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Mpango RS, Ssembajjwe W, Rukundo GZ, Birungi C, Kalungi A, Gadow KD, Patel V, Nyirenda M, Kinyanda E. Physical and psychiatric comorbidities among patients with severe mental illness as seen in Uganda. Eur Arch Psychiatry Clin Neurosci 2023; 273:613-625. [PMID: 36002543 PMCID: PMC9950291 DOI: 10.1007/s00406-022-01478-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 08/02/2022] [Indexed: 11/03/2022]
Abstract
While psychiatric and physical comorbidities in severe mental illness (SMI) have been associated with increased mortality and poor clinical outcomes, problem has received little attention in low- and middle-income countries (LMICs). This study established the prevalence of psychiatric (schizophrenia, bipolar affective disorder, and recurrent major depressive disorder) and physical (HIV/AIDS, syphilis, hypertension and obesity) comorbidities and associated factors among 1201 out-patients with SMI (schizophrenia, depression and bipolar affective disorder) attending care at two hospitals in Uganda. Participants completed an assessment battery including structured, standardised and locally translated instruments. SMIs were established using the MINI International Neuropsychiatric Interview version 7.2. We used logistic regression to determine the association between physical and psychiatric comorbidities and potential risk factors. Bipolar affective disorder was the most prevalent (66.4%) psychiatric diagnoses followed by schizophrenia (26.6%) and recurrent major depressive disorder (7.0%). Prevalence of psychiatric comorbidity was 9.1%, while physical disorder comorbidity was 42.6%. Specific comorbid physical disorders were hypertension (27.1%), obesity (13.8%), HIV/AIDS (8.2%) and syphilis (4.8%). Potentially modifiable factors independently significantly associated with psychiatric and physical comorbidities were: use of alcohol for both syphilis and hypertension comorbidities; and use of a mood stabilisers and khat in comorbidity with obesity. Only psychiatric comorbidity was positively associated with the negative outcomes of suicidality and risky sexual behaviour. The healthcare models for psychiatric care in LMICs such as Uganda should be optimised to address the high burden of psychiatric and physical comorbidities.
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Affiliation(s)
- Richard Stephen Mpango
- MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Section, P. O. Box, 49, Entebbe, Uganda.
- Senior Wellcome Trust Fellowship, Entebbe, Uganda.
- Brown School, Washington University, in St. Louis, St. Louis, MO, 63130, USA.
- Department of Mental Health, Soroti School of Health Sciences, Soroti University, P. O. Box 211, Soroti, Uganda.
- Butabika National Psychiatric Hospital, Kampala, Uganda.
| | - Wilber Ssembajjwe
- MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Section, P. O. Box, 49, Entebbe, Uganda
- Senior Wellcome Trust Fellowship, Entebbe, Uganda
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, P. O. Box 49, Entebbe, Uganda
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda
| | - Carol Birungi
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Allan Kalungi
- MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Section, P. O. Box, 49, Entebbe, Uganda
- Senior Wellcome Trust Fellowship, Entebbe, Uganda
| | - Kenneth D Gadow
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Massachusetts, USA
| | - Moffat Nyirenda
- MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Section, P. O. Box, 49, Entebbe, Uganda
- Senior Wellcome Trust Fellowship, Entebbe, Uganda
- Global Non-Communicable Diseases (NCD) Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Eugene Kinyanda
- MRC/UVRI and LSHTM Uganda Research Unit, Mental Health Section, P. O. Box, 49, Entebbe, Uganda
- Senior Wellcome Trust Fellowship, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
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Lim MH, Yoon JH, Lee WT, Kim MS, Baek SU, Won JU. Performance-Based Pay System and Job Stress Related to Depression/Anxiety in Korea: Analysis of Korea Working Condition Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4065. [PMID: 36901074 PMCID: PMC10002074 DOI: 10.3390/ijerph20054065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/10/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The adoption rate of performance-based pay systems has increased in recent years, and the adverse effects of systems have been emphasized. However, no study has analyzed the increase in the risk of depression/anxiety symptoms caused by the pay system in Korea. This study aimed to reveal the association between performance-based pay systems and symptoms of depression/anxiety, using data from the fifth Korean Working Conditions Survey. Depressive/anxiety symptoms were assessed using "yes" or "no" questions regarding medical problems related to depression/anxiety. The performance-based pay system and job stress were estimated using self-response answers. Logistic regression analyses were conducted to determine the association between performance-based pay systems, job stress, and symptoms of depression/anxiety using data from 27,793 participants. The performance-based pay system significantly increased the risk of the symptoms. Additionally, risk increments were calculated after grouping by pay system and job stress. Workers with two risk factors had the highest risk of symptoms of depression/anxiety for both sexes (male: OR 3.05; 95% CI 1.70-5.45; female: OR 2.15; 95% CI 1.32-3.50), implying synergistic effect of performance-based pay system and job stress on depression/anxiety symptoms. Based on these findings, policies should be established for early detection and protection against the risk of depression/anxiety.
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Affiliation(s)
- Myeong-Hun Lim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jin-Ha Yoon
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Won-Tae Lee
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Min-Seok Kim
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Graduate School of Public Health, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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The Role of Genetics in the Development and Pharmacotherapy of Depression and Its Impact on Drug Discovery. Int J Mol Sci 2023; 24:ijms24032946. [PMID: 36769269 PMCID: PMC9917784 DOI: 10.3390/ijms24032946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023] Open
Abstract
Complex disorders, such as depression, remain a mystery for scientists. Although genetic factors are considered important for the prediction of one's vulnerability, it is hard to estimate the exact risk for a patient to develop depression, based only on one category of vulnerability criteria. Genetic factors also regulate drug metabolism, and when they are identified in a specific combination, may result in increased drug resistance. A proper understanding of the genetic basis of depression assists in the development of novel promising medications and effective disorder management schemes. This review aims to analyze the recent literature focusing on the correlation between specific genes and the occurrence of depression. Moreover, certain aspects targeting a high drug resistance identified among patients suffering from major depressive disorder were highlighted in this manuscript. An expected direction of future drug discovery campaigns was also discussed.
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Genetic Predisposition to Schizophrenia and Depressive Disorder Comorbidity. Genes (Basel) 2022; 13:genes13030457. [PMID: 35328011 PMCID: PMC8950769 DOI: 10.3390/genes13030457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 01/27/2023] Open
Abstract
Background: Patients with schizophrenia have an increased risk of depressive disorders compared to the general population. The comorbidity between schizophrenia and depression suggests a potential coincidence of the pathophysiology and/or genetic predictors of these mental disorders. The aim of this study was to review the potential genetic predictors of schizophrenia and depression comorbidity. Materials and Methods: We carried out research and analysis of publications in the databases PubMed, Springer, Wiley Online Library, Taylor & Francis Online, Science Direct, and eLIBRARY.RU using keywords and their combinations. The search depth was the last 10 years (2010–2020). Full-text original articles, reviews, meta-analyses, and clinical observations were analyzed. A total of 459 articles were found, of which 45 articles corresponding to the purpose of this study were analyzed in this topic review. Results: Overlap in the symptoms and genetic predictors between these disorders suggests that a common etiological mechanism may underlie the presentation of comorbid depression in schizophrenia. The molecular mechanisms linking schizophrenia and depression are polygenic. The most studied candidate genes are GRIN1, GPM6A, SEPTIN4, TPH1, TPH2, CACNA1C, CACNB2, and BCL9.Conclusion: Planning and conducting genome-wide and associative genetic studies of the comorbid conditions under consideration in psychiatry is important for the development of biological and clinical predictors and a personalized therapy strategy for schizophrenia. However, it should be recognized that the problems of predictive and personalized psychiatry in the diagnosis and treatment of schizophrenia and comorbid disorders are far from being resolved.
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Calcium imaging reveals depressive- and manic-phase-specific brain neural activity patterns in a murine model of bipolar disorder: a pilot study. Transl Psychiatry 2021; 11:619. [PMID: 34876553 PMCID: PMC8651770 DOI: 10.1038/s41398-021-01750-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/18/2021] [Accepted: 11/29/2021] [Indexed: 12/25/2022] Open
Abstract
Brain pathological features during manic/hypomanic and depressive episodes in the same patients with bipolar disorder (BPD) have not been described precisely. The study aimed to investigate depressive and manic-phase-specific brain neural activity patterns of BPD in the same murine model to provide information guiding investigation of the mechanism of phase switching and tailored prevention and treatment for patients with BPD. In vivo two-photon imaging was used to observe brain activity alterations in the depressive and manic phases in the same murine model of BPD. Two-photon imaging showed significantly reduced Ca2+ activity in temporal cortex pyramidal neurons in the depression phase in mice exposed to chronic unpredictable mild stress (CUMS), but not in the manic phase in mice exposed to CUMS and ketamine. Total integrated calcium values correlated significantly with immobility times. Brain Ca2+ hypoactivity was observed in the depression and manic phases in the same mice exposed to CUMS and ketamine relative to naïve controls. The novel object recognition preference ratio correlated negatively with the immobility time in the depression phase and the total distance traveled in the manic phase. With recognition of its limitations, this study revealed brain neural activity impairment indicating that intrinsic emotional network disturbance is a mechanism of BPD and that brain neural activity is associated with cognitive impairment in the depressive and manic phases of this disorder. These findings are consistent with those from macro-imaging studies of patients with BPD. The observed correlation of brain neural activity with the severity of depressive, but not manic, symptoms need to be investigated further.
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Gao S, Ma X, Ji F, Chen C, Jiang D, Xu Y, Song X, Wang W, Lin X, Tian H, Zhuo C, Ye X, Yu H. Antipsychotics With Different Chemical Structures Cause Different Degrees of Functional Impairments in the Primary Visual Cortex in a Murine Model: A Pilot Study. PSYCHIAT CLIN PSYCH 2021; 31:364-369. [PMID: 38765639 PMCID: PMC11079715 DOI: 10.5152/pcp.2021.20022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 11/21/2020] [Indexed: 05/22/2024] Open
Abstract
Background Antipsychotic medications can impair vision in patients with schizophrenia. However, little is known regarding the pharmacodynamics of antipsychotics in the primary visual cortex. We aimed to study the pharmacodynamics of antipsychotics in the visual cortex in a murine model. Methods We used an adapted 2-photon imaging technique to observe changes in calcium dynamics induced by 4 antipsychotics (olanzapine, risperidone, aripiprazole, and amisulpride) in the primary visual cortex of healthy and schizophrenic C57BL/6 mice. Visual function was further assessed by using a novel object recognition test. Results All 4 antipsychotics decreased calcium activity in the primary visual cortex and reduced visual recognition test scores in healthy and schizophrenic mice. The most potent drug was olanzapine, followed by risperidone, aripiprazole, and amisulpride. All drugs showed significant differences between groups. Conclusion Our pilot study demonstrated that antipsychotics impair visual cortical function. This finding underscores the importance of monitoring for visual adverse events in patients receiving antipsychotic medications to treat schizophrenia.
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Affiliation(s)
- Si Gao
- Department of Psychiatry and Microimaging Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Xiaoyan Ma
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory, Tianjin Anding Hospital, Tianjin, China
| | - Feng Ji
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province, China
| | - Ce Chen
- Department of Psychiatry and Microimaging Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Deguo Jiang
- Department of Psychiatry and Microimaging Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xueqin Song
- First Affiliated Hospital, Zhengzhou University, Zhengzhou, China
- Biological Psychiatry International Joint Laboratory of Henan, Zhengzhou University, Zhengzhou, China
- Henan Psychiatric Transformational Research Key Laboratory, Zhengzhou University, Zhengzhou, China
| | - Wenqiang Wang
- Canadian and Chinese Joint Laboratory of Biological Psychiatry, Xiamen Xianye Hospital, Xiamen, Fujian Province, China
| | - Xiaodong Lin
- Department of Psychiatry and Microimaging Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
| | - Hongjun Tian
- Department of Psychiatry and Microimaging Center, Wenzhou Seventh People’s Hospital, Wenzhou, Zhejiang Province, China
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, Shandong Province, China
| | - Chuanjun Zhuo
- Department of psychiatry, Tianjin Fourth Central Hospital, Tianjin, China
| | - Xinwu Ye
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory, Tianjin Anding Hospital, Tianjin, China
| | - Haiping Yu
- Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory, Tianjin Anding Hospital, Tianjin, China
- Department of psychiatry, Tianjin Fourth Central Hospital, Tianjin, China
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Zhou Z, Wang K, Tang J, Wei D, Song L, Peng Y, Fu Y, Qiu J. Cortical thickness distinguishes between major depression and schizophrenia in adolescents. BMC Psychiatry 2021; 21:361. [PMID: 34284747 PMCID: PMC8293570 DOI: 10.1186/s12888-021-03373-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/08/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Early diagnosis of adolescent psychiatric disorder is crucial for early intervention. However, there is extensive comorbidity between affective and psychotic disorders, which increases the difficulty of precise diagnoses among adolescents. METHODS We obtained structural magnetic resonance imaging scans from 150 adolescents, including 67 and 47 patients with major depressive disorder (MDD) and schizophrenia (SCZ), as well as 34 healthy controls (HC) to explore whether psychiatric disorders could be identified using a machine learning technique. Specifically, we used the support vector machine and the leave-one-out cross-validation method to distinguish among adolescents with MDD and SCZ and healthy controls. RESULTS We found that cortical thickness was a classification feature of a) MDD and HC with 79.21% accuracy where the temporal pole had the highest weight; b) SCZ and HC with 69.88% accuracy where the left superior temporal sulcus had the highest weight. Notably, adolescents with MDD and SCZ could be classified with 62.93% accuracy where the right pars triangularis had the highest weight. CONCLUSIONS Our findings suggest that cortical thickness may be a critical biological feature in the diagnosis of adolescent psychiatric disorders. These findings might be helpful to establish an early prediction model for adolescents to better diagnose psychiatric disorders.
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Affiliation(s)
- Zheyi Zhou
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Kangcheng Wang
- grid.410585.d0000 0001 0495 1805Faculty of Psychology, Shandong Normal University, Jinan, 250014 Shandong China
| | - Jinxiang Tang
- grid.452206.7Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Sleep and Psychology Center, The Bishan Hospital of Chongqing, Chongqing, 402760 China
| | - Dongtao Wei
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Li Song
- grid.419897.a0000 0004 0369 313XKey Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715 China ,grid.263906.8Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715 China
| | - Yadong Peng
- grid.452206.7Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016 China ,Department of Psychology, Chongqing Health Center for Women and Children, Chongqing, 401147 China
| | - Yixiao Fu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, No.1, Yixueyuan Road, Yuzhong District, Chongqing, 400016, China.
| | - Jiang Qiu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, 400715, China. .,Faculty of Psychology, Southwest University, No.2 Tiansheng Road, Beibei District, Chongqing, 400715, China. .,Collaborative Innovation Center of Assessment Toward Basic Education Quality, Southwest University Branch, Beijing Normal University, Beijing, 100875, China.
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Almulla AF, Al-Rawi KF, Maes M, Al-Hakeim HK. In schizophrenia, immune-inflammatory pathways are strongly associated with depressive and anxiety symptoms, which are part of a latent trait which comprises neurocognitive impairments and schizophrenia symptoms. J Affect Disord 2021; 287:316-326. [PMID: 33812245 DOI: 10.1016/j.jad.2021.03.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/13/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The aim is to examine whether biomarkers of the immune-inflammatory response (IRS) and endogenous opioid (EOS) systems are associated with affective symptoms in schizophrenia. METHODS We recruited 115 schizophrenia patients and 43 healthy controls and assessed the Hamilton Depression (HDRS) and Anxiety (HAM-A) rating Scale scores as well as serum levels of interleukin (IL)-6, IL-10, eotaxin (CCL11), high mobility group box 1 (HMGB1), Dickkopf-related protein 1 (DKK1), and mu (MOR) and kappa (KOR) opioid receptors. RESULTS The HDRS and HAM-A scores are significantly and positively correlated with a) psychosis, hostility, excitation, mannerism, negative symptoms, psychomotor retardation, and formal thought disorders; and b) lowered scores on semantic and episodic memory, executive functions, and attention tests as measured with the Brief Assessment of Cognition in Psychiatry. Both HDRS and HAM-A are significantly increased in non-responders to treatment as compared with partial responders. Both affective scores are strongly associated with a latent vector extracted from all symptoms, reflecting overall severity of schizophrenia symptoms (OSOS), and neurocognitive test scores, reflecting a generalized cognitive decline (G-CoDe). The HDRS score was strongly and positively associated with IL-6, HMGB1, KOR, and MOR levels, and the HAM-A score with IL-6, IL-10, CCL11, HMGB1, KOR, and MOR levels. A single latent trait may be extracted from OSOS, G-CoDe, and the HDRS and HAMA scores, and this latent vector score is strongly predicted by HMGB1, MOR, and DKK1. CONCLUSION Immune-inflammatory and EOS pathways contribute to the phenome of schizophrenia, which comprises OSOS, affective, and physiosomatic symptoms, and G-CoDe.
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Affiliation(s)
- Abbas F Almulla
- Medical Laboratory Technology Department, College of Medical Technology, The Islamic University, Najaf, Iraq.
| | | | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria; IMPACT Strategic Research Centre, Deakin University, PO Box 281, Geelong, VIC, 3220, Australia.
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Zhuo C, Fang T, Chen C, Chen M, Sun Y, Ma X, Li R, Tian H, Ping J. Brain imaging features in schizophrenia with co-occurring auditory verbal hallucinations and depressive symptoms-Implication for novel therapeutic strategies to alleviate the reciprocal deterioration. Brain Behav 2021; 11:e01991. [PMID: 33305913 PMCID: PMC7882177 DOI: 10.1002/brb3.1991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) and depressive symptoms are highly prevalent in schizophrenia, and recent progress has been made in understanding the reciprocal deterioration of both symptoms through structural and functional brain imaging studies. To date, there is limited literature on this topic. In this review, we synthesized the recent literature on the neuroimaging features of schizophrenia patients with concurrent AVHs and depressive symptoms. METHODS A literature search was conducted with the major databases using the keywords, mainly including schizophrenia, AVHs, depression, neuropsychiatric disorders, brain imaging, and magnetic resonance imaging. RESULTS The existing studies have shown that AVHs and depressive symptoms reciprocally deteriorate in patients with schizophrenia, which has challenged the conventional treatment of the disease. Interestingly, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) therapies have emerged as two efficacious brain stimulation treatments that can normalize the brain regions associated with the symptoms, as shown through functional and structural brain imaging studies. In light of these important findings, there is an urgent need to conduct in-depth neuronal mechanistic studies to identify targets for stimulation therapy. CONCLUSIONS These new findings may elucidate the pathological mechanisms underlying schizophrenia with concurrent AVHs and depressive symptoms. Furthermore, this review has important clinical implications for developing novel therapeutic strategies to alleviate the reciprocal deterioration AVHs and depressive symptoms of schizophrenia patients.
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Affiliation(s)
- Chuanjun Zhuo
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Tao Fang
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
| | - Ce Chen
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
| | - Min Chen
- Department of PsychiatrySchool of Mental HealthyJining Medical UniversityJiningChina
| | - Yun Sun
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Xiaoyan Ma
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Ranli Li
- Psychiatric‐Neuroimaging‐Genetics‐Comorbidity (PNGC) LaboratoryTianjin Mental Health CenterTianjin Anding HospitalNankai University Affiliated Anding HospitalTianjinChina
| | - Hongjun Tian
- Key Laboratory of Real Time Brain Circuits Tracing of Neurology and Psychiatry (RTBNB_Lab)Tianjin Fourth Center HospitalTianjin Medical Affiliated Tianjin Fourth Central HospitalNankai University Affiliated Tianjin Fourth Center HospitalTianjinChina
| | - Jing Ping
- Department of PsychiatryWenzhou Seventh People’s HospitalWenzhouChina
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Zhou C, Kong D, Xue R, Chen M, Li G, Xu Y, Liu S, Tian H, Zhuo C. Metformin Enhances Antidepressant/Antipsychotic Combination Therapy of Schizophrenia With Comorbid Depression in a Murine Model. Front Neurosci 2020; 14:517. [PMID: 32581680 PMCID: PMC7283619 DOI: 10.3389/fnins.2020.00517] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/27/2020] [Indexed: 01/01/2023] Open
Abstract
Comorbid depressive disorders confound the diagnosis and therapy of schizophrenia. Using a murine model incorporating both MK801 and chronic unpredictable mild stress exposures, we successfully replicated both psychosis and depression. Ex vivo patch clamp recordings and in vivo calcium imaging demonstrated impaired neural activity in the prefrontal cortex (PFC). We then administered triple-drug combinations consisting of two antidepressants (mirtazapine and venlafaxine) plus an antipsychotic (either clozapine or olanzapine), and found improved PFC neuronal activity and performance in behavioral assays. Moreover, the addition of metformin to both psychotropic drug combinations brought further improvements in depressive and schizophrenic-like behaviors and physiological parameters. In summary, our data modeled the neuropathophysiology of schizophrenia with comorbid depression, and may inform drug intervention strategies.
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Affiliation(s)
- Chunhua Zhou
- Department of Pharmacology, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Dezhi Kong
- Two-Photon In Vivo Imaging Centre, Institute of Chinese Integrative Medicine, Hebei Medical University, Shijiazhuang, China
| | - Rong Xue
- Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Min Chen
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Gongying Li
- Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China
| | - Yong Xu
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Hongjun Tian
- Psychiatric-Neurological-Imaging-Laboratory, Tianjin Medical University Fourth Central Hospital, Tianjin Fourth Center Hospital, Tianjin, China
| | - Chuanjun Zhuo
- Psychiatric-Neurological-Imaging-Laboratory, Tianjin Medical University Fourth Central Hospital, Tianjin Fourth Center Hospital, Tianjin, China.,Department of Psychiatry, School of Mental Health, Jining Medical University, Jining, China.,MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
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