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Tu JH, Lu Y, Yue ZC, Ling KN, Xing YR, Chen DD, Zhu ZR, Chen TX. Suicidal incidence and gender-based discrepancies in prolonged grief disorder: insights from a meta-analysis and systematic review. Front Psychiatry 2024; 15:1427486. [PMID: 39211541 PMCID: PMC11358064 DOI: 10.3389/fpsyt.2024.1427486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 07/17/2024] [Indexed: 09/04/2024] Open
Abstract
Background In the aftermath of bereavement, our research explores the subtleties of Prolonged Grief Disorder (PGD), focusing particularly on its correlation with suicidal behaviors and their variation across genders. This study seeks to elucidate the impact of gender on these behaviors among individuals suffering from PGD, thereby enhancing our understanding and facilitating the development of tailored therapeutic interventions. Methods By November 24th, 2023, we had rigorously reviewed key databases such as PubMed, Web of Science, Cochrane Library, PsycINFO, and Embase. Independently, two researchers conducted detailed interviews and filled out questionnaires with participants to gather demographic information and record instances of prolonged grief disorder. The study also meticulously tracked occurrences of suicidal ideation, suicide attempts, suicide deaths, and self-injury among the participants. Results The findings indicate that 22.34% of males reported suicidal ideation (95% CI: 21.33-23.35), a figure that rises to 26.84% among females (95% CI: 25.99-27.69). Notably, 12.11% of males attempted suicide (95% CI: 11.49-12.72), marginally surpassing the 9.60% observed in females (95% CI: 9.17-10.04). More striking disparities were observed in suicide deaths, with rates for males at 3.66% (95% CI: 3.32-4.00) compared to a notably higher 7.12% for females (95% CI: 6.44-7.81). Furthermore, the incidence of self-injury was lower among males, at 2.48% (95% CI: 2.03-2.94), than in females, who reported a rate of 5.09% (95% CI: 4.69-5.49). These patterns underscore the critical need for gender-specific interventions aimed at reducing these significant disparities. Conclusion This study distinctly underscores the profound impact of gender on the manifestation of suicidal behaviors in individuals afflicted with prolonged grief disorder. It reveals that females are more prone to suicidal ideation, self-injury, and suicide deaths, while males predominantly exhibit a higher incidence of suicide attempts and risk-taking behaviors. These unmediated trends highlight the necessity for gender-specific clinical interventions tailored to address particular behaviors and modify prevalent patterns that typically resist conventional approaches. Systematic review registration PROSPERO (york.ac.uk), identifier CRD42023480035.
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Affiliation(s)
- Jin-Heng Tu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Yun Lu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Zong-Chao Yue
- School of Nursing, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ke-Nan Ling
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Yu-Run Xing
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Dan-Dan Chen
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Zhi-Ren Zhu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Tian-Xi Chen
- Department of Emergency Medicine, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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2
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Gareeva AE, Borodina LS, Pozdnyakov SA, Timerbulatov IF. [Pharmacogenomic and pharmacometabolomic biomarkers of the efficacy and safety of antidepressants: focus on selective serotonin reuptake inhibitors]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:26-35. [PMID: 39072563 DOI: 10.17116/jnevro202412406126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
The efficacy and safety of psychopharmacotherapy with antidepressants is of great medical importance. The search for clinical and biological predictors for choosing the optimal psychopharmacotherapy with antidepressants is actively underway all over the world. Research is mainly devoted to searching for associations of polymorphic gene variants with the efficacy and safety of therapy. However, information about a patient's genetic polymorphism is often insufficient to predict the efficacy and safety of a drug. Modern research on the personalization of pharmacotherapy should include, in addition to genetic, phenotypic biomarkers. This is important because genotyping, for example, cannot accurately predict the actual metabolic activity of an isoenzyme. To personalize therapy, a combination of methods is required to obtain the most complete profile of the efficacy and safety of the drug. Successful treatment of depression remains a challenge, and inter-individual differences in response to antidepressants are common. About half of patients with depressive disorders do not respond to the first attempt at antidepressant therapy. Serious side-effects of antidepressant pharmacotherapy and discontinuation of treatment due to their intolerance are associated with ineffective therapy. This review presents the results of the latest studies of «omics» biomarkers of the efficacy and safety of antidepressants.
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Affiliation(s)
- A E Gareeva
- Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences, Ufa, Russia
- Kemerovo State University, Kemerovo, Russia
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
| | - L S Borodina
- Republican Narcological Dispensary No. 1, Ufa, Russia
| | - S A Pozdnyakov
- Moscow Scientific and Practical Center for Narcology of the Moscow Health Department, Moscow, Russia
| | - I F Timerbulatov
- Russian Medical Academy of Continuing Professional Education, Moscow, Russia
- Usoltsev Central Clinical Psychiatric Hospital, Moscow, Russia
- Russian University of Medicine, Moscow, Russia
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3
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Pyszkowska A, Celban J, Nowacki A, Dubiel I. Maladaptive daydreaming, emotional dysregulation, affect and internalized stigma in persons with borderline personality disorder and depression disorder: A network analysis. Clin Psychol Psychother 2023; 30:1246-1255. [PMID: 37932952 DOI: 10.1002/cpp.2923] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 11/08/2023]
Abstract
Maladaptive daydreaming (MD) manifests through experiences of excessive, long-lasting daydreaming resulting in significant suffering, including isolation, distress and shame. Considering that one of its functions is a distraction from painful feelings, it is linked with escapism and plays a significant role in disorders associated with emotional dysregulation, maintaining negative symptoms, including internalized stigmatization and social withdrawal. The current study aimed to examine cognitive (internalized stigma), affective (affect, anhedonia, emotional dysregulation) and behavioural (escapism) aspects of MD in borderline personality disorder (BPD) and depression groups. The sample consisted of 188 persons, including 102 individuals with BPD. The results showed higher scores in emotional dysregulation, internalized stigma and escapism in the BPD group compared to the depression group; the subgroups did not vary in MD rates. The network analysis revealed significant differences between groups in variables dynamics, with links between MD and self-suppression escapism, negative affect in the BPD group and MD with self-suppression escapism and social withdrawal in the depression group. Emotionally dysregulation and internalized stigma factors posed as the most robust expected influence components in both networks, suggesting that the cognitive and affective factors, not strictly behavioural, are pivotal for one's functioning and regulation strategies in the groups studied. The current study allows for clinical implications in interventions focused on persons developing MD and emotional dysregulation symptoms, including persons with BPD and depression.
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Affiliation(s)
- Anna Pyszkowska
- Department of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Julia Celban
- Department of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Ari Nowacki
- Department of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
| | - Izabela Dubiel
- Department of Social Sciences, Institute of Psychology, University of Silesia in Katowice, Katowice, Poland
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4
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Addressing nurses' prolonged grief due to the COVID-19 pandemic. Nursing 2023; 53:30-33. [PMID: 36573867 DOI: 10.1097/01.nurse.0000902948.21436.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
ABSTRACT The COVID-19 pandemic resulted in physical and emotional tolls on healthcare workers and caregivers, which have caused prolonged grief disorder and persistent complex bereavement disorder. Highlighting key learnings from healthcare workers' experiences during the pandemic, this article outlines self-care strategies to help nurses better prepare for future healthcare emergencies.
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5
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Gong X, Chang R, Zou J, Tan S, Huang Z. The role and mechanism of tryptophan - kynurenine metabolic pathway in depression. Rev Neurosci 2022; 34:313-324. [PMID: 36054612 DOI: 10.1515/revneuro-2022-0047] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 07/13/2022] [Indexed: 12/22/2022]
Abstract
Major depressive disorder (MDD) is a common mental illness characterized by persistent low mood and anhedonia, normally accompanied with cognitive impairment. Due to its rising incidence and high rate of recurrence and disability, MDD poses a substantial threat to patients' physical and mental health, as well as a significant economic cost to society. However, the etiology and pathogenesis of MDD are still unclear. Chronic inflammation may cause indoleamine-2,3-dioxygenase (IDO) to become overactive throughout the body and brain, resulting in excess quinolinic acid (QUIN) and less kynuric acid (KYNA) in the brain. QUIN's neurotoxicity damages glial cells and neurons, accelerates neuronal apoptosis, hinders neuroplasticity, and causes depression due to inflammation. Therefore, abnormal TRP-KYN metabolic pathway and its metabolites have been closely related to MDD, suggesting changes in the TRP-KYN metabolic pathway might contribute to MDD. In addition, targeting TRP-KYN with traditional Chinese medicine showed promising treatment effects for MDD. This review summarizes the recent studies on the TRP-KYN metabolic pathway and its metabolites in depression, which would provide a theoretical basis for exploring the etiology and pathogenesis of depression.
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Affiliation(s)
- Xiaoli Gong
- Department of Clinical Laboratory, Fifth Affiliated Hospital, Southern Medical University, Guangzhou 510900, China
| | - Rui Chang
- Department of Histology and Embryology, School of Basic Medicine, Hengyang Medical School, University of South China, 28 W. Chang Sheng Road, Hengyang 421001, Hunan, China
| | - Ju Zou
- Department of Histology and Embryology, School of Basic Medicine, Hengyang Medical School, University of South China, 28 W. Chang Sheng Road, Hengyang 421001, Hunan, China
| | - Sijie Tan
- Department of Histology and Embryology, School of Basic Medicine, Hengyang Medical School, University of South China, 28 W. Chang Sheng Road, Hengyang 421001, Hunan, China
| | - Zeyi Huang
- Department of Clinical Laboratory, Fifth Affiliated Hospital, Southern Medical University, Guangzhou 510900, China.,Department of Histology and Embryology, School of Basic Medicine, Hengyang Medical School, University of South China, 28 W. Chang Sheng Road, Hengyang 421001, Hunan, China
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Pignataro P, Dicarlo M, Zerlotin R, Storlino G, Oranger A, Sanesi L, Lovero R, Buccoliero C, Mori G, Colaianni G, Colucci S, Grano M. Antidepressant Effect of Intermittent Long-Term Systemic Administration of Irisin in Mice. Int J Mol Sci 2022; 23:ijms23147596. [PMID: 35886944 PMCID: PMC9320584 DOI: 10.3390/ijms23147596] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/04/2022] [Accepted: 07/08/2022] [Indexed: 01/27/2023] Open
Abstract
Depression is a psychiatric disorder increasingly diffused worldwide. Evidence suggests that irisin, a myokine secreted by contracting muscle, mediates beneficial effects on several targets, including the brain. Here, the potential antidepressant properties of long-term intermittent systemic irisin administration (100 µg/kg/weekly for 1 month) were evaluated in mice by the Tail Suspension Test (TST), Forced Swim Test (FST), and Open Field Test (OFT). Furthermore, to deepen the molecular pathways underlying irisin treatment, the expression of irisin precursor, neurotrophic/growth factors, and cytokines was analyzed. Irisin treatment significantly decreased the immobility time in the TST and FST, suggesting an antidepressant effect. Additionally, irisin seemed to display an anxiolytic-like effect increasing the time spent in the OFT arena center. These findings were probably due to the modulation of endogenous brain factors as the gene expression of some neurotrophins, such as brain-derived neurotrophic factor (BDNF) and insulin-like growth factor (IGF-1), was upregulated only in irisin-treated mouse brain. Moreover, irisin modulated the expression of some cytokines (IL-1β, IL-4, IL-6, and IL-10). To the best of our knowledge, this is the first study demonstrating that the irisin antidepressant effect may be observed even with a systemic administration in mice. This could pave the way toward intriguing preclinical research in humans.
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Affiliation(s)
- Patrizia Pignataro
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, 70124 Bari, Italy; (M.D.); (G.S.); (L.S.); (S.C.)
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
- Correspondence:
| | - Manuela Dicarlo
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, 70124 Bari, Italy; (M.D.); (G.S.); (L.S.); (S.C.)
| | - Roberta Zerlotin
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
| | - Giuseppina Storlino
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, 70124 Bari, Italy; (M.D.); (G.S.); (L.S.); (S.C.)
| | - Angela Oranger
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
| | - Lorenzo Sanesi
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, 70124 Bari, Italy; (M.D.); (G.S.); (L.S.); (S.C.)
| | - Roberto Lovero
- Clinical Pathology Unit, Polyclinic of Bari, 70124 Bari, Italy;
| | - Cinzia Buccoliero
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
| | - Giorgio Mori
- Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy;
| | - Graziana Colaianni
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
| | - Silvia Colucci
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, 70124 Bari, Italy; (M.D.); (G.S.); (L.S.); (S.C.)
| | - Maria Grano
- Department of Emergency and Organ Transplantation, University of Bari, 70126 Bari, Italy; (R.Z.); (A.O.); (C.B.); (G.C.); (M.G.)
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Adiukwu F, Kamalzadeh L, Pinto da Costa M, Ransing R, de Filippis R, Pereira-Sanchez V, Larnaout A, Gonzalez-Diaz JM, Eid M, Syarif Z, Orsolini L, Ramalho R, Vadivel R, Shalbafan M. The grief experience during the COVID-19 pandemic across different cultures. Ann Gen Psychiatry 2022; 21:18. [PMID: 35701763 PMCID: PMC9196145 DOI: 10.1186/s12991-022-00397-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 06/03/2022] [Indexed: 12/04/2022] Open
Abstract
Grief is the physical or mental suffering experienced after a major loss, usually the death of a loved one. It is a universal experience, but sociocultural factors, such as cultural or ethnic identity and religious beliefs predict and shape the expression of grief. The circumstances under which people are experiencing grief during the coronavirus outbreak have adversely affected the grieving process. Unexpected deaths, social distancing rules and visitor restrictions in healthcare facilities have posed a heavier burden on the loss and have heightened the risk of grievers experiencing complicated or persistent grief. This concern led us, as early career psychiatrists (ECPs) from 14 different countries connected by the Early Career Psychiatrists Section of the World Psychiatric Association (WPA), to share our country-specific experiences on the mourning, grief tradition, and burial rites during the COVID-19 pandemic. In this paper, we discuss our experiences, similarities and differences with relation to the: 'Effect of the pandemic on mourning', 'Restrictions and Guideline on burial rites due to the pandemic', 'Effect of the pandemic on social support' and 'Role of media and telecommunication on mourning practices and burial rites'. We conclude that while telecommunication means have attempted to bridge the gap and provide some form of social connectedness, the total and global effect of the pandemic is yet to be fully seen and understood.
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Affiliation(s)
- Frances Adiukwu
- Department of Mental Health, University of Port Harcourt, Rivers, Port harcourt, Nigeria
| | - Leila Kamalzadeh
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Ramdas Ransing
- Department of Psychiatry, BKL Walawalkar Rural Medical College, Ratnagiri, 415606, Maharashtra, India
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100, Catanzaro, Italy
| | - Victor Pereira-Sanchez
- Department of Psychiatry, Columbia University, New York, NY, USA.,Department of Child and Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Amine Larnaout
- Psychiatry Department D, Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Jairo M Gonzalez-Diaz
- UR Center for Mental Health - CERSAME, School of Medicine and Health Sciences, Universidad del Rosario, Bogotá DC, Colombia.,Clínica Nuestra Señora de La Paz, Bogotá DC, Colombia.,Barcelona Clínic Schizophrenia Unit, Neurosciences Institute, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - Mario Eid
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | | | - Laura Orsolini
- Unit of Clinical Psychiatry, Department of Neurosciences/DIMSC, School of Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Rodrigo Ramalho
- Department of Social and Community Health, School of Population Health, The University of Auckland, Auckland, New Zealand
| | | | - Mohammadreza Shalbafan
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Kato M, Ogata H, Tahara H, Shimamoto A, Takekita Y, Koshikawa Y, Nishida K, Nonen S, Higasa K, Kinoshita T. Multiple Pre-Treatment miRNAs Levels in Untreated Major Depressive Disorder Patients Predict Early Response to Antidepressants and Interact with Key Pathways. Int J Mol Sci 2022; 23:ijms23073873. [PMID: 35409234 PMCID: PMC8999364 DOI: 10.3390/ijms23073873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 03/29/2022] [Accepted: 03/29/2022] [Indexed: 12/16/2022] Open
Abstract
Major depressive disorder (MDD) is a life-impairing disorder, and early successful treatment is important for a favorable prognosis. However, early response to antidepressants differs widely among individuals, and is difficult to predict pre-treatment. As miRNAs have been reported to play important roles in depression, identification of miRNAs associated with antidepressant treatment responses and their interacting genes and pathways will be beneficial in understanding the predictors and molecular mechanisms of depression treatment. This randomized control trial examined miRNAs correlated with the early therapeutic effect of selective serotonin reuptake inhibitors (SSRIs; paroxetine or sertraline) and mirtazapine monotherapy. Before medication, we comprehensively analyzed the miRNA expression of 92 depressed participants and identified genes and pathways interacting with miRNAs. A total of 228 miRNAs were significantly correlated with depressive symptoms improvements after 2 weeks of SSRIs treatment, with miR-483.5p showing the most robust correlation. These miRNAs are involved in 21 pathways, including TGF-β, glutamatergic synapse, long-term depression, and the mitogen-activated protein kinase (MAPK) signaling pathways. Using these miRNAs enabled us to predict SSRI response at week 2 with a 57% difference. This study shows that pre-treatment levels of miRNAs could be used to predict early responses to antidepressant administration, a knowledge of genes, and an identification of genes and pathways associated with the antidepressant response.
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Affiliation(s)
- Masaki Kato
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
- Correspondence:
| | - Haruhiko Ogata
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Hidetoshi Tahara
- Department of Cellular and Molecular Biology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8533, Japan;
| | - Akira Shimamoto
- Faculty of Pharmaceutical Sciences, Sanyo-Onoda City University, Sanyo Onoda 756-0084, Japan;
| | - Yoshiteru Takekita
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Yosuke Koshikawa
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Keiichiro Nishida
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
| | - Shinpei Nonen
- Department of Pharmacy, Hyogo University of Health Sciences, Kobe 650-8530, Japan;
| | - Koichiro Higasa
- Department of Genome Analysis, Institute of Biomedical Science, Kansai Medical University, Osaka 573-1191, Japan;
| | - Toshihiko Kinoshita
- Department of Neuropsychiatry, Kansai Medical University, Osaka 573-1191, Japan; (H.O.); (Y.T.); (Y.K.); (K.N.); (T.K.)
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