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Liu P, Jing L, Guo F, Xu Y, Cheng J, Liu S, Liu L, Liu Z, Zhang K, Sun N. Characteristics of gut microbiota and its correlation with hs-CRP and somatic symptoms in first-episode treatment-naive major depressive disorder. J Affect Disord 2024; 356:664-671. [PMID: 38615845 DOI: 10.1016/j.jad.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/26/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Most patients with major depressive disorder (MDD) have somatic symptoms, but little studies pay attention in the microbial-inflammatory mechanisms of these somatic symptoms. Our study aimed to investigate alterations in gut microbiota and its correlation with inflammatory marker levels and somatic symptoms in first-episode treatment-naive MDD. METHODS Subjects contained 160 MDD patients and 101 healthy controls (HCs). MDD patients were divided into MDD with somatic symptoms group (MDDS) and MDD without somatic symptoms group (MDDN) based on Somatic Self-rating Scale (SSS). 16S ribosomal RNA sequencing were performed to analyze the composition of the fecal microbiota. The inflammatory factors were measured using enzyme linked immunosorbent assay (ELISA). Correlation among the altered gut microbiota, inflammatory factor and severity of clinical symptoms were analysized. RESULTS Relative to HCs, MDD patients had higher levels of high-sensitivity C-reactive protein (hs-CRP) as well as disordered α-diversity and β-diversity of gut microbiota. Linear discriminant effect size (LEfSe) analysis showed that MDD patients had higher proportions of Bifidobacterium, Blautia, Haemophilus and lower proportions of Bacteroides, Faecalibacterium, Roseburia, Dialister, Sutterella, Parabacteroides, Bordetella, and Phascolarctobacterium from the genus aspect. Furthermore, correlation analysis showed Bacteroides and Roseburia had negative correlations with the hs-CRP, HAMD-24, the total and factor scores of SSS in all participants. Further, compared with MDDN, the Pielous evenness was higher in MDDS. Random Forest (RF) analysis showed 20 most important genera discriminating MDD-S and MDDN, HCs. The ROC analysis showed that the AUC was 0.90 and 0.81 combining these genera respectively. CONCLUSION Our study manifested MDD patients showed disordered gut microbiota and elevated hs-CRP levels, and altered gut microbiota was closely associated with hs-CRP, depressive symptoms, and somatic symptoms.
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Affiliation(s)
- Penghong Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Lin Jing
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Fengtao Guo
- Shanxi Medical University, Taiyuan 030001, PR China
| | - Yunfan Xu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Junxiang Cheng
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China
| | - Shasha Liu
- Shanxi Medical University, Taiyuan 030001, PR China
| | - Lixin Liu
- Shanxi Medical University, Taiyuan 030001, PR China; Experimental Center of Science and Research, The First Hospital of Shanxi Medical University, PR China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China
| | - Kerang Zhang
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China.
| | - Ning Sun
- Department of Psychiatry, First Hospital of Shanxi Medical University, Taiyuan 030001, PR China; Shanxi Medical University, Taiyuan 030001, PR China.
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Yang W, Wang X, Kang C, Yang L, Liu D, Zhao N, Zhang X. Establishment of a risk prediction model for suicide attempts in first-episode and drug naïve patients with major depressive disorder. Asian J Psychiatr 2023; 88:103732. [PMID: 37586124 DOI: 10.1016/j.ajp.2023.103732] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Suicide is common in patients with major depressive disorder (MDD) and has serious consequences for individuals and families. This study aims to establish a risk prediction model for suicide attempts in MDD patients to make the detection of suicide risk more accurate and effective. METHODS A cross-sectional survey, clinical examination, and biochemical indicator tests were performed on 1718 first-episode and drug naïve patients with major depressive disorder. We used Machine Learning to establish a risk prediction model for suicide attempts in FEDN patients with MDD. RESULTS Five predictors were identified by LASSO regression analysis from a total of 20 variables studied, namely psychotic symptoms, anxiety symptoms, thyroid peroxidase antibodies (ATPO), total cholesterol (TC), and high-density lipoprotein-cholesterol (HDL-C). The model constructed using the five predictors displayed moderate predictive ability, with an area under the ROC of 0.771 in the training set and 0.720 in the validation set. The DCA curve showed that the nomogram could be applied clinically if the risk threshold was between 22 % and 60 %. The risk threshold was found to be between 20 % and 60 % in external validation. CONCLUSION Introducing psychotic symptoms, anxiety symptoms, ATPO, TC, and HDL-C to the risk nomogram increased its usefulness for predicting suicide risk in patients with MDD. It may be useful in clinical decision-making or in discussions with patients, especially in crisis interventions.
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Affiliation(s)
- Wanqiu Yang
- School of Ethnology and Sociology, Yunnan University, Kunming, China; School of Medicine, Yunnan University, Kunming, China
| | - Xiaohong Wang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Chuanyi Kang
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Liying Yang
- Dalian Seventh People's Hospital (Dalian Mental Health Center), Dalian, China
| | - Di Liu
- School of Marxism, Harbin Medical University, China
| | - Na Zhao
- Department of Psychiatry, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Kwon CY, Lee B. Prevalence of suicidal behavior in patients with chronic pain: a systematic review and meta-analysis of observational studies. Front Psychol 2023; 14:1217299. [PMID: 37842717 PMCID: PMC10576560 DOI: 10.3389/fpsyg.2023.1217299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/14/2023] [Indexed: 10/17/2023] Open
Abstract
Objective Chronic pain is a leading cause of disability, severely impairing an individual's daily activity and quality of life. In addition, this condition may contribute to suicidal thoughts by leading to neuropsychological impairments, a perceived lack of meaning in life, and pain-related catastrophizing. This systematic review aimed to comprehensively investigate the prevalence and associated factors of suicidal behaviors (SBs) including suicidal ideation (SI) and suicide attempt (SA) or its complete, in individuals with chronic pain. Methods Five electronic databases were searched up to October 4, 2022. Only observational studies investigating the prevalence of SB in individuals with chronic pain were included. The methodological quality of the included studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. A meta-analysis was conducted to quantify the prevalence of SB in the population, and the command "Metaprop" was used in STATA/MP 16. In addition, factors explaining the association between chronic pain and SB identified through regression analysis were investigated. Results A total of 19 studies were included in this review (N = 3,312,343). The pooled lifetime prevalence of SI and SA was 28.90% (95% confidence interval, 17.95 to 41.26%) and 10.83% (5.72 to 17.30%), respectively, in a mixed sample comprising various chronic pain conditions. Importantly, the pooled prevalence of past 2-week SI was as high as 25.87% (18.09 to 34.50%). The methodological quality of the included studies was not optimal, and studies using validated SB assessment tools were lacking. Potential protective factors against SB in this population included pain coping and self-efficacy, older age, certain race/ethnicity groups, and marriage. Conclusion This systematic review and meta-analysis demonstrated the high prevalence of SB in individuals with chronic pain. Specifically, around 1 in 4 individuals with chronic pain had SI within the last 2 weeks. However, there was considerable heterogeneity in the pooled prevalence of SB in this population.
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine, Busan, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Vilalta-Lacarra A, Vilalta-Franch J, Serrano-Sarbosa D, Martí-Lluch R, Marrugat J, Garre-Olmo J. Association of depression phenotypes and antidepressant treatment with mortality due to cancer and other causes: a community-based cohort study. Front Psychol 2023; 14:1192462. [PMID: 37711322 PMCID: PMC10497951 DOI: 10.3389/fpsyg.2023.1192462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/31/2023] [Indexed: 09/16/2023] Open
Abstract
Objective This study aimed to assess the association of somatic depressive symptoms (SDS), cognitive/emotional depressive symptoms (C-EDS), and antidepressant treatment on mortality due to cancer and other causes in a community cohort. Methods A community-based sample recruited in 1995, 2000, and 2005 aged between 35 and 75 years was examined in two waves and followed for a median of 6.7 years. SDS and C-EDS phenotypes were assessed using the Patient Health Questionnaire-9. Medication used by participants was collected. Deaths and their causes were registered during follow-up. Cox proportional hazard models stratified by sex were performed to determine the association between depressive phenotypes and mortality. Results The cohort consisted of 5,646 individuals (53.9% women) with a mean age of 64 years (SD = 11.89). During the follow-up, 392 deaths were recorded, of which 27.8% were due to cancer. C-EDS phenotype was associated with an increased risk of cancer mortality in both men (HR = 2.23; 95% CI = 1.11-4.44) and women (HR = 3.69; 95% CI = 1.69-8.09), and SDS was significantly associated with non-cancer mortality in men (HR = 2.16; 95 CI % = 1.46-3.18). Selective serotonin reuptake inhibitors (SSRIs) were significantly associated with both cancer (HR = 2.78; 95% CI = 1.10-6.98) and non-cancer mortality (HR = 2.94; 95% CI = 1.76-4.90) only in the male population. Conclusion C-EDS phenotype was related to an increased risk of cancer mortality at 6 years. In addition, the use of SSRIs in the male population was associated with cancer and all-cause mortality.
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Affiliation(s)
| | | | - Domènec Serrano-Sarbosa
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
- Institut d'Assistencia Sanitaria, Girona, Spain
- Department of Medical Sciences, University of Girona, Girona, Spain
| | - Ruth Martí-Lluch
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
- Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Girona, Spain
| | - Jaume Marrugat
- IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain
- CIBERCV de Investigación en Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Garre-Olmo
- Girona Biomedical Research Institute (IDIBGI), Girona, Spain
- Department of Nursing, University of Girona, Girona, Spain
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Shangguan F, Chen Z, Feng L, Lu J, Zhang XY. The prevalence and clinical correlates of suicide attempts in comorbid subclinical hypothyroidism in patients with never-treated major depressive disorder in China. J Affect Disord 2022; 312:54-60. [PMID: 35728676 DOI: 10.1016/j.jad.2022.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 06/06/2022] [Accepted: 06/16/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Previous studies have emphasized the possible association between subclinical hypothyroidism (SCH) and major depressive disorder (MDD). This study aimed to further investigate suicide attempts and their clinical correlates in MDD patients with comorbid SCH. METHODS This cross-sectional study recruited 1706 eligible MDD outpatients. The Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression of Severity Scale (CGI-S) were applied to evaluate mental status. Fasting blood samples were collected to examine thyroid function. SCH was defined as thyroid stimulating hormone (TSH) > 8 mIU/L with normal free thyroxine levels. RESULTS The prevalence of suicide attempts in the SCH group (51.7 %) was significantly higher than that in the non-SCH group (15.4 %; p < 0.001). Logistic regression showed that patients with comorbid SCH were 1.81 times more likely to have attempted suicide as compared with those without (p = 0.001). Among those with TSH > 8 mIU/L, patients with severe anxiety were 3.57 times more likely to attempt suicide compared with those without (p < 0.01). Logistic regression also showed that the CGI-S score (p < 0.001) was independently associated with suicide attempts, while TSH level was not. CONCLUSIONS SCH comorbidity may pose a specific hazard in MDD patients due to increased suicide attempts. Exhibiting severe anxiety, overall severity of depressive and psychotic symptoms, but not TSH levels, may be independently correlated with suicide attempts in MDD patients with TSH > 8 mIU/L.
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Affiliation(s)
- Fangfang Shangguan
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Ziwei Chen
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Le Feng
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Jiaqi Lu
- Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing 100037, China
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 100101, China..
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Gaither R, Ranney M, Peachey A, Burock J, Rogers J, Bucci L, Beaudoin FL. A feasibility study of low-dose ketamine for acute management of suicidal ideation. J Am Coll Emerg Physicians Open 2022; 3:e12790. [PMID: 35990286 PMCID: PMC9377682 DOI: 10.1002/emp2.12790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/01/2022] [Accepted: 07/07/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Mood disorders complicated by suicidal ideation (SI) frequently present to the emergency department (ED) for care. Currently, patients with SI in the ED do not typically receive targeted interventions. Ketamine may have a role in treating SI within the ED because subanesthetic doses have rapid-acting antidepressant and antisuicidal properties. Methods This single-arm, open-label feasibility study enrolled 14 participants from the ED with acute SI who were awaiting voluntary admission to inpatient psychiatry to receive ketamine at 0.5 mg/kg, administered intravenously. Participants were assessed post administration to evaluate feasibility of administration in the ED and short-term effectiveness. Feasibility was determined by acceptability by patients and physicians as well as tolerability and ability to recruit participants into the study. Efficacy was assessed based on changes in (1) self-reported mood and (2) suicidal ideation pre- and postinfusion of ketamine. Results All patients reported severe depression and active SI at baseline. No serious adverse events were reported, and acceptability was rated highly by both participants and physicians (>70%). Two hours after receiving ketamine 0.5 mg/kg, the mean SI and somatic symptom burden were decreased compared to baseline (P < 0.001 and P = 0.005, respectively), and the mean self-reported mood was increased (P = 0.006). Improvements in mood and decreases in suicidality persisted at 6 hours. Conclusions Overall, ketamine was well tolerated, considered feasible by both participants and physicians, and demonstrated short-term efficacy. There is a growing body of evidence demonstrating the feasibility of ketamine administration in the ED, and larger randomized trials should be conducted to establish treatment recommendations for patients with SI in the ED.
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Affiliation(s)
- Rachel Gaither
- Department of EpidemiologyBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Megan Ranney
- Department of Emergency MedicineThe Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
- Department of Behavioral and Social Science and Health Services, Policy, and PracticeBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Alyssa Peachey
- Department of EpidemiologyBrown University School of Public HealthProvidenceRhode IslandUSA
| | - Jeffrey Burock
- Department of PsychiatryThe Miriam HospitalProvidenceRhode IslandUSA
| | - Jyllian Rogers
- Department of PsychiatryThe Miriam HospitalProvidenceRhode IslandUSA
| | - Lindsey Bucci
- Department of PsychiatryThe Miriam HospitalProvidenceRhode IslandUSA
| | - Francesca L. Beaudoin
- Department of EpidemiologyBrown University School of Public HealthProvidenceRhode IslandUSA
- Department of Emergency MedicineThe Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
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Ding Y, Ou Y, Yan H, Fu X, Yan M, Li H, Liu F, Guo W. Disrupted Cerebellar-Default Mode Network Functional Connectivity in Major Depressive Disorder With Gastrointestinal Symptoms. Front Cell Neurosci 2022; 16:833592. [PMID: 35308120 PMCID: PMC8927069 DOI: 10.3389/fncel.2022.833592] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
Gastrointestinal (GI) symptoms are one of the common somatic symptoms presented in patients with major depressive disorder (MDD). Higher frequency of GI symptoms and higher GI symptom burden were linked to greater depression severity and increased risk of suicide ideation. However, few studies have explored the underlying mechanisms of GI symptoms in MDD. Based on previous studies, the cerebellar-DMN circuits may play a potentially critical role in GI symptoms comorbid with depression. Fifty-two first-episode drug-naive patients with MDD (35 with GI symptoms and 17 without GI symptoms) and 28 matched healthy controls were recruited in the current study and underwent resting-state functional magnetic resonance imaging scan. Cerebellar seed-based functional connectivity maps were established. Relative to depressed patients without GI symptoms, significantly increased cerebellar-anterior default mode network (DMN) connectivities were found in those with GI symptoms. Both increased and decreased functional connectivities were found between cerebellum and posterior DMN in patients with GI symptoms compared with those without GI symptoms and healthy controls. Moreover, the right Crus I - right superior temporal gyrus connectivity value was related to severity of GI symptoms and depression in all patients with MDD. The support vector machine analysis demonstrated a satisfactory classification accuracy (89%) of the disrupted cerebellar-DMN connectivities for correctly identifying MDD patients with GI symptoms. These results revealed the possible neural mechanisms for the involvement of cerebellar-DMN circuits in GI symptoms co-occurred with MDD.
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Affiliation(s)
- Yudan Ding
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yangpan Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiaoya Fu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Meiqi Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Children’s Psychological Development and Brain Cognitive Science, Changsha, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
- Department of Psychiatry, The Third People’s Hospital of Foshan, Foshan, China
- *Correspondence: Wenbin Guo,
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Liu Y, Ou Y, Zhao J, Guo W. Abnormal interhemispheric homotopic functional connectivity is correlated with gastrointestinal symptoms in patients with major depressive disorder. J Psychiatr Res 2021; 144:234-240. [PMID: 34700211 DOI: 10.1016/j.jpsychires.2021.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 09/06/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
The severity of major depressive disorder (MDD) can be aggravated by gastrointestinal (GI) symptoms, but the neuroimaging mechanism underlying GI symptoms still remains unclear. In this study, we recruited 52 medication-free and first-episode MDD patients (35 with GI symptoms and 17 without GI symptoms) and 28 age-, sex-, and education-matched healthy controls to explore the inter-group differences in neuroimaging findings. All the participants underwent resting-state functional magnetic resonance imaging (fMRI) scan, and the functional connectivities that were reported to be abnormal in MDD were our focus of exploration. Voxel-mirrored homotopic connectivity (VMHC) method was used to explore the interhemispheric homotopic functional connectivity of all the subjects. Patients with MDD showed significantly different VMHC in brain regions in the default mode network (DMN), including the middle frontal gyrus, precuneus, inferior parietal lobule, and posterior cingulate cortex. Patients with GI symptoms exhibited significantly decreased interhemispheric homotopic functional connectivity in the middle frontal gyrus and superior frontal gyrus, compared with patients without GI symptoms. These results suggested that the DMN is involved in the neuropathology of MDD. Interhemispheric homotopic connectivity in specific regions could be applied as a biomarker to distinguish MDD patients with GI symptoms from those without GI symptoms.
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Affiliation(s)
- Yi Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yangpan Ou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jingping Zhao
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Wenbin Guo
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Donnelly HK, Richardson D, Solberg SV. Understanding Somatic Symptoms Associated with South Korean Adolescent Suicidal Ideation, Depression, and Social Anxiety. Behav Sci (Basel) 2021; 11:bs11110151. [PMID: 34821612 PMCID: PMC8615240 DOI: 10.3390/bs11110151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022] Open
Abstract
Korea's suicide rate has increased steadily in recent years and it has become the leading cause of death among Korean youth. This paper aims to propose suicide risk identification strategies for South Korean youth by identifying profiles of suicide risk alongside reported somatic complaints. For several reasons, somatic complaints are more commonly reported than mental health concerns in Korea, where somatic complaints are likely to be representative of larger mental health worries. Nationally representative data of Korean first-year middle school students were used to identify mental health profiles by examining reported suicidal ideation, depression, and social anxiety and the prediction effect of reported somatic symptoms within these profiles. Results indicated that female students reported a greater level of suicidal ideation, depression, and social anxiety compared to male students. Each gender (females and males) exhibited five different mental health profile groups, which ranged from low risk to high risk. Somatic symptoms (sleep, stomach ache, tiredness, breathing, appetite, headache, fever, nausea) significantly predicted each profile group, with sleep issues serving as the strongest predictor for risk across both genders and all groups. Therefore, for mental health professionals working with Korean youth, it is encouraged to identify and recognize somatic complaints as potentially representative of mental health concerns and suicidality risk.
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Prevalence of suicidal ideation and planning in patients with major depressive disorder: A meta-analysis of observation studies. J Affect Disord 2021; 293:148-158. [PMID: 34192629 DOI: 10.1016/j.jad.2021.05.115] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Suicidal ideation (SI) and suicide planning (SP) are associated with an increased risk of future suicide. We performed a meta-analysis of observational studies to estimate the prevalence of SI and SP in patients with major depressive disorder (MDD) and its associated factors. METHODS A systematic literature search was conducted in PubMed, EMBASE, PsycINFO and Web of Science from their commencement date until 7 October 2020. Original studies containing data on the prevalence of SI and SP in individuals with MDD were analyzed. RESULTS Forty-six articles covering 53,598 patients were included in the meta-analysis. The overall prevalence of SI was 37.7% (95% confidence interval (CI): 32.3-43.4%) and the pooled prevalence of SP was 15.1% (95% CI: 8.0--26.8%). Subgroup analyses revealed that the timeframe over which SI was assessed, source of patients, study design, and diagnostic criteria were significantly associated with the pooled prevalence of SI. Meta-regression analyses revealed that the Hamilton Depression Rating Scale (HAMD) score and percentage of male participants were positively associated with the pooled prevalence of SI. Study quality and mean age were negatively associated with the pooled prevalence of SI. In contrast, survey year and study quality were negatively associated with pooled prevalence of SP LIMITATION: SI and SP were self-reported and subject to recall bias and impression management. CONCLUSIONS SI and SP are common in patients with MDD, especially among inpatients. Preventive measures and treatments focusing on factors associated with SI and SP may reduce the risk of suicide in patients with MDD.
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Zhao K, Zhou S, Shi X, Chen J, Zhang Y, Fan K, Zhang X, Wang W, Tang W. Potential metabolic monitoring indicators of suicide attempts in first episode and drug naive young patients with major depressive disorder: a cross-sectional study. BMC Psychiatry 2020; 20:387. [PMID: 32723375 PMCID: PMC7389868 DOI: 10.1186/s12888-020-02791-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/20/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUNDS Major depressive disorder is an ordinary mental disorder, and suicide is considered to be a major concern among patients with MDD. Previous studies focused on the relationship between suicide attempts and metabolism in elderly patients with MDD, while ignore the young people. The aim of this study is to find the potential relationship between suicide attempts and metabolism in young patients with MDD to find a way to prevent and ultimately reduce suicide in young patients with MDD. METHODS Cross-sectional design was employed in the study.740 patients aged between 18 and 45 years old with MDD had been consecutively recruited in this study between 2011 and 2017, 128 of whom had suicide attempts. Their serum samples used to monitor fasting blood glucose, serum lipids as well as socio-demographic characteristics were collected. Besides, some clinical scales were also employed to measure symptoms of anxiety, depression and other conditions. RESULTS This study indicated that compared with non-suicide attempters, suicide attempters in young patients with MDD showed higher levels of FBG, TC, LDL-C (all p < 0.05) and lower levels of HDL-C(p < 0.001). Further logistic regression analysis suggested that suicide attempts were associated with increased FBG, decreased HDL-C, the course of disease, HAMD scores and obvious anxiety. CONCLUSIONS Suicide attempts in young patients with MDD may be predicted by metabolic levels in the future. And our findings suggested that the level of FBG and HDL-C can be promising biomarkers to predict the occurrence of this event.
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Affiliation(s)
- Ke Zhao
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Siyao Zhou
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Xiang Shi
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Jianjun Chen
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Yaoyao Zhang
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Kaili Fan
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Xiangyang Zhang
- grid.454868.30000 0004 1797 8574CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China ,grid.410726.60000 0004 1797 8419Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100101 China
| | - Wei Wang
- grid.268099.c0000 0001 0348 3990School of Mental Health, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Wei Tang
- The Affiliated Kangning Hospital of Wenzhou Medical University, Shengjin Road, Lucheng District, Wenzhou, 325007, Zhejiang Province, China. .,Wenzhou Medical University, Wenzhou, Zhejiang, China.
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12
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Heterogeneous association patterns of depressive subfactors in suicidality: The 2014 and 2016 Korea National Health and Nutrition Examination Surveys. J Affect Disord 2020; 272:183-190. [PMID: 32379614 DOI: 10.1016/j.jad.2020.04.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/20/2020] [Accepted: 04/27/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The heterogeneity of depressive symptoms in suicidality is poorly understood. This study examines the heterogeneous association between subfactors of depressive symptoms in suicidality. METHODS The data of 5742 participants aged 19 and older were taken from the 2014 and 2016 Korean National Health and Nutrition Examination Surveys and analyzed. Subfactors of depressive symptoms were identified utilizing factor analyses that yielded two groups (typical- and other-depressive factors). Multivariable logistic regression models were used to estimate the association between each factor and suicidality after adjusting for covariates. RESULTS Typical depressive factors included cardinal and somatic symptoms, whereas other depressive factors contained cognitive and other symptoms. The typical factors were associated with each suicidality in succession, however, others depressive factors were not. The heterogeneity of subfactors made the greatest impact on suicide attempts, controlling for all covariates, followed by suicide plans, with a robust coefficient of typical depressive factors. These differential patterns of subfactors existed especially in females and younger people, suggesting the importance of concerning typical depressive factors for those groups. LIMITATIONS Although a confirmatory factor analysis was performed, depressive subfactors need validation and reliability tests. CONCLUSIONS Our study findings may help to explain why an improved understanding of the typical depressive factors including cardinal and somatic symptoms is important to prevent suicidality, especially in females and younger people.
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Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J, Wang C, Cui L, Huang J, Fang Y. The association between somatic symptoms and suicidal ideation in Chinese first-episode major depressive disorder. J Affect Disord 2019; 245:17-21. [PMID: 30366233 DOI: 10.1016/j.jad.2018.10.110] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/25/2018] [Accepted: 10/16/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Somatic symptoms are prevalent in patients with major depressive disorder (MDD) and often associated with a high risk of suicide. However, which somatic symptoms display as significant risk factors for suicidal ideation (SI) is still poorly understood in MDD. METHODS Two thousand and seventeen Chinese patients with first-episode MDD from the National Survey on Symptomatology of Depression were included in this study. A doctor-rating assessment questionnaire was constructed to evaluate depression related somatic symptoms, and stepwise logistic regression analysis was performed to explore the relationship between somatic symptoms and SI. RESULTS Our results showed a high prevalence of current SI in first-episode MDD (50.87%), while no significant gender differences (53.32% vs. 49.26%, P = 0.076) were observed. In addition, patients who have more somatic symptoms would be at the higher risk to elicit SI, and stepwise logistic regression analysis indicated that age (β = -0.020, P < 0.001), Pre-verbal physical complaints (β = 0.356, P = 0.001), Sensory system complaints (β = 0.707, P = 0.000), Other pain conditions (β = 0.434, P < 0.001), Late insomnia (β = 0.267, P = 0.008), Hypersomnia (β = 0.936, P < 0.001), Weight loss (β = 0.272, P = 0.006), Hyposexuality (β = 0.513, P = P < 0.001) were strongly associated with current SI in first-episode Chinese major depression. CONCLUSIONS Somatic symptoms are strongly associated with SI in first-episode MDD. It is suggestive for clinicians to show concerns for patients' somatic symptoms in practice.
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Affiliation(s)
- Xinyu Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Zhiguo Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiping Xia
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jingjing Xu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chenglei Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lvchun Cui
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiru Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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Ryu S, Lee H, Lee DK, Park K. Use of a Machine Learning Algorithm to Predict Individuals with Suicide Ideation in the General Population. Psychiatry Investig 2018; 15:1030-1036. [PMID: 30301301 PMCID: PMC6258996 DOI: 10.30773/pi.2018.08.27] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 08/27/2018] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE In this study, we aimed to develop a model predicting individuals with suicide ideation within a general population using a machine learning algorithm. METHODS Among 35,116 individuals aged over 19 years from the Korea National Health & Nutrition Examination Survey, we selected 11,628 individuals via random down-sampling. This included 5,814 suicide ideators and the same number of non-suicide ideators. We randomly assigned the subjects to a training set (n=10,466) and a test set (n=1,162). In the training set, a random forest model was trained with 15 features selected with recursive feature elimination via 10-fold cross validation. Subsequently, the fitted model was used to predict suicide ideators in the test set and among the total of 35,116 subjects. All analyses were conducted in R. RESULTS The prediction model achieved a good performance [area under receiver operating characteristic curve (AUC)=0.85] in the test set and predicted suicide ideators among the total samples with an accuracy of 0.821, sensitivity of 0.836, and specificity of 0.807. CONCLUSION This study shows the possibility that a machine learning approach can enable screening for suicide risk in the general population. Further work is warranted to increase the accuracy of prediction.
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Affiliation(s)
- Seunghyong Ryu
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Hyeongrae Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Dong-Kyun Lee
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
| | - Kyeongwoo Park
- Department of Mental Health Research, National Center for Mental Health, Seoul, Republic of Korea
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15
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Fang X, Zhang C, Wu Z, Peng D, Xia W, Xu J, Wang C, Cui L, Huang J, Fang Y. Prevalence, risk factors and clinical characteristics of suicidal ideation in Chinese patients with depression. J Affect Disord 2018; 235:135-141. [PMID: 29655075 DOI: 10.1016/j.jad.2018.04.027] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/08/2018] [Accepted: 04/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Suicide risk is greatly increased in depression. Detection of those at risk is clinically important. Hence, this study aimed to evaluate the prevalence and identify independent risk factors associated with suicidal ideation (SI) in a widespread symptomatology within and outside DSM framework. METHODS This study was part of the National Survey on Symptomatology of Depression (NSSD) which was designed to investigate the magnitude of symptoms of current major depressive episode in China. Stepwise multivariable logistic regression was performed to examine the independent risk factors for SI, including variables that are statistically significant in univariate analysis. Receiver operating characteristic (ROC) was used to evaluate the performance of the regression model. RESULTS A total of 3275 patients (1293 males and 1982 females) were included in our analysis. Of these, 1750 patients (53.4%) had SI. Independent risk predictors included crying (P = 0.000; odds ratio = 1.827), helplessness (P = 0.000; odds ratio = 1.514), worthlessness (P = 0.001; odds ratio = 1.359), hopelessness (P = 0.000; odds ratio = 1.805), unusually restless (P = 0.005; odds ratio = 1.276), self-harm (P = 0.000; odds ratio = 3.385), mood-incongruent psychosis (P = 0.000; odds ratio = 2.782), feeling losing control of oneself (P = 0.009; odds ratio = 1.352), hypersomnia (P = 0.000; odds ratio = 1.805), sensory system complaints (P = 0.000; odds ratio = 1.546), derealization (P = 0.006; odds ratio = 1.580), guilt (P = 0.002; odds ratio = 1.332), suicidal attempts (P = 0.000; odds ratio = 2.841), male gender (P = 0.001; odds ratio = 0.756), the total course of depression (P = 0.010; odds ratio = 1.003) in the regression model. In addition, the areas under the curve of the ROC and the accuracy for the regression model were 0.80 and 0.76, respectively. CONCLUSIONS This study provided an effective risk model for SI in MDD and indicated that all these factors in our model allow better the employment of preventative measures.
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Affiliation(s)
- Xinyu Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chen Zhang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
| | - Zhiguo Wu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Daihui Peng
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Weiping Xia
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jingjing Xu
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Chenglei Wang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Lvchun Cui
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Jia Huang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yiru Fang
- Division of Mood Disorder, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
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16
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Hung CI, Liu CY, Yang CH, Wang SJ. Migraine and greater pain symptoms at 10-year follow-up among patients with major depressive disorder. J Headache Pain 2018; 19:56. [PMID: 30019214 PMCID: PMC6049843 DOI: 10.1186/s10194-018-0884-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 07/02/2018] [Indexed: 12/16/2022] Open
Abstract
Background No study has investigated the associations of migraine with pain symptoms over a ten-year period among outpatients with major depressive disorder (MDD). This study aimed to investigate this issue. Methods At baseline, the study enrolled 290 outpatients with MDD and followed-up the patients at six-month, two-year, and ten-year time points. MDD and anxiety comorbidities were diagnosed using the Structured Clinical Interview for DSM-IV-text revision. Migraine was diagnosed based on the International Classification of Headache Disorders. The bodily pain subscale of the Short Form 36 (SF-BP) and the pain subscale (PS) of the Depression and Somatic Symptoms scale were also used. Generalized Estimating Equation models were employed to investigate the longitudinal impacts of migraine on pain symptoms. Results MDD patients with migraine had lower SF-BP and higher PS scores than those without. Depression, anxiety, and headache indices were significantly correlated with SF-BP and PS scores. The higher the frequency of migraine, the more often patients suffered from pain symptoms. Patients with migraine at all investigated time points suffered from pain symptoms most of the time (ranging from 60.0% to 73.7%) over the 10 years. After controlling for depression and anxiety, migraine was independently associated with a decreased SF-BP score (by 8.93 points) and an increased PS score (by 1.33 points). Conclusion Migraine was an important comorbidity associated with greater severities of pain symptoms during long-term follow-up. Migraine treatment should be integrated into the treatment of depression to improve pain symptoms and quality of life in the pain dimension.
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Affiliation(s)
- Ching-I Hung
- Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang-Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang-Gung Memorial Hospital at Linkou and Chang-Gung University College of Medicine, Tao-Yuan, Taiwan
| | - Ching-Hui Yang
- Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan, Taiwan
| | - Shuu-Jiun Wang
- Faculty of Medicine and Brain Research Center, National Yang-Ming University and Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. .,Department of Neurology, Taipei Veterans General Hospital, No. 201 Shi-Pai Road, Section 2, Taipei, 112, Taiwan.
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17
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Zhou Q, Wu ZG, Wang Y, Liu XH, Chen J, Wang Y, Su YS, Zhang C, Peng DH, Hong W, Fang YR. Clinical characteristics associated with therapeutic nonadherence of the patients with major depressive disorder: A report on the National Survey on Symptomatology of Depression in China. CNS Neurosci Ther 2018; 25:215-222. [PMID: 29998606 DOI: 10.1111/cns.13030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/19/2018] [Indexed: 11/30/2022] Open
Abstract
AIMS Nonadherence is one of the leading challenges to treatment of the major depressive disorder (MDD). Few studies have systematically analyzed the relationship between clinical characteristics, especially symptoms of depressive patients and their therapeutic nonadherence over a relatively large sample. This study aimed to investigate factors of nonadherence in a nationwide survey in China. METHODS Participants with MDD who met the criteria of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) were recruited from 32 sites throughout China. Patients were all over 16 years old. A doctor-rating questionnaire with 64 symptoms based on DSM-IV was constructed to evaluate depression-related feeling and behavior. Single-factor logistic regression was utilized to screen variables, and multifactor logistic regressive analysis was used to identify which factors were risk or protective for nonadherence. We included 882 patients of poor adherence and 857 patients of good adherence. RESULTS Recurrence, untreated first episode, tricyclic antidepressant (TCA)-treated first episode, antidepressant-only-treated current episode, decrease or loss of interest, more somatic symptoms, and "atypical" symptoms were risk factors for nonadherence, whereas selective noradrenaline reuptake inhibitor (SNRI)-treated first episode was a protecting factor. CONCLUSION Clinical characteristics may play an important role in predicting nonadherence. Doctors may have to pay much attention on patients with these factors and should keep on discussing them with patients.
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Affiliation(s)
- Qian Zhou
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi-Guo Wu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Hua Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-Song Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dai-Hui Peng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, China
| | - Yi-Ru Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, China
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18
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Gonzales JA, Chou A, Rose-Nussbaumer JR, Bunya VY, Criswell LA, Shiboski CH, Lietman TM. How Are Ocular Signs and Symptoms of Dry Eye Associated With Depression in Women With and Without Sjögren Syndrome? Am J Ophthalmol 2018; 191:42-48. [PMID: 29655640 PMCID: PMC6040656 DOI: 10.1016/j.ajo.2018.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 04/02/2018] [Accepted: 04/04/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE To determine whether ocular phenotypic features of keratoconjunctivitis sicca (KCS) and/or participant-reported symptoms of dry eye disease are associated with depression in women participants enrolled in the Sjögren's International Collaborative Clinical Alliance (SICCA). DESIGN Cross-sectional study. METHODS Women enrolled in the SICCA registry from 9 international research sites. Participants met at least 1 of 5 inclusion criteria for registry enrollment (including complaints of dry eyes or dry mouth, a previous diagnosis of Sjögren syndrome (SS), abnormal serology (positive anti-Sjögren syndrome antigen A and/or B [anti-SSA and/or anti-SSB]), or elevated antinuclear antibody and rheumatoid factor), bilateral parotid gland enlargement, or multiple dental caries). At baseline, participants had oral, ocular, and rheumatologic examination; blood and saliva collection; and a labial salivary gland biopsy (LSGB). They also completed an interview and questionnaires including assessment of depression with the Patient Health Questionnaire 9 (PHQ-9). Univariate logistic regression was used to assess the association between depression and demographic characteristics, participant-reported health, phenotypic features of Sjögren syndrome, and participant-reported symptoms. Mixed-effects modeling was performed to determine if phenotypic features of KCS and/or participant-reported symptoms of dry eye disease were associated with depression, controlling for health, age, country or residence, and sex and allowing for nonindependence within geographic site. RESULTS Dry eye complaints produced a 1.82-fold (95% confidence interval [CI] 1.38-2.40) higher odds of having depression compared to being symptom-free (P < .001). Additionally, complaints of specific ocular sensations were associated with a higher odds of depression including burning sensation (odds ratio 2.25, 95% CI 1.87-2.72, P < .001) compared to those without complaints. In both women with and without SS, the presence of symptoms of dry eyes and/or dry mouth rather than SS itself resulted in higher odds of depression. One particular ocular phenotypic feature of SS, a positive ocular staining score, was inversely correlated with depression. CONCLUSIONS Participant-reported eye symptoms, particularly specific ocular sensations such as burning, were found to be positively associated with individual American College of Rheumatology/EUropean League Against Rheumatism (ACR/EULAR) SS criteria items.
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Affiliation(s)
- John A Gonzales
- F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
| | - Annie Chou
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer R Rose-Nussbaumer
- F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
| | - Vatinee Y Bunya
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lindsey A Criswell
- Departments of Medicine and Orofacial Sciences, University of California, San Francisco, San Francisco, California, USA
| | - Caroline H Shiboski
- Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, San Francisco, California, USA
| | - Thomas M Lietman
- F.I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA
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19
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Ogrodniczuk JS, Kealy D, Joyce AS, Abbass AA. Body talk: Sex differences in the influence of alexithymia on physical complaints among psychiatric outpatients. Psychiatry Res 2018; 261:168-172. [PMID: 29309955 DOI: 10.1016/j.psychres.2017.12.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/19/2017] [Accepted: 12/30/2017] [Indexed: 11/16/2022]
Abstract
This study investigated the relationship between alexithymia and physical complaints among psychiatric outpatients, and whether sex moderated this relationship. Participants (N = 185) completed measures of physical complaints (bodily symptom burden, pain severity, pain interference), alexithymia, current symptom (depression, anxiety) distress, and somatosensory amplification (i.e., a person's tendency to be bothered by physical sensations). Hierarchical regression analyses were conducted, controlling for the influence of current psychiatric symptom distress and somatosensory amplification. Findings revealed differential relationships between alexithymia and physical complaints (pain interference) for women and men, in addition to main effects for sex and alexithymia. The findings suggest that the negative influence of alexithymia on bodily-related problems may not be universal.
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Affiliation(s)
- John S Ogrodniczuk
- Department of Psychiatry, University of British Columbia, Vancouver, Canada.
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Anthony S Joyce
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Allan A Abbass
- Department of Psychiatry, Dalhousie University, Halifax, Canada
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20
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Song C, Liu BP, Zhang YP, Peng Z, Wang J, Collier AD, Echevarria DJ, Savelieva KV, Lawrence RF, Rex CS, Meshalkina DA, Kalueff AV. Modeling consequences of prolonged strong unpredictable stress in zebrafish: Complex effects on behavior and physiology. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:384-394. [PMID: 28847526 DOI: 10.1016/j.pnpbp.2017.08.021] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/17/2017] [Accepted: 08/19/2017] [Indexed: 12/12/2022]
Abstract
Chronic stress is the major pathogenetic factor of human anxiety and depression. Zebrafish (Danio rerio) have become a novel popular model species for neuroscience research and CNS drug discovery. The utility of zebrafish for mimicking human affective disorders is also rapidly growing. Here, we present a new zebrafish model of clinically relevant, prolonged unpredictable strong chronic stress (PUCS). The 5-week PUCS induced overt anxiety-like and motor retardation-like behaviors in adult zebrafish, also elevating whole-body cortisol and proinflammatory cytokines - interleukins IL-1β and IL-6. PUCS also elevated whole-body levels of the anti-inflammatory cytokine IL-10 and increased the density of dendritic spines in zebrafish telencephalic neurons. Chronic treatment of fish with an antidepressant fluoxetine (0.1mg/L for 8days) normalized their behavioral and endocrine phenotypes, as well as corrected stress-elevated IL-1β and IL-6 levels, similar to clinical and rodent data. The CNS expression of the bdnf gene, the two genes of its receptors (trkB, p75), and the gfap gene of glia biomarker, the glial fibrillary acidic protein, was unaltered in all three groups. However, PUCS elevated whole-body BDNF levels and the telencephalic dendritic spine density (which were corrected by fluoxetine), thereby somewhat differing from the effects of chronic stress in rodents. Together, these findings support zebrafish as a useful in-vivo model of chronic stress, also calling for further cross-species studies of both shared/overlapping and distinct neurobiological responses to chronic stress.
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Affiliation(s)
- Cai Song
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China; Graduate Institute of Neural and Cognitive Science, China Medical University and Hospital, Taichung 00001, Taiwan.
| | - Bai-Ping Liu
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China
| | - Yong-Ping Zhang
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China
| | - Zhilan Peng
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China
| | - JiaJia Wang
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China
| | - Adam D Collier
- ZENEREI Institute and the International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA 70458, USA
| | - David J Echevarria
- ZENEREI Institute and the International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA 70458, USA; Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Katerina V Savelieva
- ZENEREI Institute and the International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA 70458, USA
| | - Robert F Lawrence
- Afraxis, Inc. 6605 Nancy Ridge Rd. Suite 224, San Diego, CA 92121, USA
| | - Christopher S Rex
- Afraxis, Inc. 6605 Nancy Ridge Rd. Suite 224, San Diego, CA 92121, USA
| | - Darya A Meshalkina
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 3960002, Russia
| | - Allan V Kalueff
- Institute for Marine Drugs and Nutrition, Zhanjiang City Key Laboratory, College of Food Science and Technology, Guangdong Ocean University, Zhanjiang 3452001, Guangdong, China; ZENEREI Institute and the International Zebrafish Neuroscience Research Consortium (ZNRC), Slidell, LA 70458, USA; Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 3960002, Russia; Ural Federal University, Ekaterinburg 620002, Russia.
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