1
|
Davalos-Guzman AP, Vegas-Rodriguez FJ, Ramirez-Rodriguez GB, Flores-Ramos M, Romero-Luevano PV, Gonzalez-Olvera JJ, Saracco-Alvarez RA. Human olfactory neural progenitor cells reveal differences in IL-6, IL-8, thrombospondin-1, and MCP-1 in major depression disorder and borderline personality disorder. Front Psychiatry 2024; 15:1283406. [PMID: 38654728 PMCID: PMC11035822 DOI: 10.3389/fpsyt.2024.1283406] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/22/2024] [Indexed: 04/26/2024] Open
Abstract
Background Discovering biological markers is essential for understanding and treating mental disorders. Despite the limitations of current non-invasive methods, neural progenitor cells from the olfactory epithelium (hNPCs-OE) have been emphasized as potential biomarker sources. This study measured soluble factors in these cells in Major Depressive Disorder (MDD), Borderline Personality Disorder (BPD), and healthy controls (HC). Methods We assessed thirty-five participants divided into MDD (n=14), BPD (n=14), and HC (n=7). MDD was assessed using the Hamilton Depression Rating Scale. BPD was evaluated using the DSM-5 criteria and the Structured Clinical Interview for Personality Disorders. We isolated hNPCs-OE, collected intracellular proteins and conditioned medium, and quantified markers and soluble factors, including Interleukin-6, interleukin-8, and others. Analysis was conducted using one-way ANOVA or Kruskal-Wallis test and linear regression. Results We found that hNPCs-OE of MDD and BPD decreased Sox2 and laminin receptor-67 kDa levels. MASH-1 decreased in BPD, while tubulin beta-III decreased in MDD compared to controls and BPD. Also, we found significant differences in IL-6, IL-8, MCP-1, and thrombospondin-1 levels between controls and MDD, or BPD, but not between MDD and BPD. Conclusions Altered protein markers are evident in the nhNPCs-OE in MDD and BPD patients. These cells also secrete higher concentrations of inflammatory cytokines than HC cells. The results suggest the potential utility of hNPCs-OE as an in vitro model for researching biological protein markers in psychiatric disorders. However, more extensive validation studies are needed to confirm their effectiveness and specificity in neuropsychiatric disorders.
Collapse
Affiliation(s)
- Alan Patrick Davalos-Guzman
- Laboratorio de Neurogénesis, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Francisco Javier Vegas-Rodriguez
- Laboratorio de Neurogénesis, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Gerardo Bernabe Ramirez-Rodriguez
- Laboratorio de Neurogénesis, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Monica Flores-Ramos
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México, Mexico
| | - Perla Vanessa Romero-Luevano
- Laboratorio de Neurogénesis, Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Jorge Julio Gonzalez-Olvera
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México, Mexico
| | - Ricardo Arturo Saracco-Alvarez
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Ciudad de México, Mexico
| |
Collapse
|
2
|
Engler-Chiurazzi E. B cells and the stressed brain: emerging evidence of neuroimmune interactions in the context of psychosocial stress and major depression. Front Cell Neurosci 2024; 18:1360242. [PMID: 38650657 PMCID: PMC11033448 DOI: 10.3389/fncel.2024.1360242] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/25/2024] [Indexed: 04/25/2024] Open
Abstract
The immune system has emerged as a key regulator of central nervous system (CNS) function in health and in disease. Importantly, improved understanding of immune contributions to mood disorders has provided novel opportunities for the treatment of debilitating stress-related mental health conditions such as major depressive disorder (MDD). Yet, the impact to, and involvement of, B lymphocytes in the response to stress is not well-understood, leaving a fundamental gap in our knowledge underlying the immune theory of depression. Several emerging clinical and preclinical findings highlight pronounced consequences for B cells in stress and MDD and may indicate key roles for B cells in modulating mood. This review will describe the clinical and foundational observations implicating B cell-psychological stress interactions, discuss potential mechanisms by which B cells may impact brain function in the context of stress and mood disorders, describe research tools that support the investigation of their neurobiological impacts, and highlight remaining research questions. The goal here is for this discussion to illuminate both the scope and limitations of our current understanding regarding the role of B cells, stress, mood, and depression.
Collapse
Affiliation(s)
- Elizabeth Engler-Chiurazzi
- Department of Neurosurgery and Neurology, Clinical Neuroscience Research Center, Tulane Brain Institute, Tulane University School of Medicine, New Orleans, LA, United States
| |
Collapse
|
3
|
van der Wijk G, Enkhbold Y, Cnudde K, Szostakiwskyj MW, Blier P, Knott V, Jaworska N, Protzner AB. One size does not fit all: notable individual variation in brain activity correlates of antidepressant treatment response. Front Psychiatry 2024; 15:1358018. [PMID: 38628260 PMCID: PMC11018891 DOI: 10.3389/fpsyt.2024.1358018] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction To date, no robust electroencephalography (EEG) markers of antidepressant treatment response have been identified. Variable findings may arise from the use of group analyses, which neglect individual variation. Using a combination of group and single-participant analyses, we explored individual variability in EEG characteristics of treatment response. Methods Resting-state EEG data and Montgomery-Åsberg Depression Rating Scale (MADRS) symptom scores were collected from 43 patients with depression before, at 1 and 12 weeks of pharmacotherapy. Partial least squares (PLS) was used to: 1) identify group differences in EEG connectivity (weighted phase lag index) and complexity (multiscale entropy) between eventual medication responders and non-responders, and 2) determine whether group patterns could be identified in individual patients. Results Responders showed decreased alpha and increased beta connectivity, and early, widespread decreases in complexity over treatment. Non-responders showed an opposite connectivity pattern, and later, spatially confined decreases in complexity. Thus, as in previous studies, our group analyses identified significant differences between groups of patients with different treatment outcomes. These group-level EEG characteristics were only identified in ~40-60% of individual patients, as assessed quantitatively by correlating the spatiotemporal brain patterns between groups and individual results, and by independent raters through visualization. Discussion Our single-participant analyses suggest that substantial individual variation exists, and needs to be considered when investigating characteristics of antidepressant treatment response for potential clinical applicability. Clinical trial registration https://clinicaltrials.gov, identifier NCT00519428.
Collapse
Affiliation(s)
- Gwen van der Wijk
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Yaruuna Enkhbold
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Kelsey Cnudde
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Pierre Blier
- Institute of Mental Health Research, Affiliated with the University of Ottawa, Ottawa, ON, Canada
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Verner Knott
- Institute of Mental Health Research, Affiliated with the University of Ottawa, Ottawa, ON, Canada
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Natalia Jaworska
- Institute of Mental Health Research, Affiliated with the University of Ottawa, Ottawa, ON, Canada
- Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Andrea B. Protzner
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Mathison Centre, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
4
|
Wu Y, Li Y, An X, Li J, Yang C, Wang Y. Study on exosomes for identifying bipolar disorder in early stage: A cross-sectional and validation study protocol. Brain Behav 2024; 14:e3494. [PMID: 38641892 PMCID: PMC11031633 DOI: 10.1002/brb3.3494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 03/20/2024] [Accepted: 04/05/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND The difficulty is remained to accurately distinguish bipolar disorder (BD) from major depressive disorder (MDD) in early stage, with a delayed diagnosis for 5-10 years. BD patients are often treated with antidepressants systematically due to being diagnosed with MDD, affecting the disease course and clinical outcomes. The current study aims to explore the role of plasma exosomes as biomarker to distinguish BD from MDD in early stage. METHODS Two stages are included. The first stage is a cross-sectional study, comparing the concentrations of plasma exosome microRNA and related proteins among BD group, MDD group, and healthy controls (HC) group (n = 40 respectively), to identify target biomarkers preliminarily. The "Latent Class Analysis" and "Receiver Operating Characteristic" analysis will be performed to determine the optimal concentration range for each biomarker. The second stage is to validate target markers in subjects, coming from an ongoing study focusing on patients with a first depressive episode. All target biomarkers will be test in plasma samples reserved at the initial stage to detect whether the diagnosis indicated by biomarker level is consistent with the diagnosis by DSM-5. Furthermore, the correlation between specific biomarkers and the manic episode, suicidal ideation, and adverse reactions will also be observed. DISCUSSION Exosome-derived microRNA and related proteins have potential in serving as a good medium for exploring mental disorders because it can pass through the blood-brain barrier bidirectionally and convey a large amount of information stably. Improving the early diagnosis of BD would help implement appropriate intervention strategy as early as possible and significantly reduce the burden of disease.
Collapse
Affiliation(s)
- Yanqing Wu
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| | - Yuchao Li
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| | - Xuguang An
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| | - Jiangong Li
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| | - Chenghao Yang
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| | - Yi Wang
- Tianjin Mental Health CenterTianjin Anding HospitalTianjinChina
| |
Collapse
|
5
|
Yang R, Xiang H, Zheng T. Causal associations between severe mental illness and sepsis: a Mendelian randomization study. Front Psychiatry 2024; 15:1341559. [PMID: 38532990 PMCID: PMC10964346 DOI: 10.3389/fpsyt.2024.1341559] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objective SMI (severe mental illness) has been identified as a risk factor for sepsis in observational studies; however, the causal association between them has yet to be firmly established. We conducted MR (mendelian randomization) to unveil the causal relationship between SMI and sepsis as well as sepsis mortality. Methods GWAS (Genome-wide association) data for major depression and schizophrenia were selected as exposure. GWAS data for sepsis and sepsis mortality were selected as outcome. Genetic variants significantly associated with the exposure (P value<1x10-6) were selected as instruments. We primarily employed the IVW (inverse-variance weighted) method for analysis. Furthermore, we employed Cochrane's Q test to assess heterogeneity and the MR-Egger intercept test to identify horizontal pleiotropy. Results We selected 108 SNPs (single nucleotide polymorphism) used to predict major depression and 260 SNPs that predicted schizophrenia. Genetically predicted major depression was suggestively linked to a higher sepsis risk (OR=1.13, 95%CI 1.02-1.26, P=0.023). In contrast, MR analysis did not find an association between schizophrenia and sepsis risk (OR=1.00, 95%CI 0.97-1.04, P=0.811). Furthermore, no significant causal evidence was found for genetically predicted SMI in sepsis mortality. Moreover, no heterogeneity and horizontal pleiotropy were detected. Conclusion Our research revealed a suggestive association between genetically predicted major depression and an elevated risk of sepsis in individuals of European ancestry. This finding can serve as a reminder for clinicians to consider the possibility of subsequent infection and sepsis in depressive patients, which may help reduce the incidence of sepsis in individuals with depression.
Collapse
Affiliation(s)
- Ruhao Yang
- Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongyu Xiang
- Department of Rheumatology and Immunology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ting Zheng
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
6
|
Kijima R, Watanabe K, Okamoto N, Ikenouchi A, Tesen H, Kakeda S, Yoshimura R. Fronto-striato network function is reduced in major depressive disorder. Front Psychiatry 2024; 15:1336370. [PMID: 38510800 PMCID: PMC10950964 DOI: 10.3389/fpsyt.2024.1336370] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/06/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Major depressive disorder (MDD) is a major cause of poor quality of life and disability and is highly prevalent worldwide. Various pathological mechanisms are implicated in MDD, including the reward system. The human brain is equipped with a reward system that is involved in aspects such as motivation, pleasure, and learning. Several studies including a meta-analysis have been reported on the reward system network and MDD. However, to our knowledge, no studies have examined the relationship between the reward system network of drug-naïve, first-episode MDD patients and the detailed symptoms of MDD or age. The fronto-striato network (FSN) is closely related to the reward system network. The present study primarily aimed to elucidate this point. Methods A total of 89 drug-naïve first-episode MDD patients and 82 healthy controls (HCs) patients were enrolled in the study. The correlation between the FSN and age and the interaction between age and illness in the FSN were investigated in 75 patients in the MDD group and 79 patients in the HC group with available information on the FSN and age. In addition, the association between the FSN and the total scores on the 17-item Hamilton Rating Scale for Depression (HAMD-17) and scores in each symptom item was analyzed in 76 MDD subjects with information on the FSN and HAMD-17. The significance of each result was evaluated according to a p-value of <0.05. Results Age was inversely correlated with the FSN (p=2.14e-11) in the HC group but not in the MDD group (p=0.79). FSN varied with the presence of MDD and with age, particularly showing an interaction with MDD and age (p=1.04e-08). Specifically, age and the presence or absence of MDD each affected FSN, but the effect of age on FSN changed in the presence of depression. FSN did not correlate with total HAMD-17 scores or scores in each item. Discussion The reward system may be dysfunctional in patients with MDD. In addition, the effect could be greater in younger patients. Meanwhile, there is no correlation between the function of the reward system and the severity of MDD or the severity of each symptom. Thus, the reward system network may be an important biological marker of MDD, although careful consideration should be given to age and its association with the severity of the disorder. Conclusion The reward system function is decreased in MDD patients, and this decrease may be more pronounced in younger patients, although further research is still needed.
Collapse
Affiliation(s)
- Reoto Kijima
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Keita Watanabe
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Hirofumi Tesen
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Shingo Kakeda
- Department of Radiology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Fukuoka, Japan
| |
Collapse
|
7
|
Zrinzo L. Severe Refractory Obsessive Compulsive Disorder and Depression: Should We Consider Stereotactic Neurosurgery? Neuropsychiatr Dis Treat 2024; 20:469-478. [PMID: 38463457 PMCID: PMC10921944 DOI: 10.2147/ndt.s407210] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 02/22/2024] [Indexed: 03/12/2024] Open
Abstract
Functional neurosurgery involves modulation of activity within neural circuits that drive pathological activity. Neurologists and neurosurgeons have worked closely together, advancing the field for over a century, such that neurosurgical procedures for movement disorders are now accepted as "standard of care", benefiting hundreds of thousands of patients. As with movement disorders, some neuropsychiatric illnesses, including obsessive compulsive disorder and depression, can be framed as disorders of neural networks. Over the past two decades, evidence has accumulated that stereotactic neurosurgery can help some patients with mental disorders. Nevertheless, despite the availability of class I evidence for some interventions, there is a huge mismatch between the prevalence of severe refractory mental disorders and the number of referrals made to specialised functional neurosurgery services. This paper examines the historical trajectory of neurosurgery for movement and mental disorders. A review of neurosurgical techniques, including stereotactic radiofrequency ablation, gamma knife, deep brain stimulation, and magnetic resonance imaging guided focused ultrasound, explains the high degree of safety afforded by technological advances in the field. Evidence from clinical trials supporting functional neurosurgery for mental disorders, including obsessive compulsive disorder and depression, is presented. An improved understanding of modern functional neurosurgery should foster collaboration between psychiatry and neurosurgery, providing hope to patients whose symptoms are refractory to all other treatments.
Collapse
Affiliation(s)
- Ludvic Zrinzo
- Unit of Functional Neurosurgery, UCL Queen Square Institute of Neurology, London, UK
| |
Collapse
|
8
|
Lineham A, Avila-Quintero VJ, Bloch MH, Dwyer J. Exploring Predictors of Ketamine Response in Adolescent Treatment-Resistant Depression. J Child Adolesc Psychopharmacol 2024; 34:73-79. [PMID: 38170185 DOI: 10.1089/cap.2023.0047] [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] [Indexed: 01/05/2024]
Abstract
Objective: Ketamine has proved effective as a rapid-acting antidepressant agent, but treatment is not effective for everyone (approximately a quarter to a half of patients). Some adult studies have begun to investigate predictors of ketamine's antidepressant response, but no studies have examined this in adolescents with depression. Methods: We conducted a secondary data analysis of adolescents who participated in a randomized, single-dose, midazolam-controlled crossover trial of ketamine for adolescents with treatment-resistant depression. We examined the relationship between 19 exploratory demographic and clinical variables and depression symptom improvement (using the Montgomery-Åsberg Depression Rating Scale [MADRS]) at 1 and 7 days postinfusion. Results: Subjects who had fewer medication trials of both antidepressant medications and augmentation treatments were more likely to experience depression symptom improvement with ketamine. Subjects with shorter duration of their current depressive episode were more likely to experience depression symptom improvement with ketamine. Subjects currently being treated with selective serotonin reuptake inhibitor medications, and not being treated with serotonin-norepinephrine reuptake inhibitor medications, also experienced greater symptom improvement with ketamine. When receiving the midazolam control, less severe depressive symptoms, as measured by the Children's Depression Rating Scale (CDRS) (but not MADRS), and a comorbid attention-deficit/hyperactivity disorder diagnosis were associated with increased response. Conclusions: Findings should be viewed as preliminary and exploratory given the small sample size and multiple secondary analyses. Identifying meaningful predictors of ketamine response is important to inform future therapeutic use of this compound, however, considerably more research is warranted before such clinical guidance is established. The trial was registered in clinicaltrials.gov with the identifier NCT02579928.
Collapse
Affiliation(s)
- Alice Lineham
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Michael H Bloch
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Psychiatry and Yale School of Medicine, New Haven, Connecticut, USA
| | - Jennifer Dwyer
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
9
|
Benrimoh D, Kleinerman A, Furukawa TA, Iii CFR, Lenze EJ, Karp J, Mulsant B, Armstrong C, Mehltretter J, Fratila R, Perlman K, Israel S, Popescu C, Golden G, Qassim S, Anacleto A, Tanguay-Sela M, Kapelner A, Rosenfeld A, Turecki G. Towards Outcome-Driven Patient Subgroups: A Machine Learning Analysis Across Six Depression Treatment Studies. Am J Geriatr Psychiatry 2024; 32:280-292. [PMID: 37839909 DOI: 10.1016/j.jagp.2023.09.009] [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: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is a heterogeneous condition; multiple underlying neurobiological and behavioral substrates are associated with treatment response variability. Understanding the sources of this variability and predicting outcomes has been elusive. Machine learning (ML) shows promise in predicting treatment response in MDD, but its application is limited by challenges to the clinical interpretability of ML models, and clinicians often lack confidence in model results. In order to improve the interpretability of ML models in clinical practice, our goal was to demonstrate the derivation of treatment-relevant patient profiles comprised of clinical and demographic information using a novel ML approach. METHODS We analyzed data from six clinical trials of pharmacological treatment for depression (total n = 5438) using the Differential Prototypes Neural Network (DPNN), a ML model that derives patient prototypes which can be used to derive treatment-relevant patient clusters while learning to generate probabilities for differential treatment response. A model classifying remission and outputting individual remission probabilities for five first-line monotherapies and three combination treatments was trained using clinical and demographic data. Prototypes were evaluated for interpretability by assessing differences in feature distributions (e.g. age, sex, symptom severity) and treatment-specific outcomes. RESULTS A 3-prototype model achieved an area under the receiver operating curve of 0.66 and an expected absolute improvement in remission rate for those receiving the best predicted treatment of 6.5% (relative improvement of 15.6%) compared to the population remission rate. We identified three treatment-relevant patient clusters. Cluster A patients tended to be younger, to have increased levels of fatigue, and more severe symptoms. Cluster B patients tended to be older, female, have less severe symptoms, and the highest remission rates. Cluster C patients had more severe symptoms, lower remission rates, more psychomotor agitation, more intense suicidal ideation, and more somatic genital symptoms. CONCLUSION It is possible to produce novel treatment-relevant patient profiles using ML models; doing so may improve interpretability of ML models and the quality of precision medicine treatments for MDD.
Collapse
Affiliation(s)
- David Benrimoh
- Department of Psychiatry (DB, KP, GT), McGill University, Montreal, Canada; Department of Psychiatry (DB), Stanford University, Stanford, CA; Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada.
| | | | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior (TAF), Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Charles F Reynolds Iii
- Department of Psychiatry (CFR), University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Psychiatry (CFR), Tufts University School of Medicine, Medford, MA
| | - Eric J Lenze
- Department of Psychiatry (EJL), Washington University School of Medicine, St. Louis, MS
| | - Jordan Karp
- Department of Psychiatry (JK), University of Arizona, Tucson, AZ
| | - Benoit Mulsant
- Department of Psychiatry (BM), University of Toronto, Toronto, ON, Canada
| | - Caitrin Armstrong
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Joseph Mehltretter
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Robert Fratila
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Kelly Perlman
- Department of Psychiatry (DB, KP, GT), McGill University, Montreal, Canada; Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Sonia Israel
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Christina Popescu
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Grace Golden
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Sabrina Qassim
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Alexandra Anacleto
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Myriam Tanguay-Sela
- Aifred Health (DB, CA, JM, RF, KP, SI, CP, GG, SQ, AA, MTS), Montreal, Canada
| | - Adam Kapelner
- Department of Mathematics (AK), Queens College, CUNY, New York, NY
| | | | - Gustavo Turecki
- Department of Psychiatry (DB, KP, GT), McGill University, Montreal, Canada
| |
Collapse
|
10
|
Lespérance P, Desbeaumes Jodoin V, Drouin D, Racicot F, Miron JP, Longpré-Poirier C, Fournier-Gosselin MP, Thebault P, Lapointe R, Arbour N, Cailhier JF. Vagus Nerve Stimulation Modulates Inflammation in Treatment-Resistant Depression Patients: A Pilot Study. Int J Mol Sci 2024; 25:2679. [PMID: 38473935 DOI: 10.3390/ijms25052679] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/21/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
Vagal neurostimulation (VNS) is used for the treatment of epilepsy and major medical-refractory depression. VNS has neuropsychiatric functions and systemic anti-inflammatory activity. The objective of this study is to measure the clinical efficacy and impact of VNS modulation in depressive patients. Six patients with refractory depression were enrolled. Depression symptoms were assessed with the Montgomery-Asberg Depression Rating, and anxiety symptoms with the Hamilton Anxiety Rating Scale. Plasmas were harvested prospectively before the implantation of VNS (baseline) and up to 4 years or more after continuous therapy. Forty soluble molecules were measured in the plasma by multiplex assays. Following VNS, the reduction in the mean depression severity score was 59.9% and the response rate was 87%. Anxiety levels were also greatly reduced. IL-7, CXCL8, CCL2, CCL13, CCL17, CCL22, Flt-1 and VEGFc levels were significantly lowered, whereas bFGF levels were increased (p values ranging from 0.004 to 0.02). This exploratory study is the first to focus on the long-term efficacy of VNS and its consequences on inflammatory biomarkers. VNS may modulate inflammation via an increase in blood-brain barrier integrity and a reduction in inflammatory cell recruitment. This opens the door to new pathways involved in the treatment of refractory depression.
Collapse
Affiliation(s)
- Paul Lespérance
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Véronique Desbeaumes Jodoin
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - David Drouin
- Department of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
| | - Frédéric Racicot
- Division of Neurosurgery, CHUM, Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Jean-Philippe Miron
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC H2X 0C1, Canada
| | - Christophe Longpré-Poirier
- Department of Psychiatry, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC H2X 0C1, Canada
| | | | - Paméla Thebault
- Centre de Recherche du CHUM (CRCHUM), Institut du Cancer de Montréal, Montreal, QC H2X 0A9, Canada
| | - Réjean Lapointe
- Department of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Centre de Recherche du CHUM (CRCHUM), Institut du Cancer de Montréal, Montreal, QC H2X 0A9, Canada
| | - Nathalie Arbour
- Department of Neurosciences, Université de Montréal and CRCHUM, Montreal, QC H2X 0A9, Canada
| | - Jean-François Cailhier
- Department of Medicine, Université de Montréal, Montreal, QC H3T 1J4, Canada
- Centre de Recherche du CHUM (CRCHUM), Institut du Cancer de Montréal, Montreal, QC H2X 0A9, Canada
- Department of Medicine, Renal Division, CHUM, Université de Montréal, Montreal, QC H2X 0C1, Canada
| |
Collapse
|
11
|
TURHAN NÖZGEDİK, ARISOY Ö, ULAŞ F, BUĞDAYCI G, GÜLNER MALTINTAŞ. Vitamin D: An Overlooked Parameter in Studies of Depression Using Optic Coherence Tomography. Noro Psikiyatr Ars 2024; 61:66-72. [PMID: 38496230 PMCID: PMC10943944 DOI: 10.29399/npa.28369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 03/16/2023] [Indexed: 03/19/2024] Open
Abstract
Introduction The relationship between depression and inflammation and the resulting vascular/neuronal damage have been demonstrated in recent studies. In this study we aimed to investigate inflammation and the possible degeneration that can be caused by depression and accompanying vitamin D deficiency using a non-invasive imaging method of optical coherence tomography (OCT). Methods Twenty-four healthy controls and 42 drug free major depressive patients matched for age, sex and eye measurements were compared in terms of vitamin D, C Reactive Protein (CRP) and OCT parameters. The Hamilton Depression Rating Scale (HAM-D), The Clinical Global Impressions Scale (CGI) and Global Assessment of Functioning Scale (GAF) were used to assess disease severity. Results CRP level and choroidal thickness in the major depression group were significantly higher than the healthy controls. Vitamin D level and the ganglion cell layer (GCL) volume was significantly lower in the major depression group compared to healthy controls. Positive correlation was found between HAM-D and CRP in major depressive patients; a negative correlation was found between current attack duration and GCL volume. CGI was positively correlated with CRP and HAM-D. GAS was negatively correlated with CRP and HAM-D. Conclusion It has been shown that major depression might be an inflammatory disorder with possible degenerative processes observed with OCT and CRP measurements. But longitudinal follow up studies are needed to demonstrate a cause and effect relationship.
Collapse
Affiliation(s)
- Nur ÖZGEDİK TURHAN
- İzzet Baysal Mental Health and Diseases Hospital, Department of Psychiatry, Bolu, Turkey
| | - Özden ARISOY
- Bolu Abant İzzet Baysal Training and Research Hospital, Department of Psychiatry, Bolu, Turkey
| | - Fatih ULAŞ
- Bolu Abant İzzet Baysal Training and Research Hospital, Department of Ophthalmology, Bolu, Turkey
| | - Güler BUĞDAYCI
- Halic University Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey
| | | |
Collapse
|
12
|
Gwon Y, Kim JH, Lee SW. Quantification of Plasma Dopamine in Depressed Patients Using Silver-Enriched Silicon Nanowires as SERS-Active Substrates. ACS Sens 2024; 9:870-882. [PMID: 38354414 DOI: 10.1021/acssensors.3c02202] [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] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
A decrease in the levels of dopamine (DA)─a key catecholamine biomarker for major depressive disorder─highlights the need for quantitative analysis of biological fluids to aid in the early diagnosis of diverse neuropsychiatric disorders. This study developed silicon nanowires enriched with silver nanoparticles to serve as a surface-enhanced Raman scattering (SERS) substrate to enable precise and sensitive quantification of blood plasma DA levels in humans. The silver-enriched silicon nanowires (SiNWs@Ag) yielded flower-like assemblies with densely populated SERS "hot spots," allowing sensitive DA detection. By correlating DA concentration with Raman intensity at 1156 cm-1, the plasma DA levels in treatment-naïve patients with major depression (n = 18) were 2 orders of magnitude lower than those in healthy controls (n = 18) (6.56 × 10-10 M vs 1.43 × 10-8 M). The plasma DA concentrations differed significantly between the two groups (two-tailed p = 5.77×10-7), highlighting a distinct demarcation between depression patients and healthy controls. Furthermore, the SiNWs@Ag substrate effectively differentiated between DA and norepinephrine (NE) in mixtures at nanomolar levels, demonstrating its selective detection capability. This study represents the first report on the quantitative detection of DA levels in human blood samples from individuals with major depression using an SERS technique, emphasizing its potential clinical utility in the evaluation and diagnosis of neuropsychiatric disorders.
Collapse
Affiliation(s)
- Youngju Gwon
- Department of Chemical and Biological Engineering, Gachon University, San 65, Bokjeong-Dong, Sujeong-Gu, Seongnam City, Gyeonggi-do 461-701, South Korea
| | - Jong-Hoon Kim
- Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Neuroscience Research Institute, Gachon University, Incheon 21565, South Korea
| | - Sang-Wha Lee
- Department of Chemical and Biological Engineering, Gachon University, San 65, Bokjeong-Dong, Sujeong-Gu, Seongnam City, Gyeonggi-do 461-701, South Korea
| |
Collapse
|
13
|
Juby VM, Paruk S, Tomita M, Chiliza B. Ketamine for depressive symptoms: A retrospective chart review of a private ketamine clinic. S Afr J Psychiatr 2024; 30:2176. [PMID: 38444407 PMCID: PMC10913177 DOI: 10.4102/sajpsychiatry.v30i0.2176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/30/2023] [Indexed: 03/07/2024] Open
Abstract
Background There is currently no published evidence demonstrating the effectiveness and safety of subanaesthetic doses of ketamine, when administered intravenously as an adjunct treatment for depressive symptoms, in a real world setting in South Africa. Aim This retrospective chart review reports the clinical response (change in Patient Health Questionnaire - 7 score) to an initial infusion series of ketamine added to usual treatment, and the pattern of its subsequent maintenance use, for depressive symptoms. Setting A private ketamine clinic in Hilton, KwaZulu-Natal. Methods The medical records of all patients who attended a private ketamine clinic between August 2019 and 31 May 2021 were retrospectively analysed. Depression symptoms were evaluated using the Patient Health Questionaire-9 (PHQ-9) administered immediately before and 24 h after each treatment. Response was defined as a score decrease of more than 50%. Results Among the 154 patients who received ketamine infusions for depression, 67 completed a six infusion initial series, with a response rate of 60.6% and remission rate of 32.4%. Of the 154, 50% no longer experienced any suicidal ideation after treatment and adverse events were uncommon, with 6.2% of infusions requiring intervention for adverse events, mostly nausea. In addition, 48.5% of those who completed the initial series continued to receive maintenance infusions, with no evidence of escalating use or abuse. Conclusion Incorporating intravenous ketamine into the existing treatment regimens at a private clinic was associated with reduced acuteness of depression severity and suicidal ideation. This approach appeared safe and tolerable, showing no signs of abuse or dependence. Contribution This is the first known naturalistic study reporting on ketamine use for depressive symptoms in South Africa.
Collapse
Affiliation(s)
- Vidette M Juby
- Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Saaeda Paruk
- Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Mitsuaki Tomita
- Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Bonga Chiliza
- Discipline of Psychiatry, College of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
14
|
Stuiver S, Pottkämper JCM, Verdijk JPAJ, Ten Doesschate F, van Putten MJAM, Hofmeijer J, van Waarde JA. Restoration of postictal cortical activity after electroconvulsive therapy relates to recovery of orientation in person, place, and time. Eur Psychiatry 2024; 67:e16. [PMID: 38351599 DOI: 10.1192/j.eurpsy.2024.10] [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] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Most patients show temporary impairments in clinical orientation after electroconvulsive therapy (ECT)-induced seizures. It is unclear how postictal reorientation relates to electroencephalography (EEG) restoration. This relationship may provide additional measures to quantify postictal recovery and shed light on neurophysiological aspects of reorientation after ECT. METHODS We analyzed prospectively collected clinical and continuous ictal and postictal EEG data from ECT patients. Postictal EEG restoration up to 1 h was estimated by the evolution of the normalized alpha-delta ratio (ADR). Times to reorientation in the cognitive domains of person, place, and time were assessed postictally. In each cognitive domain, a linear mixed model was fitted to investigate the relationships between time to reorientation and postictal EEG restoration. RESULTS In total, 272 pairs of ictal-postictal EEG and reorientation times of 32 patients were included. In all domains, longer time to reorientation was associated with slower postictal EEG recovery. Longer seizure duration and postictal administration of midazolam were related to longer time to reorientation in all domains. At 1-hour post-seizure, most patients were clinically reoriented, while their EEG had only partly restored. CONCLUSIONS We show a relationship between postictal EEG restoration and clinical reorientation after ECT-induced seizures. EEG was more sensitive than reorientation time in all domains to detect postictal recovery beyond 1-hour post-seizure. Our findings indicate that clinical reorientation probably depends on gradual cortical synaptic recovery, with longer seizure duration leading to longer postsynaptic suppression after ECT seizures.
Collapse
Affiliation(s)
- Sven Stuiver
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
- Department of Psychiatry, Rijnstate Hospital, Arnhem, The Netherlands
| | - Julia C M Pottkämper
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
- Department of Psychiatry, Rijnstate Hospital, Arnhem, The Netherlands
- Department of Neurology and Clinical Neurophysiology, Rijnstate Hospital, Arnhem, The Netherlands
| | - Joey P A J Verdijk
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
- Department of Psychiatry, Rijnstate Hospital, Arnhem, The Netherlands
| | | | - Michel J A M van Putten
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
| | - Jeannette Hofmeijer
- Technical Medical Centre, Faculty of Science and Technology, Clinical Neurophysiology, University of Twente, Enschede, The Netherlands
- Department of Neurology and Clinical Neurophysiology, Rijnstate Hospital, Arnhem, The Netherlands
| | | |
Collapse
|
15
|
Ceylan D, Arat-Çelik HE, Aksahin IC. Integrating mitoepigenetics into research in mood disorders: a state-of-the-art review. Front Physiol 2024; 15:1338544. [PMID: 38410811 PMCID: PMC10895490 DOI: 10.3389/fphys.2024.1338544] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/24/2024] [Indexed: 02/28/2024] Open
Abstract
Mood disorders, including major depressive disorder and bipolar disorder, are highly prevalent and stand among the leading causes of disability. Despite the largely elusive nature of the molecular mechanisms underpinning these disorders, two pivotal contributors-mitochondrial dysfunctions and epigenetic alterations-have emerged as significant players in their pathogenesis. This state-of-the-art review aims to present existing data on epigenetic alterations in the mitochondrial genome in mood disorders, laying the groundwork for future research into their pathogenesis. Associations between abnormalities in mitochondrial function and mood disorders have been observed, with evidence pointing to notable changes in mitochondrial DNA (mtDNA). These changes encompass variations in copy number and oxidative damage. However, information on additional epigenetic alterations in the mitochondrial genome remains limited. Recent studies have delved into alterations in mtDNA and regulations in the mitochondrial genome, giving rise to the burgeoning field of mitochondrial epigenetics. Mitochondrial epigenetics encompasses three main categories of modifications: mtDNA methylation/hydroxymethylation, modifications of mitochondrial nucleoids, and mitochondrial RNA alterations. The epigenetic modulation of mitochondrial nucleoids, lacking histones, may impact mtDNA function. Additionally, mitochondrial RNAs, including non-coding RNAs, present a complex landscape influencing interactions between the mitochondria and the nucleus. The exploration of mitochondrial epigenetics offers valuable perspectives on how these alterations impact neurodegenerative diseases, presenting an intriguing avenue for research on mood disorders. Investigations into post-translational modifications and the role of mitochondrial non-coding RNAs hold promise to unravel the dynamics of mitoepigenetics in mood disorders, providing crucial insights for future therapeutic interventions.
Collapse
Affiliation(s)
- Deniz Ceylan
- Department of Psychiatry, School of Medicine, Koç University, Istanbul, Türkiye
- Koç University Research Center for Translational Medicine (KUTTAM), Affective Laboratory, Istanbul, Türkiye
| | | | - Izel Cemre Aksahin
- Koç University Research Center for Translational Medicine (KUTTAM), Affective Laboratory, Istanbul, Türkiye
- Graduate School of Health Sciences, Koç University, Istanbul, Türkiye
| |
Collapse
|
16
|
Kumar R, Nuñez NA, Joshi N, Joseph B, Verde A, Seshadri A, Cuellar Barboza AB, Prokop LJ, Medeiros GC, Singh B. Metabolomic biomarkers for (R, S)-ketamine and (S)-ketamine in treatment-resistant depression and healthy controls: A systematic review. Bipolar Disord 2024. [PMID: 38326104 DOI: 10.1111/bdi.13412] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
BACKGROUND Ketamine is increasingly used for treatment-resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs). METHODS A comprehensive search of several databases (Ovid MEDLINE®, Embase, and Epub Ahead of Print) was performed from each database's inception to June 29, 2022, in any language, was conducted. We included studies wherein the metabolomic biomarkers for racemic ketamine or esketamine were investigated in TRD or HCs. Our main outcomes were to examine changes in metabolites among patients treated with ketamine/esketamine and explore the association with response to ketamine/esketamine. RESULTS A total of 1859 abstracts were screened of which 11 were included for full-text review. Of these, a total of five articles were included (N = 147), including three RCTs (n = 129) and two open-label trials (n = 18). All studies used racemic ketamine; one study additionally used esketamine. The included studies evaluated patients with treatment-resistant bipolar depression (n = 22), unipolar depression (n = 91), and HCs (n = 34). The included studies reported alteration in several metabolites including acylcarnitines, lipids, kynurenine (KYN), and arginine with ketamine in TRD. Studies suggest the involvement of energy metabolism, KYN, and arginine pathways. In HCs, acetylcarnitine decreased post-infusion, whereas inconsistent findings were observed after the ketamine infusion in TRD patients. CONCLUSIONS This systematic review provides preliminary evidence that ketamine may cause changes in several important pathways involved in energy metabolism and inflammation. Larger and more rigorous studies are needed.
Collapse
Affiliation(s)
- Rakesh Kumar
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Nicolas A Nuñez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Neha Joshi
- Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Boney Joseph
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alessandra Verde
- Section of Pediatrics, Department of Translational Medical Science, Federico II University, Naples, Italy
- Division of Medical Genetics, University of Utah, Salt Lake City, Utah, USA
| | - Ashok Seshadri
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Larry J Prokop
- Mayo Medical Libraries, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Gustavo C Medeiros
- Department of Psychiatry & Behavioral Sciences, John Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| |
Collapse
|
17
|
Kendler KS, Ohlsson H, Sundquist J, Sundquist K. The predictive effect of family genetic risk scores as an indirect measure of causal effects of one disorder on another. Psychol Med 2024:1-9. [PMID: 38314515 DOI: 10.1017/s0033291723003847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND One potential cause of comorbidity is the direct causal effect of one disorder - A - on risk for subsequent onset of disorder B. Could genetic risk scores be utilized to test for such an effect? If disorder A causally impacts on risk for disorder B, then genetic risk for disorder A should be lower in cases of disorder A with v. without a prior onset of B. METHODS In all individuals (n = 905 736) born in Sweden from 1980 to 1990, from six psychiatric and drug use disorders (major depression, anxiety disorders, alcohol use disorder, drug use disorder, bipolar disorder, and schizophrenia), we formed 14 pairs of disorders A and B. In these pairs, we compared, using Cox proportional hazards models, the predictive effect of the familial-genetic risk score (FGRS) for disorder B in those who had v. had not had a prior onset of disorder A. RESULTS In all pairs, the impact of the FGRS for disorder B was significantly stronger in cases without v. with a prior history of disorder A. These effects were similar across sex, stable across levels of FGRS and not likely due to clinician bias. In many of our disorder pairs, previous clinical studies suggest a mechanism for a causal effect of disorder A on B. CONCLUSIONS Our findings provide indirect evidence that the occurrence of one psychiatric or substance use disorder often has a causal effect on risk for subsequent disorders. This mechanism may substantially contribute to the widespread comorbidity among psychiatric conditions.
Collapse
Affiliation(s)
- Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| |
Collapse
|
18
|
Meng J, Cai Y, Yao J, Yan H. Bidirectional causal relationship between psychiatric disorders and osteoarthritis: A univariate and multivariate Mendelian randomization study. Brain Behav 2024; 14:e3429. [PMID: 38361326 PMCID: PMC10869882 DOI: 10.1002/brb3.3429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/11/2023] [Accepted: 01/27/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Observational studies have shown associations between psychiatric disorders and osteoarthritis (OA). However, the causal impact of different psychiatric disorder types on specific sites of osteoarthritis remains unclear. This study aimed to comprehensively understand the potential causal associations between psychiatric disorders and osteoarthritis using Mendelian randomization (MR) analysis. METHODS We collected data from genome-wide association studies of knee osteoarthritis (KOA) (n = 403,124), hip osteoarthritis (HOA) (n = 393,873), osteoarthritis of the knee or hip (KHOA) (n = 417,596), as well as three psychiatric disorders: bipolar disorder (n = 41,917), major depressive disorder (n = 170,756), and schizophrenia (n = 76,755) among European populations. We applied bidirectional univariate and multivariate MR analyses, including inverse variance weighted, Mendelian randomization-Egger, weighted median, simple mode, and weighted mode. We considered p < .05 as a criterion for identifying potential evidence of association. Bonferroni correction was used for multiple tests. RESULTS Our univariate MR analysis results demonstrated that bipolar disorder is a protective factor for KOA (OR = 0.90, 95% CI = 0.83 to 0.97, p = 0.0048) and may also be protective for KHOA (p = 0.02). Conversely, major depression has a positive causal effect on both KOA (OR = 1.27; 95% CI = 1.08 to 1.49; p = 0.0036) and KHOA (OR = 1.24; 95% CI = 1.12 to 1.37; p = 3.62×10-05 ). Furthermore, our analysis suggested that KHOA may be a risk factor for major depression (OR = 1.06; 95% CI = 1.00 to 1.12; p = 0.0469) in reverse MR. After adjusting smoking (OR = 1.46; 95% CI = 1.19 to 1.65; p = 0.0032) and body mass index (OR = 1.44; 95% CI = 1.09 to 1.81; p = 8.56×10-04 ), the casual association between major depression and KHOA remained. CONCLUSION Our study indicates that major depression is a great risk factor for KHOA, increasing the likelihood of their occurrence. However, further in-depth studies will be required to validate these results and elucidate the underlying molecular mechanisms.
Collapse
Affiliation(s)
- Jinzhi Meng
- Bone and Joint SurgeryThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Youran Cai
- Department of OphthalmologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Jun Yao
- Bone and Joint SurgeryThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Haiwei Yan
- Department of Sports MedicineThe Fourth Affiliated Hospital of Guangxi Medical UniversityLiuzhouChina
| |
Collapse
|
19
|
Colită CI, Udristoiu I, Ancuta DL, Hermann DM, Colita D, Colita E, Glavan D, Popa-Wagner A. Epigenetics of Ageing and Psychiatric Disorders. J Integr Neurosci 2024; 23:13. [PMID: 38287856 DOI: 10.31083/j.jin2301013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 01/31/2024] Open
Abstract
Both classic epigenetic modifications and microRNAs can impact a range of bodily processes, from metabolism to brain function, and may contribute to the development of diseases such as cancer, cardiovascular disorders, and psychiatric disorders. Numerous studies suggest a connection between epigenetic changes and mood disorders. In this study, we performed a comprehensive search using PubMed and Google for the terms "epigenetics", "ageing", "miRNA", "schizophrenia", and "mood disorders" in the titles and abstracts of articles. Epigenetic changes during early life may play a crucial role in triggering severe mental disorders and shaping their clinical trajectory. Although these alterations can take place at any age, their impact may not be immediately evident or observable until later in life. Epigenetic modifications play a crucial role in the ageing process and challenge the prevailing belief that mutations are the primary driver of ageing. However, it is plausible that these epigenetic changes are a consequence of the disorder rather than its root cause. Moreover, both the disorder and the epigenetic alterations may be influenced by shared environmental or genetic factors. In the near future, we might be able to replace chronological age with biological age, based on the epigenetic clock, with the promise of providing greater therapeutic benefits. A wide range of epigenetic drugs are currently under development at various stages. Although their full effectiveness is yet to be realized, they show great potential in the treatment of cancer, psychiatric disorders, and other complex diseases.
Collapse
Affiliation(s)
- Cezar-Ivan Colită
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Ion Udristoiu
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Diana-Larisa Ancuta
- Cantacuzino National Medico-Military Institute for Research and Development, 050096 Bucharest, Romania
| | - Dirk M Hermann
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| | - Daniela Colita
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Eugen Colita
- Doctoral School, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
| | - Daniela Glavan
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania
| | - Aurel Popa-Wagner
- Department of Psychiatry, University of Medicine and Pharmacy, 200349 Craiova, Romania
- Chair of Vascular Neurology, Dementia and Ageing, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany
| |
Collapse
|
20
|
Kendler KS, Lönn SL, Sundquist J, Sundquist K. The joint effects of genetic liability and the death of close relatives on risk for major depression and alcohol use disorder in a Swedish national sample. Psychol Med 2024:1-8. [PMID: 38173119 DOI: 10.1017/s0033291723003641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
BACKGROUND To determine whether genetic risk factors for major depression (MD) and alcohol use disorder (AUD) interact with a potent stressor - death of spouse, parent, and sibling - in predicting episodes of, respectively, MD and AUD. METHODS MD and AUD registrations were assessed from national Swedish registries. In individuals born in Sweden 1960-1970, we identified 7586, 388 459, and 34 370 with the loss of, respectively, a spouse, parent, and sibling. We started following subjects at age 18 or the year 2002 with end of follow-up in 2018. We examined time to event - a registration for MD within 6 months or AUD within a year - on an additive scale, using the Nelson-Aalen estimator. Genetic risk was assessed by the Family Genetic Risk Score (FGRS). RESULTS In separate models controlling for the main effects of death of spouse, parent, and sibling, FGRS, and sex, significant interactions were seen in all analyses between genetic risk for MD and death of relative in prediction of subsequent MD registration. A similar pattern of results, albeit with weaker interaction effects, was seen for genetic risk for AUD and risk for AUD registration. Genetic risk for bipolar disorder (BD) and anxiety disorders (AD) also interacted with event exposure in predicting MD. CONCLUSIONS Genetic risk for both MD and AUD act in part by increasing the sensitivity of individuals to the pathogenic effects of environmental stressors. For prediction of MD, similar effects are also seen for genetic risk for AD and BD.
Collapse
Affiliation(s)
- Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Sara L Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health, Lund University, Malmö, Sweden
| |
Collapse
|
21
|
Abstract
BACKGROUND Social touch is an integral part of social relationships and has been associated with reward. Major depressive disorder (MDD) is characterized by severe impairments in reward processing, but the neural effects of social touch in MDD are still elusive. In this study, we aimed to determine whether the neural processing of social touch is altered in MDD and to assess the impact of antidepressant therapy. METHODS Before and after antidepressant treatment, 53 MDD patients and 41 healthy controls underwent functional magnetic resonance imaging (fMRI) while receiving social touch. We compared neural responses to social touch in the reward network, behavioral ratings of touch comfort and general aversion to interpersonal touch in patients to controls. Additionally, we examined the effect of treatment response on those measures. RESULTS Clinical symptoms decreased after treatment and 43.4% of patients were classified as responders. Patients reported higher aversion to interpersonal touch and lower comfort ratings during the fMRI paradigm than controls. Patients showed reduced responses to social touch in the nucleus accumbens, caudate nucleus and putamen than controls, both before and after treatment. Contrary to our hypotheses, these effects were independent of touch velocity. Non-responders exhibited blunted response in the caudate nucleus and the insula compared to responders, again irrespective of time. CONCLUSIONS These findings suggest altered striatal processing of social touch in MDD. Persistent dysfunctional processing of social touch despite clinical improvements may constitute a latent risk factor for social withdrawal and isolation.
Collapse
Affiliation(s)
- Clemens Mielacher
- Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Dirk Scheele
- Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany
| | - Maximilian Kiebs
- Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Laura Schmitt
- Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Torge Dellert
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Claus Lamm
- Social, Cognitive and Affective Neuroscience Unit, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - René Hurlemann
- Research Section Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
- Department of Psychiatry, School of Medicine & Health Sciences, University of Oldenburg, Bad Zwischenahn, Germany
- Research Center Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| |
Collapse
|
22
|
Vasupanrajit A, Maes M, Jirakran K, Tunvirachaisakul C. Brooding and neuroticism are strongly interrelated manifestations of the phenome of depression. Front Psychiatry 2023; 14:1249839. [PMID: 38188051 PMCID: PMC10766685 DOI: 10.3389/fpsyt.2023.1249839] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction We found that neuroticism may be identified as a subclinical manifestation of the phenome of depression, comprising depressive and anxiety symptoms, and suicidal behaviors. Rumination is positively associated with depression and neuroticism and may mediate the effects of neuroticism on depression. This study aimed to determine whether rumination or its components, including brooding or reflection, mediate the effects of neuroticism on depression or, alternatively, whether both neuroticism and rumination are manifestations of the phenome of depression. Methods This study recruited 74 depressed subjects and 44 healthy controls. The depression group was split into groups with high versus low brooding scores. We used partial least squares (PLS) to examine mediation effects. Results We found that brooding and reflection scores are significantly higher in depressed patients than in controls. Patients with higher brooding scores have increased severity of depression, anxiety, insomnia, neuroticism, and current suicidal ideation as compared with patients with lower brooding scores and controls. There is a strong positive association between rumination, and neuroticism, depression, anxiety, and lifetime and current suicidal behaviors. PLS analysis shows that brooding does not mediate the effects of neuroticism on the depression phenome because no discriminant validity could be established between neuroticism and brooding, or between neuroticism and brooding and the depression phenome. We were able to extract one validated latent vector from brooding and neuroticism, insomnia, depression, anxiety, and current suicidal behaviors. Conclusion Overall, this study supports the theory that rumination and neuroticism are reflective manifestations of the phenome of depression.
Collapse
Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D. Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D. Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China
- Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychological Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Kyung Hee University, Seoul, Republic of Korea
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D. Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Maximizing Children's Developmental Potential, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D. Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
23
|
Park J, Lee H, Jeon Y, Park EJ, Park S, Ann SH, Kim Y, Lee Y, Park G, Choi SH. Depression and Subclinical Coronary Atherosclerosis in Adults Without Clinical Coronary Artery Disease. J Am Heart Assoc 2023; 12:e030315. [PMID: 38063186 PMCID: PMC10863772 DOI: 10.1161/jaha.123.030315] [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: 03/23/2023] [Accepted: 11/15/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The relationship between depression and subclinical coronary atherosclerosis in asymptomatic individuals is not clear. We evaluated this relationship in a Korean population. METHODS AND RESULTS We analyzed 3920 individuals (mean age 54.7±7.9 years and 2603 men [66.4%]) with no history of coronary artery disease who voluntarily underwent coronary computed tomographic angiography and screening for depression using the Beck Depression Inventory as part of a general health examination. The degree and extent of subclinical coronary atherosclerosis were evaluated by coronary computed tomographic angiography, and ≥50% diameter stenosis was defined as significant. Participants were categorized into groups of those with or without depression using the Beck Depression Inventory scores ≥16 as a cutoff value. Of the study participants, 272 (6.9%) had a Beck Depression Inventory score of 16 or higher. After adjustment for cardiovascular risk factors, depression was not significantly associated with any coronary plaque (adjusted odds ratio [OR], 1.05 [95% CI, 0.78-1.41]; P=0.746), calcified plaque (OR, 0.95 [95% CI, 0.71-1.29]; P=0.758), noncalcified plaque (OR, 1.31 [95% CI, 0.79-2.17]; P=0.305), mixed plaque (OR, 1.16 [95% CI, 0.60-2.23]; P=0.659), or significant coronary artery stenosis (OR, 1.22 [95% CI, 0.73-2.03]; P=0.450). In the propensity score-matched population (n=1318) as well, none of the coronary artery disease measures of subclinical coronary atherosclerosis were statistically significantly associated with depression (all P>0.05). CONCLUSIONS In this large cross-sectional study with asymptomatic individuals undergoing coronary computed tomographic angiography and Beck Depression Inventory evaluation, depression was not associated with an increased risk of subclinical coronary atherosclerosis.
Collapse
Affiliation(s)
- Jangho Park
- Department of PsychiatryUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Hyeji Lee
- Department of Emergency MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Young‐Jee Jeon
- Department of Family MedicineUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Eun Ji Park
- Big Data CenterUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Sangwoo Park
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Soe Hee Ann
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Yong‐Giun Kim
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Yongjik Lee
- Department of Thoracic and Cardiovascular SurgeryUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Gyung‐Min Park
- Department of CardiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| | - Seong Hoon Choi
- Department of RadiologyUlsan University Hospital, University of Ulsan College of MedicineUlsanRepublic of Korea
| |
Collapse
|
24
|
Strekalova T, Svirin E, Gorlova A, Sheveleva E, Burova A, Khairetdinova A, Sitdikova K, Zakharova E, Dudchenko AM, Lyundup A, Morozov S. Resilience and Vulnerability to Stress-Induced Anhedonia: Unveiling Brain Gene Expression and Mitochondrial Dynamics in a Mouse Chronic Stress Depression Model. Biomolecules 2023; 13:1782. [PMID: 38136653 PMCID: PMC10741640 DOI: 10.3390/biom13121782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/07/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
The role of altered brain mitochondrial regulation in psychiatric pathologies, including Major Depressive Disorder (MDD), has attracted increasing attention. Aberrant mitochondrial functions were suggested to underlie distinct inter-individual vulnerability to stress-related MDD syndrome. In this context, insulin receptor sensitizers (IRSs) that regulate brain metabolism have become a focus of recent research, as their use in pre-clinical studies can help to elucidate the role of mitochondrial dynamics in this disorder and contribute to the development of new antidepressant treatment. Here, following 2-week chronic mild stress (CMS) using predation, social defeat, and restraint, MDD-related behaviour and brain molecular markers have been investigated along with the hippocampus-dependent performance and emotionality in mice that received the IRS dicholine succinate (DS). In a sucrose test, mice were studied for the key feature of MDD, a decreased sensitivity to reward, called anhedonia. Based on this test, animals were assigned to anhedonic and resilient-to-stress-induced-anhedonia groups, using a previously established criterion of a decrease in sucrose preference below 65%. Such assignment was based on the fact that none of control, non-stressed animals displayed sucrose preference that would be smaller than this value. DS-treated stressed mice displayed ameliorated behaviours in a battery of assays: sucrose preference, coat state, the Y-maze, the marble test, tail suspension, and nest building. CMS-vulnerable mice exhibited overexpression of the inflammatory markers Il-1β, tnf, and Cox-1, as well as 5-htt and 5-ht2a-R, in various brain regions. The alterations in hippocampal gene expression were the closest to clinical findings and were studied further. DS-treated, stressed mice showed normalised hippocampal expression of the plasticity markers Camk4, Camk2, Pka, Adcy1, Creb-ar, Nmda-2r-ar, and Nmda-2r-s. DS-treated and non-treated stressed mice who were resilient or vulnerable to anhedonia were compared for hippocampal mitochondrial pathway regulation using Illumina profiling. Resilient mice revealed overexpression of the mitochondrial complexes NADH dehydrogenase, succinate dehydrogenase, cytochrome bc1, cytochrome c oxidase, F-type and V-type ATPases, and inorganic pyrophosphatase, which were decreased in anhedonic mice. DS partially normalised the expression of both ATPases. We conclude that hippocampal reduction in ATP synthesis is associated with anhedonia and pro-inflammatory brain changes that are ameliorated by DS.
Collapse
Affiliation(s)
- Tatyana Strekalova
- Division of Molecular Psychiatry, Center of Mental Health, University of Hospital Würzburg, 97080 Wuerzburg, Germany
| | - Evgeniy Svirin
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Anna Gorlova
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Elizaveta Sheveleva
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Alisa Burova
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Adel Khairetdinova
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Kseniia Sitdikova
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Elena Zakharova
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Alexander M. Dudchenko
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| | - Aleksey Lyundup
- Endocrinology Research Centre, Dmitry Ulyanov St. 19, Moscow 117036, Russia;
- Research and Education Resource Center, Peoples Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya St, Moscow 117198, Russia
| | - Sergey Morozov
- Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow 125315, Russia (A.G.); (E.S.); (A.B.); (A.K.); (K.S.); (E.Z.); (A.M.D.); (S.M.)
| |
Collapse
|
25
|
Maes M, Vasupanrajit A, Jirakran K, Klomkliew P, Chanchaem P, Tunvirachaisakul C, Plaimas K, Suratanee A, Payungporn S. Adverse childhood experiences and reoccurrence of illness impact the gut microbiome, which affects suicidal behaviours and the phenome of major depression: towards enterotypic phenotypes. Acta Neuropsychiatr 2023; 35:328-345. [PMID: 37052305 DOI: 10.1017/neu.2023.21] [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] [Indexed: 04/14/2023]
Abstract
The first publication demonstrating that major depressive disorder (MDD) is associated with alterations in the gut microbiota appeared in 2008 (Maes et al., 2008). The purpose of the present study is to delineate a) the microbiome signature of the phenome of depression, including suicidal behaviours (SB) and cognitive deficits; the effects of adverse childhood experiences (ACEs) and recurrence of illness index (ROI) on the microbiome; and the microbiome signature of lowered high-density lipoprotein cholesterol (HDLc). We determined isometric log-ratio abundances or prevalences of gut microbiome phyla, genera, and species by analysing stool samples from 37 healthy Thai controls and 32 MDD patients using 16S rDNA sequencing. Six microbiome taxa accounted for 36% of the variance in the depression phenome, namely Hungatella and Fusicatenibacter (positive associations) and Butyricicoccus, Clostridium, Parabacteroides merdae, and Desulfovibrio piger (inverse association). This profile (labelled enterotype 1) indicates compositional dysbiosis, is strongly predicted by ACE and ROI, and is linked to SB. A second enterotype was developed that predicted a decrease in HDLc and an increase in the atherogenic index of plasma (Bifidobacterium, P. merdae, and Romboutsia were positively associated, while Proteobacteria and Clostridium sensu stricto were negatively associated). Together, enterotypes 1 and 2 explained 40.4% of the variance in the depression phenome, and enterotype 1 in conjunction with HDLc explained 39.9% of the variance in current SB. In conclusion, the microimmuneoxysome is a potential new drug target for the treatment of severe depression and SB and possibly for the prevention of future episodes.
Collapse
Affiliation(s)
- Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
- Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul02447, Korea
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- IMPACT Strategic Research Center, Barwon Health, Geelong, Australia
| | - Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
- Maximizing Thai Children's Developmental Potential Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pavit Klomkliew
- Center of Excellence in Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Prangwalai Chanchaem
- Center of Excellence in Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
| | - Kitiporn Plaimas
- Advanced Virtual and Intelligent Computing (AVIC) Center, Department of Mathematics and Computer Science, Faculty of Science, Chulalongkorn University, Bangkok10330, Thailand
| | - Apichat Suratanee
- Department of Mathematics, Faculty of Applied Science, King Mongkut's University of Technology North Bangkok, Bangkok10800, Thailand
| | - Sunchai Payungporn
- Center of Excellence in Systems Microbiology, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| |
Collapse
|
26
|
Rhee SJ, Ohlsson H, Sundquist J, Sundquist K, Kendler KS. Predictors of diagnostic conversion from major depression to bipolar disorder: a Swedish national longitudinal study. Psychol Med 2023; 53:7805-7816. [PMID: 37427550 PMCID: PMC10755232 DOI: 10.1017/s0033291723001848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/31/2023] [Accepted: 06/13/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND It is clinically important to predict the conversion of major depression (MD) to bipolar disorder (BD). Therefore, we sought to identify related conversion rates and risk factors. METHODS This cohort study included the Swedish population born from 1941 onward. Data were collected from Swedish population-based registers. Potential risk factors, including family genetic risk scores (FGRS), which were calculated based on the phenotypes of relatives in the extended family and not molecular data, and demographic/clinical characteristics from these registers were retrieved. Those with first MD registrations from 2006 were followed up until 2018. The conversion rate to BD and related risk factors were analyzed using Cox proportional hazards models. Additional analyses were performed for late converters and with stratification by sex. RESULTS The cumulative incidence of conversion was 5.84% [95% confidence interval (95% CI) 5.72-5.96] for 13 years. In the multivariable analysis, the strongest risk factors for conversion were high FGRS of BD [hazard ratio (HR) = 2.73, 95% CI 2.43-3.08], inpatient treatment settings (HR = 2.64, 95% CI 2.44-2.84), and psychotic depression (HR = 2.58, 95% CI 2.14-3.11). For late converters, the first registration of MD during the teenage years was a stronger risk factor when compared with the baseline model. When the interactions between risk factors and sex were significant, stratification by sex revealed that they were more predictive in females. CONCLUSIONS Family history of BD, inpatient treatment, and psychotic symptoms were the strongest predictors of conversion from MD to BD.
Collapse
Affiliation(s)
- Sang Jin Rhee
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| |
Collapse
|
27
|
Aggestrup AS, Svendsen SD, Præstegaard A, Løventoft P, Nørregaard L, Knorr U, Dam H, Frøkjær E, Danilenko K, Hageman I, Faurholt-Jepsen M, Kessing LV, Martiny K. Circadian Reinforcement Therapy in Combination With Electronic Self-Monitoring to Facilitate a Safe Postdischarge Period for Patients With Major Depression: Randomized Controlled Trial. JMIR Ment Health 2023; 10:e50072. [PMID: 37800194 DOI: 10.2196/50072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/10/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Patients with major depression exhibit circadian disturbance of sleep and mood, and when they are discharged from inpatient wards, this disturbance poses a risk of relapse. We developed a circadian reinforcement therapy (CRT) intervention to facilitate the transition from the inpatient ward to the home for these patients. CRT focuses on increasing the zeitgeber strength for the circadian clock through social contact, physical activity, diet, daylight exposure, and sleep timing. OBJECTIVE In this study, we aimed to prevent the worsening of depression after discharge by using CRT, supported by an electronic self-monitoring system, to advance and stabilize sleep and improve mood. The primary outcome, which was assessed by a blinded rater, was the change in the Hamilton Depression Rating Scale scores from baseline to the end point. METHODS Participants were contacted while in the inpatient ward and randomized 1:1 to the CRT or the treatment-as-usual (TAU) group. For 4 weeks, participants in both groups electronically self-monitored their daily mood, physical activity, sleep, and medication using the Monsenso Daybuilder (MDB) system. The MDB allowed investigators and participants to simultaneously view a graphical display of registrations. An investigator phoned all participants weekly to coinspect data entry. In the CRT group, participants were additionally phoned between the scheduled calls if specific predefined trigger points for mood and sleep were observed during the daily inspection. Participants in the CRT group were provided with specialized CRT psychoeducation sessions immediately after inclusion, focusing on increasing the zeitgeber input to the circadian system; a PowerPoint presentation was presented; paper-based informative materials and leaflets were reviewed with the participants; and the CRT principles were used during all telephone consultations. In the TAU group, phone calls focused on data entry in the MDB system. When discharged, all patients were treated at a specialized affective disorders service. RESULTS Overall, 103 participants were included. Participants in the CRT group had a significantly larger reduction in Hamilton Depression Scale score (P=.04) than those in the TAU group. The self-monitored MDB data showed significantly improved evening mood (P=.02) and sleep quality (P=.04), earlier sleep onset (P=.009), and longer sleep duration (P=.005) in the CRT group than in the TAU group. The day-to-day variability of the daily and evening mood, sleep offset, sleep onset, and sleep quality were significantly lower in the CRT group (all P<.001) than in the TAU group. The user evaluation was positive for the CRT method and the MDB system. CONCLUSIONS We found significantly lower depression levels and improved sleep quality in the CRT group than in the TAU group. We also found significantly lower day-to-day variability in daily sleep, mood parameters, and activity parameters in the CRT group than in the TAU group. The delivery of the CRT intervention should be further refined and tested. TRIAL REGISTRATION ClinicalTrials.gov NCT02679768; https://clinicaltrials.gov/study/NCT02679768. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-019-2101-z.
Collapse
Affiliation(s)
- Anne Sofie Aggestrup
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Signe Dunker Svendsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Præstegaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Philip Løventoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Lasse Nørregaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Ulla Knorr
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Henrik Dam
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Erik Frøkjær
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Hageman
- Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Lars Vedel Kessing
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Klaus Martiny
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| |
Collapse
|
28
|
Palomo M, Moreno-Castaño AB, Salas MQ, Escribano-Serrat S, Rovira M, Guillen-Olmos E, Fernandez S, Ventosa-Capell H, Youssef L, Crispi F, Nomdedeu M, Martinez-Sanchez J, De Moner B, Diaz-Ricart M. Endothelial activation and damage as a common pathological substrate in different pathologies and cell therapy complications. Front Med (Lausanne) 2023; 10:1285898. [PMID: 38034541 PMCID: PMC10682735 DOI: 10.3389/fmed.2023.1285898] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/30/2023] [Indexed: 12/02/2023] Open
Abstract
The endothelium is a biologically active interface with multiple functions, some of them common throughout the vascular tree, and others that depend on its anatomical location. Endothelial cells are continually exposed to cellular and humoral factors, and to all those elements (biological, chemical, or hemodynamic) that circulate in blood at a certain time. It can adapt to different stimuli but this capability may be lost if the stimuli are strong enough and/or persistent in time. If the endothelium loses its adaptability it may become dysfunctional, becoming a potential real danger to the host. Endothelial dysfunction is present in multiple clinical conditions, such as chronic kidney disease, obesity, major depression, pregnancy-related complications, septic syndromes, COVID-19, and thrombotic microangiopathies, among other pathologies, but also in association with cell therapies, such as hematopoietic stem cell transplantation and treatment with chimeric antigen receptor T cells. In these diverse conditions, evidence suggests that the presence and severity of endothelial dysfunction correlate with the severity of the associated disease. More importantly, endothelial dysfunction has a strong diagnostic and prognostic value for the development of critical complications that, although may differ according to the underlying disease, have a vascular background in common. Our multidisciplinary team of women has devoted many years to exploring the role of the endothelium in association with the mentioned diseases and conditions. Our research group has characterized some of the mechanisms and also proposed biomarkers of endothelial damage. A better knowledge would provide therapeutic strategies either to prevent or to treat endothelial dysfunction.
Collapse
Affiliation(s)
- Marta Palomo
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Hematology External Quality Assessment Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ana Belén Moreno-Castaño
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - María Queralt Salas
- Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, Barcelona, Spain
| | - Silvia Escribano-Serrat
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - Montserrat Rovira
- Hematopoietic Stem Cell Transplantation Unit, Hematology Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, Barcelona, Spain
| | - Elena Guillen-Olmos
- Department of Nephrology and Kidney Transplantation, Hospital Clínic de Barcelona, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR), University of Barcelona, Barcelona, Spain
| | - Sara Fernandez
- Medical Intensive Care Unit, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Lina Youssef
- BCNatal – Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic de Barcelona and Hospital Sant Joan de Déu, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Josep Carreras Leukaemia Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Fatima Crispi
- BCNatal – Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic de Barcelona and Hospital Sant Joan de Déu, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Meritxell Nomdedeu
- Hemostasis and Hemotherapy Department, Institute of Cancer and Blood Diseases, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Julia Martinez-Sanchez
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| | - Blanca De Moner
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
- Josep Carreras Leukaemia Research Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maribel Diaz-Ricart
- Hemostasis and Erythropathology Laboratory, Centre de Diagnòstic Biomèdic, Hospital Clínic de Barcelona, Institut de Recerca August Pi Sunyer, University of Barcelona, Barcelona, Spain
| |
Collapse
|
29
|
Doan TT, DeJonckheere M, Wright DR, Hutton DW, Prosser LA. Preferences and experiences of pediatricians on implementing national guidelines on universal routine screening of adolescents for major depressive disorder: A qualitative study. Compr Psychiatry 2023; 127:152412. [PMID: 37717343 DOI: 10.1016/j.comppsych.2023.152412] [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: 04/17/2023] [Revised: 08/07/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND To explore the preferences of pediatricians for key factors around the implementation of universal routine screening guidelines for major depressive disorder in adolescent patients in a primary care setting. METHOD Semi-structured qualitative interviews were conducted with U.S. pediatricians. Participants were recruited by convenience sampling and snowball sampling. Qualitive data were summarized using thematic analysis to identify themes relevant to preferences around implementing screening strategies for adolescent patients. Recruitment ended upon reaching thematic saturation when no new themes were revealed. RESULTS Of the 14 participants, 11 identified as female, 3 male, 10 white, and 4 Asian. Top themes among pediatrician participants were around the screening modality (14/14 participants), screening validity (14/14), time barriers (14/14), and confidentiality barriers (12/14). Less frequently mentioned themes by pediatricians were workplace coordination and logistics (7/14), alternative starting ages for screening (7/14), more frequent screenings than annual screenings (3/14), and additional clinical training regarding depression diagnosis and treatment (2/14). LIMITATIONS Pool of interviewed participants was limited by diversity in terms of geography, race/ethnicity, or practice settings. CONCLUSIONS To promote the uptake of universal routine screening of adolescent major depression, pediatricians expressed it was important to address key implementation factors regarding the screening modality, screening validity, time constraints, and confidential care concerns in a primary care delivery context. Findings could be used to inform the development of implementation strategies to facilitate depression screening in primary care. Future research is needed to quantitively assess decisions and tradeoffs that pediatricians make when implementing universal screening to support adolescent mental health.
Collapse
Affiliation(s)
- Tran T Doan
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Melissa DeJonckheere
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Davene R Wright
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA, USA
| | - David W Hutton
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lisa A Prosser
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI, USA; Susan B. Meister Child Health Evaluation and Research (CHEAR) Center, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
30
|
Kendler KS, Lönn SL, Sundquist J, Sundquist K. Death of parent, sibling, spouse, and child in a Swedish national sample and risk of subsequent stress reaction, major depression, alcohol-use disorder, and drug-use disorder. Psychol Med 2023; 53:7138-7150. [PMID: 37039111 PMCID: PMC10719625 DOI: 10.1017/s0033291723000570] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 12/13/2022] [Revised: 02/16/2023] [Accepted: 02/20/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND To determine, in a general population, how much rates of stress reactions (SR), major depression (MD), alcohol-use disorder (AUD) and drug-use disorder (DUD) increase after the death of close relatives. METHODS SR, MD, AUD, and DUD registrations were assessed from national Swedish registries. From the population followed from 2000 to 2018, those exposed to death of a close relative in 2002-2016 were matched to unexposed controls and analyzed in males and females by a controlled pre-post design using a difference-in-difference method. RESULTS Substantial, brief increases in risk for SR and more modest prolonged increases in MD were observed after death of relatives in both men and women greatest with children, followed by spouses, parents, and siblings. Relatively long-lasting modest increases in AUD but not DUD were also observed following death of relatives. The absolute increases for SR and MD were greater in females than males and for AUD greater in males than females. However, logistic regression analyses showed most effects did not differ significantly by sex. Consistently larger increases in disorder risk were seen with the death of younger v. older parents, siblings, and spouses and with accidental v. non-accidental death in children. CONCLUSIONS Applying a matched cohort design to Swedish population registries, death of close relatives was associated with, and likely caused, substantial increases in rates of SR, MD, and AUD, consistent with smaller prior clinical investigations. Through such registries, we can, in large representative samples, integrate the impact of exposures to selected environmental adversities into disorder risk pathways.
Collapse
Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Sara L. Lönn
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| |
Collapse
|
31
|
Kendler KS, Aggen SH. A population-based twin study of the symptomatic diagnostic criteria for major depression that occur within versus outside of major depressive episodes. Psychol Med 2023; 53:7458-7465. [PMID: 37154209 PMCID: PMC10719671 DOI: 10.1017/s0033291723001241] [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: 02/01/2023] [Revised: 04/04/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Are genetic risk factors for current depressive symptoms good proxies for genetic risk factors for syndromal major depression (MD)? METHODS In over 9000 twins from the population-based Virginia Adult Twin Study of Psychiatric and Substance Use Disorders, the occurrence of all nine DSM symptomatic criteria for MD in the last year was assessed at personal interview and then grouped by their temporal co-occurrence. The DSM criteria which occurred outside (OUT) v. inside of (IN) MD episodes were then separated. We calculated tetrachoric correlations for OUT and IN depressive criteria in monozygotic (MZ) and dizygotic (DZ) pairs and fitted univariate and bivariate ACE twin models using OpenMx. RESULTS The mean twin correlations (±95% CIs) for IN depressive criteria were substantially higher than for OUT depressive criteria in both MZ [+0.35 (0.32-0.38) v. 0.20 (0.17-0.24)] and DZ pairs [0.20 (0.17-0.24) v. 0.10 (0.04-0.16]. The mean IN-OUT cross-correlation in MZ and DZ pairs was modest [+0.15 (0.07-0.24) and +0.07 (0.03-0.12)]. The mean heritability estimates for the nine In v. Out depressive criteria was 0.31 (0.22-0.41) and 0.15 (0.08-0.21), in MZ and DZ pairs, respectively. The mean genetic correlation between the nine IN and OUT depressive criteria was +0.07 (-0.07 to 0.21). CONCLUSIONS Depressive criteria occurring outside depressive episodes are less heritable than those occurring within. These two ways criteria can manifest are not closely genetically related. Current depressive symptoms - most of which are occurring outside of depressive episodes - are not, for genetic studies, good proxies for MD.
Collapse
Affiliation(s)
- Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Steven H. Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| |
Collapse
|
32
|
Huang KW, Huang TL. Association between programmed death-1 pathway and major depression. World J Biol Psychiatry 2023; 24:822-828. [PMID: 37139744 DOI: 10.1080/15622975.2023.2209876] [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: 02/16/2023] [Accepted: 04/30/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Major depression (MD) may be associated with inflammation and immunity. PD-1 (programmed death-1), PD-L1 (programmed death-ligand 1) and PD-L2 (programmed death-ligand 2) are among the inhibitory immune mediators on the PD-1 pathway. However, previous data regarding the association between MD and PD-1 pathway were still scarce; therefore, we investigated the association of PD-1 pathway with MD. METHODS During a period of 2 years, patients with MD and healthy controls were recruited from a medical centre in this study. The diagnosis of MD was established according to the DSM-5 criteria. The severity of MD was assessed with 17-item Hamilton Depression Rating Scale. PD-1, PD-L1 and PD-L2 were detected in peripheral blood from MD patients after 4 weeks of treatment with antidepressant drugs. RESULTS A total of 54 patients with MD and 38 healthy controls were recruited. According to the analyses, there is a significantly higher PD-L2 level in MD than in healthy controls and lower PD-1 level after age and BMI adjustment. Besides, moderately positive correlation between HAM-D scores and PD-L2 level was found. CONCLUSIONS It was found that PD-1 pathway might play an important role in MD. We need a large sample to prove these results in the future.
Collapse
Affiliation(s)
- Kuan-Wei Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tiao-Lai Huang
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Genomic and Proteomic Core Laboratory, Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| |
Collapse
|
33
|
Zhu H, Sun Y, Guo S, Zhou Q, Jiang Y, Shen Y, Zhou Z, Du Z, Zhou H. Causal relationship between sex hormone-binding globulin and major depression: A Mendelian randomization study. Acta Psychiatr Scand 2023; 148:426-436. [PMID: 37681458 DOI: 10.1111/acps.13614] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/09/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE This study aimed to explore the causal relationship between sex hormone-binding globulin (SHBG) and major depression using two-sample Mendelian randomization (MR) studies. METHODS Based on the genome-wide association study (GWAS) summary data of SHBG and major depression in the European population, which included 214,989 female SHBG samples, 185,221 male SHBG samples, and 500,199 major depression samples, we used genetic factors as instrumental variables to conduct two-sample MR analyses. We used methods including inverse variance weighted (IVW), weighted median, weighted mode, and MR Egger to evaluate the bidirectional causal relationship between SHBG and major depression. RESULTS The results showed that there was a causal relationship between female SHBG and major depression, which was positively correlated. The ORs were 1.056 (95% CI: 1.005-1.109, p = 0.031) for the weighted median and 1.067 (95% CI: 1.012-1.126, p = 0.021) for the weighted mode. There was no significant effect of male SHBG on major depression (p > 0.05), and there was no significant effect of major depression on female SHBG (p > 0.05). Major depression was negatively correlated with male SHBG, indicating that major depression could lead to a decrease in male SHBG. The OR was 0.954 (95% CI: 0.916-0.993, p = 0.023) for IVW. CONCLUSION Female SHBG was positively correlated with the risk of major depression, however, major depression was found to be negatively correlated with serum SHBG levels in men, indicating that SHBG plays distinct roles in patients with major depression of different genders.
Collapse
Affiliation(s)
- Haohao Zhu
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yifan Sun
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Shuaiyi Guo
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Qin Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Ying Jiang
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Yuan Shen
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Zhenhe Zhou
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Zhiqiang Du
- Wuxi Mental Health Center, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Hongliang Zhou
- Department of Psychology, The Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, China
| |
Collapse
|
34
|
Zuo H, Li MM. Ankylosing spondylitis and psychiatric disorders in European population: a Mendelian randomization study. Front Immunol 2023; 14:1277959. [PMID: 37954601 PMCID: PMC10637577 DOI: 10.3389/fimmu.2023.1277959] [Citation(s) in RCA: 2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023] Open
Abstract
Background Epidemiologic evidence has demonstrated a correlation between ankylosing spondylitis and psychiatric disorders. However, little is known about the common genetics and causality of this association. This study aimed to investigate the common genetics and causality between ankylosing spondylitis (AS) and psychiatric disorders. Methods A two-sample Mendelian Randomization (MR) analysis was carried out to confirm causal relationships between ankylosing spondylitis and five mental health conditions including major depressive disorder (MDD), anxiety disorder (AXD), schizophrenia (SCZ), bipolar disorder (BIP), and anorexia nervosa (AN). Genetic instrumental variables associated with exposures and outcomes were derived from the largest available summary statistics of genome-wide association studies (GWAS). Bidirectional causal estimation of MR was primarily obtained using the inverse variance weighting (IVW) method. Other MR methods include MR-Egger regression, Weighted Median Estimator (WME), Weighted Mode, Simple Mode, and Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO). Sensitivity analyses are conducted to estimate the robustness of MR results. Results The findings suggest that AS may be causally responsible for the risk of developing SCZ (OR = 1.18, 95% confidence interval = (1.06, 1.31), P = 2.58 × 10-3) and AN (OR = 1.32, 95% confidence interval = (1.07, 1.64), P = 9.43 × 10-3). In addition, MDD, AXD, SCZ, AN, and BIP were not inversely causally related to AS (all p > 0.05). Conclusion Our study provides fresh insights into the relationship between AS and psychiatric disorders (SCZ and AN). Furthermore, it may provide new clues for risk management and preventive interventions for mental disorders in patients with AS.
Collapse
Affiliation(s)
| | - Min-Min Li
- Department of Clinical Laboratory Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| |
Collapse
|
35
|
Mancuso E, Sampogna G, Boiano A, Della Rocca B, Di Vincenzo M, Lapadula MV, Martinelli F, Lucci F, Luciano M. Biological correlates of treatment resistant depression: a review of peripheral biomarkers. Front Psychiatry 2023; 14:1291176. [PMID: 37941970 PMCID: PMC10628469 DOI: 10.3389/fpsyt.2023.1291176] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Many patients fail to respond to multiple antidepressant interventions, being defined as "treatment-resistant depression" (TRD) patients. TRD is usually associated with increased severity and chronicity of symptoms, increased risk of comorbidity, and higher suicide rates, which make the clinical management challenging. Efforts to distinguish between TRD patients and those who will respond to treatment have been unfruitful so far. Several studies have tried to identify the biological, psychopathological, and psychosocial correlates of depression, with particular attention to the inflammatory system. In this paper we aim to review available studies assessing the full range of biomarkers in TRD patients in order to reshape TRD definition and improve its diagnosis, treatment, and prognosis. Methods We searched the most relevant medical databases and included studies reporting original data on possible biomarkers of TRD. The keywords "treatment resistant depression" or "TRD" matched with "biomarker," "inflammation," "hormone," "cytokine" or "biological marker" were entered in PubMed, ISI Web of Knowledge and SCOPUS databases. Articles were included if they included a comparison with healthy controls (HC). Results Of the 1878 papers identified, 35 were included in the present study. Higher plasma levels of IL-6 and TNF-α were detected in TRD patients compared to HC. While only a few studies on cortisol have been found, four papers showed elevated levels of C-reactive protein among these patients and four articles focused on immunological cells. Altered kynurenine metabolism in TRD patients was reported in two studies, while contrasting results were found with regard to BDNF. Conclusion Only a few biological alterations correlate with TRD. TNF-α seems to be the most relevant biomarker to discriminate TRD patients from both HC and treatment-responsive MDD patients. Moreover, several discrepancies among studies have been found, due to methodological differences and the lack of a standardized diagnostic definition of TRD.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Mario Luciano
- Department of Psychiatry, University of Campania “L. Vanvitelli”, Caserta, Italy
| |
Collapse
|
36
|
Villanueva-Charbonneau G, Potvin S, Marchand S, McIntyre A, McIntosh D, Bissonnette A, Gendron A, Giguère CÉ, Koué MÈ, Kouassi É. Serotonin Transporter mRNA Expression Is Reduced in the Peripheral Blood Mononuclear Cells of Subjects with Major Depression but Normal in Fibromyalgia. Brain Sci 2023; 13:1485. [PMID: 37891852 PMCID: PMC10605238 DOI: 10.3390/brainsci13101485] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Fibromyalgia (FM) and major depression disorder (MDD) frequently co-occur. Both disorders may share common serotonergic alterations, although there is less evidence of such alterations in FM. It is also unclear as to whether these alterations are persistent over time or transient. The objectives of this study were to (i) examine the changes in mRNA expression of serotonin transporter (SERT) on the surface of peripheral blood mononuclear cells (PBMCs) in FM, MDD, and the FM + MDD subjects compared to healthy controls, and to (ii) evaluate the effect of drug treatment on SERT expression. METHODS PBMCs were isolated from FM, MDD, FM + MDD, and control subjects. SERT expression was analyzed at the mRNA level via quantitative real-time polymerase chain reaction. Statistical analyses were performed using analyses of variance and linear mixed-effects models. RESULTS SERT mRNA expression was significantly reduced in MDD subjects compared to controls (p < 0.001), but not in FM nor in FM + MDD subjects. Although the drug treatments improved symptoms in FM, MDD, and FM + MDD subjects, they had no significant effect on SERT mRNA expression. CONCLUSIONS These results corroborate the role of the SERT in the pathophysiology of MDD, but not in FM, and show that the decreased mRNA expression of SERT is a persistent, rather than transient, phenomenon.
Collapse
Affiliation(s)
- Gaël Villanueva-Charbonneau
- Département de Pharmacologie et Physiologie, Université de Montréal, Montréal, QC H1T 1C8, Canada
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada; (C.-É.G.); (É.K.)
| | - Stéphane Potvin
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada; (C.-É.G.); (É.K.)
- Department of Psychiatry and Addiction, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Serge Marchand
- Department of Surgery, Faculty of Medicine, University of Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
| | | | - Diane McIntosh
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | | | - Alain Gendron
- AstraZeneca Pharmaceuticals, Mississauga, ON L4Y 1M4, Canada;
| | - Charles-Édouard Giguère
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada; (C.-É.G.); (É.K.)
| | - Marie-Ève Koué
- Department of Biochemistry and Molecular Medicine, University of Montreal, Montreal, QC H3T 1J4, Canada;
| | - Édouard Kouassi
- Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, QC H1N 3V2, Canada; (C.-É.G.); (É.K.)
- Department of Medicine and Medical Specialities, University of Montreal, Montreal, QC H3T 1J4, Canada
| |
Collapse
|
37
|
Kaczmarek KT, Protokowicz K, Kaczmarek L. Matrix metalloproteinase-9: A magic drug target in neuropsychiatry? J Neurochem 2023. [PMID: 37791997 DOI: 10.1111/jnc.15976] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023]
Abstract
Neuropsychiatric conditions represent a major medical and societal challenge. The etiology of these conditions is very complex and combines genetic and environmental factors. The latter, for example, excessive maternal or early postnatal inflammation, as well as various forms of psychotrauma, often act as triggers leading to mental illness after a prolonged latent period (sometimes years). Matrix metalloproteinase-9 (MMP-9) is an extracellularly and extrasynaptic operating protease that is markedly activated in response to the aforementioned environmental insults. MMP-9 has also been shown to play a pivotal role in the plasticity of excitatory synapses, which, in its aberrant form, has repeatedly been implicated in the etiology of mental illness. In this conceptual review, we evaluate the experimental and clinical evidence supporting the claim that MMP-9 is uniquely positioned to be considered a drug target for ameliorating the adverse effects of environmental insults on the development of a variety of neuropsychiatric conditions, such as schizophrenia, bipolar disorder, major depression, autism spectrum disorders, addiction, and epilepsy. We also identify specific challenges and bottlenecks hampering the translation of knowledge on MMP-9 into new clinical treatments for the conditions above and suggest ways to overcome these barriers.
Collapse
|
38
|
Gafaranga JP. Major Depression and Panic Disorder Associated with Implanon Implant: A Case Report. Int Med Case Rep J 2023; 16:647-649. [PMID: 37808921 PMCID: PMC10557957 DOI: 10.2147/imcrj.s430840] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023] Open
Abstract
This report presents a case study of a patient who experienced depression and panic disorder symptoms associated with the use of Implanon, a contraceptive implant. This is a rare case of related prevalence data. The purpose of this report is to explore the potential relationship between Implanon and the development of these psychiatric conditions. The findings suggest a possible link between Implanon and the onset or exacerbation of depression and panic disorder symptoms. Further research is warranted to investigate the underlying mechanisms and determine the prevalence of such adverse effects.
Collapse
Affiliation(s)
- Jean Pierre Gafaranga
- Department of Psychiatry and Behavioral Sciences, School of Medicine and Pharmacy, University of Rwanda, Kigali, Rwanda
- Department of Mental Health, University Teaching Hospital of Kigali, Kigali, Rwanda
| |
Collapse
|
39
|
Strelevitz H, Dehaqani AA, Balasco L, Bozzi Y. Obtaining novel data-driven hypotheses from teaching activities: An example assessing the role of the FKBP5 gene in major depression. Eur J Neurosci 2023; 58:3595-3604. [PMID: 37649449 DOI: 10.1111/ejn.16133] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/13/2023] [Indexed: 09/01/2023]
Abstract
Many clinical and research efforts aim to develop antidepressant drugs for those suffering from major depressive disorder (MDD). Yet, even today, the available treatments are suboptimal and unpredictable, with a significant proportion of patients enduring multiple drug attempts and adverse side effects before a successful response, and, for many patients, no response at all. Thus, a clearer understanding of the mechanisms underlying MDD is necessary. In the 'Brain Development and Disease' class of our Master's program in Cognitive Sciences, we ask students to collect data about the expression of a gene whose altered expression and/or function is related to a brain disorder. The students' final exam assignment consists of writing a research article in which the collected data are discussed in relation to the relevant disorder. In the course of one of these assignments, we identified the FKBP5 gene as a key player uniting two major hypotheses of MDD pathogenesis and treatment response. FKBP5 controls biological processes including immunoregulation and glucocorticoid function, both of which are separately implicated in the development and prognosis of MDD. Gene expression analyses from the human, non-human primate and mouse Allen Brain Atlases revealed that FKBP5 is expressed in brain regions involved in MDD, particularly at ages susceptible to early-life stressors. Data re-analysis from published studies confirmed that FKBP5 expression is upregulated in relevant brain regions in human MDD and preclinical mouse models of MDD. Our experience shows that classes engaging students in data collection and analysis projects may effectively result in novel data-driven hypotheses.
Collapse
Affiliation(s)
- Heather Strelevitz
- Master in Cognitive Sciences, Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
| | - Alireza A Dehaqani
- Master in Cognitive Sciences, Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
- Italian Institute of Technology, Rovereto, Trento, Italy
| | - Luigi Balasco
- Master in Cognitive Sciences, Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
| | - Yuri Bozzi
- Master in Cognitive Sciences, Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Trento, Italy
| |
Collapse
|
40
|
Alturki Y, Badea S, Kasmi O, Alhashmi L, Arab T. Association Between Mode of Delivery and Postpartum Depression: A Cross-Sectional Study in Saudi Arabia. Cureus 2023; 15:e47013. [PMID: 37965411 PMCID: PMC10642807 DOI: 10.7759/cureus.47013] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2023] [Indexed: 11/16/2023] Open
Abstract
Background This study was conducted to explore the association between postpartum depression (PPD) and mode of delivery in pregnant women. Methods This cross-sectional study was conducted in the western region of Saudi Arabia, among 173 women from the general population who met the inclusion criteria and participated in the study from April to September 2022. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD. Statistical analysis was performed using R version 3.6.3 (R Foundation for Statistical Computing, Vienna, Austria). Counts and percentages were used for categorical variables, and means ± standard deviation were used for continuous variables. Hypothesis testing was done at a significance level of 5%. Results It was reported by 59.5% of the respondents to be having depression. Compared to respondents who reported elective cesarean or natural delivery, those who reported emergency cesarean delivery had significantly higher average EPDS scores (p = 0.036). Positive correlations were found between depression scores and all Postpartum Bonding Questionnaire (PBQ) subscales, suggesting that higher PBQ subscale scores were associated with a greater risk of depression as determined by the EPDS questionnaire. In addition, a higher prevalence of PPD was associated with the presence of chronic illnesses (p = 0.016). Conclusion Our study indicated that although there was no correlation between mode of delivery and PPD, emergency cesarean section could contribute to PPD. Furthermore, other factors such as chronic illness and educational level can affect the risk of PPD.
Collapse
Affiliation(s)
- Yousra Alturki
- College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Samia Badea
- College of Medicine, Umm Al-Qura University, Makkah, SAU
| | - Orjwan Kasmi
- College of Medicine, Umm Al-Qura University, Makkah, SAU
| | | | - Tarek Arab
- Obstetrics and Gynaecology, King Faisal Specialist Hospital and Research Centre, Madinah, SAU
| |
Collapse
|
41
|
Melville CA, Hatton C, Beer E, Hastings RP, Cooper SA, McMeekin N, Dagnan D, Appleton K, Scott K, Fulton L, Jones RSP, McConnachie A, Zhang R, Knight R, Knowles D, Williams C, Briggs A, Jahoda A. Predictors and moderators of the response of adults with intellectual disabilities and depression to behavioural activation and guided self-help therapies. J Intellect Disabil Res 2023; 67:986-1002. [PMID: 37344986 DOI: 10.1111/jir.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 05/20/2023] [Accepted: 05/24/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND No previous studies have reported predictors and moderators of outcome of psychological therapies for depression experienced by adults with intellectual disabilities (IDs). We investigated baseline variables as outcome predictors and moderators based on a randomised controlled trial where behavioural activation was compared with guided self-help. METHODS This study was an exploratory secondary data analysis of data collected during a randomised clinical trial. Participants (n = 161) were randomised to behavioural activation or guided self-help and followed up for 12 months. Pre-treatment variables were included if they have previously been shown to be associated with an increased risk of having depression in adults with IDs or have been reported as a potential predictor or moderator of outcome of treatment for depression with psychological therapies. The primary outcome measure, the Glasgow Depression Scale for Adults with Learning Disabilities (GDS-LD), was used as the dependant variable in mixed effects regression analyses testing for predictors and moderators of outcome, with baseline GDS-LD, treatment group, study centre and antidepressant use as fixed effects, and therapist as a random effect. RESULTS Higher baseline anxiety (mean difference in outcome associated with a 1 point increase in anxiety 0.164, 95% confidence interval [CI] 0.031, 0.297; P = 0.016), lower performance intelligence quotient (IQ) (mean difference in outcome associated with a 1 point increase in IQ 0.145, 95% CI 0.009, 0.280; P = 0.037) and hearing impairment (mean difference 3.449, 95% CI 0.466, 6.432; P = 0.024) were predictors of poorer outcomes, whilst greater severity of depressive symptoms at baseline (mean difference in outcome associated with 1 point increase in depression -0.160, 95% CI -0.806, -0.414; P < 0.001), higher expectation of change (mean difference in outcome associated with a 1 point increase in expectation of change -1.013, 95% CI -1.711, -0.314; p 0.005) and greater percentage of therapy sessions attended (mean difference in outcome with 1 point increase in percentage of sessions attended -0.058, 95% CI -0.099, -0.016; P = 0.007) were predictors of more positive outcomes for treatment after adjusting for randomised group allocation. The final model included severity of depressive and anxiety symptoms, lower WASI performance IQ subscale, hearing impairment, higher expectation of change and percentage of therapy sessions attended and explained 35.3% of the variance in the total GDS-LD score at 12 months (R2 = 0.353, F4, 128 = 17.24, P < 0.001). There is no evidence that baseline variables had a moderating effect on outcome for treatment with behavioural activation or guided self-help. CONCLUSIONS Our results suggest that baseline variables may be useful predictors of outcomes of psychological therapies for adults with IDs. Further research is required to examine the value of these potential predictors. However, our findings suggest that therapists consider how baseline variables may enable them to tailor their therapeutic approach when using psychological therapies to treat depression experienced by adults with IDs.
Collapse
Affiliation(s)
- C A Melville
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C Hatton
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - E Beer
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R P Hastings
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
- Department of Psychiatry, Monash University, Melbourne, Australia
| | - S-A Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N McMeekin
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D Dagnan
- Clinical Psychology, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and University of Cumbria, Newcastle upon Tyne Tyne, UK
| | - K Appleton
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - K Scott
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - L Fulton
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R S P Jones
- School of Psychology, Bangor University, Bangor, UK
| | - A McConnachie
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R Zhang
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R Knight
- Department of Social Care and Social Work, Manchester Metropolitan University, Manchester, UK
| | - D Knowles
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - C Williams
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A Briggs
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - A Jahoda
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| |
Collapse
|
42
|
Zelada MI, Garrido V, Liberona A, Jones N, Zúñiga K, Silva H, Nieto RR. Brain-Derived Neurotrophic Factor (BDNF) as a Predictor of Treatment Response in Major Depressive Disorder (MDD): A Systematic Review. Int J Mol Sci 2023; 24:14810. [PMID: 37834258 PMCID: PMC10572866 DOI: 10.3390/ijms241914810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) has been studied as a biomarker of major depressive disorder (MDD). Besides diagnostic biomarkers, clinically useful biomarkers can inform response to treatment. We aimed to review all studies that sought to relate BDNF baseline levels, or BDNF polymorphisms, with response to treatment in MDD. In order to achieve this, we performed a systematic review of studies that explored the relation of BDNF with both pharmacological and non-pharmacological treatment. Finally, we reviewed the evidence that relates peripheral levels of BDNF and BDNF polymorphisms with the development and management of treatment-resistant depression.
Collapse
Affiliation(s)
- Mario Ignacio Zelada
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Verónica Garrido
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Andrés Liberona
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Natalia Jones
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Karen Zúñiga
- Escuela de Medicina, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Hernán Silva
- Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental Norte, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| | - Rodrigo R. Nieto
- Clínica Psiquiátrica Universitaria, Hospital Clínico de la Universidad de Chile, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Psiquiatría y Salud Mental Norte, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
- Departamento de Neurociencias, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile
| |
Collapse
|
43
|
Reinhardt PR, Theis CDC, Juckel G, Freund N. Rodent models for mood disorders - understanding molecular changes by investigating social behavior. Biol Chem 2023; 404:939-950. [PMID: 37632729 DOI: 10.1515/hsz-2023-0190] [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] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/14/2023] [Indexed: 08/28/2023]
Abstract
Mood disorders, including depressive and bipolar disorders, are the group of psychiatric disorders with the highest prevalence and disease burden. However, their pathophysiology remains poorly understood. Animal models are an extremely useful tool for the investigation of molecular mechanisms underlying these disorders. For psychiatric symptom assessment in animals, a meaningful behavioral phenotype is needed. Social behaviors constitute naturally occurring complex behaviors in rodents and can therefore serve as such a phenotype, contributing to insights into disorder related molecular changes. In this narrative review, we give a fundamental overview of social behaviors in laboratory rodents, as well as their underlying neuronal mechanisms and their assessment. Relevant behavioral and molecular changes in models for mood disorders are presented and an outlook on promising future directions is given.
Collapse
Affiliation(s)
- Patrick R Reinhardt
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, D-44791 Bochum, Germany
- International Graduate School of Neuroscience, Ruhr-University Bochum, D-44801 Bochum, Germany
| | - Candy D C Theis
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, D-44791 Bochum, Germany
| | - Georg Juckel
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, D-44791 Bochum, Germany
| | - Nadja Freund
- Division of Experimental and Molecular Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital, Ruhr-University Bochum, D-44791 Bochum, Germany
| |
Collapse
|
44
|
Seki I, Izumi H, Okamoto N, Ikenouchi A, Morimoto Y, Horie S, Yoshimura R. Serum Extracellular Vesicle-Derived hsa-miR-2277-3p and hsa-miR-6813-3p Are Potential Biomarkers for Major Depression: A Preliminary Study. Int J Mol Sci 2023; 24:13902. [PMID: 37762202 PMCID: PMC10531403 DOI: 10.3390/ijms241813902] [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] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
The aim of the present study was to examine the association between miRNA levels in extracellular vesicles (EVs) from serum and the severity of Major Depression (MD). Patient sera from 16 MD cases were collected at our university hospital. The miRNAs contained in EVs were extracted using a nanofiltration method, and their expression levels were analyzed using miRNA microarrays. Intergroup comparisons were performed to validate the diagnostic performance of miRNAs in EVs. Furthermore, candidate miRNAs in EVs were added to neural progenitor cells, astrocytes, and microglial cells in vitro, and the predicted target genes of the candidate miRNAs were extracted. The predicted target genes underwent enrichment analysis. The expression levels of hsa-miR-6813-3p and hsa-miR-2277-3p were significantly downregulated with increasing depression severity of MD. The pathway enrichment analysis suggests that hsa-miR-6813-3p may be involved in glucocorticoid receptor and gamma-aminobutyric acid receptor signaling. Additionally, hsa-miR-2277-3p was found to be involved in the dopaminergic neural pathway. The analysis of serum miRNAs in EVs suggests that hsa-miR-6813-3p and hsa-miR-2277-3p could serve as novel biomarkers for MD, reflecting its severity. Moreover, these miRNAs in EVs could help understand MD pathophysiology.
Collapse
Affiliation(s)
- Issei Seki
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (I.S.); (N.O.); (A.I.)
| | - Hiroto Izumi
- Center for Stress-related Disease Control and Prevention, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (H.I.); (Y.M.)
- Department of Occupational Pneumology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan
| | - Naomichi Okamoto
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (I.S.); (N.O.); (A.I.)
| | - Atsuko Ikenouchi
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (I.S.); (N.O.); (A.I.)
| | - Yasuo Morimoto
- Center for Stress-related Disease Control and Prevention, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (H.I.); (Y.M.)
- Department of Occupational Pneumology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan
| | - Seichi Horie
- Center for Stress-related Disease Control and Prevention, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (H.I.); (Y.M.)
- Department of Health Policy and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan
| | - Reiji Yoshimura
- Department of Psychiatry, University of Occupational and Environmental Health, Kitakyusyu 807-8555, Japan; (I.S.); (N.O.); (A.I.)
| |
Collapse
|
45
|
Gómez-Gómez I, Benítez I, Bellón J, Moreno-Peral P, Oliván-Blázquez B, Clavería A, Zabaleta-del-Olmo E, Llobera J, Serrano-Ripoll MJ, Tamayo-Morales O, Motrico E. Utility of PHQ-2, PHQ-8 and PHQ-9 for detecting major depression in primary health care: a validation study in Spain. Psychol Med 2023; 53:5625-5635. [PMID: 36258639 PMCID: PMC10482708 DOI: 10.1017/s0033291722002835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/22/2022] [Accepted: 08/19/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Primary health care (PHC) professionals may play a crucial role in improving early diagnosis of depressive disorders. However, only 50% of cases are detected in PHC. The most widely used screening instrument for major depression is the Patient Health Questionnaire (PHQ), including the two-, eight- and nine-item versions. Surprisingly, there is neither enough evidence about the validity of PHQ in PHC patients in Spain nor indications about how to interpret the total scores. This study aimed to gather validity evidence to support the use of the three PHQ versions to screen for major depression in PHC in Spain. Additionally, the present study provided information for helping professionals to choose the best PHQ version according to the context. METHODS The sample was composed of 2579 participants from 22 Spanish PHC centers participating in the EIRA-3 study. The reliability and validity of the three PHQ versions for Spanish PHC patients were assessed based on responses to the questionnaire. RESULTS The PHQ-8 and PHQ-9 showed high internal consistency. The results obtained confirm the theoretically expected relationship between PHQ results and anxiety, social support and health-related QoL. A single-factor solution was confirmed. Regarding to the level of agreement with the CIDI interview (used as the criterion), our results indicate that the PHQ has a good discrimination power. The optimal cut-off values were: ⩾2 for PHQ-2, ⩾7 for PHQ-8 and ⩾8 for PHQ-9. CONCLUSIONS PHQ is a good and valuable tool for detecting major depression in PHC patients in Spain.
Collapse
Affiliation(s)
- Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Isabel Benítez
- Department of Methodology of Behavioral Sciences, Universidad de Granada, Granada, Spain
| | - Juan Bellón
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
- El Palo Health Centre, Andalusian Health Service (SAS), Málaga, Spain
- Department of Public Health and Psychiatry, University of Málaga (UMA), Málaga, Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Bárbara Oliván-Blázquez
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
- Institute for Health Research Aragón (IISA), Zaragoza, Spain
| | - Ana Clavería
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Primary Care Research Unit, Área de Vigo, SERGAS, Vigo, Spain
- I-Saúde Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
| | - Edurne Zabaleta-del-Olmo
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
- Atenció Primària Barcelona Ciutat, Gerència Territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain
- Nursing department, Faculty of Nursing, Universitat de Girona, Girona, Spain
| | - Joan Llobera
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Maria J. Serrano-Ripoll
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, Palma de Mallorca, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Olaya Tamayo-Morales
- Unidad de Investigación en Atención Primaria de Salamanca (APISAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville, Spain
- Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| |
Collapse
|
46
|
Strawbridge R, Alexander L, Richardson T, Young AH, Cleare AJ. Is there a 'bipolar iceberg' in UK primary care psychological therapy services? Psychol Med 2023; 53:5385-5394. [PMID: 35920607 PMCID: PMC10482719 DOI: 10.1017/s0033291722002343] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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] [Received: 01/10/2022] [Revised: 05/23/2022] [Accepted: 07/05/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Improving Access to Psychological Therapies (IAPT) is a primary care therapy service commissioned by England's National Health Service (NHS) for people with unipolar depression and anxiety-related disorders. Its scope does not extend to 'severe mental illness', including bipolar disorders (BD), but evidence suggests there is a high BD prevalence in ostensibly unipolar major depressive disorder (uMDD) samples. This study aimed to indicate the prevalence and characteristics of people with BD in a naturalistic cohort of IAPT patients. METHODS 371 participants were assessed before initiating therapy. Participants were categorised by indicated diagnoses: BD type-I (BD-I) or type-II (BD-II) as defined using a DSM diagnostic interview, bipolar spectrum (BSp, not meeting diagnostic criteria but exceeding BD screening thresholds), lifetime uMDD or other. Information about psychiatric history and co-morbidities was examined, along with symptoms before and after therapy. RESULTS 368 patients provided sufficient data to enable classification. 10% of participants were grouped as having BD-I, 20% BD-II, 40% BSp, 25% uMDD and 5% other. BD and uMDD participants had similar demographic characteristics, but patients meeting criteria for BD-I/BD-II had more complex psychiatric presentations. All three 'bipolar' groups had particularly high rates of anxiety disorders. IAPT therapy receipt was comparable between groups, as was therapy response (F9704 = 1.113, p = 0.351). CONCLUSIONS Notwithstanding the possibility that bipolar diathesis was overestimated, findings illustrate a high prevalence of BD in groups of people notionally with uMDD or anxiety. As well as improving the detection of BD, further substantive investigation is required to establish whether individuals affected by BD should be eligible for primary care psychological intervention.
Collapse
Affiliation(s)
- Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Laith Alexander
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, London, UK
| | | | - Allan H. Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, London, UK
| | - Anthony J. Cleare
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- South London & Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
47
|
Yoshimatsu H, Imaeda T, Higa S, Nomoto K. Clinical implication of children's depression rating scale-revised score: Linking the children's depression rating scale-revised score and clinical global impression using patients data from clinical trials. Health Sci Rep 2023; 6:e1512. [PMID: 37662533 PMCID: PMC10469025 DOI: 10.1002/hsr2.1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/12/2023] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aims The Children's Depression Rating Scale-Revised (CDRS-R) score has been widely used to assess the severity of major depression in children and adolescents; however, the clinical implications of changes in the CDRS-R score remain unclear. We evaluated these clinical implications by assessing the relationship between changes in the CDRS-R score and changes in the Clinical Global Impression of Improvement (CGI-I), in clinical research on major depression. Methods We used data from four clinical trials involving two antidepressants and evaluated the relationship between CDRS-R score changes and the CGI-I score using the equipercentile linking method. Results CDRS-R score changes corresponding to a minimally improved (score of 3) CGI-I score was approximately 14 points. Conclusion Our findings from the linking analyses are useful for interpreting the clinical implications of changes in the CDRS-R score.
Collapse
Affiliation(s)
| | | | - Shingo Higa
- Medical AffairsViatris Pharmaceuticals Japan Inc.TokyoJapan
| | - Keisuke Nomoto
- Medical AffairsViatris Pharmaceuticals Japan Inc.TokyoJapan
| |
Collapse
|
48
|
Domke AK, Hartling C, Stippl A, Carstens L, Gruzman R, Bajbouj M, Gärtner M, Grimm S. The influence of childhood emotional maltreatment on cognitive symptoms, rumination, and hopelessness in adulthood depression. Clin Psychol Psychother 2023; 30:1170-1178. [PMID: 37291938 DOI: 10.1002/cpp.2872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/10/2023]
Abstract
Childhood emotional maltreatment (CEM) is a risk factor for the pathogenesis of depressive disorders. However, it is not clear whether CEM is more strongly related to specific symptoms of depression and whether specific traits or cognitive states may mediate the association between CEM and depressive symptoms. In our cross-sectional study, including 72 patients with a current depressive episode, we investigated if CEM is specifically related to cognitive symptoms of depression. In addition, we evaluated whether CEM also influences the extent of rumination and hopelessness in adult depression. Using multiple regression analyses, we tested if CEM and rumination could predict cognitive symptoms and hopelessness. A structural equation model (SEM) was used to examine if rumination mediates the relationship between CEM and cognitive symptoms. Correlational analyses revealed that CEM was related to cognitive symptoms, rumination, and hopelessness. The regression analyses showed that only rumination was a significant predictor for cognitive symptoms and hopelessness, whereas CEM could not significantly predict the two constructs. SEM revealed that the association between CEM and cognitive symptoms in adult depression was mediated by rumination. Our results thereby suggest that CEM is a risk factor particularly for the development of cognitive symptoms as well as rumination and hopelessness in adult depression. However, the influence on cognitive symptomatology seems to be indirectly regulated by rumination. These findings may contribute to a better understanding of processes that promote depression, as well as provide guidance for more targeted treatment options.
Collapse
Affiliation(s)
- Ann-Kathrin Domke
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Corinna Hartling
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Anna Stippl
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Luisa Carstens
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Rebecca Gruzman
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Malek Bajbouj
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Matti Gärtner
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
| | - Simone Grimm
- Department of Psychiatry, Centre for Affective Neuroscience (CAN), Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Psychology, MSB Medical School Berlin, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
49
|
Niemeijer M, Reinholt N, Poulsen S, Bach B, Christensen AB, Eskildsen A, Hvenegaard M, Arendt M, Arnfred S. Trait and symptom change in group cognitive behaviour therapy for anxiety and depression. Clin Psychol Psychother 2023; 30:1058-1070. [PMID: 37106559 DOI: 10.1002/cpp.2857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/08/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
Personality traits underlying both anxiety disorders and depression are more malleable than previously presumed. This study examined associations between changes in personality traits (i.e. negative affectivity and detachment) and alleviation of anxiety and depression symptoms following cognitive behaviour therapy (CBT). We hypothesized that decreases in negative affectivity would predict alleviation of depression and anxiety symptoms and decreases in detachment would predict decreases in depression and, to a lesser degree, anxiety symptoms. Data (N = 156) were collected in a randomized controlled trial comparing transdiagnostic and diagnosis-specific group CBT for patients with major depressive disorder, social anxiety disorder, panic disorder or agoraphobia. We assessed personality traits using the Personality Inventory for DSM-5 (PID-5) and symptoms with the Hopkins Symptom Checklist 25-item scale (SCL). Prediction was based on regression analyses. We found that decreases in negative affectivity predicted lower levels of depression and anxiety symptoms while decreases in detachment only predicted lower levels of depression symptoms. The findings substantiate current efforts to explicate the dynamic interplay between personality traits and symptoms and support the existing focus on targeting negative affectivity and detachment in therapy for anxiety disorders and depression. The trial is registered at clinicaltrials.gov (ID NCT02954731).
Collapse
Affiliation(s)
- Miriam Niemeijer
- Department of Psychology, University of Copenhagen, Copenhagen K, Denmark
| | - Nina Reinholt
- Research Unit for Psychotherapy & Psychopathology, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
- Psychotherapeutical Clinic, Psychiatric Center Copenhagen, Copenhagen Ø, Denmark
| | - Stig Poulsen
- Department of Psychology, University of Copenhagen, Copenhagen K, Denmark
| | - Bo Bach
- Research Unit for Psychotherapy & Psychopathology, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
- Center for Personality Disorder Research, Psychiatric Research Unit, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
| | - Anne Bryde Christensen
- Research Unit for Psychotherapy & Psychopathology, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Anita Eskildsen
- Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Hvenegaard
- Research Unit for Psychotherapy & Psychopathology, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
| | - Mikkel Arendt
- Department of Affective Disorders, Aarhus University Hospital, Aarhus, Denmark
| | - Sidse Arnfred
- Research Unit for Psychotherapy & Psychopathology, Copenhagen University Hospital-Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
50
|
Brehaut E, Neupane D, Levis B, Wu Y, Sun Y, Ioannidis JPA, Markham S, Cuijpers P, Patten SB, Benedetti A, Thombs BD. 'Optimal' cutoff selection in studies of depression screening tool accuracy using the PHQ-9, EPDS, or HADS-D: A meta-research study. Int J Methods Psychiatr Res 2023; 32:e1956. [PMID: 36461893 PMCID: PMC10485315 DOI: 10.1002/mpr.1956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 08/17/2022] [Revised: 10/13/2022] [Accepted: 11/15/2022] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Optimal cutoff thresholds are selected to separate 'positive' from 'negative' screening results. We evaluated how depression screening tool studies select optimal cutoffs. METHODS We included studies from previously conducted meta-analyses of Patient Health Questionnaire-9, Edinburgh Postnatal Depression Scale, or Hospital Anxiety and Depression Scale-Depression accuracy. Outcomes included whether an optimal cutoff was selected, method used, recommendations made, and reporting guideline and protocol citation. RESULTS Of 212 included studies, 172 (81%) attempted to identify an optimal cutoff, and 147 of these 172 (85%) reported one or more methods. Methods were heterogeneous with Youden's J (N = 35, 23%) most common. Only 23 of 147 (16%) studies described a rationale for their method. Rationales focused on balancing sensitivity and specificity without describing why desirable. 131 of 172 studies (76%) identified an optimal cutoff other than the standard; most did not make use recommendations (N = 56; 43%) or recommended using a non-standard cutoff (N = 53; 40%). Only 4 studies cited a reporting guideline, and 4 described a protocol with optimal cutoff selection methods, but none used the protocol method in the published study. CONCLUSIONS Research is needed to guide how selection of cutoffs for depression screening tools can be standardized and reflect clinical considerations.
Collapse
Affiliation(s)
- Eliana Brehaut
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - Dipika Neupane
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
| | - Brooke Levis
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Centre for Prognosis ResearchSchool of MedicineKeele UniversityStaffordshireUK
| | - Yin Wu
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
| | - Ying Sun
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
| | - John P. A. Ioannidis
- Department of MedicineDepartment of Epidemiology and Population HealthDepartment of Biomedical Data ScienceDepartment of Statisticsand Meta‐Research Innovation Center at Stanford (METRICS)Stanford UniversityStanfordCaliforniaUSA
| | - Sarah Markham
- Department of Biostatistics and Health InformaticsKing's College LondonLondonUK
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental PsychologyAmsterdam Public Health Research InstituteVrije UniversiteitAmsterdamThe Netherlands
| | - Scott B. Patten
- Department of Community Health SciencesUniversity of CalgaryCalgaryAlbertaCanada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Respiratory Epidemiology and Clinical Research UnitMcGill University Health CentreMontréalQuébecCanada
| | - Brett D. Thombs
- Lady Davis Institute for Medical ResearchJewish General HospitalMontréalQuébecCanada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréalQuébecCanada
- Department of PsychiatryMcGill UniversityMontréalQuébecCanada
- Department of MedicineMcGill UniversityMontréalQuébecCanada
- Department of PsychologyMcGill UniversityMontréalQuébecCanada
- Biomedical Ethics UnitMcGill UniversityMontréalQuébecCanada
| |
Collapse
|