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Leijdesdorff SMJ, Bakker JM, Lange I, Michielse S, Goossens L, Klaassen R, Popma A, Schruers K, Lieverse R, Marcelis M, van Os J, Wichers M, Myin-Germeys I, van Amelsvoort T. Home alone: Social functioning as a transdiagnostic marker of mental health in youth, exploring retrospective and daily life measurements. Compr Psychiatry 2022; 115:152309. [PMID: 35325672 DOI: 10.1016/j.comppsych.2022.152309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 08/27/2021] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Early detection and intervention of mental health problems in youth are topical given that mental disorders often start early in life. Young people with emerging mental disorders however, often present with non-specific, fluctuating symptoms. Recent reports indicate a decline in social functioning (SF) as an early sign of specific emerging mental disorders such as depression or anxiety, making SF a favorable transdiagnostic approach for earlier detection and intervention. Our aim was to investigate the value of SF in relation to transdiagnostic symptoms, and as a predictor of psychopathology over time, while exploring traditional retrospective versus innovative daily diary measurements of SF in youth. METHOD Participants (N = 75) were 16-25 years of age and presented early stage psychiatric symptomatology. Psychiatric symptoms, including anxiety and depression, as well as SF -both in retrospect and in daily life- were assessed at two time points and analyzed cross-sectionally and longitudinally. RESULTS A significant and negative association between SF and all psychiatric symptoms was found, and SF was a significant predictor of change in general psychiatric symptoms over time. Results were only significant when SF was measured traditionally retrospective. CONCLUSION This study confirms a distinct relation between SF and transdiagnostic psychiatric symptoms in youth, even in a (sub)clinical population, and points towards SF as a predictor of transdiagnostic psychiatric symptoms. Further research is needed to learn more about the added value of daily life versus retrospective measurements.
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Affiliation(s)
- Sophie M J Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands.
| | - Jindra M Bakker
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Rianne Klaassen
- Department of Child and Adolescent Psychiatry, Levvel, Duivendrecht, the Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Levvel, Duivendrecht, the Netherlands; Amsterdam UMC, Amsterdam, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
| | | | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; GGzE, Eindhoven, the Netherlands
| | | | | | | | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
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Oberije C, Lieverse R, Van Wijk Y, Dubois L, Van der Wiel A, Marcus D, Sanduleanu S, Lambin P. PO-1542: Integrating biomarker performance in sample size calculations for therapeutic trials. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01560-7] [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: 10/22/2022]
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Lieverse R, Van Limbergen E, Olivo Pimentol V, Oberije C, Neri D, Yaromina A, Dubois L, Lambin P. OC-0084: Combining RT with L19-IL2 and aPDL1: from preclinical results towards a phase II trial (ImmunoSABR). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00110-9] [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: 10/22/2022]
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van Aubel E, Bakker JM, Batink T, Michielse S, Goossens L, Lange I, Schruers K, Lieverse R, Marcelis M, van Amelsvoort T, van Os J, Wichers M, Vaessen T, Reininghaus U, Myin-Germeys I. Blended care in the treatment of subthreshold symptoms of depression and psychosis in emerging adults: A randomised controlled trial of Acceptance and Commitment Therapy in Daily-Life (ACT-DL). Behav Res Ther 2020; 128:103592. [PMID: 32146218 DOI: 10.1016/j.brat.2020.103592] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
In this study, the feasibility and efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), ACT augmented with a daily life application, was investigated in 55 emerging adults (age 16 to 25) with subthreshold depressive and/or psychotic complaints. Participants were randomized to ACT-DL (n = 27) or to active control (n = 28), with assessments completed at pre- and post-measurement and 6- and 12-months follow-up. It took up to five (ACT-DL) and 11 (control) months to start group-based interventions. Participants attended on average 4.32 out of 5 ACT-DL sessions. On the app, they filled in on average 69 (48%) of signal-contingent beep-questionnaires, agreed to 15 (41%) of offered beep-exercises, initiated 19 on-demand exercises, and rated ACT-DL metaphors moderately useful. Relative to active control, interviewer-rated depression scores decreased significantly in ACT-DL participants (p = .027). Decreases in self-reported depression, psychotic-related distress, anxiety, and general psychopathology did not differ between conditions. ACT-DL participants reported increased mean NA (p = .011), relative to active controls. Mean PA did not change in either group, nor did psychological flexibility. ACT-DL is a feasible intervention, although adaptations in future research may improve delivery of and compliance with the intervention. There were mixed findings for its efficacy in reducing subthreshold psychopathology in emerging adults. Dutch Trial Register no.: NTR3808.
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Affiliation(s)
- Evelyne van Aubel
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), University of Leuven, Leuven, Belgium.
| | - Jindra Myrthe Bakker
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), University of Leuven, Leuven, Belgium; Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Tim Batink
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands; U-Center, Epen, Netherlands.
| | - Stijn Michielse
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Liesbet Goossens
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Iris Lange
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Koen Schruers
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Health Psychology, Faculty of Psychology, University of Leuven, Leuven, Belgium.
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands.
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands.
| | - Jim van Os
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, England, United Kingdom; Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Marieke Wichers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), the Netherlands.
| | - Thomas Vaessen
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), University of Leuven, Leuven, Belgium.
| | - Ulrich Reininghaus
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience (MHeNs), EURON, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Public Mental Health, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany; Center for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Inez Myin-Germeys
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), University of Leuven, Leuven, Belgium.
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Michielse S, Lange I, Bakker J, Goossens L, Verhagen S, Papalini S, Wichers M, Lieverse R, Schruers K, van Amelsvoort T, van Os J, Murray GK, Marcelis M. Reward anticipation in individuals with subclinical psychotic experiences: A functional MRI approach. Eur Neuropsychopharmacol 2019; 29:1374-1385. [PMID: 31685359 DOI: 10.1016/j.euroneuro.2019.10.002] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 07/15/2019] [Accepted: 10/07/2019] [Indexed: 11/18/2022]
Abstract
Previous research in patients with psychotic disorder has shown widespread abnormalities in brain activation during reward anticipation. Research at the level of subclinical psychotic experiences in individuals unexposed to antipsychotic medication is limited with inconclusive results. Therefore, brain activation during reward anticipation was examined in a larger sample of individuals with subclinical psychotic experiences (PE). Participants in the PE-group were included based on CAPE scores. A sample of emerging adults aged 16-26 years (n = 47) with PE and healthy controls (HC) (n = 40) underwent fMRI scanning. The Monetary Incentive Delay task was conducted with cues related to win, loss or neutral conditions. fMRI nonparametric tests were used to examine the reward versus neutral cue contrast. A significant main effect of the large win (€3.00) > neutral contrast was found in both groups showing activation in many brain areas, including classic reward regions. Whole brain analysis on the group comparison regarding the large win > neutral contrast showed significantly decreased activation in the right insula, putamen and supramarginal gyrus in the PE-group compared to controls. There was no group difference in the hypothesized reward-related region. Decreased activation in the right insula, putamen and supramarginal gyrus during reward anticipation in individuals with PE may be consistent with altered processing of sensory information, related to decreased emotional valuing and motivational tendencies and/or altered motor-cognitive processes. The absence of group differences in striatal activation suggests that activation here is intact in the earliest stages of psychosis and may exhibit progressive deterioration in as the disease develops.
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Affiliation(s)
- Stijn Michielse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Department of Neuroscience, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Simone Verhagen
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Silvia Papalini
- Laboratory of Biological Psychology, Faculty of Psychology and Educational Sciences, Leuven Brain Institute, KU Leuven, Belgium
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, England; Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, United Kingdom; Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, the Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
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Bakker JM, Goossens L, Kumar P, Lange IM, Michielse S, Schruers K, Bastiaansen JA, Lieverse R, Marcelis M, Amelsvoort van T, van Os J, Myin-Germeys I, Pizzagalli DA, Wichers M. From laboratory to life: associating brain reward processing with real-life motivated behaviour and symptoms of depression in non-help-seeking young adults. Psychol Med 2019; 49:2441-2451. [PMID: 30488820 PMCID: PMC6541542 DOI: 10.1017/s0033291718003446] [Citation(s) in RCA: 45] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Depression has been associated with abnormalities in neural underpinnings of Reward Learning (RL). However, inconsistencies have emerged, possibly owing to medication effects. Additionally, it remains unclear how neural RL signals relate to real-life behaviour. The current study, therefore, examined neural RL signals in young, mildly to moderately depressed - but non-help-seeking and unmedicated - individuals and how these signals are associated with depressive symptoms and real-life motivated behaviour. METHODS Individuals with symptoms along the depression continuum (n = 87) were recruited from the community. They performed an RL task during functional Magnetic Resonance Imaging and were assessed with the Experience Sampling Method (ESM), completing short questionnaires on emotions and behaviours up to 10 times/day for 15 days. Q-learning model-derived Reward Prediction Errors (RPEs) were examined in striatal areas, and subsequently associated with depressive symptoms and an ESM measure capturing (non-linearly) how anticipation of reward experience corresponds to actual reward experience later on. RESULTS Significant RPE signals were found in the striatum, insula, amygdala, hippocampus, frontal and occipital cortices. Region-of-interest analyses revealed a significant association between RPE signals and (a) self-reported depressive symptoms in the right nucleus accumbens (b = -0.017, p = 0.006) and putamen (b = -0.013, p = .012); and (b) the quadratic ESM variable in the left (b = 0.010, p = .010) and right (b = 0.026, p = 0.011) nucleus accumbens and right putamen (b = 0.047, p < 0.001). CONCLUSIONS Striatal RPE signals are disrupted along the depression continuum. Moreover, they are associated with reward-related behaviour in real-life, suggesting that real-life coupling of reward anticipation and engagement in rewarding activities might be a relevant target of psychological therapies for depression.
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Affiliation(s)
- Jindra M. Bakker
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
- KU Leuven, Dept. of Neuroscience, Center for Contextual Psychiatry, Leuven, Belgium
| | - Liesbet Goossens
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
| | - Poornima Kumar
- McLean Hospital, Center for Depression, Anxiety and Stress Research, Belmont, MA, USA
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Iris M.J. Lange
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
| | - Stijn Michielse
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
| | - Koen Schruers
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
- KU Leuven, Dept. of Psychology, Leuven, Belgium
| | - Jojanneke A. Bastiaansen
- University of Groningen, University Medical Centre Groningen (UMCG), Dept. of Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
- Friesland Mental Health Care Services, Leeuwarden, the Netherlands
| | - Ritsaert Lieverse
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
| | - Machteld Marcelis
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
| | - Thérèse Amelsvoort van
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
| | - Jim van Os
- Maastricht University, Maastricht University Medical Centre (MUMC), School for Mental Health and Neuroscience, Dept. of Psychiatry and Psychology, Maastricht, The Netherlands
- Utrecht University, University Medical Center, Dept. of Psychiatry, Brain Center Rudolf Magnus, Utrecht, The Netherlands
- King’s College, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
| | - Inez Myin-Germeys
- KU Leuven, Dept. of Neuroscience, Center for Contextual Psychiatry, Leuven, Belgium
| | - Diego A. Pizzagalli
- McLean Hospital, Center for Depression, Anxiety and Stress Research, Belmont, MA, USA
- Harvard Medical School, Department of Psychiatry, Boston, MA, USA
| | - Marieke Wichers
- University of Groningen, University Medical Centre Groningen (UMCG), Dept. of Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
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Michielse S, Lange I, Bakker J, Goossens L, Verhagen S, Wichers M, Lieverse R, Schruers K, van Amelsvoort T, van Os J, Marcelis M. White matter microstructure and network-connectivity in emerging adults with subclinical psychotic experiences. Brain Imaging Behav 2019; 14:1876-1888. [PMID: 31183775 PMCID: PMC7572337 DOI: 10.1007/s11682-019-00129-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Group comparisons of individuals with psychotic disorder and controls have shown alterations in white matter microstructure. Whether white matter microstructure and network connectivity is altered in adolescents with subclinical psychotic experiences (PE) at the lowest end of the psychosis severity spectrum is less clear. DWI scan were acquired in 48 individuals with PE and 43 healthy controls (HC). Traditional tensor-derived indices: Fractional Anisotropy, Axial Diffusivity, Mean Diffusivity and Radial Diffusivity, as well as network connectivity measures (global/local efficiency and clustering coefficient) were compared between the groups. Subclinical psychopathology was assessed with the Community Assessment of Psychic Experiences (CAPE) and Montgomery-Åsberg Depression Rating Scale (MADRS) questionnaires and, in order to capture momentary subclinical expression of psychosis, the Experience Sampling Method (ESM) questionnaires. Within the PE-group, interactions between subclinical (momentary) symptoms and brain regions in the model of tensor-derived indices and network connectivity measures were investigated in a hypothesis-generating fashion. Whole brain analyses showed no group differences in tensor-derived indices and network connectivity measures. In the PE-group, a higher positive symptom distress score was associated with both higher local efficiency and clustering coefficient in the right middle temporal pole. The findings indicate absence of microstructural white matter differences between emerging adults with subclinical PE and controls. In the PE-group, attenuated symptoms were positively associated with network efficiency/cohesion, which requires replication and may indicate network alterations in emerging mild psychopathology.
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Affiliation(s)
- Stijn Michielse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Department of Neuroscience, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Simone Verhagen
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Marieke Wichers
- University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, Groningen, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, England.,Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, PO Box 616, 6200, MD, Maastricht, the Netherlands.,Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, the Netherlands
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Lambin P, Lieverse R, Van Limbergen E, Pimentel VO, Marcus D, Van Der Wiel A, Theys J, Yaromina A, Dubois L, Hoeben A, Dingemans A. SP-0687 Combining Radiotherapy with Immunotherapy: focus on immunocytokines. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31107-7] [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: 10/26/2022]
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Mentzel TQ, van der Snoek R, Lieverse R, Oorschot M, Viechtbauer W, Bloemen O, van Harten PN. Clozapine Monotherapy as a Treatment for Antipsychotic-Induced Tardive Dyskinesia: A Meta-Analysis. J Clin Psychiatry 2018; 79. [PMID: 30257080 DOI: 10.4088/jcp.17r11852] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [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: 08/07/2017] [Accepted: 02/05/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Tardive dyskinesia (TD) is an antipsychotic-induced movement disorder that typically occurs after long-term exposure to antipsychotic drugs. There is evidence that switching to clozapine reduces TD. This meta-analysis reviews the effect of switching to clozapine on the severity of TD. DATA SOURCES The PubMed, PsycINFO, and Embase databases were searched for clozapine, tardive dyskinesia, and related keywords. The search was restricted to articles written in English and Dutch, and it was last updated on October 13, 2015. STUDY SELECTION Sixteen studies were included in the meta-analysis. Inclusion criteria were a diagnosis of schizophrenia or a related disorder, a switch to clozapine monotherapy, and reports of scores on a TD rating scale before and after the switch to clozapine. DATA EXTRACTION Two independent investigators extracted the data. Data were converted to standardized mean change scores and analyzed in a random-effects model. RESULTS A random-effects model showed that the overall effect of switching to clozapine was a significant reduction in TD (npatients = 1,060, d = -0.40, P < .01), especially in the 4 studies that investigated the severity of TD as a primary outcome (npatients = 48, d = -2.56, P = .02). CONCLUSIONS The overall results show that clozapine treatment can yield a slight reduction in TD. The severity of TD was reduced greatly in patients with moderate to severe TD. In patients with minimal to mild TD, switching to clozapine seldom worsens TD and a trend toward reduction is seen. These results support that a switch to clozapine should be considered for patients with moderate to severe TD and/or patients who experience substantial discomfort due to TD.
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Affiliation(s)
- Thierry Q Mentzel
- School for Mental Health and Neuroscience, Maastricht University, PO Box 616, Maastricht 6200 MD, The Netherlands. .,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,GGZ Centraal, Innova, Amersfoort, The Netherlands
| | | | - Ritsaert Lieverse
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | | | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Oswald Bloemen
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,GGZ Centraal, Innova, Amersfoort, The Netherlands
| | - Peter N van Harten
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands.,GGZ Centraal, Innova, Amersfoort, The Netherlands
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10
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Lange I, Goossens L, Michielse S, Bakker J, Lissek S, Papalini S, Verhagen S, Leibold N, Marcelis M, Wichers M, Lieverse R, van Os J, van Amelsvoort T, Schruers K. Behavioral pattern separation and its link to the neural mechanisms of fear generalization. Soc Cogn Affect Neurosci 2018; 12:1720-1729. [PMID: 29036532 PMCID: PMC5714173 DOI: 10.1093/scan/nsx104] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 09/06/2017] [Indexed: 01/09/2023] Open
Abstract
Fear generalization is a prominent feature of anxiety disorders and post-traumatic stress disorder (PTSD). It is defined as enhanced fear responding to a stimulus that bears similarities, but is not identical to a threatening stimulus. Pattern separation, a hippocampal-dependent process, is critical for stimulus discrimination; it transforms similar experiences or events into non-overlapping representations. This study is the first in humans to investigate the extent to which fear generalization relies on behavioral pattern separation abilities. Participants (N = 46) completed a behavioral task taxing pattern separation, and a neuroimaging fear conditioning and generalization paradigm. Results show an association between lower behavioral pattern separation performance and increased generalization in shock expectancy scores, but not in fear ratings. Furthermore, lower behavioral pattern separation was associated with diminished recruitment of the subcallosal cortex during presentation of generalization stimuli. This region showed functional connectivity with the orbitofrontal cortex and ventromedial prefrontal cortex. Together, the data provide novel experimental evidence that pattern separation is related to generalization of threat expectancies, and reduced fear inhibition processes in frontal regions. Deficient pattern separation may be critical in overgeneralization and therefore may contribute to the pathophysiology of anxiety disorders and PTSD.
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Affiliation(s)
- Iris Lange
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Liesbet Goossens
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jindra Bakker
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Silvia Papalini
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University, Nijmegen, The Netherlands
| | - Simone Verhagen
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Nicole Leibold
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.,Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.,Department of Psychosis Studies, Institute of Psychiatry, King's College London, King's Health Partners, London, UK
| | - Therese van Amelsvoort
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Koen Schruers
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands.,Faculty of Psychology, Center for Experimental and Learning Psychology, University of Leuven, Leuven, Belgium
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11
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Bakker JM, Goossens L, Lange I, Michielse S, Schruers K, Lieverse R, Marcelis M, van Amelsvoort T, van Os J, Myin-Germeys I, Wichers M. Real-life validation of reduced reward processing in emerging adults with depressive symptoms. J Abnorm Psychol 2018; 126:713-725. [PMID: 28782974 DOI: 10.1037/abn0000294] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Subclinical symptoms of depression are common in emerging adults. Anhedonia is one such symptom that specifically puts one at risk for developing clinical depression. Recently, important progress has been made in elucidating the underlying neurobiology of anhedonia. This progress rests on many experimental studies examining how subjects with depressive symptoms respond to anticipating and consuming rewarding stimuli. Translating these findings to real-life reward processing dynamics is an important next step in order to guide fine-tuning of preventive treatments. We propose that the Experience Sampling Methodology (ESM) represents a useful tool in addressing this issue. ESM requires individuals to carry a device that beeps at semirandom moments, inviting them to fill out a short questionnaire on mood, context, and behavior. Using this methodology, we aimed to decompose the construct of reward processing into its daily life dynamics, by investigating how positive affect (PA), reward anticipation and active behavior influence each other over time. A group of emerging adults (aged 16-25) was included, of which two-thirds presented with subclinical depressive symptoms. Associations between PA, reward anticipation and active behavior manifested in the flow of daily life. Depressive symptoms were significantly associated with reduced time-lagged associations between reward anticipation and active behavior (β = -.005, p = .006) and active behavior and reward anticipation (β = -.002, p = .027). The moderating effect of depressive symptoms on the time-lagged association between reward anticipation and PA approached significance (β = -.002, p = .051). These findings represent an important step in translating experimental knowledge on reward processing into daily life processes. (PsycINFO Database Record
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Affiliation(s)
- Jindra Myrthe Bakker
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, Maastricht University Medical Centre (MUMC), Maastricht University
| | - Liesbet Goossens
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Iris Lange
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Stijn Michielse
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Koen Schruers
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Ritsaert Lieverse
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Machteld Marcelis
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Thérèse van Amelsvoort
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Jim van Os
- School for Mental Health and Neuroscience, Department of Psychiatry and Psychology, MUMC, Maastricht University
| | - Inez Myin-Germeys
- Department of Neuroscience, Center for Contextual Psychiatry, KU Leuven
| | - Marieke Wichers
- Department of Psychiatry(UCP), Interdisciplinary Center for Psychopathology and Emotion Regulation(ICPE), University Medical Centre Groningen (UMCG), University of Groningen
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12
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Bakker JM, Lieverse R, Geschwind N, Peeters F, Myin-Germeys I, Wichers M. The Two-Sided Face of Antidepressants: The Impact of Their Use on Real-Life Affective Change during Mindfulness-Based Cognitive Therapy. Psychother Psychosom 2017; 85:180-2. [PMID: 27044053 DOI: 10.1159/000443333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 12/14/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Jindra Myrthe Bakker
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, Maastricht, The Netherlands
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13
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Frissen A, van Os J, Lieverse R, Habets P, Gronenschild E, Marcelis M. No Evidence of Association between Childhood Urban Environment and Cortical Thinning in Psychotic Disorder. PLoS One 2017; 12:e0166651. [PMID: 28045900 PMCID: PMC5207533 DOI: 10.1371/journal.pone.0166651] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 05/12/2016] [Accepted: 11/01/2016] [Indexed: 12/23/2022] Open
Abstract
Background The alterations in cortical morphology, such as cortical thinning, observed in psychotic disorder, may be the outcome of interacting genetic and environmental effects. It has been suggested that urban upbringing may represent a proxy environmental effect impacting cortical thickness (CT). Therefore, the current study examined whether the association between group as a proxy genetic variable (patients with psychotic disorder [high genetic risk], healthy siblings of patients [intermediate risk] and healthy control subjects [average risk]) and CT was conditional on different levels of the childhood urban environment and whether this was sex-dependent. Methods T1-weighted MRI scans were acquired from 89 patients with a psychotic disorder, 95 non-psychotic siblings of patients with psychotic disorder and 87 healthy control subjects. Freesurfer software was used to measure CT. Developmental urban exposure was classified as low, medium, and high, reflecting the population density and the number of moves between birth and the 15th birthday, using data from the Dutch Central Bureau of Statistics and the equivalent database in Belgium. Multilevel regression analyses were used to examine the association between group, sex, and urban upbringing (as well as their interactions) and cortical CT as the dependent variable. Results CT was significantly smaller in the patient group compared to the controls (B = -0.043, p <0.001), but not in the siblings compared to the controls (B = -0.013, p = 0.31). There was no main effect of developmental urbanicity on CT (B = 0.001, p = 0.91). Neither the three-way group × urbanicity × sex interaction (χ2 = 3.73, p = 0.16), nor the two-way group × urbanicity interaction was significant (χ2 = 0.51, p = 0.77). Conclusion The negative association between (familial risk for) psychotic disorder and CT was not moderated by developmental urbanicity, suggesting that reduced CT is not the outcome of familial sensitivity to the proxy environmental factor ‘urban upbringing’.
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Affiliation(s)
- Aleida Frissen
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
- King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, United Kingdom
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Petra Habets
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Ed Gronenschild
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
- * E-mail:
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14
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Bais B, Kamperman AM, van der Zwaag MD, Dieleman GC, Harmsen van der Vliet-Torij HW, Bijma HH, Lieverse R, Hoogendijk WJG, Lambregtse-van den Berg MP. Bright light therapy in pregnant women with major depressive disorder: study protocol for a randomized, double-blind, controlled clinical trial. BMC Psychiatry 2016; 16:381. [PMID: 27821114 PMCID: PMC5100252 DOI: 10.1186/s12888-016-1092-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [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: 10/05/2016] [Accepted: 10/26/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Depression during pregnancy is a common and high impact disease. Generally, 5-10 % of pregnant women suffer from depression. Children who have been exposed to maternal depression during pregnancy have a higher risk of adverse birth outcomes and more often show cognitive, emotional and behavioural problems. Therefore, early detection and treatment of antepartum depression is necessary. Both psychotherapy and antidepressant medication, first choice treatments in a non-pregnant population, have limitations in treating depression during pregnancy. Therefore, it is urgent and relevant to investigate alternative treatments for antepartum depression. Bright light therapy (BLT) is a promising treatment for pregnant women with depressive disorder, for it combines direct availability, sufficient efficacy, low costs and high safety, taking the safety for the unborn child into account as well. METHODS In this study, 150 pregnant women (12-18 weeks pregnant) with a DSM-V diagnosis of depressive disorder will be randomly allocated in a 1:1 ratio to one of the two treatment arms: treatment with BLT (9.000 lux) or treatment with dim red light therapy (100 lux). Both groups will be treated for 6 weeks at home on a daily basis for 30 min, within 30 min of habitual wake-up time. Follow-up will take place after 6 weeks of therapy, 3 and 10 weeks after end of therapy, at birth and 2, 6 and 18 months postpartum. Primary outcome will be the average change in depressive symptoms between the two groups, as measured by the Structured Interview Guide for the Hamilton Depression Scale - Seasonal Affective Disorder version and the Edinburg Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time will be analysed using generalized linear mixed models. Secondary outcomes will be the changes in maternal cortisol and melatonin levels, in maternal sleep quality and gestational age, birth weight, infant behaviour, infant cortisol exposure and infant cortisol stress response. DISCUSSION If BLT reduces depressive symptoms in pregnant women, it will provide a safe, cheap, non-pharmacological and efficacious alternative treatment for psychotherapy and antidepressant medication in treating antepartum depression, without any expected adverse reactions for the unborn child. TRIAL REGISTRATION Netherlands Trial Register NTR5476 . Registered 5 November 2015.
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Affiliation(s)
- Babette Bais
- Department of Psychiatry, Erasmus University Medical Centre Rotterdam, 's Gravendijkwal 230, 3015CE, Rotterdam, The Netherlands.
| | - Astrid M. Kamperman
- Department of Psychiatry, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015CE Rotterdam, The Netherlands ,Epidemiological and Social Psychiatric Research Institute, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | | | - Gwen C. Dieleman
- Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | | | - Hilmar H. Bijma
- Department of Obstetrics and Gynaecology, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Witte J. G. Hoogendijk
- Department of Psychiatry, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015CE Rotterdam, The Netherlands
| | - Mijke P. Lambregtse-van den Berg
- Department of Psychiatry, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015CE Rotterdam, The Netherlands ,Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre Rotterdam, ‘s Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
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15
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Rickelt J, Viechtbauer W, Lieverse R, Overbeek T, van Balkom AJ, van Oppen P, van den Heuvel OA, Marcelis M, Eikelenboom M, Tibi L, Schruers KR. The relation between depressive and obsessive-compulsive symptoms in obsessive-compulsive disorder: Results from a large, naturalistic follow-up study. J Affect Disord 2016; 203:241-247. [PMID: 27310102 DOI: 10.1016/j.jad.2016.06.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [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: 04/11/2016] [Revised: 05/28/2016] [Accepted: 06/03/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Despite the frequent occurrence of depressive symptoms in obsessive-compulsive disorder (OCD), little is known about the reciprocal influence between depressive and obsessive-compulsive symptoms during the course of the disease. The aim of the present study is to investigate the longitudinal relationship between obsessive-compulsive and depressive symptoms in OCD patients. METHOD We used the baseline and 1-year follow-up data of the Netherlands Obsessive Compulsive Disorder Association (NOCDA) study. In 276 patients with a lifetime diagnosis of obsessive-compulsive disorder, depressive and obsessive-compulsive symptoms were assessed at baseline and at one-year follow-up with the Beck Depression Inventory (BDI) and the Yale-Brown Obsessive Compulsive Symptom (Y-BOCS) scale. Relations were investigated using a cross-lagged panel design. RESULTS The association between the severity of depressive symptoms at baseline and obsessive-compulsive symptoms at follow-up was significant (β=0.244, p<0.001), while the association between the severity of obsessive-compulsive symptoms at baseline and depressive symptoms at follow-up was not (β=0.097, p=0.060). Replication of the analyses in subgroups with and without current comorbid major depressive disorder (MDD) and subgroups with different sequence of onset (primary versus secondary MDD) revealed the same results. LIMITATIONS There may be other factors, which affect both depressive and obsessive-compulsive symptoms that were not assessed in the present study. CONCLUSION The present study demonstrates a relation between depressive symptoms and the course of obsessive-compulsive symptoms in OCD patients, irrespective of a current diagnosis of MDD and the sequence of onset of OCD and MDD.
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Affiliation(s)
- Judith Rickelt
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands.
| | - Wolfgang Viechtbauer
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Mondriaan Mental Health Center, Maastricht, The Netherlands
| | - Thea Overbeek
- Mondriaan Mental Health Center, Maastricht, The Netherlands
| | - Anton J van Balkom
- Department of Psychiatry, VU University Medical Center (Vumc), Amsterdam, The Netherlands; EMGO+, VU University Medical Center (Vumc), Amsterdam, The Netherlands; GGZ inGeest, Amsterdam, The Netherlands
| | - Patricia van Oppen
- Department of Psychiatry, VU University Medical Center (Vumc), Amsterdam, The Netherlands; EMGO+, VU University Medical Center (Vumc), Amsterdam, The Netherlands; GGZ inGeest, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Psychiatry, VU University Medical Center (Vumc), Amsterdam, The Netherlands; Department of Anatomy & Neurosciences, VUmc, Neuroscience Campus Amsterdam (NCA), VU/VUmc, Amsterdam, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - Merijn Eikelenboom
- Department of Psychiatry, VU University Medical Center (Vumc), Amsterdam, The Netherlands; EMGO+, VU University Medical Center (Vumc), Amsterdam, The Netherlands
| | - Lee Tibi
- Psychology Department, Ben Gurion University, Be'er-Sheva, Israel
| | - Koen Rj Schruers
- Department of Psychiatry & Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands; Mondriaan Mental Health Center, Maastricht, The Netherlands; Department of Health Psychology, University of Leuven, Belgium
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16
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Mentzel TQ, Lieverse R, Levens A, Mentzel CL, Tenback DE, Bakker PR, Daanen HAM, van Harten PN. Reliability and validity of an instrument for the assessment of bradykinesia. Psychiatry Res 2016; 238:189-195. [PMID: 27086232 DOI: 10.1016/j.psychres.2016.02.011] [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: 04/22/2015] [Revised: 11/17/2015] [Accepted: 02/10/2016] [Indexed: 11/25/2022]
Abstract
Bradykinesia is associated with reduced quality of life and medication non-compliance, and it may be a prodrome for schizophrenia. Therefore, screening/monitoring for subtle bradykinesia is of clinical and scientific importance. This study investigated the validity and reliability of such an instrument. Included were 70 patients with psychotic disorders. Inertial sensors captured mean cycle duration, amplitude and velocity of four movement tasks: walking, elbow flexion/extension, forearm pronation/supination and leg agility. The concurrent validity with the Unified Parkinson's Disease Rating Scale (UPDRS) bradykinesia subscale was determined using regression analysis. Reliability was investigated with the intra-class correlation coefficient. The duration, amplitude and velocities of the four tasks measured by the instrument explained 67% of the variance on the UPDRS bradykinesia subscale. The instrument test-retest reliability was high. The instrument investigated in this study is a valid and reliable alternative to observer-rated scales. It is an ideal tool for monitoring bradykinesia as it requires little training and experience to achieve reliable results.
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Affiliation(s)
- Thierry Q Mentzel
- Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands; Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands.
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands.
| | - Amar Levens
- Department of Psychiatry, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Charlotte L Mentzel
- Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands; Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands.
| | - Diederik E Tenback
- Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands; Department of Psychiatry, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - P Rob Bakker
- Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands; Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands.
| | - Hein A M Daanen
- MOVE Research Institute, Faculty of Human Movement Sciences, VU University, Amsterdam, The Netherlands; Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek (TNO) [Dutch Organization for Applied Scientific Research], Soesterberg, The Netherlands.
| | - Peter N van Harten
- Psychiatric Centre GGz Centraal, Innova, Amersfoort, The Netherlands; Department of Psychiatry and Psychology, Maastricht University, Maastricht, The Netherlands.
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17
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Mentzel TQ, Mentzel CL, Mentzel SV, Lieverse R, Daanen HA, van Harten PN. Instrumental Assessment of Bradykinesia: A Comparison Between Motor Tasks. IEEE J Biomed Health Inform 2016; 20:521-6. [DOI: 10.1109/jbhi.2015.2412656] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Frissen A, Lieverse R, Drukker M, van Winkel R, Delespaul P. Childhood trauma and childhood urbanicity in relation to psychotic disorder. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1481-8. [PMID: 25895686 PMCID: PMC4589545 DOI: 10.1007/s00127-015-1049-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 03/23/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Urban upbringing and childhood trauma are both associated with psychotic disorders. However, the association between childhood urbanicity and childhood trauma in psychosis is poorly understood. The urban environment could occasion a background of social adversity against which any effect of childhood trauma increases. Also, any impact of the urban environment on likelihood of exposure to childhood trauma could be stronger in children who later develop psychotic disorder. The aim of this study was twofold: (1) to investigate whether childhood urbanicity moderates the effect of childhood trauma, in a model predicting psychotic disorder; (2) to investigate whether there is an association between the urban environment and childhood trauma and whether this is moderated by genetic liability for psychotic disorder. METHODS Patients with a diagnosis of non-affective psychotic disorder (n = 1119) and 589 healthy controls from the Netherlands and Belgium were studied. Childhood trauma was assessed with the Dutch version of the Childhood Trauma Questionnaire Short Form. Urban exposure was defined at four levels, considering the population density, using data from Statistics Netherlands and the equivalent database in Belgium. RESULTS There was a significant interaction between childhood urbanicity on the one hand and childhood trauma on the other, indicating that trauma was significantly associated with psychotic disorder, with increasing odds ratios for higher levels of childhood urbanicity. In addition, there was weak evidence that childhood urbanicity was associated with childhood trauma in the patient group: higher levels of childhood urbanicity were associated with higher trauma scores. CONCLUSION The urban environment may moderate the risk-increasing effect of childhood trauma for psychotic disorder and childhood urbanicity may be a risk factor for childhood trauma in individuals who later develop psychotic disorder.
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Affiliation(s)
- Aleida Frissen
- Department of Psychiatry and Psychology, Maastricht University, PO Box 616 (DRT10), 6200 MD, Maastricht, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University, PO Box 616 (DRT10), 6200 MD, Maastricht, The Netherlands.
| | - Marjan Drukker
- Department of Psychiatry and Psychology, Maastricht University, PO Box 616 (DRT10), 6200 MD, Maastricht, The Netherlands
| | - Ruud van Winkel
- Department of Psychiatry and Psychology, Maastricht University, PO Box 616 (DRT10), 6200 MD, Maastricht, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Psychology, Maastricht University, PO Box 616 (DRT10), 6200 MD, Maastricht, The Netherlands
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Frissen A, Lieverse R, Marcelis M, Drukker M, Delespaul P. Psychotic disorder and educational achievement: a family-based analysis. Soc Psychiatry Psychiatr Epidemiol 2015; 50:1511-8. [PMID: 26099998 PMCID: PMC4589556 DOI: 10.1007/s00127-015-1082-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 01/13/2015] [Accepted: 06/10/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Early social and cognitive alterations in psychotic disorder, associated with familial liability and environmental exposures, may contribute to lower than expected educational achievement. The aims of the present study were to investigate (1) how differences in educational level between parents and their children vary across patients, their healthy siblings, and healthy controls (effect familial liability), and across two environmental risk factors for psychotic disorder: childhood trauma and childhood urban exposure (effect environment) and (2) to what degree the association between familial liability and educational differential was moderated by the environmental exposures. METHODS Patients with a diagnosis of non-affective psychotic disorder (n = 629), 552 non-psychotic siblings and 326 healthy controls from the Netherlands and Belgium were studied. Participants reported their highest level of education and that of their parents. Childhood trauma was assessed with the Dutch version of the Childhood Trauma Questionnaire-Short Form. Urban exposure, expressed as population density, was rated across five levels. RESULTS Overall, participants had a higher level of education than their parents. This difference was significantly reduced in the patient group, and the healthy siblings displayed intergenerational differences that were in between those of controls and patients. Higher levels of childhood urban exposure were also associated with a smaller intergenerational educational differential. There was no evidence for differential sensitivity to childhood trauma and childhood urbanicity across the three groups. CONCLUSION Intergenerational difference in educational achievements is decreased in patients with psychotic disorder and to a lesser extent in siblings of patients with psychotic disorder, and across higher levels of childhood urban exposure. More research is required to better understand the dynamics between early social and cognitive alterations in those at risk in relation to progress through the educational system and to understand the interaction between urban environment and educational outcomes.
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Affiliation(s)
- Aleida Frissen
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD Maastricht, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD, Maastricht, The Netherlands.
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD Maastricht, The Netherlands
| | - Philippe Delespaul
- Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV1), 6200 MD Maastricht, The Netherlands
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Bakker JM, Lieverse R, Menne-Lothmann C, Viechtbauer W, Pishva E, Kenis G, Geschwind N, Peeters F, van Os J, Wichers M. Therapygenetics in mindfulness-based cognitive therapy: do genes have an impact on therapy-induced change in real-life positive affective experiences? Transl Psychiatry 2014; 4:e384. [PMID: 24755993 PMCID: PMC4012287 DOI: 10.1038/tp.2014.23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [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: 09/05/2013] [Revised: 03/05/2014] [Accepted: 03/08/2014] [Indexed: 01/27/2023] Open
Abstract
Positive affect (PA) has an important role in resilience against depression and has been shown to increase with mindfulness-based cognitive therapy (MBCT). To elucidate the underlying mechanisms of change in PA as well as develop insights that may benefit personalized medicine, the current study examined the contribution of genetic variation to individual differences in change in PA in response to MBCT. Individuals (n=126) with residual depressive symptoms were randomized to either an MBCT group or treatment as usual. PA was assessed using experience sampling methodology (ESM). Single-nucleotide polymorphisms (SNPs) in genes known to be involved in reward functioning were selected. SNPs in the genes for brain-derived neurotrophic factor (BDNF), the muscarinic acetylcholine receptor M2 (CHRM2), the dopamine receptor D4 (DRD4) and the μ1 opioid receptor (OPRM1) significantly moderated the impact of treatment condition over time on PA. Genetic variation in the genes for CHRM2 and OPRM1 specifically had an impact on the level of PA following MBCT. The current study shows that variation in response to MBCT may be contingent on genetic factors associated with the regulation of PA. These findings contribute to our understanding of the processes moderating response to treatment and prediction of treatment outcome.
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Affiliation(s)
- J M Bakker
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands,Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, PO Box 616, 6200 MD, Maastricht, The Netherlands. E-mail:
| | - R Lieverse
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - C Menne-Lothmann
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - W Viechtbauer
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - E Pishva
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - G Kenis
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - N Geschwind
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - F Peeters
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - J van Os
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands,Department of Psychosis Studies, Institute of Psychiatry, King's College, King's Health Partners, London, UK
| | - M Wichers
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
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Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, Read J, van Os J, Bentall RP. Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophr Bull 2012; 38:661-71. [PMID: 22461484 PMCID: PMC3406538 DOI: 10.1093/schbul/sbs050] [Citation(s) in RCA: 1464] [Impact Index Per Article: 122.0] [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] [Indexed: 12/20/2022]
Abstract
Evidence suggests that adverse experiences in childhood are associated with psychosis. To examine the association between childhood adversity and trauma (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis outcome, MEDLINE, EMBASE, PsychINFO, and Web of Science were searched from January 1980 through November 2011. We included prospective cohort studies, large-scale cross-sectional studies investigating the association between childhood adversity and psychotic symptoms or illness, case-control studies comparing the prevalence of adverse events between psychotic patients and controls using dichotomous or continuous measures, and case-control studies comparing the prevalence of psychotic symptoms between exposed and nonexposed subjects using dichotomous or continuous measures of adversity and psychosis. The analysis included 18 case-control studies (n = 2048 psychotic patients and 1856 nonpsychiatric controls), 10 prospective and quasi-prospective studies (n = 41,803) and 8 population-based cross-sectional studies (n = 35,546). There were significant associations between adversity and psychosis across all research designs, with an overall effect of OR = 2.78 (95% CI = 2.34-3.31). The integration of the case-control studies indicated that patients with psychosis were 2.72 times more likely to have been exposed to childhood adversity than controls (95% CI = 1.90-3.88). The association between childhood adversity and psychosis was also significant in population-based cross-sectional studies (OR = 2.99 [95% CI = 2.12-4.20]) as well as in prospective and quasi-prospective studies (OR = 2.75 [95% CI = 2.17-3.47]). The estimated population attributable risk was 33% (16%-47%). These findings indicate that childhood adversity is strongly associated with increased risk for psychosis.
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Affiliation(s)
- Filippo Varese
- Institute of Psychology, Health and Society; University of Liverpool, UK,School of Psychological Sciences, University of Manchester, UK
| | - Feikje Smeets
- Department of Psychiatry and Psychology, Maastricht University, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, Maastricht University, The Netherlands
| | - Ritsaert Lieverse
- Department of Psychiatry and Psychology, Maastricht University, The Netherlands
| | - Tineke Lataster
- Department of Psychiatry and Psychology, Maastricht University, The Netherlands
| | | | - John Read
- Department of Psychology, University of Auckland, New Zealand
| | - Jim van Os
- Department of Psychiatry and Psychology, Maastricht University, The Netherlands,King’s College London, King’s Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK,To whom correspondence should be addressed; PO Box 616 (DRT10), 6200 MD Maastricht, The Netherlands; tel: +31-43-3688683, fax: +31-43-3688689, e-mail:
| | - Richard P. Bentall
- Institute of Psychology, Health and Society; University of Liverpool, UK
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Lieverse R, Riemersma-van der Lek RF, Voermans JM, Hoogendijk WJG. [Chronotherapy for affective disorders]. Tijdschr Psychiatr 2012; 54:527-537. [PMID: 22753185] [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: 06/01/2023]
Abstract
BACKGROUND In the literature there is increasing interest in the chronobiology of affective disorders and in the most important chronotherapies for treating these disorders. AIM To discuss the background to and the main features of the most important therapies for affective disorders. METHOD Using PubMed, we performed a concise review of the literature on the use of chronotherapeutics in affective disorders and we also studied the standard textbooks on the subject. RESULTS Light therapy is the type of chronotherapy that has been studied most. Chronotherapies show interesting and promising results in open label studies, but so far there have been no randomized double-blind placebo controlled trials. CONCLUSION Chronotherapeutics provides a neurobiological model and a series of promising, possibly effective non-pharmacological therapies, particularly for affective disorders. Light therapy deserves to be included in the multidisciplinary treatment guidelines relating to affective disorders. However, more, better and longer trials are needed in order to evaluate the various types of chronotherapies.
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Affiliation(s)
- R Lieverse
- Psychiatrie en Neuropsychologie, Maastricht University, Maastricht, The Netherlands.
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Lieverse R, Van Someren EJW, Nielen MMA, Uitdehaag BMJ, Smit JH, Hoogendijk WJG. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. ACTA ACUST UNITED AC 2011; 68:61-70. [PMID: 21199966 DOI: 10.1001/archgenpsychiatry.2010.183] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
CONTEXT Major depressive disorder (MDD) in elderly individuals is prevalent and debilitating. It is accompanied by circadian rhythm disturbances associated with impaired functioning of the suprachiasmatic nucleus, the biological clock of the brain. Circadian rhythm disturbances are common in the elderly. Suprachiasmatic nucleus stimulation using bright light treatment (BLT) may, therefore, improve mood, sleep, and hormonal rhythms in elderly patients with MDD. OBJECTIVE To determine the efficacy of BLT in elderly patients with MDD. DESIGN Double-blind, placebo-controlled randomized clinical trial. SETTING Home-based treatment in patients recruited from outpatient clinics and from case-finding using general practitioners' offices in the Amsterdam region. PARTICIPANTS Eighty-nine outpatients 60 years or older who had MDD underwent assessment at baseline (T0), after 3 weeks of treatment (T1), and 3 weeks after the end of treatment (T2). Intervention Three weeks of 1-hour early-morning BLT (pale blue, approximately 7500 lux) vs placebo (dim red light, approximately 50 lux). MAIN OUTCOME MEASURES Mean improvement in Hamilton Scale for Depression scores at T1 and T2 using parameters of sleep and cortisol and melatonin levels. RESULTS Intention-to-treat analysis showed Hamilton Scale for Depression scores to improve with BLT more than placebo from T0 to T1 (7%; 95% confidence interval, 4%-23%; P = .03) and from T0 to T2 (21%; 7%-31%; P = .001). At T1 relative to T0, get-up time after final awakening in the BLT group advanced by 7% (P < .001), sleep efficiency increased by 2% (P = .01), and the steepness of the rise in evening melatonin levels increased by 81% (P = .03) compared with the placebo group. At T2 relative to T0, get-up time was still advanced by 3% (P = .001) and the 24-hour urinary free cortisol level was 37% lower (P = .003) compared with the placebo group. The evening salivary cortisol level had decreased by 34% in the BLT group compared with an increase of 7% in the placebo group (P = .02). CONCLUSIONS In elderly patients with MDD, BLT improved mood, enhanced sleep efficiency, and increased the upslope melatonin level gradient. In addition, BLT produced continuing improvement in mood and an attenuation of cortisol hyperexcretion after discontinuation of treatment. TRIAL REGISTRATION clinicaltrials.gov Identifier NCT00332670.
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Affiliation(s)
- Ritsaert Lieverse
- Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands.
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Lieverse R. [Reaction on 'beat the blues']. Tijdschr Psychiatr 2011; 53:383-385. [PMID: 21674452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Lieverse R, Bet PM. [Reaction on 'First generation versus second generation antipsychotics: little benefit in the real world']. Tijdschr Psychiatr 2010; 52:357-360. [PMID: 20458686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Lieverse R, Nielen M, Uitdehaag B, van Someren E, Smit J, Hoogendijk W. Double Blind Randomised Clinical Trial of Bright Light Therapy in Elderly Subjects with Nonseaonal Major Depressive Disorder. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)70553-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background:The cause of depression is largely unknown, but several studies point to disturbances of biological rhythmicity. The functioning of the suprachiasmatic nucleus (SCN) is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis) have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT) the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive.Methods/design:RCT (ClinicalTrials.gov identifier: NCT00332670) in 89 subjects, of 60 years and older with a diagnosis of major depressive disorder. After inclusion subjects were randomly allocated to the active (BLT) vs. placebo (dim red light) condition. just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed:Results:Main effect analyses on HADRS-17 scores revealed significant antidepressant effects from BLT. Primary results will be presented.Discussion:BLT reduces nonseasonal depression in elderly patients. Additional lightning may easily be implemented in the homes of patients to serve as add-on treatment to antidepressants or as a stand-alone treatment in elderly depressed patients. Our data support the role of a dysfunctional biological clock in depressed elderly subjects, such a finding may guide further development of novel chronobiological oriented treatment strategies.
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Lieverse R, Nielen MMA, Veltman DJ, Uitdehaag BMJ, van Someren EJW, Smit JH, Hoogendijk WJG. Bright light in elderly subjects with nonseasonal major depressive disorder: a double blind randomised clinical trial using early morning bright blue light comparing dim red light treatment. Trials 2008; 9:48. [PMID: 18671864 PMCID: PMC2553185 DOI: 10.1186/1745-6215-9-48] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [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: 05/21/2008] [Accepted: 07/31/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression frequently occurs in the elderly. Its cause is largely unknown, but several studies point to disturbances of biological rhythmicity. In both normal aging, and depression, the functioning of the suprachiasmatic nucleus (SCN) is impaired, as evidenced by an increased prevalence of day-night rhythm perturbations, such as sleeping disorders. Moreover, the inhibitory SCN neurons on the hypothalamus-pituitary adrenocortical axis (HPA-axis) have decreased activity and HPA-activity is enhanced, when compared to non-depressed elderly. Using bright light therapy (BLT) the SCN can be stimulated. In addition, the beneficial effects of BLT on seasonal depression are well accepted. BLT is a potentially safe, nonexpensive and well accepted treatment option. But the current literature on BLT for depression is inconclusive. METHODS/DESIGN This study aims to show whether BLT can reduce non-seasonal major depression in elderly patients. Randomized double blind placebo controlled trial in 126 subjects of 60 years and older with a diagnosis of major depressive disorder (MDD, DSM-IV/SCID-I). Subjects are recruited through referrals of psychiatric outpatient clinics and from case finding from databases of general practitioners and old-people homes in the Amsterdam region. After inclusion subjects are randomly allocated to the active (bright blue light) vs. placebo (dim red light) condition using two Philips Bright Light Energy boxes type HF 3304 per subject, from which the light bulbs have been covered with bright blue- or dim red light- permitting filters. Patients will be stratified by use of antidepressants. Prior to treatment a one-week period without light treatment will be used. At three time points several endocrinological, psychophysiological, psychometrically, neuropsychological measures are performed: just before the start of light therapy, after completion of three weeks therapy period, and three weeks thereafter. DISCUSSION If BLT reduces nonseasonal depression in elderly patients, then additional lighting may easily be implemented in the homes of patients to serve as add-on treatment to antidepressants or as a stand-alone treatment in elderly depressed patients. In addition, if our data support the role of a dysfunctional biological clock in depressed elderly subjects, such a finding may guide further development of novel chronobiological oriented treatment strategies. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT00332670.
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Affiliation(s)
- Ritsaert Lieverse
- Department of Psychiatry, VU University Medical Center and Academic Outpatient Clinic for Affective Disorders, Stichting GGZBuitenamstel-de Geestgronden, AJ Ernststraat 887, 1081HL, Amsterdam, The Netherlands.
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Pouwer F, Lieverse R, Diamant M, Assies J. Schizophrenia, syndrome X, and omega-3 fatty acids. Am J Psychiatry 2004; 161:1926. [PMID: 15465999 DOI: 10.1176/ajp.161.10.1926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Assies J, Visser I, Nicolson NA, Eggelte TA, Wekking EM, Huyser J, Lieverse R, Schene AH. Elevated salivary dehydroepiandrosterone-sulfate but normal cortisol levels in medicated depressed patients: preliminary findings. Psychiatry Res 2004; 128:117-22. [PMID: 15488954 DOI: 10.1016/j.psychres.2004.05.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2003] [Revised: 04/14/2004] [Accepted: 05/26/2004] [Indexed: 11/22/2022]
Abstract
Major depression is often associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. In contrast to cortisol, dehydroepiandrosterone-sulfate (DHEA-S) has been less extensively studied in depressed patients. This study examined salivary morning and evening levels of cortisol and DHEA-S in 13 medicated, unipolar, non-psychotic depressed patients and 13 healthy volunteers. Diurnal declines in cortisol and DHEA-S levels were found in both depressed and control groups. In patients compared with controls, DHEA-S was significantly elevated, in conjunction with normal cortisol levels. Based on DHEA-S at 22:00 h only, 77% of the subjects were correctly classified in a discriminant analysis as depressed or control. When simultaneously entered in a multiple regression analysis, DHEA-S (morning and evening) and cortisol (evening only) predicted symptom severity in depressed patients. These preliminary results suggest that DHEA-S may be a more sensitive indicator of depression and symptom severity than cortisol in medicated but still clinically depressed patients.
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Affiliation(s)
- Johanna Assies
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Tafelbergweg 25, 1105 BC Amsterdam, The Netherlands.
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Assies J, Lok A, Bockting CL, Weverling GJ, Lieverse R, Visser I, Abeling NGGM, Duran M, Schene AH. Fatty acids and homocysteine levels in patients with recurrent depression: an explorative pilot study. Prostaglandins Leukot Essent Fatty Acids 2004; 70:349-56. [PMID: 15041026 DOI: 10.1016/j.plefa.2003.12.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/18/2003] [Indexed: 10/26/2022]
Abstract
Major depressive disorders (MDD) and cardiovascular disease are mutually associated. They share signs and symptoms of the "metabolic syndrome". Two observations that may be causally related with the metabolic syndrome and therefore with both MDD and cardiovascular disease are a decrease in omega-3 polyunsaturated fatty acids (PUFAs) and a rise in plasma homocysteine (tHcy) levels. Both the rise in tHcy and the decrease in omega-3 PUFAs may be associated with enhanced lipid peroxidation. We exploratively studied 44 randomly chosen patients out of a cohort of 134 patients with the recurrent form of MDD (MDD-R). We measured tHcy levels together with saturated FAs, monounsaturated fatty acids (MUFAs) and PUFAs of the omega-3, omega-6 and omega-9 series in plasma and erythrocytes. Levels were compared with laboratory reference values. The main findings were a decrease in the erythrocytes of C22:5omega-3, C22:6omega-3, C24:1omega-9 and C20:3omega-9 and in the plasma a decrease in C24:1omega-9 and C20:3omega-9. The only significant association we found was between the total of omega-6 fatty acids and plasma tHcy. The FA alterations were found in patients although most of them were clinically recovered, suggesting that the alterations may represent a biological" trait" marker for recurrent depression.
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Affiliation(s)
- J Assies
- Department of Psychiatry, Academic Medical Centre, Tafelbergweg 25, Amsterdam 1105BC, The Netherlands.
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Assies J, Haverkort EB, Lieverse R, Vreken P. Effect of dehydroepiandrosterone supplementation on fatty acid and hormone levels in patients with X-linked adrenoleucodystrophy. Clin Endocrinol (Oxf) 2003; 59:459-66. [PMID: 14510908 DOI: 10.1046/j.1365-2265.2003.01868.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In X-linked adrenoleucodystrophy (X-ALD) the peroxisomal beta-oxidation of saturated very long-chain fatty acids (VLCFAs; carbon length > 22 atoms) is impaired. These fatty acids accumulate in blood and tissues, in particular in the nervous system, adrenal cortex and testis. Most patients have a primary adrenocortical insufficiency with low levels of cortisol and dehydroepiandrosterone (DHEA) and its sulphate ester (DHEA-S), collectively called DHEA(S). Surprisingly, very low plasma levels of DHEA(S) may be found when plasma cortisol and ACTH levels are normal. In animal studies DHEA administration had a peroxisome proliferating effect and induced the expression of peroxisomal enzymes involved in the beta-oxidation of fatty acids. PATIENTS AND DESIGN To study the effect of DHEA on fatty acids in X-ALD patients, we conducted a randomized double-blind study in which 14 men (age range 21-63 years) and one boy (12 years) received 50 mg of DHEA or placebo for 3 months, followed by a 1-month wash-out period, then 3 months of placebo or vice versa. RESULTS A significant rise was seen in the plasma levels of DHEA-S, Delta4-androstenedione and IGF-I. The elevated saturated VLCFAs in plasma and erythrocytes did not change. However, in erythrocytes significant decreases were found in the total amount of fatty acids, in C16:0, C18:0 and in C20:4omega-6, C22:5omega-6, C18:1omega-9, C20:1omega-9 and C20:3omega-9. In plasma, decreases were found for C18:1omega-9 and increases for C20:1omega-9. CONCLUSIONS Dehydroepiandrosterone supplementation for 3 months did not lower the elevated plasma levels of saturated very long-chain fatty acids in patients with X-linked adrenoleucodystrophy. Instead, a decrease in saturated and mono- and polyunsaturated fatty acids in erythrocytes and plasma was found. An increase of C20:1omega-9 was found in plasma only.
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Affiliation(s)
- J Assies
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, The Netherlands.
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Assies J, Haverkort EB, Lieverse R, Vreken P. Effect of Dehydroepiandrosterone (DHEA) Supplementation on Fatty Acid and Hormone Levels in Patients with X-linked Adrenoleukodystrophy. Advances in Experimental Medicine and Biology 2003; 544:243-4. [PMID: 14713236 DOI: 10.1007/978-1-4419-9072-3_30] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Johanna Assies
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, PO Box 22 700, 1100 DE Amsterdam.
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Assies J, Lieverse R. Fatty acid composition of membranes in psychiatric patients. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80346-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Assies J, Lieverse R, Vreken P, Wanders RJ, Dingemans PM, Linszen DH. Significantly reduced docosahexaenoic and docosapentaenoic acid concentrations in erythrocyte membranes from schizophrenic patients compared with a carefully matched control group. Biol Psychiatry 2001; 49:510-22. [PMID: 11257236 DOI: 10.1016/s0006-3223(00)00986-0] [Citation(s) in RCA: 132] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fatty acid research in schizophrenia has demonstrated an altered cell membrane phospholipid metabolism. Erythrocyte membrane phospholipid composition closest reflects that of neuronal membranes. METHODS (Poly)(un)saturated fatty acid concentrations were measured in the erythrocyte membranes of 19, consecutively admitted, medicated young schizophrenic patients and then compared with matched control subjects. Psychiatric symptomatology was rated with the Positive and Negative Symptom Scale and Montgomery-Asberg Depression Rating Scale. Because diet, hormones, and cannabis influence fatty acid metabolism, we included these factors in our study. RESULTS The most distinctive findings concerned the omega-3 series: C22:5 omega-3, C22:6 omega-3 (docosahexaenoic acid), and the sum of omega-3 fatty acids were significantly decreased. Interestingly, C20:4 omega-6 (arachidonic acid) was not lowered. In the omega-9 series, higher levels of C22:1 omega-9 and lower levels its elongation product, C24:1 omega-9 (nervonic acid), were found. Interestingly, the other arm of the desaturation-elongation sequence of C18:1 omega-9, C20:3 omega-9, was lower in patients. The total omega-9 fatty acid levels were also lower in patients. CONCLUSIONS Significant differences in erythrocyte fatty acid composition were found. The differences were not due to diet or hormonal status and could not be explained by the medication or cannabis use. No consistent pattern emerged from the different fatty acid abnormalities and the clinical symptom scores.
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Affiliation(s)
- J Assies
- Department of Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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