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Keyes KM, Pakserian D, Rudolph KE, Salum G, Stuart EA. Population Neuroscience: Understanding Concepts of Generalizability and Transportability and Their Application to Improving the Public's Health. Curr Top Behav Neurosci 2024. [PMID: 38589636 DOI: 10.1007/7854_2024_465] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 04/10/2024]
Abstract
In population neuroscience, samples are not often selected with equal or known probability from an underlying population of interest; in other words, samples are not often formally representative of a specified underlying population. This chapter provides an overview of an epidemiological approach to considering the implications of selective participation on the value of our results for population health. We discuss definitions of generalizability and transportability, given the growing recognition that generalizability and transportability are central for interpreting data that are aiming to be population-based. We provide evidence that differences in the prevalence of effect measure modifiers between a study sample and a target population will lead to a lack of generalizability and transportability. We provide an example of an association between a poly-genetic risk score and depression, showing how an internally valid association can differ based on the prevalence of effect measure modifiers. We show that when estimating associations, inferences from a study sample to a population can depend on clearly defining a target population. Given that representative sampling from explicitly defined target populations may not be feasible or realistic in many situations, especially given the sample sizes needed for statistical power for many exposures of interest (and especially when interactions are being tested), researchers should be well versed in tools available to enhance the interpretability of samples regarding target populations.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
| | | | - Kara E Rudolph
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Giovanni Salum
- Child and Adolescent Mental Health Initiative, Child Mind Institute & Stavros Niarchos Foundation, New York, NY, USA
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gonçalves Pacheco JP, Salum G, Hoffmann MS. Estimated Prevalence of Perinatal Depression in Low- and Middle-Income Countries Considering Uncertainty of Test Properties. JAMA Psychiatry 2023:2806609. [PMID: 37378964 DOI: 10.1001/jamapsychiatry.2023.2016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
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Zugman A, Alliende L, Medel V, Bethlehem RA, Seidlitz J, Ringlein G, Arango C, Arnatkevičiūtė A, Asmal L, Bellgrove M, Benegal V, Bernardo M, Billeke P, Bosch-Bayard J, Bressan R, Busatto G, Castro M, Chaim-Avancini T, Compte A, Costanzi M, Czepielewski L, Dazzan P, de la Fuente-Sandoval C, Di Forti M, Díaz-Caneja C, María Díaz-Zuluaga A, Du Plessis S, Duran F, Fittipaldi S, Fornito A, Freimer N, Gadelha A, Gama C, Garani R, Garcia-Rizo C, Gonzalez Campo C, Gonzalez-Valderrama A, Guinjoan S, Holla B, Ibañez A, Ivanovic D, Jackowski A, Leon-Ortiz P, Lochner C, López-Jaramillo C, Luckhoff H, Massuda R, McGuire P, Miyata J, Mizrahi R, Murray R, Ozerdem A, Pan P, Parellada M, Phahladira L, Ramirez-Mahaluf J, Reckziegel R, Reis Marques T, Reyes-Madrigal F, Roos A, Rosa P, Salum G, Scheffler F, Schumann G, Serpa M, Stein D, Tepper A, Tiego J, Ueno T, Undurraga J, Undurraga E, Valdes-Sosa P, Valli I, Villarreal M, Winton-Brown T, Yalin N, Zamorano F, Zanetti M, Winkler A, Pine D, Evans-Lacko S, Crossley N. Country-level gender inequality is associated with structural differences in the brains of women and men. Proc Natl Acad Sci U S A 2023; 120:e2218782120. [PMID: 37155867 PMCID: PMC10193926 DOI: 10.1073/pnas.2218782120] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/15/2023] [Indexed: 05/10/2023] Open
Abstract
Gender inequality across the world has been associated with a higher risk to mental health problems and lower academic achievement in women compared to men. We also know that the brain is shaped by nurturing and adverse socio-environmental experiences. Therefore, unequal exposure to harsher conditions for women compared to men in gender-unequal countries might be reflected in differences in their brain structure, and this could be the neural mechanism partly explaining women's worse outcomes in gender-unequal countries. We examined this through a random-effects meta-analysis on cortical thickness and surface area differences between adult healthy men and women, including a meta-regression in which country-level gender inequality acted as an explanatory variable for the observed differences. A total of 139 samples from 29 different countries, totaling 7,876 MRI scans, were included. Thickness of the right hemisphere, and particularly the right caudal anterior cingulate, right medial orbitofrontal, and left lateral occipital cortex, presented no differences or even thicker regional cortices in women compared to men in gender-equal countries, reversing to thinner cortices in countries with greater gender inequality. These results point to the potentially hazardous effect of gender inequality on women's brains and provide initial evidence for neuroscience-informed policies for gender equality.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Luz María Alliende
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychology, Northwestern University, Evanston, IL60208
| | - Vicente Medel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
| | - Richard A.I. Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, CambridgeCB2 8AH, United Kingdom
- Department of Psychology, University of Cambridge, CambridgeCB2 3EB, United Kingdom
| | - Jakob Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA19104
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
- Penn-Children’s Hospital of Philadelphia Lifespan Brain Institute, University of Pennsylvania, Philadelphia, PA19104
| | - Grace Ringlein
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Aurina Arnatkevičiūtė
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Laila Asmal
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Mark Bellgrove
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
| | - Vivek Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, Karnataka560029, India
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Pablo Billeke
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Jorge Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, QCH3A 2B4, Canada
- McGill University, Montreal, QCH3A 2B4, Canada
| | - Rodrigo Bressan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Geraldo F. Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Mariana N. Castro
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Department of Psychiatry and Mental Health, School of Medicine, University of Buenos Aires, Ciudad Autónoma de Buenos AiresC1114AAD, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
| | - Tiffany Chaim-Avancini
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Albert Compte
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
| | - Monise Costanzi
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Leticia Czepielewski
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Programa de Pós-Graduação em Psicologia, Instituto Psicologia, Universidade Federal do Rio Grande do Sul, Porto AlegreRS90040-060, Brazil
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Camilo de la Fuente-Sandoval
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- National Institute for Health Research (NIHR), Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, LondonSE5 8AZ, United Kingdom
| | - Covadonga M. Díaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Ana María Díaz-Zuluaga
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Stefan Du Plessis
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
- South African Medical Research Council (SA MRC), Genomics of Brain Disorders Unit, Cape Town7505, South Africa
| | - Fabio L. S. Duran
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Alex Fornito
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Jane and Terry Semel Institute for Neuroscience and Human Behavior Los Angeles, University of California Los Angeles (UCLA), Los Angeles, CA90024
| | - Ary Gadelha
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
| | - Clarissa S. Gama
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
| | - Ranjini Garani
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
| | - Clemente Garcia-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clínic de Barcelona, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d’Investigacions Biomèdiques, August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Barcelona08036, Spain
| | - Cecilia Gonzalez Campo
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
| | - Alfonso Gonzalez-Valderrama
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- School of Medicine, Universidad Finis Terrae, Santiago7501015, Chile
| | - Salvador Guinjoan
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Laureate Institute for Brain Research, Tulsa, OK74136
| | - Bharath Holla
- Department of Integrative Medicine, NIMHANS, Bengaluru, Karnataka560029, India
- Accelerator Program for Discovery in Brain disorders using Stem cells, Department of Psychiatry, NIMHANS, Bengaluru, Karnataka560029, India
| | - Agustín Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago7941169, Chile
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Cognitive Neuroscience Center (CNC), Universidad de San Andres, Victoria, Ciudad Autónoma de Buenos AiresB1644BID, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin (TCD), DublinDO2 PN40, Ireland
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA94158
| | - Daniza Ivanovic
- Laboratorio de Neurociencia Social y Neuromodulación, Centro de Investigación en Complejidad Social (neuroCICS), Facultad de Gobierno, Universidad del Desarrollo, Santiago7610658, Chile
| | - Andrea Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo04038-000, Brazil
- Department of Education, Information and Communications Technology (ICT) and Learning, Østfold University College, Halden1757, Norway
| | - Pablo Leon-Ortiz
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Christine Lochner
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch7505, South Africa
| | - Carlos López-Jaramillo
- Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín050011, Colombia
| | - Hilmar Luckhoff
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Raffael Massuda
- Department of Psychiatry, Universidade Federal do Paraná (UFPR), CuritibaPR 80060-000, Brazil
| | - Philip McGuire
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
- Wellcome Centre for Integrative Neuroimaging (WIN), University of Oxford, OxfordOX3 9DU, United Kingdom
- NIHR Oxford Health Biomedical Research Centre, OxfordOX3 7JX, United Kingdom
- Oxford HealthNational Health Service (NHS), Foundation Trust, OxfordOX4 4XN, United Kingdom
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
| | - Romina Mizrahi
- Integrated Program in Neuroscience, McGill University, Montreal, QuebecH3A 1A12B4Canada
- Clinical and Translational Sciences Lab, McGill University, Douglas Mental Health University Institute, Montreal, QCH4A 1R3, Canada
- Department of Psychiatry, McGill University,Montreal, QCH3A 1A1, Canada
| | - Robin Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MinnesotaMN55905
| | - Pedro M. Pan
- Interdisciplinary Laboratory in Clinical Neuroscience (LiNC), Department of Psychiatry, Federal University of São Paulo, São Paulo04039-032, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Mara Parellada
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Centro de Investigación Biomédica en Red Salud Mental (CIBERSAM), School of Medicine, Universidad Complutense, Madrid28009, Spain
| | - Lebogan Phahladira
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town7602, South Africa
| | - Juan P. Ramirez-Mahaluf
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Ramiro Reckziegel
- Laboratory of Molecular Psychiatry, Centro de Pesquisa Clínica, Hospital de Clínicas de Porto Alegre, Porto AlegreRS90035-007, Brazil
| | - Tiago Reis Marques
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Francisco Reyes-Madrigal
- Laboratory of Experimental Psychiatry, Direction of Research, Instituto Nacional de Neurología y Neurocirugía, Mexico City14269, Mexico
| | - Annerine Roos
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Pedro Rosa
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
| | - Giovanni Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, RS90035903, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo04038-000, Brazil
| | - Freda Scheffler
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Gunter Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai200433, China
- PONS-Centre, Charité Mental Health, Dept of Psychiatry and Psychotherapy, Charité Campus Mitte, Berlin10117, Germany
| | - Mauricio Serpa
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo05403-903, Brazil
| | - Dan J. Stein
- South African Medical Research Council (SA MRC) Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town7925, South Africa
| | - Angeles Tepper
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
| | - Jeggan Tiego
- The Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC3168, Australia
- Monash Biomedical Imaging, Monash University, Melbourne, VIC3168, Australia
| | - Tsukasa Ueno
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto606-8507, Japan
- Integrated Clinical Education Center, Kyoto University Hospital, Kyoto606-8397, Japan
| | - Juan Undurraga
- Early Intervention Program, Instituto Psiquiátrico Dr. J. Horwitz Barak, Santiago8431621, Chile
- Department of Neurology and Psychiatry, Faculty of Medicine, Clínica Alemana Universidad del DesarrolloVitacura, Santiago7650568, Chile
| | - Eduardo A. Undurraga
- Escuela de Gobierno, Pontificia Universidad Católica de Chile, Santiago7820436, Chile
- Research Center for Integrated Disaster Risk Management (CIGIDEN), Santiago7820436, Chile
- Canadian Institute for Advanced Research (CIFAR), Azrieli Global Scholars Program, CIFAR, Toronto, ONM5G 1M1, Canada
| | - Pedro Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu610054, China
- Centro de Neurociencias de Cuba, La Habana11600, Cuba
| | - Isabel Valli
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona08036, Spain
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
| | - Mirta Villarreal
- Grupo de Investigación en Neurociencias Aplicadas a las Alteraciones de la Conducta (INAAC), Fleni-Consejo Nacional de Investigaciones Científicas y Técnicas Neurosciences Institute (INEU), Ciudad Autónoma de Buenos AiresC1428, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos AiresC1033AAJ, Argentina
- Department of Physics, Universidad de Buenos Aires, Ciudad Autónoma deBuenos AiresC1428EGA, Argentina
| | - Toby T. Winton-Brown
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC3004, Australia
- Department of Psychiatry, Alfred Health, Melbourne, VIC3004, Australia
| | - Nefize Yalin
- Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, LondonSE5 8AF, United Kingdom
- South London and Maudsley National Health Service (NHS), Foundation Trust, LondonSE5 8AZ, United Kingdom
| | - Francisco Zamorano
- Unidad de Imágenes Cuantitativas Avanzadas, Departamento de Imágenes, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago7650568, Chile
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago7510602, Chile
| | - Marcus V. Zanetti
- Laboratory of Psychiatric Neuroimaging (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina Universidade de São Paulo (HCFMUSP), Faculdade de Medicina Universidade de São Paulo, São PauloSP05403-903, Brazil
- Hospital Sírio-Libanês, São Paulo01308-050, Brazil
| | | | - Anderson M. Winkler
- Department of Human Genetics, University of Texas Rio Grande Valley, Brownsville, Texas TX78520
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch (E & D), National Institute of Mental Health, National Institutes of Health, BethesdaMD20894
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, School of Economics and Political Science, LondonWC2A 2AE, United Kingdom
| | - Nicolas A. Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago8330077, Chile
- Department of Psychiatry, University of Oxford, OxfordOX3 7JX, United Kingdom
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Motta LS, Gosmann NP, Costa MDA, Jaeger MDB, Frozi J, Grevet LT, Spanemberg L, Manfro GG, Cuijpers P, Pine DS, Salum G. Placebo response in trials with patients with anxiety, obsessive-compulsive and stress disorders across the lifespan: a three-level meta-analysis. BMJ Ment Health 2023; 26:e300630. [PMID: 37142305 PMCID: PMC10163479 DOI: 10.1136/bmjment-2022-300630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/07/2023] [Indexed: 05/06/2023]
Abstract
QUESTION Randomised controlled trials assessing treatments for anxiety, obsessive-compulsive and stress-related disorders often present high placebo response rates in placebo groups. Understanding the placebo response is essential in accurately estimating the benefits of pharmacological agents; nevertheless, no studies have evaluated the placebo response across these disorders using a lifespan approach. STUDY SELECTION AND ANALYSIS We searched MEDLINE, PsycINFO, Embase, Cochrane, websites of regulatory agencies and international registers from inception to 9 September 2022. The primary outcome was the aggregate measure of internalising symptoms of participants in the placebo arms of randomised controlled trials designed to assess the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) in individuals diagnosed with anxiety, obsessive-compulsive or stress-related disorders. The secondary outcomes were placebo response and remission rates. Data were analysed through a three-level meta-analysis. FINDINGS We analysed 366 outcome measures from 135 studies (n=12 583). We found a large overall placebo response (standardised mean difference (SMD)=-1.11, 95% CI -1.22 to -1.00). The average response and remission rates in placebo groups were 37% and 24%, respectively. Larger placebo response was associated with a diagnosis of generalised anxiety disorder and post-traumatic stress disorder, when compared with panic, social anxiety and obsessive-compulsive disorder (SMD range, 0.40-0.49), and with absence of a placebo lead-in period (SMD=0.44, 95% CI 0.10 to 0.78). No significant differences were found in placebo response across age groups. We found substantial heterogeneity and moderate risk of bias. CONCLUSIONS Placebo response is substantial in SSRI and SNRI trials for anxiety, obsessive-compulsive and stress-related disorders. Clinicians and researchers should accurately interpret the benefits of pharmacological agents in contrast to placebo response. PROSPERO REGISTRATION NUMBER CRD42017069090.
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Affiliation(s)
- Luis Souza Motta
- Section of Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Natan Pereira Gosmann
- Section of Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Anxiety Disorders Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marianna de Abreu Costa
- Anxiety Disorders Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marianna de Barros Jaeger
- Anxiety Disorders Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Júlia Frozi
- Section of Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Laura Tietzmann Grevet
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lucas Spanemberg
- School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gisele Gus Manfro
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Anxiety Disorders Outpatient Program, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniel Samuel Pine
- Emotion and Development Branch, Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, Maryland, USA
| | - Giovanni Salum
- Section of Negative Affect and Social Processes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Psychiatry and Behavioral Sciences, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
- Child Mind Institute, New York, New York, USA
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5
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Mattos MIP, Mosqueiro BP, Stuart S, Salum G, Duzzo RDL, Souza LWD, Chini A, Fleck MPDA. Implementation of Group Interpersonal Psychotherapy in primary care. Rev Saude Publica 2022; 56:23. [PMID: 35476101 PMCID: PMC9004707 DOI: 10.11606/s1518-8787.2022056003731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/09/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To show the implementation process of IPT-G in primary care, including facilitating and obstructing factors, implementation strategies, and training and supervision of primary care professionals. METHODS Quantitative (cross-sectional and longitudinal) analysis of pre and post-knowledge tests; qualitative analyses of the training courses; patient recruitment; conduction of IPT-G sessions; supervision of IPT-G therapists; application of a semi-structured questionnaire to assess, investigate, and develop strategies against the identified barriers. RESULTS About 120 clinicians answered the pre-test; 84 completed the post-test. Pre- and post-test scores of IPT-G knowledge were significantly different. Twenty initially trained clinicians completed additional supervision in IPT-G. Qualitative analysis identified twelve barriers and six facilitators to IPT-G implementation in individual, organizational, and systemic contexts. CONCLUSIONS Implementation of IPT-G in primary care is a complex process with several steps. In the first step, health professionals were successfully trained in IPT-G. However, subsequent steps were more complex. Therefore, careful planning of IPT-G implementation is essential to maximize the success of this innovation.
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Affiliation(s)
- Maria Isabel Perez Mattos
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
| | - Bruno Paz Mosqueiro
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
| | - Scott Stuart
- University of Southern California. Psychiatry Department. Los Angeles, California, United States of America
| | - Giovanni Salum
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
| | - Rosana de Lima Duzzo
- Prefeitura Municipal de Porto Alegre. Unidade de Atenção Primária à Saúde. Porto Alegre, RS, Brasil
| | - Laura Wolf de Souza
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
| | - Ariane Chini
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
| | - Marcelo Pio de Almeida Fleck
- Universidade Federal do Rio Grande do Sul. Hospital de Clínicas de Porto Alegre. Departamento de Psiquiatria e Medicina Legal. Porto Alegre, RS, Brasil
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6
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Vidal-Pineiro D, Parker N, Shin J, French L, Grydeland H, Jackowski AP, Mowinckel AM, Patel Y, Pausova Z, Salum G, Sørensen Ø, Walhovd KB, Paus T, Fjell AM. Cellular correlates of cortical thinning throughout the lifespan. Sci Rep 2020; 10:21803. [PMID: 33311571 PMCID: PMC7732849 DOI: 10.1038/s41598-020-78471-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/13/2020] [Indexed: 01/11/2023] Open
Abstract
Cortical thinning occurs throughout the entire life and extends to late-life neurodegeneration, yet the neurobiological substrates are poorly understood. Here, we used a virtual-histology technique and gene expression data from the Allen Human Brain Atlas to compare the regional profiles of longitudinal cortical thinning through life (4004 magnetic resonance images [MRIs]) with those of gene expression for several neuronal and non-neuronal cell types. The results were replicated in three independent datasets. We found that inter-regional profiles of cortical thinning related to expression profiles for marker genes of CA1 pyramidal cells, astrocytes and, microglia during development and in aging. During the two stages of life, the relationships went in opposite directions: greater gene expression related to less thinning in development and vice versa in aging. The association between cortical thinning and cell-specific gene expression was also present in mild cognitive impairment and Alzheimer's Disease. These findings suggest a role of astrocytes and microglia in promoting and supporting neuronal growth and dendritic structures through life that affects cortical thickness during development, aging, and neurodegeneration. Overall, the findings contribute to our understanding of the neurobiology underlying variations in MRI-derived estimates of cortical thinning through life and late-life disease.
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Affiliation(s)
- Didac Vidal-Pineiro
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway
| | - Nadine Parker
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, M4G 1R8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Jean Shin
- The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Leon French
- Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, M5T 1L8, Canada
| | - Håkon Grydeland
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway
| | - Andrea P Jackowski
- Interdisciplinary Lab for Clinical Neurosciences (LiNC), University Federal of São Paulo, São Paulo, 04038-020, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, 90035-003, Brazil
| | - Athanasia M Mowinckel
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway
| | - Yash Patel
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, M4G 1R8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Giovanni Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, 90035-003, Brazil
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, 90035-003, Brazil
| | - Øystein Sørensen
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway
| | - Kristine B Walhovd
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0450, Oslo, Norway
| | - Tomas Paus
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, M4G 1R8, Canada.
- Institute of Medical Science, University of Toronto, Toronto, ON, M5S 1A8, Canada.
- Departments of Psychology and Psychiatry, University of Toronto, 250 College Street, Toronto, ON, M5T 1R8, Canada.
| | - Anders M Fjell
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Pb. 1094 Blindern, 0317, Oslo, Norway.
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, 0450, Oslo, Norway.
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7
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Parker N, Vidal-Pineiro D, French L, Shin J, Adams HHH, Brodaty H, Cox SR, Deary IJ, Fjell AM, Frenzel S, Grabe H, Hosten N, Ikram MA, Jiang J, Knol MJ, Mazoyer B, Mishra A, Sachdev PS, Salum G, Satizabal CL, Schmidt H, Schmidt R, Seshadri S, Schumann G, Völzke H, Walhovd KB, Wen W, Wittfeld K, Yang Q, Debette S, Pausova Z, Paus T. Corticosteroids and Regional Variations in Thickness of the Human Cerebral Cortex across the Lifespan. Cereb Cortex 2020; 30:575-586. [PMID: 31240317 PMCID: PMC7444740 DOI: 10.1093/cercor/bhz108] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 12/27/2022] Open
Abstract
Exposures to life stressors accumulate across the lifespan, with possible impact on brain health. Little is known, however, about the mechanisms mediating age-related changes in brain structure. We use a lifespan sample of participants (n = 21 251; 4-97 years) to investigate the relationship between the thickness of cerebral cortex and the expression of the glucocorticoid- and the mineralocorticoid-receptor genes (NR3C1 and NR3C2, respectively), obtained from the Allen Human Brain Atlas. In all participants, cortical thickness correlated negatively with the expression of both NR3C1 and NR3C2 across 34 cortical regions. The magnitude of this correlation varied across the lifespan. From childhood through early adulthood, the profile similarity (between NR3C1/NR3C2 expression and thickness) increased with age. Conversely, both profile similarities decreased with age in late life. These variations do not reflect age-related changes in NR3C1 and NR3C2 expression, as observed in 5 databases of gene expression in the human cerebral cortex (502 donors). Based on the co-expression of NR3C1 (and NR3C2) with genes specific to neural cell types, we determine the potential involvement of microglia, astrocytes, and CA1 pyramidal cells in mediating the relationship between corticosteroid exposure and cortical thickness. Therefore, corticosteroids may influence brain structure to a variable degree throughout life.
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Affiliation(s)
- Nadine Parker
- Institute of Medical Science, University of Toronto, Toronto M5S 1A8, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto M4G 1R8, Canada
| | - Didac Vidal-Pineiro
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo 0373, Norway
| | - Leon French
- Centre for Addiction and Mental Health, University of Toronto, Toronto M5T 1L8, Canada
| | - Jean Shin
- The Hospital for Sick Children, University of Toronto, Toronto M5G 0A4, Canada
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015, the Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain Ageing and Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW 2025, Australia
| | - Simon R Cox
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburg EH8 9JZ, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh EH8 9JZ, UK
- Department of Psychology, University of Edinburgh, Edinburg EH8 9JZ, UK
| | - Anders M Fjell
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo 0373, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo 0318, Norway
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald 17489, Germany
| | - Hans Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald 17489, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald 18147, Germany
| | - Norbert Hosten
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald 17489, Germany
| | - Mohammad Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015, the Netherlands
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
| | - Maria J Knol
- Department of Epidemiology, Erasmus MC University Medical Center Rotterdam, Rotterdam 3015, the Netherlands
| | - Bernard Mazoyer
- Groupe d’Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, Centre National de la Recherche Scientifique, Commissariat à l’Energie Atomique, et Université de Bordeaux, Bordeaux 5293, France
| | - Aniket Mishra
- Bordeaux Population Health Research Center, INSERM UMR, University of Bordeaux, Bordeaux 33076, France
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Giovanni Salum
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, TX 78229, USA
- Department of Neurology, Boston University School of Medicine, MA 02118, USA
| | - Helena Schmidt
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging, Medical University of Graz 8036, Austria
| | - Reinhold Schmidt
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz 8036, Austria
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, TX 78229, USA
- Department of Neurology, Boston University School of Medicine, MA 02118, USA
| | - Gunter Schumann
- MRC-Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London, London SE5 8AF, UK
| | - Henry Völzke
- Department of SHIP/Clinical-Epidemiological Research, Institute for Community Medicine, University Medicine Greifswald, Greifswald 17489, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald 13316, Germany
- DZD (German Centre for Diabetes Research), Site Greifswald
85764, Germany
| | - Kristine B Walhovd
- Centre for Lifespan Changes in Brain and Cognition, Department of Psychology, University of Oslo, Oslo 0373, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo 0318, Norway
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW 2052, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Katharina Wittfeld
- Department of Psychology, University of Edinburgh, Edinburg EH8 9JZ, UK
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/ Greifswald 18147, Germany
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, MA 02118, USA
| | - Stephanie Debette
- Bordeaux Population Health Research Center, INSERM UMR, University of Bordeaux, Bordeaux 33076, France
- Department of Neurology, CHU de Bordeaux, Bordeaux 33000, France
| | - Zdenka Pausova
- The Hospital for Sick Children, University of Toronto, Toronto M5G 0A4, Canada
| | - Tomáš Paus
- Institute of Medical Science, University of Toronto, Toronto M5S 1A8, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto M4G 1R8, Canada
- Departments of Psychology and Psychiatry, University of Toronto
M5T 1R8, Canada
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8
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Levandowski M, Bandinelli LP, Zugman A, Belangero S, Jackowski A, Erickson-Ridout K, Franke K, Pan P, Salum G, Tyrka A, Grassi-Oliveira R. Brain and molecular aging biomarkers in youths exposed to maltreatment: A longitudinal study. IBRO Rep 2019. [DOI: 10.1016/j.ibror.2019.07.1483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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9
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Pan PM, Salum G, Bressan RA. Debate: Dimensions of mania in youth: possibly bipolar, probably risk indicators, certainly impairing. Child Adolesc Ment Health 2019; 24:103-105. [PMID: 32677238 DOI: 10.1111/camh.12310] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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] [Accepted: 12/13/2018] [Indexed: 11/29/2022]
Abstract
We comment on the utility of latent manic dimensions to elucidate the prevalence of youth Bipolar Disorder in epidemiological samples, irrespective of sample's cultural background or clinician's predetermined prototypical definitions of a bipolar case.
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Affiliation(s)
- Pedro Mario Pan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Deparment of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
| | - Giovanni Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil.,Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rodrigo A Bressan
- Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Deparment of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents (INPD), São Paulo, Brazil
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10
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Fatori D, Salum G, Itria A, Pan P, Alvarenga P, Rohde LA, Bressan R, Gadelha A, de Jesus Mari J, Conceição do Rosário M, Manfro G, Polanczyk G, Miguel EC, Graeff-Martins AS. The economic impact of subthreshold and clinical childhood mental disorders. J Ment Health 2018; 27:588-594. [DOI: 10.1080/09638237.2018.1466041] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Daniel Fatori
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
| | - Giovanni Salum
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Alexander Itria
- Department of Collective Health, Institute of Tropical Pathology and Public Health, Federal University of Goias, Goiania, Brazil, and
| | - Pedro Pan
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Pedro Alvarenga
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
| | - Luis Augusto Rohde
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Rodrigo Bressan
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Ary Gadelha
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | | | - Gisele Manfro
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil,
| | - Guilherme Polanczyk
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil,
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11
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Rigatti R, DeSouza DA, Salum G, Alves PFO, Bottan G, Heldt E. Adaptação transcultural do Inventory of Callous-Unemotional Traits para avaliação de traços de insensibilidade e afetividade restrita de adolescentes no Brasil. Rev Gaucha Enferm 2018. [DOI: 10.1590/1983-1447.2017.03.64754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo Realizar a adaptação transcultural para o português brasileiro do instrumento Inventory of Callous-Unemotional Traits (ICU) para avaliação de traços de insensibilidade e afetividade restrita de adolescentes. Método Estudo metodológico que envolveu as etapas de tradução, retradução, avaliação por comitê de especialistas e de clareza da versão pré-final do ICU, avaliado por 40 adolescentes, entre 10 e 17 anos, de ambos os sexos, de uma escola pública. Resultados A versão pré-final do ICU foi aprovada pelo comitê de especialistas e pelo autor do instrumento. A avaliação da clareza revelou uma boa compreensão dos itens. Os 10 itens com menor clareza foram modificados conforme as sugestões. Conclusão A versão final do ICU para o português brasileiro mostrou ser similar ao instrumento original no que se refere à equivalência semântica, operacional e conceitual. Recomenda-se a realização de estudos que evidenciem a validade psicométrica do ICU adaptado para o português brasileiro.
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12
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Lúcio PS, Salum G, Swardfager W, Mari JDJ, Pan PM, Bressan RA, Gadelha A, Rohde LA, Cogo-Moreira H. Testing Measurement Invariance across Groups of Children with and without Attention-Deficit/ Hyperactivity Disorder: Applications for Word Recognition and Spelling Tasks. Front Psychol 2017; 8:1891. [PMID: 29118733 PMCID: PMC5661119 DOI: 10.3389/fpsyg.2017.01891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/12/2017] [Indexed: 11/13/2022] Open
Abstract
Although studies have consistently demonstrated that children with attention-deficit/hyperactivity disorder (ADHD) perform significantly lower than controls on word recognition and spelling tests, such studies rely on the assumption that those groups are comparable in these measures. This study investigates comparability of word recognition and spelling tests based on diagnostic status for ADHD through measurement invariance methods. The participants (n = 1,935; 47% female; 11% ADHD) were children aged 6–15 with normal IQ (≥70). Measurement invariance was investigated through Confirmatory Factor Analysis and Multiple Indicators Multiple Causes models. Measurement invariance was attested in both methods, demonstrating the direct comparability of the groups. Children with ADHD were 0.51 SD lower in word recognition and 0.33 SD lower in spelling tests than controls. Results suggest that differences in performance on word recognition and spelling tests are related to true mean differences based on ADHD diagnostic status. Implications for clinical practice and research are discussed.
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Affiliation(s)
- Patrícia S Lúcio
- Department of Psychology and Psychoanalysis, State University of Londrina, Londrina, Brazil.,Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Giovanni Salum
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Walter Swardfager
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | - Jair de Jesus Mari
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Pedro M Pan
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Rodrigo A Bressan
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Ary Gadelha
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| | - Luis A Rohde
- Department of Psychiatry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Hugo Cogo-Moreira
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
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13
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Spindola LM, Pan PM, Moretti PN, Ota VK, Santoro ML, Cogo-Moreira H, Gadelha A, Salum G, Manfro GG, Mari JJ, Brentani H, Grassi-Oliveira R, Brietzke E, Miguel EC, Rohde LA, Sato JR, Bressan RA, Belangero SI. Gene expression in blood of children and adolescents: Mediation between childhood maltreatment and major depressive disorder. J Psychiatr Res 2017; 92:24-30. [PMID: 28384542 DOI: 10.1016/j.jpsychires.2017.03.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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] [Received: 01/10/2017] [Revised: 02/27/2017] [Accepted: 03/20/2017] [Indexed: 12/14/2022]
Abstract
Investigating major depressive disorder (MDD) in childhood and adolescence can help reveal the relative contributions of genetic and environmental factors to MDD, since early stages of disease have less influence of illness exposure. Thus, we investigated the mRNA expression of 12 genes related to the hypothalamic-pituitary-adrenal (HPA) axis, inflammation, neurodevelopment and neurotransmission in the blood of children and adolescents with MDD and tested whether a history of childhood maltreatment (CM) affects MDD through gene expression. Whole-blood mRNA levels of 12 genes were compared among 20 children and adolescents with MDD diagnosis (MDD group), 49 participants without MDD diagnosis but with high levels of depressive symptoms (DS group), and 61 healthy controls (HC group). The differentially expressed genes were inserted in a mediation model in which CM, MDD, and gene expression were, respectively, the independent variable, outcome, and intermediary variable. NR3C1, TNF, TNFR1 and IL1B were expressed at significantly lower levels in the MDD group than in the other groups. CM history did not exert a significant direct effect on MDD. However, an indirect effect of the aggregate expression of the 4 genes mediated the relationship between CM and MDD. In the largest study investigating gene expression in children with MDD, we demonstrated that NR3C1, TNF, TNFR1 and IL1B expression levels are related to MDD and conjunctly mediate the effect of CM history on the risk of developing MDD. This supports a role of glucocorticoids and inflammation as potential effectors of environmental stress in MDD.
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MESH Headings
- Adolescent
- Child
- Child Abuse/psychology
- Cohort Studies
- Depressive Disorder, Major/blood
- Depressive Disorder, Major/physiopathology
- Female
- Gene Expression/physiology
- Genetic Testing
- Humans
- Hypothalamo-Hypophyseal System/metabolism
- Interleukin-1beta/genetics
- Interleukin-1beta/metabolism
- Male
- Models, Biological
- Peptide Fragments/genetics
- Peptide Fragments/metabolism
- Pituitary-Adrenal System/metabolism
- RNA, Messenger/metabolism
- Receptors, Glucocorticoid/genetics
- Receptors, Glucocorticoid/metabolism
- Receptors, Tumor Necrosis Factor, Type I/genetics
- Receptors, Tumor Necrosis Factor, Type I/metabolism
- Residence Characteristics
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- Leticia Maria Spindola
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Pedro Mario Pan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Patricia Natalia Moretti
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Vanessa Kiyomi Ota
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Marcos Leite Santoro
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil
| | - Hugo Cogo-Moreira
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Ary Gadelha
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Giovanni Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Gisele Gus Manfro
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - Jair Jesus Mari
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Helena Brentani
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department & Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Rodrigo Grassi-Oliveira
- Post-Graduation Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Brazil; Developmental Cognitive Neuroscience Lab, PUCRS, Brazil
| | | | - Euripedes Constantino Miguel
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department & Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Brazil
| | - João Ricardo Sato
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Center of Mathematics, Computation and Cognition, Universidade Federal do ABC, Brazil
| | - Rodrigo Affonseca Bressan
- LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil
| | - Sintia Iole Belangero
- Genetics Division, Department of Morphology and Genetics, Universidade Federal de Sao Paulo (UNIFESP), Brazil; LiNC - Interdisciplinary Laboratory of Clinical Neurosciences, UNIFESP, Brazil; National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Brazil; Department of Psychiatry, UNIFESP, Brazil.
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Passos IC, Vasconcelos-Moreno MP, Costa LG, Kunz M, Brietzke E, Quevedo J, Salum G, Magalhães PVS, Kapczinski F, Kauer-Sant'Anna M. Post-traumatic stress disorder and interleukin 6 - Authors' reply. Lancet Psychiatry 2016; 3:202. [PMID: 26946389 DOI: 10.1016/s2215-0366(16)00054-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Ives Cavalcante Passos
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Mirela Paiva Vasconcelos-Moreno
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Leonardo Gazzi Costa
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maurício Kunz
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Joao Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Giovanni Salum
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Pedro V S Magalhães
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Márcia Kauer-Sant'Anna
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Cliínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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15
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Passos IC, Vasconcelos-Moreno MP, Costa LG, Kunz M, Brietzke E, Quevedo J, Salum G, Magalhães PV, Kapczinski F, Kauer-Sant'Anna M. Inflammatory markers in post-traumatic stress disorder: a systematic review, meta-analysis, and meta-regression. Lancet Psychiatry 2015; 2:1002-12. [PMID: 26544749 DOI: 10.1016/s2215-0366(15)00309-0] [Citation(s) in RCA: 442] [Impact Index Per Article: 49.1] [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: 05/02/2015] [Revised: 06/16/2015] [Accepted: 06/29/2015] [Indexed: 02/03/2023]
Abstract
BACKGROUND Studies investigating inflammatory markers in post-traumatic stress disorder (PTSD) have yielded mixed results. The aim of our study was to compare concentrations of inflammatory markers in patients with PTSD compared with healthy controls. METHODS We did a meta-analysis and meta-regression of studies comparing inflammatory markers between patients with PTSD and healthy controls by searching PubMed, Embase, Scopus, Web of Science, and PsycINFO for articles published between Jan 1, 1960, and April 7, 2015. From eligible studies (ie, cross-sectional studies or baseline data from longitudinal studies of peripheral blood cytokine concentrations that compared adults with PTSD with healthy controls), we extracted outcomes of interest, such as mean and SD of peripheral blood cytokines, the time of day blood was collected, whether the study allowed patients with comorbid major depressive disorder in the PTSD group, whether patients were medication free, and severity of PTSD symptoms. We undertook meta-analyses whenever values of inflammatory markers were available in two or more studies. A random-effects model with restricted maximum-likelihood estimator was used to synthesise the effect size (assessed by standardised mean difference [SMD]) across studies. FINDINGS 8057 abstracts were identified and 20 studies were included. Interleukin 6 (SMD 0.88; p=0.0003), interleukin 1β (SMD 1.42; p=0.045), and interferon γ (SMD 0.49; p=0.002) levels were higher in the PTSD group than in healthy controls. Subgroup meta-analysis of patients who were not given medication showed higher tumour necrosis factor α (TNFα; SMD 0.69, 95% CI 0.35-1.02; p<0.0001) in the PTSD group than the control group in addition to the aforementioned cytokines. TNFα (SMD 1.32, 0.13-2.50; p=0.003), interleukin 1β (SMD 2.35, 0.01-4.68; p=0.048), and interleukin 6 (SMD 1.75, 0.97-2.53; p<0.0001) levels remained increased in the PTSD group in a subgroup meta-analysis of studies that excluded comorbid major depressive disorder. Illness duration was positively associated with interleukin 1β levels (b=0.33, p<0.0001) and severity with interleukin 6 (b=0.02, p=0.042). A model composed of several variables-presence of comorbid major depressive disorder, use of psychotropic medications, assay used, and time of day blood was collected-explained the large amount of heterogeneity between interleukin 1β, interleukin 6, and C-reactive protein studies. Egger's linear regression test revealed a potential publication bias for interleukin 1β. Additionally, for most inflammatory markers, study heterogeneity was reported to be high (I(2)>75%). INTERPRETATION PTSD is associated with increased interleukin 6, interleukin 1β, TNFα, and interferon γ levels. This information might be useful for consideration of chronic low-grade inflammation as a potential target or biomarker in PTSD treatment. Use of psychotropic medication and presence of comorbid major depressive disorder were important moderators that might explain the inconsistency between results of previous studies. Our search strategy used a range of databases and we made exhaustive effort to acquire data by contacting the authors. Notably, high levels of between-study heterogeneity were recorded for most cytokine variables measured in our analysis. However, meta-regression analysis could explain a large amount of this heterogeneity. FUNDING None.
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Affiliation(s)
- Ives Cavalcante Passos
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mirela Paiva Vasconcelos-Moreno
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Leonardo Gazzi Costa
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Maurício Kunz
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Elisa Brietzke
- Interdisciplinary Laboratory of Clinical Neurosciences, Department of Psychiatry, Federal University of São Paulo, São Paulo, SP, Brazil
| | - João Quevedo
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciuma, SC, Brazil
| | - Giovanni Salum
- Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Pedro V Magalhães
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Flávio Kapczinski
- UT Center of Excellence on Mood Disorder, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA; Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Márcia Kauer-Sant'Anna
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil; Graduation Program in Psychiatry and Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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16
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Krieger FV, Polanczyk GV, Goodman R, Rohde LA, Graeff-Martins AS, Salum G, Gadelha A, Pan P, Stahl D, Stringaris A. Dimensions of oppositionality in a Brazilian community sample: testing the DSM-5 proposal and etiological links. J Am Acad Child Adolesc Psychiatry 2013; 52:389-400.e1. [PMID: 23582870 PMCID: PMC3834546 DOI: 10.1016/j.jaac.2013.01.004] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 12/19/2012] [Accepted: 01/11/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Investigating dimensions of oppositional symptoms may help to explain heterogeneity of etiology and outcomes for mental disorders across development and provide further empirical justification for the DSM-5-proposed modifications of oppositional defiant disorder (ODD). However, dimensions of oppositionality have not previously been tested in samples outside Europe or the United States. In this study, we used a large Brazilian community sample to compare the fit of different models for dimensions of oppositional symptoms; to examine the association of psychiatric diagnoses and symptoms with dimensions of oppositionality; and to examine the associations between dimensions of oppositionality and parental history of mental disorders. METHOD A Brazilian community sample of 2,512 children 6 through 12 years old were investigated in this study. Confirmatory factorial analyses were performed to compare the fit of alternative models, followed by linear and logistic regression analyses of associations with psychiatric diagnosis and parental history of psychopathology. RESULTS A three-factor model with irritable, headstrong, and hurtful dimensions fitted best. The irritable dimension showed a strong association with emotional disorders in the child (p<.001) and history of depression (p<.01) and suicidality (p<.05) in the mother. The headstrong dimension was uniquely associated with attention-deficit/hyperactivity disorder (ADHD) in the child (p<.001) and with maternal history of ADHD symptoms (p<.05). The hurtful dimension was specifically associated with conduct disorder (p< .05). CONCLUSIONS Our findings from a large community sample of Brazilian children support a distinction between dimensions of oppositionality consistent with current DSM-5 recommendations and provide further evidence for etiological distinctions between these dimensions.
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Affiliation(s)
| | - Guilherme Vanoni Polanczyk
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil,Research Support Center on Neurodevelopment and Mental Health at the University of São Paulo
| | | | - Luis Augusto Rohde
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil,Federal University of Rio Grande do Sul, Brazil
| | - Ana Soledade Graeff-Martins
- University of São Paulo,National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil
| | - Giovanni Salum
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil,Federal University of Rio Grande do Sul, Brazil
| | - Ary Gadelha
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil
| | - Pedro Pan
- National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), Brazil,Federal University of São Paulo
| | - Daniel Stahl
- Institute of Psychiatry at King’s College London
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Isolan L, Salum G, Flores SM, Carvalho HWD, Manfro GG. Reliability and convergent validity of the Childhood Anxiety Sensitivity Index in children and adolescents. J bras psiquiatr 2012. [DOI: 10.1590/s0047-20852012000400001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE: The purpose of this study was to examine the reliability and the convergent validity of the Children Anxiety Sensitivity Index (CASI) with DSM-IV anxiety disorder symptoms, by comparison with the Screen for Child Anxiety Related Emotional Disorders (SCARED), in a community sample of Brazilian children and adolescents. METHODS: Children and adolescents from five schools were selected from a larger study that aimed to assess different aspects of childhood anxiety disorders. All participants completed the CASI and the SCARED. RESULTS: This study supported the reliability of the CASI total score. Girls reported higher total anxiety sensitivity scores than boys and there were no differences in total anxiety sensitivity scores between children and adolescents. This study showed moderate to high correlations between the CASI scores with SCARED scores, all correlations coefficients being positive and significant. CONCLUSIONS: Our findings demonstrate an appropriate reliability and evidence of convergent validity in the CASI in a sample of Brazilian children and adolescents.
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Affiliation(s)
- Luciano Isolan
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil
| | - Giovanni Salum
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil; Institute of Developmental Psychiatry for Children and Adolescent
| | | | | | - Gisele Gus Manfro
- Hospital de Clínicas de Porto Alegre, Brazil; Universidade Federal do Rio Grande do Sul, Brazil; Institute of Developmental Psychiatry for Children and Adolescent
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Balogh GA, Mailo DA, Corte MM, Roncoroni P, Nardi H, Vincent E, Martinez D, Cafasso ME, Frizza A, Ponce G, Vincent E, Barutta E, Lizarraga P, Lizarraga G, Monti C, Paolillo E, Vincent R, Quatroquio R, Grimi C, Maturi H, Aimale M, Spinsanti C, Montero H, Santiago J, Shulman L, Rivadulla M, Machiavelli M, Salum G, Cuevas MA, Picolini J, Gentili A, Gentili R, Mordoh J. Mutant p53 protein in serum could be used as a molecular marker in human breast cancer. Int J Oncol 2006; 28:995-1002. [PMID: 16525651 DOI: 10.3892/ijo.28.4.995] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
p53 wild-type is a tumor suppressor gene involved in DNA gene transcription or DNA repair mechanisms. When damage to DNA is unrepairable, p53 induces programmed cell death (apoptosis). The mutant p53 gene is the most frequent molecular alteration in human cancer, including breast cancer. Here, we analyzed the genetic alterations in p53 oncogene expression in 55 patients with breast cancer at different stages and in 8 normal women. We measured by ELISA assay the serum levels of p53 mutant protein and p53 antibodies. Immunohistochemistry and RT-PCR using specific p53 primers as well as mutation detection by DNA sequencing were also evaluated in breast tumor tissue. Serological p53 antibody analysis detected 0/8 (0%), 0/4 (0%) and 9/55 (16.36%) positive cases in normal women, in patients with benign breast disease and in breast carcinoma, respectively. We found positive p53 mutant in the sera of 0/8 (0.0%) normal women, 0/4 (0%) with benign breast disease and 29/55 (52.72%) with breast carcinoma. Immunohistochemistry evaluation was positive in 29/55 (52.73%) with mammary carcinoma and 0/4 (0%) with benign breast disease. A very good correlation between p53 mutant protein detected in serum and p53 accumulation by immunohistochemistry (83.3% positive in both assays) was found in this study. These data suggest that detection of mutated p53 could be a useful serological marker for diagnostic purposes.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Autoantibodies/blood
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Breast Neoplasms/blood
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Carcinoma in Situ/blood
- Carcinoma in Situ/genetics
- Carcinoma in Situ/pathology
- Carcinoma, Ductal, Breast/blood
- Carcinoma, Ductal, Breast/genetics
- Carcinoma, Ductal, Breast/pathology
- Enzyme-Linked Immunosorbent Assay
- Female
- Humans
- Immunohistochemistry/methods
- Middle Aged
- Mutation
- Neoplasm Staging
- Tumor Suppressor Protein p53/blood
- Tumor Suppressor Protein p53/genetics
- Tumor Suppressor Protein p53/immunology
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Affiliation(s)
- G A Balogh
- Instituto de Analistas Clinicos Asociados, IACA, Buenos Aires, Argentina.
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19
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Machiavelli MR, Salum G, Pérez JE, Ortiz EH, Romero AO, Bologna F, Vallejo CT, Lacava JA, Dominguez ME, Leone BA. Double modulation of 5-fluorouracil by trimetrexate and leucovorin in patients with advanced colorectal carcinoma. Am J Clin Oncol 2004; 27:149-54. [PMID: 15057154 DOI: 10.1097/01.coc.0000054903.27866.31] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this report is to evaluate the efficacy and toxicity (Tx) of a double modulation of 5-fluorouracil (5-FU) by trimetrexate (TMTX) and leucovorin (LV) in patients with advanced recurrent (inoperable) or metastatic colorectal cancer (ACC). Between December 1997 and August 2000, 36 patients were entered in this phase II study. Median age was 61 years, and 18 patients (50%) were female. Median performance status was 0 (range: 0-1), whereas primary tumor location was colon in 21 patients (58%) and rectum in 15 patients (42%). The number of metastatic sites was 1:29 patients (81%); 2:6 patients (17%) and 3:1 patient (3%). Hepatic involvement was observed in 33 patients (92%). Treatment consisted of TMTX 110 mg/m2 IV over 1 hour at hour (H) 0; LV 50 mg/m2 IV over 2 hours IV infusion starting at H 18; and 5-FU 900 mg/m2 IV bolus at H 20. LV (rescue) 15 mg/m2 orally was administered every 6 hours (total 6 doses) beginning at H 24. Cycles were repeated every 2 weeks until progressive disease (PD) or severe Tx. Thirty-four patients are assessable for response (R) (two patients refused further treatment after the first course of therapy), whereas all patients were assessable for Tx. Complete response: 1 patient (3%); partial response: 4 patients (12%), with an overall objective response rate of 15% (95% CI, 1%-25%); no change: 12 patients (35%); and progressive disease: 17 patients (50%). The median time to treatment failure was 4 months and median survival was 11 months. Tx was within acceptable limits. The dose-limiting side effect was mucositis. Eight episodes of grade II or III stomatitis were observed and were responsible for dosage modifications of TMTX and 5-FU. Leukopenia was observed in 16 patients (44%); neutropenia was registered in 19 patients (53%); anemia was seen in 18 patients (50%); emesis in 22 patients (61%); and dermatitis in 3 patients (8%). There were no therapy-related deaths. The double modulation of 5-FU by TMTX and LV showed modest antitumoral activity with mild to moderate Tx.
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Affiliation(s)
- M R Machiavelli
- Grupo Oncológico Cooperativo del Sur, Neuquen, República Argentina
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20
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Abstract
BACKGROUND Although not clearly defined, 'hormone refractory' prostate cancer implies disease progression after orchiectomy +/- antiandrogens. Patients in this setting are usually offered chemotherapy protocols which often lead to significant toxicity and expense. In search of a well-tolerated, active, third-line treatment, we have attempted to prolong hormonal maneuvers by using low-dose estrogen therapy. DESIGN Thirty-eight patients with evidence of disease progression (as indicated by 2 consecutively rising PSA determinations) after > or = 2 hormonal treatments (including surgical or chemical orchiectomy and a median of 3 prior treatment lines) received fosfestrol 100 mg t.i.d. per os in a continuous schedule until the appearance of progressive disease or excessive toxicity. Response was assessed by serial PSA levels. Complete response (CR) was defined as normalisation and partial response (PR) as a > or = 50 decrease of PSA levels for longer than one month. The median duration of prior treatment was 20 months and the median PSA at fosfestrol start was 126 ng/ml (range 8-12,800); symptoms (pain) were present in 73% of patients. RESULTS CR + PR were observed in 79% (95% confidence interval: 66%-92%). The median time to progression was seven months. Pain remained stable or improved in 34% and 53%, respectively, of symptomatic patients with PSA response. Toxicity included worsening of gynecomastia, peripheral edema, and deep vein thrombosis (8%). No treatment-related deaths occurred. Uni- and multivariate analyses failed to identify predictive factors for response. PSA response was associated with significantly longer survival (13 vs. 7 months, P < 0.05 by Mantel-Haentzel). CONCLUSIONS FOSF produces high rates of PSA-determined and symptomatic response in 'hormone-refractory' prostate cancer. Toxicity and ease of administration compare favorably with those reported for CHT regimens used in this setting. The role of estrogens in prostate cancer should be redefined.
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Affiliation(s)
- M Orlando
- Alexander Fleming Institute, Buenos Aires, Argentina.
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