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Liu J, Ning W, Zhang N, Zhu B, Mao Y. Estimation of the Global Disease Burden of Depression and Anxiety between 1990 and 2044: An Analysis of the Global Burden of Disease Study 2019. Healthcare (Basel) 2024; 12:1721. [PMID: 39273745 PMCID: PMC11395616 DOI: 10.3390/healthcare12171721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/19/2024] [Accepted: 08/27/2024] [Indexed: 09/15/2024] Open
Abstract
(1) Background: Depression and anxiety are the most common and severe mental disorders. This research estimated the prevalence and disease burden of depression and anxiety from 1990 to 2044. (2) Methods: Data on disease burden, population, and risk factors were identified and gathered from the Global Health Data Exchange database. The time trends, sex and age differences, key factors, and regional variations in and predictions of depression and anxiety were analyzed based on the age-standardized incidence rate, prevalence rate, and DALY rate. (3) Results: Our findings revealed that the burden of depression and anxiety was heavy. Specifically, the age-standardized DALY rate of depression started to decrease compared with trends related to anxiety disorders. Meanwhile, females bear a heavier burden for both depression and anxiety. Seniors and the middle-aged population carry the highest burden regarding mental disorders. Both high- and low-socio-demographic-index countries were found to be high-risk regions for depressive disorders. The disease burden attributed to childhood sexual abuse, bullying victimization, and intimate partner violence has increased since 1990. Finally, projections regarding depression and anxiety revealed geographic and age variations. (4) Conclusions: Public health researchers, officers, and organizations should take effective age-, sex-, and location-oriented measures.
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Affiliation(s)
- Jinnan Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
| | - Wei Ning
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
- International Centre for Reproductive Health, Ghent University, 9000 Ghent, Belgium
| | - Ning Zhang
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Bin Zhu
- School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China
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Chang YW, Buerke M, Galfalvy H, Szanto K. Childhood trauma is associated with early-onset but not late-onset suicidal behavior in late-life depression. Int Psychogeriatr 2024; 36:371-384. [PMID: 37642013 PMCID: PMC10902201 DOI: 10.1017/s1041610223000662] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To examine the relationship between childhood traumatic experiences and early and late-onset suicidal behavior among depressed older adults. DESIGN Cross-sectional study. SETTING Inpatient and outpatient psychiatric services in Pennsylvania. PARTICIPANTS Our sample included 224 adults aged 50+ (M ± SD = 62.5 ± 7.4) recruited into three depressed groups: (1) 84 suicide attempters, (2) 44 suicide ideators, and (3) 58 non-suicidal comparisons, and a non-psychiatric healthy comparison group (N = 38). MEASUREMENTS The Childhood Trauma Questionnaire measured experiences of childhood trauma such as emotional abuse, physical abuse, emotional neglect, physical neglect, and sexual abuse. RESULTS Attempters were separated into early- and late-onset based on age of first attempt using a statistical algorithm that identified a cutoff age of 30 years old. Overall, we found group differences in emotional and physical abuse and neglect in both genders and sexual abuse in females, but not in males. Early-onset attempters experienced more childhood emotional abuse and neglect than late-onset attempters and were more likely to have experienced multiple forms of abuse. They also experienced more emotional abuse and neglect than all comparison groups. Consistently, early-onset attempters more often met criteria for current or lifetime PTSD relative to late-onset attempters and most comparison groups. Late-onset attempters had similar levels of childhood trauma as other depressed groups. CONCLUSIONS Our study reaffirms that there are distinct pathways to suicidal behavior in older adults based on their age of first suicide attempt and that trauma experienced in childhood has long-lasting emotional and behavioral consequences, even into late life.
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Affiliation(s)
- Ya-Wen Chang
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Morgan Buerke
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Hanga Galfalvy
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, NY, USA
| | - Katalin Szanto
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Yonezawa K, Uchida H, Yatomi T, Ohtani Y, Nomoto-Takahashi K, Nakajima S, Mimura M, Tani H. Factors Associated with Antidepressant Effects of Ketamine: A Reanalysis of Double-Blind Randomized Placebo-Controlled Trial of Intravenous Ketamine for Treatment-Resistant Depression. PHARMACOPSYCHIATRY 2024; 57:35-40. [PMID: 37846462 DOI: 10.1055/a-2179-8884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
INTRODUCTION Predictors of treatment response to intravenous ketamine remain unclear in patients with treatment-resistant depression (TRD); therefore, this study aimed to clarify these predictors using the US National Institutes of Health database of clinical trials. METHODS Data from a placebo-controlled, double-blind, randomized controlled trial were used to assess the efficacy of intravenous ketamine in adult patients with TRD (NCT01920555). For the analysis, data were used from the participants who had received therapeutic doses of intravenous ketamine (i. e., 0.5 and 1.0 mg/kg). Logistic and multivariable regression analyses were conducted to explore the demographic and clinical factors associated with response to treatment or changes in the Hamilton Depression Rating Scale 6 items (HAM-D-6) total score. RESULTS This study included 31 patients with TRD (13 women; mean±standard deviation age, 48.4±10.9 years). Logistic regression analysis showed that the age of onset was positively correlated with treatment response after three days of ketamine administration (β=0.08, p=0.037); however, no association was observed between treatment response and age, sex, baseline HAM-D-6 total score, or dissociative score assessed with the Clinician-Administered Dissociative States Scale 40 min after ketamine infusion. Multiple regression analysis showed that no factors were correlated significantly with the percentage change in the HAM-D-6 total score three days after ketamine administration. DISCUSSION Later disease onset correlates with a better treatment response three days after ketamine infusion in patients with TRD. Glutamatergic signal transmission may be impaired in patients with an earlier onset of depression, resulting in decreased neuroplasticity, which diminishes ketamine response.
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Affiliation(s)
- Kengo Yonezawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hiroyuki Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Taisuke Yatomi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yohei Ohtani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Shinichiro Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hideaki Tani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Bashford-Largo J, R Blair RJ, Blair KS, Dobbertin M, Dominguez A, Hatch M, Bajaj S. Identification of structural brain alterations in adolescents with depressive symptomatology. Brain Res Bull 2023; 201:110723. [PMID: 37536609 PMCID: PMC10451038 DOI: 10.1016/j.brainresbull.2023.110723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/10/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Depressive symptoms can emerge as early as childhood and may lead to adverse situations in adulthood. Studies have examined structural brain alternations in individuals with depressive symptoms, but findings remain inconclusive. Furthermore, previous studies have focused on adults or used a categorical approach to assess depression. The current study looks to identify grey matter volumes (GMV) that predict depressive symptomatology across a clinically concerning sample of adolescents. METHODS Structural MRI data were collected from 338 clinically concerning adolescents (mean age = 15.30 SD=2.07; mean IQ = 101.01 SD=12.43; 132 F). Depression symptoms were indexed via the Mood and Feelings Questionnaire (MFQ). Freesurfer was used to parcellate the brain into 68 cortical regions and 14 subcortical regions. GMV was extracted from all 82 brain areas. Multiple linear regression was used to look at the relationship between MFQ scores and region-specific GMV parameter. Follow up regressions were conducted to look at potential effects of psychiatric diagnoses and medication intake. RESULTS Our regression analysis produced a significant model (R2 = 0.446, F(86, 251) = 2.348, p < 0.001). Specifically, there was a negative association between GMV of the left parahippocampal (B = -0.203, p = 0.005), right rostral anterior cingulate (B = -0.162, p = 0.049), and right frontal pole (B = -0.147, p = 0.039) and a positive association between GMV of the left bank of the superior temporal sulcus (B = 0.173, p = 0.029). Follow up analyses produced results proximal to the main analysis. CONCLUSIONS Altered regional brain volumes may serve as biomarkers for the development of depressive symptoms during adolescence. These findings suggest a homogeneity of altered cortical structures in adolescents with depressive symptoms.
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Affiliation(s)
- Johannah Bashford-Largo
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA; Center for Brain, Biology, and Behavior, University of Nebraska-Lincoln, Lincoln, NE, USA.
| | - R James R Blair
- Child and Adolescent Mental Health Centre, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Karina S Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Matthew Dobbertin
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA; Child and Adolescent Inpatient Psychiatric Unit, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Ahria Dominguez
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Melissa Hatch
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Sahil Bajaj
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Han S, Cui Q, Zheng R, Li S, Zhou B, Fang K, Sheng W, Wen B, Liu L, Wei Y, Chen H, Chen Y, Cheng J, Zhang Y. Parsing altered gray matter morphology of depression using a framework integrating the normative model and non-negative matrix factorization. Nat Commun 2023; 14:4053. [PMID: 37422463 PMCID: PMC10329663 DOI: 10.1038/s41467-023-39861-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 06/27/2023] [Indexed: 07/10/2023] Open
Abstract
The high inter-individual heterogeneity in individuals with depression limits neuroimaging studies with case-control approaches to identify promising biomarkers for individualized clinical decision-making. We put forward a framework integrating the normative model and non-negative matrix factorization (NMF) to quantitatively assess altered gray matter morphology in depression from a dimensional perspective. The proposed framework parses altered gray matter morphology into overlapping latent disease factors, and assigns patients distinct factor compositions, thus preserving inter-individual variability. We identified four robust disease factors with distinct clinical symptoms and cognitive processes in depression. In addition, we showed the quantitative relationship between the group-level gray matter morphological differences and disease factors. Furthermore, this framework significantly predicted factor compositions of patients in an independent dataset. The framework provides an approach to resolve neuroanatomical heterogeneity in depression.
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Affiliation(s)
- Shaoqiang Han
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Ruiping Zheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Shuying Li
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
| | - Bingqian Zhou
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Keke Fang
- Department of Pharmacy, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Henan Province, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Baohong Wen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Liang Liu
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Yarui Wei
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
| | - Huafu Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| | - Yuan Chen
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China.
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China.
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China.
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China.
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China.
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China.
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China.
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China.
| | - Yong Zhang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Henan Province, China
- Key Laboratory for Functional Magnetic Resonance Imaging and Molecular Imaging of Henan Province, Henan Province, China
- Engineering Technology Research Center for Detection and Application of Brain Function of Henan Province, Henan Province, China
- Engineering Research Center of Medical Imaging Intelligent Diagnosis and Treatment of Henan Province, Henan Province, China
- Key Laboratory of Magnetic Resonance and Brain Function of Henan Province, Henan Province, China
- Key Laboratory of Brain Function and Cognitive Magnetic Resonance Imaging of Zhengzhou, Henan Province, China
- Key Laboratory of Imaging Intelligence Research medicine of Henan Province, Henan Province, China
- Henan Engineering Research Center of Brain Function Development and Application, Henan Province, China
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Dai L, Zhang X, Yu R, Wang X, Deng F, Li X, Kuang L. Abnormal brain spontaneous activity in major depressive disorder adolescents with non-suicidal self injury and its changes after sertraline therapy. Front Psychiatry 2023; 14:1177227. [PMID: 37383613 PMCID: PMC10293671 DOI: 10.3389/fpsyt.2023.1177227] [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: 03/01/2023] [Accepted: 05/25/2023] [Indexed: 06/30/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) commonly occurs among adolescents with major depressive disorder (MDD), causing adverse effects on the physical and mental health of the patients. However, the underlying neurobiological mechanism of NSSI in adolescents with MDD (nsMDDs) remains unclear, and there are still challenges in the treatment. Studies have suggested that sertraline administration could be an effective way for treatment. Methods To verify the effectiveness and to explore the neurobiological processes, we treated a group of adolescents with nsMDDs with sertraline in this study. The brain spontaneous activity alteration was then investigated in fifteen unmedicated first-episode adolescent nsMDDs versus twenty-two healthy controls through the resting-state functional magnetic resonance imaging. Besides the baseline scanning for all participants, the nsMDDs group was scanned again after eight weeks of sertraline therapy to examine the changes after treatment. Results At pre-treatment, whole brain analysis of mean amplitude of low-frequency fluctuation (mALFF) was performed to examine the neuronal spontaneous activity alteration, and increased mALFF was found in the superior occipital extending to lingual gyrus in adolescent nsMDDs compared with controls. Meanwhile, decreased mALFF was found in the medial superior frontal in adolescent nsMDDs compared with controls. Compared with the pre-treatment, the nsMDDs group was found to have a trend of, respectively, decreased and increased functional neuronal activity at the two brain areas after treatment through the region of interest analysis. Further, whole brain comparison of mALFF at pre-treatment and post-treatment showed significantly decreased spontaneous activity in the orbital middle frontal and lingual gyrus in adolescent nsMDDs after treatment. Also, depression severity was significantly decreased after treatment. Conclusion The abnormal functional neuronal activity found at frontal and occipital cortex implied cognitive and affective disturbances in adolescent nsMDDs. The trend of upregulation of frontal neuronal activity and downregulation of occipital neuronal activity after sertraline treatment indicated that the therapy could be effective in regulating the abnormality. Notably, the significantly decreased neuronal activity in the decision related orbital middle frontal and anxiety-depression related lingual gyrus could be suggestive of reduced NSSI in adolescent MDD after therapy.
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Affiliation(s)
- Linqi Dai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiaoliu Zhang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Renqiang Yu
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xingyu Wang
- Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei Deng
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xue Li
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Hashmi AN, Qamar R, Taj R, Zubair UB, Agha Z, Abbasi SA, Azam M. Contributing risk factors of common psychiatric disorders in the Pakistani population. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01545-y. [PMID: 36583741 DOI: 10.1007/s00406-022-01545-y] [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: 06/26/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022]
Abstract
With an increasing incidence of psychiatric disorders worldwide, there is a need for a better understanding of the population-specific contributing risk factors that are associated with common psychiatric conditions. This study aimed to assess the correlation between socioeconomic, environmental and clinical features associated with major depression (MDD n = 479), bipolar disorder (BD n = 222) and schizophrenia (SHZ n = 146), in the Pakistani population. Multinomial logistic regression and Pearson's correlation were applied to assess the association and correlation between demographic, socioeconomic, environmental, and clinical features of MDD, BD and SHZ. In the present study, MDD was found to be more prevalent than BD and SHZ. The average age at onset (AAO), was observed to be earlier in females with BD and SHZ, in addition, females with a positive family history of MDD, BD and SHZ also had an earlier AAO. The fitted multinomial logistic regression model indicated a significant association of; aggression, tobacco use, drugs abuse, history of head injuries and family history with BD as compared to MDD, while insomnia and suicidality were significantly associated with MDD. Strong positive correlations were observed mainly between age/AAO, AAO/tobacco use and aggression/insomnia in all three cohorts. In conclusion, the present study identifies possible contributing socio-demographic, biological and environmental factors that are correlated and associated with the psychiatric conditions in the Pakistani population.
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Affiliation(s)
- Aisha Nasir Hashmi
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Raheel Qamar
- Science and Technology Sector, ICESCO, Rabat, Morocco.,Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Rizwan Taj
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Usama Bin Zubair
- Department of Psychiatry, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Zehra Agha
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan
| | - Saddam Akber Abbasi
- Statistics Program, Department of Mathematics, Statistics & Physics, College of Arts and Science, Qatar University, Doha, Qatar. .,Statistical Consulting Unit, College of Arts and Science, Qatar University, 2713, Doha, Qatar.
| | - Maleeha Azam
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Tarlai Kalan, Park Road, Islamabad, 45600, Pakistan.
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Gil M, Kim SS, Min EJ. Machine learning models for predicting risk of depression in Korean college students: Identifying family and individual factors. Front Public Health 2022; 10:1023010. [PMID: 36466485 PMCID: PMC9714606 DOI: 10.3389/fpubh.2022.1023010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Depression is one of the most prevalent mental illnesses among college students worldwide. Using the family triad dataset, this study investigated machine learning (ML) models to predict the risk of depression in college students and identify important family and individual factors. Methods This study predicted college students at risk of depression and identified significant family and individual factors in 171 family data (171 fathers, mothers, and college students). The prediction accuracy of three ML models, sparse logistic regression (SLR), support vector machine (SVM), and random forest (RF), was compared. Results The three ML models showed excellent prediction capabilities. The RF model showed the best performance. It revealed five significant factors responsible for depression: self-perceived mental health of college students, neuroticism, fearful-avoidant attachment, family cohesion, and mother's depression. Additionally, the logistic regression model identified five factors responsible for depression: the severity of cancer in the father, the severity of respiratory diseases in the mother, the self-perceived mental health of college students, conscientiousness, and neuroticism. Discussion These findings demonstrated the ability of ML models to accurately predict the risk of depression and identify family and individual factors related to depression among Korean college students. With recent developments and ML applications, our study can improve intelligent mental healthcare systems to detect early depressive symptoms and increase access to mental health services.
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Affiliation(s)
- Minji Gil
- College of Nursing, Ewha Womans University, Seoul, South Korea
| | - Suk-Sun Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea,Ewha Research Institute of Nursing Science, Ewha Womans University, Seoul, South Korea,*Correspondence: Suk-Sun Kim
| | - Eun Jeong Min
- Department of Medical Life Sciences, School of Medicine, The Catholic University of Korea, Seoul, South Korea,Eun Jeong Min
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Risk of conversion to bipolar disorder in patients with late-onset major depression. Int Clin Psychopharmacol 2022; 37:234-241. [PMID: 35916593 DOI: 10.1097/yic.0000000000000421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To evaluate the impact of age at onset on late-life depression course and on risk of conversion to bipolar disorder (BD). A retrospective chart review of 100 elderly patients (age ≥ 65 years) diagnosed with a moderate-to-severe depressive episode and followed up for at least 18 months was conducted. Among patients affected by major depressive disorder ( N = 57), follow-up morbidity differences between those with typical onset depression (TOD) (<60 years) and those with late-onset depression (LOD) (≥60 years) were investigated using Wilcoxon rank-sum test and Cox proportional hazard model. Patients belonging to the LOD group had a significantly lower percentage of follow-up time spent with depressive symptoms compared with patients with TOD ( r = 0.36; P = 0.006), but significantly more time spent with (hypo)manic episodes ( r = -0.31; P = 0.021). Moreover, LOD was significantly associated with a faster conversion to BD (hazard ratio = 3.05; P = 0.037). Depression first emerging in late life may represent an unstable condition with a high risk to convert to BD. Given the potential clinical implications, further studies on the course of LOD are required.
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Barker MS, Cosentino SA, Fremont R, Devanand DP, Huey ED. Towards Defining the Neuroanatomical Basis of Late-Onset Psychiatric Symptoms. J Geriatr Psychiatry Neurol 2022; 35:751-762. [PMID: 35380884 PMCID: PMC11270909 DOI: 10.1177/08919887221090213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Psychiatric symptoms, including changes in emotional processing, are a common feature of many neurodegenerative disorders, such as Alzheimer's disease, dementia with Lewy Bodies, frontotemporal dementia, and Huntington's disease. However, the neuroanatomical basis of emotional symptoms is not well defined; this stands in contrast to the relatively well-understood neuroanatomical correlates of cognitive and motor symptoms in neurodegenerative disorders. Furthermore, psychiatric diagnostic categories, as defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Statistical Classification of Diseases and Related Health Problems (ICD), may have limited applicability in patients with late-onset psychiatric symptoms in the context of neurodegenerative disorders. In this clinical review, we suggest that early-onset and late-onset psychiatric symptoms have distinct etiologies, and that late-onset changes in emotional processing are likely underpinned by neurodegenerative disease. Furthermore, we suggest that an improved understanding of the neuroanatomical correlates of emotional changes in neurodegenerative disease may facilitate diagnosis and future treatment development. Finally, we propose a novel clinical approach, in a preliminary attempt to incorporate late-onset emotional symptoms alongside cognitive and motor symptoms into a clinical "algorithm," with a focus on the neuroanatomy implicated when particular combinations of emotional, cognitive, and motor features are present. We anticipate that this clinical approach will assist with the diagnosis of neurodegenerative disorders, and our proposed schema represents a move towards integrating neurologic and psychiatric classification systems.
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Affiliation(s)
- Megan S. Barker
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Stephanie A. Cosentino
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Rachel Fremont
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Davangere P. Devanand
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Edward D. Huey
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Division of Geriatric Psychiatry, Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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11
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Miola A, Tondo L, Salvatore P, Baldessarini RJ. Factors associated with onset-age in major affective disorders. Acta Psychiatr Scand 2022; 146:456-467. [PMID: 36059155 PMCID: PMC9826467 DOI: 10.1111/acps.13497] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/25/2022] [Accepted: 08/28/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Research findings on factors associated with onset-age (OA) with bipolar (BD) and major depressive disorders (MDD) have been inconsistent, but often indicate greater morbidity following early OA. METHODS We considered factors associated with OA in 1033 carefully evaluated, systematically followed mood disorder subjects with DSM-5 BD (n = 505) or MDD (n = 528), comparing rates of descriptive and clinical characteristics following early (age <18), intermediate (18-40), or later onset (≥40 years), as well as regressing selected measures versus OA. Exposure time (years ill) was matched among these subgroups. RESULTS As hypothesized, many features were associated with early OA: familial psychiatric illness, including BD, greater maternal age, early sexual abuse, nondepressive first episodes, co-occurring ADHD, suicide attempts and violent suicidal behavior, abuse of alcohol or drugs, smoking, and unemployment. Other features increased consistently with later OA: %-time-depressed (in BD and MDD, women and men), as well as depressions/year and intake ratings of depression, educational levels, co-occurring medical disorders, rates of marriage and number of children. CONCLUSIONS OA averaged 7.5 years earlier in BD versus MDD (30.7 vs. 38.2). Some OA-associated measures may reflect maturation. Associations with family history and suicidal risk with earlier OA were expected; increases of time-depressed in both BD and MDD with later OA were not. We conclude that associations of OA with later morbidity are complex and not unidirectional but may be clinically useful.
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Affiliation(s)
- Alessandro Miola
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research CenterMcLean HospitalBelmontMassachusettsUSA,Department of PsychiatryUniversity of PadovaPaduaItaly
| | - Leonardo Tondo
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research CenterMcLean HospitalBelmontMassachusettsUSA,Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA,Lucio Bini Mood Disorder CentersCagliariRomeItaly
| | - Paola Salvatore
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research CenterMcLean HospitalBelmontMassachusettsUSA,Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA,Center for Healthcare Organization & Implementation ResearchUS Veterans Administration Medical CenterBedfordMassachusettsUSA
| | - Ross J. Baldessarini
- International Consortium for Mood & Psychotic Disorders Research, Mailman Research CenterMcLean HospitalBelmontMassachusettsUSA,Department of PsychiatryHarvard Medical SchoolBostonMassachusettsUSA
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12
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He X, Song J, Gao H, Li Z, Wang X, Zeng Q, Xiao Y, Feng J, Zhou D, Wang G. Serum brain-derived neurotrophic factor and glial cell-derived neurotrophic factor in patients with first-episode depression at different ages. Int J Psychiatry Clin Pract 2022:1-9. [PMID: 35980319 DOI: 10.1080/13651501.2022.2107938] [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: 10/15/2022]
Abstract
OBJECTIVES We investigated the differences in serum brain-derived neurotrophic factor (BDNF) and glial cell line-derived neurotrophic factor (GDNF) levels and clinical symptoms with first-episode depression at different ages. METHODS Ninety patients (15-60 years old) diagnosed with first-episode depression were enrolled as the study group, and they were divided into early-onset, adult and late-onset groups. The age-matched control groups were healthy volunteers. Serum BDNF and GDNF concentrations were determined by enzyme-linked immunosorbent assay (ELISA). GraphPad Prism 9 was used for t tests, one-way ANOVAs, chi-square tests, and correlation analyses. p < 0.05 indicated significant differences. RESULTS Serum BDNF and GDNF levels were lower in the whole study group and the three subgroups than in the healthy groups. Illness severity, anxiety and education were higher in the early-onset than late-onset patients. Serum BDNF levels were lower in the adult than late-onset patients. Serum BDNF levels were negatively correlated with patient CGI-SI scores. After the LSD test for multiple comparisons, the results were also significant. CONCLUSIONS Low serum BDNF and GDNF levels may be involved in the pathophysiology of first-episode depression, and there were differences in serum BDNF levels at different ages, verifying that serum BDNF and GDNF could serve as potential biomarkers of depression. KEY POINTSDepression is often conceptualised as a systemic illness with different biological mechanisms, but satisfactory explanations have not been provided thus far.The aim of our study was to investigate differences in serum BDNF and GDNF levels and their relationships with clinical symptoms in patients with first-episode depression at different ages.The potential of the neurotrophic factor hypothesis to advance the diagnosis and treatment of depression will be a very exciting new strategy for future research.
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Affiliation(s)
- Xianping He
- Growth, Development, and Mental Health of Children and Adolescence Center, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Health and Nutrition, Chongqing, China
| | - Jingyao Song
- Chongqing Changshou District Third People's Hospital, Chongqing, China
| | - He Gao
- Chongqing Changshou District Third People's Hospital, Chongqing, China
| | - Zhenyang Li
- Chongqing Changshou District Third People's Hospital, Chongqing, China
| | - Xiaochun Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Qiaoling Zeng
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Yucen Xiao
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Jiaxin Feng
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Dongdong Zhou
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Gaomao Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
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Anzolin AP, Feiten JG, Bristot G, Possebon GMP, Fleck MPDA, Caldieraro MA, Kauer-Sant'Anna M. Earlier age of onset is associated with a pro-inflammatory state in major depressive disorder. Psychiatry Res 2022; 314:114601. [PMID: 35749859 DOI: 10.1016/j.psychres.2022.114601] [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: 01/31/2022] [Revised: 04/29/2022] [Accepted: 05/01/2022] [Indexed: 10/18/2022]
Abstract
Major depressive disorder (MDD) is a common condition that affects the general population over a wide range of ages, regardless of gender and social background. Early-onset of MDD in adulthood, between ages of 18 and 30 years, is associated with worse outcomes and increased years of disability. Stress load and physical health have been associated with age of onset in MDD. We aim to investigate whether early onset MDD might be associated with changes in systemic inflammatory markers. We examined levels of following cytokines: IL-1β, IL-6, IL-10 and TNFα in 234 patients with MDD. Higher serum levels of TNFα and IL-1β are associated with the early onset of the disorder in patients with MDD. IL-6 levels were also higher in the early onset group and IL-10 levels were higher in the late onset group, but with no significant difference. Changes in the anti-inflammatory/pro-inflammatory balance have been described in mood disorders and may be implicated in its severity and pattern of progression. Our findings reinforce that higher serum levels of IL-1β and TNFα may be associated with the earlier onset subgroup of MDD patients. Future research that target inflammatory markers of immune modulation may be, key in the search for novel preventative therapeutics.
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Affiliation(s)
- Ana Paula Anzolin
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Giovana Bristot
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Gabriela Maria Pereira Possebon
- Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil
| | - Marcelo Pio de Almeida Fleck
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Marco Antonio Caldieraro
- Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil
| | - Marcia Kauer-Sant'Anna
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Department of Psychiatry and Legal Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Laboratory of Molecular Psychiatry, Experimental Research Center, Clinical Hospital (CPE-HCPA), Universidade Federal do Rio Grande do Sul (UFRGS), Avenue Ramiro Barcelos, Porto Alegre, RS CEP 90035-903, Brazil; Post-Graduation Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; National Institute for Science and Technology in Translational Medicine (INCT-TM), CNPq, FAPESP, CAPES, Brazil.
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Age-related heterogeneity revealed by disruption of white matter structural networks in patients with first-episode untreated major depressive disorder: WM Network In OA-MDD. J Affect Disord 2022; 303:286-296. [PMID: 35176347 DOI: 10.1016/j.jad.2022.02.036] [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: 08/03/2021] [Revised: 12/22/2021] [Accepted: 02/13/2022] [Indexed: 12/27/2022]
Abstract
The clinical treatment and prognosis of major depressive disorder (MDD) are limited by the high degree of disease heterogeneity. It is unclear whether there is a potential network mechanism for age-related heterogeneity. We aimed to uncover the heterogeneity of the white matter (WM) network at different ages of onset and its correlation with different symptom characteristics. 85 first-episode MDD patients and 84 corresponding healthy controls (HCs) were recruited and underwent diffusion tensor imaging scans. Structural network characteristics were analyzed using graph theory methods. We observed an accelerated age-related decline of the WM network in MDD patients compared with HCs. Distinct symptom-related networks were identified in three MDD groups with different onset-age. For early-onset MDD (18-29 years; EOD), higher guilt and loss of interest were correlated with the insula, and inferior parietal lobe which in default mode network and salience network. For mid-term-onset MDD (30-44 years; MOD), higher somatic symptoms were correlated with thalamus which in cortico-striatal-thalamic-cortical circuit. For later-onset MDD (45-60 years; LOD), poor sleep symptoms were correlated with the caudate in the basal ganglia, which suggests the cingulate operculum network in the control of sleep. These results supported a circuit-based heterogeneity associated with the age of onset in MDD. Understanding this circuit-based heterogeneity might help to develop a new target for clinical treatment strategies.
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15
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Lattari E, Pascouto AJC, Oliveira BRR, Silva LS, Oliveira AJ, Machado S, Neto GAM. Association between Estimated Cardiorespiratory Fitness and Depression among Middle-income Country Adults: Evidence from National Health Survey. Clin Pract Epidemiol Ment Health 2021; 17:198-204. [PMID: 35173788 PMCID: PMC8728566 DOI: 10.2174/1745017902117010198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/24/2021] [Accepted: 09/30/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study assessed the relationship between cardiorespiratory fitness (CRF) and depression in adults. METHODS A total of 52,611 individuals aged between 18-59 years old were evaluated for symptoms of depression and CRF. The presence of depressive symptoms was self-report through the Patient Health Questionnaire (PHQ-9), and the CRF was predicted from a non-exercise equation. The association between CRF and the presence of depression was determined by crude and multivariable-adjusted logistic regressions. RESULTS The associations were identified between symptoms of depression and CRF in both unadjusted and adjusted models. After adjusting for age categories, sex, body mass index categories, educational level, marital status, smoking, and alcohol use, the individuals with moderate CRF had 18% lower odds of depression (OR: 0.82, CI 95%: 0.71 - 0.95) compared to individuals with low CRF. CONCLUSION Depressive symptoms are inversely related to CRF levels in adults.
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Affiliation(s)
- Eduardo Lattari
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
| | | | - Bruno Ribeiro Ramalho Oliveira
- Rural Federal University of Rio de Janeiro, Physical Activity, Health, and Performance Research Laboratory, Department of Physical; Education and Sports, Seropédica, Brazil
| | - Livia Soares Silva
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
- Rural Federal University of Rio de Janeiro, Laboratory of Social Dimensions Applied to Physical Activity and Sport (LABSAFE), Department of Physical; Education and Sports, Seropédica, Brazil
| | - Aldair José Oliveira
- Salgado de Oliveira University, Postgraduate Program in Physical Activity Sciences (PGCAF), Niterói, RJ, Brazil
- Rural Federal University of Rio de Janeiro, Laboratory of Social Dimensions Applied to Physical Activity and Sport (LABSAFE), Department of Physical; Education and Sports, Seropédica, Brazil
| | - Sérgio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
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16
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Zhukovsky P, Anderson JAE, Coughlan G, Mulsant BH, Cipriani A, Voineskos AN. Coordinate-Based Network Mapping of Brain Structure in Major Depressive Disorder in Younger and Older Adults: A Systematic Review and Meta-Analysis. Am J Psychiatry 2021; 178:1119-1128. [PMID: 34645274 DOI: 10.1176/appi.ajp.2021.21010088] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Structural neuroimaging findings in younger and older adults with major depressive disorder (MDD) are highly heterogeneous, possibly as a result of methodological limitations, lack of distinction between MDD and late-life depression (LLD), or clinical moderators. Using a novel meta-analytic network mapping approach, the authors sought to identify the circuits affected in different clinical subtypes of MDD. METHODS The authors identified all voxel-based and surface-based morphometry studies published through October 2020 that compared younger adults with MDD or older adults with LLD to nonpsychiatric control participants. An activation likelihood estimation (ALE) analysis and a novel coordinate-based network mapping approach were used to identify brain circuits affected in MDD and LLD. Meta-regressions examined the impact of age at onset in older patients with LLD and treatment with antidepressants in younger patients with MDD. RESULTS The authors analyzed 145 comparisons from 143 articles, including a total of 14,318 participants (MDD: N=6,362; LLD: N=535; control subjects: N=7,421). Significant ALE results confirmed previous findings implicating the left and right parahippocampus and anterior cingulate in MDD and the anterior cingulate in LLD. In contrast, coordinate-based network mapping showed differences in the frontoparietal, dorsal attention, and visual networks both in MDD and LLD. Meta-regressions showed that late onset was significantly associated with widespread structural abnormalities in LLD, and treatment with antidepressants showed a significant association with abnormalities in the anterior cingulate (Brodmann's area 32) and dorsolateral prefrontal cortex (Brodmann's area 9) in MDD. CONCLUSIONS These findings help to clarify the shared circuitry of depression across the adult lifespan and highlight some unique circuitry relevant to late-onset depression, which may explain some of the risk for cognitive decline and dementia.
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Affiliation(s)
- Peter Zhukovsky
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - John A E Anderson
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Gillian Coughlan
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Andrea Cipriani
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
| | - Aristotle N Voineskos
- Centre for Addiction and Mental Health, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Department of Psychiatry, University of Toronto, Toronto (Zhukovsky, Anderson, Mulsant, Voineskos); Rotman Research Institute, Baycrest Hospital, Toronto (Coughlan); Department of Psychiatry, University of Oxford, and Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, U.K. (Cipriani); Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto (Mulsant, Voineskos); Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto (Mulsant, Voineskos)
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Early onset of depression and treatment outcome in patients with major depressive disorder. J Psychiatr Res 2021; 139:150-158. [PMID: 34058654 DOI: 10.1016/j.jpsychires.2021.05.048] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 05/10/2021] [Accepted: 05/18/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) is a highly heterogeneous disorder, which may partly explain why treatment outcome using antidepressants is unsatisfactory. We investigated the onset of depression as a possible clinical marker for therapy response prediction in the context of somatic biomarkers blood pressure and plasma electrolyte concentration. 889 MDD patients were divided into early (EO, n = 226), intermediate (IO, n = 493), and late onset (LO, n = 169) patients and were analyzed for differences in socio-demographic and clinical parameters, comorbidities and treatment outcome as well as systolic blood pressure and electrolytes. EO patients more often suffered from a recurrent depression, had more previous depressive episodes, a higher rate of comorbid axis I and II disorders, and more often reported of suicidality (p < 0.001) compared to IO and LO patients. Treatment outcome was not different from IO and LO patients, although LO patients responded faster. EO patients who showed an early non-improvement of depression after 2 weeks of therapy (<20% improvement) had a 4.3-fold higher likelihood to become non-remitter as compared to LO patients with an early improvement. EO patients had significantly lower systolic blood pressure than patients with IO or LO and electrolytes in EO patients were significantly correlated with depression severity. Our results confirm other studies showing an association of an early onset of depression with a slower treatment response. The worse treatment outcome in patients with an additional early non-improvement to antidepressant therapy opens perspectives to develop and test individualized treatment approaches for EO and LO patients in the future, which may be based on differences in autonomic regulation.
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18
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Chen MH, Wu HJ, Li CT, Lin WC, Bai YM, Tsai SJ, Hong CJ, Tu PC, Cheng CM, Su TP. Using classification and regression tree modelling to investigate treatment response to a single low-dose ketamine infusion: Post hoc pooled analyses of randomized placebo-controlled and open-label trials. J Affect Disord 2021; 281:865-871. [PMID: 33239245 DOI: 10.1016/j.jad.2020.11.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 09/08/2020] [Accepted: 11/07/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence suggests that clinical markers, such as comorbid anxiety, body weight, and others can assist in predicting response to low-dose ketamine infusion in treatment resistant depression patients. However, whether a composite of clinical markers may improve the predicted probability of response is uncertain. METHODS The current study investigated the results of our previous randomized placebo-controlled and open-label trials in which 73 patients with treatment-resistant depression (TRD) received a single ketamine infusion of 0.5 mg/kg. Clinical characteristics at baseline, including depression severity, duration of the current episode, obesity, comorbidity of anxiety disorder, and current suicide risk, were assessed as potential predictors in a classification and regression tree model for treatment response to ketamine infusion. RESULTS The predicted probability of a composite of age at disease onset, depression severity, duration of current episode, and obesity/overweight was significantly greater (area under curve = .736, p = .001) than that of any one marker (all p > .05). The most powerful predictors of treatment response to ketamine infusion were younger age at disease onset and obesity/overweight. The strongest predictors of treatment nonresponse were longer duration of the current episode and greater depression severity at baseline. DISCUSSION Depression severity, duration of the current episode, obesity, and age at disease onset may predict treatment response versus nonresponse to low-dose ketamine infusion. However, whether our predicted probability for a single infusion may be applied to repeated infusions would require further investigation. CLINICAL TRIAL REGISTRATION UMIN Clinical Trials Registry (UMIN000023581 and UMIN000016985).
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Hui-Ju Wu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Chen-Jee Hong
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan.
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Zhang Z, Chen Y, Wei W, Yang X, Meng Y, Yu H, Guo W, Wang Q, Deng W, Li T, Ma X. Changes in Regional Homogeneity of Medication-Free Major Depressive Disorder Patients With Different Onset Ages. Front Psychiatry 2021; 12:713614. [PMID: 34658953 PMCID: PMC8517084 DOI: 10.3389/fpsyt.2021.713614] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 08/30/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Neurobiological mechanisms underlying the development of major depressive disorder (MDD) may differ depending on onset ages. Our aim was to determine whether regional homogeneity (ReHo) changes in early-onset depression (EOD) and late-onset depression (LOD) are different, which could also delineate EOD and LOD. Methods: Ninety-one MDD patients and 115 healthy controls (HCs) were recruited, and resting-state functional magnetic resonance imaging data were collected. The ReHo comparison was conducted using analysis of variance. Results: Compared with HCs, MDD patients showed decreased ReHo in the left precentral gyrus and the left middle cingulum area, and increased ReHo in the left middle orbital frontal gyrus and superior temporal gyrus. Compared with LOD patients, young HC separately, EOD patients had significantly increased ReHo in the right inferior frontal triangular gyrus and the left postcentral gyrus. However, compared with young HC, EOD patients showed decreased ReHo in the right superior frontal gyrus/supplementary motor area and the right medial frontal gyrus. ReHo in the right inferior frontal triangular gyrus was negatively correlated with the severity of cognitive disturbance in LOD patients (r = -0.47, p = 0.002), but not in EOD patients (r = 0.21, p = 0.178). Conclusion: MDD patients with different onset ages may have different pathophysiological mechanisms; the EOD patients had more abnormal ReHo than LOD patients in the prefrontal lobe, especially the right inferior frontal triangular gyrus.
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Affiliation(s)
- Zijian Zhang
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yayun Chen
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.,The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Wei Wei
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiao Yang
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yajing Meng
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Hua Yu
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjun Guo
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Deng
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Tao Li
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.,West China Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
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20
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Association of cortical thickness with age of onset in first-episode, drug-naïve major depression. Neuroreport 2020; 30:1074-1080. [PMID: 31503209 DOI: 10.1097/wnr.0000000000001314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE We previously showed differences in brain grey matter volume changes between patients with early-onset adult depression (EOD) and late-onset adult depression (LOD). Here, we aim to identify whether cortical thickness (CT) is affected by the age of onset in patients with depression. METHODS High-resolution MRI images were obtained for 54 major depressive disorder (MDD) patients with EOD, 58 patients with LOD, 57 young healthy controls (HCs), and 58 aged HCs. Depression severity was assessed using the Hamilton Depression Rating Scale 17-item (HDRS17). Associations between CT of patients and clinical scores were analyzed. RESULTS There was a significant main effect of diagnosis for the left rostal anterior cingulate (rACC), right inferior temporal, right lateral orbitofrontal cortex (lOFC), and bilateral pericalcarine. A remarkable onset age-group effect on CT was observed in the rACC and bilateral caudal anterior cingulate (cACC). The diagnosis-by-onset age interaction effect was found in bilateral rACC and right lOFC. Thinning CT in bilateral rACC was observed in EOD patients compared to young HCs. Compared to older HCs, thicker CT in lOFC was seen in the LOD patient group. Compared with the LOD group, the EOD group showed cortical thinning of the right cACC and posterior cingulate cortex (PCC). There were no significant associations between CT in right cACC or PCC with symptom severity or illness duration. CONCLUSIONS MDD patients with different age at onset show distinct CT alterations, suggesting potentially divergent pathological mechanisms of EOD and LOD.
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21
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Abstract
The world's older population continues to grow at an unprecedented rate. This trend amplifies the necessity of improving the care of older patients with chronic health problems. Of those with chronic health problems, those with cardiovascular diseases and depression are particularly challenging due to the multifaceted nature of these conditions. This review discusses the significance of this aging trend and ways to better care for this particular population.
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Affiliation(s)
- Wei Jiang
- Department of Psychiatry and Behavioral Sciences, Duke University Health System, Durham, NC 27710, USA; Department of Medicine, Duke University Health System, Durham, NC 27710, USA.
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22
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Xiao L, Zhou JJ, Feng Y, Zhu XQ, Wu WY, Hu YD, Niu YJ, Hu J, Wang XY, Gao CG, Zhang N, Fang YR, Liu TB, Jia FJ, Feng L, Wang G. Does early and late life depression differ in residual symptoms, functioning and quality of life among the first-episode major depressive patients. Asian J Psychiatr 2020; 47:101843. [PMID: 31731143 DOI: 10.1016/j.ajp.2019.101843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/15/2019] [Accepted: 10/15/2019] [Indexed: 01/06/2023]
Abstract
AIMS & OBJECTIVES Age differences exist in many aspects in patients with major depressive disorder (MDD). The present study aims to examine the effect of age on treatment outcomes in first-episode MDD. METHODOLOGY A total of 982 first-episode major depressive patients, who were above 18 years old and admitted in both psychiatric hospitals and units of general hospitals were recruited for the present study. These patients were newly treated and responded to 8-12 weeks of antidepressant treatment. Depressive symptoms, psychosocial functioning and quality of life were measured using standardized instruments. The study population was divided into three age groups: early adult (18-44 years old), middle adult (45-59 years old), and late adult (60-85 years old). RESULTS Earlier age was associated with greater symptom severity, severer depressive symptoms in hypersomnia, concentration/decision making, negative view of the self, suicide ideation and restlessness, more impaired function, poorer satisfaction in social relationship and economic status, when compared to late adults with MDD (all P < 0.05). In the multivariable analyses, among the other variables, early age remained as an independent correlation of residual depressive severity (middle age vs. early age: OR = 0.631, 95%CI[0.462, 0.862]; old age vs. early age: OR = 0.521, 95%CI[0.348, 0.780]) and functional impairment. Comorbidity of physical illness had a negative contribution to all treatment outcomes. CONCLUSION In first major depressive episode, early age was strongly associated with depressive severity and functional impairment after responding to antidepressant treatment. Early-life depression may be an indicator of MDD for poor clinical outcomes and high clinical burden.
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Affiliation(s)
- Le Xiao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing-Jing Zhou
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yuan Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xue-Quan Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Wen-Yuan Wu
- Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, China
| | - Yong-Dong Hu
- Department of Clinical Psychology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ya-Juan Niu
- Department of Psychiatry, Beijing HuiLongGuan Hospital, Beijing, China
| | - Jian Hu
- Department of Psychiatry, the First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xue-Yi Wang
- Department of Psychiatry, the First Hospital of Hebei Medical University, Hebei, China
| | - Cheng-Ge Gao
- Department of Psychiatry, the First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China
| | - Ning Zhang
- Department of Psychiatry, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tie-Bang Liu
- Department of Psychiatry, Shenzhen Kangning Hospital, Shenzhen, China
| | - Fu-Jun Jia
- Department of Psychiatry, Guangdong Mental Health Center, Guangdong General Hospital, Guangzhou, China
| | - Lei Feng
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China.
| | - Gang Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders & Beijing Anding Hospital, Capital Medical University, Beijing, China.
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23
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Fornaro M, Solmi M, Stubbs B, Veronese N, Monaco F, Novello S, Fusco A, Anastasia A, De Berardis D, Carvalho AF, de Bartolomeis A, Vieta E. Prevalence and correlates of major depressive disorder, bipolar disorder and schizophrenia among nursing home residents without dementia: systematic review and meta-analysis. Br J Psychiatry 2020; 216:6-15. [PMID: 30864533 DOI: 10.1192/bjp.2019.5] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The elderly population and numbers of nursing homes residents are growing at a rapid pace globally. Uncertainty exists regarding the actual rates of major depressive disorder (MDD), bipolar disorder and schizophrenia as previous evidence documenting high rates relies on suboptimal methodology. AIMS To carry out a systematic review and meta-analysis on the prevalence and correlates of MDD, bipolar disorder and schizophrenia spectrum disorder among nursing homes residents without dementia. METHOD Major electronic databases were systematically searched from 1980 to July 2017 for original studies reporting on the prevalence and correlates of MDD among nursing homes residents without dementia. The prevalence of MDD in this population was meta-analysed through random-effects modelling and potential sources of heterogeneity were examined through subgroup/meta-regression analyses. RESULTS Across 32 observational studies encompassing 13 394 nursing homes residents, 2110 people were diagnosed with MDD, resulting in a pooled prevalence rate of 18.9% (95% CI 14.8-23.8). Heterogeneity was high (I2 = 97%, P≤0.001); no evidence of publication bias was observed. Sensitivity analysis indicated the highest rates of MDD among North American residents (25.4%, 95% CI 18-34.5, P≤0.001). Prevalence of either bipolar disorder or schizophrenia spectrum disorder could not be reliably pooled because of the paucity of data. CONCLUSIONS MDD is highly prevalent among nursing homes residents without dementia. Efforts towards prevention, early recognition and management of MDD in this population are warranted.
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Affiliation(s)
- Michele Fornaro
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Marco Solmi
- Neuroscience Department, Psychiatry Unit, University of Padua; Psychiatry Unit, Azienda Ospedaliera di Padova, Padua Hospital, Italy; and Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust; and Health Service and Population Research Department and the Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Francesco Monaco
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neuroscience, University of Salerno, Italy
| | - Stefano Novello
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Andrea Fusco
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | | | - Domenico De Berardis
- Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital 'G. Mazzini', Italy
| | - André F Carvalho
- Department of Psychiatry, University of Toronto; and Centre for Addiction & Mental Health (CAMH), Canada
| | - Andrea de Bartolomeis
- Neuroscience, Reproductive Science and Odontostolmatology, Section of Psychiatry, University School of Medicine 'Federico II', Italy
| | - Eduard Vieta
- Psychiatry and Psychology Department of the Hospital Clínic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Spain
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Kasyanov ED, Mazo GE, Kibitov AO. The role of family studies in research of neurobiological basis of depressive disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:87-93. [DOI: 10.17116/jnevro201911902187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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25
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Kim SS, Hayward RD, Gil M. Family Interdependence, Spiritual Perspective, Self-Transcendence, and Depression Among Korean College Students. JOURNAL OF RELIGION AND HEALTH 2018; 57:2079-2091. [PMID: 28718053 DOI: 10.1007/s10943-017-0448-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to examine the mechanisms that might account for the effects of spirituality and self-transcendence on Korean college students' depression among 197 Korean fathers, mothers, and children. A structural equation analysis indicated that spiritual perspective related to lower depression through the mediating pathway of self-transcendence for individuals. Mothers' spiritual perspective and self-transcendence related to their children's depression through the mediating pathway of their own depression, but the same was not true for fathers. Findings help explicate the intergenerational transmission of depression and important predictors of depression related to spirituality.
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Affiliation(s)
- Suk-Sun Kim
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Korea.
| | - R David Hayward
- Department of Health Behavior and Health Education, School of Public Health, The University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA
| | - Minji Gil
- College of Nursing, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Korea
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Abstract
The world's older population continues to grow at an unprecedented rate. This trend amplifies the necessity of improving the care of older patients with chronic health problems. Of those with chronic health problems, those with cardiovascular diseases and depression are particularly challenging due to the multifaceted nature of these conditions. This review discusses the significance of this aging trend and ways to better care for this particular population.
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Affiliation(s)
- Wei Jiang
- Department of Psychiatry and Behavioral Sciences, Duke University Health System, Durham, NC 27710, USA; Department of Medicine, Duke University Health System, Durham, NC 27710, USA.
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27
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Kessing LV, Bukh JD. The clinical relevance of qualitatively distinct subtypes of depression. World Psychiatry 2017; 16:318-319. [PMID: 28941112 PMCID: PMC5608844 DOI: 10.1002/wps.20461] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Lars Vedel Kessing
- Psychiatric Center Copenhagen, Rigshospitalet, University of CopenhagenDenmark
| | - Jens Drachmann Bukh
- Psychiatric Center Copenhagen, Rigshospitalet, University of CopenhagenDenmark
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28
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Shen Z, Jiang L, Yang S, Ye J, Dai N, Liu X, Li N, Lu J, Liu F, Lu Y, Sun X, Cheng Y, Xu X. Identify changes of brain regional homogeneity in early and later adult onset patients with first-episode depression using resting-state fMRI. PLoS One 2017; 12:e0184712. [PMID: 28910390 PMCID: PMC5598991 DOI: 10.1371/journal.pone.0184712] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 08/29/2017] [Indexed: 12/12/2022] Open
Abstract
Objective Previous work exhibited different brain grey matter volume (GMV) changes between patients with early adult onset depression (EOD, age 18–29) and later adult onset depression (LOD, age 30–44) by using 30-year-old as the cut-off age. To identify whether regional homogeneity (ReHo) changes are also different between EOD and LOD by using same cut-off age, we used resting-state functional magnetic resonance imaging (fMRI) to detect the abnormal ReHo between patients with EOD and LOD in the present study. Methods Resting-state fMRI scans of 58 patients with EOD, 62 patients with LOD, 60 young healthy controls (HC), and 52 old HC were obtained. The ReHo approach was used to analyze the images. Results The ANOVA analysis revealed that the ReHo values in the frontoparietal, occipital, and cerebellar regions were significantly different among the four groups. Relative to patients with LOD, patients with EOD displayed significantly increased ReHo in the left precuneus, and decreased ReHo in the right fusiform. The ReHo values in the left precuneus and the right fusiform had no significant correlation with the score of the depression rating scale or illness duration in both patient subgroups. Compared to young HC, patients with EOD showed significantly increased ReHo in the right frontoparietal regions and the right calcarine. Furthermore, the increased ReHo in the right frontoparietal regions, right insula and left hippocampus, and decreased ReHo in the left inferior occipital gyrus, right middle occipital gyrus, left calcarine, and left supplementary motor area were observed in patients with LOD when compared to old HC. Conclusions The ReHo of brain areas that were related to mood regulation was changed in the first-episode, drug-naive adult patients with MDD. Adult patients with EOD and LOD exhibited different ReHo abnormalities relative to each age-matched comparison group, suggesting that depressed adult patients with different age-onset might have different pathological mechanism.
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Affiliation(s)
- Zonglin Shen
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Linling Jiang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Shuran Yang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jing Ye
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Nan Dai
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xiaoyan Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Na Li
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Fang Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yi Lu
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xuejin Sun
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuqi Cheng
- Mental Health Institute of Yunnan Province, Kunming, Yunnan, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- * E-mail:
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Meister R, Jansen A, Härter M, Nestoriuc Y, Kriston L. Placebo and nocebo reactions in randomized trials of pharmacological treatments for persistent depressive disorder. A meta-regression analysis. J Affect Disord 2017; 215:288-298. [PMID: 28363152 DOI: 10.1016/j.jad.2017.03.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/23/2017] [Accepted: 03/08/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND We aimed to investigate placebo and nocebo reactions in randomized controlled trials (RCT) of pharmacological treatments for persistent depressive disorder (PDD). METHODS We conducted a systematic electronic search and included RCTs investigating antidepressants for the treatment of PDD. Outcomes were the number of patients experiencing response and remission in placebo arms (=placebo reaction). Additional outcomes were the incidence of patients experiencing adverse events and related discontinuations in placebo arms (=nocebo reaction). A priori defined effect modifiers were analyzed using a series of meta-regression analyses. RESULTS Twenty-three trials were included in the analyses. We found a pooled placebo response rate of 31% and a placebo remission rate of 22%. The pooled adverse event rate and related discontinuations were 57% and 4%, respectively. All placebo arm outcomes were positively associated with the corresponding medication arm outcomes. Placebo response rate was associated with a greater proportion of patients with early onset depression, a smaller chance to receive placebo and a larger sample size. The adverse event rate in placebo arms was associated with a greater proportion of patients with early onset depression, a smaller proportion of females and a more recent publication. CONCLUSIONS Pooled placebo and nocebo reaction rates in PDD were comparable to those in episodic depression. The identified effect modifiers should be considered to assess unbiased effects in RCTs, to influence placebo and nocebo reactions in practice. LIMITATIONS Limitations result from the methodology applied, the fact that we conducted only univariate analyses, and the number and quality of included trials.
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Affiliation(s)
- Ramona Meister
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Alessa Jansen
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Federal Chamber of Psychotherapists, Berlin, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Yvonne Nestoriuc
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Levente Kriston
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Armstrong NM, Meoni LA, Carlson MC, Xue QL, Bandeen-Roche K, Gallo JJ, Gross AL. Cardiovascular risk factors and risk of incident depression throughout adulthood among men: The Johns Hopkins Precursors Study. J Affect Disord 2017; 214:60-66. [PMID: 28284097 PMCID: PMC5405441 DOI: 10.1016/j.jad.2017.03.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 03/05/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Modifiable cardiovascular risk factors elevate risk of subsequent depression in older adults, but the effect of their onset before or after age 65 on incident depression is unclear. METHODS Participants were 1190 male medical students without a diagnosis of depression, who matriculated in 1948-1964 and followed through 2011. Cox proportional hazards models were used to assess associations of vascular risk-factor burden, diabetes, hypertension, hyperlipidemia, smoking status, and overweight/obese status with onset of incident depression. Adjustment covariates were race, enrollment wave, baseline age, physical activity, and heavy alcohol use. RESULTS The analysis included 44,175 person-years of follow-up. Among participants depression-free until age 65, vascular risk-factor burden after age 65 (Hazard Ratio, [HR]: 2.13, 95% Confidence Interval, [CI]: 1.17, 3.90) was associated with incident depression risk after age 65. The magnitude of vascular risk-factor burden after age 65 on depression risk after age 65 is comparable to the effect of 8.2 additional years of age. Diabetes (HR: 2.79, 95% CI: 1.25, 6.26), hypertension (HR: 2.72, 95% CI: 1.52, 4.88), and hyperlipidemia (HR: 1.88, 95% CI: 1.05, 3.35) before age 65 were associated with incident depression risk after age 65. Men diagnosed with diabetes after age 65 had 2.87 times the risk of incident depression after age 65 (95% CI: 1.24, 6.62). LIMITATIONS Our findings are restricted to male former medical students, which may affect study generalizability. CONCLUSIONS Results support the vascular depression hypothesis. Depression screening in older adults with vascular risk-factor burden may provide an avenue for prevention of late-onset depression.
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Affiliation(s)
- Nicole M Armstrong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Lucy A Meoni
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle C Carlson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qian-Li Xue
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Center on Aging and Health, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph J Gallo
- Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, and Johns Hopkins Center on Aging and Health, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Bukh JD, Bech P, Kessing LV. Diagnostic Stability of Comorbid Personality Disorders Among Patients Fully or Partially Remitted From First-Episode Depression: A 5-Year Follow-Up Study. J Pers Disord 2017; 31:208-220. [PMID: 27322576 DOI: 10.1521/pedi_2016_30_253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The diagnostic stability of comorbid personality disorders among patients with depression remains unclear. A total of 262 patients suffering from first-episode depression were assessed using the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II) and reassessed after 5 years. A total of 87 patients (33%) were diagnosed with a personality disorder at baseline, and 63 of them (72%) maintained a personality disorder diagnosis at follow-up (kappa coefficient 0.71). At cluster level, 63% maintained a diagnosis within cluster B and 48% maintained a cluster C disorder across the follow-up period (kappa coefficients of 0.54 and 0.64, respectively). Hence, comorbid personality disorders cannot be taken just as artifacts of the depressive mood that will remit spontaneously or with further treatment of the primary depression. Furthermore, the stability of personality disorders diagnoses was not predicted by clinical characteristics of the depression, nor of the course of the affective disorder during follow-up.
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Affiliation(s)
| | - Per Bech
- Psychiatric Centre North Sealand, Hiller⊘d, Denmark
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Assessing the presence of shared genetic architecture between Alzheimer's disease and major depressive disorder using genome-wide association data. Transl Psychiatry 2017; 7:e1094. [PMID: 28418403 PMCID: PMC5416691 DOI: 10.1038/tp.2017.49] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 01/24/2017] [Accepted: 01/25/2017] [Indexed: 01/03/2023] Open
Abstract
Major depressive disorder (MDD) and Alzheimer's disease (AD) are both common in older age and frequently co-occur. Numerous phenotypic studies based on clinical diagnoses suggest that a history of depression increases risk of subsequent AD, although the basis of this relationship is uncertain. Both illnesses are polygenic, and shared genetic risk factors could explain some of the observed association. We used genotype data to test whether MDD and AD have an overlapping polygenic architecture in two large population-based cohorts, Generation Scotland's Scottish Family Health Study (GS:SFHS; N=19 889) and UK Biobank (N=25 118), and whether age of depression onset influences any relationship. Using two complementary techniques, we found no evidence that the disorders are influenced by common genetic variants. Using linkage disequilibrium score regression with genome-wide association study (GWAS) summary statistics from the International Genomics of Alzheimer's Project, we report no significant genetic correlation between AD and MDD (rG=-0.103, P=0.59). Polygenic risk scores (PRS) generated using summary data from International Genomics of Alzheimer's Project (IGAP) and the Psychiatric Genomics Consortium were used to assess potential pleiotropy between the disorders. PRS for MDD were nominally associated with participant-recalled AD family history in GS:SFHS, although this association did not survive multiple comparison testing. AD PRS were not associated with depression status or late-onset depression, and a survival analysis showed no association between age of depression onset and genetic risk for AD. This study found no evidence to support a common polygenic structure for AD and MDD, suggesting that the comorbidity of these disorders is not explained by common genetic variants.
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Abnormal functional connectivity of the amygdala in first-episode and untreated adult major depressive disorder patients with different ages of onset. Neuroreport 2017; 28:214-221. [DOI: 10.1097/wnr.0000000000000733] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bech P, Kessing LV, Bukh JD. The validity of dysthymia to predict clinical depressive symptoms as measured by the Hamilton Depression Scale at the 5-year follow-up of patients with first episode depression. Nord J Psychiatry 2016; 70:563-6. [PMID: 27181030 DOI: 10.1080/08039488.2016.1180712] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND In long-term follow-up studies on depression, the Eysenck Neuroticism Scale (ENS) at the score level of dysthymia has been found to be valid at predicting poor outcome. AIMS The ENS dysthymia level was compared with the Beck Depression Inventory (BDI) level to predict the prevalence of depressive symptoms at the 5-year follow-up of patients initially diagnosed with first episode depression using the Hamilton Depression Scale (HAM-D) to express depressive symptoms. METHODS A total of 301 in- or outpatients aged 18-70 years with a recent single depressive episode were assessed by ENS, BDI, and HAM-D from 2005-2007. At 5-year follow-up from 2011-2013, the participants were re-assessed by HAM-D. The HAM-D was used to measure depressive symptoms at the 5-year follow-up. The Mokken analysis was used to indicate scalability of the BDI and ENS. RESULTS A total of 185 participants were available for the psychometric analysis of the ESN and BDI, and the scalability was found acceptable. In total, 99 patients were available for the predictive analysis. Both the ENS and the BDI were significantly associated with depressive symptoms (HAM-D17 ≥ 8) at the 5-year follow-up (p < 0.05). CONCLUSION Dysthymia as measured by the two self-rating scales ENS and BDI can be considered part of a 'double depression' in patients with first episode depression, implying an existence of depressive symptoms at the 5-year follow-up. CLINICAL IMPLICATIONS Evaluation of dysthymia or neuroticism is important to perform, even in patients with first episode depression, in order to identify 'double depression'.
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Affiliation(s)
- Per Bech
- a Psychiatric Research Unit, Psychiatric Centre North Zealand , Copenhagen University Hospital , Hillerød , Denmark
| | - Lars Vedel Kessing
- b Psychiatric Centre Copenhagen, Department O , Rigshospitalet , Copenhagen , Denmark
| | - Jens Drachmann Bukh
- b Psychiatric Centre Copenhagen, Department O , Rigshospitalet , Copenhagen , Denmark
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35
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Shen Z, Cheng Y, Yang S, Dai N, Ye J, Liu X, Lu J, Li N, Liu F, Lu Y, Sun X, Xu X. Changes of grey matter volume in first-episode drug-naive adult major depressive disorder patients with different age-onset. NEUROIMAGE-CLINICAL 2016; 12:492-498. [PMID: 27668175 PMCID: PMC5026687 DOI: 10.1016/j.nicl.2016.08.016] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 07/30/2016] [Accepted: 08/19/2016] [Indexed: 12/25/2022]
Abstract
Objective Little is known about the pathological mechanism of early adult onset depression (EOD) and later adult onset depression (LOD). We seek to determine whether grey matter volume (GMV) change in EOD and LOD are different, which could also delineate EOD and LOD. Methods In present study, 147 first-episode, drug-naive patients with major depressive disorder (MDD), age between 18 and 45, were divided into two groups on the basis of age of MDD onset: the early adult onset group (age 18–29) and the later adult onset group (age 30–44), and a total of 130 gender-, and age-, matched healthy controls (HC) were also divided into two groups which fit for each patient group. Magnetic resonance imaging was conducted on all subjects. The voxel-based morphometry (VBM) approach was employed to analyze the images. Results Widespread abnormalities of GMV throughout parietal, temporal, limbic regions, occipital cortex and cerebellum were observed in MDD patients. Compare to young HC, reduced GMV in right fusiform gyrus, right middle temporal gyrus, vermis III and increased GMV in right middle occipital gyrus were seen in the EOD group. In contrast, relative to old HC, decreased GMV in the right hippocampus and increased GMV in the left middle temporal gyrus were observed in the LOD group. Compared to the LOD group, the EOD group had smaller GMV in right posterior cingulate cortex. There was no significant correlation between GMV of the right posterior cingulate cortex and the score of the depression rating scale in patients group. Conclusions The GMV of the brain areas that were related to mood regulation was decreased in the first-episode, drug-naive adult patients with MDD. Adult patients with EOD and LOD exhibited different GMV changes relative to each age-matched comparison group, suggesting depressed adult patients with different age-onset might have different pathological mechanism. Grey matter volume widely decreased in the drug-naive adult patients with MDD. Depressed patients with different age-onset have different grey matter change. 30 years old is an appropriate cutoff age for different age-onset depression.
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Affiliation(s)
- Zonglin Shen
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Yuqi Cheng
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Shuran Yang
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Nan Dai
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Jing Ye
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Xiaoyan Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Jin Lu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Na Li
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Fang Liu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Yi Lu
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Xuejin Sun
- Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
| | - Xiufeng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan 650032, China
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Hwang J, Xin S, Ou Y, Zhang W, Liang Y, Chen J, Yang X, Chen X, Guo T, Yang X, Ma W, Li J, Zhao B, Tu Y, Kong J. Enhanced default mode network connectivity with ventral striatum in subthreshold depression individuals. J Psychiatr Res 2016; 76:111-20. [PMID: 26922247 PMCID: PMC4838997 DOI: 10.1016/j.jpsychires.2016.02.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Revised: 01/29/2016] [Accepted: 02/11/2016] [Indexed: 01/11/2023]
Abstract
Subthreshold depression (StD) is a highly prevalent condition associated with increased service utilization and social morbidity. Nevertheless, due to limitations in current diagnostic systems that set the boundary for major depressive disorder (MDD), very few brain imaging studies on the neurobiology of StD have been carried out, and its underlying neurobiological mechanism remains unclear. In recent years, accumulating evidence suggests that the disruption of the default mode network (DMN), a network involved in self-referential processing, affective cognition, and emotion regulation, is involved in major depressive disorder. Using independent component analysis, we investigated resting-state default mode network (DMN) functional connectivity (FC) changes in two cohorts of StD patients with different age ranges (young and middle-aged, n = 57) as well as matched controls (n = 79). We found significant FC increase between the DMN and ventral striatum (key region in the reward network), in both cohorts of StD patients in comparison with controls. In addition, we also found the FC between the DMN and ventral striatum was positively and significantly associated with scores on the Center for Epidemiologic Studies Depression Scale (CES-D), a measurement of depressive symptomatology. We speculate that this enhanced FC between the DMN and the ventral striatum may reflect a self-compensation to ameliorate the lowered reward function.
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Affiliation(s)
- J.W. Hwang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - S.C. Xin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Y.M. Ou
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - W.Y. Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Y.L. Liang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA,Neuroscience Program, Wellesley College, USA
| | - J. Chen
- School of Management, Beijing University of Chinese Medicine, Beijing, China
| | - X.Q. Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Institute of Health Preserving of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - X.Y. Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA
| | - T.W. Guo
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Department of Oncology and Hematology, Dongzhimen Hospital affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - X.J. Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - W.H. Ma
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - J. Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - B.C. Zhao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Y. Tu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China,Correspondence will be addressed to: Tuya Bao, School of Acupuncture-Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Chaoyang District, Beijing, China, 100029, , Phone: +86-10-6428-7822. Jian Kong, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, , Phone: +1-617-7267893
| | - J. Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, MA, USA,Correspondence will be addressed to: Tuya Bao, School of Acupuncture-Moxibustion and Tuina, Beijing University of Traditional Chinese Medicine, Chaoyang District, Beijing, China, 100029, , Phone: +86-10-6428-7822. Jian Kong, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, , Phone: +1-617-7267893
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Bukh JD, Andersen PK, Kessing LV. Rates and predictors of remission, recurrence and conversion to bipolar disorder after the first lifetime episode of depression--a prospective 5-year follow-up study. Psychol Med 2016; 46:1151-1161. [PMID: 26743873 DOI: 10.1017/s0033291715002676] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND In depression, non-remission, recurrence of depressive episodes after remission and conversion to bipolar disorder are crucial determinants of poor outcome. The present study aimed to determine the cumulative incidences and clinical predictors of these long-term outcomes after the first lifetime episode of depression. METHOD A total of 301 in- or out-patients aged 18-70 years with a validated diagnosis of a single depressive episode were assessed from 2005 to 2007. At 5 years of follow-up, 262 patients were reassessed by means of the life chart method and diagnostic interviews from 2011 to 2013. Cumulative incidences and the influence of clinical variables on the rates of remission, recurrence and conversion to bipolar disorder, respectively, were estimated by survival analysis techniques. RESULTS Within 5 years, 83.3% obtained remission, 31.5% experienced recurrence of depression and 8.6% converted to bipolar disorder (6.3% within the first 2 years). Non-remission increased with younger age, co-morbid anxiety and suicidal ideations. Recurrence increased with severity and treatment resistance of the first depression, and conversion to bipolar disorder with treatment resistance, a family history of affective disorder and co-morbid alcohol or drug abuse. CONCLUSIONS The identified clinical characteristics of the first lifetime episode of depression should guide patients and clinicians for long-term individualized tailored treatment.
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Affiliation(s)
- J D Bukh
- Psychiatric Centre Copenhagen,Research Unit for Affective Disorders,Department O,Rigshospitalet,Copenhagen,Denmark
| | - P K Andersen
- Department of Biostatistics,University of Copenhagen,Copenhagen,Denmark
| | - L V Kessing
- Psychiatric Centre Copenhagen,Research Unit for Affective Disorders,Department O,Rigshospitalet,Copenhagen,Denmark
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Seow LSE, Vaingankar JA, Abdin E, Sambasivam R, Jeyagurunathan A, Pang S, Chong SA, Subramaniam M. Positive mental health in outpatients with affective disorders: Associations with life satisfaction and general functioning. J Affect Disord 2016; 190:499-507. [PMID: 26561940 DOI: 10.1016/j.jad.2015.10.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/05/2015] [Accepted: 10/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Positive mental health (PMH) is an integral and essential component of health that encompasses emotional, psychological and social well-being. The Keyes' two continua model of mental health and illness posits that mental health status is not merely the absence of mental health problems, and it can be enhanced regardless of a diagnosis of mental illness. The present study hypothesized that mentally ill patients with higher levels of PMH would be associated with better life satisfaction and general functioning. METHODS 218 outpatients with affective disorders at a tertiary psychiatric hospital were recruited and administered the multidimensional Positive Mental Health instrument, which was validated and developed in Singapore to measure PMH. Depression and anxiety severity were also assessed. Associations of positive mental health with life satisfaction and general functioning were investigated in linear regression models. RESULTS PMH scores varied largely within patients with depressive and anxiety disorders but did not differ statistically across the two diagnoses, except for emotional support. PMH was associated with both life satisfaction and general functioning with little evidence of confounding by sociodemographic and clinical status. LIMITATIONS The cross-sectional design of the study could not examine causal relationships. Findings may be restrictive to treatment-seeking population with specific affective disorders. CONCLUSION Our study provides evidence to support the notion that a good mental health state is not simply the absence of a mental disorder. Mentally ill patients can also have high levels of PMH that possibly have a moderating or mediating effect on the relationship between patients' clinical symptoms and life satisfaction or general functioning.
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Affiliation(s)
| | | | | | | | | | - Shirlene Pang
- Research Division, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Treatment-resistant depression: are animal models of depression fit for purpose? Psychopharmacology (Berl) 2015; 232:3473-95. [PMID: 26289353 DOI: 10.1007/s00213-015-4034-7] [Citation(s) in RCA: 100] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 07/20/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Resistance to antidepressant drug treatment remains a major health problem. Animal models of depression are efficient in detecting effective treatments but have done little to increase the reach of antidepressant drugs. This may be because most animal models of depression target the reversal of stress-induced behavioural change, whereas treatment-resistant depression is typically associated with risk factors that predispose to the precipitation of depressive episodes by relatively low levels of stress. Therefore, the search for treatments for resistant depression may require models that incorporate predisposing factors leading to heightened stress responsiveness. METHOD Using a diathesis-stress framework, we review developmental, genetic and genomic models against four criteria: (i) increased sensitivity to stress precipitation of a depressive behavioural phenotype, (ii) resistance to chronic treatment with conventional antidepressants, (iii) a good response to novel modes of antidepressant treatment (e.g. ketamine; deep brain stimulation) that are reported to be effective in treatment-resistant depression and (iv) a parallel to a known clinical risk factor. RESULTS We identify 18 models that may have some potential. All require further validation. Currently, the most promising are the Wistar-Kyoto (WKY) and congenital learned helplessness (cLH) rat strains, the high anxiety behaviour (HAB) mouse strain and the CB1 receptor knockout and OCT2 null mutant mouse strains. CONCLUSION Further development is needed to validate models of antidepressant resistance that are fit for purpose. The criteria used in this review may provide a helpful framework to guide research in this area.
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40
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Liu YH, Chen L, Su YA, Fang YR, Srisurapanont M, Hong JP, Hatim A, Chua HC, Bautista D, Si TM. Is early-onset in major depression a predictor of specific clinical features with more impaired social function? Chin Med J (Engl) 2015; 128:811-5. [PMID: 25758278 PMCID: PMC4833988 DOI: 10.4103/0366-6999.152654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Early-onset major depressive disorder (MDD) (EOD) is often particularly malignant due to its special clinical features, accompanying impaired social function, protracted recovery time, and frequent recurrence. This study aimed to observe the effects of age onset on clinical characteristics and social function in MDD patients in Asia. Methods: In total, 547 out-patients aged 18–65 years who were from 13 study sites in five Asian countries were included. These patients had MDD diagnose according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria. Clinical features and social function were assessed using Symptom Checklist-90-revised (SCL-90-R) and Sheehan Disability Scale (SDS). Quality of life was assessed by a 36-item Short-form Health Survey (SF-36). Analyses were performed using a continuous or dichotomous (cut-off: 30 years) age-of-onset indicator. Results: Early-onset MDD (EOD, <30 years) was associated with longer illness (P = 0.003), unmarried status (P < 0.001), higher neuroticism (P ≤ 0.002) based on the SCL-90-R, and more limited social function and mental health (P = 0.006, P = 0.007) based on the SF-36 and SDS. The impairment of social function and clinical severity were more prominent at in-patients with younger onset ages. Special clinical features and more impaired social function and quality of life were associated with EOD, as in western studies. Conclusions: EOD often follows higher levels of neuroticism. Age of onset of MDD may be a predictor of clinical features and impaired social function, allowing earlier diagnosis and treatment.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tian-Mei Si
- Key Laboratory of Mental Health, Ministry of Mental Health and Peking University Institute of Mental Health, Beijing 100191, China
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Resistance to antidepressant drugs: the case for a more predisposition-based and less hippocampocentric research paradigm. Behav Pharmacol 2015; 25:352-71. [PMID: 25083567 DOI: 10.1097/fbp.0000000000000066] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The first half of this paper briefly reviews the evidence that (i) stress precipitates depression by damaging the hippocampus, leading to changes in the activity of a distributed neural system involving, inter alia, the amygdala, the ventromedial and dorsolateral prefrontal cortex, the lateral habenula and ascending monoamine pathways, and (ii) antidepressants work by repairing the damaged hippocampus, thus restoring the normal balance of activity within that circuitry. In the second half of the paper we review the evidence that heightened vulnerability to depression, either because of a clinical history of depression or because of the presence of genetic, personality or developmental risk factors, also confers resistance to antidepressant drug treatment. Thus, although antidepressants provide an efficient means of reversing the neurotoxic effects of stress, they are much less effective in conditions where vulnerability to depression is elevated and the role of stress in precipitating depression is correspondingly lower. Consequently, the issue of vulnerability should feature much more prominently in antidepressant research. Most of the current animal models of depression are based on the induction of a depressive-like phenotype by stress, and pay scant attention to vulnerability. As antidepressants are relatively ineffective in vulnerable individuals, this in turn implies a need for the development of different clinical and preclinical methodologies, and a shift of focus away from the current preoccupation with the hippocampus as a target for antidepressant action in vulnerable patients.
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Gade A, Kristoffersen M, Kessing LV. Neuroticism in Remitted Major Depression: Elevated with Early Onset but Not Late Onset of Depression. Psychopathology 2015; 48:400-7. [PMID: 26555606 DOI: 10.1159/000440813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/01/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND The personality trait of neuroticism is strongly related to depression, but depression is etiologically heterogeneous. Late-onset depression (LOD) may be more closely related to vascular factors, and previous studies of neuroticism in LOD versus early-onset depression (EOD) have not been consistent. METHOD We examined neuroticism, extraversion and perceived stress in 88 fully remitted depressed patients with a mean age of 60 years and with a history of hospitalization for major depressive disorder. Patients were divided into those with onset after and those with onset before 50 years of age (LOD and EOD, respectively), and the two groups were compared both with each other and with matched control groups of healthy subjects. RESULTS EOD patients showed increased levels of neuroticism in comparison with both LOD and matched controls, who did not differ. The association between age of onset and neuroticism was confirmed in analyses based on age of depression onset as a continuous variable. CONCLUSION Neuroticism may be an etiological factor in EOD but not or less so in LOD. This finding contributes to the growing evidence for etiological differences between early- and late-onset late-life depression.
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Affiliation(s)
- Anders Gade
- Department of Psychology, Copenhagen University, Copenhagen, Denmark
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Arean PA, Niu G. Choosing treatment for depression in older adults and evaluating response. Clin Geriatr Med 2014; 30:535-51. [PMID: 25037294 DOI: 10.1016/j.cger.2014.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
An update is provided on the current information regarding late life depression with regard to assessment, clinical implications, and treatment recommendations. Several treatments are considered evidence-based, but when deployed into field trials, the efficacy of these treatments falls short. It is thought that the lower impact in community trials is due in large part to patient, clinical, environmental, socio-economic, and cognitive correlates that influence treatment response. The aim is to assist providers in making decisions about what type of treatment to recommend based on a sound assessment of these clinical correlates.
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Affiliation(s)
- Patricia A Arean
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Grace Niu
- Department of Psychiatry, University of California, San Francisco, 401 Parnassus Avenue, San Francisco, CA 94143, USA
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Bukh JD, Bock C, Kessing LV. Association between genetic polymorphisms in the serotonergic system and comorbid personality disorders among patients with first-episode depression. J Pers Disord 2014; 28:365-78. [PMID: 24344840 DOI: 10.1521/pedi_2013_27_123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Studies on the association between genetic polymorphisms and personality disorders have provided inconsistent results. Using the "enriched sample method," the authors of the present study aimed to assess the association between polymorphisms in the serotonergic transmitter system and comorbid personality disorders in patients recently diagnosed with first-episode depression. A total of 290 participants were systematically recruited via the Danish Psychiatric Central Research Register. Diagnoses of personality disorders were assessed by a SCID-II interview, and polymorphisms in the genes encoding the serotonin transporter, serotonin receptors 1A, 2A, 2C, and tryptophan hydroxylase 1 were genotyped. The authors found a significant effect of the length polymorphism in the serotonin transporter gene (5-HTTLPR) on cluster B personality disorder (mainly borderline disorder), but no influence on cluster C personality disorder, and no associations between other polymorphisms and personality disorders. The study adds evidence to the effect of the serotonin transporter gene specifically on cluster B personality disorders.
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Wang Z, Gao K, Hong W, Xing M, Wu Z, Chen J, Zhang C, Yuan C, Huang J, Peng D, Wang Y, Lu W, Yi Z, Yu X, Zhao J, Fang Y. Guidelines disconcordance in acute bipolar depression: data from the national Bipolar Mania Pathway Survey (BIPAS) in mainland China. PLoS One 2014; 9:e96096. [PMID: 24763748 PMCID: PMC3999095 DOI: 10.1371/journal.pone.0096096] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 04/03/2014] [Indexed: 12/14/2022] Open
Abstract
With the recent attention to the importance of evidence-based medicine in psychiatry, a number of treatment guidelines have been published. This survey investigated prescribing pattern and predictors for guideline disconcordance in the acute treatment of bipolar depression across mainland China. Pharmacological treatments of 1078 patients with bipolar depression were examined. Guidelines disconcordance was determined by comparing the medication(s) patients were prescribed with the recommendation(s) in the guidelines of the Canadian Network for Mood and Anxiety Treatments. Predictors for guidelines discordance were analyzed with logistic regression. Of the 1078 patients, 50.2% patients were treated against treatment guidelines recommendations. The patients who were treated in general hospitals (OR = 1.53, 95% CI 1.18-1.97), with a depressive episode (OR = 1.67, 95% CI 1.27-2.19) and an older age at first onset (OR = 1.62, 95% CI 1.15-2.28) were more likely to receive guideline-disconcordant treatment than their counterparts. In contrast, the patients with current mental comorbidity, an older age at study entry, a longer duration of disease, and more frequent episodes in past year were less likely to receive guideline-disconcordant treatments than their counterparts with an OR of 0.43 (95% CI 0.24-0.77), 0.52 (95CI% 0.36-0.75), 0.48 (95% CI 0.36-0.65), and 0.50 (95% CI 0.38-0.64), respectively. Our finding suggested the disconcordance with treatment guidelines in patients with an acute bipolar depression is common under naturalistic conditions in mainland China, and the predicting factors correlated with guidelines disconcordance include both psychiatrist-specific (clinicians from general hospitals) and patient-specific features (a depressive episode at first onset, no current co-morbidity with mental disorders, a younger age at study entry, an older age at first onset, shorter duration of disease, and non-frequent episodes in past year).
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Affiliation(s)
- Zuowei Wang
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Division of Mood Disorders, Hongkou District Mental Health Center of Shanghai, Shanghai, China
| | - Keming Gao
- Mood and Anxiety Clinic in the Mood Disorders Program, Department of Psychiatry, University Hospitals Case Medical Center/Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
| | - Wu Hong
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mengjuan Xing
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhiguo Wu
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Chen
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengmei Yuan
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jia Huang
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Wang
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weihong Lu
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenghui Yi
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Yu
- Institute of Mental Health, Peking University, Beijing, China
| | - Jingping Zhao
- Mental Health Institute, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yiru Fang
- Division of Mood Disorders, Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wu RH, Feng C, Xu Y, Hua T, Liu XY, Fang M. Late-onset depression in the absence of stroke: associated with silent brain infarctions, microbleeds and lesion locations. Int J Med Sci 2014; 11:587-92. [PMID: 24782647 PMCID: PMC4003543 DOI: 10.7150/ijms.8025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/25/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Late-onset depression (LOD) is a frequent mood disorder among elderly. Previous studies have proved that LOD is associated with cerebral silent lesions especially white matter lesions (WML) and yielded the "vascular depression" hypothesis to explain the pathogenesis of LOD. However, there were relatively few studies about the association between silent brain infarctions (SBIs), microbleeds (MBs) and the prevalence of LOD. In this study we sought to evaluate the presence, accumulation and locations of SBIs and MBs, and explore the possible association between them and LOD. METHODS 65 patients of LOD diagnosed according to DSM-IV and 270 subjects of control group were enrolled and scanned by MRI to analyze the presence, numbers and locations of SBIs and MBs. Clinical and radiological characteristics were compared between LOD patients and control group. Logistic regression models were constructed to identify the independent risk factors for LOD. RESULTS LOD patients had higher prevalence and numbers of both SBIs and MBs. SBIs and MBs in the left hemisphere, SBIs in basal ganglia and lobar MBs were all independent risk factors for LOD. CONCLUSION The presence of both SBIs and MBs were associated with a higher rate LOD. Lesions in some specific locations might be critical for the presence of LOD.
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Affiliation(s)
- Ri-Han Wu
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Chao Feng
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
- 2. Yiwu Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang, China
| | - Yu Xu
- 3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Ting Hua
- 3. Department of Radiology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Xue-Yuan Liu
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
| | - Min Fang
- 1. Department of Neurology, Shanghai Tenth People's Hospital of Tongji University, School of Medicine, Shanghai, China
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Microbleeds in late-life depression: comparison of early- and late-onset depression. BIOMED RESEARCH INTERNATIONAL 2014; 2014:682092. [PMID: 24719883 PMCID: PMC3955674 DOI: 10.1155/2014/682092] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/21/2014] [Accepted: 01/21/2014] [Indexed: 01/25/2023]
Abstract
Late-life depression could be classified roughly as early-onset depression (EOD) and late-onset depression (LOD). LOD was proved to be associated with cerebral lesions including white matter hyperintensities (WMH) and silent brain infarctions (SBI), differently from EOD. However, it is unclear whether similar association is present between LOD and microbleeds which are also silent lesions. In this study, 195 patients of late-life depression were evaluated and divided into EOD, presenile-onset depression (POD), and LOD groups; 85 healthy elderly controls were enrolled as controls. Subjects were scanned by MRI including susceptibility weighted images to evaluate white matter hyperintensities (WMH), silent brain infarctions (SBI), and microbleeds. The severity of depression was evaluated with 15-item Geriatric Depression Scale. Psychosocial factors were investigated with Scale of Life Events and Lubben Social Network Scale. Logistic regression and linear regression were performed to identify the independent risk factors for depression. Results showed that LOD patients had higher prevalence of microbleeds than EOD, POD, and control patients. The prevalence of lobar microbleeds and microbleeds in the left hemisphere was the independent risk factor for the occurrence of LOD; a high number of microbleeds were associated with severe state of LOD, whereas life events and lack of social support were more important for EOD and POD. All these results indicated that Microbleeds especially lobar microbleeds and microbleeds in the left hemisphere were associated with LOD but not with EOD.
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Machado S, Arias-Carrión O, Paes F, Ribeiro P, Cagy M, Piedade R, Almada LF, Anghinah R, Basile L, Moro MF, Orsini M, Silva JG, Silva AC, Nardi AE. Changes in Cortical Activity During Real and Imagined Movements: an ERP Study. Clin Pract Epidemiol Ment Health 2013; 9:196-201. [PMID: 24358049 PMCID: PMC3866622 DOI: 10.2174/1745017901309010196] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/08/2013] [Accepted: 10/09/2013] [Indexed: 11/22/2022]
Abstract
This study aims to compare the topographic distribution of cortical activation between real and imagined movement through event-related potential (ERP). We are specifically interested in identifying, the topographic distribution of activated areas, the intensity of activated areas, and the temporal occurrence of these activations on preparation and motor response phases. Twelve healthy and right handed subjects were instructed to perform a task under real and imagery conditions. The task was performed simultaneously to electroencephalographic (EEG) recording. When compared the conditions, we found a statistically significant difference in favor of real condition revealed by performing an unpaired t-test with multiple corrections of Bonferroni, demonstrating negative activity on electrode C3 and positive activity on the electrode C4 only in motor response phase. These findings revealed similar functional connections established during real and imagery conditions, suggesting that there are common neural substrate and similar properties of functional integration shared by conditions.
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Affiliation(s)
- Sergio Machado
- Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil; National Institute for Translational Medicine (INCT-TM), Brazil
- Quiropraxia Program of the Faculty of Health Sciences, Central University (UCEN), Santiago, Chile
- Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil
- Institute of Phylosophy, Federal University of Uberlândia (IFILO/UFU), Brazil
| | - Oscar Arias-Carrión
- Movement Disorders and Transcranial Magnetic Stimulation Unit, Hospital General Dr. Manuel Gea González, México DF, México
| | - Flávia Paes
- Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil; National Institute for Translational Medicine (INCT-TM), Brazil
| | - Pedro Ribeiro
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil
- Bioscience Department (EEFD/UFRJ), School of Physical Education, Rio de Janeiro, Brazil
| | - Mauricio Cagy
- Bioengenieren Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Roberto Piedade
- Brain Mapping and Sensory Motor Integration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil
| | | | - Renato Anghinah
- Center for Cognitive Disorders of the Division of Clinical Neurology of the HCFMUSP
| | - Luis Basile
- Laboratory of Psychophysiology, Faculdade da Saúde, Universidade Metodista de São Paulo, São Paulo, Brazil, Division of Neurosurgery, University of São Paulo Medical School, São Paulo, Brazil
| | - Maria Francesca Moro
- Department of Public Health and Clinical and Molecular Medicine, University of Cagliari, Italy
| | - Marco Orsini
- Neurology Department, Antonio Pedro University Hospital, Federal Fluminense University, Rio de Janeiro, Brazil
- Sciences Rehabilitation Masters Program – UNISUAM
| | | | - Adriana Cardoso Silva
- Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil; National Institute for Translational Medicine (INCT-TM), Brazil
| | - Antonio E. Nardi
- Panic and Respiration, Institute of Psychiatry of Federal University of Rio de Janeiro, Brazil; National Institute for Translational Medicine (INCT-TM), Brazil
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Koorevaar AML, Comijs HC, Dhondt ADF, van Marwijk HWJ, van der Mast RC, Naarding P, Oude Voshaar RC, Stek ML. Big Five personality and depression diagnosis, severity and age of onset in older adults. J Affect Disord 2013; 151:178-85. [PMID: 23820093 DOI: 10.1016/j.jad.2013.05.075] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 04/09/2013] [Accepted: 05/25/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Personality may play an important role in late-life depression. The aim of this study is to examine the association between the Big Five personality domains and the diagnosis, severity and age of onset of late-life depression. METHODS The NEO-Five Factor Inventory (NEO-FFI) was cross-sectionally used in 352 depressed and 125 non-depressed older adults participating in the Netherlands Study of Depression in Older Persons (NESDO). Depression diagnosis was determined by the Composite International Diagnostic Interview (CIDI). Severity of depression was assessed by the Inventory of Depressive Symptomatology (IDS). Logistic and linear regression analyses were applied. Adjustments were made for sociodemographic, cognitive, health and psychosocial variables. RESULTS Both the presence of a depression diagnosis and severity of depression were significantly associated with higher Neuroticism (OR=1.35, 95% CI=1.28-1.43 and B=1.06, p<.001, respectively) and lower Extraversion (OR=.79, 95% CI=.75-.83; B=-.85, p<.001) and Conscientiousness (OR=.86, 95% CI=.81.-.90; B=-.86, p<.001). Earlier onset of depression was significantly associated with higher Openness (B=-.49, p=.026). LIMITATIONS Due to the cross-sectional design, no causal inferences can be drawn. Further, current depression may have influenced personality measures. CONCLUSIONS This study confirms an association between personality and late-life depression. Remarkable is the association found between high Openness and earlier age of depression onset.
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Affiliation(s)
- A M L Koorevaar
- Department of Old-age and Hospital Psychiatry, GGZ Noord Holland Noord, Oude Hoeverweg 10, 1816 BT Alkmaar, The Netherlands.
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Epp JR, Beasley CL, Galea LAM. Increased hippocampal neurogenesis and p21 expression in depression: dependent on antidepressants, sex, age, and antipsychotic exposure. Neuropsychopharmacology 2013; 38:2297-306. [PMID: 23778854 PMCID: PMC3773682 DOI: 10.1038/npp.2013.132] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 05/14/2013] [Accepted: 05/15/2013] [Indexed: 12/15/2022]
Abstract
The mammalian hippocampus continues to generate new neurons throughout life. The function of adult-generated neurons remains controversial, but adult neurogenesis in the hippocampus is related to depression. Studies show that neurogenesis in the hippocampus is regulated by antidepressants in both humans and rodents, but no studies have examined the effects of age, sex, or antipsychotic exposure on the relationship between depression, antidepressant exposure, and hippocampal neurogenesis in humans. Hippocampal sections were obtained from the Stanley Medical Research Institute and were immunohistochemically labeled for the immature neuron marker doublecortin and the cell cycle arrest marker p21. We compared the number of cells in the granule cell layer and subgranular zone that expressed these proteins in brains from control subjects (n=12), patients with major depressive disorder (MDD) without psychotic symptoms (n=12), and patients with MDD and psychotic symptoms (n=12). We show here that the density of doublecortin/NeuN expression was increased in MDD patients compared with controls and MDD patients with psychosis, with the effect greater in women. Further, we show that older depressed patients without psychosis had higher levels of p21/NeuN expression and that depressed individuals prescribed antidepressants had higher levels of p21/NeuN expression, but only in older women. We show for the first time that changes in neurogenesis due to prescribed antidepressants or depression are dependent on age, sex, and the presence of antipsychotics or psychotic symptoms.
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Affiliation(s)
- Jonathan R Epp
- Program in Neuroscience, Department of Psychology, Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Clare L Beasley
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Liisa AM Galea
- Program in Neuroscience, Department of Psychology, Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada,Program in Neuroscience, Department of Psychology, Centre for Brain Health, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4, Canada, Tel: +604 822 6536, Fax: +604 822 6923, E-mail:
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