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Li YZ, Qin X, Liu FH, Chen WX, Wei YF, Wang N, Yan S, Kang Y, Zhao YH, Gao S, Gong TT, Wu QJ. Prediagnosis Depression Rather Than Anxiety Symptoms Is Associated with Decreased Ovarian Cancer Survival: Findings from the Ovarian Cancer Follow-Up Study (OOPS). J Clin Med 2022; 11:jcm11247394. [PMID: 36556009 PMCID: PMC9781310 DOI: 10.3390/jcm11247394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022] Open
Abstract
Background: The relationship between prediagnosis depression, anxiety symptoms, and ovarian cancer (OC) survival is unknown. We aimed to explore these associations to provide further epidemiological evidence. Methods: We investigated the relationship between prediagnosis depression, anxiety symptoms, and OC survival in a prospective cohort study of newly diagnosed OC patients aged 18−79 years. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 at diagnosis, respectively. Deaths were ascertained until 31 March 2021 via medical records and active follow-up. Multivariable-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with prediagnosis depression and anxiety symptoms and all-cause mortality of OC. Results: We found 56 (9.4%) and 235 (39.3%) OC patients with depression and anxiety symptoms, respectively. During a median follow-up of 37.2 months (interquartile range 24.7−50.2 months), 130 deaths were confirmed. Compared with non-depression symptoms, patients with prediagnosis depressive symptoms showed a significantly increased risk of OC mortality (HR = 2.10, 95% CI: 1.20−3.70). Of note, the association was still robust when focusing on the OC patients with severe depressive symptoms (HR = 2.10, 95% CI: 1.07−4.12). However, we observed no association between prediagnosis anxiety symptoms of different severity and OC mortality. Interestingly, OC patients with combined moderate depression and anxiety symptoms had a significantly increased risk of OC mortality (HR = 3.23, 95% CI: 1.14−9.11) compared to those with no symptoms of depression and anxiety. Notably, Wilms’s tumor 1 was significantly associated with depression and anxiety symptoms (p < 0.05). Conclusions: Prediagnosis depression increases the risk of OC mortality. Large multicenter studies are required to confirm this finding.
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Affiliation(s)
- Yi-Zi Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Xue Qin
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Wen-Xiao Chen
- Department of Sports Medicine and Joint Surgery, The People’s Hospital of Liaoning Province, Shenyang 110000, China
| | - Yi-Fan Wei
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Na Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200433, China
| | - Shi Yan
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ye Kang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Song Gao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Correspondence: (T.-T.G.); (Q.-J.W.); Tel.: +86-24-96615-13652 (T.-T.G.); +86-24-96615-13652 (Q.-J.W.)
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 110004, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, China Medical University, Shenyang 110004, China
- Correspondence: (T.-T.G.); (Q.-J.W.); Tel.: +86-24-96615-13652 (T.-T.G.); +86-24-96615-13652 (Q.-J.W.)
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Chen M, Liu M, Guo X, Zhou J, Yang H, Zhong G, Men L, Xie Y, Tong G, Liu Q, Luan J, Zhou H. Effects of Xinkeshu tablets on coronary heart disease patients combined with anxiety and depression symptoms after percutaneous coronary intervention: A meta-analysis. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 104:154243. [PMID: 35717809 DOI: 10.1016/j.phymed.2022.154243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/17/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Xinkeshu tablets (XKS), a well-known Chinese patent drug, have been administered to coronary heart disease (CHD) patients with anxiety and depression after percutaneous coronary intervention (PCI). PURPOSE This meta-analysis aimed to systematically evaluate the clinical effects of XKS for treating CHD patients with anxiety and depression after PCI. METHODS Randomized controlled trials (RCTs) about XKS alone or combined with conventional drugs for the treatment of CHD patients with anxiety and depression after PCI were retrieved from 7 databases (MEDLINE, EMBASE, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM) and Wanfang Database) through November 2021. First, the studies were reviewed and screened by two independent assessors according to the eligibility criteria. Second, the methodological quality of the eligible studies was evaluated based on the Cochrane Collaboration's tool for assessing the risk of bias. Subsequently, meta-analysis was performed by using RevMan 5.4 software, and publication bias was evaluated by Stata 12.0 software. Finally, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to rate the quality of the evidence. RESULTS In total, 11 clinical RCTs involving 1000 patients were included in this study. This meta-analysis found that compared with conventional treatment alone, XKS combined with conventional treatment significantly improved the anxiety scale scores (SMD = -1.97, 95% CI -3.13 to -0.82; p = 0.0008; I2 = 98%), the depression scores (SMD = -2.80, 95% CI -4.49 to -1.10; p = 0.001; I2 = 98%), the scores on the Medical Outcomes Study 36 Item Short Form Health Survey (SF36) (MD = 11.22, 95% CI 4.19 to 18.26; p =0.002; I2 = 95%) and the blood lipid levels of total cholesterol (TC) (MD = -0.38, 95% CI -0.62 to -0.13; p = 0.003; I2 = 0%) and triglyceride (TG) (MD = -0.31, 95% CI -0.46 to -0.17; p < 0.0001; I2 = 0%). CONCLUSION The current evidence suggests that XKS might benefit CHD patients experiencing anxiety and depression after PCI by helping to improve their depression symptoms, TC and TG blood lipid levels. However, due to insufficient methodological quality of the studies, several risks of bias and inadequate reporting of the clinical data, more rigorous, multicenter, sufficient-sample and double-blind randomized clinical trials are warranted.
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Affiliation(s)
- Mingtai Chen
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China; Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China.
| | - Mengnan Liu
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; National Traditional Chinese Medicine Clinical Research Base and Department of Cardiovascular, Hospital (T.C.M) Affiliated to Southwest Medical University, Luzhou, Sichuan, PR China
| | - Xin Guo
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Jie Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Huayi Yang
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China
| | - Guofu Zhong
- Intensive Care Unit, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Ling Men
- Department of Neurology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Ying Xie
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macao, PR China
| | - Guangdong Tong
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Department of Liver Disease, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, PR China
| | - Qiang Liu
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China
| | - Jienan Luan
- Department of Cardiovascular Disease, Shenzhen Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen, PR China
| | - Hua Zhou
- Faculty of Chinese Medicine and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Taipa, Macao, PR China; Joint Laboratory for Translational Cancer Research of Chinese Medicine of the Ministry of Education of the People's Republic of China, Macau University of Science and Technology, Taipa, Macao, PR China; Guangdong Provincial Hospital of Chinese Medicine, Guangdong Provincial Academy of Chinese Medical Sciences, State Key Laboratory of Dampness Syndrome of Chinese Medicine, Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, PR China.
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Das DR, Nayak MR, Mohapatra D, Mahanta D. Association of Anxiety and Depression in Patients Undergoing Cardiac Catheterization With Number of Major Coronary Artery Stenosis: A Cross-Sectional Study. Cureus 2022; 14:e21630. [PMID: 35233310 PMCID: PMC8881283 DOI: 10.7759/cureus.21630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction The relationship between the level of anxiety and depression among coronary artery disease (CAD) patients and coronary angiographic findings is ambiguously mentioned in studies. Past evidence shows that the relationship between anxiety and depression with coronary artery disease can be bidirectional. There is a paucity of literature on the association of levels of anxiety and depression with the number of coronary arteries involved in coronary artery disease. Methods This study was conducted in a tertiary care hospital to find the level of anxiety and depression in patients undergoing cardiac catheterization and their association with the numbers of the major coronary artery involved. Patients undergoing cardiac catheterization in the Department of Cardiovascular Science of a tertiary care hospital in India from May 2020 to December 2020 were considered for inclusion in the study. Coronary artery disease was diagnosed based on the combination of clinical, ECG, echocardiography, or biomarker parameters in various combinations. These patients were further subjected to coronary angiogram to know the extent of stenosis and the number of coronary vessels involved in the disease. The level of anxiety and depression was measured by using the Hospital Anxiety and Depression Scale (HADS) during the period of admission and at least 24 hours after diagnosis and at least 12 hours before cardiac catheterization. The data was entered into SPSS software version 22.0 (Armonk, NY: IBM Corp.) for statistical analysis. Chi-square test, Kolmogorov-Smirnov test, and Kruskal-Wallis test were used for the interpretation of data and find an association between severity of anxiety and depression with the number of major coronary vessels involved. Results Anxiety was seen in 83.3% of the patients with 31.5% having severe anxiety. Depression was found in 77.8% with 38.9% suffering from severe depression. The anxiety and depression scores of HADS were significantly higher in those with triple-vessel disease compared to the double-vessel or single-vessel disease. Conclusion Screening and management of anxiety and depression is an essential part of the care of patients with coronary artery disease. People with triple-vessel disease need the most attention and appropriate management of anxiety and depression.
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Zhu Y, Wei Y, Duan J, Li J, Zhang R, Sun J, Wang P, Liu Z, Lv J, Wei S, Jiang X, Wang F, Tang Y. The role of leptin in indirectly mediating "somatic anxiety" symptoms in major depressive disorder. Front Psychiatry 2022; 13:757958. [PMID: 35911226 PMCID: PMC9337242 DOI: 10.3389/fpsyt.2022.757958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Leptin is a multifunctional hormone secreted from adipose tissue, which plays a core role in regulating energy intake and expenditure. Evidence has demonstrated that leptin receptors are located in brain areas involved in emotional processing, and major depressive disorder (MDD) is characterized by dysfunction of emotional processing. Taken together, these features suggest that leptin may play a potential role in the pathophysiology of MDD. However, the precise roles of leptin in modulating depressive symptoms in MDD remain unclear. METHODS Participants [18 drug-naïve MDD patients, 15 unaffected first-degree relatives of MDD patients (FDR-MDD), and 40 healthy controls] completed clinical assessments and provided blood samples for measurement of leptin levels. We evaluated the effect of leptin on clinical status (MDD or FDR-MDD) and symptomatic dimensionalities of MDD using mediation analysis. RESULTS We found that leptin was increased in MDD patients and this only predicted "somatic anxiety" symptoms. Furthermore, leptin was a significant and indirect mediator of the association between clinical status (MDD or FDR-MDD) and "somatic anxiety" symptoms. CONCLUSION Our finding that leptin was a significant and indirect mediator of clinical status (MDD or FDR-MDD) and "somatic anxiety" symptoms suggests that leptin may indirectly affect somatic depressive symptoms in MDD. Our findings may provide a theoretical basis for novel clinical interventions in MDD.
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Affiliation(s)
- Yue Zhu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yange Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jia Duan
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jianing Li
- China Medical University and Queen's University of Belfast Joint College, China Medical University, Shenyang, China
| | - Ran Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiaze Sun
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Pengshuo Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhuang Liu
- School of Public Health, China Medical University, Shenyang, China
| | - Jing Lv
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Psychiatry, Corning Hospital, Shenzhen, China
| | - Shengnan Wei
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiaowei Jiang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Fei Wang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Radiology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yanqing Tang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, China.,Brain Function Research Section, The First Affiliated Hospital of China Medical University, Shenyang, China.,Department of Gerontology, The First Affiliated Hospital of China Medical University, Shenyang, China
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Yama K, Asari Y, Ono A, Machida M, Miura J. Plasma Interleukin-10 Levels Are Altered in Women with Severe Premenstrual Syndrome: A Preliminary Study. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2020; 1:73-79. [PMID: 33786476 PMCID: PMC7784795 DOI: 10.1089/whr.2019.0010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The precise pathophysiology of premenstrual syndrome (PMS) is unknown, and chronic inflammation has been implicated in PMS. However, inflammatory markers, including cytokines and C-reactive protein (CRP), have not been investigated before and after menstruation in relation to PMS among the same participants. This study investigated whether the plasma levels of tumor necrosis factor-α, interleukin (IL)-6, IL-10, and CRP are related to PMS. Methods: The study included 21 healthy Japanese women (aged 19-24 years) with a regular menstrual cycle. Inflammatory marker levels in plasma were determined using enzyme-linked immunosorbent assay. In addition, the level of depressiveness was assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. Results: Of the 21 women, 7 were considered to have moderate-to-severe PMS (PMS [+] group) and 14 were considered to have no or mild PMS (PMS [-]), and none of the participants had premenstrual dysphoric disorder. The IL-10 levels were significantly lower before than after menstruation in the PMS (-) group. The IL-10 levels before menstruation were significantly higher in the PMS (+) group than in the PMS (-) group. Other markers did not show relevant differences between the groups. The CES-D scores were higher in the PMS (+) group than in the PMS (-) group both before and after menstruation. There were positive correlations between the CES-D scores and IL-6 levels before menstruation and the CES-D scores and IL-10 levels after menstruation. Conclusions: The IL-10 levels before menstruation were higher in women with PMS than in those without PMS, and these levels might be related to PMS.
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Affiliation(s)
- Kaori Yama
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Yuki Asari
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Aiko Ono
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Maiko Machida
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
| | - Jun Miura
- Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan
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Ely AV, Alio C, Bygrave D, Burke M, Walker E. Relationship Between Psychological Distress and Cognitive Function Differs as a Function of Obesity Status in Inpatient Heart Failure. Front Psychol 2020; 11:162. [PMID: 32116957 PMCID: PMC7033423 DOI: 10.3389/fpsyg.2020.00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/21/2020] [Indexed: 01/19/2023] Open
Abstract
Heart failure (HF) is a chronic medical condition rapidly growing in prevalence. Evidence links HF to cognitive decline, obesity, and psychological distress. The current study examined the association between cognitive function and ejection fraction (EF%), anxiety, depression, and obesity in inpatient HF. Patients completed the Generalized Anxiety Disorder 7-Item Scale (GAD-7), Patient Health Questionnaire 9-Item Scale (PHQ-9), and Mini-Cog while hospitalized for HF. Additional demographic and medical information was gathered via chart review. All models controlled for age. Of 117 patients assessed (49% male), 55% (n = 64) were obese. ANCOVA analyses were conducted comparing those with obesity and without on cognitive function: model A included EF%, model B included depression, and model C included anxiety. All three models were significantly related to cognitive function. There was a significant interaction effect of EF% and obesity and of anxiety and obesity to predict Mini-Cog scores. Post hoc partial correlational analyses revealed that anxiety was negatively associated with Mini-Cog scores among only patients without obesity. Depression was not significantly related to cognitive function in either group. However, patients with obesity demonstrated higher depression and anxiety than patients without. Results suggest that at lower EF%, and with higher anxiety, patients without obesity may be at greater risk of cognitive dysfunction than those with obesity. Cognitive dysfunction among HF patients with obesity may be independent of psychological distress. These findings may reflect the “obesity paradox” observed among HF patients, in that patients with obesity may have a different biopsychosocial presentation, which may lead to unexpected clinical outcomes. Further research is necessary to articulate the relationship of obesity and cognitive function in HF.
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Affiliation(s)
- Alice V Ely
- Department of Psychiatry, Christiana Care, Newark, DE, United States.,Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States
| | - Courtney Alio
- Department of Psychiatry, Christiana Care, Newark, DE, United States
| | - Desiree Bygrave
- Department of Psychiatry, Christiana Care, Newark, DE, United States.,School of Nursing, University of Delaware, Newark, DE, United States
| | - Marykate Burke
- Department of Psychiatry, Christiana Care, Newark, DE, United States
| | - Earl Walker
- Department of Psychiatry, Christiana Care, Newark, DE, United States
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Vuong E, Nothling J, Lombard C, Jewkes R, Peer N, Abrahams N, Seedat S. Peripheral adiponectin levels in anxiety, mood, trauma- and stressor-related disorders: A systematic review and meta-analysis. J Affect Disord 2020; 260:372-409. [PMID: 31539673 DOI: 10.1016/j.jad.2019.09.050] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/01/2019] [Accepted: 09/08/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Anxiety, mood, trauma- and stressor-related disorders confer increased risk for metabolic disease. Adiponectin, a cytokine released by adipose tissue is associated with these disorders and obesity via inflammatory processes. Available data describing associations with mental disorders remain limited and conflicted. METHODS A systematic search was conducted for English, peer-reviewed articles from inception until February 2019 that assessed for serum or plasma adiponectin levels in adults with an anxiety, mood or trauma-related disorder. Diagnoses were determined by psychiatric interview, based on DSM-IV, DSM-5 or ICD-10 criteria. Analyses were performed using STATA 15 and Standardized mean difference (SMD) with 95% confidence interval was applied to pool the effect size of meta-analysis studies. RESULTS In total 65 eligible studies were included in the systematic review and 30 studies in this meta-analysis. 19,178 participants (11,262 females and 7916 males), comprising healthy adults and adults with anxiety, mood and trauma-related disorders, were included. Overall results indicated an inverse association between adiponectin levels and examined mental disorders. Specifically, patients with an anxiety disorder (SMD = -1.18 µg/mL, 95% CI, -2.34; -0.01, p = 0.047); trauma or stressor-related disorder (SMD = -0.34 µg/mL, 95% CI, -0.52; -0.17, p = 0.0000) or bipolar disorder (SMD = -0.638 µg/mL, 95% CI, -1.16, -0.12, p = 0.017) had significant lower adiponectin levels compared to healthy adults. LIMITATIONS Heterogeneity, potential publication bias, and lack of control for important potential confounders were significant limitations. CONCLUSION Peripheral adiponectin levels appear to be inversely associated with anxiety, mood, trauma- and stressor related disorders and may be a promising biomarker for diagnosis and disease monitoring.
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Affiliation(s)
- E Vuong
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa.
| | - J Nothling
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | - C Lombard
- Biostatistics Unit, South Africa Medical Research Council, Cape Town, South Africa
| | - R Jewkes
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - N Peer
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Durban, South Africa
| | - N Abrahams
- Gender and Health Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - S Seedat
- South African Research Chairs Initiative (SARChI), PTSD Program, Department of Psychiatry, Stellenbosch University, South Africa; Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
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Inflammation in Fear- and Anxiety-Based Disorders: PTSD, GAD, and Beyond. Neuropsychopharmacology 2017; 42:254-270. [PMID: 27510423 PMCID: PMC5143487 DOI: 10.1038/npp.2016.146] [Citation(s) in RCA: 422] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 07/01/2016] [Accepted: 07/12/2016] [Indexed: 02/07/2023]
Abstract
The study of inflammation in fear- and anxiety-based disorders has gained interest as growing literature indicates that pro-inflammatory markers can directly modulate affective behavior. Indeed, heightened concentrations of inflammatory signals, including cytokines and C-reactive protein, have been described in posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), and phobias (agoraphobia, social phobia, etc.). However, not all reports indicate a positive association between inflammation and fear- and anxiety-based symptoms, suggesting that other factors are important in future assessments of inflammation's role in the maintenance of these disorders (ie, sex, co-morbid conditions, types of trauma exposure, and behavioral sources of inflammation). The most parsimonious explanation of increased inflammation in PTSD, GAD, PD, and phobias is via the activation of the stress response and central and peripheral immune cells to release cytokines. Dysregulation of the stress axis in the face of increased sympathetic tone and decreased parasympathetic activity characteristic of anxiety disorders could further augment inflammation and contribute to increased symptoms by having direct effects on brain regions critical for the regulation of fear and anxiety (such as the prefrontal cortex, insula, amygdala, and hippocampus). Taken together, the available data suggest that targeting inflammation may serve as a potential therapeutic target for treating these fear- and anxiety-based disorders in the future. However, the field must continue to characterize the specific role pro-inflammatory signaling in the maintenance of these unique psychiatric conditions.
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9
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Bertone-Johnson ER. Chronic Inflammation and Premenstrual Syndrome: A Missing Link Found? J Womens Health (Larchmt) 2016; 25:857-8. [DOI: 10.1089/jwh.2016.5937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Elizabeth R. Bertone-Johnson
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts
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10
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Gu G, Zhou Y, Zhang Y, Cui W. Increased prevalence of anxiety and depression symptoms in patients with coronary artery disease before and after percutaneous coronary intervention treatment. BMC Psychiatry 2016; 16:259. [PMID: 27450548 PMCID: PMC4957885 DOI: 10.1186/s12888-016-0972-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 07/15/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Evidence suggests that coronary heart disease (CHD) is associated with increased anxiety and a high incidence of comorbid anxiety and depression. However, the association between percutaneous coronary intervention (PCI) and comorbid anxiety and depression has not been previously investigated. This study aims to determine the relationship between PCI and anxiety and depression symptoms in CHD patients in terms of the occurrence, prone factors, and long-term outcomes of CHD. METHODS One hundred seventy CHD patients who underwent PCI treatment between September 2013 and February 2014 at the Second Hospital of Hebei Medical University were randomly selected. All patients independently completed the Hospital Anxiety and Depression Scale (HADS) and a preoperative questionnaire; they also provided details regarding their PCI-related concerns one day before PCI, as well as one day and one, three, six, and 12 months after PCI. RESULTS PCI treatment was significantly associated with the symptoms of anxiety, depression, affective disorders, and comorbid anxiety and depression (χ(2) = 90.18, 54.45, 101.59, 64.83; p < 0.01) at each follow-up time point. Moreover, PCI treatment was linearly correlated with each of these psychological issues (p < 0.01). CONCLUSION The prevalence of anxiety, depression, and comorbid anxiety and depression symptoms significantly increases one day before and after PCI treatment; however, the incidence of these psychological issues significantly decreases with time following PCI. A low level of education, apprehension with regard to nursing quality, potential cardiac dysfunction, surgery sequelae, and surgery failure are also associated with a high prevalence of anxiety and depression symptoms.
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Affiliation(s)
- Guoqiang Gu
- Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215, He Ping Xi Road, Shijiazhuang, 05000 China
| | - Yaqing Zhou
- Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215, He Ping Xi Road, Shijiazhuang, 05000 China
| | - Ying Zhang
- Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215, He Ping Xi Road, Shijiazhuang, 05000 China
| | - Wei Cui
- Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215, He Ping Xi Road, Shijiazhuang, 05000, China.
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11
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Borrow AP, Stranahan AM, Suchecki D, Yunes R. Neuroendocrine Regulation of Anxiety: Beyond the Hypothalamic-Pituitary-Adrenal Axis. J Neuroendocrinol 2016; 28. [PMID: 27318180 DOI: 10.1111/jne.12403] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 05/20/2016] [Accepted: 06/17/2016] [Indexed: 02/06/2023]
Abstract
The central nervous system regulates and responds to endocrine signals, and this reciprocal relationship determines emotional processing and behavioural anxiety. Although the hypothalamic-pituitary-adrenal (HPA) axis remains the best-characterised system for this relationship, other steroid and peptide hormones are increasingly recognised for their effects on anxiety-like behaviour and reward. The present review examines recent developments related to the role of a number of different hormones in anxiety, including pregnane neurosteroids, gut peptides, neuropeptides and hormonal signals derived from fatty acids. Findings from both basic and clinical studies suggest that these alternative systems may complement or occlude stress-induced changes in anxiety and anxiety-like behaviour. By broadening the scope of mechanisms for depression and anxiety, it may be possible to develop novel strategies to attenuate stress-related psychiatric conditions. The targets for these potential therapies, as discussed in this review, encompass multiple circuits and systems, including those outside of the HPA axis.
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Affiliation(s)
- A P Borrow
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
| | - A M Stranahan
- Department of Neuroscience and Regenerative Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - D Suchecki
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - R Yunes
- Instituto de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad de Mendoza, Mendoza, Argentina
- Área de Farmacología, Facultad de Ciencias Médicas, Universidad Nacional de Cuyo, Mendoza, Argentina
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12
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Prelog M, Hilligardt D, Schmidt CA, Przybylski GK, Leierer J, Almanzar G, El Hajj N, Lesch KP, Arolt V, Zwanzger P, Haaf T, Domschke K. Hypermethylation of FOXP3 Promoter and Premature Aging of the Immune System in Female Patients with Panic Disorder? PLoS One 2016; 11:e0157930. [PMID: 27362416 PMCID: PMC4928917 DOI: 10.1371/journal.pone.0157930] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/07/2016] [Indexed: 02/02/2023] Open
Abstract
Immunological abnormalities associated with pathological conditions, such as higher infection rates, inflammatory diseases, cancer or cardiovascular events are common in patients with panic disorder. In the present study, T cell receptor excision circles (TRECs), Forkhead-Box-Protein P3 gene (FOXP3) methylation of regulatory T cells (Tregs) and relative telomere lengths (RTLs) were investigated in a total and subsamples of 131 patients with panic disorder as compared to 131 age- and sex-matched healthy controls in order to test for a potential dysfunction and premature aging of the immune system in anxiety disorders. Significantly lower TRECs (p = 0.004) as well as significant hypermethylation of the FOXP3 promoter region (p = 0.005) were observed in female (but not in male) patients with panic disorder as compared to healthy controls. No difference in relative telomere length was discerned between patients and controls, but significantly shorter telomeres in females, smokers and older persons within the patient group. The presently observed reduced TRECs in panic disorder patients and FOXP3 hypermethylation in female patients with panic disorder potentially reflect impaired thymus and immunosuppressive Treg function, which might partly account for the known increased morbidity and mortality of anxiety disorders conferred by e.g. cancer and cardiovascular disorders.
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Affiliation(s)
- Martina Prelog
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Deborah Hilligardt
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | | | - Grzegorz K. Przybylski
- Clinic for Internal Medicine C, University of Greifswald, Greifswald, Germany
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Johannes Leierer
- Department of Internal Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giovanni Almanzar
- Department of Pediatrics, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Nady El Hajj
- Institute of Human Genetics, University of Wuerzburg, Wuerzburg, Germany
| | - Klaus-Peter Lesch
- Molecular Psychiatry, Department of Psychiatry, Psychosomatics and Psychotherapy, University of Wuerzburg, Wuerzburg, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
| | - Peter Zwanzger
- Department of Psychiatry and Psychotherapy, University of Muenster, Muenster, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universtät Munich, Munich, Germany
- kbo-Inn-Salzach-Klinikum, Wasserburg am Inn, Germany
| | - Thomas Haaf
- Institute of Human Genetics, University of Wuerzburg, Wuerzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Wuerzburg, Germany
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Poole EM, Kubzansky LD, Sood AK, Okereke OI, Tworoger SS. A prospective study of phobic anxiety, risk of ovarian cancer, and survival among patients. Cancer Causes Control 2016; 27:661-8. [PMID: 27023470 DOI: 10.1007/s10552-016-0739-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/21/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE In ovarian cancer patients and mouse models, psychosocial stress is associated with higher circulating markers of angiogenesis and cell migration, impaired immune response, and increasing tumor burden and aggressiveness. In the Nurses' Health Studies (NHS/NHSII), we assessed whether phobic anxiety, a marker of chronic distress, was associated with risk of incident ovarian cancer as well as survival among ovarian cancer patients. METHODS We used Cox proportional hazards regression to model the relative risks (RRs) and 95 % confidence intervals (CI) of ovarian cancer incidence and survival by categories of the Crown-Crisp phobic anxiety index (CCI). RESULTS We identified 779 cases of ovarian cancer during 2,497,892 person-years of follow-up. For baseline CCI (NHS: 1988; NHSII: 1993), we observed a statistically nonsignificant increased risk of epithelial ovarian cancer (RR for CCI ≥ 4 vs. 0 or 1: 1.14; 95 % CI 0.96-1.36). However, when we updated CCI (NHS: 2004; NHSII: 2005), the associations were attenuated. Pre-diagnosis CCI was not associated with ovarian cancer survival (RR for ≥4 vs. 0 or 1: 1.00; 95 % CI 0.77-1.31); results were similar for post-diagnosis CCI. CONCLUSIONS Distress, as measured by phobic anxiety symptoms, was not associated with ovarian cancer risk, although we cannot rule out a modest association. Future research should explore the role of phobic anxiety and other forms of psychological distress and ovarian cancer risk and survival.
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Affiliation(s)
- Elizabeth M Poole
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, 3rd Floor, Boston, MA, 02115, USA.
| | | | | | - Olivia I Okereke
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, 3rd Floor, Boston, MA, 02115, USA.,Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Shelley S Tworoger
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Ave, 3rd Floor, Boston, MA, 02115, USA.,Harvard TH Chan School of Public Health, Boston, MA, USA
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A prospective study of leukocyte telomere length and risk of phobic anxiety among women. Psychiatry Res 2015; 230:545-52. [PMID: 26603336 PMCID: PMC4767547 DOI: 10.1016/j.psychres.2015.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 08/14/2015] [Accepted: 10/01/2015] [Indexed: 12/24/2022]
Abstract
We prospectively examined the relation of relative telomere lengths (RTLs), a marker of biological aging, to phobic anxiety in later-life. RTLs in peripheral blood leukocytes were measured among 3194 women in the Nurses' Health Study who provided blood samples in 1989/90. The Crown-Crisp Phobic Index (CCI, range=0–16) was assessed in 1988 and 2004. Only participants with CCI≤3 (consistent with no meaningful anxiety symptoms) in 1988 were included. We related baseline RTLs to odds ratios (ORs) of incident high phobic anxiety symptoms (CCI≥6). To enhance clinical relevance, we used finite mixture modeling (FMM) to relate baseline RTLs to latent classes of CCI in 2004. RTLs were not significantly associated with high phobic anxiety symptoms after 16 years of follow-up. However, FMM identified 3 groups of phobic symptoms in later-life: severe, minimal/intermediate, and non-anxious. The severe group had non-significantly shorter multivariable-adjusted mean RTLs than the minimal/intermediate and non-anxious groups. Women with shorter telomeres vs. longest telomeres had non-significantly higher likelihood of being in the severe vs. non-anxious group. Overall, there was no significant association between RTLs and incident phobic anxiety symptoms. Further work is required to explore potential connections of telomere length and emergence of severe phobic anxiety symptoms during later-life.
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15
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Martin S, Vincent A, Taylor AW, Atlantis E, Jenkins A, Januszewski A, O’Loughlin P, Wittert G. Lower Urinary Tract Symptoms, Depression, Anxiety and Systemic Inflammatory Factors in Men: A Population-Based Cohort Study. PLoS One 2015; 10:e0137903. [PMID: 26445118 PMCID: PMC4622039 DOI: 10.1371/journal.pone.0137903] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 08/22/2015] [Indexed: 11/19/2022] Open
Abstract
Background The relationship between lower urinary tract symptoms (LUTS) and common mental health disorders such as depression and anxiety in men remains unclear. Inflammation has recently been identified as an independent risk factor for LUTS and depression. This study aimed to assess the association between depression, anxiety and LUTS, and the moderating influence of systemic inflammation, in the presence of other biopsychosocial confounders. Methods Participants were randomly-selected from urban, community-dwelling males aged 35–80 years at recruitment (n = 1195; sample response rate:67.8%). Of these, 730 men who attended baseline (2002–5) and follow-up clinic visits (2007–10), with complete outcome measures, and without prostate or bladder cancer and/or surgery, neurodegenerative conditions, or antipsychotic medications use, were selected for the present study. Unadjusted and multi-adjusted regression models of incident storage and voiding LUTS and incident depression and anxiety were combined with serum inflammatory markers (high-sensitive C-reactive protein (hsCRP), tumor necrosis factor-alpha (TNF-α), interleukin–6 (IL–6), myeloperoxidase (MPO), soluble e-selectin (e-Sel)) and socio-demographic, lifestyle, and health-related factors. Hierarchical multiple regression was used to assessed the moderating effect of inflammatory markers. Results The incidence of storage, voiding LUTS, depression and anxiety was 16.3% (n = 108), 12.1% (n = 88), 14.5% (n = 108), and 12.2% (n = 107). Regression models demonstrated that men with depression and anxiety at baseline were more likely to have incident storage, but not voiding LUTS (OR: 1.26, 99%CI: 1.01–4.02; and OR:1.74; 99%CI:1.05–2.21, respectively). Men with anxiety and storage LUTS at baseline were more likely to have incident depression (OR: 2.77, 99%CI: 1.65–7.89; and OR:1.45; 99%CI:1.05–2.36, respectively), while men with depression and voiding LUTS were more likely to have anxiety at follow-up (OR: 5.06, 99%CI: 2.81–9.11; and OR:2.40; 99%CI:1.16–4.98, respectively). CRP, TNF-α, and e-Sel were found to have significant moderating effects on the development of storage LUTS (1.06, 0.91–1.96, R2 change: 12.7%), depression (1.17, 1.01–1.54, R2 change: 9.8%), and anxiety (1.35, 1.03–1.76, R2 change: 10.6%), respectively. Conclusions There is a bidirectional relationship between storage, but not voiding, LUTS and both depression and anxiety. We observed variable moderation effects for selected inflammatory markers on the development of depression, anxiety and storage LUTS.
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Affiliation(s)
- Sean Martin
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| | - Andrew Vincent
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, University of Adelaide, Adelaide, South Australia, Australia
| | - Evan Atlantis
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- School of Nursing and Midwifery, University of Western Sydney, Sydney, New South Wales, Australia
| | - Alicia Jenkins
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Andrzej Januszewski
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Peter O’Loughlin
- Chemical Pathology, SA Pathology, Adelaide, South Australia, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men’s Health, University of Adelaide, Adelaide, South Australia, Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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16
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Strasser B, Fuchs D. Role of physical activity and diet on mood, behavior, and cognition. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.npbr.2015.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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17
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Neri Calixto M, Ayllón Alvarez D, Vieyra Reyes P, Hernández-González M, Jiménez-Garcés C, Flores Ocampo P. Influencia de grelina y leptina sobre alteraciones psiquiátricas en sujetos con obesidad. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.mei.2015.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Hagan KA, Wu T, Rimm EB, Eliassen AH, Okereke OI. Phobic Anxiety and Plasma Levels of Global Oxidative Stress in Women. EUROPEAN JOURNAL OF PSYCHIATRY 2015; 29:7-20. [PMID: 26635425 DOI: 10.4321/s0213-61632015000100001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Psychological distress has been hypothesized to be associated with adverse biologic states such as higher oxidative stress and inflammation. Yet, little is known about associations between a common form of distress - phobic anxiety - and global oxidative stress. Thus, we related phobic anxiety to plasma fluorescent oxidation products (FlOPs), a global oxidative stress marker. METHODS We conducted a cross-sectional analysis among 1,325 women (aged 43-70 years) from the Nurses' Health Study. Phobic anxiety was measured using the Crown-Crisp Index (CCI). Adjusted least-squares mean log-transformed FlOPs were calculated across phobic categories. Logistic regression models were used to calculate odds ratios (OR) comparing the highest CCI category (≥6 points) vs. lower scores, across FlOPs quartiles. RESULTS No association was found between phobic anxiety categories and mean FlOP levels in multivariable adjusted linear models. Similarly, in multivariable logistic regression models there were no associations between FlOPs quartiles and likelihood of being in the highest phobic category. Comparing women in the highest vs. lowest FlOPs quartiles: FlOP_360: OR=0.68 (95% CI: 0.40-1.15); FlOP_320: OR=0.99 (95% CI: 0.61-1.61); FlOP_400: OR=0.92 (95% CI: 0.52, 1.63). CONCLUSIONS No cross-sectional association was found between phobic anxiety and a plasma measure of global oxidative stress in this sample of middle-aged and older women.
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Affiliation(s)
- Kaitlin A Hagan
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA ; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tianying Wu
- Division of Epidemiology and Biostatistics, Department of Environmental Health, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Eric B Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA ; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA ; Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA
| | - A Heather Eliassen
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA ; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Olivia I Okereke
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA ; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA ; Division of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Rebelo F, de Jesus Pereira Pinto T, Franco-Sena AB, Lepsch J, Benaim C, Struchiner CJ, Kac G. Plasma adiponectin is inversely associated with antenatal anxiety: Results from a Brazilian cohort. Psychoneuroendocrinology 2015; 51:92-100. [PMID: 25305545 DOI: 10.1016/j.psyneuen.2014.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/14/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
Antenatal anxiety may increase the risk of undesirable birth outcomes. Studies have demonstrated an association between adiponectin and anxiety, but this issue has not been investigated during pregnancy. This study aimed to evaluate the association between plasma adiponectin, measured throughout gestation, and the occurrence of anxiety at late pregnancy (30-36th weeks). A prospective cohort was investigated in Rio de Janeiro, Brazil. Healthy pregnant women, aged 20-40 years, were evaluated between gestational weeks 5-13, 22-26 and 30-36. State anxiety was measured using a validated version of the State-Trait Anxiety Inventory, and women were categorized as high (score≥50, n=30) or low anxiety (score<50, n=129). Plasma samples for all trimesters were analyzed using commercial ELISA kits to determine adiponectin concentrations (U/mL). Statistical analysis involved student's t-tests, chi-square, Pearson correlation, multiple logistic regression and linear mixed effects (LME) regression to model longitudinal trends of adiponectin, stratified for anxiety categories. Women with higher anxiety scores had lower mean concentrations of 3rd trimester adiponectin compared with those with lower scores (7.9; 95% CI: 7.0-8.9 vs. 9.9; 95% CI: 9.1-10.7). Women with 3rd trimester adiponectin values within the third tertile (10.47-26.57U/mL) were less likely to have high antenatal anxiety (adjusted OR=0.30; 95% CI: 0.09-0.98) compared with those within the first tertile (2.25-7.08U/mL). Unlike women with low levels of anxiety, those with high levels had a significant decrease of plasma adiponectin throughout pregnancy (β=-0.07; 95% CI: -0.13-[-0.01] vs. β=-0.01; 95% CI: -0.05 to 0.03). Multiple LME model indicated higher adiponectin throughout pregnancy for women with low anxiety (β=-1.57; 95% CI: -2.78-[-0.37]). In conclusion, plasma adiponectin throughout pregnancy was inversely associated with antenatal anxiety.
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Affiliation(s)
- Fernanda Rebelo
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 Manguinhos, Rio de Janeiro, RJ, Brazil; Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Thatiana de Jesus Pereira Pinto
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Ana Beatriz Franco-Sena
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Jaqueline Lepsch
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Camila Benaim
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
| | - Claudio José Struchiner
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480 Manguinhos, Rio de Janeiro, RJ, Brazil.
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Department of Social and Applied Nutrition, Institute of Nutrition Josué de Castro. Rio de Janeiro Federal University, Avenida Carlos Chagas Filho, 367/CCS-Bloco J-2° andar, sala 29. Cidade Universitária-Ilha do Fundão, Rio de Janeiro, RJ, Brazil.
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Wędrychowicz A, Zając A, Pilecki M, Kościelniak B, Tomasik PJ. Peptides from adipose tissue in mental disorders. World J Psychiatry 2014; 4:103-111. [PMID: 25540725 PMCID: PMC4274582 DOI: 10.5498/wjp.v4.i4.103] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 11/14/2014] [Accepted: 12/10/2014] [Indexed: 02/05/2023] Open
Abstract
Adipose tissue is a dynamic endocrine organ that is essential to regulation of metabolism in humans. A new approach to mental disorders led to research on involvement of adipokines in the etiology of mental disorders and mood states and their impact on the health status of psychiatric patients, as well as the effects of treatment for mental health disorders on plasma levels of adipokines. There is evidence that disturbances in adipokine secretion are important in the pathogenesis, clinical presentation and outcome of mental disorders. Admittedly leptin and adiponectin are involved in pathophysiology of depression. A lot of disturbances in secretion and plasma levels of adipokines are observed in eating disorders with a significant impact on the symptoms and course of a disease. It is still a question whether observed dysregulation of adipokines secretion are primary or secondary. Moreover findings in this area are somewhat inconsistent, owing to differences in patient age, sex, socioeconomic status, smoking habits, level of physical activity, eating pathology, general health or medication. This was the rationale for our detailed investigation into the role of the endocrine functions of adipose tissue in mental disorders. It seems that we are continually at the beginning of understanding of the relation between adipose tissue and mental disorders.
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Bertone-Johnson ER, Ronnenberg AG, Houghton SC, Nobles C, Zagarins SE, Takashima-Uebelhoer BB, Faraj JL, Whitcomb BW. Association of inflammation markers with menstrual symptom severity and premenstrual syndrome in young women. Hum Reprod 2014; 29:1987-94. [DOI: 10.1093/humrep/deu170] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Valleau JC, Sullivan EL. The impact of leptin on perinatal development and psychopathology. J Chem Neuroanat 2014; 61-62:221-32. [PMID: 24862904 DOI: 10.1016/j.jchemneu.2014.05.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 04/18/2014] [Accepted: 05/11/2014] [Indexed: 01/29/2023]
Abstract
Leptin has long been associated with metabolism as it is a critical regulator of both food intake and energy expenditure, but recently, leptin dysregulation has been proposed as a mechanism of psychopathology. This review discusses the evidence supporting a role for leptin in mental health disorders and describes potential mechanisms that may underlie this association. Leptin plays a critical role in pregnancy and in fetal growth and development. Leptin's role and profile during development is examined in available human studies, and the validity of applying studies conducted in animal models to the human population are discussed. Rodents experience a postnatal leptin surge, which does not occur in humans or larger animal models. This suggests that further research using large mammal models, which have a leptin profile across pregnancy and development similar to humans, are of high importance. Maternal obesity and hyperleptinemia correlate with increased leptin levels in the umbilical cord, placenta, and fetus. Leptin levels are thought to impact fetal brain development; likely by activating proinflammatory cytokines that are known to impact many of the neurotransmitter systems that regulate behavior. Leptin is likely involved in behavioral regulation as leptin receptors are widely distributed in the brain, and leptin influences cortisol release, the mesoaccumbens dopamine pathway, serotonin synthesis, and hippocampal synaptic plasticity. In humans, both high and low levels of leptin are reported to be associated with psychopathology. This inconsistency is likely due to differences in the metabolic state of the study populations. Leptin resistance, which occurs in the obese state, may explain how both high and low levels of leptin are associated with psychopathology, as well as the comorbidity of obesity with numerous mental illnesses. Leptin resistance is likely to influence disorders such as depression and anxiety where high leptin levels have been correlated with symptomatology. Schizophrenia is also associated with both low and high leptin levels. However, as anti-psychotics pharmacotherapy induces weight gain, which elevates leptin levels, drug-naïve populations are needed for further studies. Elevated circulating leptin is consistently found in childhood neurodevelopmental disorders including autism spectrum disorders and Rhett disorder. Further, studies on the impact of leptin and leptin resistance on psychopathology and neurodevelopmental disorders are important directions for future research. Studies examining the mechanisms by which exposure to maternal obesity and hyperleptinemia during fetal development impact brain development and behavior are critical for the health of future generations.
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Affiliation(s)
- Jeanette C Valleau
- Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, 505 NW 185th Ave., Beaverton, OR, USA
| | - Elinor L Sullivan
- Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, 505 NW 185th Ave., Beaverton, OR, USA; Department of Biology, University of Portland, 5000 N Willamette Blvd., Portland, OR, USA.
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Duarte H, Teixeira AL, Rocha NP, Domingues RB. Increased serum levels of adiponectin in migraine. J Neurol Sci 2014; 342:186-8. [PMID: 24819919 DOI: 10.1016/j.jns.2014.04.035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 04/15/2014] [Accepted: 04/22/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVES Inflammatory mediators, including adipokines, have been studied in migraine pathophysiology; however, their role is not yet well established. The aim of the present study was to investigate adiponectin (ADP) and its association with clinical parameters and psychiatric comorbidities in migraine patients compared with controls. METHODS This was a cross sectional study including migraine patients and controls. Beck depression and anxiety inventories, Headache impact test, and Allodynia symptom checklist were recorded. Adiponectin was measured by ELISA. RESULTS Sixty-eight migraine patients and sixty-five controls without headache were included. The ADP levels were significantly higher among patients with migraine (43.6±11.8 versus 36.6±9.7 ng/mL, P<0.0001). Adiponectin levels were not correlated with depression and anxiety scores, as well as with migraine severity and allodynia scores. CONCLUSION ADP levels were raised in migraine, independently of psychiatric comorbidities, migraine impact, and allodynia.
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Affiliation(s)
- Halina Duarte
- Neurosciences Postgraduation Program, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Antonio L Teixeira
- Neurosciences Postgraduation Program, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil; Interdisciplinar Laboratory of Medical Investigation, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Natália P Rocha
- Interdisciplinar Laboratory of Medical Investigation, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Renan B Domingues
- Neurosciences Postgraduation Program, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil; CHRU, Pole Neurologie, Université Lille 2, Lille, France; CAPES Foundation, Ministry of Education, Brasilia, DF, Brazil.
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Farvid MS, Qi L, Hu FB, Kawachi I, Okereke OI, Kubzansky LD, Willett WC. Phobic anxiety symptom scores and incidence of type 2 diabetes in US men and women. Brain Behav Immun 2014; 36:176-82. [PMID: 24184473 PMCID: PMC3947213 DOI: 10.1016/j.bbi.2013.10.025] [Citation(s) in RCA: 20] [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] [Received: 08/06/2013] [Revised: 10/24/2013] [Accepted: 10/25/2013] [Indexed: 10/26/2022] Open
Abstract
CONTEXT Emotional stress may be a risk factor for type 2 diabetes (T2D), but the relation between phobic anxiety symptoms and risk of T2D is uncertain. OBJECTIVE To evaluate prospectively the association between phobic anxiety symptoms and incident T2D in three cohorts of US men and women. DESIGN, SETTING AND PATIENTS We followed 30,791 men in the Health Professional's Follow-Up Study (HPFS) (1988-2008), 68,904 women in the Nurses' Health Study (NHS) (1988-2008), and 79,960 women in the Nurses' Health Study II (NHS II) (1993-2011). Phobic anxiety symptom scores, as measured by the Crown-Crisp index (CCI), calculated from 8 questions, were administered at baseline and updated in 2004 for NHS, in 2005 for NHS II, and in 2000 for HPFS. Incident T2D was confirmed by a validated supplementary questionnaire. We used Cox proportional hazards analysis to evaluate associations with incident T2D. RESULTS During 3,099,651 person-years of follow-up, we documented 12,831 incident T2D cases. In multivariate Cox proportional-hazards models with adjustment for major lifestyle and dietary risk factors, the hazard ratios (HRs) of T2D across categories of increasing levels of CCI (scores=2 to <3, 3 to <4, 4 to <6, ⩾6), compared with a score of <2, were increased significantly by 6%, 10%, 10% and 13% (Ptrend=0.001) for NHS; and by 19%, 11%, 21%, and 29% (Ptrend<0.0001) for NHS II. Each score increment in CCI was associated with 2% higher risk of T2D in NHS (HRs, 1.02, 95% confidence intervals: 1.01-1.03) and 4% higher risk of T2D in NHS II (HRs, 1.04, 95% confidence intervals: 1.02-1.05). Further adjustment for depression did not change the results. In HPFS, the association between CCI and T2D was not significant after adjusting for lifestyle variables. CONCLUSION Our results suggest that higher phobic anxiety symptoms are associated with an increased risk of T2D in women.
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Affiliation(s)
- Maryam S Farvid
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States.
| | - Lu Qi
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Frank B Hu
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Olivia I Okereke
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Department of Psychiatry, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, United States
| | - Walter C Willett
- Department of Nutrition, Harvard School of Public Health, Boston, MA, United States; Department of Epidemiology, Harvard School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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Kohlboeck G, Romanos M, Tiesler C, Koletzko S, Kratzsch J, Thiery J, Bauer CP, von Berg A, Berdel D, Hoffmann B, Schaaf B, Lehmann I, Herbarth O, Heinrich J. Peer problems are associated with elevated serum leptin levels in children. Psychol Med 2014; 44:255-265. [PMID: 23561045 DOI: 10.1017/s003329171300069x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Leptin is thought to act as an important mediator in stress reactions. To date, no study has examined the association between psychological stress and leptin levels in children. This study aimed to assess the association between emotional symptoms and peer problems and serum leptin levels in children aged 10 years of the two population-based GINI-plus and LISA-plus birth cohorts. METHOD Cross-sectional data from 2827 children aged 10 years were assessed with regard to leptin concentrations in serum and behavioral problems using the parent-reported Strengths and Difficulties Questionnaire (SDQ). Linear regression modeling was applied to determine the likelihood of elevated leptin levels in children with emotional symptoms and peer problems, controlling for socio-economic status (SES), body mass index (BMI), fasting serum leptin levels, pubertal development and sex hormones. RESULTS We found that increases in emotional symptoms (exp β adj = 1.03, s.e. = 0.02, p < 0.04) and peer problems (exp β adj = 1.05, s.e. = 0.01, p = 0.0001) were significantly associated with higher serum leptin levels controlled for BMI and sociodemographic factors. Similar results were found when the fasting serum leptin sample was examined (exp β adj = 1.08, s.e. = 0.04, p = 0.0294). Gender-stratified analyses showed a significant relationship between serum leptin and peer problems in girls (exp β adj = 1.05, s.e. = 0.02, p = 0.03), and a borderline significant association in boys (exp β adj = 1.04, s.e. = 0.02, p = 0.05). CONCLUSIONS Children with peer problems have higher stress and eat more, acquire a higher body fat mass and thus, through increased leptin resistance, exhibit higher leptin levels.
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Affiliation(s)
- G Kohlboeck
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - M Romanos
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Wuerzburg, Germany
| | - C Tiesler
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
| | - S Koletzko
- Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Germany
| | - J Kratzsch
- University Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Germany
| | - J Thiery
- University Leipzig, Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Germany
| | - C-P Bauer
- Department of Pediatrics, Technical University of Munich, Germany
| | - A von Berg
- Department of Pediatrics, Marien-Hospital Wesel, Germany
| | - D Berdel
- Department of Pediatrics, Marien-Hospital Wesel, Germany
| | - B Hoffmann
- Leibniz Research Institute for Environmental Medicine, University of Düsseldorf, Germany
| | - B Schaaf
- Medical Practice for Pediatrics, Bad Honnef, Germany
| | - I Lehmann
- UFZ-Center for Environmental Research, Leipzig, Germany
| | - O Herbarth
- University Leipzig, Faculty of Medicine, Environmental Medicine and Hygiene, Leipzig, Germany
| | - J Heinrich
- Helmholtz Zentrum Muenchen, German Research Center for Environmental Health, Institute of Epidemiology I, Neuherberg, Germany
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Morris AA, Vaccarino V. Evidence Linking Mental Health with Obesity and Metabolic Syndrome: The Role of Inflammation. Curr Nutr Rep 2013. [DOI: 10.1007/s13668-013-0054-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Phobic anxiety and cognitive performance over 4 years among community-dwelling older women in the Nurses' Health Study. Am J Geriatr Psychiatry 2013; 21:1125-34. [PMID: 23567369 PMCID: PMC3516630 DOI: 10.1016/j.jagp.2013.01.050] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2011] [Accepted: 06/30/2012] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To examine the relation of phobic anxiety to late-life cognitive trajectory. DESIGN Prospective cohort. SETTING Nurses' Health Study-U.S. registered nurses. PARTICIPANTS A total of 16,351 women among whom phobic anxiety symptoms were assessed in 1988 (mean age = 63 years). MEASUREMENTS Beginning a decade after phobic anxiety ascertainment (mean age = 74 years), three assessments of general cognition, word and paragraph immediate and delayed recall, category fluency, and attention or working memory were administered over an average of 4.4 years; global cognitive and verbal memory composite scores were generated from the component tests. General linear models of response profiles were used to evaluate relations of phobic anxiety to initial cognitive performance and subsequent change. RESULTS Higher phobic anxiety was associated with poorer initial performance: for example, comparing women with the highest anxiety to those with no or minimal symptoms, the multivariate-adjusted mean difference (95% confidence interval) in scores was -0.10 (-0.13,-0.06) standard units for the global score summarizing all tests, and -0.08 (-0.11,-0.04) standard units for verbal memory (summarizing four word- and paragraph-recall tasks). Mean differences between extreme categories of phobic anxiety were equal to those for participants aged 1.5-2 years apart: that is, cognitively equivalent to being about 2 years older. There were no relations of phobic anxiety to subsequent cognitive change. CONCLUSIONS Higher mid-life phobic anxiety was related to worse later-life overall cognition and verbal memory. Yet, profiles of poorer cognition with higher anxiety remained parallel over time, suggesting phobic anxiety may impose impact on cognition earlier in life, rather than ongoing impact in later-life.
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Sinnamon GCB, Caltabiano M, Baune BT. Differentiating disordered affect in children and adolescents with type 1 diabetes. J Affect Disord 2013; 147:51-8. [PMID: 23141632 DOI: 10.1016/j.jad.2012.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 10/08/2012] [Accepted: 10/08/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is evidence for increased risk of affective disorders (AD) in adults with type 1 diabetes however, the prevalence and characteristics of AD in young people with the condition is unclear. Comorbid AD in type 1 diabetes is associated with deleterious self-management, sub-optimal clinical indicators, reduced quality of life, poorer physical health, increased complications, increased high risk behaviours in adolescence and young adulthood, and earlier mortality. The present study investigated the prevalence and character of AD in young people with type 1 diabetes. METHODS The self-report PH-PANAS-C was employed in a cross-sectional, case-control design to identify and differentiate full-syndrome (FS) and subthreshold (St) levels of AD in 53 participants with type 1 diabetes (case) and 54 age-balanced controls (N=107; 7-18 yrs). RESULTS Case participants reported greater AD than controls. When differentiated, only anxiety was significantly more prevalent. Case participants reported less positive affect, and greater negative affect and autonomic arousal. Further, 1:3 case participants presented with St symptoms of AD. LIMITATIONS Self-report measures are known to produce moderated responses therefore symptoms may be more severe than reported. There has been some suggestion that responses to somatic items in the PH-PANAS-C may relate to diabetes-specific states rather than affect-related symptoms however, recent evidence has refuted this argument. CONCLUSIONS AD, particularly anxiety, represents a significant clinical concern in young people with type 1 diabetes both as a disorder in its own right and as a major impediment to primary care and management of the diabetes. The significant dominance of anxiety-related symptoms and prevalence of subthreshold presentation warrant further investigation.
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Affiliation(s)
- Grant C B Sinnamon
- Department of Psychiatry and Psychiatric Neuroscience, School of Medicine and Dentistry, James Cook University, Angus Smith Drive, Townsville, QLD, Australia.
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Watkins LL, Koch GG, Sherwood A, Blumenthal JA, Davidson JRT, O'Connor C, Sketch MH. Association of anxiety and depression with all-cause mortality in individuals with coronary heart disease. J Am Heart Assoc 2013; 2:e000068. [PMID: 23537805 PMCID: PMC3647264 DOI: 10.1161/jaha.112.000068] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Depression has been related to mortality in coronary heart disease (CHD) patients, but few studies have evaluated the role of anxiety or the role of the co‐occurrence of depression and anxiety. We examined whether anxiety is associated with increased risk of mortality after accounting for depression in individuals with established CHD. Methods and Results The cohort was composed of 934 men and women with confirmed CHD (mean age, 62±11 years) who completed the Hospital Anxiety and Depression scale (HADS) during hospitalization for coronary angiography. Over the 3‐year follow‐up period, there were 133 deaths. Elevated scores on the HADS anxiety subscale (HADS‐A≥8) were associated with increased risk of mortality after accounting for established risk factors including age, congestive heart failure, left ventricular ejection fraction, 3‐vessel disease, and renal disease (hazard ratio [HR], 2.27; 95% CI, 1.55 to 3.33; P<0.001). Elevated scores on the HADS depression subscale (HADS‐D≥8) were also associated with increased risk of mortality (HR, 2.18; 95% CI, 1.47 to 3.22; P<0.001). When both psychosocial factors were included in the model, each maintained an association with mortality (anxiety, HR, 1.83; 95% CI, 1.18 to 2.83; P=0.006; depression, HR, 1.66; 95% CI, 1.06 to 2.58; P=0.025). Estimation of the HR for patients with both anxiety and depression versus those with neither revealed a larger HR than for patients with either factor alone (HR, 3.10; 95% CI, 1.95 to 4.94; P<0.001). Conclusions Anxiety is associated with increased risk of mortality in CHD patients, particularly when comorbid with depression. Future studies should focus on the co‐occurrence of these psychosocial factors as markers of increased mortality risk.
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Affiliation(s)
- Lana L Watkins
- Departments of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
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O'Donovan A, Slavich GM, Epel ES, Neylan TC. Exaggerated neurobiological sensitivity to threat as a mechanism linking anxiety with increased risk for diseases of aging. Neurosci Biobehav Rev 2012; 37:96-108. [PMID: 23127296 DOI: 10.1016/j.neubiorev.2012.10.013] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 10/19/2012] [Accepted: 10/28/2012] [Indexed: 12/11/2022]
Abstract
Anxiety disorders increase risk for the early development of several diseases of aging. Elevated inflammation, a common risk factor across diseases of aging, may play a key role in the relationship between anxiety and physical disease. However, the neurobiological mechanisms linking anxiety with elevated inflammation remain unclear. In this review, we present a neurobiological model of the mechanisms by which anxiety promotes inflammation. Specifically we propose that exaggerated neurobiological sensitivity to threat in anxious individuals may lead to sustained threat perception, which is accompanied by prolonged activation of threat-related neural circuitry and threat-responsive biological systems including the hypothalamic-pituitary-adrenal (HPA) axis, autonomic nervous system (ANS), and inflammatory response. Over time, this pattern of responding can promote chronic inflammation through structural and functional brain changes, altered sensitivity of immune cell receptors, dysregulation of the HPA axis and ANS, and accelerated cellular aging. Chronic inflammation, in turn, increases risk for diseases of aging. Exaggerated neurobiological sensitivity to threat may thus be a treatment target for reducing disease risk in anxious individuals.
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Affiliation(s)
- Aoife O'Donovan
- Department of Psychiatry, University of California, San Francisco, CA, USA.
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31
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Okereke OI, Prescott J, Wong JYY, Han J, Rexrode KM, De Vivo I. High phobic anxiety is related to lower leukocyte telomere length in women. PLoS One 2012; 7:e40516. [PMID: 22808180 PMCID: PMC3394740 DOI: 10.1371/journal.pone.0040516] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 06/12/2012] [Indexed: 11/23/2022] Open
Abstract
Background Chronic psychological distress has been linked to shorter telomeres, an indication of accelerated aging. Yet, little is known about relations of anxiety to telomeres. We examined whether a typically chronic form of anxiety – phobic anxiety – is related to telomere length. Methodology/Principal Findings Relative telomere lengths (RTLs) in peripheral blood leukocytes were measured by quantitative real-time polymerase chain reaction among 5,243 women (aged 42–69 years) who: were participants in the Nurses' Health Study; were controls in prior case-control studies of telomeres and disease, or randomly selected healthy participants in a cognitive function sub-study; had completed the Crown-Crisp phobic index proximal to blood collection. Adjusted least-squares mean RTLs (z-scores) were calculated across phobic categories. Higher phobic anxiety was generally associated with lower RTLs (age-adjusted p-trend = 0.09); this association was similar after adjustment for confounders – paternal age-at-birth, smoking, body mass index (BMI) and physical activity (p-trend = 0.15). Notably, a threshold was identified. Among women with Crown-Crisp<6 points, the multivariable-adjusted least-squares mean RTL z-score = 0.02 standard units; however, among the most phobic women (Crown-Crisp≥6), the multivariable-adjusted least-squares mean RTL z-score = −0.09 standard units (mean difference = −0.10 standard units; p = 0.02). The magnitude of this difference was comparable to that for women 6 years apart in age. Finally, effect modification by BMI, smoking and paternal age was observed: associations were stronger among highly phobic women with BMI≥25 kg/m2, without smoking history, or born to fathers aged ≥40 years. Conclusions/Significance In this large, cross-sectional study high phobic anxiety was associated with shorter telomeres. These results point toward prospective investigations relating anxiety to telomere length change.
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Affiliation(s)
- Olivia I Okereke
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, United States of America.
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Jeong HG, Min BJ, Lim S, Kim TH, Lee JJ, Park JH, Lee SB, Han JW, Choi SH, Park YJ, Jang HC, Kim KW. Plasma adiponectin elevation in elderly individuals with subsyndromal depression. Psychoneuroendocrinology 2012; 37:948-55. [PMID: 22130479 DOI: 10.1016/j.psyneuen.2011.11.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 11/01/2011] [Accepted: 11/02/2011] [Indexed: 12/15/2022]
Abstract
Adiponectin, one of the adipokines, has believed to play a role in developing of depression, but the relationship between plasma adiponectin and depressive disorder is still unclear. To investigate the association between plasma adiponectin and depressive disorders, we measured plasma adiponectin concentrations in 785 randomly sampled elderly Koreans including 41 patients with major depressive disorder (MDD), 46 with minor depressive disorder (MnDD), and 61 with subsyndromal depression (SSD). Plasma adiponectin levels were different among the diagnostic groups (df=3, F=4.928, P=0.002). The plasma adiponectin level in the SSD patients was higher than in the non-depressed controls (NC) (12.48 ± 8.38 μg/ml versus 9.27 ± 6.21 μg/ml, P=0.001, Tukey's post hoc comparison). However, plasma adiponectin levels in the MnDD and MDD patients were comparable with those found in the NC (P>0.1, Tukey's post hoc comparison). The elevation of plasma adiponectin in the SSD patients remained significant in men (P=0.002, Tukey's post hoc comparison) but not in women. In the subjects without MDD and MnDD, plasma adiponectin level was positively correlated with the Hamilton Depression Rating Scale score (r=0.156, P<0.001) and the Geriatric Depression Scale (r=0.117, P=0.002). When men and women were analyzed separately, these significant correlations were confined to men. Circulating adiponectin concentration may play a role in compensation on process for depressive mood.
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Affiliation(s)
- Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Kiecolt-Glaser JK, Christian LM, Andridge R, Hwang BS, Malarkey WB, Belury MA, Emery CF, Glaser R. Adiponectin, leptin, and yoga practice. Physiol Behav 2012; 107:809-13. [PMID: 22306535 DOI: 10.1016/j.physbeh.2012.01.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/14/2012] [Accepted: 01/20/2012] [Indexed: 12/15/2022]
Abstract
To address the mechanisms underlying hatha yoga's potential stress-reduction benefits, we compared adiponectin and leptin data from well-matched novice and expert yoga practitioners. These adipocytokines have counter-regulatory functions in inflammation; leptin plays a proinflammatory role, while adiponectin has anti-inflammatory properties. Fifty healthy women (mean age=41.32, range=30-65), 25 novices and 25 experts, provided fasting blood samples during three separate visits. Leptin was 36% higher among novices compared to experts, P=.008. Analysis of adiponectin revealed a borderline effect of yoga expertise, P=.08; experts' average adiponectin levels were 28% higher than novices across the three visits. In contrast, experts' average adiponectin to leptin ratio was nearly twice that of novices, P=.009. Frequency of self-reported yoga practice showed significant negative relationships with leptin; more weeks of yoga practice over the last year, more lifetime yoga sessions, and more years of yoga practice were all significantly associated with lower leptin, with similar findings for the adiponectin to leptin ratio. Novices and experts did not show even marginal differences on behavioral and physiological dimensions that might represent potential confounds, including BMI, central adiposity, cardiorespiratory fitness, and diet. Prospective studies addressing increased risk for type II diabetes, hypertension, and cardiovascular disease have highlighted the importance of these adipocytokines in modulating inflammation. Although these health risks are clearly related to more extreme values then we found in our healthy sample, our data raise the possibility that longer-term and/or more intensive yoga practice could have beneficial health consequences by altering leptin and adiponectin production.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, Ohio State University College of Medicine, 460 Medical Center Boulevard, Columbus, OH 43210, USA.
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The association between anxiety and C-reactive protein (CRP) levels: results from the Northern Finland 1966 birth cohort study. Eur Psychiatry 2011; 26:363-9. [PMID: 21570260 DOI: 10.1016/j.eurpsy.2011.02.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 01/31/2011] [Accepted: 02/06/2011] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Anxiety frequently accompanies low-grade inflammation-associated conditions like depression, insulin resistance, coronary heart disease and metabolic syndrome. The association between anxiety and low-grade inflammation is, unlike between depression and low-grade inflammation, a very sparsely studied area in general populations. The aim of the present study was to investigate whether anxiety symptoms as well as comorbid anxiety and depressive symptoms are associated with low-grade inflammation at population level. METHODS The general population-based Northern Finland 1966 Birth Cohort was followed until age 31 (n=2688 males and 2837 females), when the highly sensitive CRP concentrations were measured. Anxiety and depressive symptoms were defined by Hopkins Symptom Checklist-25 (HSCL-25). RESULTS After adjusting for confounders, logistic regression analyses showed that anxiety symptoms alone increased the probability for elevated hs-CRP levels (>3.0mg/L) in males over two-fold (2.19 CI 95% 1.08-4.46), while comorbid anxiety and depressive symptoms caused a 1.7-fold (1.76 CI 95% 1.13-2.74) increase in the probability for elevated hs-CRP levels (1.0-3.0mg/L). CONCLUSIONS Our results support the hypothesis that anxiety as well as comorbid anxiety and depression can be associated with an increased risk for low-grade inflammation in males at population level.
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Häfner S, Zierer A, Emeny RT, Thorand B, Herder C, Koenig W, Rupprecht R, Ladwig KH. Social isolation and depressed mood are associated with elevated serum leptin levels in men but not in women. Psychoneuroendocrinology 2011; 36:200-9. [PMID: 20692102 DOI: 10.1016/j.psyneuen.2010.07.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2010] [Revised: 06/10/2010] [Accepted: 07/08/2010] [Indexed: 12/20/2022]
Abstract
BACKGROUND Leptin, involved in energy homeostasis and a predictor of cardiovascular disease, has recently been recognized as mediator in stress reactions. We aimed to explore the association between leptin levels and two stress-related conditions, social isolation and depressed mood, both associated with increased cardiovascular mortality. METHODS We analysed leptin levels in 1229 subjects (643 men, 586 women), derived from the population-based MONIKA/KORA study. Standardized questionnaires were used to assess depressive mood and social isolation. In a multiple linear regression adjusted for body weight, age and survey, the association between leptin, social isolation and depressed mood and its interaction was explored in men and women separately. Leptin was then dichotomized and four analyses, adjusted for age, BMI, lifestyle factors, psychosomatic complaints and metabolic variables were performed to compare the risk of elevated leptin levels in the risk groups. RESULTS Increased leptin levels were associated with social isolation (p=0.04) and the interaction between social isolation and depressed mood (p=0.02) in men but not in women. In socially isolated and depressed men, leptin levels (mean: 6.07 ng/ml) were significantly increased compared to neither depressed nor isolated men (mean: 4.51 ng/ml, p=0.04). In the multivariate adjusted logistic regression model, the combination of depressed state and social isolation was associated with a 4-fold increased risk (p<0.001) for elevated leptin levels. CONCLUSION The finding of elevated leptin levels in socially isolated and depressed men raises the possibility that increased cardiovascular mortality in socially isolated men is partially mediated by hyperleptinemia.
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Affiliation(s)
- S Häfner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
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Terre L. Is There a Connection Between Diabetes and Psychological Dysfunction? Am J Lifestyle Med 2010. [DOI: 10.1177/1559827610375905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This review discusses evidence-based perspectives on the relationship between diabetes and psychological distress. Future directions for inquiry and clinical management also are addressed.
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Affiliation(s)
- Lisa Terre
- Department of Psychology, University of Missouri-Kansas City,
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Huffman JC, Celano CM, Januzzi JL. The relationship between depression, anxiety, and cardiovascular outcomes in patients with acute coronary syndromes. Neuropsychiatr Dis Treat 2010; 6:123-36. [PMID: 20505844 PMCID: PMC2874336 DOI: 10.2147/ndt.s6880] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Depression and anxiety occur at high rates among patients suffering an acute coronary syndrome (ACS). Both depressive symptoms and anxiety appear to adversely affect in-hospital and long term cardiac outcomes of post-ACS patients, independent of traditional risk factors. Despite their high prevalence and serious impact, mood and anxiety symptoms go unrecognized and untreated in most ACS patients and such symptoms (rather than being transient reactions to ACS) persist for months and beyond. The mechanisms by which depression and anxiety are linked to these negative medical outcomes are likely a combination of the effects of these conditions on inflammation, catecholamines, heart rate variability, and endothelial function, along with effects on health-promoting behavior. Fortunately, standard treatments for these disorders appear to be safe, well-tolerated and efficacious in this population; indeed, selective serotonin reuptake inhibitors may actually improve cardiac outcomes. Future research goals include gaining a better understanding of the combined effects of depression and anxiety, as well as definitive prospective studies of the impact of treatment on cardiac outcomes. Clinically, protocols that allow for efficient and systematic screening, evaluation, and treatment for depression and anxiety in cardiac patients are critical to help patients avoid the devastating effects of these illnesses on quality of life and cardiac health.
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Affiliation(s)
- Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit Street/Blake 11, Boston, MA, USA.
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Current literature in diabetes. Diabetes Metab Res Rev 2009; 25:i-x. [PMID: 19790194 DOI: 10.1002/dmrr.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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