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Botacin EC, Duarte SMB, Stefano JT, Barbosa MED, Pessoa MG, Oliveira CP. ASSOCIATION BETWEEN ANXIETY AND DEPRESSION IN METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE (MASLD). ARQUIVOS DE GASTROENTEROLOGIA 2024; 61:e23128. [PMID: 39045999 DOI: 10.1590/s0004-2803.24612023-128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/09/2023] [Indexed: 07/25/2024]
Abstract
BACKGROUND This study aimed to assess the frequency and intensity of anxious and depressive symptoms in patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD). METHODS This is a descriptive and cross-sectional study, resulting from 106 patients from the Hepatology outpatient clinic at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, Brazil without a history of alcohol abuse, verified by the alcohol use disorders identification test (AUDIT). These were assessed using the sociodemographic data sheet, Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Scale (HAM-D). RESULTS A total of 69.8% were women and 30.2% were men, with a mean age of 61 years. The majority (71.7%) discovered MASLD through routine exams, presenting as comorbidities: Type 2 diabetes mellitus (59.4%), Dyslipidemia (49.1%), Arterial hypertension (68.9%), Obesity (61.3%) and Metabolic syndrome [MetS (63.2%)]. The HADS scale indicates 34% probability of anxiety and 33% depressive symptoms. The Hamilton's scales of intensity indicates 63.9% severe anxiety and 54.3% severe depression. There is also a relationship between anxiety, depression and the female gender, as well as between depression and MetS. CONCLUSION The findings point to the presence of anxiety and depression in more than one third of MASLD patients, most with severe symptoms. The group is concentrated in the elderly, with many comorbidities, including MetS. There was a positive correlation between anxiety, depression and being female; also, being significant between MetS and depression.
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Affiliation(s)
- Eloyse Cristina Botacin
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
| | - Sebastião Mauro Bezerra Duarte
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
| | - José Tadeu Stefano
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
| | - Mary Ellen Dias Barbosa
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
| | - Mario Guimarães Pessoa
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
| | - Cláudia P Oliveira
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Laboratório de Gastroenterologia Clínica e Experimental (LIM-07), Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
- Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Departamento de Gastroenterologia e Hepatologia, São Paulo, SP, Brasil
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Nelson CA, Brundage JN, Williams BM, Baldridge JK, Stockard AL, Bassett CH, Burger BJ, Gunter BT, Payne AJ, Yorgason JT, Steffensen SC, Bills KB. Voluntary Exercise Ameliorates Chronic Ethanol Withdrawal-Induced Adaptations of Opioid Receptor Expression in the Nucleus Accumbens, Dopamine Release, and Ethanol Consumption. Biomedicines 2024; 12:1593. [PMID: 39062166 PMCID: PMC11274624 DOI: 10.3390/biomedicines12071593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/05/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Exercise has increasingly been recognized as an adjunctive therapy for alcohol-use disorder (AUD), yet our understanding of its underlying neurological mechanisms remains limited. This knowledge gap impedes the development of evidence-based exercise guidelines for AUD treatment. Chronic ethanol (EtOH) exposure has been shown to upregulate and sensitize kappa opioid receptors (KORs) in the nucleus accumbens (NAc), which is innervated by dopamine (DA) neurons in the midbrain ventral tegmental area (VTA), which may contribute to AUD-related behaviors. In this study, we investigated the impact of voluntary exercise in EtOH-dependent mice on EtOH consumption, KOR and delta opioid receptor (DOR) expression in the NAc and VTA, and functional effects on EtOH-induced alterations in DA release in the NAc. Our findings reveal that voluntary exercise reduces EtOH consumption, reduces KOR and enhances DOR expression in the NAc, and modifies EtOH-induced adaptations in DA release, suggesting a competitive interaction between exercise-induced and EtOH-induced alterations in KOR expression. We also found changes to DOR expression in the NAc and VTA with voluntary exercise but no significant changes to DA release. These findings elucidate the complex interplay of AUD-related neurobiological processes, highlighting the potential for exercise as a therapeutic intervention for AUD.
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Affiliation(s)
- Christina A. Nelson
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
| | - James N. Brundage
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Benjamin M. Williams
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Jared K. Baldridge
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Alyssa L. Stockard
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Charlton H. Bassett
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Brandon J. Burger
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
| | - Bridger T. Gunter
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
| | - Andrew J. Payne
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
| | - Jordan T. Yorgason
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Scott C. Steffensen
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
- Department of Psychology/Neuroscience, Brigham Young University, Provo, UT 84602, USA (J.K.B.); (A.L.S.)
| | - Kyle B. Bills
- Department of Biomedical Sciences, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA; (C.A.N.); (K.B.B.)
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Wooldridge JS, Tynan M, Rossi FS, Gasperi M, McLean CL, Bosch J, Trivedi RB, Herbert MS, Afari N. Patterns of adverse childhood experiences and cardiovascular risk factors in U.S. adults. Stress Health 2023; 39:48-58. [PMID: 35618265 PMCID: PMC9699903 DOI: 10.1002/smi.3167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 05/02/2022] [Accepted: 05/16/2022] [Indexed: 02/06/2023]
Abstract
Adverse Childhood Experiences (ACEs) are associated with poor health yet, we know little about how distinct patterns of ACE types are associated with cardiovascular (cardiovascular (CVD)) risk factors. The current study 1) examined associations of latent ACE classes with modifiable CVD risk factors including high cholesterol, smoking, diabetes, hypertension, high triglycerides, physical inactivity, overweight/obesity, and lifetime depression; and 2) examined the impact of socioeconomic status-related (SES) factors on these relationships. Using a cross-sectional analysis of the National Epidemiologic Survey of Alcohol and Related Conditions-III (n = 36,309) data, four latent classes of ACEs were previously identified: 1) low adversity, 2) primarily household dysfunction, 3) primarily maltreatment, and 4) multiple adversity types. We examined the association of these classes with CVD risk factors in adulthood and subsequently, the same model accounting for SES-related factors. Tobacco smoking, overweight/obesity, and lifetime depression were each associated with higher odds of being in classes 2, 3, and 4 than class 1, respectively. These relationships held after adjusting for SES-related factors. Class 4 was associated with the most CVD risk factors, including high triglycerides and high cholesterol after controlling for SES-related factors. The consistent associations between tobacco smoking, overweight/obesity, and lifetime depression with each adverse ACE profile, even after controlling for SES, suggest behavioural CVD prevention programs should target these CVD risk factors simultaneously.
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Affiliation(s)
- Jennalee S. Wooldridge
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Mara Tynan
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology
| | - Fernanda S. Rossi
- VA Palo Alto Health Care System, Center for Innovation to Implementation
- Stanford University Department of Psychiatry and Behavioral Sciences
| | - Marianna Gasperi
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Caitlin L. McLean
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
| | - Jeane Bosch
- National Center for PTSD, Dissemination & Training Division
| | - Ranak B. Trivedi
- VA Palo Alto Health Care System, Center for Innovation to Implementation
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Division of Public Mental Health and Population Sciences
| | - Matthew S. Herbert
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
| | - Niloofar Afari
- VA San Diego Healthcare System
- University of California San Diego, Department of Psychiatry
- VA Center of Excellence for Stress and Mental Health
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Psychotic-like experiences are associated with physical disorders in general population: A cross-sectional study from the NESARC II. J Psychosom Res 2023; 165:111128. [PMID: 36608509 DOI: 10.1016/j.jpsychores.2022.111128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 12/04/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) constitute subthreshold symptoms of psychotic disorders, and belong to five distinct dimensions: Positive, Negative, Depressive, Mania and Disorganization. PLEs are associated with various psychiatric disorders. However, few studies examined their association with physical disorders. OBJECTIVE Our aims were (1) to assess the associations between various physical disorders and PLEs in a U.S. representative sample, and (2) to examine these associations according to the five dimensions of PLEs. METHOD We used data from the wave II (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-II), a large national sample representative of the US population (N = 34,653). Participants were assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule 4. Twenty-two PLEs were examined. Lifetime prevalence and adjusted Odds-Ratio (aOR) reflecting the association of sixteen physical disorders (including notably metabolic conditions and heart diseases) with PLEs were calculated. RESULTS All studied physical disorders were associated with the presence of PLEs. Particularly the presence of any physical condition, any heart disease and diabetes were more frequent in participants with at least one PLE compared with the group without any PLE (aOR = 1.74, 95% CI = 1.62-1.87, aOR = 1.44, 95% CI = 1.33-1.55 and aOR = 1.38, 95% CI = 1.24-1.54, respectively). Almost all physical disorders were associated with the five dimensions of PLEs. CONCLUSIONS PLEs were associated with a large range of physical disorders, with a gradual dose effect. To assess PLEs in the general population could help with the screening of subjects with physical disorders.
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Svensson M, Erhardt S, Hållmarker U, James S, Deierborg T. A physically active lifestyle is associated with lower long-term incidence of bipolar disorder in a population-based, large-scale study. Int J Bipolar Disord 2022; 10:26. [DOI: 10.1186/s40345-022-00272-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
Physical activity has been proposed to be beneficial for the symptomatic control of bipolar disorder, but the duration of the effects, sex-specific mechanisms, and impact of exercise intensity are not known.
Method
With an observational study design, we followed skiers and age and sex-matched non-skiers from the general population to investigate if participation in a long-distance cross-country ski race (Vasaloppet) was associated with a lower risk of getting diagnosed with bipolar disorder. Using the Swedish population and patient registries, skiers in Vasaloppet and age and sex-matched non-skiers from the general population were analyzed for any diagnosis of bipolar disorder after participation in the race. Additionally, we used finishing time of the ski race as a proxy for intensity levels to investigate if exercise intensity impacts the risk of bipolar disorder among the physically active skiers.
Results
Previous participation in a long distance ski race (n = 197,685, median age 36 years, 38% women) was associated with a lower incidence of newly diagnosed bipolar compared to an age and sex-matched general population (n = 197,684) during the up to 21 years follow-up (adjusted hazard ratio, HR = 0.48). The finishing time of the race did not significantly impact the risk of bipolar disorder in men. Among women, high performance (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with an increased risk of bipolar disorder compared to slower skiing women (HR = 2.07).
Conclusions
Our results confirm that a physically active lifestyle is associated with a lower risk of developing bipolar disorder. Yet, to elucidate the direction of causality in this relationship requires complementary study designs. And the influence of physical performance level on the risk of bipolar disorder warrants further examinations among women.
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Thornton J, Nagpal T, Reilly K, Stewart M, Petrella R. The 'miracle cure': how do primary care physicians prescribe physical activity with the aim of improving clinical outcomes of chronic disease? A scoping review. BMJ Open Sport Exerc Med 2022; 8:e001373. [PMID: 35999822 PMCID: PMC9362801 DOI: 10.1136/bmjsem-2022-001373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives To identify how primary care physicians (PCPs) prescribe physical activity for patients with chronic disease, and to determine characteristics of physical activity interventions with improved clinical outcomes of chronic disease. Design A scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews 2018 was completed. Data sources Four bibliographic databases (Medline, EMBASE, SPORTDiscus, CINAHL) and four grey literature/unpublished databases (Proquest, National Institute for Health and Care Excellence, Canadian Health Research Collections, Clinical Trials) were searched from inception to 7 March 2022. Eligibility criteria for selecting studies Studies involving PCP-delivered physical activity prescriptions or counselling for participants with a chronic disease or mental health condition, which reported clinical outcomes were included. Opinion papers, news and magazine articles and case reports were excluded, as were studies in which a physical activity intervention was provided for primary prevention of chronic disease, prescribed by healthcare providers or researchers other than PCPs, or for healthy participants without chronic disease. Results An initial search identified 4992 records. Fifteen studies met inclusion criteria. Characteristics of physical activity prescriptions that improved clinical outcomes included: personalised advice; brief intervention; behavioural supports (handouts and/or referrals) and physician follow-up. Reported adverse events were rare. Research gaps include optimal timing and length of follow-up, and the long-term and cost-effectiveness of interventions. Summary/Conclusion Several characteristics of physical activity counselling by PCPs for patients with chronic disease may improve clinical outcomes, although research gaps remain. Studies exploring the effectiveness of physical activity prescription for individuals with chronic conditions are urgently needed.
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Affiliation(s)
- Jane Thornton
- Family Medicine, Western University Schulich School of Medicine & Dentistry, London, Ontario, Canada
| | - Taniya Nagpal
- Department of Kinesiology, Brock University, Saint Catharines, Ontario, Canada
| | - Kristen Reilly
- Family Medicine, Western University, London, Ontario, Canada
| | - Moira Stewart
- Family Medicine, Western University, London, Ontario, Canada
| | - Robert Petrella
- Department of Family Practice, The University of British Columbia Faculty of Medicine, Vancouver, Columbia, Canada
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Sá Filho AS, Cheniaux E, de Paula CC, Murillo-Rodriguez E, Teixeira D, Monteiro D, Cid L, Yamamoto T, Telles-Correia D, Imperatori C, Budde H, Machado S. Exercise is medicine: a new perspective for health promotion in bipolar disorder. Expert Rev Neurother 2020; 20:1099-1107. [PMID: 32762382 DOI: 10.1080/14737175.2020.1807329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Similar effects in reducing the symptoms of the mood disorder are reported in the literature compared the action of drugs and aerobic exercise sessions, demonstrating the potential of exercise in the control and mood stabilization. Therefore, there are many reasons to believe that the increased cardiorespiratory fitness (VO2max) can be an important means of protection and a reducing potential of physical and mental damage in bipolar disorders (BD). This review will highlight the current pattern of response of exercise on the pathophysiology of BD, relating the possible mechanisms, and hypotheses based on exercises. AREAS COVERED The mechanism of monoaminergic action and its relationship with exercise, role of physical conditioning and increased VO2Max on neurotrophin release, and new perspectives on long-term exercise will be reviewed. EXPERT OPINION The adaptations to training, although little explored in the context of BD, can induce the expression of substances that co-regulate several processes related to the pathophysiology of BD. Furthermore, high intensity interval training (HIIT) can also be adjusted to improve the physical fitness and health in patients with BD. Future research is needed to adopt a training strategy that is both time efficient and adequate for the population in question.
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Affiliation(s)
- Alberto Souza Sá Filho
- Department of Physical Education, Paulista University (UNIP) , São Paulo, Brazil.,Department of Physical Education, University Center of Anápolis (Unievangélica) , Anápolis, Brazil
| | - Elie Cheniaux
- School of Medical Sciences, State University of Rio De Janeiro (UERJ) , Rio De Janeiro, Brazil.,Institute of Psychiatry, Federal University of Rio De Janeiro , Rio De Janeiro, Brazil
| | - Carolina Cavalcante de Paula
- Department of Cellular, Tissue and Developmental Biology, The Institute of Biomedical Science, The University of São Paulo (ICB/USP) , São Paulo, Brazil
| | - Eric Murillo-Rodriguez
- International Neuroscience Research Group , Yucatan, México.,Laboratorio De Neurociencias Moleculares E Integrativas, Escuela De Medicina, División Ciencias De La Salud, Universidad Anáhuac Mayab , Mérida, Mexico
| | - Diogo Teixeira
- International Neuroscience Research Group , Yucatan, México.,Faculty of Physical Education and Sport, ULHT , Lisbon, Portugal
| | - Diogo Monteiro
- International Neuroscience Research Group , Yucatan, México.,Research Centre in Sports, Health and Human Development, CIDESD , Rio Maior, Portugal.,Sport Science School of Rio Maior, Polytechnique Institute of Santarém , Rio Maior, Portugal
| | - Luis Cid
- International Neuroscience Research Group , Yucatan, México.,Research Centre in Sports, Health and Human Development, CIDESD , Rio Maior, Portugal.,Sport Science School of Rio Maior, Polytechnique Institute of Santarém , Rio Maior, Portugal
| | - Tetsuya Yamamoto
- International Neuroscience Research Group , Yucatan, México.,Graduate School of Technology, Industrial and Social Sciences, Tokushima University , Tokushima, Japan
| | - Diogo Telles-Correia
- International Neuroscience Research Group , Yucatan, México.,Clínica Universitária De Psicologia E Psiquiatria, Faculdade De Medicina, Universidade De Lisboa , Lisbon, Portugal.,Departamento De Psiquiatria, Faculdade De Medicina, Universidade De Lisboa , Lisbon, Portugal
| | - Claudio Imperatori
- International Neuroscience Research Group , Yucatan, México.,Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190 , Rome, Italy
| | - Henning Budde
- International Neuroscience Research Group , Yucatan, México.,Faculty of Human Sciences, Medical School Hamburg, University of Applied Science and Medical University , Hamburg, Germany
| | - Sergio Machado
- Institute of Psychiatry, Federal University of Rio De Janeiro , Rio De Janeiro, Brazil.,International Neuroscience Research Group , Yucatan, México.,Laboratory of Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado De Oliveira University (UNIVERSO) , Niterói, Brazil.,Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados , RJ, Brazil
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Sun H, Gao X, Que X, Liu L, Ma J, He S, Gao Q, Wang T. The causal relationships of device-measured physical activity with bipolar disorder and schizophrenia in adults: A 2-Sample mendelian randomization study. J Affect Disord 2020; 263:598-604. [PMID: 31780129 DOI: 10.1016/j.jad.2019.11.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 11/06/2019] [Accepted: 11/09/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND To examine the causal association of device-measured physical activity with Bipolar disorder (BIP) and schizophrenia (SCZ) in adults by performing 2-sample MR analysis. METHODS Summary-level data for exposure variable including overall physical activity, and three different types of physical activities(sedentary, moderate intensity activity, sleep duration) were derived from UK Biobank(n = 91,105). Summary-level data for outcomes were obtained from Psychiatric Genomics Consortium (PGC) including BIP (n = 51,710) and SCZ(n = 65,967). Cochran's Q statistics, MR-Egger regression, and MR-PRESSO global test were used to identify pleiotropy and MR-PRESSO outlier test for removing the pleiotropy of the genetic instruments. For assessing causality, proven MR techniques including one main analysis(IVW)and four sensitive analysis(MLE,SME,WME, MR-PRESSO)were applied for robust results. RESULTS Five MR methods provided consistent genetically evidence that overall physical activity was associated with lower risk of BIP(OR, 0.491; 95% CI: 0.314-0.767; p = 0.002), there was no significant relationship between overall physical activity and SCZ(IVW OR; 1.133; 95% CI: 0.636-2.020; p = 0.672). In addition, no significant causal association was observed between any other types of physical activities and both mental disorders. LIMITATIONS The nonlinear association of physical activities on BIP and SCZ were unaccessible through MR analysis. CONCLUSIONS This study provides genetic evidence that overall physical activity is an effective preventive factor for BIP but not for SCZ. Together with evidence from observational studies, our finding provides further rationale for individuals at risk for BIP to maintain physical activity.
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Affiliation(s)
- Heli Sun
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Xue Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Ximei Que
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Long Liu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Jinsha Ma
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Simin He
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Qian Gao
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
| | - Tong Wang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, 56 Xinjiannanlu Street, Taiyuan, Shanxi, 030000, China.
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Luo Z, Li Y, Hou Y, Liu X, Jiang J, Wang Y, Liu X, Qiao D, Dong X, Li R, Wang F, Wang C. Gender-specific prevalence and associated factors of major depressive disorder and generalized anxiety disorder in a Chinese rural population: the Henan rural cohort study. BMC Public Health 2019; 19:1744. [PMID: 31881870 PMCID: PMC6935131 DOI: 10.1186/s12889-019-8086-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 12/15/2019] [Indexed: 12/29/2022] Open
Abstract
Background This study aims to investigate the prevalence and associated factors of major depressive disorder (MDD) and generalized anxiety disorder (GAD) by gender in Chinese rural adults. Methods A total of 29,993 participants aged from 18 to 79 years from the Henan Rural Cohort Study were included in this study. The Patient Health Questionnaire-2 (PHQ-2) and Generalized Anxiety Disorder-2 (GAD-2) were used to assess MDD and GAD through a face-to-face interview. Multivariate logistic regression model was conducted to analyze the associated factors for MDD and GAD. Results The age-standardized prevalence of MDD and GAD (and 95%CI) in the total sample were 5.41% (5.17–5.66%) and 4.94% (4.71–5.18%), respectively. Besides, the crude prevalence in women were significantly higher than men for both MDD (6.81% vs. 4.77%) and GAD (6.63% vs. 3.93%) (both P < 0.001). Tetrachoric correlation test showed high comorbidity between MDD and GAD (r = 0.88, P = 0.01). Further analysis revealed that age, sex, marital status, educational level, per capita monthly income, drinking, physical activity, and body mass index were associated with MDD and GAD in the overall sample. Gender difference was found among age groups for MDD (Pinteraction < 0.001). Conclusions These findings showed that Chinese rural adults were at low risk for prevalence of MDD and GAD. Women had higher prevalence and risks for MDD and GAD compared with men, indicating that women deserved more attention. Gender-specific interventions on the modifiable associated factors are urgently needed to improve the mental conditions for Chinese rural population. Clinical trial registration The Henan Rural Cohort Study has been registered in the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.
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Affiliation(s)
- Zhicheng Luo
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Yuqian Li
- Department of Clinical Pharmacology, School of Pharmaceutical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yitan Hou
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Jingjing Jiang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Yan Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Xue Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Dou Qiao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Xiaokang Dong
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Ruiying Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China
| | - Fang Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China.
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, People's Republic of China.
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10
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Sliedrecht W, de Waart R, Witkiewitz K, Roozen HG. Alcohol use disorder relapse factors: A systematic review. Psychiatry Res 2019; 278:97-115. [PMID: 31174033 DOI: 10.1016/j.psychres.2019.05.038] [Citation(s) in RCA: 161] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 12/12/2022]
Abstract
A relapsing-remitting course is very common in patients with an Alcohol Use Disorder (AUD). Understanding the determinants associated with alcohol resumption remains a formidable task. This paper examines relapse determinants based on a systematic review of recent alcohol literature (2000-2019). Relevant databases were consulted for articles that contained information about specific relapse determinants and reported statistical significance of each relapse determinant in predicting relapse. Relapse was broadly defined based on the characterization in the included articles. From the initial identified 4613 papers, a total of 321 articles were included. Results encompass multiple relapse determinants, which were ordered according to biopsychosocial and spiritual categories, and presented, using a descriptive methodology. Psychiatric co-morbidity, AUD severity, craving, use of other substances, health and social factors were consistently significantly associated with AUD relapse. Conversely, supportive social network factors, self efficacy, and factors related to purpose and meaning in life, were protective against AUD relapse. Despite heterogeneity in different methods, measures, and sample characteristics, these findings may contribute to a better therapeutic understanding in which specific factors are associated with relapse and those that prevent relapse. Such factors may have a role in a personalized medicine framework to improve patient outcomes.
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Affiliation(s)
- Wilco Sliedrecht
- De Hoop GGZ, Provincialeweg 70, 3329 KP Dordrecht, the Netherlands.
| | - Ranne de Waart
- Mentrum/Arkin, Wisselwerking 46-48, 1112 XR Diemen, the Netherlands.
| | - Katie Witkiewitz
- The University of New Mexico (UNM), MSC 03-2220, Univ of New Mexico, Albuquerque, NM 87131, USA.
| | - Hendrik G Roozen
- The University of New Mexico (UNM), Center on Alcoholism, Substance Abuse, and Addictions (CASAA), MSC 11 6280, 1 Univ of New Mexico, Albuquerque, NM 87106, USA.
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11
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He JP, Paksarian D, Merikangas KR. Physical Activity and Mental Disorder Among Adolescents in the United States. J Adolesc Health 2018; 63:628-635. [PMID: 30170937 DOI: 10.1016/j.jadohealth.2018.05.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 05/02/2018] [Accepted: 05/24/2018] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To estimate associations between physical activity (PA) and a broad range of lifetime mental disorders among adolescents, and to evaluate whether the context of sports participation impacts these associations. METHODS The sample included 6,483 13-18 year-olds from the National Comorbidity Survey Adolescent Supplement. Adolescents completed face-to-face psychiatric interviews and a parent provided diagnostic and other family-level information on the participating adolescent by completing a self-administered questionnaire. PA was measured by adolescent self-report and dichotomized to indicate vigorous exercise several times a week. Nineteen psychiatric disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria. Multiple logistic regression analyses were used to estimate associations of PA with mental disorders, suicidality, and psychological distress. RESULTS Two thirds of adolescents reported being physically active. Active adolescents had significantly lower odds of mood disorder (Odds ratio[OR] = .74, 95% confidence interval [CI]=.58-.94), bipolar II disorder (OR = .54, 95% CI=.30-.99), and general psychological distress (OR = .71, 95% CI=.52-.96) than less/inactive adolescents. In contrast, adolescents who engaged in PA were more likely to have lifetime alcohol use disorder (OR = 1.78, 95% CI = 1.11-2.85), bulimia (OR = 5.84, 95% CI = 2.48-13.79), generalized anxiety disorder (OR = 2.04, 95% CI = 1.16-3.58), and posttraumatic stress disorder (OR = 1.65, 95% CI = 1.07-2.55). The direct associations between PA and alcohol use disorder and bulimia appeared to be specific to adolescents who participated in organized sports. DISCUSSION Associations between PA and lifetime mental disorder among adolescents may differ according to both disorder type and the context in which PA occurs. Longitudinal studies that assess the context of PA may be able to explain apparent discrepant associations between PA and mental disorder.
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Affiliation(s)
- Jian-Ping He
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Diana Paksarian
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland
| | - Kathleen R Merikangas
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, Maryland.
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12
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Fornaro M, Solmi M, Veronese N, De Berardis D, Buonaguro EF, Tomasetti C, Perna G, Preti A, Carta MG. The burden of mood-disorder/cerebrovascular disease comorbidity: essential neurobiology, psychopharmacology, and physical activity interventions. Int Rev Psychiatry 2017; 29:425-435. [PMID: 28681620 DOI: 10.1080/09540261.2017.1299695] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Cardio-vascular diseases (CVDs) and CVD-related disorders (including cerebrovascular diseases; CBVDs) are a major public health concern as they represent the leading cause of mortality and morbidity in developed countries. Patients with CVDs and CBVDs co-morbid with mood disorders, especially bipolar disorder (BD) and major depressive disorder (MDD), suffer reduced quality-of-life and significant disability adjusted for years of life and mortality. The relationship between CVDs/CBVDs and mood disorders is likely to be bidirectional. Evidence for shared genetic risk of pathways involved in stress reaction, serotonin or dopamine signalling, circadian rhythms, and energy balance was reported in genome-wide association studies. There is some evidence of a neuroprotective effect of various antidepressants, which may be boosted by physical exercise, especially by aerobic ones. Patients with CVDs/CBVDs should be routinely attentively evaluated for the presence of mood disorders, with tools aimed at detecting both symptoms of depression and of hypomania/mania. Behavioural lifestyle interventions targeting nutrition and exercise, coping strategies, and attitudes towards health should be routinely provided to patients with mood disorders, to prevent the risk of CVDs/CBVDs. A narrative review of the evidence is herein provided, focusing on pharmacological and physical therapy interventions.
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Affiliation(s)
- Michele Fornaro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy.,b Department of Psychiatry , Columbia University Medical Center, New York State Psychiatric Institute , New York , NY , USA
| | - Marco Solmi
- c Neuroscience Department , University of Padua , Padua , Italy.,d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy
| | - Nicola Veronese
- d Institute for Clinical Research and Education in Medicine, I.R.E.M , Padua , Italy.,e Department of Medicine (DIMED), Geriatrics Division , University of Padova , Padova , Italy
| | - Domenico De Berardis
- f Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment , Hospital 'G. Mazzini' , Teramo , Italy
| | - Elisabetta Filomena Buonaguro
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Carmine Tomasetti
- a Department of Neuroscience, Reproductive Science and Odontostomatology , School of Medicine 'Federico II' Naples , Naples , Italy
| | - Giampaolo Perna
- g Department of Psychiatry and Neuropsychology , Maastricht University , Maastricht , Netherlands.,h Department of Clinical Neurosciences, FoRiPsi , Hermanas Hospitalarias-Villa San Benedetto Menni Hospital , Albese con Cassano , Como , Italy.,i Department of Psychiatry and Behavioural Sciences, Leonard Miller School of Medicine , University of Miami , Miami , FL , USA
| | - Antonio Preti
- j Center of Liaison Psychiatry and Psychosomatics , University Hospital, University of Cagliari , Monserrato , Cagliari , Italy
| | - Mauro Giovanni Carta
- k Department of Public Health, Clinical and Molecular Medicine , University of Cagliari , Monserrato , Cagliari , Italy
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13
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Suetani S, Saha S, Milad A, Eakin E, Scott JG, McGrath JJ. Common mental disorders and recent physical activity status: findings from a National Community Survey. Soc Psychiatry Psychiatr Epidemiol 2017; 52:795-802. [PMID: 27832319 DOI: 10.1007/s00127-016-1307-3] [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: 06/17/2016] [Accepted: 10/30/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE To explore the association between histories of common mental disorders, delusional-like experiences, and recent physical activity using a large nationally representative population-based sample from Australia. We predicted that a past history of a common mental disorder or delusional-like experiences would be associated with insufficient physical activity. METHODS The study was based on the Australian National Survey of Mental Health and Wellbeing 2007 (n = 8841). The Composite International Diagnostic Interview was used to identify a lifetime and past year history of common mental disorders and delusional-like experiences. Physical activity over the preceding week was estimated using the questions based on the Active Australia survey with respondents classified as (a) insufficiently physically active versus (b) sufficiently physically active based on national recommendations. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors. RESULTS Almost half of the participants (46.0%) were classified as sufficiently physically active. Compared to those with no past mental disorder, those with lifetime or past year history of common mental disorders did not differ on recent physical activity status. Furthermore, we found no significant association between the number of lifetime mental disorders or the presence of delusional-like experience and recent physical activity status. CONCLUSIONS Our findings suggest that a diagnosis of common mental disorder, with or without recent symptoms and comorbid diagnoses, or even having self-ascribed perception of poor mental well-being, is not associated with insufficient physical activity.
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Affiliation(s)
- Shuichi Suetani
- School of Medicine, University of Queensland, Brisbane, Australia. .,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia. .,Queensland Brain Institute, University of Queensland, St Lucia, Australia.
| | - Sukanta Saha
- School of Medicine, University of Queensland, Brisbane, Australia.,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Australia
| | - Adam Milad
- School of Public Health, University of Queensland, Herston, Australia
| | - Elizabeth Eakin
- School of Public Health, University of Queensland, Herston, Australia
| | - James G Scott
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,University of Queensland Centre for Clinical Research, University of Queensland, Herston, Australia.,Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, Australia
| | - John J McGrath
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, 4076, Australia.,Queensland Brain Institute, University of Queensland, St Lucia, Australia
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14
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Barry DT, Pilver Glenn CE, Hoff RA, Potenza MN. Pain Interference and Incident Medical Disorders in the General Population. PAIN MEDICINE 2017; 18:1209-1217. [PMID: 28339518 DOI: 10.1093/pm/pnw252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective To investigate the longitudinal relationship between pain interference and incident general medical conditions in a nationally representative sample. Methods Secondary data analysis comprising chi-square tests and binomial logistic regression analyses were performed on data obtained from the US National Epidemiologic Survey on Alcohol and Related Conditions from 34,465 adult respondents who completed wave 1 (2000-2001) and wave 2 (2004-2005) data collection. Models were adjusted for multiple potentially confounding factors. Respondents were categorized at wave 1 according to past-month pain interference (i.e., no or low pain interference, moderate pain interference, severe pain interference). Results In multivariate analyses, moderate or severe pain interference (as compared to no or low pain interference) was associated with the incidence of any medical condition; any heart condition, including angina, tachycardia and other heart disease; any stomach condition, including stomach ulcer and gastritis; arthritis; and hypertension (all P < 0.05). Severe (but not moderate) pain interference as compared with no or low pain interference was additionally associated with new occurrences of myocardial infarction, any liver disease, other liver disease, and arteriosclerosis (all P < 0.05). Conclusions These findings suggest that the relationship between pain interference and general medical conditions is complex. A more complete understanding of this relationship is likely to involve further exploration of possible mechanisms, including whether it is the pain itself, the ascertainment of pain etiology, or pain treatment that is associated with incident general medical conditions.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry.,APT Foundation Pain Treatment Services, New Haven, Connecticut
| | - Corey E Pilver Glenn
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
| | - Rani A Hoff
- Department of Psychiatry.,Department of Neurobiology
| | - Marc N Potenza
- Department of Psychiatry.,Department of Neurobiology.,Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut
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15
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Mansur RB, Santos CM, Rizzo LB, Cunha GR, Asevedo E, Noto MN, Pedrini M, Zeni M, Cordeiro Q, McIntyre RS, Brietzke E. Inter-relation between brain-derived neurotrophic factor and antioxidant enzymes in bipolar disorder. Bipolar Disord 2016; 18:433-9. [PMID: 27488494 DOI: 10.1111/bdi.12418] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 06/28/2016] [Accepted: 07/01/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Accumulating evidence indicates that oxidative stress and neurotrophins have a bidirectional relationship. In this post hoc, exploratory analysis, we investigated the association between plasma brain-derived neurotrophic factor (BDNF) levels and activities of the antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD) in individuals with bipolar disorder (BD) and healthy controls. METHODS We measured plasma levels of BDNF and activities of GPx and SOD in individuals with BD (n=59) and healthy controls (n=26). Information related to current and past psychiatric/medical history, as well as to metabolic comorbidities, was also reported. RESULTS There were negative correlations between BDNF, GPx (r=-.449, P≤.001) and GPx/SOD ratio (r=-.503, P<.001), and a positive correlation between BDNF and SOD (r=.254, P=.020). There was a moderating effect of body mass index (BMI) on the association between BDNF and GPx/SOD rate ratio [(RR)=1.002, P=.034]; interactions between impaired glucose metabolism (IGM), GPx (RR=1.016, P=.033), and GPx/SOD ratio (RR=1.026, P=.002) were also observed. These results were significant in models that included age, gender, alcohol, tobacco and medication use. CONCLUSIONS There was a robust and independent correlation between peripheral BDNF and antioxidant enzyme activities in individuals with BD, which was moderated by metabolic comorbidities. These results reinforce the concept that these systems are associated and further extend knowledge of the putative effect of metabolic comorbidities in the pathophysiological substrates of BD.
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Affiliation(s)
- Rodrigo B Mansur
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Camila M Santos
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Lucas B Rizzo
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Department of Psychiatry, Clinic for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Graccielle R Cunha
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Elson Asevedo
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariane N Noto
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Vila Maria Outpatient Clinic, São Paulo, Brazil
| | - Mariana Pedrini
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Maiara Zeni
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Elisa Brietzke
- Research Group in Behavioral Neuroscience of Bipolar Disorder (GP-TB), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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16
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Melo MCA, Daher EDF, Albuquerque SGC, de Bruin VMS. Exercise in bipolar patients: A systematic review. J Affect Disord 2016; 198:32-8. [PMID: 26998794 DOI: 10.1016/j.jad.2016.03.004] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 02/27/2016] [Accepted: 03/05/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Sedentary lifestyle is frequent in psychiatric disorders, however the directions of this association and benefits of physical activity are unclear. This is a systematic review about exercise in patients with bipolar disorder. METHODS We performed a systematic literature search of studies published in English (1995 Jan to 2016 Jan) in PubMed, and Cochrane Library combining the medical terms 'physical activity' or 'sedentary' or 'physical exercise' with 'bipolar disorder' or 'mania' or 'bipolar depression'. RESULTS Thirty-one studies were selected and included 15,587 patients with bipolar disorder. Sedentary lifestyle varied from 40% to 64.9%. Physical activity was associated with less depressive symptoms, better quality of life and increased functioning. Some evidence indicates a relationship between vigorous exercises and mania. Three prospective cohorts were reported; and no prospective randomized controlled trial was identified. Three studies focused on biomarkers in bipolar patients; and one reported the relationship between exercise and sleep in this group. Two assessed physical exercise in adolescents. LIMITATIONS (1) Differences between studies preventing a unified analysis; (2) most studies were cross-sectional; (3) motivation for exercising is a selection bias in most studies; (4) no intervention study assessing only physical exercise; (5) lack of studies comparing exercise across mood states. CONCLUSION Generally, exercise was associated with improved health measures including depressive symptoms, functioning and quality of life. Evidence was insufficient to establish a cause-effect relationship between mood and physical exercise. Future research including randomized trials is needed to clarify the role of physical activity in bipolar patients.
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17
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Mansur RB, Rizzo LB, Santos CM, Asevedo E, Cunha GR, Noto MN, Pedrini M, Zeni M, Cordeiro Q, McIntyre RS, Brietzke E. Adipokines, metabolic dysfunction and illness course in bipolar disorder. J Psychiatr Res 2016; 74:63-9. [PMID: 26748249 DOI: 10.1016/j.jpsychires.2015.12.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 10/27/2015] [Accepted: 12/03/2015] [Indexed: 12/11/2022]
Abstract
Replicated evidence indicates that individuals with BD are differentially affected by metabolic comorbidities and that its occurrence is a critical mediator and/or moderator of BD outcomes. This study aimed to explore the role of adipokines on bipolar disorder (BD) course and its relationship with metabolic comorbidities (i.e. type 2 diabetes mellitus, obesity). We measured plasma levels of adiponectin and leptin, as well as anthropometric and metabolic parameters of 59 patients with BD and 28 healthy volunteers. Our results showed that, in female participants, adiponectin was lower in individuals with BD, relative to healthy controls (p = 0.017). In the BD population, adiponectin levels were correlated with fasting glucose (r = -0.291, p = 0.047), fasting insulin (r = -0.332, p = 0.023), C-peptide (r = 0.040, p = 0.040), homeostatic model assessment-insulin resistance (r = -0.411, p = 0.004), HDL (r = 0.508, p < 0.001), VLDL (r = -0.395, p = 0.005) and triglycerides (r = -0.310, p = 0.030). After adjustment for age, gender and BMI, individuals with BD and low adiponectin levels (i.e. < 7.5 μg/ml), had a higher number of mood episodes (p < 0.001), lower number of psychiatric hospitalizations (p = 0.007), higher depressive symptoms (p < 0.001) and lower levels of functioning (p = 0.020). In conclusion, adiponectin levels, either directly or as a proxy of metabolic dysfunction, is independently associated with an unfavorable course of illness in BD.
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Affiliation(s)
- Rodrigo B Mansur
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada.
| | - Lucas B Rizzo
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Department of Psychiatry, Clinic for Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Camila M Santos
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Elson Asevedo
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Graccielle R Cunha
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Mariane N Noto
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil; Vila Maria Outpatient Clinic in São Paulo, Brazil
| | - Mariana Pedrini
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Maiara Zeni
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo (ISCMSP), Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neurosciences (LINC), Department of Psychiatry, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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18
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Serrano Ripoll MJ, Oliván-Blázquez B, Vicens-Pons E, Roca M, Gili M, Leiva A, García-Campayo J, Demarzo MP, García-Toro M. Lifestyle change recommendations in major depression: Do they work? J Affect Disord 2015; 183:221-8. [PMID: 26025368 DOI: 10.1016/j.jad.2015.04.059] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Modifying some lifestyle factors can be useful in depression, at least as an adjuvant treatment. Combining different lifestyle interventions seems to be an adequate strategy to increase their antidepressant efficacy according with preliminary studies, but this issue has not been enough investigated. METHODS The present study is a randomized, double-blinded, multicentre, two arm-parallel clinical trials, with a 12 month follow-up. The sample consisted of 273 Primary Care patients. Four combined hygienic-dietary written recommendations were given to the patients about diet, exercise, light exposure and sleep hygiene. RESULTS Both active and control interventions were associated with improvement on BDI (Beck Depression Inventory) scores. However, there were not statistically significant differences (7.0 vs. 7.6; p=0.594). LIMITATIONS We were unable to monitor whether patients carry out recommendations. Intervention could be too difficult to accomplish for depressed patients without enough support and supervision. CONCLUSIONS Just giving written lifestyle recommendations are not enough for depressive patients to benefit from them, so perhaps lifestyle change recommendations work or do not work on Depression depending on how they are presented to patients and on monitoring systems of their implementation.
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Affiliation(s)
- M J Serrano Ripoll
- University of Balearic Islands, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Palma, Spain
| | - B Oliván-Blázquez
- Department of Psychology and Sociology, University of Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - E Vicens-Pons
- Primary Care Prevention and Health Promotion Research Network, Spain; Psychiatric Service, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | - M Roca
- University of Balearic Islands, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Palma, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - M Gili
- University of Balearic Islands, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Palma, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - A Leiva
- Primary Care Research Unit of Mallorca, Health Services-IbSalut, Instituto de Investigación Sanitaria, Spain
| | - J García-Campayo
- Department of Psychology and Sociology, University of Zaragoza, Spain; Primary Care Prevention and Health Promotion Research Network, Spain
| | - M P Demarzo
- "Mente Aberta" - Brazilian Center for Mindfulness and Health Promotion, Federal University of Sao Paulo, UNIFESP, Brazil
| | - M García-Toro
- University of Balearic Islands, Institut Universitari d'Investigació en Ciències de la Salut (IUNICS), Palma, Spain; Primary Care Prevention and Health Promotion Research Network, Spain.
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19
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García-Rodríguez O, Blanco C, Wall MM, Wang S, Jin CJ, Kendler KS. Toward a comprehensive developmental model of smoking initiation and nicotine dependence. Drug Alcohol Depend 2014; 144:160-9. [PMID: 25262528 PMCID: PMC4253146 DOI: 10.1016/j.drugalcdep.2014.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study aims to identify predictors of smoking initiation and nicotine dependence (ND) to develop a comprehensive risk-factor model based on Kendler's development model for major depression. METHODS Data were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), Wave 2 (n=34,653). Risk factors were divided into five developmental tiers according to Kendler's model (childhood, early adolescence, late adolescence, adulthood, past-year). Hierarchical logistic regression models were built to predict the risk of smoking initiation and the risk of ND, given initiation. The continuation ratio (CR) was tested by ordinal logistic regression to examine whether the impact of the predictors was the same on smoking initiation or ND. RESULTS The final models highlighted the importance of different tiers for each outcome. The CR identified substantial differences in the predictors of smoking initiation versus ND. Childhood tier appears to be more determinant for smoking initiation while the effect of more distal tiers (i.e. childhood and early adolescence) was tempered by more proximal ones (i.e. late adolescence, adulthood and past-year) in ND, with few sex differences. CONCLUSIONS The differential effect of some predictors on each outcome shows the complexity of pathways from smoking initiation to ND. While some risk factors may be shared, others impact only at one stage or have even an inverse effect. An adaptation of Kendler's developmental model for major depression showed high predictive power for smoking initiation and ND.
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Affiliation(s)
- Olaya García-Rodríguez
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain; New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA.
| | - Carlos Blanco
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Melanie M. Wall
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Shuai Wang
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Chelsea J. Jin
- New York State Psychiatric Institute, Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, NY 10032, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA 23298-0126, USA
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Pilver CE, Libby DJ, Hoff RA, Potenza MN. Gender differences in the relationship between gambling problems and the incidence of substance-use disorders in a nationally representative population sample. Drug Alcohol Depend 2013; 133:204-11. [PMID: 23755930 PMCID: PMC3786018 DOI: 10.1016/j.drugalcdep.2013.05.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 04/30/2013] [Accepted: 05/06/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cross-sectional studies have demonstrated gender-related differences in the associations between problem-gambling severity and substance-use disorders; however, these associations have not been examined longitudinally. We aimed to examine the prospective associations between problem-gambling severity and incident substance-use disorders in women versus men. METHODS Analyses were conducted using Wave-1 and Wave-2 NESARC data focusing on psychiatric diagnoses from 34,006 non-institutionalized US adults. Inclusionary criteria for pathological gambling were used to categorize Wave-1 participants as at-risk/problem gambling (ARPG) and non-ARPG (i.e. non-gambling/low-frequency gambling/low-risk gambling). Dependent variables included the three-year incidence of any substance-use disorder, alcohol-use disorders, nicotine dependence, drug-use disorders, prescription drug-use disorders, and illicit drug-use disorders. RESULTS Significant gender-by-ARPG status interactions were observed with respect to the three-year incidence of nicotine dependence and prescription drug-use disorders, and approached significance with respect to incident alcohol-use disorders. ARPG (relative to non-ARPG) was positively associated with nicotine dependence among women (OR=2.00; 95% CI=1.24-3.00). ARPG was negatively associated with incident prescription drug-use disorders among men (OR=0.30; 95% CI=0.10-0.88)). Finally, ARPG was positively associated with incident alcohol-use disorders among men (OR=2.20; 95% CI=1.39-3.48). CONCLUSIONS Gambling problems were associated with an increased 3-year incidence of nicotine dependence in women and alcohol dependence in men. These findings highlight the importance of considering gender in prevention and treatment initiatives for adults who are experiencing gambling problems. Moreover, the specific factors underlying the differential progressions of specific substance-use disorders in women and men with ARPG warrant identification.
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Affiliation(s)
- Corey E. Pilver
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT 06520, USA
| | - Daniel J. Libby
- Stonington Institute, 75 Swantown Hill Road, North Stonington, CT 06359, USA
,VA CT Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA
| | - Rani A. Hoff
- VA CT Healthcare System, 950 Campbell Ave, West Haven, CT 06516, USA
,Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06519, USA
| | - Marc N. Potenza
- Department of Psychiatry, Yale University School of Medicine, 34 Park Street, New Haven, CT 06519, USA
,Department of Neurobiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
,Yale Child Study Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT 06520, USA
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Barry DT, Pilver CE, Hoff RA, Potenza MN. Pain interference and incident mood, anxiety, and substance-use disorders: findings from a representative sample of men and women in the general population. J Psychiatr Res 2013; 47:1658-64. [PMID: 23992771 PMCID: PMC3835154 DOI: 10.1016/j.jpsychires.2013.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/02/2013] [Accepted: 08/02/2013] [Indexed: 11/19/2022]
Abstract
To examine gender differences in the longitudinal relationship between past-month pain interference and incident mood, anxiety, and substance-use disorders, chi-square tests and binomial logistic regression analyses were performed on data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions from 34,465 adult respondents (47.9% men; 52.1% women) who completed waves 1 (2000-2001) and 2 (2004-2005) data collection. Models were adjusted for potentially confounding factors (i.e., age, race, marital status, educational level, employment, household income, number of stressful life events, number of general medical conditions, and wave-1 psychopathology). Respondents were categorized at wave 1 according to their past-month level of pain interference (i.e., no or low pain interference, moderate pain interference, severe pain interference). Moderate and severe pain interference (as compared to no or low pain interference) in male and female respondents was associated with the incidence of several psychiatric disorders. A stronger relationship was observed in male respondents as compared to female ones between past-month moderate pain interference and a new onset of any mood disorder (OR=1.57, p=0.03) and major depressive disorder (OR=1.60, p=0.03), and between past-month severe pain interference and a new onset of alcohol abuse or dependence (OR=1.69, p=0.045) and nicotine dependence (OR=1.48, p=0.04). These findings suggest that providers should consider screening patients with past-month moderate or severe pain interference for mood, anxiety, and substance-use problems and monitor the possible development of subsequent comorbid psychiatric disorders.
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Affiliation(s)
- Declan T Barry
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; APT Foundation Pain Treatment Services, New Haven, CT, USA.
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Donald S, Chartrand H, Bolton JM. The relationship between nicotine cessation and mental disorders in a nationally representative sample. J Psychiatr Res 2013; 47:1673-9. [PMID: 23890363 DOI: 10.1016/j.jpsychires.2013.05.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
Abstract
The objective of this study was to examine the relationship between Axis I and II mental disorders, quality of life, and nicotine dependence cessation in a nationally representative sample. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a nationally representative survey of adults in the United States (N = 34,653). People who met DSM-IV criteria for nicotine dependence previously but who had abstained from nicotine in the last year (nicotine cessation) were compared to people currently dependent on nicotine as well as lifetime abstainers using multivariate logistic regression. Outcomes of interest included DSM-IV Axis I and II mental disorders, treatment seeking for mental disorders, and quality of life measures. In adjusted models, individuals who ceased nicotine use in the last year were less likely to have past-year mood [adjusted odds ratio (AOR) = 0.64; 95% confidence interval (CI) 0.50-0.82, p < 0.001] and substance use disorders (AOR = 0.65, 95% CI 0.52-0.82, p < 0.001) compared to those with current nicotine dependence. They were also less likely to have narcissistic and borderline personality disorders. Compared to those with current nicotine dependence, cessation was associated with an improved quality of life, both physically (beta = 1.65; standard error 0.40, p < 0.001) and mentally (beta = 2.17, standard error 0.39, p < 0.001). In conclusion, nicotine dependence cessation was associated with reduced likelihood of several mental disorders and a higher quality of life compared to those with current nicotine dependence. These findings provide further support for public health policy aimed at smoking cessation.
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Affiliation(s)
- Sean Donald
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
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Abstract
Major depressive disorder (MDD) is a source of great disease burden, due in part to the limited accessibility and effectiveness of current treatments. Although current treatments are efficacious in a segment of the population with MDD, there is a clear need for alternative and augmentation treatment strategies. Exercise is one such alternative treatment option. Research has shown exercise to be efficacious as both a stand-alone and an augmentation therapy. As a result, exercise is now included in the American Psychiatric Association's treatment recommendations. The purpose of this article is to provide clinicians with a knowledge base to prescribe exercise to their patients. The authors describe the evidence supporting the use of exercise in the treatment of MDD, provide evidence-based recommendations for prescribing exercise, and address practical considerations related to prescribing exercise in real-world treatment settings.
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