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Hernández-Sauret A, Martin de la Torre O, Redolar-Ripoll D. Use of transcranial magnetic stimulation (TMS) for studying cognitive control in depressed patients: A systematic review. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2024:10.3758/s13415-024-01193-w. [PMID: 38773020 DOI: 10.3758/s13415-024-01193-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/23/2024]
Abstract
Major depressive disorder (MDD) is a debilitating mental disorder and the leading cause of disease burden. Major depressive disorder is associated with emotional impairment and cognitive deficit. Cognitive control, which is the ability to use perceptions, knowledge, and information about goals and motivations to shape the selection of goal-directed actions or thoughts, is a primary function of the prefrontal cortex (PFC). Psychotropic medications are one of the main treatments for MDD, but they are not effective for all patients. An alternative treatment is transcranial magnetic stimulation (TMS). Previous studies have provided mixed results on the cognitive-enhancing effects of TMS treatment in patients with MDD. Some studies have found significant improvement, while others have not. There is a lack of understanding of the specific effects of different TMS protocols and stimulation parameters on cognitive control in MDD. Thus, this review aims to synthesize the effectiveness of the TMS methods and a qualitative assessment of their potential benefits in improving cognitive functioning in patients with MDD. We reviewed 21 studies in which participants underwent a treatment of any transcranial magnetic stimulation protocol, such as repetitive TMS or theta-burst stimulation. One of the primary outcome measures was any change in the cognitive control process. Overall, the findings indicate that transcranial magnetic stimulation (TMS) may enhance cognitive function in patients with MDD. Most of the reviewed studies supported the notion of cognitive improvement following TMS treatment. Notably, improvements were predominantly observed in inhibition, attention, set shifting/flexibility, and memory domains. However, fewer significant improvements were detected in evaluations of visuospatial function and recognition, executive function, phonemic fluency, and speed of information processing. This review found evidence supporting the use of TMS as a treatment for cognitive deficits in patients with MDD. The results are promising, but further research is needed to clarify the specific TMS protocol and stimulation locations that are most effective.
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Affiliation(s)
- Ana Hernández-Sauret
- Cognitive Neurolab, Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Rambla del Poblenou 156, Barcelona, Spain.
- Instituto Brain360, Unidad Neuromodulación y Neuroimagen, Calle Maó 9, Barcelona, Spain.
| | - Ona Martin de la Torre
- Cognitive Neurolab, Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Rambla del Poblenou 156, Barcelona, Spain
- Instituto Brain360, Unidad Neuromodulación y Neuroimagen, Calle Maó 9, Barcelona, Spain
| | - Diego Redolar-Ripoll
- Cognitive Neurolab, Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Rambla del Poblenou 156, Barcelona, Spain
- Instituto Brain360, Unidad Neuromodulación y Neuroimagen, Calle Maó 9, Barcelona, Spain
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Vicent-Gil M, Trujols J, Serra-Blasco M, Navarra-Ventura G, Puigdemont D, Alemany C, Crivillés S, de Diego-Adeliño J, Cardoner N, Portella MJ. If you feel you can't, you won't: the role of subjective and objective cognitive competence on psychosocial functioning in depression. Eur Psychiatry 2023; 66:e83. [PMID: 37855104 PMCID: PMC10755570 DOI: 10.1192/j.eurpsy.2023.2454] [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: 05/04/2023] [Revised: 07/27/2023] [Accepted: 08/21/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The purpose of this exploratory study is to examine the role of sociodemographic, clinical, and cognitive - both objective and subjective - factors in overall and in specific domains of psychosocial functioning, in patients with depression at different clinical states of the disease (remitted and non-remitted). METHODS A sample of 325 patients with major depressive disorder, 117 in remission and 208 in non-remission, were assessed with a semi-structured interview collecting sociodemographic, clinical, cognitive (with neuropsychological tests and the Perceived Deficit Questionnaire), and functional (Functioning Assessment Short Test) characteristics. Backward regression models were conducted to determine associations of global and specific areas of functioning with independent factors, for both clinical states. RESULTS Residual depressive symptomatology and self-appraisal of executive competence were significantly associated with psychosocial functioning in remitted patients, in overall and some subdomains of functioning, particularly cognitive and interpersonal areas. While depressive symptoms, executive deficits and self-appraisal of executive function were significantly related to functional outcomes in non-remitted patients, both in overall functioning and in most of subdomains. DISCUSSION This study evidences the strong association of one's appraisal of executive competence with psychosocial functioning, together with depressive symptoms, both in remitted and non-remitted patients with depression. Therefore, to achieve full recovery, clinical management of patients should tackle not only the relief of core depressive symptoms, but also the cognitive ones, both those that are objectified with neuropsychological tests and those that are reported by the patients themselves.
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Affiliation(s)
- Muriel Vicent-Gil
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joan Trujols
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Maria Serra-Blasco
- eHealth ICOnnecta’t Program and Psycho-Oncology Service, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Spain
| | - Guillem Navarra-Ventura
- Institut d’Investigació Sanitària Illes Balears (IdISBa), Hospital Universitari Son Espases, Palma, Spain
- Institut Universitari d’Investigació en Ciències de la Salut (IUNICS), Universitat de les Illes Balears, Palma, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III (CIBERES-ISCIII), Madrid, Spain
| | - Dolors Puigdemont
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Carlo Alemany
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Sara Crivillés
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Javier de Diego-Adeliño
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Narcís Cardoner
- Department of Psychiatry and Legal Medicine, Institute of Neuroscience, Universitat Autònoma de Barcelona (UAB)
| | - Maria J. Portella
- Sant Pau Mental Health Research Group, Institut d’Investigació Biomèdica Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III (CIBERSAM-ISCIII), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
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Fiabane E, Scarpina F, Ottonello M, Pistarini C. Spontaneous Changes in Attentional Capabilities and Reasoning After an Alcohol Rehabilitation Treatment: Evidence About the Role of Age and Alcohol Use. Neuropsychiatr Dis Treat 2023; 19:1321-1329. [PMID: 37284250 PMCID: PMC10239759 DOI: 10.2147/ndt.s403217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/30/2023] [Indexed: 06/08/2023] Open
Abstract
Purpose In this study, we evaluated changes in attentional capabilities and reasoning among early abstinent alcohol-dependent individuals after a 28-day residential rehabilitation program (not including cognitive treatment). Furthermore, we explored the role of individual characteristics and disease-related factors (i.e., length of alcohol use, history of polysubstance dependence, severity of alcohol use) on spontaneous cognitive recovery. Patients and Methods Fifty-five patients with a diagnosis of Alcohol Use Disorder (AUD) were consecutively recruited from a residential rehabilitation hospital in Northern Italy. The majority were male (67.3%) with a mean age of 47.83 years (SD = 8.21). The computerized Psychology Experiment Building Language Test Battery was used to assess the performance at the Posner Cueing Test, Go/no-go Task, Trail Making Test (TMT), Tower of London (TOL), and Balloon Analog Risk Scale. The evaluation was performed twice: at the beginning (T0) and at its end (T1, before the hospital discharge). Results We observed statistically improvements over time in the performance at the: 1) TOL in the time amount required to solve the task (p < 0.001); and 2) TMT in the indexes relative to the number of errors (p = 0.003) and the total time required to solve the task (p < 0.001). Age played a significant role on the changes observed in the score relative to the time amount used by participants to solve the task in TMT (test (p = 0.03) and in TOL (p = 0.02). Moreover, the length of alcohol dependence had an effect on the change observed for the time amount to solve the TMT (time) (p = 0.01). Conclusion We found spontaneous recovery after alcohol detoxification on some, but not all, cognitive functions assessed in our study. The neuropsychological assessment and the identification of patients with cognitive impairment and specific risk factors (e.g., older age and longer history of alcohol use) is important to orient cognitive rehabilitation and increase the efficacy of AUD treatments.
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Affiliation(s)
- Elena Fiabane
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, Pavia, Italy
| | - Federica Scarpina
- Rita Levi Montalcini” Department of Neurosciences, University of Turin, Turin, Italy
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale S. Giuseppe, Piancavallo, VCO, Italy
| | - Marcella Ottonello
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Physical and Rehabilitation Medicine of Pavia Institute, Pavia, Italy
| | - Caterina Pistarini
- Istituti Clinici Scientifici Maugeri IRCCS, Department of Neurorehabilitation of Pavia Institute, Pavia, Italy
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Zhu N, Tong J, Pei Y, Zhang J, Sun X. Factors associated with objective and subjective cognitive impairment in Chinese patients with acute major depressive disorder. BMC Psychiatry 2023; 23:348. [PMID: 37208711 DOI: 10.1186/s12888-023-04857-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 05/09/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Patients diagnosed withmajor depressive disorder (MDD) usually experience impaired cognitive functioning, which might negatively impact their clinical and functional outcomes. This study aimed to investigate the association of specific clinical factors with cognitive dysfunction in a group of MDD patients. METHODS A total of 75 subjects diagnosed with recurrent MDD were evaluated during the acute stage. Their cognitive functions were assessed using the THINC-integrated tool (THINC-it) for attention/alertness, processing speed, executive function, and working memory. Clinical psychiatric evaluations, such as the Hamilton Anxiety Scale (HAM-A), the Young Mania Rating Scale (YMRS), the Hamilton Depression Scale (HAM-D), and the Pittsburgh Sleep Quality Index(PSQI), were used to assess patients' levels of anxiety, depression and sleeping problems. The investigated clinical variables were age, years of education, age at onset, number of depressive episodes, disease duration, presence of depressive and anxiety symptoms, sleep problems, and number of hospitalizations. RESULTS The results revealed that significant differences were observed between the two groups in the THINC-it total scores, Spotter, Codebreaker, Trails, and PDQ-5-D scores (P < 0.001). The THINC-it total scores, Spotter, Codebreaker, Trails, and Symbol Check were significantly associated with age and age at onset(P < 0.01). In addition, regression analysis found that years of education was positively associated with the Codebreaker total scores (P < 0.05). the THINC-it total scores, Symbol Check, Trails, and Codebreaker were correlated with the HAM-D total scores(P < 0.05). Additionally, the THINC-it total scores, Symbol Check, PDQ-5-D and Codebreaker significantly correlated with the PSQI total scores (P < 0.05). CONCLUSION We found a significant statistical association between almost all cognitive domains and different clinical aspects in depressive disorder, such asage, age at onset, severity of depression, years of education, and sleep problems. Additionally, education was shown to be a protective factor against processing speed impairments. Special considerations of these factors might help outline better management strategies to improve cognitive functions in MDD patients.
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Affiliation(s)
- Na Zhu
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Tong
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yu Pei
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Jie Zhang
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Xirong Sun
- Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China.
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Association between baseline cognitive symptoms and the subsequent presenteeism and global function in patients with major depressive disorder. J Psychiatr Res 2022; 154:324-331. [PMID: 36027860 DOI: 10.1016/j.jpsychires.2022.07.036] [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: 07/29/2021] [Revised: 07/07/2022] [Accepted: 07/20/2022] [Indexed: 11/21/2022]
Abstract
Cognitive symptoms in major depressive disorder (MDD) contribute to impaired functional abilities and work productivity, particularly presenteeism. We investigated the association between baseline cognitive symptoms and subsequent presenteeism, and global functional impairment in Japanese patients with MDD from PERFORM-J (Prospective Epidemiological Research on Functioning Outcomes Related to Major Depressive Disorder in Japan) - a 6-month, multicenter, epidemiological study data. A total of 518 patients initiating antidepressant monotherapy (first-line or switched from another drug) were enrolled. Assessments include Perceived Deficits Questionnaire - Depression (PDQ-D) for cognitive complaints, Sheehan Disability Scale (SDS) for global function (analysed n = 318), and Work Productivity and Activity Impairment Questionnaire for presenteeism (analysed n = 122). A strong association between changes in presenteeism and changes in SDS scores (r: total = 0.636; work/school = 0.686) was observed. After adjusting for sociodemographic and MDD-related factors, patients without cognitive complaints at baseline showed lower odds of impaired presenteeism at 6 months versus patients with cognitive complaints (0.243, 95% CI: 0.079 to 0.747, p = 0.014) and also in patients with first episode of MDD against with recurrent MDD (0.327 (95% CI: 0.136 to 0.787). Similarly, patients without cognitive complaints had healthier global functioning (lower mean SDS total score) than patients with cognitive complaints (8.3 vs 11.2; 95% CI, -5.189 to -0.578; p = 0.014). First depressive episode (lower risk of presenteeism), being male, and low baseline SDS total score (better global functioning) were also associated with improved outcomes. These results highlight the potential value of baseline PDQ-D scores in predicting subsequent workplace and global functioning in patients undergoing treatment for MDD.
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Wang M, Qi X, Yang X, Fan H, Dou Y, Guo W, Wang Q, Chen E, Li T, Ma X. The pattern glare and visual memory are disrupted in patients with major depressive disorder. BMC Psychiatry 2022; 22:518. [PMID: 35918667 PMCID: PMC9344705 DOI: 10.1186/s12888-022-04167-9] [Citation(s) in RCA: 2] [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: 11/10/2021] [Accepted: 07/25/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Visual memory impairment is one of the most commonly complained symptoms in patients with major depressive disorder (MDD). Pattern glare is also a distorted visual phenomenon that puzzles patients with MDD. Nevertheless, how these two phenomena interact in MDD remains unknown. This study investigated the association between pattern glare and visual memory in MDD patients. METHODS Sixty-two patients with MDD and forty-nine age-, sex- and education level-matched healthy controls (HCs) were included in this study. The Pattern Recognition Memory (PRM) test and the Brief Visual Memory Test-Revised (BVMT-R) were applied to measure visual memory. The pattern glare test including three patterns with different spatial frequencies (SFs) was used to explore pattern glare levels. RESULTS Patients with MDD scored lower on the PRM-PCi, BVMT-R1, BVMT-R2, BVMT-R3, and BVMT-Rt and higher on the PRM-MCLd than HCs (all p < 0.05). Pattern glare scores for MDD patients were higher with mid-SF (p < 0.001), high-SF (p = 0.006) and mid-high SF differences (p = 0.01) than for HCs. A positive correlation between mid-SF and PRM-MCLd scores in all participants was observed (p = 0.01, r = 0.246). A negative correlation between mid-high difference scores and BVMT-R2 scores (p = 0.032, r = -0.317) was observed in HCs, but no significant correlation was observed in MDD patients. CONCLUSIONS The present study showed that visual memory and pattern glare are disrupted in MDD. Visual memory may be associated with pattern glare and needs to be studied in future work.
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Affiliation(s)
- Min Wang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | | | - Xiao Yang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Huanhuan Fan
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yikai Dou
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Wanjun Guo
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiang Wang
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Eric Chen
- grid.415550.00000 0004 1764 4144Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Tao Li
- grid.412901.f0000 0004 1770 1022Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China ,grid.412901.f0000 0004 1770 1022Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Mental Health Center, West China Hospital of Sichuan University, Chengdu, China. .,Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China.
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He E, Liu M, Gong S, Fu X, Han Y, Deng F. White Matter Alterations in Depressive Disorder. Front Immunol 2022; 13:826812. [PMID: 35634314 PMCID: PMC9133348 DOI: 10.3389/fimmu.2022.826812] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/22/2022] [Indexed: 11/13/2022] Open
Abstract
Depressive disorder is the most prevalent affective disorder today. Depressive disorder has been linked to changes in the white matter. White matter changes in depressive disorder could be a result of impaired cerebral blood flow (CBF) and CBF self-regulation, impaired blood-brain barrier function, inflammatory factors, genes and environmental factors. Additionally, white matter changes in patients with depression are associated with clinical variables such as differential diagnosis, severity, treatment effect, and efficacy assessment. This review discusses the characteristics, possible mechanisms, clinical relevance, and potential treatment of white matter alterations caused by depressive disorders.
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Melhuish Beaupre LM, Tiwari AK, Gonçalves VF, Zai CC, Marshe VS, Lewis CM, Martin NG, McIntosh AM, Adams MJ, Baune BT, Levinson DF, Boomsma DI, Penninx BWJH, Breen G, Hamilton S, Awasthi S, Ripke S, Jones L, Jones I, Byrne EM, Hickie IB, Potash JP, Shi J, Weissman MM, Milaneschi Y, Shyn SI, de Geus EJC, Willemsen G, Brown GM, Kennedy JL. Corrigendum: Potential genetic overlap between insomnia and sleep symptoms in major depressive disorder: A polygenic risk score analysis. Front Psychiatry 2022; 13:893816. [PMID: 35990050 PMCID: PMC9387200 DOI: 10.3389/fpsyt.2022.893816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyt.2021.734077.].
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Affiliation(s)
- Lindsay M Melhuish Beaupre
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Arun K Tiwari
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vanessa F Gonçalves
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Victoria S Marshe
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.,Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Doug F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dorret I Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Steve Hamilton
- The Permanente Medical Group, San Francisco, CA, United States
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany.,Analytic and Translational Genetic Unit, Massachusetts General Hospital, Boston, MA, United States.,Medical and Population Genetics, Broad Institute, Cambridge, MA, United States.,Department of Psychiatry, Charité, Berlin, Germany
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, United Kingdom
| | - Ian Jones
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Enda M Byrne
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - James P Potash
- Psychiatry Department, University of Iowa, Iowa City, IA, United States
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Myrna M Weissman
- Psychiatry Department, Columbia University College of Physicians and Surgeons, New York, NY, United States.,Division of Epidemiology, New York State Psychiatric Institute, New York, NY, United States
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Stanley I Shyn
- Washington Permanente Medical Group, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Eco J C de Geus
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gonneke Willemsen
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gregory M Brown
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Zhou Y, Wang C, Lan X, Zheng W, Li H, Chao Z, Wu K, McIntyre RS, Ning Y. The potential pro-cognitive effects with intravenous subanesthetic ketamine in adults with treatment-resistant major depressive or bipolar disorders and suicidality. J Psychiatr Res 2021; 144:312-319. [PMID: 34715598 DOI: 10.1016/j.jpsychires.2021.10.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/30/2021] [Accepted: 10/19/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Ketamine has rapid and robust antidepressant effects in depression, while its effects on cognitive measures are less clearly understood. This aim of the study herein is to determine whether ketamine has direct pro-cognitive effects in real-world treatment depression and/or suicidality. METHODS Subjects with unipolar (n = 84) and bipolar (n = 27) depression suffering treatment resistance or suicidality received six infusions of ketamine (0.5 mg/kg) during a 12-day period. Depression symptoms were assessed using the Montgomery-Asberg Depression Rating Scale at baseline, day 13 and day 26. Cognitive domains, including processing speed, working memory, visual learning and verbal learning were also measured using the MATRICS Consensus Cognitive Battery at the same time-points. RESULTS Significant improvement was observed in processing speed at day 13 (effect size [ES] = 0.501) and day 26 (ES = 0.654), and verbal learning at day 13 (ES = 0.362). Path analysis showed significant direct (β = 2.444, P = 0.017) and indirect (β = 1.220, P = 0.048) effect of ketamine on processing speed, indicating its improvement was partly independent of improvement in depressive symptoms. The direct effect (β = -1.963, P = 0.052) of ketamine on verbal learning was not significant, whereas the indirect effect (β = 1.386, P = 0.024) was significant, indicating treatment with ketamine indirectly improved verbal learning performance, via changes in depressive symptom. CONCLUSION Six infusions of ketamine have a potential mood independent pro-cognitive effect on processing speed in adults with treatment depression and/or suicidality. The potential pro-cognitive effects of ketamine provide the basis for hypothesizing that other clinical outcomes (e.g., suicidality, functional impairment) reported with ketamine treatment may be in part mediated by improvement in cognition.
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Affiliation(s)
- Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Chengyu Wang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xiaofeng Lan
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Hanqiu Li
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Ziyuan Chao
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Kai Wu
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; Department of Biomedical Engineering, School of Material Science and Engineering, South China University of Technology, Guangzhou, China
| | - Roger S McIntyre
- Canadian Rapid Treatment Center of Excellence, Mississauga, ON, Canada; Mood Disorders Psychopharmacology Unit, Poul Hansen Depression Centre, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada.
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China; The First School of Clinical Medicine, Southern Medical University, Guangzhou, China.
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10
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Espenes R, Kirsebom BE, Eriksson C, Waterloo K, Hessen E, Johnsen SH, Selnes P, Fladby T. Amyloid Plaques and Symptoms of Depression Links to Medical Help-Seeking due to Subjective Cognitive Decline. J Alzheimers Dis 2021; 75:879-890. [PMID: 32333584 PMCID: PMC7369054 DOI: 10.3233/jad-190712] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background: Subjective cognitive decline (SCD) is associated with an increased risk of Alzheimer’s disease (AD). However, patients reporting SCD to their general practitioner are not always referred to a memory clinic. Objective: To investigate whether prior history of medical help-seeking is associated with AD biomarker abnormality, worse cognitive performance, and/or depressive symptoms in SCD. Methods: We compared levels of cerebrospinal fluid (CSF) Aβ1 - 42, cognitive performance, and depressive symptoms (15-item Geriatric Depression Scale, GDS-15) between healthy controls (n = 88), SCD with a history of medical help seeking (SCD-HS, n = 67), and SCD non help-seekers (SCD-NHS, n = 44). Cases with evidence of amyloid plaques (CSF Aβ1 - 42 ≤708 ng/l) and symptoms of depression (GDS-15≥6) were determined in both SCD groups. Results: The SCD-HS group had lower CSF Aβ1 - 42 (p < 0.01), lower word list learning and memory recall (p < 0.0001), and an increased level of depressive symptoms (p < 0.0001) compared to controls and SCD-NHS cases. The SCD-HS group had more cases with symptoms of depression (n = 12, 18%) and amyloid plaques (n = 18, 27%) compared to SCD-NHS (n = 1, 2% and n = 7, 16%, respectively). None of the SCD-HS cases and only one SCD-NHS case had concurrent symptoms of depression and amyloid plaques. The SCD-HS cases showed equal word list learning and memory performance regardless of amyloid status or symptoms of depression. Conclusion: Medical help-seeking in SCD is associated with an increased risk of AD pathology or symptoms of depression. However, subtle memory deficits are seen in SCD help-seekers, also without amyloid plaques or symptoms of depression.
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Affiliation(s)
- Ragna Espenes
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bjørn-Eivind Kirsebom
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Cecilia Eriksson
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Knut Waterloo
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Erik Hessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.,Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
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11
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Sánchez-Carro Y, Portella MJ, Leal-Leturia I, Salvat-Pujol N, Etxandi M, de Arriba-Arnau A, Urretavizcaya M, Pousa E, Toll A, Álvarez P, Soria V, López-García P. Age at illness onset and physical activity are associated with cognitive impairment in patients with current diagnosis of major depressive disorder. J Affect Disord 2021; 279:343-352. [PMID: 33099048 DOI: 10.1016/j.jad.2020.10.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 09/04/2020] [Accepted: 10/12/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Cognitive impairment has been reported in patients with Major Depressive Disorder (MDD). This study aims to explore the association between lifestyle habits and health-related factors and the presence of cognitive symptoms in MDD patients. METHODS Demographic, clinical, health-related variables and cognitive scores measured with the Cambridge Neuropsychological Test Automated Battery (CANTAB) were compared between 74 patients with current MDD and 68 healthy controls (HC). To test the hypothesis of associated factors to cognitive symptoms, multivariate backward stepwise linear regression models were run. RESULTS Significant neuropsychological deficits were evident in MDD compared with HC in the global cognitive index (F=8.29; df=1, 140; p=0.005). In the regression analysis performed on MDD and HC, years of schooling (β=-0.11; p=<0.001), job status (β=-0.50; p=0.016), physical activity (β=-0.25; p=0.04) and age at illness onset (β=0.17; p=0.017) were statistically significant factors associated to cognitive impairment. The regression model ran in HC showed that only years of schooling were significant (β=-0.07; p=<0.001) in this group. LIMITATIONS Sample size was relatively small. Everyday cognitive skills were not evaluated. CONCLUSIONS MDD patients have cognitive deficits. These deficits are linked with the years of education, job status, age of onset of the disease and the performance of physical activity. These results support the importance of the implementation of interventions targeting the cognitive reserve and lifestyle habits of MDD patients, in addition to the conventional therapeutic approach focused on symptoms control.
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Affiliation(s)
- Yolanda Sánchez-Carro
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain.
| | - Maria J Portella
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autonoma de Barcelona (UAB), Catalonia, Spain
| | - Itziar Leal-Leturia
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
| | - Neus Salvat-Pujol
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Etxandi
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Aida de Arriba-Arnau
- Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain
| | - Mikel Urretavizcaya
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Esther Pousa
- Servei de Psiquiatria, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alba Toll
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM, Barcelona, Spain
| | - Pilar Álvarez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Institute of Neuropsychiatry and Addictions, Hospital del Mar, IMIM, Barcelona, Spain
| | - Virginia Soria
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain; Bellvitge University Hospital, Psychiatry Department. Bellvitge Biomedical Research Institute (IDIBELL), Neurosciences Group - Psychiatry and Mental Health. Barcelona, Spain; Department of Clinical Sciences, School of Medicine, Universitat de Barcelona, Barcelona, Spain
| | - Pilar López-García
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain; Department of Psychiatry, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Carlos III Health Institute, Spain
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12
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Melhuish Beaupre LM, Tiwari AK, Gonçalves VF, Zai CC, Marshe VS, Lewis CM, Martin NG, McIntosh AM, Adams MJ, Baune BT, Levinson DF, Boomsma DI, Penninx BWJH, Breen G, Hamilton S, Awasthi S, Ripke S, Jones L, Jones I, Byrne EM, Hickie IB, Potash JP, Shi J, Weissman MM, Milaneschi Y, Shyn SI, de Geus EJC, Willemsen G, Brown GM, Kennedy JL. Potential Genetic Overlap Between Insomnia and Sleep Symptoms in Major Depressive Disorder: A Polygenic Risk Score Analysis. Front Psychiatry 2021; 12:734077. [PMID: 34925085 PMCID: PMC8678563 DOI: 10.3389/fpsyt.2021.734077] [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: 07/22/2021] [Accepted: 11/01/2021] [Indexed: 11/14/2022] Open
Abstract
Background: The prevalence of insomnia and hypersomnia in depressed individuals is substantially higher than that found in the general population. Unfortunately, these concurrent sleep problems can have profound effects on the disease course. Although the full biology of sleep remains to be elucidated, a recent genome-wide association (GWAS) of insomnia, and other sleep traits in over 1 million individuals was recently published and provides many promising hits for genetics of insomnia in a population-based sample. Methods: Using data from the largest available GWAS of insomnia and other sleep traits, we sought to test if sleep variable PRS scores derived from population-based studies predicted sleep variables in samples of depressed cases [Psychiatric Genomics Consortium - Major Depressive Disorder subjects (PGC MDD)]. A leave-one-out analysis was performed to determine the effects that each individual study had on our results. Results: The only significant finding was for insomnia, where p-value threshold, p = 0.05 was associated with insomnia in our PGC MDD sample (R 2 = 1.75-3, p = 0.006). Conclusion: Our results reveal that <1% of variance is explained by the variants that cover the two significant p-value thresholds, which is in line with the fact that depression and insomnia are both polygenic disorders. To the best of our knowledge, this is the first study to investigate genetic overlap between the general population and a depression sample for insomnia, which has important treatment implications, such as leading to novel drug targets in future research efforts.
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Affiliation(s)
- Lindsay M Melhuish Beaupre
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Arun K Tiwari
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Vanessa F Gonçalves
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Clement C Zai
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Victoria S Marshe
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,Department of Medical and Molecular Genetics, King's College London, London, United Kingdom
| | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Mark J Adams
- Division of Psychiatry, University of Edinburgh, Edinburgh, United Kingdom
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.,Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,Melbourne Medical School, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Doug F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dorret I Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, United Kingdom.,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, King's College London, London, United Kingdom
| | - Steve Hamilton
- The Permanente Medical Group, San Francisco, CA, United States
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Universitäts Medizin Berlin Campus Charité Mitte, Berlin, Germany.,Analytic and Translational Genetic Unit, Massachusetts General Hospital, Boston, MA, United States.,Medical and Population Genetics, Broad Institute, Cambridge, MA, United States.,Department of Psychiatry, Charité, Berlin, Germany
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, United Kingdom
| | - Ian Jones
- Medical Research Council (MRC) Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, United Kingdom
| | - Enda M Byrne
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - Ian B Hickie
- Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia
| | - James P Potash
- Psychiatry Department, University of Iowa, Iowa City, IA, United States
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, United States
| | - Myrna M Weissman
- Psychiatry Department, Columbia University College of Physicians and Surgeons, New York, NY, United States.,Division of Epidemiology, New York State Psychiatric Institute, New York, NY, United States
| | - Yuri Milaneschi
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Stanley I Shyn
- Washington Permanente Medical Group, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Eco J C de Geus
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gonneke Willemsen
- Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience, Amsterdam UMC/Vrije Universiteit, Amsterdam, Netherlands
| | - Gregory M Brown
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - James L Kennedy
- Molecular Brain Science Research Department, Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, ON, Canada.,Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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13
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Ishigooka J, Hoshino T, Imai T, Yoshida H, Ono M, Ota M, Moriguchi Y, Fujikawa K, Shintani A, Fernandez JL. Patient and Physician Perspectives of Depressive Symptoms and Expectations for Treatment Outcome: Results from a Web-Based Survey. Neuropsychiatr Dis Treat 2021; 17:2915-2924. [PMID: 34531658 PMCID: PMC8440229 DOI: 10.2147/ndt.s324968] [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: 06/15/2021] [Accepted: 08/18/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE A previous international study suggested that perceptions of depression symptoms, social function, and treatment expectations are different between patients/physicians. We aimed to examine whether such differences exist in Japan. METHODS A web-based survey was conducted with patients who reported that they had been diagnosed with depression, and physicians who reported that they had treated patients with depression, in Japan. Questionnaires were designed to quantify patients' perceptions of symptoms, social function, and treatment expectations. Patients were categorized into three stages of disorder based on their reported current symptoms: severe symptomatic, mild symptomatic, and remission. Physicians were assigned up to three patients, were provided with patient information from the questionnaire completed by those patients, and finally the completed questionnaire forms for each patient. Agreement between the perceptions of the patients and physicians was examined for each stage. RESULTS Of the 2618 eligible patients, 828 were assigned to 326 eligible physicians. Overall, we found small differences in the perceptions of depression treatment between patients/physicians. Slightly fewer physicians than patients reported physical symptoms (85% vs 91%; p=0.018) in the mild symptomatic stage. Fewer physicians than patients reported cognitive symptoms in the severe (82% vs 87%; p=0.029) and mild (54% vs 66%; p=0.003) symptomatic stages. Social function was deemed to be lower by physicians than by patients, across all stages of disorder (p<0.001). Regarding treatment expectations, more physicians than patients reported "return to a normal life" in the mild symptomatic (51% vs 35%, p<0.001) and remission stages (57% vs 36%, p<0.001), and more patients than physicians reported "reduction of side effects" in the severe (10% vs 4%, p=0.004) and mild (12% vs 5%, p<0.001) symptomatic disorder stages. CONCLUSION These results suggest small differences in patient/physician perceptions of depression treatment in Japan. Discrepancies between patients'/physicians' perceptions may vary depending on the medical environment.
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Affiliation(s)
| | - Tatsuya Hoshino
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Takumi Imai
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Hisako Yoshida
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Midori Ono
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Mihoko Ota
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | | | - Keita Fujikawa
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Ayumi Shintani
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka, Japan
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14
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Gill H, Gill B, Rodrigues NB, Lipsitz O, Rosenblat JD, El-Halabi S, Nasri F, Mansur RB, Lee Y, McIntyre RS. The Effects of Ketamine on Cognition in Treatment-Resistant Depression: A Systematic Review and Priority Avenues for Future Research. Neurosci Biobehav Rev 2020; 120:78-85. [PMID: 33242561 DOI: 10.1016/j.neubiorev.2020.11.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/12/2020] [Accepted: 11/12/2020] [Indexed: 12/28/2022]
Abstract
Replicated evidence has documented cognitive deficits in populations with treatment-resistant depression (TRD). Approximately 40 % of patients with MDD present with impairment of one or more cognitive domains. As such, there is an unmet need to discover treatments that have pro-cognitive effects in TRD patients. Ketamine has demonstrated efficacy as a rapid-onset intervention for the treatment of depression. The objective of the current review was to assess the effects of ketamine on cognition in TRD patients. We systematically searched PubMed, Google Scholar and PsycINFO between database inception to March 24th, 2020. We identified five studies that evaluated cognition in TRD populations following ketamine treatment. All studies included a 0.5 mg/kg subanesthetic intravenous (IV) administration of ketamine. One study found significant improvements in complex (p = .008) and simple (p = .027) working memory and one study found improvements in visual learning memory following IV ketamine infusions (p = .014). Improvements in speed of processing and verbal learning memory were observed in anxious TRD participants only. Importantly, a subanesthetic dose of IV ketamine does not worsen cognitive function.
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Affiliation(s)
- Hartej Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Barjot Gill
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Nelson B Rodrigues
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Orly Lipsitz
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Joshua Daniel Rosenblat
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada
| | - Sabine El-Halabi
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Flora Nasri
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Pharmacology, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
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15
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Taivalantti M, Barnett JH, Halt AH, Koskela J, Auvinen J, Timonen M, Järvelin MR, Veijola J. Depressive symptoms as predictors of visual memory deficits in middle-age. J Affect Disord 2020; 264:29-34. [PMID: 31846899 DOI: 10.1016/j.jad.2019.11.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/29/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression has been known to affect memory and other cognitive domains. The objective of this longitudinal cohort study was to investigate longitudinal associations between depressive symptoms at age 31 years and visual memory and new learning at the age of 46 years. We investigated whether depressive symptoms at age 31 predicted visual memory deficits at age 46 years, and whether changes in depressive symptoms between 31 and 46 years predicted visual memory at age 46. METHODS Participants were members of the Northern Finland Birth Cohort 1966. Depressive symptoms were assessed with the Symptom Checklist-25 (SCL-25) on both occasions. Visual memory and new learning were assessed using Paired Associative Learning (PAL) test at the age 46 follow-up. PAL total errors adjusted and first trial memory score were used as outcomes and basic educational level, relationship status, physical activity and diet at baseline were considered as confounding factors in linear regression analysis. RESULTS A total of 5029 (57% female) participants were included in the main analysis. No associations were found between depressive symptoms or change in depressive symptoms and visual memory and new learning scores. The result did not change following cut-offs 1.55 and 1.75 for depression. LIMITATIONS SCL-25 only measures symptoms during the past week. Only one cognitive domain was assessed. CONCLUSIONS Contrary to our hypothesis, neither baseline depressive symptoms nor change in depressive symptoms predicted visual memory scores 15 years later. It appears that sub-clinical depressive symptoms do not effect this cognitive domain in the middle-aged population.
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Affiliation(s)
- Marjo Taivalantti
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridge Cognition Ltd, Cambridge, UK
| | - Anu-Helmi Halt
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Jari Koskela
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland; Oulunkaari Health Centre, Ii, Finland
| | - Markku Timonen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland; Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Biocenter Oulu, University of Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland; Department of Life Sciences, College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu and Department of psychiatry, University Hospital of Oulu, Oulu, Finland
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16
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Christensen MC, Wong CMJ, Baune BT. Symptoms of Major Depressive Disorder and Their Impact on Psychosocial Functioning in the Different Phases of the Disease: Do the Perspectives of Patients and Healthcare Providers Differ? Front Psychiatry 2020; 11:280. [PMID: 32390877 PMCID: PMC7193105 DOI: 10.3389/fpsyt.2020.00280] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022] Open
Abstract
This analysis was undertaken to examine the relationship between different symptoms of major depressive disorder (MDD) and psychosocial functioning from the perspectives of patients and healthcare providers (HCPs) across the different phases of the disease (acute, post-acute, and remission). Data regarding symptoms of MDD and psychosocial functioning, assessed by an adapted version of the Functioning Assessment Short Test (FAST) scale, were elicited via an online survey from 2,008 patients diagnosed with MDD (based on their personal experience of the disease) and 3,138 patients observed by 1,046 HCPs (based on individual patient records). Correlations between patient-reported and HCP-reported MDD symptoms and impairment of psychosocial functioning were assessed by multivariate regression analysis. The population comprised 1,946 patient respondents and 3,042 HCP-reported patients. Patients reported experiencing a wider range of symptoms and greater impairment of functioning than reported by HCPs across all phases of the disease. At the domain level, only cognitive symptoms were found to be significantly associated with functioning during the acute phase from the perspective of patients, while from the HCPs' perspective both mood and cognitive symptoms significantly impacted functioning in this phase. Significant associations were seen between mood, physical, and cognitive symptom domains and functioning in both cohorts during the post-acute and remission phases. Differences in associations between individual MDD symptoms and functioning were also observed between the two cohorts across all disease phases; in particular, HCPs found that more physical symptoms impacted functioning during remission than did patients. In summary, the results suggest that perceptions of MDD symptoms and the associations between these symptoms and functioning differ significantly between patients and HCPs across all phases of the disease. These findings further highlight the need for improved communication between patients and HCPs in order to set appropriate treatment goals and promote symptomatic and functional recovery in MDD.
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Affiliation(s)
| | | | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.,The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
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Kuang L, Cui D, Jiao Q, Guo Y, Cao W, Gao W, Qiu J, Su L, Lu G. Alterations of Cognition and Cerebral Ventricle Volume in Manic and Euthymic Pediatric Bipolar Disorder. Front Psychiatry 2020; 11:593629. [PMID: 33381058 PMCID: PMC7767823 DOI: 10.3389/fpsyt.2020.593629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction: It remains unknown whether volumetric alterations of ventricles are similar or not in pediatric bipolar disorder (PBD) among different mood states. The present study aims to estimate ventricular volumetric alteration of PBD patients in manic and euthymic status, as well as the relationship between this alteration and cognitive changes. Methods: T1 magnetic resonance images were obtained from 20 manic PBD patients, 21 euthymic PBD patients, and 19 healthy controls (HCs). Ventricular volumes were automatically obtained via FreeSurfer 6.0 software. Ventricular volumes and cognitive indices were compared among the three groups, and the relationship between ventricular volumes and cognitive/clinical indices was analyzed. Results: In contrast to HCs, manic and euthymic PBD patients exhibited decreased cognitive scores of the Stroop color-word test and the digit span subtest. Manic PBD subjects presented enlarged volumes in the bilateral ventricles, third ventricle, and whole ventricles, and euthymic PBD participants displayed increased volumes in the third ventricle, fourth ventricle, and whole ventricles. No significant differences in cognitive performance and ventricular volumes were found between PBD groups. No significant correlation was discovered between ventricular volumes and cognitive/clinical indices in both manic and euthymic PBD patients. Conclusions: No significant differences in cognitive performance and ventricle volume were observed between euthymic and manic PBD groups, which may imply that the alterations are not specific to mood state. It may indicate structural and functional damage of corresponding brain circuits in euthymic PBD patients similar with that of manic PBD, which may provide clues to the diagnosis and treatment of euthymic PBD.
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Affiliation(s)
- Liangfeng Kuang
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Dong Cui
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Qing Jiao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yongxin Guo
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weifang Cao
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weijia Gao
- Department of Child Psychology, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Linyan Su
- Mental Health Institute of the Second Xiangya Hospital, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, China
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18
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Hori H, Katsuki A, Atake K, Yoshimura R, Nakamura J, Baune BT. Risk factors for further sick leave among Japanese workers returning to work after an episode of major depressive disorder: a prospective follow-up study over 1 year. BMJ Open 2019; 9:e029705. [PMID: 31511285 PMCID: PMC6747669 DOI: 10.1136/bmjopen-2019-029705] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We aimed to investigate the risk factors for further sick leave episodes among Japanese workers returning to work after time off with a major depressive disorder. DESIGN A prospective study with 1 year of follow-up. PARTICIPANTS We recruited 103 workers who had returned to work after taking sick leave with a major depressive disorder. Adjusted HRs with 95% CIs were calculated using Cox proportional hazard models to examine the risk of further sick leave. RESULTS In the adjusted analysis, we show that Social Adaptation Self-evaluation Scale scores (HR 0.95; p=0.019), 3-back correct response rate (N-back test) (HR 0.97; p<0.001) and benzodiazepine dosage (diazepam equivalent) (HR1.07; p=0.014) were associated with further episodes of sick leave. CONCLUSIONS Poorer social and cognitive functioning, together with higher diazepam dosages, were associated with an increased likelihood of additional sick leave.
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Affiliation(s)
- Hikaru Hori
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Asuka Katsuki
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kiyokazu Atake
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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19
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Abstract
Cognitive dysfunction is common in many psychiatric disorders. While it has long been described as a core feature in schizophrenia, more recent data suggest qualitatively similar impairments in patients with bipolar disorder and major depressive disorder. There is compelling evidence to suggest that cognitive impairment contributes directly to functional disability and reduced quality of like across these disorders. As current treatments focus heavily on "primary" symptoms of mood and psychosis, the standard of care typically leaves cognitive deficits unmanaged. With this in mind, the field has recently begun to consider intervening directly on this important symptom domain, with several ongoing trials in schizophrenia. Fewer studies have targeted cognition in bipolar disorder and still fewer in MDD. With progress toward considering this domain as a target for treatment comes the need for consensus guidelines and methodological recommendations on cognitive trial design. In this manuscript, we first summarize the work conducted to date in this area for schizophrenia and for bipolar disorder. We then begin to address these same issues in MDD and emphasize the need for additional work in this area.
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20
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Knight MJ, Baune BT. Social cognitive abilities predict psychosocial dysfunction in major depressive disorder. Depress Anxiety 2019; 36:54-62. [PMID: 30211966 DOI: 10.1002/da.22844] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/21/2018] [Accepted: 09/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with social cognitive deficits (e.g., poor affect recognition and impaired theory of mind). However, the contribution of social cognitive issues to psychosocial dysfunction in MDD (e.g., occupational functioning and interpersonal relationships) has not been investigated. The current study evaluated the relationship between specific social cognitive domains (e.g., prosody interpretation) and psychosocial dysfunction in subjects with lifetime MDD, as well as currently depressed, remitted, and healthy controls (HCs) subjects. METHOD Data were obtained from 213 participants in the Cognitive Function and mood study (CoFaMS), a cross-sectional study of mood, social cognition, cold cognition, and psychosocial functioning in mood disorders. Participants' (current MDD n = 42, remitted MDD n = 69, and HCs n = 102) social cognitive abilities were assessed using the Social Perception subtest of the Wechsler Adult Intelligence Scale, and psychosocial dysfunction was clinically evaluated with the Functioning Assessment Short Test (FAST). RESULTS The results indicated that prosody interpretation, but not facial affect or meaning interpretation, was associated with psychosocial dysfunction in subjects with lifetime MDD, as well as remitted MDD subjects relative to HCs. In contrast, social cognition was not associated with functioning in participants with current MDD or in HCs. CONCLUSIONS These results suggest that the relationship between social cognition and psychosocial functioning differs between the acute and remitted stage of illness in MDD, and that prosody interpretation should be considered a treatment target in patients with residual psychosocial issues.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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21
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Knight MJ, Baune BT. The Direct and Indirect Relationship Between Social Cognition and Psychosocial Dysfunction in Major Depressive Disorder. Front Psychiatry 2019; 10:347. [PMID: 31156485 PMCID: PMC6533355 DOI: 10.3389/fpsyt.2019.00347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Recent evidence suggests that depressed patients experience social cognitive deficits (e.g., poor affect recognition). However, very little is known regarding the contribution of social cognitive deficits to psychosocial dysfunction (e.g., occupational functioning). In particular, the mechanistic roles of depression severity and cognitive deficits (e.g., memory) in this domain have not been explored. The current study evaluated the extent to which mood symptoms and cognitive deficits provide a mechanistic explanation for the relationship between social cognitive and psychosocial deficits in major depressive disorder (MDD). Methods: Data were obtained from 111 participants with MDD (75 Female, mean age = 35, 84% Caucasian, 12% Asian, 4% Other) in the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of mood, social cognition, cognition, and psychosocial functioning in mood disorders. Social cognitive abilities were assessed using the Social Perception subtest of the Wechsler Adult Intelligence Scale, and psychosocial dysfunction was clinically evaluated with the Functioning Assessment Short Test (FAST). Results: Cognitive deficits and mood symptoms did not significantly mediate relationships between social cognitive ability and psychosocial dysfunction. The exception was executive function, which mediated an indirect relationship between meaning interpretation (i.e., theory of mind) and self-perceived cognitive dysfunction. Conclusion: The results suggest that the relationship between social cognitive deficits and psychosocial dysfunction is not mechanistically explained by mood symptoms or nonsocial cognition. Development of treatment strategies targeting social cognitive deficits in patients with MDD is warranted.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University Hospital Münster, University of Münster, Münster, Germany
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22
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Baune BT, Christensen MC. Differences in Perceptions of Major Depressive Disorder Symptoms and Treatment Priorities Between Patients and Health Care Providers Across the Acute, Post-Acute, and Remission Phases of Depression. Front Psychiatry 2019; 10:335. [PMID: 31178765 PMCID: PMC6537882 DOI: 10.3389/fpsyt.2019.00335] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 04/29/2019] [Indexed: 11/15/2022] Open
Abstract
Limited data exist on concordance between patients' and health care providers' (HCPs) perceptions regarding symptoms of major depressive disorder (MDD) and treatment priorities, particularly across disease phases. This study examined concordance during the acute, post-acute, and remission phases of MDD. In an online survey, 2,008 patients responded based on their experience with MDD, and 1,046 HCPs responded based on their clinical experience treating patients with MDD. Questions included symptom frequency and severity, treatment priorities, and impact on psychosocial functioning. Patients reported more frequently mood, physical, and cognitive symptoms than HCPs in the post-acute and remission phases and greater impact on psychosocial functioning. Patients reported that all these symptoms require high treatment priority across the phases of MDD, generally to a greater extent than HCPs. Patients also gave high emphasis to addressing impairment in psychosocial functioning early in the treatment course. A substantial difference in the effectiveness of treating symptoms of MDD between patients and HCPs was observed. This is the first study to quantify, broadly, differences in perceptions of MDD symptom prevalence, severity, and treatment priorities across MDD phases, and the study findings highlight a need for improved communication between patients and HCPs about symptoms, their impact on psychosocial functioning, and treatment priorities across phases.
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Affiliation(s)
- Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia.,Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
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23
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Fourrier C, Sampson E, Mills NT, Baune BT. Anti-inflammatory treatment of depression: study protocol for a randomised controlled trial of vortioxetine augmented with celecoxib or placebo. Trials 2018; 19:447. [PMID: 30126458 PMCID: PMC6102899 DOI: 10.1186/s13063-018-2829-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 07/30/2018] [Indexed: 12/12/2022] Open
Abstract
Background In patients with major depressive disorder (MDD), antidepressant response and remission rates are low, highlighting the need for new treatment approaches. Recently, the abundant literature linking inflammatory processes and depressive symptoms have led to the hypothesis that selecting treatment for MDD based on the patient’s inflammatory status could be a promising strategy to improve outcomes in patients suffering from MDD. The aim of the randomised control trial we propose is to investigate the antidepressant efficacy of the combined treatment of MDD with antidepressant medication plus anti-inflammatory medication in individuals with raised inflammation levels. For the first time, this study will prospectively test the efficacy of an antidepressant plus anti-inflammatory augmentation based on baseline inflammatory maker levels in MDD using a randomised controlled trial design. Methods This study proposes to measure blood C-reactive protein (CRP) levels before the initiation of treatment in 200 participants with MDD. Study participants are then assigned into one of two study strata: either into the ‘Depression with inflammation’ stratum (CRP levels > 3 mg/L); or into the ‘Depression without inflammation’ stratum (CRP levels ≤ 3 mg/L). Within each of the two study strata, participants randomly receive either antidepressant medication alone (vortioxetine) plus anti-inflammatory medication (celecoxib) or vortioxetine plus placebo for six weeks. At the end of the treatment period, participants have the opportunity to continue vortioxetine alone for a six-month post-trial period. Clinical outcomes are measured at baseline, fortnightly during the treatment period and at the three-month and six-month post-trial visits. The primary outcome is change in MADRS score, with a primary endpoint of a score reduction by 50% from baseline to six weeks (end of augmentation treatment with celecoxib). Secondary clinical outcomes are changes in the cognitive dimensions of depression (cognitive function, emotion processing and social cognition). Biological outcome measures (levels of CRP and other inflammatory markers) are measured at baseline, after six weeks of treatment and at the six-month post-trial visit. Discussion The current study will generate novel evidence for biomarker-based personalised antidepressant treatment selection based on patient inflammatory status before treatment. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12617000527369p. Registered on 11 April 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2829-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Célia Fourrier
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Emma Sampson
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Natalie T Mills
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, 3010, VIC, Australia.
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24
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Knight MJ, Air T, Baune BT. The role of cognitive impairment in psychosocial functioning in remitted depression. J Affect Disord 2018; 235:129-134. [PMID: 29655074 DOI: 10.1016/j.jad.2018.04.051] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 03/20/2018] [Accepted: 04/04/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive dysfunction is a prevalent and disabling symptom of Major Depressive Disorder (MDD), and is often retained in the remitted stage of illness. Emerging evidence suggests that cognitive impairment may be associated with dysfunction in a number of psychosocial domains (e.g., workplace productivity, social relationships). The current study explored the relationship between cognition and psychosocial functioning in remitted MDD and in healthy controls. METHODS Data were obtained from 182 participants of the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of cognition, mood, and social cognition in mood disorders. Participants' (Remitted MDD n = 72, Healthy n = 110) cognition was assessed with a battery of cognitive tests including the Repeatable Battery for the Assessment of Neuropsychological Function (RBANS) and other standard measures of cognition (e.g., The Tower of London task). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST). RESULTS The results indicated that executive functioning was the strongest independent predictor of functioning in remitted MDD patients, whereas various cognitive domains predicted psychosocial functioning in healthy individuals. LIMITATIONS Psychosocial functioning was measured with a clinical interview, and was therefore reliant on clinicians' judgement of impairment, as opposed to more objective measures of functioning. CONCLUSIONS These findings suggest that executive cognition plays an important role in functional recovery in remitted depression, and may be a crucial target in adjunctive treatment.
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Affiliation(s)
- Mattew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
| | - Tracy Air
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, 57 North Terrace, Adelaide, SA 5000, Australia.
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25
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Peyrot WJ, Van der Auwera S, Milaneschi Y, Dolan CV, Madden PAF, Sullivan PF, Strohmaier J, Ripke S, Rietschel M, Nivard MG, Mullins N, Montgomery GW, Henders AK, Heat AC, Fisher HL, Dunn EC, Byrne EM, Air TA, Baune BT, Breen G, Levinson DF, Lewis CM, Martin NG, Nelson EN, Boomsma DI, Grabe HJ, Wray NR, Penninx BWJH. Does Childhood Trauma Moderate Polygenic Risk for Depression? A Meta-analysis of 5765 Subjects From the Psychiatric Genomics Consortium. Biol Psychiatry 2018; 84:138-147. [PMID: 29129318 PMCID: PMC5862738 DOI: 10.1016/j.biopsych.2017.09.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/01/2017] [Accepted: 09/01/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND The heterogeneity of genetic effects on major depressive disorder (MDD) may be partly attributable to moderation of genetic effects by environment, such as exposure to childhood trauma (CT). Indeed, previous findings in two independent cohorts showed evidence for interaction between polygenic risk scores (PRSs) and CT, albeit in opposing directions. This study aims to meta-analyze MDD-PRS × CT interaction results across these two and other cohorts, while applying more accurate PRSs based on a larger discovery sample. METHODS Data were combined from 3024 MDD cases and 2741 control subjects from nine cohorts contributing to the MDD Working Group of the Psychiatric Genomics Consortium. MDD-PRS were based on a discovery sample of ∼110,000 independent individuals. CT was assessed as exposure to sexual or physical abuse during childhood. In a subset of 1957 cases and 2002 control subjects, a more detailed five-domain measure additionally included emotional abuse, physical neglect, and emotional neglect. RESULTS MDD was associated with the MDD-PRS (odds ratio [OR] = 1.24, p = 3.6 × 10-5, R2 = 1.18%) and with CT (OR = 2.63, p = 3.5 × 10-18 and OR = 2.62, p = 1.4 ×10-5 for the two- and five-domain measures, respectively). No interaction was found between MDD-PRS and the two-domain and five-domain CT measure (OR = 1.00, p = .89 and OR = 1.05, p = .66). CONCLUSIONS No meta-analytic evidence for interaction between MDD-PRS and CT was found. This suggests that the previously reported interaction effects, although both statistically significant, can best be interpreted as chance findings. Further research is required, but this study suggests that the genetic heterogeneity of MDD is not attributable to genome-wide moderation of genetic effects by CT.
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Affiliation(s)
- Wouter J Peyrot
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, the Netherlands.
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Yuri Milaneschi
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, the Netherlands
| | - Conor V Dolan
- Department of Biological Psychology, VU University Medical Center, Amsterdam, the Netherlands
| | - Pamela A F Madden
- Department of Psychiatry, Washington University Medical School, St. Louis, Missouri
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Michel G Nivard
- Department of Biological Psychology, VU University Medical Center, Amsterdam, the Netherlands
| | - Niamh Mullins
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Grant W Montgomery
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Anjali K Henders
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Andrew C Heat
- Department of Psychiatry, Washington University Medical School, St. Louis, Missouri
| | - Helen L Fisher
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Erin C Dunn
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Enda M Byrne
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Tracy A Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Cathryn M Lewis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Nick G Martin
- Queensland Institute of Medical Research Berghofer Medical Research Institute, Brisbane, Australia
| | - Elliot N Nelson
- Department of Psychiatry, Washington University Medical School, St. Louis, Missouri
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Medical Center, Amsterdam, the Netherlands
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Naomi R Wray
- Queensland Brain Institute, University of Queensland, Brisbane, Australia; Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Brenda W J H Penninx
- Department of Psychiatry, VU University Medical Center and GGZ inGeest, Amsterdam, the Netherlands
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26
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Yu C, Baune BT, Wong ML, Licinio J. Investigation of short tandem repeats in major depression using whole-genome sequencing data. J Affect Disord 2018; 232:305-309. [PMID: 29501989 DOI: 10.1016/j.jad.2018.02.046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/02/2018] [Accepted: 02/16/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a leading contributor to global disease burden. Recent studies have shown that genetic factors play significant roles in the susceptibility to this condition; however, the underlying genetic basis currently remains largely unknown. Short tandem repeat (STR) has been proposed as an explanatory factor in the "missing heritability" of complex diseases or traits. METHODS We investigated STR variations from 15 MDD patients and 10 ethnically matched healthy controls based on their deep whole-genome sequencing (WGS) data. The lobSTR software was used to computationally determine STRs. RESULTS The results of the Mexican-American sample showed that STRs are significantly richer in healthy controls than in MDD cases on each of the 23 chromosomes (all false discovery rates, FDR P-values < 0.0062); while for the Australian of European-ancestry sample, there was no statistically significant STRs difference between MDD cases and controls. LIMITATIONS High quality WGS costs limited obtaining larger datasets. CONCLUSIONS This preliminary work is the first study that STR variations are applied to investigate MDD based on WGS data. The results on Mexican-American population may imply that within the same ancestry, targeted sequencing on a specific chromosome or region of genome would be sufficient for examining the relationship between STR and MDD. Further studies should examine larger sequencing datasets on other ethnic groups.
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Affiliation(s)
- Chenglong Yu
- Robinson Research Institute, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5005, Australia; Mind and Brain Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia; School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA 5005, Australia
| | - Ma-Li Wong
- Mind and Brain Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia; School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia; Department of Psychiatry, College of Medicine, State University of New York, Upstate Medical University, Syracuse, NY 13210, USA
| | - Julio Licinio
- Department of Psychiatry, College of Medicine, State University of New York, Upstate Medical University, Syracuse, NY 13210, USA; Departments of Pharmacology and Medicine, College of Medicine, State University of New York, Upstate Medical University, Syracuse, NY 13210, USA
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Low-frequency and rare variants may contribute to elucidate the genetics of major depressive disorder. Transl Psychiatry 2018; 8:70. [PMID: 29581422 PMCID: PMC5913271 DOI: 10.1038/s41398-018-0117-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 12/01/2017] [Accepted: 12/30/2017] [Indexed: 11/09/2022] Open
Abstract
Major depressive disorder (MDD) is a common but serious psychiatric disorder with significant levels of morbidity and mortality. Recent genome-wide association studies (GWAS) on common variants increase our understanding of MDD; however, the underlying genetic basis remains largely unknown. Many studies have been proposed to explore the genetics of complex diseases from a viewpoint of the "missing heritability" by considering low-frequency and rare variants, copy-number variations, and other types of genetic variants. Here we developed a novel computational and statistical strategy to investigate the "missing heritability" of MDD. We applied Hamming distance on common, low-frequency, and rare single-nucleotide polymorphism (SNP) sets to measure genetic distance between two individuals, and then built the multi-dimensional scaling (MDS) pictures. Whole-exome genotyping data from a Los Angeles Mexican-American cohort (203 MDD and 196 controls) and a European-ancestry cohort (473 MDD and 497 controls) were examined using our proposed methodology. MDS plots showed very significant separations between MDD cases and healthy controls for low-frequency SNP set (P value < 2.2e-16) and rare SNP set (P value = 7.681e-12). Our results suggested that low-frequency and rare variants may play more significant roles in the genetics of MDD.
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Baune BT, Sluth LB, Olsen CK. The effects of vortioxetine on cognitive performance in working patients with major depressive disorder: A short-term, randomized, double-blind, exploratory study. J Affect Disord 2018; 229:421-428. [PMID: 29331703 DOI: 10.1016/j.jad.2017.12.056] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/13/2017] [Accepted: 12/27/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Major Depressive Disorder (MDD) is a complex disease characterized by emotional, physical and cognitive symptoms. We explored the efficacy of vortioxetine versus placebo on outcomes of cognition, functioning and mood symptoms in working patients with depression, using paroxetine as an active reference. METHODS Gainfully employed patients (18-65 years, N = 152) with MDD were randomized 1:1:1 to 8 weeks' double-blind, parallel treatment either with vortioxetine (10mg/day) or paroxetine (20mg/day), or with placebo. The primary efficacy measure was the Digit Symbol Substitution Test (DSST), analyzed using a mixed model for repeated measurements, and the key secondary efficacy measure was the University of San Diego Performance-based Skills Assessment - Brief (UPSA-B), analyzed using analysis of covariance (last observation carried forward). RESULTS At week 8, DSST and UPSA-B performance had improved relative to baseline in all treatment groups, with no statistically significant differences between treatment groups. While improvements in mood were comparable for vortioxetine and paroxetine, numerical improvements in cognitive performance (DSST) were larger with vortioxetine. Vortioxetine significantly improved overall cognitive performance and clinician-rated functioning relative to placebo. The majority of adverse events were mild or moderate, with nausea being the most common adverse event for vortioxetine. LIMITATIONS Small sample sizes implied limited statistical power. CONCLUSION This explorative study showed no significant differences versus placebo in DSST or UPSA-B performance at week 8. However, secondary results support vortioxetine as an effective and well-tolerated antidepressant, supporting an added benefit for cognition and functioning, which could have particular therapeutic relevance for the working patient population.
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Affiliation(s)
- Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia.
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Yu C, Baune BT, Fu KA, Wong ML, Licinio J. Genetic clustering of depressed patients and normal controls based on single-nucleotide variant proportion. J Affect Disord 2018; 227:450-454. [PMID: 29154167 DOI: 10.1016/j.jad.2017.11.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/27/2017] [Accepted: 11/06/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Genetic components play important roles in the susceptibility to major depressive disorder (MDD). The rapid development of sequencing technologies is allowing scientists to contribute new ideas for personalized medicine; thus, it is essential to design non-invasive genetic tests on sequencing data, which can help physicians diagnose and differentiate depressed patients and healthy individuals. METHODS We have recently proposed a genetic concept involving single-nucleotide variant proportion (SNVP) in genes to study MDD. Using this approach, we investigated combinations of distance metrics and hierarchical clustering criteria for genetic clustering of depressed patients and ethnically matched controls. RESULTS We analysed clustering results of 25 human subjects based on their SNVPs in 46 newly discovered candidate genes. CONCLUSIONS According to our findings, we recommend Canberra metric with Ward's method to be used in hierarchical clustering of depressed and normal individuals. Futures studies are needed to advance this line of research validating our approach in larger datasets, those may also be allow the investigation of MDD subtypes. LIMITATIONS High quality sequencing costs limited our ability to obtain larger datasets.
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Affiliation(s)
- Chenglong Yu
- Robinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia; Mind and Brain Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Ke-Ang Fu
- School of Statistics and Mathematics, Zhejiang Gongshang University, Hangzhou, Zhejiang, China
| | - Ma-Li Wong
- Mind and Brain Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia; College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
| | - Julio Licinio
- College of Medicine, Departments of Psychiatry, Pharmacology and Medicine, State University of New York, Upstate Medical University, Syracuse, NY, USA
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30
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Knight MJ, Baune BT. Executive Function and Spatial Cognition Mediate Psychosocial Dysfunction in Major Depressive Disorder. Front Psychiatry 2018; 9:539. [PMID: 30420817 PMCID: PMC6215806 DOI: 10.3389/fpsyt.2018.00539] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 10/10/2018] [Indexed: 01/19/2023] Open
Abstract
Background: Cognitive and psychosocial dysfunction are prevalent and disabling features of Major Depressive Disorder (MDD). Emerging evidence suggests that poor cognitive functioning mediates the negative effect of MDD on psychosocial function. However, there is a lack of research examining the domain-specific nature of this relationship. The current study evaluated whether the relationship between MDD and specific psychosocial subdomains (e.g., autonomy, occupational functioning) was mediated by domain-specific cognitive deficits. Methods: Data from 155 participants was obtained from the Cognitive Function and Mood Study (CoFaMS), a cross-sectional analysis of mood, cognition, social cognition, and functioning in individuals with MDD. Cognitive functioning was assessed (Current MDD n = 45, Healthy n = 110), with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Colorado Assessment Tests (CATs), and the Psychology Experiment Building Language (PEBL). Psychosocial functioning was clinically evaluated with the Functioning Assessment Short Test (FAST). Results: The results indicated that spatial cognition and executive functioning partially mediated the negative effect of MDD on overall psychosocial functioning, autonomy, and subjective cognition. In contrast, spatial and executive domains showed divergent mediation patterns on interpersonal relationships and leisure time. Conclusions: The findings suggest that executive and spatial cognition play an important role in the pathology of overall psychosocial functioning, and specific functional issues in MDD. Treatments targeting psychosocial recovery in MDD may be improved by emphasizing executive and spatial cognitive remediation.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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31
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Culverhouse RC, Saccone NL, Horton AC, Ma Y, Anstey KJ, Banaschewski T, Burmeister M, Cohen-Woods S, Etain B, Fisher HL, Goldman N, Guillaume S, Horwood J, Juhasz G, Lester KJ, Mandelli L, Middeldorp CM, Olié E, Villafuerte S, Air TM, Araya R, Bowes L, Burns R, Byrne EM, Coffey C, Coventry WL, Gawronski KAB, Glei D, Hatzimanolis A, Hottenga JJ, Jaussent I, Jawahar C, Jennen-Steinmetz C, Kramer JR, Lajnef M, Little K, Zu Schwabedissen HM, Nauck M, Nederhof E, Petschner P, Peyrot WJ, Schwahn C, Sinnamon G, Stacey D, Tian Y, Toben C, Van der Auwera S, Wainwright N, Wang JC, Willemsen G, Anderson IM, Arolt V, Åslund C, Bagdy G, Baune BT, Bellivier F, Boomsma DI, Courtet P, Dannlowski U, de Geus EJC, Deakin JFW, Easteal S, Eley T, Fergusson DM, Goate AM, Gonda X, Grabe HJ, Holzman C, Johnson EO, Kennedy M, Laucht M, Martin NG, Munafò MR, Nilsson KW, Oldehinkel AJ, Olsson CA, Ormel J, Otte C, Patton GC, Penninx BWJH, Ritchie K, Sarchiapone M, Scheid JM, Serretti A, Smit JH, Stefanis NC, Surtees PG, Völzke H, Weinstein M, Whooley M, Nurnberger JI, Breslau N, Bierut LJ. Collaborative meta-analysis finds no evidence of a strong interaction between stress and 5-HTTLPR genotype contributing to the development of depression. Mol Psychiatry 2018; 23:133-142. [PMID: 28373689 PMCID: PMC5628077 DOI: 10.1038/mp.2017.44] [Citation(s) in RCA: 186] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 01/23/2017] [Accepted: 02/02/2017] [Indexed: 01/01/2023]
Abstract
The hypothesis that the S allele of the 5-HTTLPR serotonin transporter promoter region is associated with increased risk of depression, but only in individuals exposed to stressful situations, has generated much interest, research and controversy since first proposed in 2003. Multiple meta-analyses combining results from heterogeneous analyses have not settled the issue. To determine the magnitude of the interaction and the conditions under which it might be observed, we performed new analyses on 31 data sets containing 38 802 European ancestry subjects genotyped for 5-HTTLPR and assessed for depression and childhood maltreatment or other stressful life events, and meta-analysed the results. Analyses targeted two stressors (narrow, broad) and two depression outcomes (current, lifetime). All groups that published on this topic prior to the initiation of our study and met the assessment and sample size criteria were invited to participate. Additional groups, identified by consortium members or self-identified in response to our protocol (published prior to the start of analysis) with qualifying unpublished data, were also invited to participate. A uniform data analysis script implementing the protocol was executed by each of the consortium members. Our findings do not support the interaction hypothesis. We found no subgroups or variable definitions for which an interaction between stress and 5-HTTLPR genotype was statistically significant. In contrast, our findings for the main effects of life stressors (strong risk factor) and 5-HTTLPR genotype (no impact on risk) are strikingly consistent across our contributing studies, the original study reporting the interaction and subsequent meta-analyses. Our conclusion is that if an interaction exists in which the S allele of 5-HTTLPR increases risk of depression only in stressed individuals, then it is not broadly generalisable, but must be of modest effect size and only observable in limited situations.
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Affiliation(s)
- R C Culverhouse
- Department of Medicine and Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - N L Saccone
- Department of Genetics and Division of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - A C Horton
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Y Ma
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - K J Anstey
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - M Burmeister
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - S Cohen-Woods
- School of Psychology, Faculty of Social and Behavioural Sciences, Flinders University, Adelaide, SA, Australia
| | - B Etain
- Sorbonne Paris Cité, Université Paris Diderot, UMR-S 1144, Paris, France
- AP-HP, Groupe Saint-Louis-Lariboisière-F. Widal, Paris, France
- INSERM, U1144, Paris, France
| | - H L Fisher
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - N Goldman
- Office of Population Research, Princeton University, Princeton, NJ, USA
| | - S Guillaume
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - J Horwood
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - G Juhasz
- MTA-SE-NAP B Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
| | - K J Lester
- School of Psychology, University of Sussex, Brighton, UK
| | - L Mandelli
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - C M Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - E Olié
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - S Villafuerte
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - T M Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - R Araya
- Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, London, UK
| | - L Bowes
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - R Burns
- Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, ACT, Australia
| | - E M Byrne
- Institute for Molecular Bioscience, University of Queensland, Brisbane, QLD, Australia
| | - C Coffey
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - W L Coventry
- Discipline of Psychology, University of New England, Armidale, NSW, Australia
| | - K A B Gawronski
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - D Glei
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - A Hatzimanolis
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - I Jaussent
- INSERM U1061 Neuropsychiatry, Montpellier, France
| | - C Jawahar
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - C Jennen-Steinmetz
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - J R Kramer
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - K Little
- Murdoch Childrens Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics and School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - H M Zu Schwabedissen
- Biopharmacy, Department Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - M Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - E Nederhof
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - P Petschner
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - W J Peyrot
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - C Schwahn
- Department of Prosthetic Dentistry, Gerostomatology and Dental Materials, University Medicine Greifswald, Greifswald, Germany
| | - G Sinnamon
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - D Stacey
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Y Tian
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - C Toben
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - N Wainwright
- Department of Public Health and Primary Care, School of Clinical Medicine, Cambridge, UK
| | - J-C Wang
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - G Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - I M Anderson
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - V Arolt
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - C Åslund
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Västmanland County Hospital Västerås, Västerås, Sweden
| | - G Bagdy
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - F Bellivier
- Sorbonne Paris Cité, Université Paris Diderot, UMR-S 1144, Paris, France
- AP-HP, Groupe Saint-Louis-Lariboisière-F. Widal, Paris, France
- INSERM, U1144, Paris, France
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Neuroscience Campus Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - P Courtet
- Université Montpellier, Montpellier, France
- INSERM U1061 Neuropsychiatry, Montpellier, France
- Department of Emergency Psychiatry and Acute Care, CHU Montpellier, Montpellier, France
| | - U Dannlowski
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - E J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- EMGO+ Institute for Health and Care Research, VU Medical Center Amsterdam, Amsterdam, The Netherlands
| | - J F W Deakin
- Neuroscience and Psychiatry Unit, The University of Manchester, Manchester, UK
- Manchester Academic Health Sciences Centre, Manchester, UK
| | - S Easteal
- John Curtin School of Medical Research, The Australian National University, Canberra, ACT, Australia
| | - T Eley
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - D M Fergusson
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - A M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - X Gonda
- Department of Pharmacodynamics, Semmelweis University, Budapest, Hungary
- NAP-A-SE New Antidepressant Target Research Group, Semmelweis University, Budapest, Hungary
- MTA-SE Neuropsychopharmacology and Neurochemistry Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary
- Department of Psychiatry and Psychotherapy, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - C Holzman
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - E O Johnson
- Fellow Program and Behavioral Health and Criminal Justice Division, RTI International, Research Triangle Park, NC, USA
| | - M Kennedy
- Department of Pathology, University of Otago Christchurch, Christchurch, New Zealand
| | - M Laucht
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - N G Martin
- Genetic Epidemiology, QIMR Berghofer, Brisbane, QLD, Australia
| | - M R Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
- UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
| | - K W Nilsson
- Centre for Clinical Research, Uppsala University, Uppsala, Sweden
- Västmanland County Hospital Västerås, Västerås, Sweden
| | - A J Oldehinkel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - C A Olsson
- Deakin University Geelong, Centre for Social and Early Emotional Development, School of Psychology, Faculty of Health, Burwood, VIC, Australia
- Department of Paediatrics and School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, VIC, Australia
| | - J Ormel
- University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion Regulation, Groningen, The Netherlands
| | - C Otte
- Charité Universitätsmedizin Berlin, Klinik für Psychiatrie und Psychotherapie Campus Benjamin Franklin, Berlin, Germany
| | - G C Patton
- Department of Paediatrics, Murdoch Childrens Research Institute, University of Melbourne, Melbourne, VIC, Australia
| | - B W J H Penninx
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - K Ritchie
- INSERM U1061 Neuropsychiatry, Montpellier, France
| | - M Sarchiapone
- Department of Health Sciences, University of Molise, Campobasso, Italy
| | - J M Scheid
- Department of Psychiatry, Michigan State University, East Lansing, MI, USA
| | - A Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - J H Smit
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam, The Netherlands
| | - N C Stefanis
- Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - P G Surtees
- Department of Public Health and Primary Care, School of Clinical Medicine, Cambridge, UK
| | - H Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Weinstein
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - M Whooley
- Veterans Affairs Health Care System and University of California, San Francisco, CA, USA
| | - J I Nurnberger
- Institute of Psychiatric Research, Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - N Breslau
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - L J Bierut
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
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Clark SR, Schubert KO, Olagunju AT, Lyrtzis EA, Baune BT. Cognitive and Functional Assessment of Psychosis Stratification Study (CoFAPSS): Rationale, Design, and Characteristics. Front Psychiatry 2018; 9:662. [PMID: 30559688 PMCID: PMC6287598 DOI: 10.3389/fpsyt.2018.00662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 11/19/2018] [Indexed: 11/13/2022] Open
Abstract
Prediction of treatment response and illness trajectory in psychotic disorders including schizophrenia, bipolar affective disorder, schizoaffective disorder, and psychotic depression is difficult due to heterogeneity in presentation and outcome. Consequently, patients may receive prolonged ineffective treatments leading to functional decline, illness chronicity, and iatrogenic physical illness. One approach to addressing these problems is to stratify patients based on historical, clinical, and biological signatures. Such an approach has the potential to improve categorization resulting in better understanding of underlying mechanisms and earlier evidence-based treatment with reduced side effect burden. To investigate these multimodal signatures we developed the Cognitive and Functional Assessment of Psychosis Stratification Study (CoFAPSS) employing a prospective study design and a healthy control group comparison. The main aim of this study is to investigate cognitive, and biological "genomics" markers of psychotic illnesses that can be integrated with clinical data to improve prediction of risk and define functional trajectories. We also aim to identify biological "genomic" signatures underpinning variation in treatment response and adverse medical outcomes. The study commenced in June 2016, including patients with primary diagnosis of psychotic disorders including schizophrenia, bipolar affective disorder, schizoaffective disorder, and psychotic depression according to DSM-5 criteria. The assessment covers a wide range of participant history (life stressors, trauma, and family history), cognitive dimensions (social perception, memory and learning, attention, executive function, and general cognition), measures to assess psychosocial function and quality of life, psychotic symptom severity, clinical course of illness, and parameters for adverse medical outcome. Blood is collected for comprehensive genomic discovery analyses of biological (genomic, transcriptomic, proteomic, and cell-biologic) markers. The CoFAPSS is a novel approach that integrates clinical, cognitive and biological "genomic" markers to clarify clinico-pathological basis of risk, functional trajectories, disease stratification, treatment response, and adverse medical outcome. The CoFAPSS team welcomes collaborations with both national and international investigators.
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Affiliation(s)
- Scott R Clark
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
| | - Andrew T Olagunju
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia.,Department of Psychiatry University of Lagos, Lagos, Nigeria
| | - Ellen Alexandra Lyrtzis
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia.,Department of Psychiatry, Melbourne Medical School, The University of Melbourne Melbourne, VIC, Australia
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Knight MJ, Baune BT. Executive Subdomains Are Differentially Associated With Psychosocial Outcomes in Major Depressive Disorder. Front Psychiatry 2018; 9:309. [PMID: 30042703 PMCID: PMC6048277 DOI: 10.3389/fpsyt.2018.00309] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 06/21/2018] [Indexed: 12/02/2022] Open
Abstract
Background: Deficits in executive functioning are frequently associated with poor psychosocial outcomes in Major Depressive Disorder (MDD). However, there is a poor understanding of the domain-specific relationships between executive subdomains (e.g., forward planning, decision making) and specific psychosocial issues (e.g., occupational functioning, social relationships). The current study explored these relationships across currently depressed and remitted MDD patients, as well as a healthy control group. Methods: Data from 142 participants were obtained from the Cognitive Functioning and Mood Study (CoFaM-S), a cross sectional study of mood, cognition, and psychosocial functioning in mood disorders. Participants' [current depression n = 31, remitted depression n = 52, healthy controls (HC) n = 59] executive functioning was evaluated with well-established tests of executive subdomains (i.e., Tower of London, card sorting, Stroop task). The Functioning Assessment Short Test (FAST) was employed to clinically evaluate psychosocial dysfunction. Results: The results indicated that forward planning was most strongly associated with psychosocial issues in the current depression group as compared to HCs, while cognitive updating was primary in the remitted group vs. HC. Conclusions: These findings suggest that executive subdomains are deferentially associated with psychosocial issues across different stages of depressive illness, and that forward planning and cognitive updating should be considered in adjunctive cognitive treatment.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
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Van der Auwera S, Peyrot WJ, Milaneschi Y, Hertel J, Baune B, Breen G, Byrne E, Dunn EC, Fisher H, Homuth G, Levinson D, Lewis C, Mills N, Mullins N, Nauck M, Pistis G, Preisig M, Rietschel M, Ripke S, Sullivan P, Teumer A, Völzke H, Boomsma DI, Wray NR, Penninx B, Grabe H. Genome-wide gene-environment interaction in depression: A systematic evaluation of candidate genes: The childhood trauma working-group of PGC-MDD. Am J Med Genet B Neuropsychiatr Genet 2018; 177:40-49. [PMID: 29159863 PMCID: PMC5726923 DOI: 10.1002/ajmg.b.32593] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/28/2017] [Accepted: 08/08/2017] [Indexed: 12/16/2022]
Abstract
Gene by environment (GxE) interaction studies have investigated the influence of a number of candidate genes and variants for major depressive disorder (MDD) on the association between childhood trauma and MDD. Most of these studies are hypothesis driven and investigate only a limited number of SNPs in relevant pathways using differing methodological approaches. Here (1) we identified 27 genes and 268 SNPs previously associated with MDD or with GxE interaction in MDD and (2) analyzed their impact on GxE in MDD using a common approach in 3944 subjects of European ancestry from the Psychiatric Genomics Consortium who had completed the Childhood Trauma Questionnaire. (3) We subsequently used the genome-wide SNP data for a genome-wide case-control GxE model and GxE case-only analyses testing for an enrichment of associated SNPs. No genome-wide significant hits and no consistency among the signals of the different analytic approaches could be observed. This is the largest study for systematic GxE interaction analysis in MDD in subjects of European ancestry to date. Most of the known candidate genes/variants could not be supported. Thus, their impact on GxE interaction in MDD may be questionable. Our results underscore the need for larger samples, more extensive assessment of environmental exposures, and greater efforts to investigate new methodological approaches in GxE models for MDD.
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Affiliation(s)
- Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Wouter J Peyrot
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - Yuri Milaneschi
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - Johannes Hertel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Bernhard Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, MRC Social Genetic and Developmental Psychiatry Centre, King's College London, London, Great Britain
- NIHR BRC for Mental Health, King's College London, London, Great Britain
| | - Enda Byrne
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Erin C Dunn
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, Massachusetts
| | - Helen Fisher
- Institute of Psychiatry, Psychology and Neuroscience, MRC Social Genetic and Developmental Psychiatry Centre, King's College London, London, Great Britain
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, Department of Functional Genomics, University Medicine and Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Douglas Levinson
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Cathryn Lewis
- Institute of Psychiatry, Psychology and Neuroscience, MRC Social Genetic and Developmental Psychiatry Centre, King's College London, London, Great Britain
- Department of Medical and& Molecular Genetics, King's College London, London, Great Britain
| | - Natalie Mills
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Niamh Mullins
- Institute of Psychiatry, Psychology and Neuroscience, MRC Social Genetic and Developmental Psychiatry Centre, King's College London, London, Great Britain
| | - Matthias Nauck
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Giorgio Pistis
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Martin Preisig
- Department of Psychiatry, University Hospital of Lausanne, Prilly, Switzerland
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Stephan Ripke
- Medical and Population Genetics, Broad Institute, Cambridge, Massachusetts
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry and Psychotherapy, University medicine Berlin Campus Charité Mitte, Berlin, Germany
| | - Patrick Sullivan
- Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Dorret I Boomsma
- Department of Biological Psychology & EMGO+ Institute for Health and Care Research, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Naomi R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Brenda Penninx
- Department of Psychiatry, Vrije Universiteit Medical Center and GGZ in Geest, Amsterdam, The Netherlands
| | - Hans Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
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Barreira DP, Marinho RT, Bicho M, Fialho R, Ouakinin SRS. Psychosocial and Neurocognitive Factors Associated With Hepatitis C - Implications for Future Health and Wellbeing. Front Psychol 2018; 9:2666. [PMID: 30687151 PMCID: PMC6333630 DOI: 10.3389/fpsyg.2018.02666] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 12/11/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Hepatitis C virus (HCV) infection involves changes not only from the point of view of physical health, but also emotional, and social that have a significant impact on the quality of life of these patients. According to the literature review, it seems that there is an important association between psychosocial factors, in particular on a cognitive level and disease progression. The aim of this mini-review is to summarize recent literature looking at the associations between psychosocial and neurocognitive factors and HCV. Methods: PubMed/Medline was systematically searched for psychosocial and neurocognitive factors associated with hepatitis C, treatment adherence, and patient wellbeing. Results: Patients present with a range of extrahepatic symptoms including fatigue, anxiety, depression, and neurocognitive dysfunction. HCV's impact on quality of life and wellbeing has serious clinical and social implications. Conclusion: Hepatitis C and its management continue to have a profound impact on health and psychologic wellbeing. Considering the serious extrahepatic implications for individuals, it is imperative that healthcare professionals pay close attention to psychosocial and neurocognitive factors. The focus on combined clinical approaches could enhance understanding about the health and social impacts of hepatitis C along the life course.
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Affiliation(s)
- David Pires Barreira
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Lisboa Norte-Hospital de Santa Maria, Lisbon, Portugal
- *Correspondence: David Pires Barreira,
| | - Rui Tato Marinho
- Faculdade de Medicina, Universidade de Lisboa, Serviço de Gastrenterologia e Hepatologia, Centro Hospitalar Lisboa Norte-Hospital de Santa Maria, Lisbon, Portugal
| | - Manuel Bicho
- Laboratório de Genética, Faculdade de Medicina, Instituto de Saúde Ambiental, Universidade de Lisboa, Lisbon, Portugal
| | - Renata Fialho
- Assertive Outreach Team, Sussex Partnership NHS Foundation Trust, Brighton and Hove, United Kingdom
| | - Silvia Raquel Soares Ouakinin
- Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Abstract
PURPOSE OF REVIEW The principal aim of this review is to highlight recent advances in our understanding of cognitive dysfunction in major depressive disorder (MDD). We review new assessment and treatment approaches, in which cognition and associated psychosocial dysfunction are considered primary outcomes. RECENT FINDINGS Current work suggests that cognitive dysfunction reduces occupational productivity, and interferes broadly with domains of day-to-day and social functioning. These findings imply that cognitive dysfunction interacts with emotional and social factors relevant to MDD. Recent advances in screening instruments enable standardized detection of cognitive symptoms in MDD. Clinical trials suggest that cognitive symptoms are suitable targets and primary outcomes of psychological and pharmacological treatments. SUMMARY A growing interest in cognitive dysfunction in MDD has improved our ability to assess and treat MDD. Future research will be strengthened by the use of consistent terminology, standardized cognitive screening, and treatments that target cognitive dysfunction in MDD. Integration of emotional and social treatment strategies may further advance clinical efficacy.
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Investigation of copy number variation in subjects with major depression based on whole-genome sequencing data. J Affect Disord 2017; 220:38-42. [PMID: 28578134 DOI: 10.1016/j.jad.2017.05.044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/26/2017] [Accepted: 05/28/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Despite recent intensive research using genome-wide association studies, the underlying biological basis of major depressive disorder (MDD) still remains unknown. In contrast to genotyping platforms which identify specific variations, whole-genome sequencing (WGS) allows us to detect all private genetic variations within an individual. So far there have been no studies investigating copy number variations (CNVs) in subjects with MDD using WGS data. METHODS We obtained complete WGS paired-end reads data of 15 MDD patients and 10 ethnically matched healthy controls. We performed alignments for the sequencing reads and used GASV package to call CNVs including deletion, inversion, translocation and divergence for those subjects. RESULTS Our results show that, in the Mexican-American sample, deletion CNVs were significantly richer in MDD cases than healthy controls on each of 23 chromosomes. However, other types of CNVs failed to reach any significance. In the Australian sample, there was no statistically significant difference of CNVs between MDD cases and controls. Furthermore, we found that the Australian group had significantly more deletion CNVs than the Mexican-American group. LIMITATIONS High quality WGS costs limited obtaining larger datasets. The GASV package does not currently support duplication or insertion CNVs. CONCLUSIONS To our knowledge this is the first time that CNVs detected by WGS data are used to study major depression. The conclusion that deletion CNVs are significantly richer in MDD cases than healthy controls is consistent with the previous finding about recurrent depressive disorder by genome-wide association analysis of CNVs on a large genotyping microarray data.
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Yu C, Baune BT, Licinio J, Wong ML. Whole-genome single nucleotide variant distribution on genomic regions and its relationship to major depression. Psychiatry Res 2017; 252:75-79. [PMID: 28258043 PMCID: PMC5730269 DOI: 10.1016/j.psychres.2017.02.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 02/06/2017] [Accepted: 02/19/2017] [Indexed: 11/22/2022]
Abstract
Recent advances in DNA technologies have provided unprecedented opportunities for biological and medical research. In contrast to current popular genotyping platforms which identify specific variations, whole-genome sequencing (WGS) allows for the detection of all private mutations within an individual. Major depressive disorder (MDD) is a chronic condition with enormous medical, social and economic impacts. Genetic analysis, by identifying risk variants and thereby increasing our understanding of how MDD arises, could lead to improved prevention and the development of new and more effective treatments. Here we investigated the distributions of whole-genome single nucleotide variants (SNVs) on 12 different genomic regions for 25 human subjects using the symmetrised Kullback-Leibler divergence to measure the similarity between their SNV distributions. We performed cluster analysis for MDD patients and ethnically matched healthy controls. The results showed that Mexican-American controls grouped closer; in contrast depressed Mexican-American participants grouped away from their ethnically matched controls. This implies that whole-genome SNV distribution on the genomic regions may be related to major depression.
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Affiliation(s)
- Chenglong Yu
- Mind and Brain Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia; School of Medicine, Flinders University, Bedford Park, SA 5042, Australia.
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA 5005, Australia
| | - Julio Licinio
- Mind and Brain Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia; School of Medicine, Flinders University, Bedford Park, SA 5042, Australia
| | - Ma-Li Wong
- Mind and Brain Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA 5000, Australia; School of Medicine, Flinders University, Bedford Park, SA 5042, Australia
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Knight MJ, Baune BT. Psychosocial Dysfunction in Major Depressive Disorder-Rationale, Design, and Characteristics of the Cognitive and Emotional Recovery Training Program for Depression (CERT-D). Front Psychiatry 2017; 8:280. [PMID: 29312014 PMCID: PMC5732931 DOI: 10.3389/fpsyt.2017.00280] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 11/29/2017] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Psychosocial dysfunction is associated with poor longitudinal course of depression and is not sufficiently addressed by existing pharmaceutical or psychological treatments. The aim of the current study is to evaluate the efficacy of a novel intervention designed to improve psychosocial function in depressed individuals. Impaired cognition, emotion processing, and social cognition appear to underlie (i.e., cause) psychosocial dysfunction in depression. The current treatment will target functioning in these domains (i.e., cognition, emotion, social cognition) with repeated training tasks, following the rationale that therapeutic benefits will arise in psychosocial functioning. It is expected that personalizing treatment by participants' baseline functioning will enhance clinical efficacy, by comparison with standard treatment in which baseline functioning is not considered. METHODS The study is a randomized, controlled treatment (RCT), in which the efficacy of a personalized and standard intervention will be compared. Sixteen treatment sessions will be administered over an 8-week period. These treatments are designed to improve cognition, emotion processing and social cognition. Assessments of psychosocial functioning, as well as a number of secondary outcomes, will occur at baseline, 4 weeks (mid-RCT), 8 weeks (end of RCT), and in the observational period at baseline (week 9) and 3 and 6 months post-RCT. Recruitment will commence in July 2017, including subjects diagnosed with major depressive disorder according to DSM-IV-TR criteria. DISCUSSION This research will provide new insight into the roles of cognition, emotion processing, and social cognition in psychosocial dysfunction in depression. In addition, the relative clinical efficacy of personalized versus standard treatment approaches will be assessed. ETHICS AND DISSEMINATION This study has been approved by the human research ethics committees of the Royal Adelaide Hospital and the University of Adelaide (ethics code: R20170611). The study has been registered with the Australia and New Zealand Clinical Trials Registry Registration number: ACTRN12617000899347, web link: http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12617000899347p. The results of the current study will be published in academic journals following completion of recruitment in 2019. Data will be owned and retained by the University of Adelaide, with access restricted to the research team responsible for the study.
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Affiliation(s)
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
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