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Maugeri N, De Lorenzo R, Mazza MG, Palladini M, Ciceri F, Rovere-Querini P, Manfredi AA, Benedetti F. Preferential and sustained platelet activation in COVID-19 survivors with mental disorders. Sci Rep 2024; 14:16119. [PMID: 38997256 PMCID: PMC11245597 DOI: 10.1038/s41598-024-64094-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 06/05/2024] [Indexed: 07/14/2024] Open
Abstract
Pre-existing mental disorders are considered a risk factor for severe COVID-19 outcomes, possibly because of higher vascular burden. Moreover, an unconventional platelet activation characterizes COVID-19 and contributes to inflammatory and thrombotic manifestations. In the light of the inflammation theory of mental disorders, we hypothesized that patients with mental disorders could be sensitive to the SARS-CoV-2 elicited platelet activation. We investigated platelet activation in 141 COVID-19 survivors at one month after clearance of the virus, comparing subjects with or without an established pre-existing diagnosis of mental disorder according to the DSM-5. We found that platelets from patients with a positive history of psychiatric disorder underwent unconventional activation more frequently than conventional activation or no activation at all. Such preferential activation was not detected when platelets from patients without a previous psychiatric diagnosis were studied. When testing the effects of age, sex, and psychiatric history on the platelet activation, GLZM multivariate analysis confirmed the significant effect of diagnosis only. These findings suggest a preferential platelet activation during acute COVID-19 in patients with a pre-existing psychiatric disorder, mediated by mechanisms associated with thromboinflammation. This event could have contributed to the higher risk of severe outcome in the psychiatric population.
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Affiliation(s)
- Norma Maugeri
- Vita-Salute San Raffaele University, Milan, Italy.
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy.
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy
| | - Mario Gennaro Mazza
- Vita-Salute San Raffaele University, Milan, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Mariagrazia Palladini
- Vita-Salute San Raffaele University, Milan, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milan, Italy
- Hematology and Bone Marrow Transplant Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy
| | - Angelo A Manfredi
- Vita-Salute San Raffaele University, Milan, Italy
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Via Olgettina 58, 20132, Milan, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milan, Italy
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Shen HP, Dong X, Li ZB, Wu JZ, Zheng CM, Hu XJ, Qian C, Wang SP, Zhao YL, Li JC. Protein Profiles and Novel Molecular Biomarkers of Schizophrenia Based on 4D-DIA Proteomics. J Proteome Res 2024; 23:2376-2385. [PMID: 38856018 DOI: 10.1021/acs.jproteome.4c00040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Schizophrenia is a severe psychological disorder. The current diagnosis mainly relies on clinical symptoms and lacks laboratory evidence, which makes it very difficult to make an accurate diagnosis especially at an early stage. Plasma protein profiles of schizophrenia patients were obtained and compared with healthy controls using 4D-DIA proteomics technology. Furthermore, 79 DEPs were identified between schizophrenia and healthy controls. GO functional analysis indicated that DEPs were predominantly associated with responses to toxic substances and platelet aggregation, suggesting the presence of metabolic and immune dysregulation in patients with schizophrenia. KEGG pathway enrichment analysis revealed that DEPs were primarily enriched in the chemokine signaling pathway and cytokine receptor interactions. A diagnostic model was ultimately established, comprising three proteins, namely, PFN1, GAPDH and ACTBL2. This model demonstrated an AUC value of 0.972, indicating its effectiveness in accurately identifying schizophrenia. PFN1, GAPDH and ACTBL2 exhibit potential as biomarkers for the early detection of schizophrenia. The findings of our studies provide novel insights into the laboratory-based diagnosis of schizophrenia.
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Affiliation(s)
- Hui-Ping Shen
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Xiaotao Dong
- Major Disease Biomarker Research Laboratory, School of Basic Medical Science, Henan University, Kaifeng 475004, China
| | - Zhi-Bin Li
- Major Disease Biomarker Research Laboratory, School of Basic Medical Science, Henan University, Kaifeng 475004, China
| | - Jing-Zhu Wu
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Chun-Mei Zheng
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Xie-Jun Hu
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Chao Qian
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Sheng-Pang Wang
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Yu-Long Zhao
- Department of Psychiatry, Shaoxing Seventh People's Hospital, Shaoxing 312000, China
| | - Ji-Cheng Li
- Major Disease Biomarker Research Laboratory, School of Basic Medical Science, Henan University, Kaifeng 475004, China
- Institute of Cell Biology, Zhejiang University School of Medicine, Hangzhou 310058, China
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3
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von Känel R. Stress-Induced Hypercoagulability: Insights from Epidemiological and Mechanistic Studies, and Clinical Integration. Semin Thromb Hemost 2024. [PMID: 38914118 DOI: 10.1055/s-0044-1787660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
By integrating findings from comprehensive reviews, meta-analyses, and cutting-edge genetic studies, this article illuminates the significance of stress-induced hypercoagulability in clinical medicine. In particular, the findings from numerous prospective cohort studies indicate that stress and hemostatic factors of a hypercoagulable state are associated with increased incident risk and poor prognosis for atherosclerotic cardiovascular disease and venous thromboembolism. Mendelian randomization studies suggest that these associations are partially causal. The review synthesizes extensive research on the link between acute and chronic stress and hypercoagulability, outlining a potential pathway from stress to thrombosis risk. Consistent with the allostatic load concept, acute stress-induced hypercoagulability, initially adaptive, can turn maladaptive under chronic stress or excessive acute stress, leading to arterial or venous thrombotic events. Individuals with predisposing factors, including atherosclerosis, thrombophilia, or immobilization, may exhibit an increased risk of thrombotic disease during stress. Contextual sociodemographic characteristics, the stress experience, and coping resources additionally modulate the extent of stress-induced hypercoagulability. Research into the neuroendocrine, cellular, and molecular bases reveals how stress influences platelet activation coagulation and fibrinolysis. The activation of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, along with vagal withdrawal, and the effects of catecholamines, cortisol, and vasopressin, are the central mechanisms involved. Hemoconcentration, inflammation, endothelial dysfunction, and thrombopoiesis additionally contribute to stress-induced hypercoagulability. Further research is needed to prove a causal link between chronic stress and hypercoagulability. This includes exploring its implications for the prevention and management of thrombotic diseases in stressed individuals, with a focus on developing effective psychosocial and pharmacological interventions.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Poletti S, Mazza MG, Benedetti F. Inflammatory mediators in major depression and bipolar disorder. Transl Psychiatry 2024; 14:247. [PMID: 38851764 PMCID: PMC11162479 DOI: 10.1038/s41398-024-02921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are highly disabling illnesses defined by different psychopathological, neuroimaging, and cognitive profiles. In the last decades, immune dysregulation has received increasing attention as a central factor in the pathophysiology of these disorders. Several aspects of immune dysregulations have been investigated, including, low-grade inflammation cytokines, chemokines, cell populations, gene expression, and markers of both peripheral and central immune activation. Understanding the distinct immune profiles characterizing the two disorders is indeed of crucial importance for differential diagnosis and the implementation of personalized treatment strategies. In this paper, we reviewed the current literature on the dysregulation of the immune response system focusing our attention on studies using inflammatory markers to discriminate between MDD and BD. High heterogeneity characterized the available literature, reflecting the heterogeneity of the disorders. Common alterations in the immune response system include high pro-inflammatory cytokines such as IL-6 and TNF-α. On the contrary, a greater involvement of chemokines and markers associated with innate immunity has been reported in BD together with dynamic changes in T cells with differentiation defects during childhood which normalize in adulthood, whereas classic mediators of immune responses such as IL-4 and IL-10 are present in MDD together with signs of immune-senescence.
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Affiliation(s)
- Sara Poletti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Zhang Y, Zheng Y, Ni P, Liang S, Li X, Yu H, Wei W, Qi X, Yu X, Xue R, Zhao L, Deng W, Wang Q, Guo W, Li T. New role of platelets in schizophrenia: predicting drug response. Gen Psychiatr 2024; 37:e101347. [PMID: 38616969 PMCID: PMC11015174 DOI: 10.1136/gpsych-2023-101347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Background Elevated platelet count (PLTc) is associated with first-episode schizophrenia and adverse outcomes in individuals with precursory psychosis. However, the impact of antipsychotic medications on PLTc and its association with symptom improvement remain unclear. Aims We aimed to investigate changes in PLTc levels following antipsychotic treatment and assess whether PLTc can predict antipsychotic responses and metabolic changes after accounting for other related variables. Methods A total of 2985 patients with schizophrenia were randomised into seven groups. Each group received one of seven antipsychotic treatments and was assessed at 2, 4 and 6 weeks. Clinical symptoms were evaluated using the positive and negative syndrome scale (PANSS). Additionally, we measured blood cell counts and metabolic parameters, such as blood lipids. Repeated measures analysis of variance was used to examine the effect of antipsychotics on PLTc changes, while structural equation modelling was used to assess the predictive value of PLTc on PANSS changes. Results PLTc significantly increased in patients treated with aripiprazole (F=6.00, p=0.003), ziprasidone (F=7.10, p<0.001) and haloperidol (F=3.59, p=0.029). It exhibited a positive association with white blood cell count and metabolic indicators. Higher baseline PLTc was observed in non-responders, particularly in those defined by the PANSS-negative subscale. In the structural equation model, PLTc, white blood cell count and a latent metabolic variable predicted the rate of change in the PANSS-negative subscale scores. Moreover, higher baseline PLTc was observed in individuals with less metabolic change, although this association was no longer significant after accounting for baseline metabolic values. Conclusions Platelet parameters, specifically PLTc, are influenced by antipsychotic treatment and could potentially elevate the risk of venous thromboembolism in patients with schizophrenia. Elevated PLTc levels and associated factors may impede symptom improvement by promoting inflammation. Given PLTc's easy measurement and clinical relevance, it warrants increased attention from psychiatrists. Trial registration number ChiCTR-TRC-10000934.
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Affiliation(s)
- Yamin Zhang
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Yanghao Zheng
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
| | - Peiyan Ni
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Sugai Liang
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xiaojing Li
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Hua Yu
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Wei Wei
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xueyu Qi
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Xueli Yu
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Rui Xue
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Qiang Wang
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjun Guo
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
| | - Tao Li
- Department of Neurobiology, Zhejiang University School of Medicine Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
- Liangzhu Laboratory, Zhejiang University MOE Frontier Science Center for Brain Science and Brain Machine Integration, Hangzhou, Zhejiang, China
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Papic I, Bistrovic P, Krecak I, Ortner Hadziabdic M, Lucijanic M. Specific adverse outcomes associated with selective serotonin reuptake inhibitors use in COVID-19 patients might be potentiated by remdesivir use. J Psychopharmacol 2024; 38:395-403. [PMID: 38481078 DOI: 10.1177/02698811241237868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
BACKGROUND Due to non-consistent reports in the literature, there are uncertainties about the potential benefits and harms of selective serotonin reuptake inhibitors (SSRIs) in patients with Coronavirus disease 2019 (COVID-19). AIM To investigate associations of SSRIs with clinical characteristics and unwanted outcomes among real-life severe and critical COVID-19 patients and their relationship with remdesivir (RDV) use. METHODS This retrospective cohort study evaluated a total of 1558 COVID-19 patients of the white race treated in a tertiary center institution, among them 779 patients treated with RDV and 779 1:1 case-matched patients. RESULTS A total of 78 (5%) patients were exposed to SSRIs during hospitalization, similarly distributed among patients treated with RDV and matched patients (5.1 and 4.9%). No significant associations of SSRI use with age, sex, comorbidity burden, and COVID-19 severity were present in either of the two cohorts (p > 0.05 for all analyses). In multivariate analyses adjusted for clinically meaningful variables, SSRI use was significantly associated with higher mortality among RDV (adjusted odds ratio (aOR) 2.0, p = 0.049) and matched patients (aOR 2.22, p = 0.044) and with higher risk for mechanical-ventilation (aOR 2.57, p = 0.006), venous-thromboembolism (aOR 3.69, p = 0.007), and bacteremia (aOR 2.22, p = 0.049) among RDV treated patients. CONCLUSIONS Adverse outcomes associated with SSRI use in COVID-19 patients might be potentiated by RDV use, and clinically significant interactions between these two drug classes might exist. Although our findings raise important considerations for clinical practice, they are limited by retrospective nature of the study, lack of ethnic diversity, and the potential for unmeasured confounding factors. Future studies exploring underlying biological mechanisms are needed.
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Affiliation(s)
- Ivan Papic
- Department of Pharmacy, University hospital Dubrava, Zagreb, Croatia
| | - Petra Bistrovic
- Department of Cardiology, University hospital Dubrava, Zagreb, Croatia
| | - Ivan Krecak
- Department of Internal Medicine, General hospital of Sibenik-Knin county, Sibenik, Croatia
- Faculty of Medicine, University of Rijeka, Rijeka, Croatia
- University of Applied Sciences, Sibenik, Croatia
| | - Maja Ortner Hadziabdic
- Centre for Applied Pharmacy, Faculty of Pharmacy and Biochemistry, University of Zagreb, Zagreb, Croatia
| | - Marko Lucijanic
- Department of Hematology, University hospital Dubrava, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
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Hashimoto H, Imai S, Yamashita R, Kiyomi A, Sugiura M. Association of Antipsychotic Drugs with the Risk of Recurrent Venous Thromboembolism: A Retrospective Study of Data from a Japanese Inpatient Database. Drugs Real World Outcomes 2024; 11:109-116. [PMID: 38015358 DOI: 10.1007/s40801-023-00401-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Approximately a decade has passed since the addition of venous thromboembolism to the list of significant adverse reactions of antipsychotic drugs. However, only a few studies have investigated the relationship between antipsychotic use and venous thromboembolism in the Japanese population. PURPOSE We aimed to evaluate the risk of recurrent venous thromboembolism in users of antipsychotic drugs and update the evidence on venous thromboembolism in the Japanese population. METHODS A cross-sectional retrospective analysis of data from a large Japanese claims database, managed by Medical Data Vision Co. Ltd., was conducted. Adult patients who experienced venous thromboembolism between October 2014 and September 2018 in acute care hospitals were identified. The risk of recurrent venous thromboembolism was evaluated with logistic regression using demographic variables. The data of patients using antipsychotic drugs within specific therapeutic classes were also evaluated. RESULTS We included 8960 patients (mean age, 69 years; 59.2% female). Recurrent venous thromboembolism was observed in 686 patients (7.7%). The risk of recurrent venous thromboembolism was significantly higher in younger patients [< 65 years: reference; 65-74 years: odds ratio (OR) 0.81, 95% confidence interval (CI) 0.66-0.99, p = 0.04; ≥ 75 years: OR 0.77, 95% CI 0.64-0.94, p = 0.01], those with history of surgery (OR 1.39, 95% CI 1.18-1.65, p = 0.01), and anticoagulant users (OR 2.25, 95% CI 1.46-3.48, p = 0.01) and was significantly lower in the presence of comorbidities (OR 0.68, 95% CI 0.58-0.81, p< 0.01) and fractures (OR 0.49, 95% CI 0.26-0.94, p = 0.03). Long-term antipsychotic drug prescriptions (> 14 days) were associated with a higher risk of venous thromboembolism than short-term prescriptions (≤ 14 days) (OR 1.56, 95% CI 1.04-2.34, p = 0.03). CONCLUSIONS In patients with a history of venous thromboembolism, particular attention should be paid to recurrence in younger patients. If antipsychotic drugs are prescribed for > 14 days to patients with a history of venous thromboembolism, they should be administered carefully, guided by reported findings. Further evaluations using different databases or populations are required to generalize the findings of this study.
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Affiliation(s)
- Hiroyuki Hashimoto
- Department of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Shinobu Imai
- Division of Pharmacoepidemiology, Department of Healthcare and Regulatory Sciences, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Ryoka Yamashita
- Department of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Anna Kiyomi
- Department of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392, Japan
| | - Munetoshi Sugiura
- Department of Drug Safety and Risk Management, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji, Tokyo, 192-0392, Japan.
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Chen Y, Peng W, Pang M, Zhu B, Liu H, Hu D, Luo Y, Wang S, Wu S, He J, Yang Y, Peng D. The effects of psychiatric disorders on the risk of chronic heart failure: a univariable and multivariable Mendelian randomization study. Front Public Health 2024; 12:1306150. [PMID: 38299073 PMCID: PMC10827915 DOI: 10.3389/fpubh.2024.1306150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/04/2024] [Indexed: 02/02/2024] Open
Abstract
Background Substantial evidence suggests an association between psychiatric disorders and chronic heart failure. However, further investigation is needed to confirm the causal relationship between these psychiatric disorders and chronic heart failure. To address this, we evaluated the potential effects of five psychiatric disorders on chronic heart failure using two-sample Mendelian Randomization (MR). Methods We selected single nucleotide polymorphisms (SNPs) associated with chronic heart failure and five psychiatric disorders (Attention-Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Major Depression, Bipolar Disorder and Schizophrenia (SCZ)). Univariable (UVMR) and multivariable two-sample Mendelian Randomization (MVMR) were employed to assess causality between these conditions. Ever smoked and alcohol consumption were controlled for mediating effects in the multivariable MR. The inverse variance weighting (IVW) and Wald ratio estimator methods served as the primary analytical methods for estimating potential causal effects. MR-Egger and weighted median analyses were also conducted to validate the results. Sensitivity analyses included the funnel plot, leave-one-out, and MR-Egger intercept tests. Additionally, potential mediators were investigated through risk factor analyses. Results Genetically predicted heart failure was significantly associated with ADHD (odds ratio (OR), 1.12; 95% CI, 1.04-1.20; p = 0.001), ASD (OR, 1.29; 95% CI, 1.07-1.56; p = 0.008), bipolar disorder (OR, 0.89; 95% CI, 0.83-0.96; p = 0.001), major depression (OR, 1.15; 95% CI, 1.03-1.29; p = 0.015), SCZ (OR, 1.04; 95% CI, 1.00-1.07; p = 0.024). Several risk factors for heart failure are implicated in the above cause-and-effect relationship, including ever smoked and alcohol consumption. Conclusion Our study demonstrated ADHD, ASD, SCZ and major depression may have a causal relationship with an increased risk of heart failure. In contrast, bipolar disorder was associated with a reduced risk of heart failure, which could potentially be mediated by ever smoked and alcohol consumption. Therefore, prevention strategies for heart failure should also incorporate mental health considerations, and vice versa.
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Affiliation(s)
- Yang Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Wenke Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Min Pang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Botao Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Huixing Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Die Hu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Yonghong Luo
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Shuai Wang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Sha Wu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Jia He
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Yang Yang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
| | - Daoquan Peng
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, China
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Abdel Samei AM, Mahmoud DAM, Salem Boshra B, Abd El Moneam MHED. The Interplay Between Blood Inflammatory Markers, Symptom Domains, and Severity of ADHD Disorder in Children. J Atten Disord 2024; 28:66-76. [PMID: 37715696 DOI: 10.1177/10870547231197213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
OBJECTIVE ADHD has a multi-factorial etiology among which the inflammatory theory presupposition. We aimed to explore the interplay between blood inflammatory markers; neutrophil lymphocyte ratios (NLR), platelet\lymphocyte ratio (PLR), mean platelet volume (MPV), symptom domains, and severity of ADHD. METHOD A total of 50 children with ADHD and 50 healthy controls were recruited. Children were assessed using the mini-international neuropsychiatric interview for children and adolescents (MINI-KID), the Wechsler intelligence scale for children, the Conners' parent rating scale. Then, NLR, PLR, and MPV were measured. RESULTS There was a statistically significant difference between children with ADHD and the control group with regard to all blood inflammatory markers (except platelet count). The subtypes and severity of ADHD had no significant relation with NLR, PLR, and MPV. CONCLUSION blood inflammatory markers are significantly high in children with ADHD but could not predict specific symptom domains or severity.
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Cui S, Li J, Liu Y, Yao G, Wu Y, Liu Z, Sun L, Sun L, Liu H. Correlation of systemic immune-inflammation index and moderate/major depression in patients with depressive disorders: a large sample cross-sectional study. Front Psychiatry 2023; 14:1159889. [PMID: 37275977 PMCID: PMC10232846 DOI: 10.3389/fpsyt.2023.1159889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Objective To evaluate the clinical value of systemic immune-inflammation index (SII) based on peripheral blood neutrophil, lymphocyte, and platelet count in evaluating the subtype and severity of depression in patients with depressive disorder. Methods This retrospective cohort study was conducted in the Third People's Hospital of Fuyang City from January 1, 2020 to December 31, 2022. The data included sociodemographic information at admission, clinical data, discharge diagnosis and inflammatory markers. Patients were divided into low SII group and high SII group according to the optimal threshold of SII determined by receiver operating characteristic curve (ROC curve). Binary logistic regression was used to analyze the correlation between moderate/major depression and SII level. Results Compared to the low SII group, the high SII group had a higher age level (χ2 = 7.663, p = 0.006), more smokers (χ2 = 9.458, p = 0.002), more moderate/major depression patients (χ2 = 45.645, p < 0.001), and a higher proportion of patients with accompanying somatic symptoms (χ2 = 14.867, p < 0.001). In the final logistic regression model, after controlling for confounding factors, SII at admission was significantly associated with moderate/major depression [β =1.285, p < 0.001; odds ratio (95% confidence intervals) = 3.614 (2.693-4.850)]. Patients with high SII scores were 3.614 times more likely to have moderate/severe depression than those with low SII scores. We propose a cut-off value of SII =540.78 (sensitivity = 36.4% and specificity = 80.3%) according to the maximum Youden index. Conclusion Our research indicates that SII may be a useful, repeatable, convenient, and affordable index to identify moderate/major depression in depressive disorder.
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Affiliation(s)
- Shu Cui
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Juanjuan Li
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Yun Liu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Gaofeng Yao
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Yanhai Wu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Zhiwei Liu
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
| | - Liang Sun
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
- Department of Psychiatry, Chaohu Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Longlong Sun
- Department of Psychiatry, Third People’s Hospital of Fuyang, Fuyang, Anhui, China
- Department of Psychiatry, Chaohu Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital Affiliated to Anhui Medical University, Hefei, Anhui, China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, Anhui, China
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Manolis TA, Manolis AA, Melita H, Manolis AS. Neuropsychiatric disorders in patients with heart failure: not to be ignored. Heart Fail Rev 2022:10.1007/s10741-022-10290-2. [DOI: 10.1007/s10741-022-10290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
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Teppo K, Jaakkola J, Biancari F, Halminen O, Linna M, Putaala J, Mustonen P, Kinnunen J, Jolkkonen S, Niemi M, Hartikainen J, Airaksinen KEJ, Lehto M. Mental health conditions and bleeding events in patients with incident atrial fibrillation: A Finnish nationwide cohort study. Gen Hosp Psychiatry 2022; 78:117-122. [PMID: 36057233 DOI: 10.1016/j.genhosppsych.2022.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/23/2022] [Accepted: 08/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We assessed the hypothesis that mental health conditions (MHCs) are associated with higher risk of bleeding in patients with atrial fibrillation (AF). METHODS The registry-based FinACAF study covers all patients with AF diagnosed during 2007-2018 in Finland. MHCs of interest were depression, bipolar disorder, anxiety disorder, schizophrenia, and any MHC. The outcomes were first-ever gastrointestinal, intracranial, and any bleeding event. RESULTS We identified 205,019 patients (50.9% female; mean age 72.3 [standard deviation 13.4] years) with incident AF without prior bleeding, and the prevalence of any MHC was 6.1%. Any MHC, depression, and anxiety disorder were associated with the risk of any bleeding (adjusted hazard ratios (HRs) 1.19 [1.12-1.27], 1.21 [1.13-1.30], and 1.21 [1.08-1.35], respectively). Additionally, any MHC and depression were associated with the risk of gastrointestinal and intracranial bleeding and anxiety disorder with gastrointestinal bleeding. Bipolar disorder and schizophrenia were not associated with risk of bleeding. Use of oral anticoagulants was associated with the risk of any bleeding (adjusted HR 1.24 [95% CI 1.21-1.28)]), and this association was similar in patients with and without MHCs. Serotonin reuptake inhibitors were not associated with bleeding risk. CONCLUSIONS MHCs are associated with a higher risk of bleeding in patients with AF.
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Affiliation(s)
| | - Jussi Jaakkola
- University of Turku, Turku, Finland; Heart Unit, Satakunta Central Hospital, Pori, Finland
| | - Fausto Biancari
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; Clinica Montevergine, GVM Care & Research, Mercogliano, Italy
| | - Olli Halminen
- Department of Industrial Engineering and Management, Aalto University, Espoo, Finland
| | - Miika Linna
- Aalto University, Espoo, Finland; University of Eastern Finland, Kuopio, Finland
| | - Jukka Putaala
- Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | | | - Janne Kinnunen
- Neurology, Helsinki University Hospital, and University of Helsinki, Helsinki, Finland
| | | | - Mikko Niemi
- Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland
| | - Juha Hartikainen
- University of Eastern Finland, Kuopio, Finland; Heart Center, Kuopio University Hospital, Kuopio, Finland
| | - K E Juhani Airaksinen
- University of Turku, Turku, Finland; Heart Center, Turku University Hospital, Turku, Finland
| | - Mika Lehto
- Heart and Lung Center, Helsinki University Hospital, Helsinki, Finland; University of Helsinki, Faculty of Medicine, Helsinki, Finland; Lohja Hospital, Department of Internal Medicine, Lohja, Finland
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Amitai M, Kaffman S, Kroizer E, Lebow M, Magen I, Benaroya-Milshtein N, Fennig S, Weizman A, Apter A, Chen A. Neutrophil to-lymphocyte and platelet-to-lymphocyte ratios as biomarkers for suicidal behavior in children and adolescents with depression or anxiety treated with selective serotonin reuptake inhibitors. Brain Behav Immun 2022; 104:31-38. [PMID: 35470013 DOI: 10.1016/j.bbi.2022.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Both the neutrophil/lymphocyte ratio (NLR) and the platelet/lymphocyte ratio (PLR) have been proposed as biomarkers of suicidal risk in adults with depression. We examined whether these ratios may be considered biomarkers for suicidal behavior in young patients with major depressive or anxiety disorders before treatment with selective serotonin reuptake inhibitors (SSRIs), or as biomarkers for the adverse event of SSRI-associated suicidality. METHODS Children and adolescents meeting criteria for major depressive or anxiety disorder were recruited. Serum levels of three pro-inflammatory cytokines (TNF-α, IL-6, IL-1β) were assessed; and NLR and PLR calculated, from blood samples collected at baseline and after 8 weeks treatment with SSRI. A Mann-Whitney test was performed to evaluate differences in NLR and PLR between children with and without a history of a suicide attempt prior to treatment. We compared hematological parameters before and after treatment, and between children who developed SSRI-associated suicidality versus children without treatment emergent suicidality. RESULTS Among 91 children and adolescents (aged 13.9 ± 2.4 years), baseline NLR and PLR were significantly higher among those with a history of a suicide attempt versus those without such history. Statistically significant correlations were found for the suicide ideation subscale in the Columbia suicide severity rating scale with both baseline NLR and PLR. Baseline NLR and PLR were similar in children who did and did not develop SSRI-associated suicidality after 8 weeks. In the final logistic regression model (χ2 = 18.504, df = 4, p value = 0.001), after controlling for sex, depression severity and IL-6 levels, NLR was significantly associated with a past suicide attempt (β = 1.247, p = 0.019; OR [95% CI] = 3.478 [1.230-9.841]), with a NLR cut-off value of = 1.76 (area under the curve = 0.75 (95% CI = 0.63-0.88, sensitivity = 73%, and specificity = 71%, p value = 0.003). CONCLUSIONS High NLR and PLR values may be associated with suicidal behavior in depressed and anxious children and adolescents. NLR appears as a better predictor of suicide attempt than PLR, and thus may be a useful biomarker of suicidality in young patients with depression or anxiety.
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Affiliation(s)
- Maya Amitai
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany; Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Shaked Kaffman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eitan Kroizer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maya Lebow
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Iddo Magen
- Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Genetics, Weizmann Institute of Science, Rehovot, Israel
| | - Noa Benaroya-Milshtein
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Silvana Fennig
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Laboratory of Biological Psychiatry, Felsenstein Medical Research Center, Petach Tikva, Israel; Research Unit, Geha Mental Health Center, Petach Tikva, Israel
| | - Alan Apter
- Department of Psychiatry, Feinberg Child Study Center, Schneider Children's Medical Center of Israel, Petach Tikva, affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alon Chen
- Department of Brain Sciences, Weizmann Institute of Science, Rehovot, Israel; Department of Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel; Department of Stress Neurobiology and Neurogenetics, Max-Planck Institute of Psychiatry, Munich, Germany
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Wei Y, Feng J, Ma J, Chen D, Chen J. Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in patients with affective disorders. J Affect Disord 2022; 309:221-228. [PMID: 35460739 DOI: 10.1016/j.jad.2022.04.092] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 03/02/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE There is substantial evidence to support that the alterations in the immune-inflammation system play a crucial role in the pathogenic mechanism of affective disorders. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) have been recently investigated as simple, rapid, and inexpensive inflammation markers. The purpose of the research is to use large-scale clinical data to study the difference of the inflammation ratios in first-episode MDD, recurrent MDD, BD depressive episodes and manic episode. METHODS A cross-sectional design was applied to retrospectively analyse the data that were extracted from electronic health records. A total of 16,174 Chinese affective disorder patients were enrolled in this study, and 6681 healthy subjects served as controls. The differences in the NLR, MLR, PLR and whole blood count data among different groups were compared, and the contributing factors for the occurrence of MDD and BD were analysed. RESULTS First-episode and recurrent MDD patients exhibited significantly elevated NLRs and MLRs compared to healthy controls. Compared with the MDD patients, the BD patients showed higher NLRs and MLRs and lower PLRs. Further analysis showed that the BD manic episode patients had significantly elevated NLRs and MLRs compared to patients with BD depressive episodes or MDD. MLR was a risk factor for the occurrence of MDD and that the NLR and MLR were risk factors for the occurrence of BD. CONCLUSIONS Our study highlights the role of systemic inflammation in the pathophysiology of MDD and BD, particularly during manic BD episodes.
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Affiliation(s)
- Yanyan Wei
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China
| | - Junhui Feng
- Jining Psychiatric Hospital, Jidai Road 1#, Jining 272000, Shandong, China
| | - Jinbao Ma
- Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing 100000, China
| | - Dongning Chen
- Beijing Tongren Hospital, Dongjiaomin Road 1#, Beijing 100000, China
| | - Jingxu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing 100096, China.
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Shan J, Tian H, Zhou C, Wang H, Ma X, Li R, Yu H, Chen G, Zhu J, Cai Z, Lin C, Cheng L, Xu Y, Liu S, Zhang C, Luo Q, Zhang Y, Jin S, Liu C, Zhang Q, Lv L, Yang L, Chen J, Li Q, Liu W, Yue W, Song X, Zhuo C. Prevalence of Heavy Menstrual Bleeding and Its Associated Cognitive Risks and Predictive Factors in Women With Severe Mental Disorders. Front Pharmacol 2022; 13:904908. [PMID: 35910343 PMCID: PMC9326357 DOI: 10.3389/fphar.2022.904908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
There has been limited studies examining treatment-induced heavy menstrual bleeding (HMB) in women with severe mental illnesses. The aim of this study was to examine HMB prevalence and HMB-associated factors in young women (18–34 years old) diagnosed with bipolar disorder (BP), major depressive disorder (MDD), or schizophrenia (SCZ) who have full insight and normal intelligence. Eighteen-month menstruation histories were recorded with pictorial blood loss assessment chart assessments of HMB. Multivariate analyses were conducted to obtain odds ratios (ORs) and 95% confidence intervals (CIs). Drug effects on cognition were assessed with the MATRICS Consensus Cognitive Battery (MCCB). HMB prevalence were: BP, 25.85%; MDD, 18.78%; and SCH, 13.7%. High glycosylated hemoglobin (HbA1c) level was a strong risk factor for HMB [BP OR, 19.39 (16.60–23.01); MDD OR, 2.69 (4.59–13.78); and SCZ OR, 9.59 (6.14–12.43)]. Additional risk factors included fasting blood sugar, 2-h postprandial blood glucose, and use of the medication valproate [BP: OR, 16.00 (95%CI 12.74–20.22); MDD: OR, 13.88 (95%CI 11.24–17.03); and SCZ OR, 11.35 (95%CI 8.84–19.20)]. Antipsychotic, antidepressant, and electroconvulsive therapy use were minor risk factors. Pharmacotherapy-induced visual learning impairment was associated with HMB [BP: OR, 9.01 (95%CI 3.15–13.44); MDD: OR, 5.99 (95%CI 3.11–9.00); and SCZ: OR, 7.09 (95%CI 2.99–9.20)]. Lithium emerged as a protective factor against HMB [BP: OR, 0.22 (95%CI 0.14–0.40); MDD: OR, 0.30 (95%CI 0.20–0.62); and SCZ: OR, 0.65 (95%CI 0.33–0.90)]. In SCZ patients, hyperlipidemia and high total cholesterol were HMB-associated factors (ORs, 1.87–2.22). Psychiatrist awareness of HMB risk is concerningly low (12/257, 2.28%). In conclusion, prescription of VPA should be cautioned for women with mental illness, especially BP, and lithium may be protective against HMB.
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Affiliation(s)
- Jianmin Shan
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Xiaoyan Ma
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Ranli Li
- MECT Center, Sleep Disorder Center, Tianjin Anding Hospital, Tianjin, China
| | - Haiping Yu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Jingjing Zhu
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Ziyao Cai
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Chongguang Lin
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Langlang Cheng
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Congpei Zhang
- Inpatient Department of Harbin First Psychiatry Hospital, Harbin, China
| | - Qinghua Luo
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yunshu Zhang
- Inpatient Department of Hebei Mental Health Center, Baoding, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Qiuyu Zhang
- Institute of Psychiatry, Jining Medical University, Jinning, China
| | - Luxian Lv
- Department of Psychiatry, Henan Psychiatry Hospital, Xinxiang, China
| | - Lei Yang
- Key Laboratory of Mental Health, Ministry of Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Jiayue Chen
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
| | - Qianchen Li
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Wei Liu
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Weihua Yue
- Department of Psychiatry, The First Hospital Affiliated to Harbin Medical University, Harbin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
| | - Chuanjun Zhuo
- Department of Psychiatry, Tianjin Fourth Center Hospital, Tianjin, China
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Laboratory of Psychiatric-Neuroimaging-Genetic and Cor-morbidity, Tianjin Mental Health Center of Tianjin Medical University, Tianjin Anding Hospital, Tianjin, China
- *Correspondence: Wei Liu, ; Weihua Yue, ; Xueqin Song, ; Chuanjun Zhuo,
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A retrospective cohort study of the change in inflammatory parameters in childhood schizophrenia and bipolar disorder from childhood to adulthood. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1109124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background/Aim: The etiologies of childhood schizophrenia and bipolar disorder have not yet been clarified. In cases in which the symptoms of mood are not dominant and psychotic symptoms are more dominant, it may be difficult to distinguish between childhood schizophrenia and bipolar disorder diagnoses. Follow-up studies concerning this subject have indicated that approximately half of the adolescents diagnosed with bipolar disorder were first (and incorrectly) diagnosed with schizophrenia. Therefore, strong markers are still needed to be used in the differential diagnosis at the time of the first application. An increase in the number of studies on the neuroinflammatory process in pediatric schizophrenia and bipolar illness have started to appear in the literature. The neutrophil–lymphocyte, thrombocyte–lymphocyte, and thrombocyte–neutrophil ratio (NLR, TLR, and TNR, respectively) levels in patients with childhood schizophrenia and childhood bipolar disorder at the time of admission and five years later were evaluated to determine whether inflammatory markers changed over time.
Methods: Twelve patients diagnosed with childhood schizophrenia and 14 patients diagnosed with childhood bipolar disorder were included in the study. Active infections, medical, neurological, endocrine, and metabolic illnesses, mental retardation, further concomitant psychiatric diagnoses, and intoxication were all exclusion factors. Hemograms from the same patients who satisfied the inclusion criteria when they originally applied and again at the fifth year follow-up were evaluated. Age, gender, neutrophil, lymphocyte, leukocyte, and thrombocyte values were recorded. NLR was calculated by dividing the neutrophil count by lymphocyte count. TLR value was calculated by dividing the thrombocyte count by lymphocyte count. TNR value was calculated by dividing the thrombocyte count by neutrophil count. Bipolar disorder and schizophrenia status were compared using NLR, TLR, and TNR parameters both at the time of initial diagnosis and at the fifth year of follow-up.
Results: When the initial admission hemograms of patients with childhood schizophrenia or childhood bipolar disorder were examined, no statistically significant differences between the two groups in terms of NLR (P = 0.150) and TLR (P = 0.440) were found. TNR was significantly higher in childhood bipolar disorder patients than in childhood schizophrenia (P = 0.015). At the fifth year follow-up, the hemograms of individuals diagnosed with either childhood schizophrenia or childhood bipolar disorder were compared, and no statistically significant differences between the two groups in NLR, (P = 0.572),TLR (P = 0.758), and TNR (P = 0.328) were found.
Conclusion: It was concluded that NLR and TLR levels did not change significantly over time in either disease and could not be used for the differential diagnosis of either disease. TNR may be considered for differential diagnoses in childhood schizophrenia and bipolar disease, particularly at the time of the first episode after confirmation of this study's findings with future studies.
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Ziani PR, Feiten JG, Goularte JF, Colombo R, Antqueviezc B, Géa LP, Rosa AR. Potential Candidates for Biomarkers in Bipolar Disorder: A Proteomic Approach through Systems Biology. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2022; 20:211-227. [PMID: 35466093 PMCID: PMC9048014 DOI: 10.9758/cpn.2022.20.2.211] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/02/2021] [Accepted: 07/03/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Paola Rampelotto Ziani
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics - Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
| | - Jacson Gabriel Feiten
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Rafael Colombo
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- University of Caxias do Sul, Caxias do Sul, Brasil
| | - Bárbara Antqueviezc
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
| | - Luiza Paul Géa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Adriane Ribeiro Rosa
- Laboratory of Molecular Psychiatry, Hospital Clinic of Porto Alegre, Porto Alegre, Brasil
- Postgraduate Program in Biological Sciences: Pharmacology and Therapeutics - Institute of Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Faculty of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Brasil
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Smolarczyk-Kosowska J, Kosowski M, Kunert Ł, Filipczyk K, Wojciechowski M, Piegza M, Gorczyca P, Okopień B, Pudlo R. Impact of Venlafaxine on Platelet Count and Activity—Case Report and Narrative Review. Medicina (B Aires) 2022; 58:medicina58050626. [PMID: 35630043 PMCID: PMC9145928 DOI: 10.3390/medicina58050626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
Venlafaxine (VEN) is considered to be one of the most effective antidepressants. It belongs to the group of serotonin (5-HT) and noradrenaline (NA) reuptake inhibitors (SNRIs). NA and 5-HT have receptors on the surface of platelets and are involved in platelet aggregation. In this case study, we present the case of a patient treated for one of the types of myeloproliferative neoplasm (MPN), essential thrombocythemia (ET), in whom VEN was added to pharmacotherapy during the treatment of a severe episode of depression with psychotic symptoms. We observed a gradual reduction in platelet count when increasing the dose of VEN. We also present a narrative review of literature about the effect of VEN on platelet counts and activity. We conclude that, in the group of patients taking VEN, attention should be paid to the rare adverse effect of a decrease in the number of platelets.
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Affiliation(s)
- Joanna Smolarczyk-Kosowska
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
- Correspondence:
| | - Michał Kosowski
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland; (M.K.); (B.O.)
| | - Łukasz Kunert
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
| | - Karolina Filipczyk
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
| | - Marcin Wojciechowski
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
| | - Magdalena Piegza
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
| | - Piotr Gorczyca
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland; (M.K.); (B.O.)
| | - Robert Pudlo
- Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland; (Ł.K.); (K.F.); (M.W.); (M.P.); (P.G.); (R.P.)
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19
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Abstract
BACKGROUND Blood platelets, due to shared biochemical and functional properties with presynaptic serotonergic neurons, constituted, over the years, an attractive peripheral biomarker of neuronal activity. Therefore, the literature strongly focused on the investigation of eventual structural and functional platelet abnormalities in neuropsychiatric disorders, particularly in depressive disorder. Given their impact in biological psychiatry, the goal of the present paper was to review and critically analyze studies exploring platelet activity, functionality, and morpho-structure in subjects with depressive disorder. METHODS According to the PRISMA guidelines, we performed a systematic review through the PubMed database up to March 2020 with the search terms: (1) platelets in depression [Title/Abstract]"; (2) "(platelets[Title]) AND depressive disorder[Title/Abstract]"; (3) "(Platelet[Title]) AND major depressive disorder[Title]"; (4) (platelets[Title]) AND depressed[Title]"; (5) (platelets[Title]) AND depressive episode[Title]"; (6) (platelets[Title]) AND major depression[Title]"; (7) platelet activation in depression[All fields]"; and (8) platelet reactivity in depression[All fields]." RESULTS After a detailed screening analysis and the application of specific selection criteria, we included in our review a total of 106 for qualitative synthesis. The studies were classified into various subparagraphs according to platelet characteristics analyzed: serotonergic system (5-HT2A receptors, SERT activity, and 5-HT content), adrenergic system, MAO activity, biomarkers of activation, responsivity, morphological changes, and other molecular pathways. CONCLUSIONS Despite the large amount of the literature examined, nonunivocal and, occasionally, conflicting results emerged. However, the findings on structural and metabolic alterations, modifications in the expression of specific proteins, changes in the aggregability, or in the responsivity to different pro-activating stimuli, may be suggestive of potential platelet dysfunctions in depressed subjects, which would result in a kind of hyperreactive state. This condition could potentially lead to an increased cardiovascular risk. In line with this hypothesis, we speculated that antidepressant treatments would seem to reduce this hyperreactivity while representing a potential tool for reducing cardiovascular risk in depressed patients and, maybe, in other neuropsychiatric conditions. However, the problem of the specificity of platelet biomarkers is still at issue and would deserve to be deepened in future studies.
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20
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Labonté C, Zhand N, Park A, Harvey PD. Complete blood count inflammatory markers in treatment-resistant schizophrenia: Evidence of association between treatment responsiveness and levels of inflammation. Psychiatry Res 2022; 308:114382. [PMID: 34995832 DOI: 10.1016/j.psychres.2021.114382] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 12/25/2021] [Accepted: 12/30/2021] [Indexed: 11/24/2022]
Abstract
Accumulating evidence suggests that the variable response to antipsychotic treatment in schizophrenia reflects distinct biological subtypes. The pathophysiology of schizophrenia is associated with alteration in the immune system which can be measured with complete blood count (CBC) markers of systemic inflammation, including the neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). While previous research suggested a decrease in CBC inflammatory markers following treatment, it is unknown if treatment or response to treatment is associated with CBC markers in treatment-resistant schizophrenia. Here, we retrospectively analyzed the CBC at admission and discharge in schizophrenia inpatients classified as treatment-responsive, treatment-resistant, and ultra-treatment-resistant. Despite similar NLR at admission, the subtypes manifested different changes in NLR during treatment resulting in significant differences at discharge. Only the treatment-responsive group presented a significant decrease in inflammatory markers after treatment. Additionally, we found that the responsive group had a higher PLR at admission and was the only subgroup to demonstrate a significant reduction following treatment. In sum, our results support the idea that persistent inflammation is a biological trait marker of treatment resistance in schizophrenia.
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Affiliation(s)
- Caleb Labonté
- The Royal Ottawa Mental Health Center, Schizophrenia and Recovery Program, 1145 Carling Ave, Ottawa, Ontario K1Z 7K4, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Naista Zhand
- The Royal Ottawa Mental Health Center, Schizophrenia and Recovery Program, 1145 Carling Ave, Ottawa, Ontario K1Z 7K4, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Angela Park
- The Royal Ottawa Mental Health Center, Schizophrenia and Recovery Program, 1145 Carling Ave, Ottawa, Ontario K1Z 7K4, Canada
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States
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21
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Zhuo C, Chen G, Lin C, Ping J, Zhu J, Wang L, Jin S, Liu C, Zhang Q, Yang L, Li Q, Zhou C, Cheng L, Tian H, Song X. Risk-to-befit ratios of consecutive antidepressants for heavy menstrual bleeding in young women with bipolar disorder or major depressive disorder. Front Psychiatry 2022; 13:1012644. [PMID: 36386987 PMCID: PMC9650378 DOI: 10.3389/fpsyt.2022.1012644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/06/2022] [Indexed: 11/24/2022] Open
Abstract
The occurrence of heavy menstrual bleeding (HMB) induced by pharmacological agents has been reported in young adult women. This study aimed to investigate a possible association between the occurrence rates of HMB and different treatment methods such as antidepressant agents alone and in combination with other pharmacological agents. The examined cohort included young women (age 18-35 years, n = 1,949) with bipolar disorder (BP) or major depressive disorder (MDD). Menstruation history for 24 months was recorded and evaluated according to pictorial blood loss assessment charts of HMB. Multivariate analyses were conducted to determine odds ratios (ORs) and 95% confidence intervals. The examined antidepressant agents had varying ORs for patients with BP vs. those with MDD. For example, the ORs of venlafaxine-induced HMB were 5.27 and 4.58 for patients with BP and MDD, respectively; duloxetine-induced HMB, 4.72 and 3.98; mirtazapine-induced HMB, 3.26 and 2.39; fluvoxamine-induced HMB, 3.11 and 2.08; fluoxetine-induced HMB, 2.45 and 1.13; citalopram-induced HMB, 2.03 and 1.25; escitalopram-induced HMB, 1.85 and 1.99; agomelatine-induced HMB, 1.45 and 2.97; paroxetine-induced HMB, 1.19 and 1.75; sertraline-induced HMB, 0.88 and 1.13; reboxetine-induced HMB, 0.45 and 0.45; and bupropion-induced HMB, 0.33 and 0.37, in each case. However, when antidepressant agents were combined with valproate, the OR of HMB greatly increased, with distinct profiles observed for patients with BP vs. those with MDD. For example, the ORs of HMB induced by venlafaxine combined with valproate were 8.48 and 6.70 for patients with BP and MDD, respectively; for duloxetine, 5.40 and 4.40; mirtazapine, 5.67 and 3.73; fluvoxamine, 5.27 and 3.37; fluoxetine, 3.69 and 4.30; citalopram, 5.88 and 3.46; escitalopram, 6.00 and 7.55; agomelatine, 4.26 and 5.65; paroxetine, 5.24 and 3.25; sertraline, 4.97 and 5.11; reboxetine, 3.54 and 2.19; and bupropion, 4.85 and 3.46, in each case. In conclusion, some antidepressant agents exhibited potential risks of inducing HMB. Therefore, a combined prescription of antidepressant agents and valproate should be carefully considered for young women with HMB.
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Affiliation(s)
- Chuanjun Zhuo
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China.,Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Guangdong Chen
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Chongguang Lin
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jing Ping
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Jingjing Zhu
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Lina Wang
- Laboratory of Psychiatric-Neuroimaging-Genetic and Comorbidity, Tianjin Anding Hospital, Tianjin Mental Health Center of Tianjin Medical University, Tianjin, China
| | - Shili Jin
- Inpatient Department, Shandong Daizhuang Hospital, Jining, China
| | - Chuanxin Liu
- College of Mental Disorder, Jining Medical University, Jining, China
| | - Qiuyu Zhang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Lei Yang
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Qianchen Li
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Langlang Cheng
- Department of Psychiatry, Wenzhou Seventh Peoples Hospital, Wenzhou, China
| | - Hongjun Tian
- Key Laboratory of Multiple Organs Damage in Patients With Metal Disorder, Tianjin Fourth Center Hospital, Nankai University Affiliated Tianjin Fourth Center Hospital, Tianjin, China
| | - Xueqin Song
- Department of Psychiatry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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22
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Grech J, Chan MV, Ochin C, Lachapelle A, Thibord F, Schneider Z, Nkambule BB, Armstrong PCJ, de Melendez CW, Tucker KL, Garelnabi M, Warner TD, Chen M, Johnson AD. Serotonin‐affecting antidepressant use in relation to platelet reactivity. Clin Pharmacol Ther 2021; 111:909-918. [PMID: 34939182 PMCID: PMC9305794 DOI: 10.1002/cpt.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/10/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Joseph Grech
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
| | - Melissa Victoria Chan
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
- The Blizard Institute London UK
| | - Chinedu Ochin
- Department of Biomedical and Nutritional Sciences University of Massachusetts Lowell, Lowell, MA
- Center for Population Health University of Massachusetts Lowell, Lowell, MA
| | - Amber Lachapelle
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
| | - Florian Thibord
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
| | - Zoe Schneider
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
| | | | | | | | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences University of Massachusetts Lowell, Lowell, MA
- Center for Population Health University of Massachusetts Lowell, Lowell, MA
| | - Mahdi Garelnabi
- Department of Biomedical and Nutritional Sciences University of Massachusetts Lowell, Lowell, MA
- Center for Population Health University of Massachusetts Lowell, Lowell, MA
| | | | - Ming‐Huei Chen
- National Heart, Lung and Blood Institute Population Sciences Branch, Framingham, MA
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23
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Karatoprak S, Uzun N, Akıncı MA, Dönmez YE. Neutrophil-lymphocyte and Platelet-lymphocyte Ratios among Adolescents with Substance Use Disorder: A Preliminary Study. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:669-676. [PMID: 34690121 PMCID: PMC8553541 DOI: 10.9758/cpn.2021.19.4.669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/25/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022]
Abstract
Objective Substance use disorder (SUD) is a serious public health problem affecting both the individual and the society, and substance use-related deaths and disability have been shown to increase gradually. Recent etiologic studies have reported that there is a relation between inflammatory parameters and psychiatric disorders. The neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) used as an indicator of inflammation have been shown to be increased in various psychiatric disorders. In this study, we aimed to investigate the NLR and PLR in adolescents with SUD. Methods This study was conducted by retrospectively examining the records of 55 male adolescents who were followed up with SUD in a child and adolescent psychiatry outpatient clinic between November 2019−June 2020. Patients who had comorbid psychiatric disorder were included, and those who received any psychotropic medication were excluded. A total of 61 healthy male adolescents in the same age range without any psychiatric disorders were recruited as a control group. Neutrophil-lymphocyte-platelet counts were noted retrospectively from complete blood tests, and NLR-PLR were calculated. Results The NLR and PLR of adolescents with SUD were significantly higher than the healthy adolescents (p < 0.01, p < 0.01, respectively). In addition, conduct disorder, depression, and attention deficit/hyperactivity disorder, which were determined as the most common comorbid psychiatric disorders had no effects on NLR (p = 0.513, p = 0.584, p = 0.394, respectively) and PLR (p = 0.210, p = 0.346, p = 0.359, respectively). Conclusion The results of current study indicate that inflammatory processes may have a key role in the pathophysiology of SUD.
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Affiliation(s)
- Serdar Karatoprak
- Department of Child and Adolescent Psychiatry, Elazıg Fethi Sekin City Hospital, Elazıg, Turkey
| | - Necati Uzun
- Department of Child and Adolescent Psychiatry, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Dr. Ali Kemal Belviranlı Maternity and Children’s Hospital, Konya, Turkey
| | - Yunus Emre Dönmez
- Department of Child and Adolescent Psychiatry, School of Medicine, Inonu University, Malatya, Turkey
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24
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Bellman V, Russell N, Depala K, Dellenbaugh A, Desai S, Vadukapuram R, Patel S, Srinivas S. Challenges in Treating Cancer Patients With Unstable Psychiatric Disorder. World J Oncol 2021; 12:137-148. [PMID: 34804276 PMCID: PMC8577605 DOI: 10.14740/wjon1402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/17/2021] [Indexed: 11/14/2022] Open
Abstract
In this review, we first present a case of chronic myeloid leukemia with acute psychosis, and then we will discuss the incidence of cancer in patients with psychotic disorders, the manifestations of new-onset psychosis, and the prevalence of preexisting psychosis in cancer patients, coupled with their impact on the treatment, diagnosis, and prognosis of cancer. This was a case that presented with acute psychosis and was found to have an elevated white blood cell count upon admission to an inpatient psychiatric unit. He was diagnosed with chronic myeloid leukemia and successfully managed with imatinib/dasatinib therapy. Psychiatrically, he was stabilized on two long-acting injectable medications to help maintain adherence. We were able to eliminate his active psychotic symptoms and return him to normal functioning in affect and thinking, achieving sustained compliance with treatment. We identified multiple inconsistencies in screening for cancer of all types in these patients, masking of signs and symptoms that would typically clue physicians to the presence of cancers, underreporting of symptoms, and disparate access to healthcare resources in patients with mental disorders when compared to the general population. Treatment of cancer in these patients as compared to the general population has also been shown to be incongruent, which will be elaborated upon. Psychiatric interventions, as well as supportive measures, for treating patients who are facing challenges during active cancer treatment will be discussed.
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Affiliation(s)
- Val Bellman
- Department of Psychiatry, University of Missouri Kansas City School of Medicine, 1000 E. 24th Street, Kansas City, MO 64108, USA
| | - Nina Russell
- University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | - Kartik Depala
- University of Missouri Kansas City School of Medicine, Kansas City, MO, USA
| | | | - Saral Desai
- Department of Psychiatry, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | - Ramu Vadukapuram
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Sushma Srinivas
- A.J. Institute of Medical Sciences and Research Centre, NH66, Kuntikan, Mangalore, Karnataka, India
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25
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Subramaniapillai M, Chen VCH, McIntyre RS, Yang YH, Chen YL. Added burden of major depressive disorder on cardiovascular morbidity and mortality among patients with cardiovascular disease and the modifying effects of antidepressants: A national retrospective cohort study. J Affect Disord 2021; 294:580-585. [PMID: 34332358 DOI: 10.1016/j.jad.2021.07.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND To evaluate the likelihood of a future cardiovascular event (i.e., in-hospital mortality or cardiovascular disease [CVD] complications/interventions) among patients with CVD and major depressive disorder (MDD) compared to those without MDD, and the antidepressant use on future cardiovascular events between the two groups. METHODS This is a retrospective cohort with propensity score matching with 8941 patients with CVD and MDD, and 8941 non-MDD patients using data from the Longitudinal Health Insurance Database from 1999 to 2013 in Taiwan. The outcome was in-hospital mortality and the incidence of revascularization (i.e., percutaneous transluminal coronary angioplasty [PTCA] and coronary artery bypass graft surgery [CABG]). RESULTS Patients with CVD and MDD were more likely to need revascularization (an adjusted hazard ratio [aHR]: 1.26 and 95% CI: 1.12-1.43) than those without MDD, regardless of whether PTCA (aHR: 1.23 and 95% CI: 1.07-1.40) or CABG (aHR: 1.60 and 95% CI: 1.16-2.21) had occurred. Antidepressant use was associated with a tendency of reduced risk of mortality (aHR: 0.92 and 95% CI: 0.84-1.00). Although the magnitude of aHR ranged from 0.92 to 0.95 with revascularization, they did not reach significant levels. LIMITATIONS Some covariates could not be controlled because they were not included in the national register dataset, and the causality is limited in an observational study. CONCLUSIONS Patients with CVD with MDD are more likely to experience a cardiovascular complication requiring intervention than CVD patients without MDD. Antidepressant use is associated with reduced in-hospital mortality.
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Affiliation(s)
- Mehala Subramaniapillai
- Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Centre, University Health Network, Toronto, ON, Canada
| | - Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Tauyuan, Taiwan; Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Centre, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chia-Yi, Taiwan; Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Lung Chen
- Department of Healthcare Administration, Asia University, Taiwan; Department of Psychology, Asia University, Taiwan.
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26
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Puangsri P, Ninla-Aesong P. Potential usefulness of complete blood count parameters and inflammatory ratios as simple biomarkers of depression and suicide risk in drug-naive, adolescents with major depressive disorder. Psychiatry Res 2021; 305:114216. [PMID: 34571404 DOI: 10.1016/j.psychres.2021.114216] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/06/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022]
Abstract
We determined whether an elevated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were associated with depression in major depressive disorder (MDD), or suicide risk in MDD patients. A total of 137 adolescents with MDD who were antidepressant-naïve and 56 healthy controls (HC) were included. Recent suicidal behaviors were assessed. The NLR, PLR, and MLR were calculated from parameters obtained from a routine complete blood cell count parameters and compared between the MDD subgroups and HC. Cohen's d was calculated as a measure of effect size. The linear relationship between biomarkers with depression severity or suicidality severity was also analysed. Changes in CBC parameters and inflammatory ratios appeared to be more closely related to the suicidality severity than depressive severity. As compared with HC, the WBC count, neutrophil percentage, platelet count, NLR, and PLR were higher in MDD, whereas the lymphocyte percentage was lower. As compared to non-suicidal ideation (non-SI) MDD and HC, the lymphocyte percentage was decreased in MDD with suicidal attempts (SA), whereas monocyte count and MLR were increased. Suicidal attempts in MDD patients were associated with the lower lymphocytes percentage, as well as the elevated monocyte count and MLR.
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Affiliation(s)
- Pavarud Puangsri
- Department of Clinical Sciences, School of Medicine, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Putrada Ninla-Aesong
- Department of Preclinical Sciences, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand 80161.
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Ljubin-Golub T, Uzun S, Mimica N, Kozumplik O, Kalinic D, Kovacic Petrovic Z, Folnegovic Grosic P, Pivac N. Platelet serotonin concentration and trait aggression in veterans with post-traumatic stress disorder: a preliminary study. Stress 2021; 24:787-794. [PMID: 34006175 DOI: 10.1080/10253890.2021.1920918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Animal and human studies suggest that aggressive behavior may be modulated by brain serotonergic system. Serotonergic (5-HT) dysfunction is associated with post-traumatic stress disorder (PTSD), but also with increased aggression and impulsivity, hallmarks of PTSD. The aim of the study was to investigate the association of platelet 5-HT concentration and various types of aggression and impulsivity in veterans with PTSD. A group of 42 male combat-related PTSD subjects entered the study. Four different aggression facets were measured by the Buss and Perry's Aggression Questionnaire (BPAQ). Verbal and physical types of impulsive aggressive behavior were measured by the subscales of the Žužul's Aggressiveness Inventory A-87. Impulsivity was determined using Eysenck's IVE questionnaire. PTSD severity was evaluated by Watson's PTSD questionnaire. Platelet serotonin concentration was determined spectrofluorimetrically. Confounding variables were: age, body mass, alcohol use, comorbid depression, and tobacco use. Platelet 5-HT concentration and PTSD severity were independently associated only with impulsive types of aggression, as higher platelet 5-HT concentration and more severe PTSD were related to more impulsive aggression. These results strongly recommend distinguishing between specific types of aggression facets, and advise the importance of theory-based concepts of aggression facets when evaluating the biological correlates of aggression.
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Affiliation(s)
| | - Suzana Uzun
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Zagreb, Croatia
- Faculty of Medicine, University of Osijek Josip Juraj Strossmayer, Osijek, Croatia
| | - Ninoslav Mimica
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Oliver Kozumplik
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Zagreb, Croatia
- Faculty of Medicine, University of Osijek Josip Juraj Strossmayer, Osijek, Croatia
| | - Dubravka Kalinic
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Zrnka Kovacic Petrovic
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapce, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | | | - Nela Pivac
- Rudjer Boskovic Institute, Zagreb, Croatia
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Karatas KS, Bahceci I, Telatar TG, Bahceci B, Hocaoglu C. Relationship between disease and disease severity and semaphorin 5A and hemogram level in obsessive-compulsive disorder. Nord J Psychiatry 2021; 75:509-515. [PMID: 33771090 DOI: 10.1080/08039488.2021.1896779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Semaphorin 5A (SEMA 5A) is a neuroprotein that regulates the formation of excitatory synapses between neurons, important in autoimmunity, inflammatory processes and behaviors. This study aimed to investigate the SEMA 5A levels in patients with obsessive-compulsive disorder (OCD) diagnosed for the first time and evaluate the relationship of disease and disease severity with the blood SEMA 5A level and hemogram. METHODS More than 41,465 patients who applied to the psychiatry clinic from January 2018 to December 2020 were evaluated according to the DSM-5 criteria; 57 patients diagnosed with OCD for the first time, who met the inclusion criteria, were included in the study. Disease severity was investigated administering the Yale Brown Obsessive Compulsion Scale. The peripheral blood SEMA 5A level and hemogram were measured and evaluated in relation to platelet (PLT) activity, neutrophil-lymphocyte ratio (NLR), PLT-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), and compared with control group of 26 people. RESULTS The comparison of the groups revealed a significant difference in SEMA 5A and CRP level, neutrophil count and percentage, lymphocyte count, PLT activity. A significant correlation was found between disease and SEMA 5A level, NLR, PLR, and PLT parameters in diagnosis of OCD. As the severity of OCD increased, the SEMA 5A level and PLT count decreased, while the PDW and MLR values increased. CONCLUSION In patients with OCD, a relationship was found between plasma SEMA 5A, PLT activity, NLR, PLR, and MLR activity levels with disease and the disease severity.
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Affiliation(s)
- Kader Semra Karatas
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Ilkay Bahceci
- Medical Microbiology and Clinical Microbiology Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Tahsin Gokhan Telatar
- Public Health Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Bulent Bahceci
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Cicek Hocaoglu
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
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Mazza MG, Palladini M, De Lorenzo R, Magnaghi C, Poletti S, Furlan R, Ciceri F, Rovere-Querini P, Benedetti F. Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up. Brain Behav Immun 2021; 94:138-147. [PMID: 33639239 PMCID: PMC7903920 DOI: 10.1016/j.bbi.2021.02.021] [Citation(s) in RCA: 254] [Impact Index Per Article: 84.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/28/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022] Open
Abstract
COVID-19 outbreak is associated with mental health implications during viral infection and at short-term follow-up. Data on psychiatric and cognitive sequelae at medium-term follow-up are still lacking. During an ongoing prospective cohort study, the psychopathological and cognitive status of 226 COVID-19 pneumonia survivors (149 male, mean age 58) were prospectively evaluated one and three months after hospital discharge. Psychiatric clinical interview, self-report questionnaires, and neuropsychological profiling of verbal memory, working memory, psychomotor coordination, executive functions, attention and information processing, and verbal fluency were performed. Three months after discharge from the hospital, 35.8% still self-rated symptoms in the clinical range in at least one psychopathological dimension. We observed persistent depressive symptomatology, while PTSD, anxiety, and insomnia decreased during follow-up. Sex, previous psychiatric history, and the presence of depression at one month affected the depressive symptomatology at three months. Regardless of clinical physical severity, 78% of the sample showed poor performances in at least one cognitive domain, with executive functions and psychomotor coordination being impaired in 50% and 57% of the sample. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted self-rated depressive symptomatology and cognitive impairment at three-months follow-up; and changes of SII predicted changes of depression during follow-up. Neurocognitive impairments associated with severity of depressive psychopathology, and processing speed, verbal memory and fluency, and psychomotor coordination were predicted by baseline SII. We hypothesize that COVID-19 could result in prolonged systemic inflammation that predisposes patients to persistent depression and associated neurocognitive dysfunction. The linkage between inflammation, depression, and neurocognition in patients with COVID-19 should be investigated in long-term longitudinal studies, to better personalize treatment options for COVID-19 survivors.
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Affiliation(s)
- Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy; Vita-Salute San Raffaele University, Milano, Italy.
| | - Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Rebecca De Lorenzo
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Cristiano Magnaghi
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
| | - Roberto Furlan
- Vita-Salute San Raffaele University, Milano, Italy,Clinical Neuroimmunology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Fabio Ciceri
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy,Vita-Salute San Raffaele University, Milano, Italy
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Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, Riga S, Ciobanu AM. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers. J Clin Med 2021; 10:1924. [PMID: 33946871 PMCID: PMC8125288 DOI: 10.3390/jcm10091924] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/27/2022] Open
Abstract
(1) Background: Recent research suggests inflammation as a factor involved in the pathophysiology of mood disorders. Neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammatory (SII) index ratios have been studied as peripheral markers of inflammation in bipolar and major depressive disorders. The purpose of this study is to comparatively analyze these inflammatory ratios among manic episodes of bipolar disorder, bipolar depression and unipolar depression. (2) Methods: 182 patients were retrospectively included in the study and divided into three groups: 65 manic patients, 34 patients with bipolar depression, and 83 unipolar depressive patients. White blood cells, neutrophils, monocytes, lymphocytes, and platelets were retrieved from the patients' database. NLR, MLR, PLR, and SII index were calculated using these parameters. (3) Results: Patients with manic episodes had elevated NLR (p < 0.001), MLR (p < 0.01), PLR (p < 0.05), and SII index (p < 0.001) compared to unipolar depression and increased NLR (p < 0.05) and SII index (p < 0.05) when compared to bipolar depression. NLR (p < 0.01) and SII index (p < 0.05) were higher in the bipolar depression than unipolar depression. NLR is an independent predictor of the bipolar type of depression in depressive patients. (4) Conclusions: The results confirm the role of inflammation in the pathophysiology of mood disorders and suggest the ability of NLR as a marker for the differentiation of bipolar from unipolar depression.
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Affiliation(s)
- Vlad Dionisie
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Gabriela Adriana Filip
- Department of Physiology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Robert Constantin Movileanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Emanuel Moisa
- Department of Orthopaedics, Anaesthesia and Intensive Care Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
- Neuroscience Department, Discipline of Psychiatry, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Brusov OS, Oleichik IV, Karpova NS, Faktor MI, Sizov SV. [Correlations between thrombodynamic parameters of coagulation and negative syndromes in patients with schizophrenia]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 120:86-91. [PMID: 33459546 DOI: 10.17116/jnevro202012012186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To identify a possible correlation between parameters of thrombodynamic coagulation and negative syndromes in patients with schizophrenia. MATERIAL AND METHODS The study included 148 female inpatients, aged 16 to 57 years, with the following mental disorders: schizophrenia with attack-like/attack-progressive/continuous type of course (F20.00-2), schizotypal disorder with affective fluctuations (F21.3-4). The thrombodynamics test (TD) was carried out on a T-2 thrombodynamics recorder (Hemacore LLC, Moscow, Russia). RESULTS A positive correlation was shown between the thrombodynamic parameters of clot growth rates (V, Vst, and Vi), clot size at the 30th minute (CS), and the total severity of negative syndromes (PANSS). There is a negative correlation between the time of spontaneous clots (Tsp) and the total severity of negative syndromes in patients. Positive correlations of V and Vst with scores on the fourth (Passive/apathetic social withdrawal), fifth (Difficulty in abstract thinking) and seventh (Stereotyped thinking) items of the PANSS negative subscale were revealed. There is a negative correlation between Tsp and the score on the 7th item, i.e. a shorter time for the appearance of spontaneous clots corresponds to a more pronounced Stereotyped thinking in patients. CONCLUSION For the first time, correlations between thrombodynamic indicators of hypercoagulation and negative syndromes in patients with schizophrenia are identified, which emphasizes the need to normalize hemostasis to prevent further aggravation of these disorders.
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Affiliation(s)
- O S Brusov
- Mental Health Research Center, Moscow, Russia
| | | | - N S Karpova
- Mental Health Research Center, Moscow, Russia
| | - M I Faktor
- Mental Health Research Center, Moscow, Russia
| | - S V Sizov
- Mental Health Research Center, Moscow, Russia
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Fusar-Poli L, Natale A, Amerio A, Cimpoesu P, Grimaldi Filioli P, Aguglia E, Amore M, Serafini G, Aguglia A. Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder. Brain Sci 2021; 11:brainsci11010058. [PMID: 33418881 PMCID: PMC7825034 DOI: 10.3390/brainsci11010058] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes.
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Affiliation(s)
- Laura Fusar-Poli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02110, USA
| | - Patriciu Cimpoesu
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Pietro Grimaldi Filioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence:
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von Känel R, Merz F, Pfister H, Brückl T, Zimmermann P, Uhr M, Holsboer F, Höhne N, Ising M. Evidence for an enhanced procoagulant state in remitted major depression. World J Biol Psychiatry 2020; 21:766-774. [PMID: 31755344 DOI: 10.1080/15622975.2019.1696475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Hypercoagulability is one mechanism to explain the increased risk of incident atherothrombotic disease in patients with major depressive disorder (MDD). We examined whether patients with remitted MDD show an enhanced procoagulant state. METHODS 63 individuals (median age 35 years, 59% women), 40 with a DSM-IV diagnosis of remitted MDD, made by a clinical interview, and 23 healthy controls provided blood samples for the measurement of fibrinogen, D-dimer, von Willebrand factor, and plasminogen activator inhibitor-1. Standardised z-scores of plasma levels of these haemostatic factors were added to form a procoagulant index (PCI) as the primary outcome variable. Self-ratings of residual depressive symptoms and trait anxiety were also obtained. RESULTS Compared with controls, remitted MDD patients had higher PCI (p = 0.013, Cohen's d = 0.69) and fibrinogen (p = 0.001, d = 0.91), controlling for age, sex, body mass index, smoking and C-reactive protein. There were no significant associations of the PCI and individual haemostatic molecules with age of MDD onset, time since the last MDD episode, the number of previous MDD episodes and residual depressive symptoms. Additional adjustment for anxiety symptoms did not change these results. CONCLUSIONS Remitted MDD is associated with an enhanced procoagulant state. Hypercoagulability seems more a trait than a state characteristic of depression.
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Affiliation(s)
- Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | | | - Tanja Brückl
- Max Planck Institute of Psychiatry, Munich, Germany
| | | | - Manfred Uhr
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Florian Holsboer
- Max Planck Institute of Psychiatry, Munich, Germany.,HMNC Brain Health GmbH, Munich, Germany
| | - Nina Höhne
- Max Planck Institute of Psychiatry, Munich, Germany.,Centre for Digitization Bavaria, Munich, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
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Li H, Zhao M, Xu Y. [Biochemical analysis between common type and critical type of COVID-19 and clinical value of neutrophil/lymphocyte ratio]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:965-971. [PMID: 32895161 DOI: 10.12122/j.issn.1673-4254.2020.07.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To identify the key biochemical indicators that affect the clinical type and outcomes of COVID-19 patients and explore the application of neutrophil/lymphocyte ratio (NLR) in COVID-19. METHODS Ninety-three patients with confirmed diagnosis of COVID-19 admitted in Ezhou Central Hospital from February to April in 2020 were analyzed. Among them, 43 patients were selected from Intensive Care Unit (ICU) with the diagnosis of critical type of COVID-19, and 50 cases of common type were selected from the Department of Respiratory Medicine. The baseline data, blood routine test and biochemical indexes of the patients were collected on the first day of admission. NLRs of the patients were calculated, and COX survival analysis according to the NLR 4-category method was performed. The patients' outcomes were analyzed with receiver operating curves (ROCs). The patients were divided into two groups according to NLR cutoff value for comparison of the biochemical indexes. Based on the patients' outcomes, NLR cutoff value classification and clinical classification, multiple binary logistics regression was performed to screen the key variables and explore their significance in COVID-19. RESULTS The NLR four-category method was not applicable for prognostic evaluation of the patients. The cut-off value of NLR for predict the prognosis of COVID-19 was 11.26, with a sensitivity of 0.903 and a specificity of 0.839; the laboratory indicators of the patients with NLR < 11.26 were similar to those in patients of the common type; the indicators were also similar between patients with NLR≥11.26 and those with critical type COVID-19. NLR, WBC, NEUT, PCT, DD, BUN, TNI, BNP, and LDH had significant effects on the clinical classification and outcome of the patients (P < 0.05); Cr, Ca, PH, and Lac had greater impact on the outcome of the patients (P < 0.05), while Na, PCO2 had greater impact on the clinical classification of the patients (P < 0.05). CONCLUSIONS NLR can be used as an important reference for clinical classification, prognostic assessment, and biochemical abnormalities of COVID-19. Patients of critical type more frequently have bacterial infection with more serious inflammatory reactions, severer heart, lung and kidney damages, and much higher levels of DD and LDH than those of the common type. NLR, NEUT, DD, TNI, BNP, LDH, Ca, PCT, PH, and Lac have obvious influence on the prognosis of COVID-19 and should be observed dynamically.
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Affiliation(s)
- Hongbing Li
- Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - Maojun Zhao
- Department of Emergency Medicine, Guiyang First People's Hospital, Guiyang 550002, China
| | - Yingsheng Xu
- Department of Nutrition, Ezhou Central Hospital, Ezhou 436000, China
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Shimokhina NY, Savchenko AA, Petrova MM. Peculiarities of Platelet Metabolism in Patients with Acute Coronary Syndrome with Anxiety-Depressive Disorders and Informativity of Enzymes in the Forecast of Development of Cardiovascular Complications. Pharmaceuticals (Basel) 2020; 13:ph13080169. [PMID: 32731561 PMCID: PMC7466177 DOI: 10.3390/ph13080169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/25/2020] [Accepted: 07/26/2020] [Indexed: 02/06/2023] Open
Abstract
Anxiety–depressive disorders (ADD) are a risk factor of cardiovascular mortality in patients with coronary artery disease (CAD). Acute coronary syndrome (ACS) is the main clinical manifestation of a progressing CAD. Metabolic processes disorder in platelets can be one of the causes of cardiovascular complications in patients with ACS and concomitant ADD. We studied platelets metabolism and prognostic informativity of NAD(P)-dependent dehydrogenases of platelets in ACS patients with ADD in terms of forecasting cardiovascular complications development over a year of observation. The levels of NAD- and NADP-dependent dehydrogenases of platelets were determined by means of a bioluminescent method during the first 24 h after admission to hospital and in dynamics in 10 days. Among 315 examined patients, ADD was found in 161 (51.1%). ACS patients with concomitant ADD had both cytoplasmic and mitochondrial processes impairment in platelets that consisted in a decrease of energy metabolism intensity, inhibition of anaerobic glycolysis reactions and lipid catabolism. After 12 months of follow-up, 41 (25.5%) cardiovascular complications were detected in the group of ACS patients with ADD and 20 (13.0%) in the group of ACS patients without ADD. According to the results of the analysis of the neural network based on NAD(P)-dependent dehydrogenases of platelets activity in ACS patients with ADD, indicators were obtained that are informative for predicting the development of recurrent cardiovascular complications.
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Affiliation(s)
- Natalya Yu. Shimokhina
- Faculty of Medicine, Prof. V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, Partizan Zheleznyak Street 1, 660022 Krasnoyarsk, Russia; (A.A.S.); (M.M.P.)
- Correspondence: ; Tel.: +7-923-356-9392
| | - Andrey A. Savchenko
- Faculty of Medicine, Prof. V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, Partizan Zheleznyak Street 1, 660022 Krasnoyarsk, Russia; (A.A.S.); (M.M.P.)
- Laboratory of Molecular and Cellular Physiology and Pathology, Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences, Scientific Research Institute of Medical Problems of the North, Partizan Zheleznyak Street 3g, 660022 Krasnoyarsk, Russia
| | - Marina M. Petrova
- Faculty of Medicine, Prof. V. F. Voino-Yasenetsky Krasnoyarsk State Medical University, Partizan Zheleznyak Street 1, 660022 Krasnoyarsk, Russia; (A.A.S.); (M.M.P.)
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Mazza MG, Lucchi S, Rossetti A, Clerici M. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: A meta-analysis and systematic review. World J Biol Psychiatry 2020; 21:326-338. [PMID: 30806142 DOI: 10.1080/15622975.2019.1583371] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objectives: Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR, MLR and PLR in non-affective psychosis.Methods: Eight studies have been identified from the main electronic databases. Meta-analyses based on random-effects models have been carried out generating pooled standardised mean differences (SMDs) between non-affective psychotic patients and healthy controls (HCs).Results: Subjects with non-affective psychosis had a significant higher NLR and MLR as compared with HC (respectively SMD = 0.715; P < 0.001; I2=57.565% and SMD = 0.417; P = 0.001; I2=65.754%), confirmed by heterogeneity-based sensitivity analysis. Subgroup analyses showed no differences in effect size across different study characteristics, including drug treatment status, diagnosis, and setting. Meta-regression showed that age influenced the relationship between non-affective psychosis and MLR. A trend of significance, not confirmed by heterogeneity-based sensitivity analysis, was observed in PLR with patients showing higher PLR than HC.Conclusions: Our meta-analysis supports the hypothesis that an inflammatory activation occurs in non-affective psychosis and inflammatory ratios, especially NLR and MLR, may be useful to detect this activation.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Sara Lucchi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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Kim HA, Lee JW, Kim SJ, Oh HS, Im WY, Kim JW. Second-generation antipsychotics activate platelets in antipsychotic-naive and antipsychotic-free patients with schizophrenia: A retrospective study. Int J Psychiatry Med 2020; 55:105-113. [PMID: 31488003 DOI: 10.1177/0091217419874277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Among the risk factors for cerebrovascular/cardiovascular disease or thromboembolic events caused by the administration of second-generation antipsychotics, clinicians have mainly focused on metabolic side effects, with little interest in the effects on platelet activity. Because excessive platelet activity can increase the risk for cerebrovascular/cardiovascular disease, the aim of this study was to investigate the effect of second-generation antipsychotics on platelet activity in patients with schizophrenia. METHODS The medical records of patients with schizophrenia who were treated with second-generation antipsychotics were retrospectively reviewed. The degree of platelet activation was assessed by measuring the mean platelet component. RESULTS Wilcoxon signed-rank test revealed that mean platelet component levels were significantly decreased by the administration of second-generation antipsychotics (V = 20; p < 0.05), suggesting that the administration of second-generation antipsychotics may increase platelet activation. CONCLUSION Because platelet activation is an additional risk factor for the occurrence of cerebrovascular/cardiovascular disease, results of this study suggest that clinicians should carefully monitor the degree of platelet activation after the administration of second-generation antipsychotics.
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Affiliation(s)
- Hyun-Ah Kim
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Jong Wook Lee
- Department of Laboratory Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Seung Jun Kim
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Hong-Seok Oh
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Woo Young Im
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea
| | - Ji-Woong Kim
- Department of Psychiatry, College of Medicine, Konyang University, Daejeon, Republic of Korea.,Myunggok Medical Research Institute, College of Medicine, Konyang University, Daejeon, Republic of Korea
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Ludhiadch A, Muralidharan A, Balyan R, Munshi A. The molecular basis of platelet biogenesis, activation, aggregation and implications in neurological disorders. Int J Neurosci 2020; 130:1237-1249. [PMID: 32069430 DOI: 10.1080/00207454.2020.1732372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Platelets are anucleated blood constituents, vital for hemostasis and involved in the pathophysiology of several cardiovascular, neurovascular diseases as well as inflammatory processes and metastasis. Over the past few years, the molecular processes that regulate the function of platelets in hemostasis and thrombosis have emerged revealing platelets to be perhaps more complex than may have been expected. The most understood part of platelets is to respond to a blood vessel injury by altering shape, secreting granule contents, and aggregating. These responses, while advantageous for hemostasis, can become detrimental when they root ischemia or infarction. Only a few transcription and signaling factors involved in platelet biogenesis have been identified till date. Platelets encompass an astonishingly complete array of organelles and storage granules including mitochondria, lysosomes, alpha granules, dense granules, a dense tubular system (analogous to the endoplasmic reticulum of nucleated cells); a highly invaginated plasma membrane system known as the open canalicular system (OCS) and large fields of glycogen. Platelets as a model cells to study neurological disorders have been recommended by several researchers since several counterparts exist between platelets and the brain, which make them interesting for studying the neurobiology of various neurological disorders. This review has been compiled with an aim to integrate the latest research on platelet biogenesis, activation and aggregation focusing on the molecular pathways that power and regulate these processes. The dysregulation of important molecular players affecting fluctuating platelet biology and thereby resulting in neurovascular diseases has also been discussed.
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Affiliation(s)
- Abhilash Ludhiadch
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
| | - Abhishek Muralidharan
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
| | - Renuka Balyan
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
| | - Anjana Munshi
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab, India
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Hu J, Zhou W, Zhou Z, Han J, Dong W. Elevated neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict post-stroke depression with acute ischemic stroke. Exp Ther Med 2020; 19:2497-2504. [PMID: 32256727 PMCID: PMC7086204 DOI: 10.3892/etm.2020.8514] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
Post-stroke depression (PSD) is the most prevalent psychiatric complication of acute ischemic stroke. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are indicators of inflammation and are associated with stroke and depression. Therefore, the purpose of the present study was to examine the relationship between NLR/PLR and PSD. Retrospective analysis was carried out in 376 patients with first-ever acute ischemic stroke in the First Affiliated Yijishan Hospital of Wannan Medical College between March 2015 and September 2017. Patients were divided into PSD (n=104; 27.7%) and non-PSD (n=272; 72.3%) groups according to the Diagnostic and Statistical Manual of Mental Disorders-IV criteria at 6 months after stroke. Clinical data were collected retrospectively. NLR and PLR were acquired retrospectively from the routine blood tests performed at admission. A total of 120 healthy volunteers from the physical examination center in the First Affiliated Yijishan Hospital of Wannan Medical College were recruited as controls. Using logistic regression analysis, NLR (≥4.02) and PLR (≥203.74) were independently associated with PSD. NLR, odds ratio (OR) 3.926, 95% confidence intervals (CI, 2.365-7.947), P<0.001; PLR, OR 3.853, 95% CI (2.214-6.632), P=0.002. The ability of the combined index [area under the receiver operating characteristic curve, 0.701; 95% CI (0.622-0.780); P<0.001] to diagnose PSD was greater than that of either ratio alone. Higher NLRs and PLRs (≥4th quartile) were associated with PSD with a 5.79-fold (P<0.001) increase compared with lower levels of both. Higher NLRs and PLRs were found to be associated with depression 6 months after stroke, and the combined index was more meaningful than either alone in the early clinical detection of PSD.
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Affiliation(s)
- Jia Hu
- Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China.,Department of Neurology, The First Affiliated Hospital of Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Wei Zhou
- Department of Cardiovascular Surgery, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Zhiming Zhou
- Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Jian Han
- Department of Imaging Center, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Wanli Dong
- Department of Neurology, The First Affiliated Hospital of Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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40
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Vasilyeva EF, Brusov OS. [Platelets, hemostasis and mental disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:103-108. [PMID: 31851180 DOI: 10.17116/jnevro2019119111103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Platelets are an easily accessible model for the study of biochemical mechanisms of mental diseases, including schizophrenia and depression. This literature review addresses a role of platelet activation in the pathogenesis of mental diseases. Platelet activation observed in patients with schizophrenia, depression and other mental illnesses is associated with the development of cardiovascular disease and an increased risk of thrombotic complications, which can be the main cause of morbidity and mortality in patients with mental disorders. A deeper understanding of the biochemical mechanisms of mental disorders will help in the study of clinical consequences of these disorders and in choosing the right therapeutic strategy for patients.
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Affiliation(s)
| | - O S Brusov
- Mental Health Research Center, Moscow, Russia
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Brusov OS, Karpova NS, Faktor MI, Sizov SV, Oleichik IV. [Reduction of plasma procoagulant activity in patients with schizophrenia during pharmacotherapy: thrombodynamic parameters of coagulation before and after treatment]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:51-55. [PMID: 31793543 DOI: 10.17116/jnevro201911910151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM To detect plasma procoagulant activity in patients with schizophrenia at admission to the hospital in a state of exacerbation before (point 1) and after (point 2) pharmacotherapy and evaluate plasma and platelet hemostasis abnormalities. MATERIAL AND METHODS The study included 80 women, aged from 16 to 57 years, median age 28 years, with schizophrenia with continuous, paroxysmal-progressive or paroxysmal course (F20.00, F20.01, F20.02 according to ICD-10). In 42 of 80 patients, depressive disorders in the structure of schizophrenia were observed. The thrombodynamic test (TD) was performed on T-2 Trombodynamis device according to the manufacturer's instructions (Hemacore LLC, Moscow, Russia). Blood for the TD test was taken in admission to the hospital (point 1) and on discharge (point 2). All patients received standard pharmacotherapy according to their condition. RESULTS For the first time, it was established that in the whole group of patients (n=46) thrombodynamic indicators of the rate of growth of the clot: initial velocity (Vin), stationary velocity (Vst) and adjusted for spontaneous clots velocity (V) and the amount of clot for 30 minutes test TD (ClotSize, CS) were significantly higher compared to normal values. The mean time of occurrence of spontaneous thrombosis (Tsp) was significantly less than 30 min (p<0.0001), indicating rapid, spontaneous thrombosis. Other parameters of TD did not differ significantly from the norm. As a result of treatment, the initial growth rate of the clot from the activator (Vi) decreased from 58,5 μm/min to 54,5 μm/min; V speed from 37,4 μm/min to 33,5 μm/min; CS clot size from 1249 μm to 1219 μm; clot density - from 24 874 units up to 23 658 units. All these changes are significant. Such dynamics of plasma hemostasis clearly indicates a significant decrease in the coagulation activity of the blood plasma of patients as a result of treatment. An increase in the time of appearance of spontaneous clots after treatment (from 23.5 minutes to 30.5 minutes) indicates a decrease in the procoagulant activity of platelet microparticles after treatment, i.e. the reduction of platelet activation as a result of treatment. CONCLUSION Our studies have shown for the first time that treatment of patients with antidepressants and antipsychotics reduces the generation of spontaneous clots. The treatment of patients with schizophrenia is accompanied by a decrease in the activity of plasma and platelet hemostasis. This is of great practical importance, since hypercoagulation of spontaneous clots in schizophrenic patients aggravates their chronic inflammatory disorders and affects their resistance to treatment.
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Affiliation(s)
- O S Brusov
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - N S Karpova
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - M I Faktor
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - S V Sizov
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
| | - I V Oleichik
- Mental Health Research Center, Ministry of Science and Higher Education, Moscow, Russia
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Hu J, Zhou W, Zhou Z, Yang Q, Han J, Yan Y, Dong W. [Predictive value of inflammatory indicators for post-stroke depression in patients with ischemic stroke]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:665-671. [PMID: 31270044 DOI: 10.12122/j.issn.1673-4254.2019.06.06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the association of venous blood neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) and levels of interleukin-17 (IL-17) and IL-6 at 2 weeks after admission with the occurrence of post-stroke depression (PSD) in patients with first-ever acute ischemic stroke. METHODS The hospitalized patients with first-ever acute ischemic stroke were recruited consecutively from the Department of Neurology of Yijishan Hospital from March, 2015 to September, 2017. The demographic and baseline clinical data on admission and the imaging data were collected. The diagnosis of PSD was established in line with DSM-IV (SCID-I-R) at 3 months during the follow-up. The severity of PSD was assessed using the Hamilton Depression Scale (HAMD-17). Multivariate logistic regression analysis was used to investigate the correlation of NLR, PLR, IL-17, and IL-6 with PSD in these patients. RESULTS A total of 376 patients with acute ischemic stroke were enrolled, including 224 male patients (59.57%) and 152 female patients (40.43%), whose mean age was 61.37±10.34 years. Of these patients 104 (27.66%) were found to have PSD. Univariate analysis showed that gender, years of education, BMI, widowhood, NIHSS score, MMSE score, mRS score, and laboratory indexes (NLR, PLR, IL-17, and IL-6) were all significantly correlated with PSD (all P < 0.05). Multivariate logistic regression analysis showed that, after adjusting for the compounding factors, the third quartile of NLR (P < 0.001), the third quartile of PLR (P=0.002), IL-17 (P=0.025) and IL-6 (P=0.016) were independent factors that predicted the occurrence of PSD. CONCLUSIONS Elevated NLR and PLR at admission and levels of IL-17 and IL-6 at 2 weeks after admission are all independent predictors of the occurrence of PSD at 3 months after stroke.
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Affiliation(s)
- Jia Hu
- Department of Neurology, Yijishan Hospital, Wuhu 241001, China
| | - Wei Zhou
- Department of Cardiovascular Surgery, Yijishan Hospital, Wuhu 241001, China
| | - Zhiming Zhou
- Department of Neurology, Yijishan Hospital, Wuhu 241001, China
| | - Qian Yang
- Department of Neurology, Yijishan Hospital, Wuhu 241001, China
| | - Jian Han
- Imaging Center, Yijishan Hospital, Wuhu 241001, China
| | - Yan Yan
- Department of Neurology, Yijishan Hospital, Wuhu 241001, China
| | - Wanli Dong
- Department of Neurology, First Affiliated Hospital of Soochow University, Suzhou 215000, China
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Mazza MG, Tringali AGM, Rossetti A, Botti RE, Clerici M. Cross-sectional study of neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in mood disorders. Gen Hosp Psychiatry 2019; 58:7-12. [PMID: 30818102 DOI: 10.1016/j.genhosppsych.2019.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Neutrophil-lymphocyte, monocyte-lymphocyte and platelet-lymphocyte ratio are inexpensive and reproducible biomarkers of inflammation found to be elevated in mood disorders. This study aimed to compare inflammatory ratios between bipolar disorder and major depressive disorder and between bipolar disorder manic episodes and bipolar disorder depressive episodes. METHOD We included 142 Caucasian patients (major depressive disorder: n = 36; bipolar disorder manic episode: n = 66; bipolar disorder depressive episode: n = 40). We measured white blood cells, neutrophils, lymphocytes, monocytes, platelets, glucose, and total cholesterol. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio were calculated. RESULTS Neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio were significantly higher in bipolar disorder manic episodes when compared to bipolar disorder depressive episodes and major depressive disorder episodes after adjustment for age, sex, body mass index, and smoking. CONCLUSION To our knowledge, our study is the first one to compare inflammatory ratios between different bipolar disorder phases and major depressive disorder episodes. In accord with previous studies on other inflammatory mediators, we found higher neutrophil-lymphocyte and monocyte-lymphocyte ratios in bipolar manic episodes, suggesting that inflammatory changes occur especially during acute episodes of mania.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy.
| | | | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | | | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
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Aydin M, Cetin Ilhan B, Elmas TS, Cokunlu Y, Eren I. Şizofreni hastalarında ortalama trombosit hacminin değerlendirilmesi. FAMILY PRACTICE AND PALLIATIVE CARE 2018. [DOI: 10.22391/fppc.401101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2018. [PMID: 29535038 DOI: 10.1016/j.pnpbp.2018.03.012] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The immune and inflammatory system is involved in the etiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR and PLR in mood disorder. We identified 11 studies according to our inclusion criteria from the main Electronic Databases. Meta-analyses were carried out generating pooled standardized mean differences (SMDs) between index and healthy controls (HC). Heterogeneity was estimated. Relevant sensitivity and meta-regression analyses were conducted. Subjects with bipolar disorder (BD) had higher NLR and PLR as compared with HC (respectively SMD = 0.672; p < 0.001; I2 = 82.4% and SMD = 0.425; p = 0.048; I2 = 86.53%). Heterogeneity-based sensitivity analyses confirmed these findings. Subgroup analysis evidenced an influence of bipolar phase on the overall estimate whit studies including subjects in manic and any bipolar phase showing a significantly higher NLR and PLR as compared with HC whereas the effect was not significant among studies including only euthymic bipolar subjects. Meta-regression showed that age and sex influenced the relationship between BD and NLR but not the relationship between BD and PLR. Meta-analysis was not carried out for MLR because our search identified only one study when comparing BD to HC, and only one study when comparing MDD to HC. Subjects with major depressive disorder (MDD) had higher NLR as compared with HC (SMD = 0.670; p = 0.028; I2 = 89.931%). Heterogeneity-based sensitivity analyses and meta-regression confirmed these findings. Our meta-analysis supports the hypothesis that an inflammatory activation occurs in mood disorders and NLR and PLR may be useful to detect this activation. More researches including comparison of NLR, PLR and MLR between different bipolar phases and between BD and MDD are needed.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy.
| | - Sara Lucchi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | | | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Eugenia Rossana Botti
- Servizio Psichiatrico di Diagnosi e Cura, Ospedale di Desio, Azienda Socio Sanitaria Territoriale di Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
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Letmaier M, Grohmann R, Kren C, Toto S, Bleich S, Engel R, Gary T, Papageorgiou K, Konstantinidis A, Holl AK, Painold A, Kasper S. Venous thromboembolism during treatment with antipsychotics: Results of a drug surveillance programme. World J Biol Psychiatry 2018; 19:175-186. [PMID: 28112047 DOI: 10.1080/15622975.2017.1285048] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Venous thromboembolism (VTE) can be a life-threatening medical condition that may lead to leg swelling, respiratory distress and death. METHODS The AMSP (Arzneimittelsicherheit in der Psychiatrie) is a continuous multicentre drug surveillance programme that assesses severe adverse drug reactions during treatment of psychiatric inpatients. We report on a total of 264,422 inpatients who were treated with antipsychotics (APs) and monitored from 1993 to 2011 in 99 psychiatric hospitals. RESULTS During this period VTE events were reported for 89 inpatients, corresponding to an occurrence rate of 34 cases per 100,000 inpatient admissions treated with APs or 43 cases per 10,000 person-years. The occurrence of VTE was greatest in patients over the age of 65 years of age with mood disorders. The chemical class of butyrophenones (48/100,000) followed by atypical APs (36/100,000) showed the highest occurrence rate for VTE compared to thioxanthenes (23/100,000), which were less associated with VTE. If imputed alone, pipamperone (61/100,000) and risperidone (55/100,000) were most frequently associated with VTE. In general, there was no difference in occurrence rate of VTE between high- and low-potency APs. CONCLUSIONS These results suggest that clinicians should consider AP drug exposure as a potential risk factor for VTE for patients older than 65 years. Additionally, the diagnosis of an affective disorder seems to increase the risk for VTE.
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Affiliation(s)
- Martin Letmaier
- a Department of Psychiatry , Medical University of Graz , Graz , Austria
| | - Renate Grohmann
- b Department of Psychiatry , Ludwig-Maximilians-University , Munich , Germany
| | | | - Sermin Toto
- d Department of Psychiatry, Social Psychiatry and Psychotherapy , Hannover Medical School , Hannover , Germany
| | - Stefan Bleich
- d Department of Psychiatry, Social Psychiatry and Psychotherapy , Hannover Medical School , Hannover , Germany
| | - Rolf Engel
- b Department of Psychiatry , Ludwig-Maximilians-University , Munich , Germany
| | - Thomas Gary
- e Department of Angiology , Medical University of Graz , Graz , Austria
| | - Konstantinos Papageorgiou
- f Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry , Medical University of Vienna , Vienna , Austria
| | - Anastasios Konstantinidis
- f Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry , Medical University of Vienna , Vienna , Austria
| | | | - Annamaria Painold
- a Department of Psychiatry , Medical University of Graz , Graz , Austria
| | - Siegfried Kasper
- f Department of Psychiatry and Psychotherapy, Division of Biological Psychiatry , Medical University of Vienna , Vienna , Austria
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Affiliation(s)
- Brian R Branchford
- Section of Hematology/Oncology/Bone Marrow Transplant, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO .,Center for Cancer and Blood Disorders, Children's Hospital Colorado, Aurora, CO.,University of Colorado Hemophilia and Thrombosis Center, Aurora, CO
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Gylvin SH, Jørgensen CC, Fink-Jensen A, Johansson PI, Kehlet H. Psychopharmacologic treatment and blood transfusion in fast-track total hip and knee arthroplasty. Transfusion 2017; 57:971-976. [DOI: 10.1111/trf.13992] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/15/2016] [Accepted: 11/15/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Silas Hinsch Gylvin
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
| | - Christoffer Calov Jørgensen
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
| | - Anders Fink-Jensen
- Psychiatric Centre Copenhagen and Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology; University of Copenhagen; Copenhagen Denmark
| | - Pär I. Johansson
- Department of Clinical Immunology; Rigshospitalet; Copenhagen Denmark
- Department of Surgery; University of Texas Health Medical School; Houston Texas
- Capital Region Blood Bank; Rigshospitalet; Copenhagen Denmark
| | - Henrik Kehlet
- Section of Surgical Pathophysiology; Rigshospitalet; Copenhagen Denmark
- Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty; Aarhus Denmark
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