. For mothers, hair cortisol levels were associated with socioeconomic level, skin color, age, hair treatment and hair natural color. CONCLUSION This study provides estimates of hair cortisol levels in a diverse population in a upper-middle income country. Although just a few predictors were associated with maternal/child cortisol levels, socioeconomic level was the key variable that should be incorporated in studies using hair cortisol to measure biological manifestations of stress, but other variables, such as some hair and sociodemographic characteristics are important to consider when using hair cortisol.
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Weigensberg MJ, Wen CK, Sanogo F, Toledo-Corral C, Ding L. Imagine HEALTH: Changes in diurnal salivary cortisol patterns following a 12-week guided imagery RCT lifestyle intervention in predominantly Latino adolescents. Psychoneuroendocrinology 2023; 151:106053. [PMID: 36842257 DOI: 10.1016/j.psyneuen.2023.106053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Alterations in diurnal salivary cortisol patterns have been linked to adverse metabolic health outcomes. We have previously shown that stress-reduction guided imagery (GI) can reduce salivary cortisol levels acutely. We now ask whether addition of GI into a 12-week lifestyle intervention designed to improve eating and physical activity behaviors can alter diurnal salivary cortisol patterns and perceived stress. METHODS 232 adolescent participants (ages 14-17 years) were cluster randomized by school into one of four intervention arms: non-intervention Control (C; n = 51), Lifestyle (LS; n=61), Stress-Reduction GI (SRGI; n = 55), and Lifestyle Behavior GI (LBGI; n = 65). LS group received one nutrition and one physical activity class per week after-school for 12 weeks. SRGI and LBGI groups received same LS classes plus an additional weekly GI session. Salivary cortisol was assessed pre- and post-intervention on 3 days, 3 times daily, at awakening, 30-minutes post-awakening, and in the evening to determine Cortisol Awakening Response (CAR) and Diurnal Cortisol Slope (DCS). Perceived Stress Scale (PSS) was administered pre- and post-intervention. Mixed effects modeling was used for intent-to-treat analysis and sensitivity analysis was used for those participants adherent to intervention protocol. RESULTS Analysis of 208 subjects with complete data showed a small between-group increase in CAR in LBGI vs C (p = 0.045, d=0.24), with no significant group differences among other intervention arms. There were no between group differences in change in DCS or change in PSS after 12-weeks. Amongst adherent participants, LBGI showed a small-moderate increase in CAR (p = 0.03, d=0.37), and moderate-large reduction in PSS (p = 0.02, d=-0.66) compared to C. There were no other between group differences in CAR, DCS, or PSS. CONCLUSION LBGI led to an increase in CAR, and in adherent subjects, a decrease in PSS, suggesting GI may be a mind-body intervention that can affect both objective and subjective measures of the stress response. Whether changes in cortisol patterns in this population affect measures of mental or physical health remains to be determined.
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Affiliation(s)
| | | | - Fatimata Sanogo
- USC Keck School of Medicine, Department of Population and Public Health Sciences, USA
| | | | - Li Ding
- USC Keck School of Medicine, Department of Population and Public Health Sciences, Division of Biostatistics, USA
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18
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The effect of acute exercise on the cortisol awakening response. Eur J Appl Physiol 2023; 123:1027-1039. [PMID: 36629945 DOI: 10.1007/s00421-023-05132-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 01/01/2023] [Indexed: 01/12/2023]
Abstract
The effects of acute exercise on the cortisol awakening response (CAR), characterized by the rapid increase in cortisol concentrations within the 30-45 min following sleep offset has yet to be fully elucidated. Thus, our study investigated the effects of late-evening acute exercise on the CAR the following morning. We hypothesized that exercise would have a significant effect on the CAR the following morning. Twelve participants (mean (SD): age = 23 (4) years; mass = 76.8 (8.7) kg; height = 175.6 (5.0) cm; [Formula: see text]O2max = 48.9 (7.5) ml.kg-1.min-1) reported to the laboratory in the evening (1800 h) on two occasions and were randomly assigned to either exercise for one hour (70-75% of maximal power output) or rest condition. Blood and saliva samples were assayed for cortisol. Mixed-effects models determined the effect of exercise on the cortisol response post-waking in both blood and saliva. Participants demonstrated an average exercise-induced increase in circulating cortisol of 477.3%, with actual mean (SD) heart rate relative to maximum of 87.04% (6.14%). Model results demonstrated a negative effect for exercise condition when modeling the serum and salivary cortisol responses to awakening via a quadratic growth model (serum, βCondition = - 42.26 [95% CI - 64.52 to - 20.01], p < 0.001; saliva, βCondition = - 11.55 [95% CI - 15.52 to - 7.57], p < 0.001). These results suggest that cortisol concentrations in saliva and blood are significantly lower the morning following a prior evening exercise session. Therefore, the CAR may serve as a useful biomarker to monitor responses to exercise training, although the underlying mechanism for these decreases in the CAR should be investigated further.
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Vasiliadis HM, Pitrou I, Grenier S, Berbiche D, Hudon C. Psychological Distress, Cognition, and Functional Disability Trajectory Profiles of Aging in Primary Care Older Adults. Clin Gerontol 2023; 46:819-831. [PMID: 35387578 DOI: 10.1080/07317115.2022.2060158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To identify profiles of aging by combining psychological distress, cognition and functional disability, and their associated factors. METHODS Data were drawn from the Étude sur la Santé des Aînés-Services study and included 1585 older adults. Sociodemographic, psychosocial, lifestyle and health factors were informed from structured interviews. Group-based multi-trajectory modeling and multinomial logistic regression were used to identify aging profiles and correlates. Sampling weights were applied to account for the sampling plan. RESULTS The weighted sample size was 1591. Three trajectories were identified: a favorable (79.0%), intermediate (14.5%), and severe scenario (6.5%). Factors associated with the severe scenario were older age, male gender, lower education, the presence of anxiety disorders, low physical activity, and smoking. Membership in the intermediate scenario was associated with daily hassles, physical disorders, anxiety and depression, antidepressant/psychotherapy use, low physical activity, and no alcohol use. High social support was protective against less favorable profiles. CONCLUSIONS Symptoms of anxiety and depression and high burden of physical disorders were associated with less favorable trajectories. Modifiable lifestyle factors have a significant effect on healthy aging. CLINICAL IMPLICATIONS Assessment and management of anxio-depressive symptoms are important in older adults. Clinical interventions including access to psychotherapy and promotion of healthier lifestyles should be considered.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Isabelle Pitrou
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Sébastien Grenier
- Department of Psychology, University of Montreal, Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Quebec, Canada
| | - Djamal Berbiche
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne Research Center, Longueuil, Quebec, Canada
| | - Carol Hudon
- School of Psychology (Laval University), CERVO Brain Research Centre, and VITAM Research Centre, Quebec, Quebec, Canada
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20
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Groeger D, Murphy EF, Tan HTT, Larsen IS, O'Neill I, Quigley EMM. Interactions between symptoms and psychological status in irritable bowel syndrome: An exploratory study of the impact of a probiotic combination. Neurogastroenterol Motil 2023; 35:e14477. [PMID: 36178333 PMCID: PMC10078522 DOI: 10.1111/nmo.14477] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/06/2022] [Accepted: 09/20/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Stress is an exacerbator of irritable bowel syndrome (IBS) symptoms, and anxiety and depression are co-morbidities. Bifidobacterium longum strains 1714® and 35642® attenuate stress responses in healthy people and reduce symptoms in IBS, respectively. Here, we explore relationships between the psychological and visceral effects of the two strains (COMBO) in IBS subjects and biomarkers of stress and inflammation. METHODS We recruited 40 patients with IBS (Rome III) and mild to moderate anxiety (HADS-A) and/or depression (HADS-D) and 57 asymptomatic female controls with low or moderate stress. IBS patients were fed COMBO (1 × 109 cfu/day) for 8 weeks with an 8-week washout. IBS symptoms, psychometric measures, salivary cortisol awakening response (CAR), and plasma inflammatory biomarkers were assessed every 4 weeks. KEY RESULTS Compared to healthy controls, IBS subjects had a blunted CAR. Treatment with COMBO restored CAR and improved IBS symptoms compared to baseline during the treatment phase. The COMBO reduced HADS-D, HADS-A score, and TNF-α, while sleep quality improved significantly from baseline to the end of the intervention. Surprisingly, these parameters improved further once treatment ended and maintained this improvement by Week 16. CONCLUSIONS AND INFERENCES These findings suggest that the stress response is a major driver of IBS symptoms. The time course of the beneficial effect of COMBO on IBS symptoms suggests that this is achieved through a restoration of the stress response. In contrast, the time course of the effects of COMBO on anxiety and depression in IBS paralleled an anti-inflammatory effect as indicated by a reduction in circulating levels of TNF-α.
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Affiliation(s)
| | | | | | | | - Ian O'Neill
- Department of Microbiology, APC Microbiome IrelandNational University of IrelandCorkIreland
| | - Eamonn M. M. Quigley
- Division of Gastroenterology and Hepatology, Lynda K and David M Underwood Center for Digestive Disorders, Houston Methodist HospitalWeill Cornell Medical CollegeHoustonTexasUSA
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Kanes SJ, Dennie L, Perera P. Targeting the Arginine Vasopressin V 1b Receptor System and Stress Response in Depression and Other Neuropsychiatric Disorders. Neuropsychiatr Dis Treat 2023; 19:811-828. [PMID: 37077711 PMCID: PMC10106826 DOI: 10.2147/ndt.s402831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/23/2023] [Indexed: 04/21/2023] Open
Abstract
A healthy stress response is critical for good mental and overall health and promotes neuronal growth and adaptation, but the intricately balanced biological mechanisms that facilitate a stress response can also result in predisposition to disease when that equilibrium is disrupted. The hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system plays a critical role in the body's response and adaptation to stress, and vasopressinergic regulation of the HPA axis is critical to maintaining system responsiveness during chronic stress. However, exposure to repeated or excessive physical or emotional stress or trauma can shift the body's stress response equilibrium to a "new normal" underpinned by enduring changes in HPA axis function. Exposure to early life stress due to adverse childhood experiences can also lead to lasting neurobiological changes, including in HPA axis function. HPA axis impairment in patients with depression is considered among the most reliable findings in biological psychiatry, and chronic stress has been shown to play a major role in the pathogenesis and onset of depression and other neuropsychiatric disorders. Modulating HPA axis activity, for example via targeted antagonism of the vasopressin V1b receptor, is a promising approach for patients with depression and other neuropsychiatric disorders associated with HPA axis impairment. Despite favorable preclinical indications in animal models, demonstration of clinical efficacy for the treatment of depressive disorders by targeting HPA axis dysfunction has been challenging, possibly due to the heterogeneity and syndromal nature of depressive disorders. Measures of HPA axis function, such as elevated cortisol levels, may be useful biomarkers for identifying patients who may benefit from treatments that modulate HPA axis activity. Utilizing clinical biomarkers to identify subsets of patients with impaired HPA axis function who may benefit is a promising next step in fine-tuning HPA axis activity via targeted antagonism of the V1b receptor.
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Affiliation(s)
- Stephen J Kanes
- EmbarkNeuro, Oakland, CA, USA
- Correspondence: Stephen J Kanes, EmbarkNeuro, Inc, 1111 Broadway, Suite 1300, Oakland, CA, 94607, USA, Tel +1 610 757 7821, Email
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22
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Bowles NP, Thosar SS, Butler MP, Clemons NA, Robinson LD, Ordaz OH, Herzig MX, McHill AW, Rice SPM, Emens J, Shea SA. The circadian system modulates the cortisol awakening response in humans. Front Neurosci 2022; 16:995452. [PMID: 36408390 PMCID: PMC9669756 DOI: 10.3389/fnins.2022.995452] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background In humans, circulating cortisol usually peaks 30–60 min after awakening from nocturnal sleep, this is commonly referred to as the cortisol awakening response (CAR). We examined the extent to which the CAR is influenced by the circadian system, independent of behaviors including sleep. Materials and methods We examined the CAR in 34 adults (20 female) using two complementary multiday in-laboratory circadian protocols performed in dim light, throughout which behavioral factors were uniformly distributed across the 24-hour circadian cycle. Protocol 1 consisted of 10 identical consecutive 5-hour 20-minute sleep/wake cycles, and protocol 2 consisted of 5 identical consecutive 18-hour sleep/wake cycles. Salivary melatonin was used as the circadian phase marker (0° = dim light melatonin onset). During each sleep/wake cycle, salivary cortisol was measured upon scheduled awakening and 50-minutes later, with the change in cortisol defined as the CAR. Cosinor analyses were used to detect any significant circadian rhythmicity in the CAR. In secondary analyses, we adjusted the models for time awake before lights on, total sleep time, percent of rapid eye movement (REM) sleep, and percent of non-rapid eye movement (NREM) sleep. Results Both protocols revealed a similar circadian rhythm in the CAR, with peaks occurring at a circadian phase corresponding to 3:40–3:45 a.m., with no detectable CAR during the circadian phases corresponding to the afternoon. In addition to the sinusoidal component of the circadian rhythm, total sleep time was also associated with the CAR for protocol 1. The percent of sleep spent in REM or NREM sleep were not associated with the CAR in either protocol. Conclusion Our results show that the CAR exhibits a robust circadian rhythm that persists even after adjusting for prior sleep. Presuming that the CAR optimizes physiological responses to the anticipated stressors related to awakening, these findings may have implications for shift workers who wake up at unusual circadian phases. A blunted CAR in shift workers upon awakening in the evening may result in diminished responses to stressors.
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Affiliation(s)
- Nicole P. Bowles
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: Nicole P. Bowles,
| | - Saurabh S. Thosar
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Knight Cardiovascular Institute, School of Medicine, Oregon Health and Science University, Portland, OR, United States
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
| | - Matthew P. Butler
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States
| | - Noal A. Clemons
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - LaTroy D. Robinson
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Omar H. Ordaz
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Maya X. Herzig
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
| | - Andrew W. McHill
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
| | - Sean P. M. Rice
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
| | - Jonathan Emens
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
- VA Portland Health Care System, Portland, OR, United States
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR, United States
- OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, OR, United States
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23
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Linnemann P, Friedrich N, Nauck M, Teismann H, Berger K. The relationship between cortisol awakening response and trait resilience in two patient cohorts and one population-based cohort. World J Biol Psychiatry 2022; 24:429-438. [PMID: 36239666 DOI: 10.1080/15622975.2022.2129445] [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] [Indexed: 10/17/2022]
Abstract
OBJECTIVES We examined (1) the proportion of cortisol awakening non-responders, (2) the association between cortisol awakening response (CAR) and trait resilience, and (3) the association between CAR increase and trait resilience in two patient cohorts (depression and myocardial infarction [CVD]) and one population-based cohort. METHODS Eight hundred and eighty study participants delivered CAR scores (response and increase) based on three self-collected saliva samples and a trait resilience score. Descriptive data of CAR non-responders were reported and calculated. Associations between CAR response/increase and trait resilience, sociodemographic and compliance variables were evaluated using multiple logistic and multiple linear regression analyses stratified by cohort. RESULTS The proportion of CAR non-responders was high in all cohorts (57% depression cohort, 53.4% CVD cohort, 51.6% control cohort). In the depression cohort age was associated with CAR response and increase. In the CVD cohort salivary collection on a weekday was associated with CAR response and awakening time with CAR increase. In the control cohort age was associated with CAR response and sex with CAR increase. CONCLUSIONS We observed many CAR non-responders and significant associations between CAR response and CAR increase with single sociodemographic and compliance variables. We did not find significant relationships between CAR response or increase and trait resilience.
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Affiliation(s)
- Patrick Linnemann
- Institute of Epidemiology and Social Medicine, University of Münster, Munster, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henning Teismann
- Institute of Epidemiology and Social Medicine, University of Münster, Munster, Germany
| | - Klaus Berger
- Institute of Epidemiology and Social Medicine, University of Münster, Munster, Germany
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Neyer S, Witthöft M, Cropley M, Pawelzik M, Sütterlin S, Lugo RG. The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder patients—A replication study. Front Neurosci 2022; 16:952903. [DOI: 10.3389/fnins.2022.952903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
The cortisol awakening response (CAR) is a non-invasive biomarker for hypothalamic-pituitary-adrenal axis (HPA) dysregulation, reflecting accumulated stress over time. In a previous study we reported that a blunted CAR before an inpatient treatment predicted self-reported depressive symptoms six weeks and six months after discharge [Eikeseth, F. F., Denninghaus, S., Cropley, M., Witthöft, M., Pawelzik, M., & Sütterlin, S. (2019). The cortisol awakening response at admission to hospital predicts depression severity after discharge in major depressive disorder (MDD) patients. Journal of Psychiatric Research, 111, 44-50)]. This replication study adopted an improved overall methodology with more stringent assessment protocols and monitoring. The longitudinal design included 122 inpatients from a psychosomatic hospital with a diagnosis of MDD displaying symptoms of moderate to severe major depression (n = 80 females). The CAR was measured at intake. Depression severity was assessed as Beck Depression Inventory II scores at intake, discharge, 6 weeks and 6 months following discharge. Results from the original study were replicated in terms of effect size but did not reach statistical significance (correlation between BDI-II 6 months after discharge and AUCg: r = −0.213; p = 0.054). The replication study yielded nearly identical correlation coefficients as in the original study (BDI-II 6 months and CAR, r = −0.223, p < 0.05). The replication of previously reported effect sizes with a concurrent lack of statistical significance in the more restrictive, larger and better controlled replication study may well inform research on psycho-endocrinological predictors for treatment success, but suggests a rather limited practical relevance for cortisol awakening response measures in this clinical context.
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McClain AC, Xiao RS, Tucker KL, Falcón LM, Mattei J. Depressive symptoms and allostatic load have a bidirectional association among Puerto Rican older adults. Psychol Med 2022; 52:3073-3085. [PMID: 33443008 PMCID: PMC8277900 DOI: 10.1017/s0033291720005139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Depression is strongly associated with chronic disease; yet, the direction of this relationship is poorly understood. Allostatic load (AL) provides a framework for elucidating depression-disease pathways. We aimed to investigate bidirectional, longitudinal associations of baseline depressive symptoms or AL with 5-year AL or depressive symptoms, respectively. METHODS Data were from baseline, 2-year, and 5-year visits of 620 adults (45-75 years) enrolled in the Boston Puerto Rican Health Study. The Center for Epidemiology Studies Depression (CES-D) scale (0-60) captured depressive symptoms, which were categorized at baseline as low (<8), subthreshold (8-15), or depression-likely (⩾16) symptoms. AL was calculated from 11 parameters of biological functioning, representing five physiological systems. Baseline AL scores were categorized by the number of dysregulated parameters: low (0-2), moderate (3-5), or high (⩾6) AL. Multivariable, multilevel random intercept and slope linear regression models were used to examine associations between 3-category baseline CES-D score and 5-year continuous AL score, and between baseline 3-category AL and 5-year continuous CES-D score. RESULTS Baseline subthreshold depressive symptoms [(mean (95% CI)): 4.8 (4.5-5.2)], but not depression-likely symptoms [4.5 (4.2-4.9)], was significantly associated with higher 5-year AL scores, compared to low depressive symptoms [4.3 (3.9-4.7)]. Baseline high AL [19.4 (17.6-21.2)], but not low AL [18.5 (16.5-20.6)], was significantly associated with higher 5-year CES-D score, compared to baseline moderate AL [16.9 (15.3-18.5)]. CONCLUSIONS Depressive symptoms and AL had a bi-directional relationship over time, indicating a nuanced pathway linking depression with chronic diseases among a minority population.
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Affiliation(s)
- Amanda C. McClain
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Rui S. Xiao
- IQVIA, Real-World Evidence, Cambridge, MA, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts, Lowell, MA, USA
| | - Luis M. Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Lin YH, Jen HJ, Lin YK, Seo JD, Chang WP. Cortisol Awakening Response and Stress in Female Nurses on Monthly Shift Rotations: A Longitudinal Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9506583. [PMID: 36158880 PMCID: PMC9499772 DOI: 10.1155/2022/9506583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 09/01/2022] [Indexed: 11/18/2022]
Abstract
The majority of shift nurses are female, there is still an expectation that they fulfil the traditional role of women in the family in Asia, often conflicting with shift work, increases stress, and affects cortisol secretion patterns. This study was to understand the changes in the cortisol awakening response (CAR) and work stress in nursing personnel working in different shifts. We recruited 41 female shift nurses. We administered the Taiwan Nurse Stress Checklist (NSC), and the nurses themselves collected saliva samples upon waking and 30 minutes after waking for three consecutive days at home. The saliva samples enabled us to analyze the increase in cortisol levels following waking (CARi) of nurses working different shifts (day, evening, and night). We then analyzed the data obtained using a hierarchical linear model (HLM). The results indicated that in terms of stress from the inability to complete personal tasks, the regression coefficients of night-shift nurses vs. day-shift nurses (B = 4.39, p < .001) and night-shift nurses vs. evening-shift nurses (B = 3.95, p < .001) were positive, which means that night-shift nurses were under significantly greater stress than day-shift and evening-shift nurses. With regard to CARi, the regression coefficients of night-shift nurses vs. day-shift nurses (B = -3.41, p < .001) and night-shift nurses vs. evening-shift nurses (B = -2.92, p < .01) were negative, which means that night-shift nurses have significantly lower CARi values than day-shift and evening-shift nurses. With regard to cortisol levels 30 minutes after waking, the regression coefficients of night-shift nurses vs. day-shift nurses (B = -3.88, p < .01) and night-shift nurses vs. evening-shift nurses (B = -3.31, p < .01) were negative, which means that night-shift nurses have significantly lower cortisol levels 30 minutes after waking than day-shift and evening-shift nurses. These results indicate that female night-shift nurses display the lowest CARi and cortisol levels 30 minutes after waking and are more negatively affected by being unable to complete personal tasks.
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Affiliation(s)
- Yu-Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hsiu-Ju Jen
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan
| | - Jang-Dong Seo
- Department of Statistics, Indiana University, Bloomington, USA
| | - Wen-Pei Chang
- Department of Nursing, Shuangho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Refsgaard E, Schmedes AV, Martiny K. Salivary Cortisol Awakening Response as a Predictor for Depression Severity in Adult Patients with a Major Depressive Episode Performing a Daily Exercise Program. Neuropsychobiology 2022; 81:246-256. [PMID: 35016170 DOI: 10.1159/000521234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The hypothalamic-pituitary-adrenal axis function in depression has been the subject of considerable interest, and its function has been tested with a variety of methods. We investigated associations between saliva cortisol at awakening and the 24-h urine cortisol output, both measured at study baseline, with endpoint depression scores. METHODS Patients were admitted to a psychiatric inpatient ward with a major depressive episode and were started on fixed duloxetine treatment. They delivered saliva samples at awakening and 15, 30, and 60 min post-awakening and sampled urine for 24 h. Subsequently, they started a daily exercise program maintained for a 9-week period. Clinician-rated depression severity was blindly assessed with the Hamilton Depression Rating 6-item subscale (HAM-D6). The cortisol awakening response was quantified by the area under the curve with respect to the ground (AUCG) and with respect to the rise (AUCI) using saliva cortisol levels in the 1-h period after awakening. Analysis of expected associations between depression severity, AUCG, AUCI, exercise, and 24-h cortisol output was performed in a general linear model. RESULTS In all, 35 participants delivered saliva or 24-h urine samples. The mean age was 49.0 years (SD = 11.0) with 48.6% females with a mean baseline HAM-D6 score of 12.2 (SD = 2.3). In a statistical model investigating the association between HAM-D6 at week 9 as a dependent variable and AUCI, concurrent HAM-D6, gender, smoking, and exercise volume as covariates, we found a significant effect of AUCI, concurrent HAM-D6, and exercise. The following statistics were found: AUCI (regression coefficient 0.008; F value = 9.1; p = 0.007), concurrent HAM-D6 (regression coefficient 0.70; F value = 8.0; p = 0.01), and exercise (regression coefficient -0.005; F value = 5.7; p = 0.03). The model had an R2 of 0.43. The association between HAM-D6 endpoint scores and the AUCI showed that higher AUCI values predicted higher HAM-D6 endpoint values. The association between HAM-D6 endpoint scores and the exercise level showed that a high exercise level was associated with lower HAM-D6 endpoint values. CONCLUSION The results thus showed that high AUCI values predicted less improvement of depression and high exercise levels predicted more improvement of depression. These findings need to be confirmed in larger samples to test if more covariates can improve prediction of depression severity.
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Affiliation(s)
- Else Refsgaard
- Psychiatric Research Unit, Mental Health Centre North Zealand, Hillerod, Denmark
| | | | - Klaus Martiny
- Mental Health Centre Copenhagen, Copenhagen, Denmark
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28
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Kinlein SA, Wallace NK, Savenkova MI, Karatsoreos IN. Chronic hypothalamic-pituitary-adrenal axis disruption alters glutamate homeostasis and neural responses to stress in male C57Bl6/N mice. Neurobiol Stress 2022; 19:100466. [PMID: 35720261 PMCID: PMC9198473 DOI: 10.1016/j.ynstr.2022.100466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
It is now well-established that stress elicits brain- and body-wide changes in physiology and has significant impacts on many aspects of health. The hypothalamic-pituitary-adrenal (HPA) axis is the major neuroendocrine system mediating the integrated response to stress. Appropriate engagement and termination of HPA activity enhances survival and optimizes physiological and behavioral responses to stress, while dysfunction of this system is linked to negative health outcomes such as depression, anxiety, and post-traumatic stress disorder. Glutamate signaling plays a large role in the transmission of stress-related information throughout the brain. Furthermore, aberrant glutamate signaling has negative consequences for neural plasticity and synaptic function and is linked to stress-related pathology. However, the connection between HPA dysfunction and glutamate signaling is not fully understood. We tested how HPA axis dysfunction (using low dose chronic corticosterone in the drinking water) affects glutamate homeostasis and neural responses under baseline and acute stress in male C57BL/6N mice. Using laser microdissection and transcriptomic analyses, we show that chronic disruption of the HPA axis alters the expression of genes related to glutamate signaling in the medial prefrontal cortex (mPFC), hippocampus, and amygdala. While neural responses to stress (as measured by FOS) in the hippocampus and amygdala were not affected in our model of HPA dysfunction, we observed an exaggerated response to stress in the mPFC. To further probe this we undertook in vivo biosensor measurements of the dynamics of extracellular glutamate responses to stress in the mPFC in real-time, and found glutamate dynamics in the mPFC were significantly altered by chronic HPA dysfunction. Together, these findings support the hypothesis that chronic HPA axis dysfunction alters glutamatergic signaling in regions known to regulate emotional behavior, providing more evidence linking HPA dysfunction and stress vulnerability.
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Feneberg AC, Forbes PAG, Piperno G, Pronizius E, Stijovic A, Skoluda N, Lamm C, Nater UM, Silani G. Diurnal dynamics of stress and mood during COVID-19 lockdown: a large multinational ecological momentary assessment study. Proc Biol Sci 2022; 289:20212480. [PMID: 35611528 PMCID: PMC9130787 DOI: 10.1098/rspb.2021.2480] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The COVID-19 pandemic resulted in severe disruption to people's lives as governments imposed national 'lockdowns'. Several large surveys have underlined the detrimental short- and long-term mental health consequences resulting from this disruption, but survey findings are only informative of individuals' retrospectively reported psychological states. Furthermore, knowledge on psychobiological responses to lockdown restrictions is scarce. We used smartphone-based real-time assessments in 731 participants for 7 days and investigated how individuals' self-reported stress and mood fluctuated diurnally during lockdown in spring 2020. We found that age, gender, financial security, depressive symptoms and trait loneliness modulated the diurnal dynamics of participants' momentary stress and mood. For example, younger and less financially secure individuals showed an attenuated decline in stress as the day progressed, and similarly, more lonely individuals showed a diminished increase in calmness throughout the day. Hair collected from a subsample (n = 140) indicated a decrease in cortisol concentrations following lockdown, but these changes were not related to any of the assessed person-related characteristics. Our findings provide novel insights into the psychobiological impact of lockdown and have implications for how, when and which individuals might benefit most from interventions during psychologically demanding periods.
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Affiliation(s)
- Anja C. Feneberg
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Paul A. G. Forbes
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Giulio Piperno
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Ekaterina Pronizius
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria
| | - Ana Stijovic
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
| | - Nadine Skoluda
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria,Research Platform The Stress of Life (SOLE)—Processes and Mechanisms underlying Everyday Life Stress, University of Vienna, Vienna, Austria
| | - Claus Lamm
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Vienna, Austria,Research Platform The Stress of Life (SOLE)—Processes and Mechanisms underlying Everyday Life Stress, University of Vienna, Vienna, Austria
| | - Urs M. Nater
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria,Research Platform The Stress of Life (SOLE)—Processes and Mechanisms underlying Everyday Life Stress, University of Vienna, Vienna, Austria
| | - Giorgia Silani
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria,Research Platform The Stress of Life (SOLE)—Processes and Mechanisms underlying Everyday Life Stress, University of Vienna, Vienna, Austria
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Associations of three major physiological stress systems with suicidal ideation and suicide attempts in patients with a depressive and/or anxiety disorder. Brain Behav Immun 2022; 102:195-205. [PMID: 35202735 DOI: 10.1016/j.bbi.2022.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 01/30/2022] [Accepted: 02/18/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND People with depressive and/or anxiety disorders are at increased risk of suicidal ideation and suicide attempts, but biological correlates signaling such risk remain unclear. Independent and cumulative dysregulations in physiological stress systems, in particular the hypothalamic-pituitaryadrenal axis (HPA-axis), immune-inflammatory system, and autonomous nervous system (ANS), may contribute to this risk. However, findings have either been heterogeneous or absent thus far. METHODS Associations between individual markers and cumulative indices of the HPA-axis (cortisol awakening response and evening cortisol), immune-inflammatory system (C-reactive protein, interleukin-6 (IL-6), and tumor necrosis factor-α), and the ANS (heart rate, respiratory sinus arrhythmia, and pre-ejection period) and the outcomes no suicide ideation with suicide attempt (SI-SA+), suicide ideation without suicide attempt (SI+SA-) and suicide ideation with suicide attempt (SI+SA+) were investigated in 1749 persons with depressive and/or anxiety disorders from the Netherlands Study of Depression and Anxiety (NESDA). RESULTS High levels of CRP and IL-6 were associated with SI-SA+ and SI+SA+ respectively when compared to non-suicidal patients after adjusting for confounders and multiple testing. Also, cumulative immune-inflammatory dysregulations were positively associated with SI+SA+, suggesting a dose-response effect. No significant associations were found between HPA-axis or ANS indicators and suicide-outcomes and between immune-inflammatory system markers or cumulative stress system dysregulations and SI+SA-. CONCLUSION Although stress system markers could not differentiate between SI+SA- and non-suicidal patients, findings indicate that dysregulations of individual and cumulative immune-inflammatory markers are associated with suicide attempts in depressive and/or anxiety patients. Thus, immune-inflammatory system dysregulation may be involved in the pathophysiology of suicidal behavior, supporting further examination of the effects of anti-inflammatory interventions on suicidality.
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31
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Budziñski ML, Sokn C, Gobbini R, Ugo B, Antunica-Noguerol M, Senin S, Bajaj T, Gassen NC, Rein T, Schmidt MV, Binder EB, Arzt E, Liberman AC. Tricyclic antidepressants target FKBP51 SUMOylation to restore glucocorticoid receptor activity. Mol Psychiatry 2022; 27:2533-2545. [PMID: 35256747 DOI: 10.1038/s41380-022-01491-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 02/02/2022] [Accepted: 02/14/2022] [Indexed: 12/11/2022]
Abstract
FKBP51 is an important inhibitor of the glucocorticoid receptor (GR) signaling. High FKBP51 levels are associated to stress-related disorders, which are linked to GR resistance. SUMO conjugation to FKBP51 is necessary for FKBP51's inhibitory action on GR. The GR/FKBP51 pathway is target of antidepressant action. Thus we investigated if these drugs could inhibit FKBP51 SUMOylation and therefore restore GR activity. Screening cells using Ni2+ affinity and in vitro SUMOylation assays revealed that tricyclic antidepressants- particularly clomipramine- inhibited FKBP51 SUMOylation. Our data show that clomipramine binds to FKBP51 inhibiting its interaction with PIAS4 and therefore hindering its SUMOylation. The inhibition of FKBP51 SUMOylation decreased its binding to Hsp90 and GR facilitating FKBP52 recruitment, and enhancing GR activity. Reduction of PIAS4 expression in rat primary astrocytes impaired FKBP51 interaction with GR, while clomipramine could no longer exert its inhibitory action. This mechanism was verified in vivo in mice treated with clomipramine. These results describe the action of antidepressants as repressors of FKBP51 SUMOylation as a molecular switch for restoring GR sensitivity, thereby providing new potential routes of antidepressant intervention.
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Affiliation(s)
- Maia L Budziñski
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - Clara Sokn
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - Romina Gobbini
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - Belén Ugo
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - María Antunica-Noguerol
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - Sergio Senin
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina
| | - Thomas Bajaj
- Neurohomeostasis Research Group, Department of Psychiatry, Bonn Clinical Center, University of Bonn, 53127, Bonn, Germany
| | - Nils C Gassen
- Neurohomeostasis Research Group, Department of Psychiatry, Bonn Clinical Center, University of Bonn, 53127, Bonn, Germany.,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, D-80804, Munich, Germany
| | - Theo Rein
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, D-80804, Munich, Germany
| | - Mathias V Schmidt
- Research Group Neurobiology of Stress Resilience, Max Planck Institute of Psychiatry, D-80804, Munich, Germany
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, D-80804, Munich, Germany
| | - Eduardo Arzt
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina. .,Departamento de Fisiología y Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, C1428EGA, Argentina.
| | - Ana C Liberman
- Instituto de Investigación en Biomedicina de Buenos Aires (IBioBA) - CONICET - Partner Institute of the Max Planck Society, Buenos Aires, C1425FQD, Argentina.
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Krempel R, Schleicher D, Jarvers I, Ecker A, Brunner R, Kandsperger S. Sleep quality and neurohormonal and psychophysiological accompanying factors in adolescents with depressive disorders: study protocol. BJPsych Open 2022; 8:e57. [PMID: 35236539 PMCID: PMC8935910 DOI: 10.1192/bjo.2022.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Depressive disorders are common mental health problems during adolescence. Many adolescents with depression describe difficulties with sleeping. Findings of previous studies regarding changes in objective sleep quality in adolescents with depressive disorders are heterogeneous. AIMS This study aims to investigate differences in objective and subjective sleep quality between adolescents with depressive disorders and healthy peers, and to evaluate if potential changes in sleep occur concurrently with changes in the release of cortisol and alpha-amylase after awakening. METHOD This non-interventional parallel study examines correlations between depressive disorders, sleep quality and release of stress hormones. Sleep quality in the past 2 weeks, severity of depressive symptoms, psychiatric comorbidities and stress response of 30 adolescents with depressive disorders and 30 healthy controls (N = 60) are assessed via questionnaires. In participants' home environments, the objective sleep quality of seven consecutive nights is measured by sleep accelerometry. After awakening, participants answer sleep questionnaires to examine the subjective sleep quality of those nights. Furthermore, salivary cortisol and alpha-amylase are measured three times after awakening (+0 min, +30 min and +45 min after awakening). CONCLUSIONS Sleep is an important factor for prognosis and well-being in adolescents with depression. The results of this study can be highly valuable to integrate a more detailed examination of sleep quality and sleeping impairments in the treatment of adolescent depressive disorders.
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Affiliation(s)
- Rebekka Krempel
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Daniel Schleicher
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Irina Jarvers
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Angelika Ecker
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Stephanie Kandsperger
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
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Zareian B, Anderl C, LeMoult J, Galea LAM, Prior JC, Rights JD, Ross CJ, Ge S, Hayward AC, Chen FS. Assessing the role of adolescent hormonal contraceptive use on risk for depression: a 3-year longitudinal study protocol. BMC Womens Health 2022; 22:48. [PMID: 35197045 PMCID: PMC8864455 DOI: 10.1186/s12905-022-01623-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 02/09/2022] [Indexed: 08/14/2024] Open
Abstract
BACKGROUND The incidence of depression in human females rises steadily throughout adolescence, a critical period of pubertal maturation marked by increasing levels of gonadal hormones including estrogens and progesterone. These gonadal hormones play a central role in social and emotional development and may also contribute to the increased occurrence of depression in females that begins in early adolescence. In this study, we examine whether and how introducing synthetic estrogen and progestin derivatives through the use of combined hormonal contraceptives (CHC), affects adolescent females' risk for developing depression. We further assess potential links between CHC use and alterations in stress responses and social-emotional functioning. METHODS Using a longitudinal cohort design, we will follow a sample of adolescent females over the span of three years. Participants will be assessed at three time points: once when they are between 13 and 15 years of age, and at approximately 18 and 36 months after their initial assessment. Each time point will consist of two online sessions during which participants will complete a clinical interview that screens for key symptoms of mental health disorders, along with a series of questionnaires assessing their level of depressive symptoms and history of contraceptive use. They will also complete a standardized social-evaluative stress test and an emotion recognition task, as well as provide saliva samples to allow for assessment of their circulating free cortisol levels. DISCUSSION In this study we will assess the effect of CHC use during adolescence on development of Major Depressive Disorder (MDD). We will control for variables previously found to or proposed to partially account for the observed relationship between CHC use and MDD, including socioeconomic status, age of sexual debut, and CHC-related variables including age of first use, reasons for use, and its duration. In particular, we will discover whether CHC use increases depressive symptoms and/or MDD, whether elevated depressive symptoms and/or MDD predict a higher likelihood of starting CHC, or both. Furthermore, this study will allow us to clarify whether alterations in stress reactivity and social-emotional functioning serve as pathways through which CHC use may result in increased risk of depressive symptoms and/or MDD.
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Affiliation(s)
- Bita Zareian
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Christine Anderl
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Leibniz-Institut für Wissensmedien, Tübingen, Germany
| | - Joelle LeMoult
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Liisa A M Galea
- Department of Psychology, University of British Columbia, Vancouver, Canada.,Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, Canada
| | - Jerilynn C Prior
- Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada.,BC Women's Health Research Institute, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Jason D Rights
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Colin J Ross
- BC Children's Hospital Research Institute, Vancouver, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Sabrina Ge
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Annie C Hayward
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - Frances S Chen
- Department of Psychology, University of British Columbia, Vancouver, Canada.
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Scarth M, Vonk JMJ, Gerritsen L, GGeerlings MI. Association of childhood maltreatment and cortisol with the severity and stability of depression symptoms. J Affect Disord 2022; 299:559-567. [PMID: 34936915 DOI: 10.1016/j.jad.2021.12.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/09/2021] [Accepted: 12/17/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Little is known about patterns of depression symptoms over time in older adults. This study aims to assess the association of childhood maltreatment and cortisol levels with latent classes of depression symptoms over ten years in older adults. METHODS A total of 752 participants (mean age 61.7±9.5, female 18%) in the Second Manifestations of ARTerial disease-Memory, depression and aging (SMART-Medea) study provided up to twenty measures of depression symptoms over ten years based on the Patient Health Questionnaire-9 (PHQ-9). At baseline, salivary cortisol was measured, and childhood maltreatment was assessed. Responses to the PHQ-9 were indicators in a latent class analysis. Multinomial regression determined associations between class membership and cortisol and maltreatment, adjusting for age, sex, and education. RESULTS Four distinct classes were identified; never depressed (n=275, 37%), energy/sleep difficulties (n=237, 32%), mild depression symptoms (n=152, 20%) and fluctuating severe depression (n=88, 12%). Childhood maltreatment was associated with mild depression symptoms (OR=1.95, 95% CI: 1.17-3.25) and fluctuating severe depression (OR=3.50, 95% CI: 1.99-6.15). Blunted morning cortisol was associated with energy/sleep difficulties (OR=0.98, 95% CI: 0.95-1.00) and fluctuating severe depression (OR=0.96, 95% CI: 0.92-0.99). There was no evidence for interaction between maltreatment and cortisol. LIMITATIONS There is limited generalizability due to the cohort consisting of participants with atherosclerosis and being mostly male. This study utilizes retrospective self-reporting of childhood maltreatment. CONCLUSION Childhood maltreatment and blunted morning cortisol independently contribute to a worse depression course. Blunted morning cortisol may contribute to sub-clinical depression symptoms, specifically difficulties with energy levels and sleep.
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Affiliation(s)
- Morgan Scarth
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Jet M J Vonk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Lotte Gerritsen
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Mirjam I GGeerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
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- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
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Gbaoui L, Fachet M, Lüno M, Meyer-Lotz G, Frodl T, Hoeschen C. Breathomics profiling of metabolic pathways affected by major depression: Possibilities and limitations. Front Psychiatry 2022; 13:1061326. [PMID: 36590606 PMCID: PMC9795849 DOI: 10.3389/fpsyt.2022.1061326] [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: 10/04/2022] [Accepted: 11/24/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the most common psychiatric disorders with multifactorial etiologies. Metabolomics has recently emerged as a particularly potential quantitative tool that provides a multi-parametric signature specific to several mechanisms underlying the heterogeneous pathophysiology of MDD. The main purpose of the present study was to investigate possibilities and limitations of breath-based metabolomics, breathomics patterns to discriminate MDD patients from healthy controls (HCs) and identify the altered metabolic pathways in MDD. METHODS Breath samples were collected in Tedlar bags at awakening, 30 and 60 min after awakening from 26 patients with MDD and 25 HCs. The non-targeted breathomics analysis was carried out by proton transfer reaction mass spectrometry. The univariate analysis was first performed by T-test to rank potential biomarkers. The metabolomic pathway analysis and hierarchical clustering analysis (HCA) were performed to group the significant metabolites involved in the same metabolic pathways or networks. Moreover, a support vector machine (SVM) predictive model was built to identify the potential metabolites in the altered pathways and clusters. The accuracy of the SVM model was evaluated by receiver operating characteristics (ROC) analysis. RESULTS A total of 23 differential exhaled breath metabolites were significantly altered in patients with MDD compared with HCs and mapped in five significant metabolic pathways including aminoacyl-tRNA biosynthesis (p = 0.0055), branched chain amino acids valine, leucine and isoleucine biosynthesis (p = 0.0060), glycolysis and gluconeogenesis (p = 0.0067), nicotinate and nicotinamide metabolism (p = 0.0213) and pyruvate metabolism (p = 0.0440). Moreover, the SVM predictive model showed that butylamine (p = 0.0005, pFDR=0.0006), 3-methylpyridine (p = 0.0002, pFDR = 0.0012), endogenous aliphatic ethanol isotope (p = 0.0073, pFDR = 0.0174), valeric acid (p = 0.005, pFDR = 0.0162) and isoprene (p = 0.038, pFDR = 0.045) were potential metabolites within identified clusters with HCA and altered pathways, and discriminated between patients with MDD and non-depressed ones with high sensitivity (0.88), specificity (0.96) and area under curve of ROC (0.96). CONCLUSION According to the results of this study, the non-targeted breathomics analysis with high-throughput sensitive analytical technologies coupled to advanced computational tools approaches offer completely new insights into peripheral biochemical changes in MDD.
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Affiliation(s)
- Laila Gbaoui
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
| | - Melanie Fachet
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
| | - Marian Lüno
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Gabriele Meyer-Lotz
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Thomas Frodl
- Department for Psychiatry and Psychotherapy, Medical Faculty, Otto von Guericke University, Magdeburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital, RWTH Aachen, Aachen, Germany
| | - Christoph Hoeschen
- Chair of Medical Systems Technology, Institute for Medical Technology, Otto von Guericke University, Magdeburg, Germany
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Osborne S, Biaggi A, Hazelgrove K, Preez AD, Nikkheslat N, Sethna V, Zunszain PA, Conroy S, Pawlby S, Pariante CM. Increased maternal inflammation and poorer infant neurobehavioural competencies in women with a history of major depressive disorder from the psychiatry research and motherhood - Depression (PRAM-D) study. Brain Behav Immun 2022; 99:223-230. [PMID: 34644586 DOI: 10.1016/j.bbi.2021.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Stress in pregnancy is associated with adverse outcomes in offspring, and developmental programming is a potential mechanism. We have previously shown that depression in pregnancy is a valid and clearly defined stress paradigm, and both maternal antenatal and offspring stress-related biology is affected. This study aims to clarify whether maternal biology in pregnancy and offspring outcomes can also be influenced by a history of a prior depression, in the absence of depression in pregnancy. Our primary hypothesis is that, similarly to women with depression in pregnancy, women with a history of depression but who are not depressed in pregnancy will have increased cortisol secretion and markers of immune system function, and that their offspring will have poorer neuro-developmental competencies and increased cortisol stress response. METHODS A prospective longitudinal design was used in 59 healthy controls and 25 women with a past history of depression who were not depressed in pregnancy, named as 'history-only', and their offspring. Maternal antenatal stress-related biology (cortisol and markers of immune system function) and offspring outcomes (gestational age at birth, neonatal neurobehaviour (Neonatal Behavioural Assessment Scale, NBAS), cortisol stress response and basal cortisol at 2 and 12 months) and cognitive, language and motor development (Bayley Scales of Infant and Toddler Development (BSID)) were measured. RESULTS Compared with healthy pregnant women, those with a history of depression who remain free of depression in pregnancy exhibit increased markers of immune system function in pregnancy: IL-8 (d = 0.63, p = 0.030), VEGF (d = 0.40, p = 0.008) and MCP-1 (d = 0.61, p = 0.002) and have neonates with lower neurobehavioural scores in most areas, reaching statistical significance in thesocial-interactive (d = 1.26, p = 0.015) cluster. However, there were no differences in maternal or offspring HPA axis function or in infant development at 12 months. CONCLUSION Our study indicates that pregnant women with a history of depression have increased markers of immune system function, and their offspring show behavioural alterations that may be the effects of in utero programming, epigenetic factors or genetic predisposition.
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Affiliation(s)
- Sarah Osborne
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Alessandra Biaggi
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Katie Hazelgrove
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Andrea Du Preez
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, Cutcombe Road, London SE5 9RX, UK
| | - Naghmeh Nikkheslat
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Vaheshta Sethna
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK; Sackler Institute for Translational Neurodevelopment, Department of Forensic & Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Patricia A Zunszain
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Susan Conroy
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Susan Pawlby
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK
| | - Carmine M Pariante
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London SE5 9RT, UK.
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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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Foshati S, Ghanizadeh A, Akhlaghi M. Extra-Virgin Olive Oil Improves Depression Symptoms Without Affecting Salivary Cortisol and Brain-Derived Neurotrophic Factor in Patients With Major Depression: A Double-Blind Randomized Controlled Trial. J Acad Nutr Diet 2021; 122:284-297.e1. [PMID: 34358723 DOI: 10.1016/j.jand.2021.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 07/04/2021] [Accepted: 07/29/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Many patients with depression are reluctant to take psychiatric medications. Hence, complementary therapies such as nutritional considerations could be advantageous. The antidepressant potential of olive oil has been proved in observational studies. OBJECTIVE The effect of extra-virgin olive oil (EVOO) on depression symptoms and cortisol and brain-derived neurotrophic factor (BDNF) levels in patients with depression was examined. DESIGN AND PARTICIPANTS This was a double-blind randomized controlled trial conducted on 73 patients suffering from major depressive disorder in Shiraz, Iran, in 2016. INTERVENTION The patients were randomly assigned to intervention (EVOO) and control (sunflower oil) groups and consumed 25 mL/d of the corresponding oil for 52 days. MAIN OUTCOME MEASURES Depression symptoms were assessed by Beck Depression Inventory-II (BDI-II) and 7-item Hamilton Depression Rating Scale (HAMD-7). Salivary cortisol levels were determined immediately after awakening and 30 minutes later. Cortisol awakening response and the area under the curve with respect to ground and increase were computed. Serum BDNF concentrations were also measured. STATISTICAL ANALYSES PERFORMED Statistical analysis was conducted based on intention-to-treat and per-protocol approaches. Within-group changes were examined with repeated measures (for BDI-II and HAMD-7) and with paired t test (for other variables). Between-group comparisons were performed with analysis of covariance after adjustment for confounding factors. RESULTS In intention-to-treat analysis, HAMD-7 score was the only variable with significant changes within and between groups, the latter as a greater decline in EVOO group (P = .001). BDI-II score did not show significant change in either group but the between-group comparison revealed a significant difference (P = .021). EVOO showed antidepressant effect in severely depressed patients (P = .017 for BDI-II and 0.008 for HAMD-7) but not in mild/moderate depression category. Serum BDNF concentrations, salivary cortisol levels at immediately after awakening (T0) and 30 minutes later, cortisol awakening response, the area under the curve with respect to ground and increase did not change within or between groups. Results of per-protocol analysis were not different. CONCLUSIONS The results of this study suggested beneficial effects of EVOO on depression symptoms in patients with severe depression but not in those with mild to moderate depression. The effects were significant from both statistical and clinical points of view.
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Gordon JL, Halleran M, Beshai S, Eisenlohr-Moul TA, Frederick J, Campbell TS. Endocrine and psychosocial moderators of mindfulness-based stress reduction for the prevention of perimenopausal depressive symptoms: A randomized controlled trial. Psychoneuroendocrinology 2021; 130:105277. [PMID: 34058560 DOI: 10.1016/j.psyneuen.2021.105277] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The menopause transition is associated with an increased risk of depressive symptoms. The current study aimed to test whether Mindfulness-Based Stress Reduction, an 8-week group intervention involving meditation and yoga, might reduce the risk of depressive symptoms among perimenopausal women. A secondary aim was to examine baseline characteristics, including sensitivity to estradiol fluctuation, as a moderator of treatment effects. METHODS 104 healthy women from the community in the menopause transition were enrolled and randomized to MBSR (n = 52) or a waitlist control condition (n = 52). Randomization was carried out using a random number generator and opaque sealed envelopes. Depressive symptoms, the main outcome, were assessed every two weeks for 6 months using the Center for Epidemiologic Studies Depression Scale (CES-D). The occurrence of an elevated CES-D score (≥16) and of a major depressive episode were pre-identified secondary outcomes. The following surveys were used to assess additional outcomes of interest every two months: the Perceived Stress Scale, Spielberger Trait Anxiety Inventory, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index. Baseline characteristics examined as potential moderators of treatment benefit included: baseline CES-D score, past depressive episodes, recent stressful life events, a history of physical or sexual abuse, and emotional sensitivity to reproductive hormone fluctuation. Outcome assessors were blinded to the participants' assigned treatment arm. RESULTS Outcome data were available for 44 women assigned to MBSR and 51 women in the waitlist condition. Women randomized to MBSR reported fewer depressive symptoms, less perceived stress, less anxiety, increased resilience, and improved sleep (ps < 0.001). Furthermore, several baseline characteristics predicted a greater mood benefit of MBSR, including: a history of major depression (p for the interaction <0.001), a greater number of recent stressful life events (p < .001), being in the early menopause transition (p = .002), and an increased emotional sensitivity to reproductive hormone fluctuation (p = .004). There were no group differences in the occurrence of major depressive episodes (p > .05). CONCLUSIONS MBSR appears to be an effective intervention for the prevention of depressive symptoms in the menopause transition.
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Affiliation(s)
- Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada.
| | - Maria Halleran
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Shadi Beshai
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | | | | | - Tavis S Campbell
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
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The effects of Pythagorean Self-Awareness Intervention on patients with major depressive disorder: A pilot randomized controlled trial. J Psychiatr Res 2021; 138:326-334. [PMID: 33894540 DOI: 10.1016/j.jpsychires.2021.03.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/26/2021] [Accepted: 03/31/2021] [Indexed: 11/20/2022]
Abstract
Stress plays an important role in major depressive disorder (MDD). Thus, a variety of stress management programs have been developed for people with this diagnosis. This is a pilot randomized clinical trial which implemented a holistic stress management program, Pythagorean Self-Awareness Intervention (PSAI) in adults with MDD, aiming to evaluate the effectiveness of PSAI compared to standard care for reduction of depressive symptoms (primary aim), improving mental health and quality of life (secondary aims). A total of 69 participants were randomized to an intervention group (N = 34), who received the usual care provided for patients with major depression and attended the PSAI program, and a control group (N = 35), who received the usual care only. Measurements were taken in both groups before and after the intervention and included: 1. Self-report questionnaires for measuring depressive symptoms, healthy lifestyle, perceived stress, anxiety, positive and negative affect and sleep quality, 2 Cognitive function assessment tools, 3. Hair and salivary cortisol. The intervention group demonstrated significantly greater reductions in depressive symptoms, negative affect, perceived stress, sleep quality and significantly greater increase in visual memory and healthy lifestyle compared to the control group. In addition, the intervention group demonstrated a significant reduction in first morning salivary cortisol, indicating a reduction in diurnal stress levels, while no significant change of salivary cortisol was observed in the control group. Finally, none of the study's groups demonstrated a significant change in hair cortisol concentration. In conclusion, PSAI can be applied to adults suffering from MDD with significant benefits for their mental health and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04536714.
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Dal Buono A, Caldirola D, Allocca M. Genetic susceptibility to inflammatory bowel disease: should we be looking to the hypothalamus? Expert Rev Clin Immunol 2021; 17:803-806. [PMID: 34047240 DOI: 10.1080/1744666x.2021.1933443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Arianna Dal Buono
- IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Hospital - IRCCS, Milan, Italy
| | - Daniela Caldirola
- Department of Clinical Neurosciences, Villa San Benedetto Menni Hospital, Hermanas Hospitalarias, Como, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mariangela Allocca
- IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Hospital - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Crewther BT, Kasprzycka W, Cook CJ, Rola R. Impact of one HF-rTMS session over the DLPFC and motor cortex on acute hormone dynamics and emotional state in healthy adults: a sham-controlled pilot study. Neurol Sci 2021; 43:651-659. [PMID: 34041633 DOI: 10.1007/s10072-021-05335-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/17/2021] [Indexed: 11/26/2022]
Abstract
Studies indicate that high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) can lower cortisol concentration or output, with some evidence suggesting a link to testosterone. Together, these stress and social hormones might help regulate the emotional response to HF-rTMS. This pilot study evaluated the effect of HF-rTMS on acute testosterone and cortisol dynamics and emotional state in eleven healthy adults. Using a sham-controlled, single-blind, crossover design, participants completed a HF-rTMS session targeting the dorsolateral prefrontal cortex (DLPFC) and motor cortex on separate days. Stimulation (250 total pulses) was applied at 90% of the resting motor threshold. Salivary testosterone and cortisol, mood, motivation, anxiety, and heart rate (HR) were assessed before (T1) and 1 (T2), 15 (T3), and 30 min (T4) after each session. There were no significant session differences in testosterone and cortisol concentration, mood, motivation, and HR. Although DLPFC stimulation produced less anxiety (vs. motor cortex), and testosterone output was stable across both treatments (vs. sham-related decline in testosterone), neither differed from the sham. Within-person fluctuations in testosterone, mood, motivation, and/or anxiety were significantly related across the DLPFC and motor cortex trials only. In conclusion, a single sub-maximal session of HF-rTMS did not affect the hormonal, emotional, or physiological state of healthy adults, relative to a sham. However, the emergence of stimulation-specific testosterone and/or emotional linkages suggests that the repeated effects of HF-rTMS may also manifest at the individual level. This offers another pathway to explain the therapeutic efficacy of rTMS and a model to explore interindividual variability in health-related outcomes.
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Affiliation(s)
- Blair T Crewther
- Department of Endocrinology, Institute of Sport - National Research Institute, Warsaw, Poland.
- Institute of Optoelectronics, Military University of Technology, Warsaw, Poland.
| | - Wiktoria Kasprzycka
- Institute of Optoelectronics, Military University of Technology, Warsaw, Poland
| | - Christian J Cook
- Biomedical Sciences, School of Science and Technology, University of New England, Armidale, Australia
- Hamlyn Centre, Imperial College, London, UK
| | - Rafał Rola
- Institute of Optoelectronics, Military University of Technology, Warsaw, Poland
- Military Institute of Aviation Medicine, Warsaw, Poland
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Romijn M, van Tilburg LJL, Hollanders JJ, van der Voorn B, de Goede P, Dolman KM, Heijboer AC, Broekman BFP, Rotteveel J, Finken MJJ. The Association between Maternal Stress and Glucocorticoid Rhythmicity in Human Milk. Nutrients 2021; 13:nu13051608. [PMID: 34064929 PMCID: PMC8151700 DOI: 10.3390/nu13051608] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Chronic stress is often accompanied by alterations in the diurnal rhythm of hypothalamus–pituitary–adrenal activity. However, there are limited data on the diurnal rhythmicity of breast milk glucocorticoids (GCs) among women with psychological distress. We compared mothers who sought consultation at an expertise center for pregnant women with an increased risk of psychological distress with control mothers for GC diurnal rhythmicity in milk and saliva obtained at the same time. Methods: We included 19 mothers who sought consultation at the psychiatry–obstetric–pediatric (POP) outpatient clinic and 44 control mothers. One month postpartum, mothers collected on average eight paired milk and saliva samples during a 24 h period. GC levels were measured using liquid chromatography–tandem mass spectrometry. GC rhythmicity parameters were determined with specialized software. Results: For both milk and saliva, no group differences regarding GC rhythms were found. Milk cortisol area under the curve with respect to the ground was lower in the POP group than in the control group (p = 0.02). GC levels in human milk and saliva were highly correlated within each group (p < 0.001). Conclusion: Although there were no differences between groups in GC rhythmicity, the total amount of milk cortisol was lower in the POP group. Long-term follow-up is needed to address the impact of vertical transmission of breast milk GCs.
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Affiliation(s)
- Michelle Romijn
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
- Correspondence: ; Tel.: +31-(0)20-444-3137
| | - Luca J. L. van Tilburg
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Jonneke J. Hollanders
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Bibian van der Voorn
- Department of Pediatrics, Division of Endocrinology, Erasmus MC-Sophia Children’s Hospital, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands;
| | - Paul de Goede
- Laboratory of Endocrinology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, 1105 AZ Amsterdam, The Netherlands;
| | - Koert M. Dolman
- Department of Pediatrics, Onze Lieve Vrouwe Gasthuis (OLVG), 1006 AE Amsterdam, The Netherlands;
| | - Annemieke C. Heijboer
- Department of Clinical Chemistry, Endocrine Laboratory, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Birit F. P. Broekman
- Department of Psychiatry, VU University Medical Centre, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands;
| | - Joost Rotteveel
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
| | - Martijn J. J. Finken
- Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam University Medical Centers, location VUmc, 1081 HV Amsterdam, The Netherlands; (L.J.L.v.T.); (J.J.H.); (J.R.); (M.J.J.F.)
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Vrije Universiteit Amsterdam, Amsterdam UMC, 1081 HV Amsterdam, The Netherlands
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Markopoulou K, Fischer S, Papadopoulos A, Poon L, Rane LJ, Fekadu A, Cleare AJ. Comparison of hypothalamo-pituitary-adrenal function in treatment resistant unipolar and bipolar depression. Transl Psychiatry 2021; 11:244. [PMID: 33903590 PMCID: PMC8076168 DOI: 10.1038/s41398-021-01343-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 01/19/2021] [Accepted: 02/25/2021] [Indexed: 01/04/2023] Open
Abstract
Altered functioning of the hypothalamic-pituitary-adrenal (HPA) axis has been demonstrated in patients with treatment-resistant depression, although studies have often conflated patients with unipolar and bipolar depression. This is problematic given that the two groups often present with opposed neurovegetative symptom patterns. The aim of this study was to test, for the first time, whether post-awakening cortisol, a highly reliable, naturalistic measure of HPA functioning, could distinguish patients with clearly defined treatment-resistant unipolar (TRUD) and bipolar depression (TRBD). A total of 37 patients with TRUD, 17 patients with TRBD, and 47 healthy controls were recruited. Areas under the curve (AUC) with respect to the ground (g) and increase (i) of post-awakening cortisol concentrations (awakening, +15, +30, +45, +60, +90 min) were measured over two days. Patients with TRUD had higher total cortisol production in the morning hours compared to controls (AUCg, p = 0.01), while they did not differ in terms of the awakening response (AUCi, p = 0.28). By contrast, subjects with TRBD had lower total cortisol when compared to controls by trend (AUCg, p = 0.07), while they did not differ in the awakening response (AUCi, p = 0.15). A direct comparison of TRUD and TRBD revealed differences in the AUCg (p = 0.003) and AUCi (p = 0.03). This finding of comparatively elevated HPA axis activity in the morning in TRUD and attenuated HPA axis activity in TRBD attests to a fundamental biological distinction between unipolar and bipolar depression. It has implications for the understanding and treatment of bipolar depression and in differentiating the two types of depression.
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Affiliation(s)
- Kalypso Markopoulou
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Susanne Fischer
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.7400.30000 0004 1937 0650Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Zürich, Switzerland
| | - Andrew Papadopoulos
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lucia Poon
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Lena J. Rane
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
| | - Abebaw Fekadu
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK ,grid.7123.70000 0001 1250 5688Centre for Innovative Drug Development and Therapeutic Trials for Africa, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anthony J. Cleare
- grid.13097.3c0000 0001 2322 6764Centre for Affective Disorders, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Affective Disorders Unit and Laboratory, South London and Maudsley NHS Foundation Trust, London, UK
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45
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Taylor SG, Roberts AM, Zarrett N. A Brief Mindfulness-Based Intervention (bMBI) to Reduce Teacher Stress and Burnout. TEACHING AND TEACHER EDUCATION 2021; 100:103284. [PMID: 35391939 PMCID: PMC8986160 DOI: 10.1016/j.tate.2021.103284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Teacher stress and burnout contribute to attrition and stress-related health concerns. Despite some positive effects, previous mindfulness-based interventions (MBI) have failed to incorporate key elements of methodological rigor and have included large dosages despite research suggesting that such dosages are iatrogenic. The current study demonstrates the efficacy of a brief MBI (bMBI; four sessions, six total hours) to reduce self-reported stress, burnout, and depression, and suggests the bMBI can protect against deleterious impacts to physiological functioning. The study informs the design and implementation of future MBIs, including strategies for reducing intervention dosages, in order to improve effectiveness and maximize cost-effectiveness.
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Affiliation(s)
- Stephen G. Taylor
- University of South Carolina, Columbia, SC, USA, Department of Psychology
| | - Alex M. Roberts
- University of South Carolina, Columbia, SC, USA, Department of Psychology
| | - Nicole Zarrett
- University of South Carolina, Columbia, SC, USA, Department of Psychology
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Varela YM, de Almeida RN, Galvão ACDM, de Sousa GM, de Lima ACL, da Silva NG, Leocadio-Miguel MA, Lobão-Soares B, Hallak JEC, Maia-de-Oliveira JP, Galvão-Coelho NL. Psychophysiological responses to group cognitive-behavioral therapy in depressive patients. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01324-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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47
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Sasaki Y, Shobugawa Y, Nozaki I, Takagi D, Nagamine Y, Funato M, Chihara Y, Shirakura Y, Lwin KT, Zin PE, Bo TZ, Sone T, Win HH. Association between depressive symptoms and objective/subjective socioeconomic status among older adults of two regions in Myanmar. PLoS One 2021; 16:e0245489. [PMID: 33507963 PMCID: PMC7842968 DOI: 10.1371/journal.pone.0245489] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 01/03/2021] [Indexed: 12/20/2022] Open
Abstract
Low objective socioeconomic status (SES) has been correlated with poor physical and mental health among older adults. Some studies suggest that subjective SES is also important for ensuring sound physical and mental health among older adults. However, few studies have been conducted on the impact of both objective and subjective SES on mental health among older adults. This study examines whether objective or subjective SES is associated with depressive symptoms in older adults in Myanmar. This cross-sectional study, conducted between September and December, 2018, used a multistage sampling method to recruit participants from two regions of Myanmar, for face-to-face interviews. The Geriatric Depression Scale (GDS) was used to evaluate the depressive symptoms. Participants were classified as having no depressive symptom (GDS score <5) and having depressive symptoms (GDS score ≥5). Objective and subjective SES were assessed using the wealth index and asking participants a multiple-choice question about their current financial situation, respectively. The relationship between objective/subjective SES and depressive symptoms was examined using a multivariable logistic regression analysis. The mean age of the 1,186 participants aged 60 years and above was 69.7 (SD: 7.3), and 706 (59.5%) were female. Among them, 265 (22.3%) had depressive symptoms. After adjusting for objective SES and other covariates, only low subjective SES was positively associated with depressive symptoms (adjusted odds ratio, AOR: 4.18, 95% confidence interval, CI: 2.98-5.87). This association was stronger among participants in the rural areas (urban areas, AOR: 2.10, 95% CI: 1.08-4.05; rural areas, AOR: 5.65, 95% CI: 3.69-8.64). Subjective SES has a stronger association with depressive symptoms than objective SES, among older adults of the two regions in Myanmar, especially in the rural areas. Interventions for depression in older adults should consider regional differences in the context of subjective SES by reducing socioeconomic disparities among the communities.
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Affiliation(s)
- Yuri Sasaki
- National Institute of Public Health, Wako, Japan
- * E-mail:
| | - Yugo Shobugawa
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ikuma Nozaki
- National Center for Global Health and Medicine, Tokyo, Japan
| | | | | | - Masafumi Funato
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Yuki Chihara
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yuki Shirakura
- Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | | | - Poe Ei Zin
- University of Medicine 1, Yangon, Myanmar
| | | | | | - Hla Hla Win
- University of Medicine 1, Yangon, Myanmar
- University of Public Health, Yangon, Myanmar
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48
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Krystal AD, Mittoux A, Lindsten A, Baker RA. Chronobiologic parameter changes in patients with major depressive disorder and sleep disturbance treated with adjunctive brexpiprazole: An open-label, flexible-dose, exploratory substudy. J Affect Disord 2021; 278:288-295. [PMID: 32979560 DOI: 10.1016/j.jad.2020.09.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 07/31/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Circadian rhythm disturbances have been reported in patients with major depressive disorder (MDD). Among these is an increased phase angle between peak cortisol concentration and dim-light melatonin onset (DLMO). The aim of this study was to evaluate changes in chronobiologic parameters of sleep in patients with MDD receiving adjunctive brexpiprazole. METHODS This was an interventional, multicenter, open-label, flexible-dose, exploratory study in patients with MDD and inadequate response to antidepressant treatment who were experiencing sleep disturbances. Patients received adjunctive brexpiprazole 2-3 mg/day for 8 weeks. Outcome measures included cortisol and melatonin levels, used to calculate phase angle, and the Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN). RESULTS The mean (standard error) phase angle between peak cortisol and DLMO increased by 108 (61) minutes from baseline to Week 8 (n = 9). BRIAN Total score changed (improved) by -14.6 (4.6) points from baseline to Week 8 (n = 9). Change in phase angle and BRIAN Total score showed a moderate-to-high correlation (Pearson coefficient: 0.68; 95% confidence limits: 0.04, 0.93; p = 0.040). LIMITATIONS This study is limited by its small sample size, and its single-arm, open-label design. CONCLUSIONS The findings provide a preliminary indication that the phase angle between peak cortisol and DLMO is of interest as a potential biomarker for depression and therapeutic response. Adjunctive brexpiprazole may represent a strategy for correcting circadian dysfunction in patients with MDD and inadequate response to antidepressant treatment. ClinicalTrials.gov identifier: NCT01942733.
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Affiliation(s)
- Andrew D Krystal
- Duke University Hospital, Durham, NC, United States; University of California, San Francisco, CA, United States.
| | | | | | - Ross A Baker
- Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, United States
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Walker WH, Walton JC, Nelson RJ. Disrupted circadian rhythms and mental health. HANDBOOK OF CLINICAL NEUROLOGY 2021; 179:259-270. [PMID: 34225967 DOI: 10.1016/b978-0-12-819975-6.00016-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
During the evolution of life, the temporal rhythm of our rotating planet was internalized in the form of circadian rhythms. Circadian rhythms are ~24h internal manifestations that drive daily patterns of physiology and behavior. These rhythms are entrained (synchronized) to the external environment, primarily by the light-dark cycle, and precisely controlled via molecular clocks located within the suprachiasmatic nucleus of the hypothalamus. Misalignment and/or disruption of circadian rhythms can have detrimental consequences for human health. Indeed, studies suggest strong associations between mental health and circadian rhythms. However, direct interactions between mood regulation and the circadian system are just beginning to be uncovered and appreciated. This chapter examines the relationship between disruption of circadian rhythms and mental health. The primary focus will be outlining the association between circadian disruption, in the form of night shift work, exposure to light at night, jet lag, and social jet lag, and psychiatric illness (i.e., anxiety, major depressive disorder, bipolar disorder, and schizophrenia). Additionally, we review animal models of disrupted circadian rhythms, which provide further evidence in support of a strong association between circadian disruption and affective responses. Finally, we discuss future directions for the field and suggest areas of study that require further investigation.
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Affiliation(s)
- William H Walker
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States.
| | - James C Walton
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
| | - Randy J Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, United States
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50
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Qing Y, van Zuiden M, Eriksson C, Lopes Cardozo B, Simon W, Ager A, Snider L, Sabin ML, Scholte W, Kaiser R, Rijnen B, Olff M. Cortisol awakening response over the course of humanitarian aid deployment: a prospective cohort study. Eur J Psychotraumatol 2020; 11:1816649. [PMID: 33680342 PMCID: PMC7875048 DOI: 10.1080/20008198.2020.1816649] [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: 11/24/2022] Open
Abstract
Background: Internationally deployed humanitarian aid (HA) workers are routinely confronted with potentially traumatic stressors. However, it remains unknown whether HA deployment and related traumatic stress are associated with long-term changes in hypothalamic-pituitary-adrenal (HPA) axis function. Therefore, we investigated whether cortisol awakening response (CAR) decreased upon deployment and whether this was moderated by previous and recent trauma exposure and parallel changes in symptom severity and perceived social support. Methods: In this prospective study, n = 86 HA workers (68% females) completed questionnaires regarding trauma exposure, posttraumatic stress disorder (PTSD), anxiety and depressive symptoms and perceived social support, as well as salivary cortisol assessments at awakening and 30 minutes post-awakening at before, early and 3-6 months post-deployment. Results: Linear mixed models showed significantly decreased CAR (b(SE) = -.036(.011), p = .002) and awakening cortisol over time (b(SE) = -.007(.003), p = .014). The extent of awakening cortisol change was significantly moderated by interactions between previous and recent trauma exposure. Also, a steeper awakening cortisol decrease was significantly associated with higher mean anxiety and PTSD symptoms across assessments. No significant effects were found for social support. Conclusions: We observed attenuated CAR and awakening cortisol upon HA deployment, with a dose-response effect between trauma exposure before and during the recent deployment on awakening cortisol. Awakening cortisol change was associated with PTSD and anxiety symptom levels across assessments. Our findings support the need for organizational awareness that work-related exposures may have long-lasting biological effects. Further research assessing symptoms and biological measures in parallel is needed to translate current findings into guidelines on the individual level.
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Affiliation(s)
- Yulan Qing
- Department of Psychiatry, Amsterdam University Medical Centers, Location AMC, Amsterdam Neuroscience and Public Health Research Institutes, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Location AMC, Amsterdam Neuroscience and Public Health Research Institutes, University of Amsterdam, Amsterdam, The Netherlands
| | - Cynthia Eriksson
- Graduate School of Psychology, Fuller Theological Seminary, Pasadena, CA, USA
| | - Barbara Lopes Cardozo
- Division of Global Health Protection, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | | | - Alastair Ager
- Mailman School of Public Health, Columbia University, New York, NY, USA.,Institute for Global Health and Development, Queen Margaret University, Scotland, UK
| | - Leslie Snider
- The MHPSS Collaborative for Children and Families in Adversity, Save the Children Denmark, København, Denmark
| | - Miriam Lewis Sabin
- The Partnership for Maternal, Newborn & Child Health (PMNCH), Geneva 27, Switzerland
| | - Willem Scholte
- Department of Psychiatry, Amsterdam University Medical Centers, Location AMC, Amsterdam Neuroscience and Public Health Research Institutes, University of Amsterdam, Amsterdam, The Netherlands.,The Antares Foundation, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Reinhard Kaiser
- Division of Global Health Protection, Centers for Disease Control and Prevention (CDC), Dulles, VA, USA
| | - Bas Rijnen
- Namibia University of Science and Technology, Windhoek, Namibia
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, Location AMC, Amsterdam Neuroscience and Public Health Research Institutes, University of Amsterdam, Amsterdam, The Netherlands.,ARQ National Psychotrauma Centre, Diemen, The Netherlands
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