Leptin's Inverse Association with Brain Morphology and Depressive Symptoms - A Discovery and Confirmatory Study Across Two Independent Samples

BACKGROUND

Major Depressive Disorder (MDD) has a complex, bi-directional relationship with metabolic dysfunction, yet the neural correlates of this association are not well understood.

METHOD

In this cross-sectional investigation, we employed a two-step 'discovery and confirmatory' strategy, utilizing two independent samples (Sample 1: 288 participants, Sample 2: 196 participants) to examine the association between circulating indicators of metabolic health (leptin and adiponectin) and brain structures in individuals with MDD.

RESULTS

We found a replicable inverse correlation between leptin levels and cortical surface area within essential brain areas responsible for emotion regulation, such as the left posterior cingulate cortex, right pars orbitalis, right superior temporal gyrus, and right insula (standardized beta coefficient (SBC) ranged: -0.27 to -0.49, puncorrected <0.05). Notably, this relationship was independent of C-Reactive Protein levels. We also identified a significant interaction effect of leptin levels and diagnosis on the cortical surface area of the right superior temporal gyrus (SBC = 0.26 in sample 1, SBC = 0.30 in sample 2, puncorrected < 0.05). We also observed a positive correlation between leptin levels and atypical depressive symptoms in both MDD groups (r = 0.14 in sample 1, r = 0.29 in sample 2, puncorrected < 0.05).

CONCLUSION

The inverse association between leptin and cortical surface area in brain regions that are important for emotion processing and leptin's association with sleep disturbances supports the hypothesis that metabolic processes may be related to emotion regulation. However, the molecular mechanisms through which leptin might exert these effects should be explored further.

A Longitudinal Study of Stress During Pregnancy, Children's Sleep and Polygenic Risk for Poor Sleep in the General Pediatric Population

Early life stress is robustly associated with poor sleep across life. Preliminary studies suggest that these associations may begin already in utero. Here, we study the longitudinal associations of prenatal psychosocial stress with sleep across childhood, and assess whether prenatal stress interacts with genetic liability for poor sleep.The study is embedded in the Generation R population-based birth cohort. Caregivers reported on prenatal psychosocial stress (life events, contextual, parental or interpersonal stressors) and on children's sleep at ages 2 months, 1.5, 2, 3 and 6 years. The study sample consisted of 4,930 children; polygenic risk scores for sleep traits were available in 2,063.Prenatal stress was consistently associated with more sleep problems across assessments. Effect sizes ranged from small (B = 0.21, 95%CI: 0.14;0.27) at 2 months to medium (B = 0.45, 95%CI: 0.38;0.53) at 2 years. Prenatal stress was moreover associated with shorter sleep duration at 2 months (Bhrs = -0.22, 95%CI: -0.32;-0.12) and at 2 years (Bhrs = -0.04, 95%CI -0.07; -0.001), but not at 3 years (Bhrs = 0.02, 95%CI: -0.02;0.06). Prenatal negative life events interacted with polygenic risk for insomnia to exacerbate sleep problems at 6 years (Binteraction = 0.07, 95%CI: 0.02;0.13).Psychosocial stress during pregnancy has negative associations with children's sleep that persist across childhood, and are exacerbated by genetic liability for insomnia. Associations with sleep duration were more pronounced in infancy and seem to attenuate with age. These findings highlight the role of the prenatal environment for developing sleep regulation, and could inform early intervention programs targeting sleep in children from high-risk pregnancies.

Oral contraceptives, depressive and insomnia symptoms in adult women with and without depression

BACKGROUND

Worldwide, oral contraceptive (OC) use is a very common form of birth control, although it has been associated with symptoms of depression and insomnia. Insomnia is a risk factor for major depressive disorder (MDD) but may also be a symptom of the disorder. Despite the large number of women who use OC, it is yet unknown whether women with previous or current diagnosis of depression are more likely to experience more severe depressive and insomnia symptoms during concurrent OC use than women without diagnosis of depression.

AIM

This study examined associations between OC use and concurrent symptoms of depression (including atypical depression) and insomnia as well as between OC and prevalences of concurrent dysthymia and MDD. Participants were adult women with and without a history of MDD or dysthymia. We hypothesized that OC use is associated with concurrent increased severity of depressive symptoms and insomnia symptoms, as well as with an increased prevalence of concurrent diagnoses of dysthymia and MDD. We also hypothesized that a history of MDD or dysthymia moderates the relationship between OC use and depressive and insomnia symptoms.

METHODS

Measurements from premenopausal adult women from the Netherlands Study of Depression and Anxiety (NESDA) were grouped, based on whether participants were using OC or naturally cycling (NC). OC use, timing and regularity of the menstrual cycle were assessed with a structured interview, self-reported symptoms of depression (including atypical depression), insomnia with validated questionnaires, and MDD and dysthymia with structured diagnostic interviews.

RESULTS

We included a total of 1301 measurements in women who reported OC use and 1913 measurements in NC women (mean age 35.6, 49.8% and 28.9% of measurements in women with a previous depression or current depression, respectively). Linear mixed models showed that overall, OC use was neither associated with more severe depressive symptoms (including atypical depressive symptoms), nor with higher prevalence of diagnoses of MDD or dysthymia. However, by disentangling the amalgamated overall effect, within-person estimates indicated increased depressive symptoms and depressive disorder prevalence during OC use, whereas between-person estimated indicated lower depressive symptoms and prevalence of depressive disorders. OC use was consistently associated with more severe concurrent insomnia symptoms, in the overall estimates as well as in the within-person and between-person estimates. Presence of current or previous MDD or dysthymia did not moderate the associations between OC use and depressive or insomnia symptoms.

DISCUSSION

The study findings showed consistent associations between OC use and more severe insomnia symptoms, but no consistent associations between OC and depressive symptoms or diagnoses. Instead, post-hoc analyses showed that associations between OC and depression differed between within- and between person-estimates. This indicates that, although OC shows no associations on the overall level, some individuals might experience OC-associated mood symptoms. Our findings underscore the importance of accounting for individual differences in experiences during OC use. Furthermore, it raises new questions about mechanisms underlying associations between OC, depression and insomnia.

Life Stressors and Sleep Problems as Predictors of the Likelihood of Lifetime Cannabis Use among Black Adults with Criminal Justice Contact

Background

The criminal justice system is the second largest referral source to publicly funded marijuana use disorder treatment. Individuals with criminal justice contact (being unfairly treated or abused by the police, lifetime arrest, incarceration, or parole) have reported notably high levels of stress, sleep problems, and marijuana use. There are well-known race and sex disparities in marijuana use and criminal justice contact. However, understanding is limited on the role that stressors and sleep problems contribute to marijuana use among Black adults who experience criminal justice contact.

Objectives

To determine whether life stressors and sleep problems contribute to lifetime marijuana use among Black adults with criminal justice contact and if there are sex differences.

Methods

We performed multivariate logistic analysis, using nationally representative data of a non-institutionalized population sample (n=1508) of the National Survey of American Life from 2001 to 2003. We compared life stressors and sleep problems between Black adults with criminal justice contact who had lifetime marijuana use and those who did not have lifetime marijuana use. All analyses were stratified by sex.

Results

In the sample of Black males with criminal justice contacts, individuals who reported financial stress (PR: 1.34, 95% CI: 1.12-1.60) had a higher prevalence of experiencing lifetime marijuana use than Black males who reported no financial stress. Black males who reported that they were spiritual (PR: .76, 95% CI: .61-.93) had a lower prevalence of experiencing lifetime marijuana use than Black males who indicated that they were not spiritual. Black females who reported family stress (PR: 1.38, 95% CI: 1.04-1.82) had a higher prevalence of experiencing lifetime marijuana use than Black females who reported no family stress.

Conclusions

These results underscore the importance of considering sex differences in life stressors when developing etiologic models of marijuana use disorder for Black adults who have experienced criminal justice contact.

The efficacy of affective and sensory psychotherapy module for sleep disturbances in generalized anxiety disorder

OBJECTIVE

This study was aimed to examine the effectiveness of a newly developed therapeutic method focusing on affective and sensory processes in the treatment of sleep problems in outpatients with Generalized Anxiety Disorder (GAD), called the 'Affective and Sensory Psychotherapy Module' (ASPM).

METHOD

A randomised controlled trial was conducted, there were 60 outpatient participants. The Generalized Anxiety Disorder 7-Item Scale (GAD-7) and the Pittsburgh Sleep Quality Index (PSQI) were used at baseline, post-treatment, and 3 month follow-up.

RESULTS

There were no significant differences between the therapeutic and control groups at baseline. The therapeutic group showed a significant improvement in sleep quality and anxiety decrease compared to the control group. Sex differences did not occur in the results for within-subjects and between-group effects in this study.

CONCLUSIONS

The present study supported the efficacy of ASPM in the treatment of sleep problems in adult outpatients with GAD.

Maturing Out of Alcohol Use in Young Adulthood: Latent Class Growth Trajectories and Concurrent Young Adult Correlates

BACKGROUND

The purpose of this study was to evaluate intraindividual variation in "maturing out" of alcohol use by using latent class growth trajectories of alcohol use from adolescence (age 17 years) through young adulthood (age 33 years). We also modeled trajectory group differences with regard to concurrent, age-relevant domains of substance use, health (e.g., physical health rating, sleep problems), interpersonal functioning (e.g., conflict with partner), and occupational functioning (e.g., intrinsic motivation).

METHODS

Growth mixture modeling was used with a sample of 1,004 adolescents/young adults, and 3 trajectory groups were identified as follows: (i) a Normative Use group (n = 646) with low alcohol use remaining stable from adolescence to young adulthood; (ii) a Moderate Increase group (n = 300) with moderate alcohol use increasing slowly from adolescence to emergent adulthood (age 23 years) and then decreasing slightly from emergent adulthood to young adulthood (age 33 years); and (iii) a High Increase group (n = 58) with a high, increasing pattern of alcohol use from adolescence to emergent adulthood and then a small decrease in use from emergent adulthood to young adulthood.

RESULTS

At age 33 years, trajectory groups differed, with High and Moderate Increase groups differing significantly from the Normative Use group in current alcohol and other substance use and other risk factors (e.g., friends' alcohol use). Furthermore, the High and Moderate Increase groups differed from the Normative Use group on indicators of health (poorer sleep and more sleep problems), social functioning (higher partner and work-family conflict), and occupational functioning (lower intrinsic work motivation).

CONCLUSIONS

These findings suggest that trajectory group membership in alcohol use from adolescence to young adulthood is associated with the domains of substance use, health, and social and occupational functioning. Furthermore, the findings suggest that maturing out applies primarily to a subset of those individuals at moderate to higher levels of alcohol use.

Behavioral Phenotype of ASD Preschoolers with Gastrointestinal Symptoms or Food Selectivity

This study investigated the prevalence and type of gastrointestinal (GI) and food selectivity (FS) symptoms in 163 preschoolers with ASD, and their possible links with core ASD features and emotional/behavioural problems. 40.5% of children with ASD had at least one severe GI symptom or FS. Preschoolers with and without GI symptoms and with and without FS were significantly different on several emotional/behavioural problems and restrictive/repetitive behaviours, whereas they did not differ significantly on performance IQ and autistic severity. The GI plus FS group presented with Sleep Problems, Self-injurious Behaviors and Anxiety Problems. Results indicated the need for early identification of GI disturbances and FS in order to design tailored intervention for these symptoms frequently associated to challenging behaviours in ASD.

Relationship between Mobile Phone Addiction and the Incidence of Poor and Short Sleep among Korean Adolescents: a Longitudinal Study of the Korean Children & Youth Panel Survey

Three of ten teenagers in Korea are addicted to mobile phones. The aim of this study was to examine the relationship between mobile phone addiction and the incidence of poor sleep quality and short sleep duration in adolescents. We used longitudinal data from the Korean Children & Youth Panel Survey conducted by the National Youth Policy Institute in Korea (2011-2013). A total of 1,125 students at baseline were included in this study after excluding those who already had poor sleep quality or short sleep duration in the previous year. A generalized estimating equation was used to analyze the data. High mobile phone addiction (mobile phone addiction score > 20) increased the risk of poor sleep quality but not short sleep duration. We suggest that consistent monitoring and effective intervention programs are required to prevent mobile phone addiction and improve adolescents' sleep quality.