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Canevelli M, Bersani FS, Sciancalepore F, Salzillo M, Cesari M, Tarsitani L, Pasquini M, Ferracuti S, Biondi M, Bruno G. Frailty in Caregivers and Its Relationship with Psychological Stress and Resilience: A Cross-SectionalStudy Based on the Deficit Accumulation Model. J Frailty Aging 2022; 11:59-66. [PMID: 35122092 DOI: 10.14283/jfa.2021.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Studies increasingly suggest that chronic exposure to psychological stress can lead to health deterioration and accelerated ageing, thus possibly contributing to the development of frailty. Recent approaches based on the deficit accumulation model measure frailty on a continuous grading through the "Frailty Index" (FI), i.e. a macroscopic indicator of biological senescence and functional status. OBJECTIVES The study aimed at testing the relationship of FI with caregiving, psychological stress, and psychological resilience. DESIGN Cross-sectional study, with case-control and correlational analyses. PARTICIPANTS Caregivers of patients with dementia (n=64), i.e. individuals a priori considered to be exposed to prolonged psychosocial stressors, and matched controls (n=64) were enrolled. MEASUREMENTS The two groups were compared using a 38-item FI condensing biological, clinical, and functional assessments. Within caregivers, the association of FI with Perceived Stress Scale (PSS) and Brief Resilience Scale (BRS) was tested. RESULTS Caregivers had higher FI than controls (F=8.308, p=0.005). FI was associated directly with PSS (r=0.660, p<0.001) and inversely with BRS (r=-0.637, p<0.001). Findings remained significant after adjusting for certain confounding variables, after excluding from the FI the conditions directly related to psychological stress, and when the analyses were performed separately among participants older and younger than 65 years. CONCLUSIONS The results provide insight on the relationship of frailty with caregiving, psychological stress, and resilience, with potential implications for the clinical management of individuals exposed to chronic emotional strain.
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Affiliation(s)
- M Canevelli
- Marco Canevelli, Francesco Saverio Bersani, Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy, ,
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Garcovich S, Bersani FS, Chiricozzi A, De Simone C. Mass quarantine measures in the time of COVID-19 pandemic: psychosocial implications for chronic skin conditions and a call for qualitative studies. J Eur Acad Dermatol Venereol 2020; 34:e293-e294. [PMID: 32330329 PMCID: PMC7267356 DOI: 10.1111/jdv.16535] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- S Garcovich
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - F S Bersani
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - A Chiricozzi
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - C De Simone
- Dermatology, Department of Medical and Surgical Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Verhoeven JE, Yang R, Wolkowitz OM, Bersani FS, Lindqvist D, Mellon SH, Yehuda R, Flory JD, Lin J, Abu-Amara D, Makotkine I, Marmar C, Jett M, Hammamieh R. Epigenetic Age in Male Combat-Exposed War Veterans: Associations with Posttraumatic Stress Disorder Status. Mol Neuropsychiatry 2018; 4:90-99. [PMID: 30397597 PMCID: PMC6206951 DOI: 10.1159/000491431] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/30/2018] [Indexed: 12/27/2022]
Abstract
DNA methylation patterns change with age and can be used to derive an estimate of "epigenetic age," an indicator of biological age. Several studies have shown associations of posttraumatic stress disorder (PTSD) with worse somatic health and early mortality, raising the possibility of accelerated biological aging. This study examined associations between estimated epigenetic age and various variables in 160 male combat-exposed war veterans with (n = 79) and without PTSD (n = 81). DNA methylation was assessed in leukocyte genomic DNA using the Illumina 450K DNA methylation arrays. Epigenetic age was estimated using Horvath's epigenetic clock algorithm and Δage (epigenetic age-chronological age) was calculated. In veterans with PTSD (Δage = 3.2), Δage was on average lower compared to those without PTSD (Δage = 5.0; p = 0.02; Cohen's d = 0.42). This between-group difference was not explained by race/ethnicity, lifestyle factors or childhood trauma. Antidepressant use, however, explained part of the association. In the PTSD positive group, telomerase activity was negatively related to Δage (β = -0.35; p = 0.007). In conclusion, veterans with PTSD had significantly lower epigenetic age profiles than those without PTSD. Further, current antidepressant use and higher telomerase activity were related to relatively less epigenetic aging in veterans with PTSD, speculative of a mechanistic pathway that might attenuate biological aging-related processes in the context of PTSD.
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Affiliation(s)
- Josine E. Verhoeven
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ruoting Yang
- D, Frederick National Laboratory for Cancer Research, Frederick, Maryland, USA
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
| | - Owen M. Wolkowitz
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Francesco S. Bersani
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniel Lindqvist
- Department of Psychiatry, UCSF Weill Institute for Neuroscience, University of California San Francisco, School of Medicine, San Francisco, California, USA
- Department of Clinical Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Synthia H. Mellon
- Department of OB/GYN and Reproductive Sciences, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Rachel Yehuda
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janine D. Flory
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, School of Medicine, San Francisco, California, USA
| | - Duna Abu-Amara
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York, USA
- Department of Psychiatry, New York University, New York, New York, USA
| | - Iouri Makotkine
- James J. Peters Veterans Administration Medical Center Bronx, New York, New York, USA
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Charles Marmar
- Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, New York, USA
- Department of Psychiatry, New York University, New York, New York, USA
| | - Marti Jett
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
| | - Rasha Hammamieh
- Integrative Systems Biology, U.S. Army Center for Environmental Health Research, Fort Detrick, Maryland, USA
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Lindqvist D, Wolkowitz OM, Picard M, Ohlsson L, Bersani FS, Fernström J, Westrin Å, Hough CM, Lin J, Reus VI, Epel ES, Mellon SH. Circulating cell-free mitochondrial DNA, but not leukocyte mitochondrial DNA copy number, is elevated in major depressive disorder. Neuropsychopharmacology 2018; 43:1557-1564. [PMID: 29453441 PMCID: PMC5983469 DOI: 10.1038/s41386-017-0001-9] [Citation(s) in RCA: 116] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/23/2017] [Accepted: 12/21/2017] [Indexed: 01/07/2023]
Abstract
Major depressive disorder (MDD) has been linked to mitochondrial defects, which could manifest in mitochondrial DNA (mtDNA) polymorphisms or mutations. Additionally, copy number of mtDNA (mtDNA-cn) can be quantified in peripheral blood mononuclear cells (PBMC)s, indirectly reflecting cellular energetics, or in the circulating cell-free mtDNA (ccf-mtDNA) levels, which may reflect a fraction of the mitochondrial genome released during cellular stress. Few studies have examined ccf-mtDNA in MDD, and no studies have tested its relationship with intracellular mtDNA-cn or with antidepressant treatment response. Here, mtDNA levels were quantified in parallel from: (i) PBMCs and (ii) cell-free plasma of 50 unmedicated MDD subjects and 55 controls, in parallel with PBMC telomere length (TL) and antioxidant enzyme glutathione peroxidase (GpX) activity. MtDNA measures were repeated in 19 MDD subjects after 8 weeks of open-label SSRI treatment. In analyses adjusted for age, sex, BMI, and smoking, MDD subjects had significantly elevated levels of ccf-mtDNA (F = 20.6, p = 0.00002). PBMC mtDNA-cn did not differ between groups (p > 0.4). In preliminary analyses, we found that changes in ccf-mtDNA with SSRI treatment differed between SSRI responders and non-responders (F = 6.47, p = 0.02), with the non-responders showing an increase in ccf-mtDNA and responders not changing. Baseline ccf-mtDNA was positively correlated with GpX (r = 0.32, p = 0.001), and PBMC mtDNA correlated positively with PBMC TL (r = 0.38, p = 0.0001). These data suggest that plasma ccf-mtDNA and PBMC mtDNA-cn reflect different cellular processes and that the former may be more reflective of certain aspects of MDD pathophysiology and of the response to SSRI antidepressants.
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Affiliation(s)
- Daniel Lindqvist
- Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden. .,Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA, USA. .,Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden.
| | - Owen M. Wolkowitz
- 0000 0001 2297 6811grid.266102.1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA
| | - Martin Picard
- 0000 0001 2285 2675grid.239585.0Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY USA ,0000 0001 2285 2675grid.239585.0Department of Neurology and Columbia Translational Neuroscience Initiative, Columbia University Medical Center, New York, NY USA ,0000 0001 2285 2675grid.239585.0Columbia Aging Center, Columbia University Medical Center, New York, NY USA
| | - Lars Ohlsson
- 0000 0000 9961 9487grid.32995.34Department of Biomedical Science, Malmö University, Malmö, Sweden
| | - Francesco S. Bersani
- 0000 0001 2297 6811grid.266102.1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA ,grid.7841.aDepartment of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Johan Fernström
- 0000 0001 0930 2361grid.4514.4Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden ,Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden
| | - Åsa Westrin
- 0000 0001 0930 2361grid.4514.4Faculty of Medicine, Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden ,Psychiatric Clinic, Lund, Division of Psychiatry, Lund, Sweden
| | - Christina M. Hough
- 0000 0001 2297 6811grid.266102.1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA ,0000 0000 9632 6718grid.19006.3ePresent Address: Department of Psychology, University of California, Los Angeles (UCLA), Los Angeles, CA USA
| | - Jue Lin
- 0000 0001 2297 6811grid.266102.1Department of Biochemistry and Biophysics, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA
| | - Victor I. Reus
- 0000 0001 2297 6811grid.266102.1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA
| | - Elissa S. Epel
- 0000 0001 2297 6811grid.266102.1Department of Psychiatry, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA
| | - Synthia H. Mellon
- 0000 0001 2297 6811grid.266102.1Department of OB/GYN and Reproductive Sciences, University of California San Francisco (UCSF) School of Medicine, San Francisco, CA USA
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Minichino A, Francesconi M, Carrión RE, Delle Chiaie R, Bevilacqua A, Parisi M, Rullo S, Bersani FS, Biondi M, Cadenhead K. From neurological soft signs to functional outcome in young individuals in treatment with secondary services for non-psychotic disorders: a path analysis. Psychol Med 2017; 47:1192-1203. [PMID: 28052777 DOI: 10.1017/s0033291716003056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Functional decline among patients with mental illness is not unique to individuals with psychotic disorders. Despite this, research on early predictors of functional outcome mainly focused on individuals thought to have an 'at risk mental state' (ARMS) for psychosis. There is evidence suggesting that certain early vulnerability markers, such as neurological soft signs (NSS), may explain variability in functional outcomes independent of the level of psychosis risk and the traditional diagnostic classification. METHOD Structural equation modeling was applied to baseline data from a prospective longitudinal study of 138 young individuals in treatment with secondary services for non-psychotic disorders. We evaluated theoretically based models of pathways to functional outcome starting from NSS. The intervening variables were established according to previous evidence and drawn from two general categories: cognition (neuro- and social-) and negative symptoms (expressive and experiential). RESULTS A final trimmed model was a single path running from NSS to neurocognition to experiential negative symptoms to outcome. It could not be improved by adding or dropping connections that would change the single path to multiple paths. The indirect effect from NSS to outcome was significant. The validity of the model was independent of the ARMS status and the psychiatric diagnosis. CONCLUSIONS Our results provide evidence for a single pathway model in which the starting and intervening variables represent modifiable trans-diagnostic therapeutic targets to improve functional trajectories in young individuals with a recent-onset psychiatric diagnosis and different levels of psychosis risk.
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Affiliation(s)
- A Minichino
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M Francesconi
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - R E Carrión
- Division of Psychiatry,Zucker Hillside Hospital,Long Island,NY,USA
| | - R Delle Chiaie
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - A Bevilacqua
- Research Center in Neurobiology,Daniel Bovet (CRiN),Rome,Italy
| | | | - S Rullo
- Casa di Cura Villa Letizia,Rome,Italy
| | - F S Bersani
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - M Biondi
- Department of Neurology and Psychiatry,Sapienza University of Rome,Rome,Italy
| | - K Cadenhead
- Department of Psychiatry,UCSD,La Jolla,CA,USA
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Simonato P, Bersani FS, Santacroce R, Cinosi E, Schifano F, Bersani G, Martinotti G, Corazza O. Can mobile phone technology support a rapid sharing of information on novel psychoactive substances among health and other professionals internationally? Hum Psychopharmacol 2017; 32. [PMID: 28568113 DOI: 10.1002/hup.2580] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/15/2017] [Accepted: 02/20/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND The diffusion of novel psychoactive substances (NPSs), combined with the ability of the Internet to act as an online marketplace, has led to unprecedented challenges for governments, health agencies, and substance misuse services. Despite increasing research, there is a paucity of reliable information available to professionals working in the field. The paper will present the pilot results of the first mobile application (SMAIL) for rapid information sharing on NPSs among health professionals. METHODS The development of SMAIL was divided into 2 parts: (a) the creation of the application for registered users, enabling them to send an SMS or email with the name or "street name" of an NPS and receive within seconds emails or SMS with the information, when available and (b) the development of a database to support the incoming requests. RESULTS One hundred twenty-two professionals based in 22 countries used the service over the pilot period of 16 months (from May 2012 to September 2013). Five hundred fifty-seven enquires were made. Users received rapid information on NPSs, and 61% of them rated the service as excellent. CONCLUSIONS This is the right time to use mobile phone technologies for rapid information sharing and prevention activities on NPSs.
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Affiliation(s)
- Pierluigi Simonato
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK
| | - Francesco S Bersani
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Rita Santacroce
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Eduardo Cinosi
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Fabrizio Schifano
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Ornella Corazza
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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Bersani FS, Wolkowitz OM, Milush JM, Sinclair E, Eppling L, Aschbacher K, Lindqvist D, Yehuda R, Flory J, Bierer LM, Matokine I, Abu-Amara D, Reus VI, Coy M, Hough CM, Marmar CR, Mellon SH. A population of atypical CD56(-)CD16(+) natural killer cells is expanded in PTSD and is associated with symptom severity. Brain Behav Immun 2016; 56:264-70. [PMID: 27025668 DOI: 10.1016/j.bbi.2016.03.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 03/22/2016] [Accepted: 03/25/2016] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) has been associated with immune disturbances, including a higher incidence of infections and autoimmune diseases as well as a net pro-inflammatory state. Natural killer (NK) cells, a key component of the innate immune system, have been less well-studied in PTSD despite their importance in immunity. METHODS We studied two independent samples of combat-exposed male war veterans with or without PTSD, the first ("Discovery Sample") to generate hypotheses, and the second ("Validation Sample") to replicate the findings. The Discovery Sample was comprised of 42 PTSD subjects and 42 controls. The Validation Sample was comprised of 25 PTSD subjects and 30 controls. Participants had fasting, morning blood samples collected for examination of the frequency of NK cell subsets, determined by flow cytometry. The current and lifetime Clinician Administered PTSD Scale (CAPS) was used to assess symptom severity. Statistical analyses were adjusted for age and BMI. RESULTS PTSD subjects compared to controls had (i) a significantly higher relative frequency of atypical CD56(-)CD16(+) NK cells in the Discovery Sample (p=0.027), which was replicated in the Validation Sample (p=0.004) and the combined sample (p<0.001), and (ii) a non-significantly lower relative frequency of CD56(bright)CD16(-) NK cells in the two samples (p=0.082; p=0.118), which became statistically significant in the combined sample (p=0.020). Further, within subjects with PTSD of both samples, the relative frequency of atypical CD56(-)CD16(+) NK cells was near significantly positively correlated with lifetime PTSD severity (p=0.074). DISCUSSION This study is the first to characterize NK cell subsets in individuals with PTSD. The results suggest that combat-exposed men with PTSD exhibit an aberrant profile of NK cells with significantly higher frequencies of an atypical population of CD56(-)CD16(+) cells and possibly lower frequencies of the functional CD56(bright)CD16(-) NK cell subsets. Higher proportions of dysfunctional CD56(-)CD16(+) cells have been reported in certain chronic viral infections and in senescent individuals. It is possible that this could contribute to immune dysfunctions and prematurely senescent phenotypes seen in PTSD.
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Affiliation(s)
- Francesco S Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
| | - Jeffrey M Milush
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Elizabeth Sinclair
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Lorrie Eppling
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, CA, USA
| | - Kirstin Aschbacher
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Linda M Bierer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Iouri Matokine
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA; James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Duna Abu-Amara
- Department of Psychiatry, New York University, New York, NY, USA; Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Christina M Hough
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Charles R Marmar
- Department of Psychiatry, New York University, New York, NY, USA; Steven and Alexandra Cohen Center for Posttraumatic Stress and TBI, New York, NY, USA
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, USA
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8
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Bersani FS, Lindqvist D, Mellon SH, Epel ES, Yehuda R, Flory J, Henn-Hasse C, Bierer LM, Makotkine I, Abu-Amara D, Coy M, Reus VI, Lin J, Blackburn EH, Marmar C, Wolkowitz OM. Association of dimensional psychological health measures with telomere length in male war veterans. J Affect Disord 2016; 190:537-542. [PMID: 26571103 DOI: 10.1016/j.jad.2015.10.037] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/12/2015] [Accepted: 10/16/2015] [Indexed: 12/24/2022]
Abstract
BACKGROUND Several psychiatric disorders may be characterized by peripheral telomere shortening. However, it is unclear whether telomere shortening is associated with these psychiatric disorders per se or, rather, with underlying dimensional parameters that are often, but not necessarily, associated with them. We explored the association between dimensional psychopathological measures and telomere length (TL) in granulocytes among veterans independent of psychiatric diagnosis. METHODS Seventy-six combat-exposed male veterans (41 psychiatrically healthy, 18 with Posttraumatic Stress Disorder [PTSD] and 17 with concomitant PTSD and Major Depressive Disorder [MDD]) had TL assayed. Assessments included Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory-II (BDI-II), Early Trauma Inventory (ETI), Symptom Checklist-90-R Global Severity Index (SCL-90-GSI), Perceived Stress Scale (PSS) and Positive and Negative Affect Schedule (PANAS). Correlations were corrected for age, BMI, antidepressants and ethnicity. RESULTS Across subjects, TL was negatively correlated with early trauma (p<0.001), global psychopathological severity (p=0.044) and perceived stress (p=0.019), positively correlated with positive affect (p=0.026), not significantly correlated with symptom severity of PTSD, depression or negative affect. Across these dimensions, early trauma and positive affect were associated with TL after excluding subjects with somatic illnesses. LIMITATIONS The study was cross-sectional with a moderate sample size and only male combat-exposed subjects. CONCLUSIONS These preliminary findings suggest that early trauma, severity of perceived stress and general psychopathological symptoms are more closely associated with shorter TL than is the severity of core diagnostic symptoms of PTSD or MDD, whereas positive affect is associated with longer TL. Larger-scale studies should assess TL associated with specific psychiatric dimensions, apart from only categorical psychiatric diagnoses, to develop more specific biologically-relevant endophenotypes.
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Affiliation(s)
- Francesco S Bersani
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Daniel Lindqvist
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden
| | - Synthia H Mellon
- Department of OB/GYN and Reproductive Science, University of California San Francisco, San Francisco, CA, USA
| | - Elissa S Epel
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA; Center for Health and Community, University of California San Francisco, San Francisco, CA, USA
| | - Rachel Yehuda
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Janine Flory
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Clare Henn-Hasse
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Linda M Bierer
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Iouri Makotkine
- Department of Psychiatry, MSSM/James J. Peters Veterans Administration Medical Center, New York, NY, USA
| | - Duna Abu-Amara
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Michelle Coy
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Victor I Reus
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth H Blackburn
- Department of Biochemistry and Biophysics, University of California San Francisco, San Francisco, CA, USA
| | - Charles Marmar
- Department of Psychiatry, Steven and Alexandra Cohen Veterans Center for Posttraumatic Stress and Traumatic Brain Injury, New York, NY, USA
| | - Owen M Wolkowitz
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA.
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Bersani G, Bersani FS, Caroti E, Russo P, Albano G, Valeriani G, Imperatori C, Minichino A, Manuali G, Corazza O. Negative symptoms as key features of depression among cannabis users: a preliminary report. Eur Rev Med Pharmacol Sci 2016; 20:547-552. [PMID: 26914132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Cannabis use is frequent among depressed patients and may lead to the so-called "amotivational syndrome", which combines symptoms of affective flattening and loss of emotional reactivity (i.e. the so-called "negative" symptomatology). The aim of this study was to investigate the negative symptomatology in depressed patients with concomitant cannabis use disorders (CUDs) in comparison with depressed patients without CUDs. PATIENTS AND METHODS Fifty-one patients with a diagnosis of Major Depressive Disorder (MDD) and concomitant CUD and fifty-one MDD patients were enrolled in the study. The 21-Item Hamilton Depression Rating Scale (HDRS) and the negative symptoms subscales of the Positive and Negative Syndrome Scale (PANSS) were used to assess depressive and negative symptomatology. RESULTS Patients with cannabis use disorders presented significantly more severe negative symptoms in comparison with patients without cannabis use (15.18 ± 2.25 vs 13.75 ± 2.44; t100 = 3.25 p = 0.002). DISCUSSION A deeper knowledge of the "negative" psychopathological profile of MDD patients who use cannabis may lead to novel etiopathogenetic models of MDD and to more appropriate treatment approaches.
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Affiliation(s)
- G Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
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10
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Bersani FS, Lindqvist D, Mellon SH, Penninx BW, Verhoeven JE, Révész D, Reus VI, Wolkowitz OM. Telomerase activation as a possible mechanism of action for psychopharmacological interventions. Drug Discov Today 2015; 20:1305-9. [DOI: 10.1016/j.drudis.2015.06.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 06/10/2015] [Accepted: 06/30/2015] [Indexed: 12/18/2022]
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11
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Bersani FS, Corazza O, Albano G, Bruschi S, Minichino A, Vicinanza R, Bersani G, Martinotti G, Schifano F. The "Eyeballing" technique: an emerging and alerting trend of alcohol misuse. Eur Rev Med Pharmacol Sci 2015; 19:2311-2317. [PMID: 26166661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Alternative methods of alcohol consumption have recently emerged among adolescents and young adults, including the alcohol "eyeballing", which consist in the direct pouring of alcoholic substances on the ocular surface epithelium. In a context of drug and behavioural addictions change, "eyeballing" can be seen as one of the latest and potentially highly risky new trends. We aimed to analyze the existing medical literature as well as online material on this emerging trend of alcohol misuse. MATERIALS AND METHODS Literature on alcohol eyeballing was searched in PsychInfo and Pubmed databases. Results were integrated with a multilingual qualitative assessment of the database provided by The Global Public Health Intelligence Network (GPHIN) and of a range of websites, drug fora and other online resources between March 2013 and July 2013. RESULTS Alcohol eyeballing is common among adolescents and young adults; substances with high alcohol content, typically vodka, are used for this practice across the EU and internationally. The need for a rapid/intense effect of alcohol, competitiveness, novelty seeking and avoidance of "alcoholic fetor" are the most frequently reported motivations of "eyeballers". Local effects of alcohol eyeballing include pain, burning, blurred vision, conjunctive injection, corneal ulcers or scarring, permanent vision damage and eventually blindness. CONCLUSIONS Alcohol eyeballing represents a phenomenon with potential permanent adverse consequences, deserving the attention of families and healthcare providers. Health and other professionals should be informed about this alerting trend of misuse. Larger observational studies are warranted to estimate the prevalence, characterize the effects, and identify adequate forms of interventions for this emerging phenomenon.
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Affiliation(s)
- F S Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
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12
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Bersani FS, Minichino A, Fojanesi M, Gallo M, Maglio G, Valeriani G, Biondi M, Fitzgerald PB. Cingulate Cortex in Schizophrenia: its relation with negative symptoms and psychotic onset. A review study. Eur Rev Med Pharmacol Sci 2014; 18:3354-3367. [PMID: 25491609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The cingulate cortex is a functionally heterogeneous region involved in diverse cognitive and emotional processes. It is a region of special interest to investigate the neurological substrate of schizophrenia. The aim of this paper is to review all the studies that investigated the relation between the cingulate cortex and two of the most important and little known areas of this disease: the psychotic onset and the negative symptoms. MATERIAL AND METHODS Relevant literature was identified through a search in PubMed, Web of Science, and Cochrane database. Search terms included negative symptoms, cingulate cortex, cingulate gyrus, schizophrenia, PET, SPECT, MRI, fMRI, BOLD, deficit schizophrenia, early-onset schizophrenia, psychotic onset, psychosis. RESULTS 9 studies evidenced a link between negative symptoms and hypoactivity of cingulate cortex, whereas 7 studies did not. A positive relationship between anterior cingulate cortex gray matter thinning and high risk for schizophrenia is well characterized in literature. CONCLUSIONS In a large portion of patients hypoactivity of cingulate cortex underlie the presence of negative symptoms. In particular, ACC (anterior cingulated cortex) thinning seems to be related to the increasing social withdrawal that is characteristic of the psychosis prodrome. New therapies focused on the brain stimulation of the cingulate cortex could represent an important aid for patients with this kind of symptoms.
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Affiliation(s)
- F S Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
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Bersani G, Moscariello MA, Bersani FS, Colletti C, Anastasia A, Prinzivalli E, Valeriani G, Salviati M. Dissociative symptoms in female patients with mood and anxiety disorders: a psychopathological and temperamental investigation. Eur Rev Med Pharmacol Sci 2014; 18:3217-3222. [PMID: 25487931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Dissociative symptoms are frequent among psychiatric patients and may considerably affect patients' psychopathological condition and treatment outcomes. The objectives of the study are to assess the presence of dissociative symptoms in female patients with mood and anxiety disorders, to investigate their correlation with the clinical severity of the disorders and to investigate those personality traits that are more frequent in patients with high levels of dissociation. PATIENTS AND METHODS 50 Caucasian females were enrolled in the study. Patients were assessed through the Self-Report Symptom Check-List, the Dissociative Experiences Scale (DES) and rating scales for Depression and Anxiety. RESULTS The mean DES score in the overall sample was 16.6. 32% of patients had a DES score > 20. Depressive symptoms positively correlated with the DES total scores. Dissociator patients presented some significantly different temperamental characteristics in comparison with non dissociator patients. CONCLUSIONS Dissociative symptoms are highly present in patients with mood and anxiety disorders and correlate with the severity of depressive symptoms. Specific personality traits more frequently observed in dissociator people may represent predisposing factors; their early identification could be clinically relevant.
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Affiliation(s)
- G Bersani
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.
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Bersani FS, Minichino A, Enticott PG, Mazzarini L, Khan N, Antonacci G, Raccah RN, Salviati M, Delle Chiaie R, Bersani G, Fitzgerald PB, Biondi M. Deep transcranial magnetic stimulation as a treatment for psychiatric disorders: a comprehensive review. Eur Psychiatry 2012; 28:30-9. [PMID: 22559998 DOI: 10.1016/j.eurpsy.2012.02.006] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 02/25/2012] [Accepted: 02/26/2012] [Indexed: 12/12/2022] Open
Abstract
Deep transcranial magnetic stimulation (TMS) is a technique of neuromodulation and neurostimulation based on the principle of electromagnetic induction of an electric field in the brain. The coil (H-coil) used in deep TMS is able to modulate cortical excitability up to a maximum depth of 6 cm and is therefore able not only to modulate the activity of the cerebral cortex but also the activity of deeper neural circuits. Deep TMS is largely used for the treatment of drug-resistant major depressive disorder (MDD) and is being tested to treat a very wide range of neurological, psychiatric and medical conditions. The aim of this review is to illustrate the biophysical principles of deep TMS, to explain the pathophysiological basis for its utilization in each psychiatric disorder (major depression, autism, bipolar depression, auditory hallucinations, negative symptoms of schizophrenia), to summarize the results presented thus far in the international scientific literature regarding the use of deep TMS in psychiatry, its side effects and its effects on cognitive functions.
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Affiliation(s)
- F S Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
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Rapinesi C, Kotzalidis GD, Serata D, Del Casale A, Bersani FS, Solfanelli A, Scatena P, Raccah RN, Brugnoli R, Digiacomantonio V, Carbonetti P, Fensore C, Tatarelli R, Angeletti G, Ferracuti S, Girardi P. Efficacy of add-on deep transcranial magnetic stimulation in comorbid alcohol dependence and dysthymic disorder: three case reports. Prim Care Companion CNS Disord 2012; 15:12m01438. [PMID: 23724355 DOI: 10.4088/pcc.12m01438] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 11/27/2012] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Craving for alcohol is associated with abnormal activation in the dorsolateral prefrontal cortex. Deep transcranial magnetic stimulation (dTMS) has shown promise in the treatment of depression. There are few treatment options for treatment-resistant dysthymic disorder comorbid with alcohol use disorder. OBJECTIVE To investigate the possible anticraving efficacy of bilateral dorsolateral prefrontal cortex high-frequency dTMS in 3 patients with comorbid long-term DSM-IV-TR dysthymic disorder and alcohol use disorder. METHOD Three patients with alcohol use disorder with dysthymic disorder in their detoxification phase (abstaining for > 1 month) underwent twenty 20-minute sessions of 20 Hz dTMS over the dorsolateral prefrontal cortex over 28 days between 2011 and 2012. Alcohol craving was rated with the Obsessive Compulsive Drinking Scale and depressive symptoms with the Hamilton Depression Rating Scale. RESULTS All 3 patients responded unsatisfactorily to initial intravenous antidepressant and antianxiety combinations but responded after 10 dTMS sessions, improving on both anxiety-depressive symptoms and craving. This improvement enabled us to reduce antidepressant dosages after dTMS cycle completion. DISCUSSION High-frequency bilateral dorsolateral prefrontal cortex dTMS with left prevalence was found to produce significant anticraving effects in alcohol use disorder comorbid with dysthymic disorder. The potential of dTMS for reducing craving in patients with substance use disorder deserves to be further investigated.
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Affiliation(s)
- Chiara Rapinesi
- Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, School of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
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