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Davyson E, Shen X, Gadd DA, Bernabeu E, Hillary RF, McCartney DL, Adams M, Marioni R, McIntosh AM. Metabolomic Investigation of Major Depressive Disorder Identifies a Potentially Causal Association With Polyunsaturated Fatty Acids. Biol Psychiatry 2023; 94:630-639. [PMID: 36764567 PMCID: PMC10804990 DOI: 10.1016/j.biopsych.2023.01.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Metabolic differences have been reported between individuals with and without major depressive disorder (MDD), but their consistency and causal relevance have been unclear. METHODS We conducted a metabolome-wide association study of MDD with 249 metabolomic measures available in the UK Biobank (n = 29,757). We then applied two-sample bidirectional Mendelian randomization and colocalization analysis to identify potentially causal relationships between each metabolite and MDD. RESULTS A total of 191 metabolites tested were significantly associated with MDD (false discovery rate-corrected p < .05), which decreased to 129 after adjustment for likely confounders. Lower abundance of omega-3 fatty acid measures and a higher omega-6 to omega-3 ratio showed potentially causal effects on liability to MDD. There was no evidence of a causal effect of MDD on metabolite levels. Furthermore, genetic signals associated with docosahexaenoic acid colocalized with loci associated with MDD within the fatty acid desaturase gene cluster. Post hoc Mendelian randomization of gene-transcript abundance within the fatty acid desaturase cluster demonstrated a potentially causal association with MDD. In contrast, colocalization analysis did not suggest a single causal variant for both transcript abundance and MDD liability, but rather the likely existence of two variants in linkage disequilibrium with one another. CONCLUSIONS Our findings suggest that decreased docosahexaenoic acid and increased omega-6 to omega-3 fatty acids ratio may be causally related to MDD. These findings provide further support for the causal involvement of fatty acids in MDD.
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Affiliation(s)
- Eleanor Davyson
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Xueyi Shen
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Danni A Gadd
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Elena Bernabeu
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Robert F Hillary
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Daniel L McCartney
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Riccardo Marioni
- Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom; Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, United Kingdom.
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Sırlıer Emir B, Yıldız S, Kazgan Kılıçaslan A, Kılıçarslan G, Kurt O, Korkmaz S, Atmaca M. Evaluation of Arterial Stiffness in Depression Patients. ALPHA PSYCHIATRY 2023; 24:193-199. [PMID: 38105785 PMCID: PMC10724755 DOI: 10.5152/alphapsychiatry.2023.221099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/19/2023] [Indexed: 12/19/2023]
Abstract
Background It has been known that there is a significant correlation between depression and cardiovascular diseases. However, the reasons behind this correlation that could affect mortality and morbidity were not fully identified. The present study aimed to analyze arterial stiffness diagnosed with ultrasonography, which could be associated with cardiovascular disease risks in depression patients, and to compare the findings with those of healthy controls. Methods The study was conducted with 35 depression patients and 35 healthy individuals. Routine complete blood and biochemistry tests were requested for all patients, and their weight and height, waist circumference, and diastolic and systolic arterial blood pressure were measured. Femoral and carotid artery intima-media thickness and other arterial stiffness parameters were determined with Doppler ultrasonography. Results It was determined that the systolic pressure (P = .028) was higher in the patient group (P = .028). Also, the carotid elastic modulus (P = .048) was significantly higher in the patient group. A negative and significant correlation was determined between femoral compliance and chlorpromazine equivalent dose (P = .021, r = -0.389). Conclusion It was determined that the systolic blood pressure and carotid elastic modulus arterial stiffness parameters were significantly higher in depression patients. Measurable arterial stiffness parameters should be investigated in depression patients as cardiovascular risk markers. Furthermore, the determination of the effects of psychotropic drugs employed in arterial stiffness treatment could play an important role in the determination of cardiovascular disease risk in these patients.
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Affiliation(s)
- Burcu Sırlıer Emir
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Sevler Yıldız
- Department of Psychiatry, University of Binali Yıldırım, Erzincan, Turkey
| | | | - Gülhan Kılıçarslan
- Department of Psychiatry, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - Osman Kurt
- Department of Public Health, Adıyaman Provincial Health Directorate, Adıyaman, Turkey
| | - Sevda Korkmaz
- Department of Psychiatry, University of Fırat, Elazığ, Turkey
| | - Murad Atmaca
- Department of Psychiatry, University of Fırat, Elazığ, Turkey
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Sharifan P, Darroudi S, Rafiee M, Toussi MSE, Sedgh Doust FN, Taghizadeh N, Fazl Mashhadi MR, Ghazizadeh H, Mohammadi MA, Dabagh AE, Ebrahimian AR, Yousefi M, Esmaily H, Ferns GA, Soflaei SS, Ghayour-Mobarhan M. Association of dietary and blood inflammatory indicators with depression, anxiety, and stress in adults with vitamin D deficiency. Int J Geriatr Psychiatry 2023; 38:e5972. [PMID: 37539817 DOI: 10.1002/gps.5972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND There is growing evidence that vitamin D may be related to mental health. The aim of the current study was to investigate the association of dietary and blood inflammatory factors with mental health disorders in subjects with vitamin D deficiency, shedding further light on the complex interplay of these conditions. METHOD In this cross-sectional study, 306 subjects completed the validated Depression, Anxiety, and Stress Scale questionnaire to evaluate their depression, anxiety, and stress scores. Dietary inflammatory index (DII) and healthy eating index (HEI) were calculated using a validated 65-item food frequency questionnaire. Blood samples were taken and vitamin D, cytokine, and hs-CRP levels were measured using enzyme-linked immunosorbent assay kits. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) were calculated using standard laboratory methods. RESULTS The subjects were divided into two groups based on their vitamin D levels: a vitamin D < 20 μg/dl group (N = 257) and a vitamin D ≥ 20 μg/dl group (N = 49). Between group analysis revealed that only DII (p = 0.015), platelet (p = 0.04), and hs-CRP (p = 0.015) were significantly different. In adults with vitamin D levels below 20 μg/dl, NLR and DII were significantly higher in subjects with anxiety (p < 0.05), and this relationship remained significant only for NLR after adjusting for age and sex. Additionally, PLR and HEI were significantly different in depressed compared to non-depressed subjects, and this association remained significant only for HEI after adjusting for age and sex. CONCLUSION In subjects with vitamin D deficiency, increased levels of PLR, NLR, and DII were associated with depression and anxiety, while HEI was negatively associated with depression. These associations were not found in subjects with vitamin D levels ≥20 μg/dl.
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Affiliation(s)
- Payam Sharifan
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Rafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Niloofar Taghizadeh
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | | | - Hamideh Ghazizadeh
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Ebrahimi Dabagh
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Yousefi
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Sara Saffar Soflaei
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Sobolewska-Nowak J, Wachowska K, Nowak A, Orzechowska A, Szulc A, Płaza O, Gałecki P. Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases. Biomedicines 2023; 11:1903. [PMID: 37509542 PMCID: PMC10377477 DOI: 10.3390/biomedicines11071903] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/11/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.
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Affiliation(s)
| | - Katarzyna Wachowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Artur Nowak
- Department of Immunopathology, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Orzechowska
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
| | - Agata Szulc
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Olga Płaza
- Psychiatric Clinic of the Faculty of Health Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Piotr Gałecki
- Department of Adult Psychiatry, Medical Univeristy of Lodz, 90-419 Lodz, Poland
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Guillen-Burgos H, Moreno-Lopez S, Acevedo-Vergara K, Pérez-Florez M, Pachón-Garcia C, Gálvez-Flórez JF. Risk of childhood trauma exposure and severity of bipolar disorder in Colombia. Int J Bipolar Disord 2023; 11:7. [PMID: 36763206 PMCID: PMC9918651 DOI: 10.1186/s40345-023-00289-5] [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: 09/21/2022] [Accepted: 02/01/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) is higher in developing countries. Childhood trauma exposure is a common environmental risk factor in Colombia and might be associated with a more severe course of bipolar disorder in Low-Middle Income-Countries. We carried out the first case-control study in Colombia using a structural clinical interview and the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to describe the prevalence and association between trauma exposure during childhood with a severe course of illness (early age onset, rapid cycling, ideation or suicide attempt, or ≥ 3 hospitalization) in a sample of BD patients. RESULTS A total of 114 cases and 191 controls evaluated showed the following results. Cases included 61.4% BD type I and 38.6% BD type II. The median age was 31.5 years (IQR, 75-24) for BD patients and 31 years old (IQR, 38-24) for healthy controls. A higher prevalence of childhood trauma was evidenced in cases compared to controls. Emotional abuse, physical abuse, sexual abuse, physical neglect and emotional neglect evidenced a strong association with severe bipolar disorder (OR = 3.42, p < .001; OR = 4.68, p < .001; OR = 4.30, p = .003; OR = 5.10, p < .001; OR = 5.64, p < .001, respectively). CONCLUSIONS This is the first association study between childhood trauma exposure as a higher risk for a severe course of illness in BD patients in Colombian. Our findings highlight the higher prevalence of childhood trauma in bipolar patients and the strong association of childhood trauma with severe bipolar disorder. These findings are relevant for screening and evaluating childhood trauma exposure during the course of BD patients.
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Affiliation(s)
- Hernán Guillen-Burgos
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia. .,School of Health Science, Universidad Simon Bolivar, Carrera 54 No 64-222, Barranquilla, Colombia. .,Instituto Cardiovascular del Cesar, Valledupar, Colombia.
| | - Sergio Moreno-Lopez
- grid.7247.60000000419370714School of Medicine, Universidad de Los Andes, Bogotá, Colombia ,Otolaryngology and Allergology Research Group, Unidad Médico Quirúrgica de Otorrinolaringología (UNIMEQ‐ORL), Bogotá, Colombia
| | - Kaleb Acevedo-Vergara
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Manuel Pérez-Florez
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Catherine Pachón-Garcia
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia
| | - Juan Francisco Gálvez-Flórez
- Center for Clinical and Translational Research, La Misericordia Clinica Internacional, Barranquilla, Colombia ,Zerenia Clinics, Bogotá, Colombia ,Latin American Society of Liaison Psychiatry (SOLAPSIQUE), Bogotá, Colombia
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Ringin E, Meyer D, Neill E, Phillipou A, Tan EJ, Toh WL, Sumner PJ, Owen N, Hallgren M, Dunstan DW, Rossell SL, Van Rheenen TE. Psychological-health correlates of physical activity and sedentary behaviour during the COVID pandemic. Ment Health Phys Act 2022; 23:100481. [PMID: 36406837 PMCID: PMC9664206 DOI: 10.1016/j.mhpa.2022.100481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/04/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND While physical inactivity is associated with adverse psychological outcomes, less is known about the psychological outcomes associated with sedentary behaviour, and specifically, its mentally active and passive forms. The COVID-19 pandemic represents a unique opportunity to study associations between these variables in light of widespread stay-at-home mandates and restrictions on outdoor exercise/social activities. Using a cross-sectional dataset acquired during the COVID-19 pandemic in Australia, we examined whether physical activity and sedentary behaviour were associated with subjective quality of life (sQoL) and subjective cognitive dysfunction, and whether these associations were mediated by depressive symptoms. METHODS 658 participants (males = 169, females = 489) self-reported data on physical activity and sedentary behaviour in an online survey during May 2020-May 2021. Data on physical activity and sedentary behaviour (both mentally active and passive types) was compared according to whether it was collected during or out of a lockdown period. Regression models were used to test associations of physical activity and sedentary behaviour with sQoL and subjective cognitive dysfunction, and whether these associations were mediated by depression severity. RESULTS Physical activity was beneficially associated with sQoL, whereas sedentary behaviour (both total hours and the reduction of mentally active/increase in mentally passive behaviour) was detrimentally associated with sQoL. These associations were mediated by depression severity. Physical activity and sedentary behaviour were also indirectly associated with subjective cognitive dysfunction by virtue of their associations with depression severity. CONCLUSIONS There are important differences in the psychological correlates of mentally passive and active sedentary behaviours. Our findings suggest that health promotion strategies should focus on not only increasing physical activity but also reducing passive sedentary behaviours as a means of maintaining good psychological health.
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Affiliation(s)
- Elysha Ringin
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
| | - Denny Meyer
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Erica Neill
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
- St Vincent's Mental Health, St Vincent's Hospital, Victoria, Australia
| | - Andrea Phillipou
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
- Department of Mental Health, Austin Hospital, Melbourne, Victoria, Australia
| | - Eric J Tan
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
- St Vincent's Mental Health, St Vincent's Hospital, Victoria, Australia
| | - Wei Lin Toh
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Philip J Sumner
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
| | - Neville Owen
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use and Social Environment (EPiCSS), Department of Global Public Health Sciences, Karolinska Institutet, Stockholm, 171 77, Sweden
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Susan L Rossell
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
- St Vincent's Mental Health, St Vincent's Hospital, Victoria, Australia
| | - Tamsyn E Van Rheenen
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Melbourne, Australia
- Centre for Mental Health, School of Health Sciences, Swinburne University, Melbourne, Australia
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Stapp EK, Paksarian D, He JP, Glaus J, Conway KP, Merikangas KR. Mood and anxiety profiles differentially associate with physical conditions in US adolescents. J Affect Disord 2022; 299:22-30. [PMID: 34838604 DOI: 10.1016/j.jad.2021.11.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Mood and anxiety are widely associated with physical conditions, but research and treatment are complicated by their overlap, clinical heterogeneity, and manifestation on a spectrum rather than as discrete disorders. In contrast to previous work relying on threshold-level disorders, we examined the association between empirically-derived profiles of mood and anxiety syndromes with physical conditions in a nationally-representative sample of US adolescents. METHODS Participants were 2,911 adolescents (aged 13-18) from the National Comorbidity Survey-Adolescent Supplement who provided information on physical conditions and reported at least one lifetime mood-anxiety 'syndrome' based on direct interviews with the Composite International Diagnostic Interview Version 3.0. Mood-anxiety syndromes reflected 3-level ratings from subthreshold to severe distress/impairment, and subtyped mood episodes. Stepwise latent profile analysis identified mood-anxiety profiles and tested associations with physical conditions. RESULTS Three mood-anxiety profiles were identified: "Mood-GAD" (25.6%)-non-atypical depression, mania, generalized anxiety; "Atypical-Panic" (11.3%)-atypical depression, panic; and "Reference" (63.1%)-lower mood and anxiety except specific phobia. Headaches were more prevalent in Mood-GAD and Atypical-Panic than Reference (47.9%, 50.1%, and 37.7%, respectively; p=0.011). Heart problems were more common in Mood-GAD than Atypical-Panic (7.4% v 2.2%, p=0.004) and Reference, with back/neck pain more prevalent in Mood-GAD than Reference (22.5% v 15.3%, p=0.016). LIMITATIONS Broad categories of physical conditions without information on specific diagnoses; replication regarding specificity is recommended. CONCLUSIONS Heart problems and pain-related conditions were differentially associated with specific mood-anxiety profiles. Subtyping depression and anxiety-inclusive of subthreshold syndromes-and their patterns of clustering may facilitate etiologic and intervention work in multimorbidity.
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Affiliation(s)
- Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jian-Ping He
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Jennifer Glaus
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA; Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Kevin P Conway
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA.
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Mikhaylov AY, Yumashev AV, Kolpak E. Quality of life, anxiety and depressive disorders in patients with extrasystolic arrhythmia. Arch Med Sci 2022; 18:328-335. [PMID: 35316917 PMCID: PMC8924838 DOI: 10.5114/aoms.2020.101359] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 08/13/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The aim of this study was to perform a comparative and economic analysis of the degree of development of anxiety-depressive disorder in patients with different types of extrasystolic arrhythmia using different assessment scales. MATERIAL AND METHODS The study was conducted in 2018-2019 at the premises of clinic No. 4, involving 450 patients (Moscow, Russia). Patients were divided into three groups: with coronary heart disease (CHD) (147 patients), with myocardiodystrophy (MCD) (113) and with cardiopsychoneurosis (CPN) (190). Everyone underwent round-the-clock electrocardiography (ECG) and echocardiography. If symptoms of depressive disorder are detected in a timely manner, the risk of adverse cardiovascular diseases may be reduced. RESULTS Depression and anxiety indicators on all three scales differed significantly (p ≤ 0.05) in patients with supraventricular extrasystole (more than 40 points on the Zung scale, 14 points on the Montgomery-Asberg depression scale, more than 38 points on Zung and 3 points on Covi anxiety scales). For patients with ventricular extrasystole, a significant difference was established between groups 1 and 2 only in terms of the level of depression on the Zung scale. Factors of psychogenic origin determine the development of cardiac rhythm disturbances. CONCLUSIONS The study showed that for supraventricular extrasystoles, these factors determine the overall health of the patient. The differences between the three groups are significant on all scales of depression and anxiety (p ≤ 0.05). The most susceptible to depression and anxiety are patients with extrasystolic arrhythmias diagnosed with CHD, as well as MCD.
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Affiliation(s)
- Alexey Y. Mikhaylov
- Financial Research Institute of the Ministry of Finance of the Russian Federation, Moscow, Russia
| | - Alexei V. Yumashev
- Department of Prosthetic Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Eugeny Kolpak
- Department of Applied Mathematics and Control Process, Saint Petersburg State University, Saint Petersburg, Russia
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MacLellan A, Fureix C, Polanco A, Mason G. Can animals develop depression? An overview and assessment of ‘depression-like’ states. BEHAVIOUR 2021. [DOI: 10.1163/1568539x-bja10132] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Abstract
Describing certain animal behaviours as ‘depression-like’ or ‘depressive’ has become common across several fields of research. These typically involve unusually low activity or unresponsiveness and/or reduced interest in pleasure (anhedonia). While the term ‘depression-like’ carefully avoids directly claiming that animals are depressed, this narrative review asks whether stronger conclusions can be legitimate, with animals developing the clinical disorder as seen in humans (cf., DSM-V/ICD-10). Here, we examine evidence from animal models of depression (especially chronically stressed rats) and animals experiencing poor welfare in conventional captive conditions (e.g., laboratory mice and production pigs in barren environments). We find troubling evidence that animals are indeed capable of experiencing clinical depression, but demonstrate that a true diagnosis has yet to be confirmed in any case. We thus highlight the importance of investigating the co-occurrence of depressive criteria and discuss the potential welfare and ethical implications of animal depression.
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Affiliation(s)
- Aileen MacLellan
- Department of Integrative Biology, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Carole Fureix
- Bristol Veterinary School, University of Bristol, Langford, UK
| | - Andrea Polanco
- Department of Integrative Biology, University of Guelph, Guelph, ON, Canada N1G 2W1
| | - Georgia Mason
- Department of Integrative Biology, University of Guelph, Guelph, ON, Canada N1G 2W1
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Baroni C, Lionetti V. The impact of sex and gender on heart-brain axis dysfunction: current concepts and novel perspectives. Can J Physiol Pharmacol 2021; 99:151-160. [PMID: 33002366 DOI: 10.1139/cjpp-2020-0391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The heart-brain axis (HBA) recapitulates all the circuits that regulate bidirectional flow of communication between heart and brain. Several mechanisms may underlie the interdependent relationship involving heterogeneous tissues at rest and during specific target organ injury such as myocardial infarction, heart failure, arrhythmia, stroke, mood disorders, or dementia. In-depth translational studies of the HBA dysfunction under single-organ injury should include both male and female animals to develop sex- and gender-oriented prevention, diagnosis, and treatment strategies. Indeed, sex and gender are determining factors as females and males exhibit significant differences in terms of susceptibility to risk factors, age of onset, severity of symptoms, and outcome. Despite most studies having focused on the male population, we have conducted a careful appraisal of the literature investigating HBA in females. In particular, we have (i) analyzed sex-related heart and brain illnesses, (ii) recapitulated the most significant studies simultaneously conducted on cardio- and cerebro-vascular systems in female populations, and (iii) hypothesized future perspectives for the development of a gender-based approach to HBA dysfunction. Although sex- and gender-oriented research is at its infancy, the impact of sex on HBA dysfunction is opening unexpected new avenues for managing the health of female subjects exposed to risk of lifestyle multi-organ disease.
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Affiliation(s)
- Carlotta Baroni
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Vincenzo Lionetti
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- UOS Anesthesiology and Intensive Care Medicine, Fondazione Toscana G. Monasterio, Pisa, Italy
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Giurgi-Oncu C, Tudoran C, Enatescu VR, Tudoran M, Pop GN, Bredicean C. Evolution of Heart Rate Variability and Heart Rate Turbulence in Patients with Depressive Illness Treated with Selective Serotonin Reuptake Inhibitors. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E590. [PMID: 33167574 PMCID: PMC7694481 DOI: 10.3390/medicina56110590] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/16/2022]
Abstract
Background and objectives: Major depressive disorder (MDD) and cardiovascular diseases (CVDs) represent serious and prevalent medical conditions. Autonomic nervous system (ANS) dysfunctions, expressed by parameters of heart rate variability (HRV) and heart rate turbulence (HRT), have been repeatedly associated with depression. The aim of our study was to identify potential HRV and HRT alterations in patients with MDD, before and after selective serotonin reuptake inhibitor (SSRI) therapy, and to observe any correlations between these parameters and the severity of depressive symptoms. Another aim was to evidence if there was a normalization or improvement of HRV and HRT parameters that paralleled the reduction of the intensity of depressive symptoms. Materials and Methods: We studied heart rate variability (HRV) and heart rate turbulence (HRT) in a sample of 78 patients, aged under 51 years, who were referred to our outpatient clinic between June 2017 and December 2019, for complaints in the context of a new onset major depressive disorder (MDD), before and after therapy with SSRIs. Results: By using 24 h Holter ECG monitoring, we evidenced alterations of HRV and HRT parameters, significantly correlated with the severity of depressive symptoms (p < 0.001), as assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS). Our results indicated that these parameters improved following one and six months of SSRI therapy, when a partial or total remission of depressive symptoms was achieved (p < 0.001). Changes in HRV parameters were correlated with the reduction of the severity of depression. Conclusions: In our study group, we highlighted, through 24 h ECG Holter monitoring, frequent and clear HRV and HRT abnormalities that were statistically correlated with the severity of depressive symptoms. Furthermore, we were able to document a progressive improvement of these parameters, which corresponded with the improvement of depressive symptoms under SSRI therapy, when compared to the values measured before the commencement of antidepressant pharmacotherapy.
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Affiliation(s)
- Catalina Giurgi-Oncu
- Discipline of Psychiatry, Department of Neuroscience, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (C.G.-O.); (V.R.E.); (C.B.)
| | - Cristina Tudoran
- Discipline of Cardiology, Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (M.T.); (G.N.P.)
| | - Virgil Radu Enatescu
- Discipline of Psychiatry, Department of Neuroscience, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (C.G.-O.); (V.R.E.); (C.B.)
| | - Mariana Tudoran
- Discipline of Cardiology, Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (M.T.); (G.N.P.)
| | - Gheorghe Nicusor Pop
- Discipline of Cardiology, Department VII, Internal Medicine II, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (M.T.); (G.N.P.)
| | - Cristina Bredicean
- Discipline of Psychiatry, Department of Neuroscience, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Place Nr. 2, 300041 Timis, Romania; (C.G.-O.); (V.R.E.); (C.B.)
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Tobaldini E, Carandina A, Toschi-Dias E, Erba L, Furlan L, Sgoifo A, Montano N. Depression and cardiovascular autonomic control: a matter of vagus and sex paradox. Neurosci Biobehav Rev 2020; 116:154-161. [DOI: 10.1016/j.neubiorev.2020.06.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 05/13/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
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Haussleiter IS, Neumann E, Lorek S, Ueberberg B, Juckel G. Role of child maltreatment and gender for bipolar symptoms in young adults. Int J Bipolar Disord 2020; 8:10. [PMID: 32115670 PMCID: PMC7049538 DOI: 10.1186/s40345-019-0173-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/16/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Child maltreatment has been shown to be associated with a wide range of mental disorders, including bipolar disorders. In this 2-year follow-up study, recollections of emotional, physical and sexual abuse were related to bipolar symptoms, namely depressive, hypomanic and manic symptoms. METHODS The sample consists of 134 students who took part at five measurement times within the 2-year period. Data were collected with self-report scales. RESULTS The results show that recollections of abuse, particularly emotional abuse, were associated with more severe depressive symptoms; this finding, however, only applied to women. Hypomanic and manic symptoms were not associated with recollections of abuse. For hypomanic symptoms, however, a significant decrease over the 2 years was observed. CONCLUSIONS The findings of this study suggest that recollections of abusive experiences in childhood combined with female gender increase the risk for depression, whereas hypomanic and manic states are probably better predicted by other factors, such as current life circumstances.
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Affiliation(s)
- Ida S Haussleiter
- Research Institute for Mental Health, Ruhr-University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany.,Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital Bochum, Bochum, Germany
| | - Eva Neumann
- Research Institute for Mental Health, Ruhr-University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany.
| | - Sandra Lorek
- Research Institute for Mental Health, Ruhr-University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany
| | - Bianca Ueberberg
- Research Institute for Mental Health, Ruhr-University Bochum, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791, Bochum, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr-University Bochum, LWL-University Hospital Bochum, Bochum, Germany
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15
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Iseger TA, van Bueren NE, Kenemans JL, Gevirtz R, Arns M. A frontal-vagal network theory for Major Depressive Disorder: Implications for optimizing neuromodulation techniques. Brain Stimul 2020; 13:1-9. [DOI: 10.1016/j.brs.2019.10.006] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/30/2019] [Accepted: 10/08/2019] [Indexed: 12/22/2022] Open
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Choi KW, Jeon HJ. Heart Rate Variability for the Prediction of Treatment Response in Major Depressive Disorder. Front Psychiatry 2020; 11:607. [PMID: 32695031 PMCID: PMC7339656 DOI: 10.3389/fpsyt.2020.00607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/11/2020] [Indexed: 11/13/2022] Open
Abstract
Major depressive disorder (MDD) is one of the disabling diseases in the world-wide, and known to increase cardiac morbidity and mortality. Therefore, previous studies related heart rate variability (HRV) have been conducted to evaluate and diagnose MDD, and to predict treatment outcomes in patient with MDD. We reviewed extensively on the previous peer-reviewed publications associated with this issue, using Pub-Med. In this review article, we introduce the basic concept of HRV and HRV measures, and present several important findings associated with diagnosis and treatment prediction in MDD with using HRV parameters. Furthermore, we discuss the possible underlying mechanism of this phenomenon, and suggest several considerations for the future research.
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Affiliation(s)
- Kwan Woo Choi
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - Hong Jin Jeon
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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Almeida J, Oliveira LA, Benini R, Crestani CC. Role of hippocampal nitrergic neurotransmission in behavioral and cardiovascular dysfunctions evoked by chronic social stress. Nitric Oxide 2020; 94:114-124. [DOI: 10.1016/j.niox.2019.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 11/18/2019] [Accepted: 11/18/2019] [Indexed: 12/21/2022]
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Mental Health in the Workplace: A Call to Action Proceedings From the Mental Health in the Workplace-Public Health Summit. J Occup Environ Med 2019; 60:322-330. [PMID: 29280775 DOI: 10.1097/jom.0000000000001271] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to declare a call to action to improve mental health in the workplace. METHODS We convened a public health summit and assembled an Advisory Council consisting of experts in the field of occupational health and safety, workplace wellness, and public policy to offer recommendations for action steps to improve health and well-being of workers. RESULTS The Advisory Council narrowed the list of ideas to four priority projects. CONCLUSIONS The recommendations for action include developing a mental health in the workplace (1) "how to" guide, (2) scorecard, (3) recognition program, and (4) executive training.
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Abstract
PURPOSE OF REVIEW Breathlessness debilitates countless people with a wide range of common diseases. For some people, the experience of breathlessness is poorly explained by the findings of medical tests. This disparity complicates diagnostic and treatment options and means that disease-modifying treatments do not always have the expected effect upon symptoms. These observations suggest that brain processing of respiratory perceptions may be somewhat independent of disease processes. This may help to explain the dissonance observed in some patients between physical disease markers and the lived experience of breathlessness. RECENT FINDINGS A body of breathlessness research using functional neuroimaging has identified a relatively consistent set of brain areas that are associated with breathlessness. These areas include the insula, cingulate and sensory cortices, the amygdala and the periaqueductal gray matter. We interpret these findings in the context of new theories of perception that emphasize the importance of distributed brain networks. Within this framework, these perceptual networks function by checking an internal model (a set of expectations) against peripheral sensory inputs, instead of the brain acting as a passive signal transducer. Furthermore, other factors beyond the physiology of breathlessness can influence the system. SUMMARY A person's expectations and mood are major contributors to the function of the brain networks that generate perceptions of breathlessness. Breathlessness, therefore, arises from inferences made by the brain's integration of both expectations and sensory inputs. By better understanding individual differences across these contributing perceptual factors, we will be better poised to develop targeted and individualized treatments for breathlessness that could complement disease-modifying therapies.
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Affiliation(s)
- Lucy L. Marlow
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Olivia K. Faull
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - Sarah L. Finnegan
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Kyle T.S. Pattinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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20
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Wei J, Hou R, Zhang X, Xu H, Xie L, Chandrasekar EK, Ying M, Goodman M. The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis. Br J Psychiatry 2019; 215:449-455. [PMID: 30968781 DOI: 10.1192/bjp.2019.74] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Late-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.AimTo estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults. METHOD We conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings. RESULTS A total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression. CONCLUSION Late-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.Declaration of interestNone.
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Affiliation(s)
- Jingkai Wei
- Department of Epidemiology,Gillings School of Global Public Health,University of North Carolina at Chapel Hill,USA
| | - Ruixue Hou
- Department of Nutrition,Gillings School of Global Public Health,University of North Carolina at Chapel Hill,USA
| | | | - Huiwen Xu
- Department of Public Health Sciences,School of Medicine and Dentistry,University of Rochester,USA
| | - Liyang Xie
- Department of Health Services Administration,School of Public Health,University of Maryland,USA
| | | | - Meiling Ying
- PhD Student,Department of Public Health Sciences,School of Medicine and Dentistry,University of Rochester,USA
| | - Michael Goodman
- Professor of Epidemiology,Department of Epidemiology,Rollins School of Public Health,Emory University,USA
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Social Support, Unstable Angina, and Stroke as Predictors of Depression in Patients With Coronary Heart Disease. J Cardiovasc Nurs 2019; 33:179-186. [PMID: 28489724 DOI: 10.1097/jcn.0000000000000419] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Depression is known to adversely affect coronary heart disease patients in western countries; however, no study of social support and depression has been conducted in the Chinese population. OBJECTIVE The aim of this study was to investigate the predictors of depression in patients with coronary heart disease. METHODS Between January and December 2015, a cross-sectional sample of 105 Taiwanese patients from cardiology units completed a demographic and clinical characteristics questionnaire, Enhancing Recovery in Coronary Heart Disease Social Support Inventory, and Patient Health Questionnaire-9. RESULTS Thirty-nine percent of the participants reported low social support, and 61.0% had depression symptoms. Eight factors predicted depression. Social support was significantly and adversely correlated with depression (r = -.481, P < .01). The other 7 factors were positively correlated with depression: age (r = .212, P < .05), reported monthly income of less than US $600 (F = 4.98, P = .001), lack of exercise (F = 3.75, P = .027), history of stroke (t = -2.45, P = .016) and kidney disease (t = -2.41, P = .018), unstable angina (F = 3.56, P = .031), and groin puncture (F = 3.27, P = .042). A hierarchical regression model explained 43.7% of the variance in depression. CONCLUSION Social support, unstable angina, and stroke may be important predictors of depression in patients with coronary heart disease. These findings help clinical staff to understand physical and mental health problems in cardiovascular patients. Thus, we suggest that early depression prediction and sufficient social support can help patients to face their disease and thus improve depression and health care quality.
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Selohilwe O, Bhana A, Garman EC, Petersen I. Evaluating the role of levels of exposure to a task shared depression counselling intervention led by behavioural health counsellors: outcome and process evaluation. Int J Ment Health Syst 2019; 13:42. [PMID: 31198438 PMCID: PMC6556962 DOI: 10.1186/s13033-019-0299-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 05/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background In the context of a large treatment gap for common mental disorders (CMDs) and shortage of mental health specialists in low- and middle-income countries, there is increasing evidence of the effectiveness of task sharing of counselling interventions to increase access to mental health care for CMDs at primary health care level. This study evaluated the relationship between levels of exposure to a task-shared counselling intervention and psychosocial outcomes (depression, functional disability, internalised stigma and social support) in chronic care service users with comorbid depression in South Africa guided by the Medical Research Council process evaluation framework. Implementation and participant-level factors that promote greater exposure were also investigated. Method The study design was a cohort study comprising of 173 participants referred by primary health care nurses for the task-shared counselling intervention. The study site comprised four primary health care facilities in a sub-district of the Dr. Kenneth Kaunda district in the North West Province of South Africa. The participants were assessed for psychosocial outcomes at three time points: baseline, 3 months and at 12 months. The number of counselling sessions each participant was exposed to was collected for each participant. Linear regression models were used to test the influence of counselling exposure on each of the psychosocial variables between baseline and endline. In-depth qualitative interviews were conducted on 29 randomly selected participants, stratified according to exposure to counselling sessions, and analysed using framework analysis. Findings Findings from the cohort study indicated a significant reduction in depression severity at 12 months. Internalised stigma and functional disability improved from baseline to endline. Participants receiving 5-8 sessions have the greatest reduction in PHQ9 scores from baseline to endline (β = - 2.46, 95% CI - 5.06 to 0.15) compared to those with 0 sessions (β = - 0.51, 95% CI - 3.62 to 2.60, p = 0.064). The WHODAS scores decreased significantly more from baseline to endline among those who received 5-8 sessions (β = - 10.73, 95% CI - 19.86 to 1.59) compared to those with 0 sessions (β = 2.25, 95% CI - 8.65 to 13.14, p = 0.021). No significant differences as a function of levels of counselling exposure from baseline to endline was observed for OSS-3 scores. An improvement in ISMI scores from 1-4 sessions to 5-8 sessions was found (β = - 4.05, 95% CI - 7.30 to - 0.80, p = 0.015). The qualitative process evaluation indicated that the service was acceptable and accessible; but that session attendance was hindered by women's' caregiving burden, poor counsellor attributes and poor referral processes. Conclusion Exposure to a greater number of sessions (5-8 sessions) was found to optimize functional ability, reduce stigma, and potentially reduce depression symptoms. In order to enhance session attendance, lay counsellor delivered psychosocial interventions need to pay attention to (i) counsellor selection criteria, particularly person-centred care qualities; and (ii) strengthening referral processes in contexts where mental health literacy is low.
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Affiliation(s)
- One Selohilwe
- 1Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Arvin Bhana
- 1Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa.,2Health Systems Research Unit, South African Medical Research Council, Durban, South Africa
| | - Emily C Garman
- 3Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Inge Petersen
- 1Centre for Rural Health, School of Nursing and Public Health and School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
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Vloet TD, Jans T, Frey A, Häußler M, Vloet A, Geissler J, Susewind M, von Dobschütz B, Frantz S, Romanos M. Mean Heart Rate and Parameters of Heart Rate Variability in Depressive Children and the Effects of Antidepressant Medication. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2019; 47:253-260. [PMID: 30971175 DOI: 10.1024/1422-4917/a000672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction: Researchers have repeatedly discovered an association between depression and autonomic cardiac dysregulation in adults. However, corresponding data concerning minors are still rare. Method: For this exploratory, cross-sectional study, we included N = 43 minors (age range 9-17 years). The subjects were depressive subjects with or without antidepressant medication (N = 23) or healthy control children (HC) (N = 20). We assessed several indices of cardiac functioning using long-term electrocardiogram data (mean heart rate, HR, and several parameters of heart rate variability, HRV). We hypothesized that increased HR and reduced HRV are associated with depressive disorders. Furthermore, we assessed the impact of age, sex, and antidepressant medication on HR and HRV. Results: When sex and age were controlled for, HR was significantly increased in depressive minors compared to HC. However, our preliminary data suggest that this might not be the case in medicated patients, and there were no differences between groups regarding HRV parameters. There was no significant correlation in the whole sample between severity of depression and both HR and HRV. In the subsample of patients with depression, antidepressant medication was associated with lower HR and higher indices of HRV. Conclusion: The data indicate an association between depression and altered autonomic cardiac regulation, which can already manifests in minors.
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Affiliation(s)
- Timo D Vloet
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany.,a First authors
| | - Thomas Jans
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany.,a First authors
| | - Anna Frey
- 2 Department of Internal Medicine I, University Hospital, Würzburg, Germany
| | - Marie Häußler
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Andrea Vloet
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Julia Geissler
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Moritz Susewind
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | | | - Stefan Frantz
- 2 Department of Internal Medicine I, University Hospital, Würzburg, Germany
| | - Marcel Romanos
- 1 Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
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Chan KL, Cathomas F, Russo SJ. Central and Peripheral Inflammation Link Metabolic Syndrome and Major Depressive Disorder. Physiology (Bethesda) 2019; 34:123-133. [PMID: 30724127 PMCID: PMC6586832 DOI: 10.1152/physiol.00047.2018] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/04/2018] [Accepted: 12/05/2018] [Indexed: 01/16/2023] Open
Abstract
Metabolic syndrome and major depression are two of the most common and debilitating disorders worldwide, occurring with significant rates of comorbidity. Recent studies have uncovered that each of these conditions is associated with chronic, low-grade inflammation. This is characterized by increased circulating pro-inflammatory cytokines, altered leukocyte population frequencies in blood, accumulation of immune cells in tissues including the brain, and activation of these immune cells. Cytokines that become elevated during obesity can contribute to the progression of metabolic syndrome by directly causing insulin resistance. During chronic stress, there is evidence that these cytokines promote depression-like behavior by disrupting neurotransmitter synthesis and signal transduction. Animal models of obesity and depression have revealed a bi-directional relationship whereby high-fat feeding and chronic stress synergize and exacerbate metabolic dysregulation and behavioral abnormalities. Although far from conclusive, emerging evidence suggests that inflammation in the central and peripheral immune system may link metabolic syndrome to major depressive disorder. In this review, we will synthesize available data supporting this view and identify critical areas for future investigation.
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Affiliation(s)
- Kenny L Chan
- Department of Neuroscience, Center for Affective Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York
| | - Flurin Cathomas
- Department of Neuroscience, Center for Affective Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York
| | - Scott J Russo
- Department of Neuroscience, Center for Affective Neuroscience, and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai , New York
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25
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Hasselmann H, Gamradt S, Taenzer A, Nowacki J, Zain R, Patas K, Ramien C, Paul F, Wingenfeld K, Piber D, Gold SM, Otte C. Pro-inflammatory Monocyte Phenotype and Cell-Specific Steroid Signaling Alterations in Unmedicated Patients With Major Depressive Disorder. Front Immunol 2018; 9:2693. [PMID: 30532752 PMCID: PMC6265986 DOI: 10.3389/fimmu.2018.02693] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/31/2018] [Indexed: 12/21/2022] Open
Abstract
Several lines of evidence have strongly implicated inflammatory processes in the pathobiology of major depressive disorder (MDD). However, the cellular origin of inflammatory signals and their specificity remain unclear. We examined the phenotype and glucocorticoid signaling in key cell populations of the innate immune system (monocytes) vs. adaptive immunity (T cells) in a sample of 35 well-characterized, antidepressant-free patients with MDD and 35 healthy controls individually matched for age, sex, smoking status and body mass index. Monocyte and T cell phenotype was assessed by flow cytometry. Cell-specific steroid signaling was determined by mRNA expression of pre-receptor regulation (11β-hydroxysteroid dehydrogenase type 1; 11β -HSD1), steroid receptor expression [glucocorticoid receptor (GR) and mineralocorticoid receptor (MR)], and the downstream target glucocorticoid-induced leucine-zipper (GILZ). We also collected salivary cortisol samples (8:00 a.m. and 10:00 p.m.) on two consecutive days. Patients showed a shift toward a pro-inflammatory phenotype characterized by higher frequency and higher absolute numbers of non-classical monocytes. No group differences were observed in major T cell subset frequencies and phenotype. Correspondingly, gene expression indicative of steroid resistance (i.e., lower expression of GR and GILZ) in patients with MDD was specific to monocytes and not observed in T cells. Monocyte phenotype and steroid receptor expression was not related to cortisol levels or serum levels of IL-6, IL-1β, or TNF-α. Our results thus suggest that in MDD, cells of the innate and adaptive immune system are differentially affected with shifts in monocyte subsets and lower expression of steroid signaling related genes.
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Affiliation(s)
- Helge Hasselmann
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefanie Gamradt
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Aline Taenzer
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Nowacki
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Rami Zain
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Kostas Patas
- Institut für Neuroimmunologie und Multiple Sklerose, (INIMS), Zentrum für Molekulare Neurobiologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Caren Ramien
- Institut für Neuroimmunologie und Multiple Sklerose, (INIMS), Zentrum für Molekulare Neurobiologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, (NCRC), Charité - Universitätsmedizin Berlin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité Universitätsmedizin Berlin, Berlin, Germany.,Klinik für Neurologie, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Katja Wingenfeld
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Dominique Piber
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan M Gold
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institut für Neuroimmunologie und Multiple Sklerose, (INIMS), Zentrum für Molekulare Neurobiologie, Universitätsklinikum Hamburg Eppendorf, Hamburg, Germany.,Medizinische Klinik m.S. Psychosomatik, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Otte
- Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Cardiac and behavioral effects of social isolation and experimental manipulation of autonomic balance. Auton Neurosci 2018; 214:1-8. [PMID: 30177218 DOI: 10.1016/j.autneu.2018.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 08/03/2018] [Accepted: 08/14/2018] [Indexed: 12/15/2022]
Abstract
Improved understanding of how depression and social isolation interact to increase cardiac morbidity and mortality will improve public health. This experiment evaluated the effect of pharmacological autonomic blockade on cardiac and behavioral reactivity following social isolation in prairie voles. Experiment 1 validated the dose and time course of pharmacological autonomic antagonism of peripheral β-adrenergic (atenolol) and muscarinic cholinergic receptors (atropine methyl nitrate), and Experiment 2 used a novel protocol to investigate behavioral responses in the tail suspension test during pharmacological autonomic blockade as a function of social isolation (vs. paired control). Prairie voles isolated for 4 weeks (vs. paired) displayed significantly elevated heart rate and reduced heart rate variability. Autonomic receptor antagonism by atenolol led to exaggerated reductions in heart rate and standard deviation of normal-to-normal intervals, and lower amplitude of respiratory sinus arrhythmia in the isolated group (vs. paired). Administration of atropine led to an attenuated increase in heart rate in the isolated group (vs. paired), and similar near-zero levels of respiratory sinus arrhythmia amplitude in both groups. During the tail suspension test, isolated animals (vs. paired) displayed significantly greater immobility. In paired animals, atenolol administration did not influence immobility; atropine administration increased the duration of immobility (vs. vehicle). In isolated animals, atenolol administration increased the duration of immobility; atropine did not influence immobility duration (vs. vehicle). The current study contributes to our understanding of differential effects of social isolation and autonomic imbalance on cardiac and behavioral reactivity.
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Wu PY, Lin MY, Tsai PS. Alternate healthy eating index and risk of depression: A meta-analysis and systemematic review. Nutr Neurosci 2018; 23:101-109. [PMID: 29804517 DOI: 10.1080/1028415x.2018.1477424] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Objective: The alternate healthy eating index has been associated with depression. However, results reported in the literature are inconsistent. The present meta-analysis determined the association between the AHEI or AHEI-2010 and depression in adults without chronic disease.Methods: Nine electronic databases and the reference lists of identified studies were systematically searched for studies published up to December 2016. Articles examining the association between depression and the AHEI or AHEI-2010 in adults were included.Results: We identified eight observational studies with 10 effect sizes involving a total of 38,360 participants. When both the AHEI and AHEI-2010 were considered, the dietary index score was associated with a significant reduction in depression risk (odds ratio OR=0.70, 95% confidence interval CI=0.57-0.87). However, the subgroup analysis indicated that the AHEI-2010 (OR=0.69, 95% CI=0.56-0.89), but not the AHEI (OR=0.60, 95% CI=0.30-1.17), was significantly associated with reduced odds of depression. The heterogeneity among the included studies was significantly high (Q=48.9, P<0.01, I2=81.60%).Discussion: Our findings suggest that the AHEI-2010 is associated with a reduction in depression risk. However, well-designed randomized controlled trials must be conducted to confirm the causal relationship between the AHEI-2010 and depression.
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Affiliation(s)
- Pei-Yu Wu
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
| | - Mei-Yu Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
| | - Pei-Shan Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taiwan 250 Wu-Hsing St., Taipei 110, Taipei, Taiwan
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Rueda MA. Depresión en la mujer. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2017.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Sahafi E, Peeri M, Hosseini MJ, Azarbyjani MA. Cardiac oxidative stress following maternal separation stress was mitigated following adolescent voluntary exercise in adult male rat. Physiol Behav 2018; 183:39-45. [DOI: 10.1016/j.physbeh.2017.10.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 10/17/2017] [Accepted: 10/19/2017] [Indexed: 12/27/2022]
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Grippo AJ. Opinion: "Heart Rate Variability, Health and Well-Being: A Systems Perspective" Research Topic. Front Public Health 2017; 5:246. [PMID: 28993803 PMCID: PMC5622597 DOI: 10.3389/fpubh.2017.00246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 01/06/2023] Open
Affiliation(s)
- Angela J Grippo
- Department of Psychology, Northern Illinois University, DeKalb, IL, United States
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Murphy MO, Loria AS. Sex-specific effects of stress on metabolic and cardiovascular disease: are women at higher risk? Am J Physiol Regul Integr Comp Physiol 2017; 313:R1-R9. [PMID: 28468942 DOI: 10.1152/ajpregu.00185.2016] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 04/18/2017] [Accepted: 04/28/2017] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease (CVD) has traditionally been viewed as a male disease; however, the relative risk for obesity and hypertension morbidity and mortality, major risk factors for CVD, is higher for women in the United States. Emerging epidemiological data strongly support stressful experiences as a modifiable risk factor for obesity, insulin resistance, and heart disease in women at all ages. Therefore, primary prevention of these diseases may be associated with both identifying and increasing the knowledge regarding the sex differences in emotional functioning associated with physiological responses to stress. The purpose of this review is to highlight the growing body of clinical and experimental studies showing that stress, obesity-associated metabolic disturbances, and CVD comorbidities are more prevalent in females. Overall, this review reveals the need for investigations to decipher the early origins of these comorbidities. Targeting the sources of behavioral/emotional stress through the trajectory of life has the potential to reduce the alarming projected rates for chronic disease in women.
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Affiliation(s)
- Margaret O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
| | - Analia S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, Kentucky
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Murphy MO, Cohn DM, Loria AS. Developmental origins of cardiovascular disease: Impact of early life stress in humans and rodents. Neurosci Biobehav Rev 2017; 74:453-465. [PMID: 27450581 PMCID: PMC5250589 DOI: 10.1016/j.neubiorev.2016.07.018] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 02/07/2023]
Abstract
The Developmental Origins of Health and Disease (DOHaD) hypothesizes that environmental insults during childhood programs the individual to develop chronic disease in adulthood. Emerging epidemiological data strongly supports that early life stress (ELS) given by the exposure to adverse childhood experiences is regarded as an independent risk factor capable of predicting future risk of cardiovascular disease. Experimental animal models utilizing chronic behavioral stress during postnatal life, specifically maternal separation (MatSep) provides a suitable tool to elucidate molecular mechanisms by which ELS increases the risk to develop cardiovascular disease, including hypertension. The purpose of this review is to highlight current epidemiological studies linking ELS to the development of cardiovascular disease and to discuss the potential molecular mechanisms identified from animal studies. Overall, this review reveals the need for future investigations to further clarify the molecular mechanisms of ELS in order to develop more personalized therapeutics to mitigate the long-term consequences of chronic behavioral stress including cardiovascular and heart disease in adulthood.
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Affiliation(s)
- M O Murphy
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - D M Cohn
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States
| | - A S Loria
- Department of Pharmacology and Nutritional Sciences, University of Kentucky, Lexington, KY, United States.
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Finnell JE, Lombard CM, Padi AR, Moffitt CM, Wilson LB, Wood CS, Wood SK. Physical versus psychological social stress in male rats reveals distinct cardiovascular, inflammatory and behavioral consequences. PLoS One 2017; 12:e0172868. [PMID: 28241050 PMCID: PMC5328366 DOI: 10.1371/journal.pone.0172868] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/12/2017] [Indexed: 01/22/2023] Open
Abstract
Repeated exposure to social stress can precipitate the development of psychosocial disorders including depression and comorbid cardiovascular disease. While a major component of social stress often encompasses physical interactions, purely psychological stressors (i.e. witnessing a traumatic event) also fall under the scope of social stress. The current study determined whether the acute stress response and susceptibility to stress-related consequences differed based on whether the stressor consisted of physical versus purely psychological social stress. Using a modified resident-intruder paradigm, male rats were either directly exposed to repeated social defeat stress (intruder) or witnessed a male rat being defeated. Cardiovascular parameters, behavioral anhedonia, and inflammatory cytokines in plasma and the stress-sensitive locus coeruleus were compared between intruder, witness, and control rats. Surprisingly intruders and witnesses exhibited nearly identical increases in mean arterial pressure and heart rate during acute and repeated stress exposures, yet only intruders exhibited stress-induced arrhythmias. Furthermore, re-exposure to the stress environment in the absence of the resident produced robust pressor and tachycardic responses in both stress conditions indicating the robust and enduring nature of social stress. In contrast, the long-term consequences of these stressors were distinct. Intruders were characterized by enhanced inflammatory sensitivity in plasma, while witnesses were characterized by the emergence of depressive-like anhedonia, transient increases in systolic blood pressure and plasma levels of tissue inhibitor of metalloproteinase. The current study highlights that while the acute cardiovascular responses to stress were identical between intruders and witnesses, these stressors produced distinct differences in the enduring consequences to stress, suggesting that witness stress may be more likely to produce long-term cardiovascular dysfunction and comorbid behavioral anhedonia while exposure to physical stressors may bias the system towards sensitivity to inflammatory disorders.
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Affiliation(s)
- Julie E Finnell
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Calliandra M Lombard
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Akhila R Padi
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Casey M Moffitt
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - L Britt Wilson
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Christopher S Wood
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
| | - Susan K Wood
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina School of Medicine, Columbia, South Carolina, United States of America
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Impact of concomitant medication use on myocardial 123I-mIBG imaging results in patients with heart failure. Nucl Med Commun 2017; 38:141-148. [DOI: 10.1097/mnm.0000000000000619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Peacock BN, Scheiderer DJ, Kellermann GH. Biomolecular aspects of depression: A retrospective analysis. Compr Psychiatry 2017; 73:168-180. [PMID: 28006716 DOI: 10.1016/j.comppsych.2016.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 11/05/2016] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The effects of psychological stress, oxidative stress, and chronic low grade inflammation on the neuro-immune connection have been implicated in the pathogenesis of depression. Thus, in the recent past, there has been a growing effort in determining the mechanism of this pathogenesis. While attempting to map out, this mechanism researchers and clinicians have searched for clinically relevant biomarkers for use in the diagnosis and for the assessment of those suffering from depression. In this study, we have performed a retrospective analysis of biomarkers with clinically relevant potentials, including peripheral catecholamines, chemokines, cytokines, and neurotransmitters. METHODS The retrospective analysis was performed on data collected over a six-year period of time (July 2009 to July 2015), gathered from patients (N=1399; Mage=42, SD=13; 71% female, 29% male) who submitted samples with complaints of feeling hopeless, worthless, isolated, alone, general sadness, overwhelmed, and/or a lack of interest in things they once enjoyed. The data collected consisted of quantitative values of urinary catecholamines and neurotransmitters (peripheral dopamine, epinephrine, histamine, kynurenic acid, norepinephrine, β-PEA, and serotonin), salivary hormones (peripheral cortisol and melatonin), and peripheral blood mononuclear cell secreted cytokines and chemokines (Interleukins 1β, 6, 8, 10, MCP-1, GCSF, and TNFα). Statistical and clinical significance was assessed by comparison with a control group (N=2395; Mage=42, SD=13; 70% female, 30% male), calculating the percent mean difference, p value, and effect size (Cohen's ɗ) for each parameter between groups. RESULTS The findings of this study suggested that, in a model of general depression, there is a dysregulation in the enzymatic production and degradation of catecholamines, neurotransmitters, hormones, and immunological proteins. A cycle of interaction was found between all of these biomolecules, where an increase or decrease in one marker could result in a stimulatory or inhibitory effect on others. The mechanism of this was proposed to occur through the interaction of psychological stress, inflammation, and oxidative stress pathways. All of these biomolecules were found to be significantly altered in the general depression group and are key components of the interaction between the neurological and immunological systems. CONCLUSIONS This study serves to further elucidate the role of biomolecules in the regulation of affective disorders, such as depression. Resulting in providing a network of clinically relevant biomarkers to objectively assess and monitor general depression.
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May HT, Bair TL, Reiss-Brennan B, Knight S, Anderson JL, Horne BD, Brunisholz KD, Muhlestein JB. The association of antidepressant and statin use with death and incident cardiovascular disease varies by depression severity. PSYCHOL HEALTH MED 2017; 22:919-931. [DOI: 10.1080/13548506.2017.1281975] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Heidi T. May
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
| | - Tami L. Bair
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
| | | | - Stacey Knight
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeffrey L. Anderson
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Benjamin D. Horne
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | - Joseph B. Muhlestein
- Intermountain Medical Center, Intermountain Heart Institute, Murray, UT, USA
- Department of Medicine, University of Utah, Salt Lake City, UT, USA
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Wong MFF. Factors associated with anxiety and depression among patients with implantable cardioverter defibrillator. J Clin Nurs 2016; 26:1328-1337. [PMID: 27859926 DOI: 10.1111/jocn.13637] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To identify factors associated with anxiety and depression of patients with implantable cardioverter defibrillators. BACKGROUND Implantable cardioverter defibrillator is effective to increase survival from life-threatening arrhythmias, but it lowers health-related quality of life. Anxiety and depression had significant negative association with health-related quality of life. However, knowledge about factors associated with these two negative emotions in this specific population is inadequate. DESIGN A cross-sectional descriptive design was conducted. Secondary analysis was performed to address the aim. METHODS A convenience sampling of patients with implantable cardioverter defibrillators was performed. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale through face-to-face interview. RESULTS Stepwise multivariable regression results showed that older age (aged 60-69 and ≥70: B = 2·08 and 3·31, p = 0·039 and <0·001), self-care dependence (B = 3·47, p < 0·001), being married (B = -2·21, p = 0·004) and having ischaemic heart disease (B = -1·80, p = 0·008) were significantly associated with depression. However, there was no significant factor associated with anxiety. CONCLUSIONS Factors associated with depression among patients with implantable cardioverter defibrillator are identified. Older age (aged ≥60) and more self-care dependence have positive, but being married and having ischaemic heart disease have negative association with depression. Strategies to reduce psychological distress are highlighted. RELEVANCE TO CLINICAL PRACTICE The study findings direct the care to improve health-related quality of life by reducing and controlling vulnerabilities arising from depression. Patients who are older people (≥aged 60) and more self-care dependent perceive higher depression. Nursing strategies are suggested to reduce depression especially for those who are older people and more self-care dependent. Early screening is essential to provide immediate care for reducing vulnerabilities arising from depression. Performing comprehensive assessment for self-care ability and providing adequate assistance are crucial. Family involvement may reduce depression through providing physical and psychosocial support.
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Affiliation(s)
- Mei Fung Florence Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China
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Shi M, Liu L, Wang ZY, Wang L. Prevalence of depressive symptoms and its correlations with positive psychological variables among Chinese medical students: an exploratory cross-sectional study. BMC Psychiatry 2016; 16:3. [PMID: 26754773 PMCID: PMC4707780 DOI: 10.1186/s12888-016-0710-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/08/2016] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Knowledge about the prevalence of depressive symptoms among Chinese medical students and its related factors is rather limited. Understanding the correlates of depressive symptoms and the roles that positive psychological variables play in depressive symptoms is of vital importance for future interventions. The main objectives of this study were to investigate the prevalence of depressive symptoms and the integrated effects of resilience, hope and optimism on depressive symptoms among Chinese medical students. METHODS This multi-center cross-sectional study was conducted in June 2014. The questionnaires that consisted of the Center for Epidemiologic Studies Depression Scale (CES-D), Wagnild and Young Resilience Scale-14 (RS-14), Adult Dispositional Hope Scale (ADHS), Life Orientation Test-Revised (LOT-R), and socio-demographic characteristics, were distributed to students at four medical colleges or universities in Liaoning province, China. A total of 2925 medical students became the final subjects. Hierarchical linear regression analyses were used to explore the integrated effects of resilience, hope and optimism on depressive symptoms. RESULTS The prevalence of depressive symptoms among Chinese medical students was 66.8 % (CES-D ≥ 16). Resilience, hope and optimism were all negatively correlated with depressive symptoms and they accounted for 26.1 % of the variance in depressive symptoms. CONCLUSIONS The high prevalence of depressive symptoms among Chinese medical students calls for special attention from all stakeholders, especially university authorities. Intervention strategies that focus on enhancing the positive psychological variables of resilience, hope and optimism can be integrated into depression prevention and treatment programs.
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Affiliation(s)
- Meng Shi
- Department of English, School of Fundamental Sciences, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Li Liu
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Zi Yue Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
| | - Lie Wang
- Department of Social Medicine, School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning, PR China.
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Granville Smith I, Parker G, Rourke P, Cvejic E, Vollmer-Conna U. Acute coronary syndrome and depression: A review of shared pathophysiological pathways. Aust N Z J Psychiatry 2015. [PMID: 26219293 DOI: 10.1177/0004867415597304] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To examine the evidence for shared pathophysiological pathways in acute coronary syndrome and major depression and to conceptualise the dynamic interplay of biological systems and signalling pathways that link acute coronary syndrome and depression within a framework of neuro-visceral integration. METHODS Relevant articles were sourced via a search of published literature from MEDLINE, EMBASE and PubMed using a variety of search terms relating to biological connections between acute coronary syndrome and depression. Additional articles from bibliographies of retrieved papers were assessed and included where relevant. RESULTS Despite considerable research efforts, a clear understanding of the biological processes connecting acute coronary syndrome and depression has not been achieved. Shared abnormalities are evident across the immune, platelet/endothelial and autonomic/stress-response systems. From the available evidence, it seems unlikely that a single explanatory model could account for the complex interactions of biological pathways driving the pathophysiology of these disorders and their comorbidity. CONCLUSION A broader conceptual framework of mind-body or neuro-visceral integration that can incorporate the existence of several causative scenarios may be more useful in directing future research and treatment approaches for acute coronary syndrome-associated depression.
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Affiliation(s)
- Isabelle Granville Smith
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Gordon Parker
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Poppy Rourke
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Erin Cvejic
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Uté Vollmer-Conna
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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Anagnostopoulos A, Ledergerber B, Jaccard R, Shaw SA, Stoeckle M, Bernasconi E, Barth J, Calmy A, Berney A, Jenewein J, Weber R. Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS). PLoS One 2015; 10:e0140943. [PMID: 26492488 PMCID: PMC4619594 DOI: 10.1371/journal.pone.0140943] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 09/30/2015] [Indexed: 11/28/2022] Open
Abstract
Objectives We studied the incidence and prevalence of, and co-factors for depression in the Swiss HIV Cohort Study. Methods Depression-specific items were introduced in 2010 and prospectively collected at semiannual cohort visits. Clinical, laboratory and behavioral co-factors of incident depression among participants free of depression at the first two visits in 2010 or thereafter were analyzed with Poisson regression. Cumulative prevalence of depression at the last visit was analyzed with logistic regression. Results Among 4,422 participants without a history of psychiatric disorders or depression at baseline, 360 developed depression during 9,348 person-years (PY) of follow-up, resulting in an incidence rate of 3.9 per 100 PY (95% confidence interval (CI) 3.5–4.3). Cumulative prevalence of depression during follow-up was recorded for 1,937/6,756 (28.7%) participants. Incidence and cumulative prevalence were higher in injection drug users (IDU) and women. Older age, preserved work ability and higher physical activity were associated with less depression episodes. Mortality (0.96 per 100 PY, 95% CI 0.83–1.11) based upon 193 deaths over 20,102 PY was higher among male IDU (2.34, 1.78–3.09), female IDU (2.33, 1.59–3.39) and white heterosexual men (1.32, 0.94–1.84) compared to white heterosexual women and homosexual men (0.53, 0.29–0.95; and 0.71, 0.55–0.92). Compared to participants free of depression, mortality was slightly elevated among participants with a history of depression (1.17, 0.94–1.45 vs. 0.86, 0.71–1.03, P = 0.033). Suicides (n = 18) did not differ between HIV transmission groups (P = 0.50), but were more frequent among participants with a prior diagnosis of depression (0.18 per 100 PY, 95%CI 0.10–0.31; vs. 0.04, 0.02–0.10; P = 0.003). Conclusions Depression is a frequent co-morbidity among HIV-infected persons, and thus an important focus of care.
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Affiliation(s)
- Alexia Anagnostopoulos
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Bruno Ledergerber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - René Jaccard
- Independent Researcher, HIV Practitioner, Zurich, Switzerland
| | - Susy Ann Shaw
- Division of Infectious Diseases, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Marcel Stoeckle
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
| | - Enos Bernasconi
- Division of Infectious Diseases, Regional Hospital Lugano, Lugano, Switzerland
| | - Jürgen Barth
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Alexandra Calmy
- Division of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland
| | - Alexandre Berney
- Psychiatry Liaison Service, Lausanne University Hospital, Lausanne, Switzerland
| | - Josef Jenewein
- Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Zurich, Switzerland
| | - Rainer Weber
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
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Depressive Symptom Frequency and Prevalence of Cardiovascular Diseases—Analysis of Patients in the National Health and Nutrition Examination Survey. Am J Ther 2015; 22:382-7. [DOI: 10.1097/mjt.0000000000000043] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Banikazemi Z, Mokhber N, Safarian M, Mazidi M, Mirzaei H, Esmaily H, Azarpazhooh MR, Ghafouri-Taleghani F, Ghayour-Mobarhan M, Ferns GA. Dietary vitamin E and fat intake are related to Beck's depression score. Clin Nutr ESPEN 2015; 10:e61-e65. [PMID: 28531460 DOI: 10.1016/j.clnesp.2014.12.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 11/28/2014] [Accepted: 12/11/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE There is a high prevalence of depressive disorders in all regions of the world. The importance of dietary factors in the causation of depression is suggested from epidemiologic studies in Western countries, but evidence from non-Western populations are lacking. We aimed to assess the relationship between dietary factors with depression scores in a cohort from north eastern Iran. METHODS A total of 7172 subjects (2725 men and 4447 women) were recruited. Dietary intake was assessed using a 24-h dietary recall questionnaire, and depressive symptoms were assessed using the Beck's depression questionnaire. RESULTS The age of the population samples were 49.3 ± 8.2 years for the male and 48.1 ± 8.0 years for the female subgroups. Crude intake of MUFA, SFA and TFA in patients was associated with depression scores. On the other hand, there were significant correlations between depression score and total energy adjusted intake of trans-fatty acid (TFA), cholesterol, vitamin E (p < 0.01 for all parameters). CONCLUSION There was an association between diet and depression score among a representative sample of individuals from north eastern Iran, with MUFA intake being inversely related, and vitamin E intake being directly related to Beck's depression score. However it cannot be determined whether this is related to the causation of depression in this cross sectional study.
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Affiliation(s)
- Zarrin Banikazemi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Naghmeh Mokhber
- Departemant of Psychiatrics, Faculty of Medicine, Psychiatric Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Safarian
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mohsen Mazidi
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Hamed Mirzaei
- Department of Medical Biotechnology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran; Department of Statistics, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Mahmoud Reza Azarpazhooh
- Cardiovascular Research Center, Faculty of Medicine, MUMS, Azadi Square, Pardise Daneshgah, Mashhad, Iran
| | - Fatemeh Ghafouri-Taleghani
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- Biochemistry of Nutrition Research Center, School of Medicine, Mashhad University of Medical Science, Mashhad, Iran; Cardiovascular Research Center, Faculty of Medicine, MUMS, Azadi Square, Pardise Daneshgah, Mashhad, Iran.
| | - Gordon A Ferns
- Division of Medical Education, Brighton & Sussex Medical School, Rm 342, Mayfield House, University of Brighton, BN1 9PH, United Kingdom
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Harshaw C. Interoceptive dysfunction: toward an integrated framework for understanding somatic and affective disturbance in depression. Psychol Bull 2015; 141:311-363. [PMID: 25365763 PMCID: PMC4346391 DOI: 10.1037/a0038101] [Citation(s) in RCA: 170] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Depression is characterized by disturbed sleep and eating, a variety of other nonspecific somatic symptoms, and significant somatic comorbidities. Why there is such close association between cognitive and somatic dysfunction in depression is nonetheless poorly understood. An explosion of research in the area of interoception-the perception and interpretation of bodily signals-over the last decade nonetheless holds promise for illuminating what have until now been obscure links between the social, cognitive-affective, and somatic features of depression. This article reviews rapidly accumulating evidence that both somatic signaling and interoception are frequently altered in depression. This includes comparative studies showing vagus-mediated effects on depression-like behaviors in rodent models as well as studies in humans indicating both dysfunction in the neural substrates for interoception (e.g., vagus, insula, anterior cingulate cortex) and reduced sensitivity to bodily stimuli in depression. An integrative framework for organizing and interpreting this evidence is put forward which incorporates (a) multiple potential pathways to interoceptive dysfunction; (b) interaction with individual, gender, and cultural differences in interoception; and (c) a developmental psychobiological systems perspective, emphasizing likely differential susceptibility to somatic and interoceptive dysfunction across the lifespan. Combined with current theory and evidence, it is suggested that core symptoms of depression (e.g., anhedonia, social deficits) may be products of disturbed interoceptive-exteroceptive integration. More research is nonetheless needed to fully elucidate the relationship between mind, body, and social context in depression.
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Almeida J, Duarte JO, Oliveira LA, Crestani CC. Effects of nitric oxide synthesis inhibitor or fluoxetine treatment on depression-like state and cardiovascular changes induced by chronic variable stress in rats. Stress 2015; 18:462-74. [PMID: 26068517 DOI: 10.3109/10253890.2015.1038993] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Comorbidity between mood disorders and cardiovascular disease has been described extensively. However, available antidepressants can have cardiovascular side effects. Treatment with selective inhibitors of neuronal nitric oxide synthase (nNOS) induces antidepressant effects, but whether the antidepressant-like effects of these drugs are followed by cardiovascular changes has not been previously investigated. Here, we tested in male rats exposed to chronic variable stress (CVS) the hypothesis that nNOS blockers are advantageous compared with conventional antidepressants in terms of cardiovascular side effects. We compared the effects of chronic treatment with the preferential nNOS inhibitor 7-nitroindazole (7-NI) with those evoked by the conventional antidepressant fluoxetine on alterations that are considered as markers of depression (immobility in the forced swimming test, FST, decreased body weight gain and increased plasma corticosterone concentration) and cardiovascular changes caused by CVS. Rats were exposed to a 14-day CVS protocol, while being concurrently treated daily with either 7-NI (30 mg/kg) or fluoxetine (10 mg/kg). Fluoxetine and 7-NI prevented the increase in immobility in the FST induced by CVS and reduced plasma corticosterone concentration in stressed rats. Both these treatments also prevented the CVS-evoked reduction of the depressor response to vasodilator agents and baroreflex changes. Fluoxetine and 7-NI-induced cardiovascular changes independent of stress exposure, including cardiac autonomic imbalance, increased intrinsic heart rate and vascular sympathetic modulation, a reduction of the pressor response to vasoconstrictor agents, and impairment of baroreflex activity. Altogether, these findings provide evidence that fluoxetine and 7-NI have similar effects on the depression-like state induced by CVS and on cardiovascular function.
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Affiliation(s)
- Jeferson Almeida
- a Laboratory of Pharmacology , School of Pharmaceutical Sciences, São Paulo State University , UNESP, Araraquara, SP , Brazil and
- b Joint UFSCar-UNESP Graduate Program in Physiological Sciences , São Carlos, SP , Brazil
| | - Josiane O Duarte
- a Laboratory of Pharmacology , School of Pharmaceutical Sciences, São Paulo State University , UNESP, Araraquara, SP , Brazil and
- b Joint UFSCar-UNESP Graduate Program in Physiological Sciences , São Carlos, SP , Brazil
| | - Leandro A Oliveira
- a Laboratory of Pharmacology , School of Pharmaceutical Sciences, São Paulo State University , UNESP, Araraquara, SP , Brazil and
- b Joint UFSCar-UNESP Graduate Program in Physiological Sciences , São Carlos, SP , Brazil
| | - Carlos C Crestani
- a Laboratory of Pharmacology , School of Pharmaceutical Sciences, São Paulo State University , UNESP, Araraquara, SP , Brazil and
- b Joint UFSCar-UNESP Graduate Program in Physiological Sciences , São Carlos, SP , Brazil
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Abstract
Depression occurs in people of all ages across all world regions; it is the second leading cause of disability and its global burden increased by 37.5% between 1990 and 2010. Autonomic changes are often found in altered mood states and appear to be a central biological substrate linking depression to a number of physical dysfunctions. Alterations of autonomic nervous system functioning that promotes vagal withdrawal are reflected in reductions of heart rate variability (HRV) indexes. Reduced HRV characterizes emotional dysregulation, decreased psychological flexibility and defective social engagement, which in turn are linked to prefrontal cortex hypoactivity. Altogether, these pieces of evidence support the idea that HRV might represent a useful endophenotype for psychological/physical comorbidities, and its routine application should be advised to assess the efficacy of prevention/intervention therapies in a number of psychosomatic and psychiatric dysfunctions. Further research, also making use of appropriate animal models, could provide a significant support to this point of view and possibly help to identify appropriate antidepressant therapies that do not interefere with physical health.
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Affiliation(s)
- Andrea Sgoifo
- a Stress Physiology Laboratory, Department of Neuroscience , University of Parma , Parma , Italy and
| | - Luca Carnevali
- a Stress Physiology Laboratory, Department of Neuroscience , University of Parma , Parma , Italy and
| | | | - Mario Amore
- b Department of Neuroscience , Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genova , Genova , Italy
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Grippo AJ, Moffitt JA, Henry MK, Firkins R, Senkler J, McNeal N, Wardwell J, Scotti MAL, Dotson A, Schultz R. Altered Connexin 43 and Connexin 45 protein expression in the heart as a function of social and environmental stress in the prairie vole. Stress 2015; 18:107-14. [PMID: 25338193 PMCID: PMC4675659 DOI: 10.3109/10253890.2014.979785] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Exposure to social and environmental stressors may influence behavior as well as autonomic and cardiovascular regulation, potentially leading to depressive disorders and cardiac dysfunction including elevated sympathetic drive, reduced parasympathetic function, and ventricular arrhythmias. The cellular mechanisms that underlie these interactions are not well understood. One mechanism may involve alterations in the expression of Connexin43 (Cx43) and Connexin45 (Cx45), gap junction proteins in the heart that play an important role in ensuring efficient cell-to-cell coupling and the maintenance of cardiac rhythmicity. The present study investigated the hypothesis that long-term social isolation, combined with mild environmental stressors, would produce both depressive behaviors and altered Cx43 and Cx45 expression in the left ventricle of prairie voles - a socially monogamous rodent model. Adult, female prairie voles were exposed to either social isolation (n = 22) or control (paired, n = 23) conditions (4 weeks), alone or in combination with chronic mild stress (CMS) (1 week). Social isolation, versus paired control conditions, produced significantly (p < 0.05) increased depressive behaviors in a 5-min forced swim test, and CMS exacerbated (p < 0.05) these behaviors. Social isolation (alone) reduced (p < 0.05) total Cx43 expression in the left ventricle; whereas CMS (but not isolation) increased (p < 0.05) total Cx45 expression and reduced (p < 0.05) the Cx43/Cx45 ratio, measured via Western blot analysis. The present findings provide insight into potential cellular mechanisms underlying altered cardiac rhythmicity associated with social and environmental stress in the prairie vole.
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Affiliation(s)
- Angela J. Grippo
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - Julia A. Moffitt
- Department of Physiology and Pharmacology, Des Moines University, Des Moines, IA
- Department of Kinesiology, St. Ambrose University, Davenport, IA
| | - Matthew K. Henry
- Department of Physiology and Pharmacology, Des Moines University, Des Moines, IA
| | - Rachel Firkins
- Department of Physiology and Pharmacology, Des Moines University, Des Moines, IA
| | - Jonathan Senkler
- Department of Physiology and Pharmacology, Des Moines University, Des Moines, IA
| | - Neal McNeal
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - Joshua Wardwell
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - Melissa-Ann L. Scotti
- Department of Psychology, Northern Illinois University, DeKalb, IL
- Department of Psychiatry and Brain-Body Center, University of Illinois at Chicago, Chicago, IL
| | - Ashley Dotson
- Department of Psychology, Northern Illinois University, DeKalb, IL
| | - Rachel Schultz
- Department of Psychology, Northern Illinois University, DeKalb, IL
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Brown PJ, Roose SP, Fieo R, Liu X, Rantanen T, Sneed JR, Rutherford BR, Devanand DP, Avlund K. Frailty and depression in older adults: a high-risk clinical population. Am J Geriatr Psychiatry 2014; 22:1083-95. [PMID: 23973252 PMCID: PMC3930630 DOI: 10.1016/j.jagp.2013.04.010] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2012] [Revised: 04/17/2013] [Accepted: 04/18/2013] [Indexed: 01/04/2023]
Abstract
OBJECTIVE To identify salient characteristics of frailty that increase risk of death in depressed elders. METHODS Data were from the Nordic Research on Ageing Study from research sites in Denmark, Sweden, and Finland. Participants were 1,027 adults aged 75 years (436 men and 591 women). Time of death was obtained, providing a maximum survival time of 11.08 years (initial evaluation took place between 1988 and 1991). RESULTS Depressed elders showed greater baseline impairments in each frailty characteristic (gait speed, grip strength, physical activity levels, and fatigue). Simultaneous models including all four frailty characteristics showed slow gait speed (hazard ratio: 1.84; 95% confidence interval: 1.05-3.21) and fatigue (hazard ratio: 1.94; 95% confidence interval: 1.11-3.40) associated with faster progression to death in depressed women; none of the frailty characteristics in the simultaneous model was associated with death in depressed men. In women, the effect of impaired gait speed on mortality rates nearly doubled when depression was present (nondepressed women: no gait impairment = 26%; slow gait = 40%; depressed women: no gait impairment = 32%; slow gait = 58%). A similar pattern was observed for fatigue. CONCLUSION The confluence of specific characteristics of frailty (fatigue and slow gait speed) and depressive illness is associated with an increased risk of death in older adults; this association is particularly strong in older depressed women. Future research should investigate whether multimodal interventions targeting depressive illness, mobility deficits, and fatigue can decrease mortality and improve quality of life in older depressed individuals with characteristics of the syndrome of frailty.
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Affiliation(s)
- Patrick J Brown
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY.
| | - Steven P Roose
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY
| | - Robert Fieo
- Sergievsky Center and the Taub Institute, Columbia University College of Physicians and Surgeons, New York, NY
| | - Xinhua Liu
- Division of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - Taina Rantanen
- The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Jyväskylä, Finland
| | - Joel R Sneed
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY; Queens College, City University of New York, New York, NY
| | - Bret R Rutherford
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY
| | - D P Devanand
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY
| | - Kirsten Avlund
- Department of Public Health and Center for Health Ageing, University of Copenhagen, Copenhagen, Denmark; Danish Aging Research Centre, Universities of Aarhus, Southern Denmark and Copenhagen, Denmark
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48
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Daglas R, Conus P, Cotton SM, Macneil CA, Hasty MK, Kader L, Berk M, Hallam KT. The impact of past direct-personal traumatic events on 12-month outcome in first episode psychotic mania: trauma and early psychotic mania. Aust N Z J Psychiatry 2014; 48:1017-24. [PMID: 25122448 DOI: 10.1177/0004867414545672] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Past traumatic events have been associated with poorer clinical outcomes in people with bipolar disorder. However, the impact of these events in the early stages of the illness remains unclear. The aim of this study was to investigate whether prior traumatic events were related to poorer outcomes 12 months following a first episode of psychotic mania. METHODS Traumatic events were retrospectively evaluated from patient files in a sample of 65 participants who had experienced first episode psychotic mania. Participants were aged between 15 and 28 years and were treated at a specialised early psychosis service. Clinical outcomes were measured by a variety of symptomatic and functioning scales at the 12-month time-point. RESULTS Direct-personal traumatic experiences prior to the onset of psychotic mania were reported by 48% of the sample. Participants with past direct-personal trauma had significantly higher symptoms of mania (p=0.02), depression (p=0.03) and psychopathology (p=0.01) 12 months following their first episode compared to participants without past direct-personal trauma, with medium to large effects observed. After adjusting for baseline scores, differences in global functioning (as measured by the Global Assessment of Functioning scale) were non-significant (p=0.05); however, participants with past direct-personal trauma had significantly poorer social and occupational functioning (p=0.04) at the 12-month assessment with medium effect. CONCLUSIONS Past direct-personal trauma may predict poorer symptomatic and functional outcomes after first episode psychotic mania. Limitations include that the findings represent individuals treated at a specialist early intervention centre for youth and the retrospective assessment of traumatic events may have been underestimated.
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Affiliation(s)
- Rothanthi Daglas
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Philippe Conus
- Treatment and Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, Prilly, Switzerland
| | - Sue M Cotton
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | | | | | - Linda Kader
- Orygen Youth Health Clinical Program, Parkville, Australia
| | - Michael Berk
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia Barwon Health and the Geelong Clinic, Swanston Centre, Geelong, Australia
| | - Karen T Hallam
- Department of Psychology, Victoria University, Melbourne, Australia
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Bastrikov OY, Belov VV, Grigoricheva EA. GENDER SPECIFICS OF STRUCTURAL AND FUNCTIONAL PARAMETERS OF VESSELS IN RELATION TO PSYCHOEMOTIONAL FACTORS IN ALMOST HEALTHY INDIVIDUALS. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2014. [DOI: 10.15829/1728-8800-2014-3-36-40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim.To study gender specifics of structural and functional parameters of brachiocephal arteries with the relation to psychoemotional factors in almost healthy individuals.Material and Methods.Overall 107 almost healthy economically active individuals included from organized population (46 male, 61 female), with the average age 43,4±10,8 y. All participants underwent psychological testing that included questionnaires: Spolberger-Khanin test, depression evaluation scale by the Center for Epidemiological Studies, visualanalogue scale (modified Dembo-Rubinstein), the social frustration level, social adaptation test by Holmes-Rey, ultrasound scanning of brachiocephal arteries with evaluation of local rigidity parameters.Results.There were significant gender differences found for the vessel wall structural and functional parameters. Average values of systolic and diastolic diameters, total common carotid artery wall thickness were higher in males, but the rigidity index - in women. Prevalence of personal anxiety and clinically significant stress estimates by the Holmes-Rey scale was significantly higher in women, 75% and 36%, resp. In both groups the association of psycho-emotional factors and vessel parameters was found. But for men there was independent relation of reactive and personal anxiety with the thickness of “intima-media” and in women – correlation of depression and vessel wall compliance.Conclusion.The results direct to the need for further research of novel methods for complex primary prophylaxy of stress-induced remodeling of vessels with the connection to psychoemotional and gender specifics.
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Affiliation(s)
- O. Yu. Bastrikov
- SBEI HPE “South-Ural State Medical University” of the Ministry of Health. Chelyabinsk, Russia
| | - V. V. Belov
- SBEI HPE “South-Ural State Medical University” of the Ministry of Health. Chelyabinsk, Russia
| | - E. A. Grigoricheva
- SBEI HPE “South-Ural State Medical University” of the Ministry of Health. Chelyabinsk, Russia
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50
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Wong FMF, Sit JWH, Wong EML, Choi KC. Factors associated with health-related quality of life among patients with implantable cardioverter defibrillator: identification of foci for nursing intervention. J Adv Nurs 2014; 70:2821-34. [DOI: 10.1111/jan.12434] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | - Janet Wing Hung Sit
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
| | - Eliza Mi Ling Wong
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
| | - Kai Chow Choi
- The Chinese University of Hong Kong; the Nethersole School of Nursing; Hong Kong
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