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Pisanu C, Congiu D, Meloni A, Paribello P, Patrinos GP, Severino G, Ardau R, Chillotti C, Manchia M, Squassina A. Dissecting the genetic overlap between severe mental disorders and markers of cellular aging: Identification of pleiotropic genes and druggable targets. Neuropsychopharmacology 2024; 49:1033-1041. [PMID: 38402365 DOI: 10.1038/s41386-024-01822-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/17/2024] [Accepted: 02/04/2024] [Indexed: 02/26/2024]
Abstract
Patients with severe mental disorders such as bipolar disorder (BD), schizophrenia (SCZ) and major depressive disorder (MDD) show a substantial reduction in life expectancy, increased incidence of comorbid medical conditions commonly observed with advanced age and alterations of aging hallmarks. While severe mental disorders are heritable, the extent to which genetic predisposition might contribute to accelerated cellular aging is not known. We used bivariate causal mixture models to quantify the trait-specific and shared architecture of mental disorders and 2 aging hallmarks (leukocyte telomere length [LTL] and mitochondrial DNA copy number), and the conjunctional false discovery rate method to detect shared genetic loci. We integrated gene expression data from brain regions from GTEx and used different tools to functionally annotate identified loci and investigate their druggability. Aging hallmarks showed low polygenicity compared with severe mental disorders. We observed a significant negative global genetic correlation between MDD and LTL (rg = -0.14, p = 6.5E-10), and no significant results for other severe mental disorders or for mtDNA-cn. However, conditional QQ plots and bivariate causal mixture models pointed to significant pleiotropy among all severe mental disorders and aging hallmarks. We identified genetic variants significantly shared between LTL and BD (n = 17), SCZ (n = 55) or MDD (n = 19), or mtDNA-cn and BD (n = 4), SCZ (n = 12) or MDD (n = 1), with mixed direction of effects. The exonic rs7909129 variant in the SORCS3 gene, encoding a member of the retromer complex involved in protein trafficking and intracellular/intercellular signaling, was associated with shorter LTL and increased predisposition to all severe mental disorders. Genetic variants underlying risk of SCZ or MDD and shorter LTL modulate expression of several druggable genes in different brain regions. Genistein, a phytoestrogen with anti-inflammatory and antioxidant effects, was an upstream regulator of 2 genes modulated by variants associated with risk of MDD and shorter LTL. While our results suggest that shared heritability might play a limited role in contributing to accelerated cellular aging in severe mental disorders, we identified shared genetic determinants and prioritized different druggable targets and compounds.
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Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
| | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - George P Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, School of Health Sciences, Department of Pharmacy, University of Patras, Patras, Greece
- College of Medicine and Health Sciences, Department of Genetics and Genomics, United Arab Emirates University, Al‑Ain, Abu Dhabi, UAE
- Zayed Center for Health Sciences, United Arab Emirates University, Al‑Ain, Abu Dhabi, UAE
| | - Giovanni Severino
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy.
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Isayeva U, Manchia M, Collu R, Primavera D, Deriu L, Caboni E, Iaselli NM, Sundas D, Tusconi M, Pinna F, Paribello P, Scherma M, Pisanu C, Meloni A, Zai CC, Congiu D, Squassina A, Fratta W, Fadda P, Carpiniello B. Symptomatic remission and recovery in major psychosis: Is there a role for BDNF? A secondary analysis of the LABSP cohort data. Schizophr Res 2024; 266:197-204. [PMID: 38422890 DOI: 10.1016/j.schres.2024.02.019] [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: 08/24/2023] [Revised: 02/01/2024] [Accepted: 02/17/2024] [Indexed: 03/02/2024]
Abstract
Remission, relapse prevention, and clinical recovery are crucial areas of interest in schizophrenia (SCZ) research. Although SCZ is a chronic disorder with poor overall outcomes, years of research demonstrated that recovery is possible. There are considerable data linking brain-derived neurotrophic factor (BDNF) to SCZ, however, evidence on the role of BDNF in remission in SCZ is scarce. This secondary analysis of the Longitudinal Assessment of BDNF in Sardinian patients (LABSP) data aimed to investigate the relationship between serum BDNF levels and symptomatic remission, simultaneous clinical and functional remission, and recovery in patients with SCZ. A total of 105 patients with SCZ or schizoaffective disorder were recruited for a longitudinal assessment of BDNF levels over 24 months. Longitudinal data were analyzed using mixed-effects linear regression models. The study found significant associations between use of long acting injectables (χ2 = 7.075, df = 1, p = 0.008), baseline serum BDNF levels (U = 701, z = -2.543, p = 0.011), and "childhood" (U = 475, z = -2.124, p = 0.034) and "general" (U = 55, z = -2.014, p = 0.044) subscales of the Premorbid Adjustment Scale (PAS) with patients maintaining remission and recovery. The diagnosis of SCZ was significantly associated with lower BDNF levels for patients with simultaneous clinical and functional remission (Z = 2.035, p = 0.0419) and recovery (Z = 2.009, p = 0.0445) compared to those without. There were no significant associations between remission in the entire sample and longitudinal serum BDNF levels or genetic variants within the BDNF gene. These findings provide further insight into the complex relationship between BDNF and SCZ.
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Affiliation(s)
- Ulker Isayeva
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Roberto Collu
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Diego Primavera
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luca Deriu
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Edoardo Caboni
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Novella Maria Iaselli
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Davide Sundas
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Massimo Tusconi
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Maria Scherma
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Anna Meloni
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, Institute of Medical Science, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Donatella Congiu
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Walter Fratta
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy; Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Cagliari, Italy
| | - Paola Fadda
- Division of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy; Centre of Excellence "Neurobiology of Dependence", University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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Baune BT, Minelli A, Carpiniello B, Contu M, Domínguez Barragán J, Donlo C, Ferensztajn-Rochowiak E, Glaser R, Kelch B, Kobelska P, Kolasa G, Kopeć D, Martínez de Lagrán Cabredo M, Martini P, Mayer MA, Menesello V, Paribello P, Perera Bel J, Perusi G, Pinna F, Pinna M, Pisanu C, Sierra C, Stonner I, Wahner VTH, Xicota L, Zang JCS, Gennarelli M, Manchia M, Squassina A, Potier MC, Rybakowski F, Sanz F, Dierssen M. An integrated precision medicine approach in major depressive disorder: a study protocol to create a new algorithm for the prediction of treatment response. Front Psychiatry 2024; 14:1279688. [PMID: 38348362 PMCID: PMC10859920 DOI: 10.3389/fpsyt.2023.1279688] [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: 08/18/2023] [Accepted: 12/21/2023] [Indexed: 02/15/2024] Open
Abstract
Major depressive disorder (MDD) is the most common psychiatric disease worldwide with a huge socio-economic impact. Pharmacotherapy represents the most common option among the first-line treatment choice; however, only about one third of patients respond to the first trial and about 30% are classified as treatment-resistant depression (TRD). TRD is associated with specific clinical features and genetic/gene expression signatures. To date, single sets of markers have shown limited power in response prediction. Here we describe the methodology of the PROMPT project that aims at the development of a precision medicine algorithm that would help early detection of non-responder patients, who might be more prone to later develop TRD. To address this, the project will be organized in 2 phases. Phase 1 will involve 300 patients with MDD already recruited, comprising 150 TRD and 150 responders, considered as extremes phenotypes of response. A deep clinical stratification will be performed for all patients; moreover, a genomic, transcriptomic and miRNomic profiling will be conducted. The data generated will be exploited to develop an innovative algorithm integrating clinical, omics and sex-related data, in order to predict treatment response and TRD development. In phase 2, a new naturalistic cohort of 300 MDD patients will be recruited to assess, under real-world conditions, the capability of the algorithm to correctly predict the treatment outcomes. Moreover, in this phase we will investigate shared decision making (SDM) in the context of pharmacogenetic testing and evaluate various needs and perspectives of different stakeholders toward the use of predictive tools for MDD treatment to foster active participation and patients' empowerment. This project represents a proof-of-concept study. The obtained results will provide information about the feasibility and usefulness of the proposed approach, with the perspective of designing future clinical trials in which algorithms could be tested as a predictive tool to drive decision making by clinicians, enabling a better prevention and management of MDD resistance.
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Affiliation(s)
- Bernhard T. Baune
- Department of Mental Health, University of Münster, Münster, Germany
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia
- Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetics Unit, San Giovanni di Dio Fatebenefratelli Center (IRCCS), Brescia, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Contu
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Chus Donlo
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | | | - Rosa Glaser
- Department of Mental Health, University Hospital Münster, Münster, Germany
| | - Britta Kelch
- Department of Mental Health, University Hospital Münster, Münster, Germany
| | - Paulina Kobelska
- Department of Science, Grants and International Cooperation, Poznan University of Medical Sciences, Poznan, Poland
| | - Grzegorz Kolasa
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Dobrochna Kopeć
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Paolo Martini
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Miguel-Angel Mayer
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Valentina Menesello
- Genetics Unit, San Giovanni di Dio Fatebenefratelli Center (IRCCS), Brescia, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Júlia Perera Bel
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Giulia Perusi
- Department of Mental Health and Addiction Services, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marco Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Cesar Sierra
- Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Inga Stonner
- Department of Mental Health, University Hospital Münster, Münster, Germany
| | | | - Laura Xicota
- Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, United States
| | | | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetics Unit, San Giovanni di Dio Fatebenefratelli Center (IRCCS), Brescia, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marie-Claude Potier
- Paris Brain Institute (ICM), National Centre for Scientific Research (CNRS), Paris, France
| | - Filip Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Ferran Sanz
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- Research Programme on Biomedical Informatics (GRIB), Hospital del Mar Research Institute (IMIM), Barcelona, Spain
| | - Mara Dierssen
- Centre for Genomic Regulation (CRG), Barcelona, Spain
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Pinna F, Suprani F, Paribello P, Milia P, Sanna L, Manchia M, Boi G, Pes A, Lai L, Deiana V, Lostia di Santa Sofia S, Puddu L, Fatteri F, Ghiani A, Lai A, Carpiniello B. Food and Alcohol Disturbance in High School Adolescents: Prevalence, Characteristics and Association with Problem Drinking and Eating Disorders. Int J Environ Res Public Health 2024; 21:83. [PMID: 38248546 PMCID: PMC10815297 DOI: 10.3390/ijerph21010083] [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] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/30/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024]
Abstract
Food and alcohol disturbance (FAD) is characterized by the association of alcohol use with compensatory behaviors such as restricting calories, physical activity and purging. Despite not being part of the current nosography, research has grown in the past 10 years, mostly on college students' samples. In this study, we aim to describe the prevalence, characteristics and association of FAD with problem drinking (PD) and eating disorder risk (EDR) in a sample of Italian high school students. Participants were 900 high school students (53.6% males; mean age = 16.22) that were administered standardized questionnaires. Students who screened positive for PD, EDR and both were, respectively, 17.3%, 5.9% and 1.3%. Approximately one out four students reported FAD behaviors, mostly to control weight and by restricting calories, with higher prevalence and severity among those who screened positive for PD. Purging behaviors were rare overall (15.5%), but significantly more frequent in participants who screened positive for both PD and EDR (41.7%). FAD was more strongly associated with alcohol use severity than with ED symptom severity across all subgroups. FAD behaviors appear to be common in the Italian high school population and more strongly associated with PD. Future studies should investigate FAD's impact on adolescents' functioning and possible early interventions.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Paola Milia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Lucia Sanna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Graziella Boi
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Annadele Pes
- Department of Mental Health and Addictions, ASL Cagliari, 09127 Cagliari, Italy; (G.B.); (A.P.)
| | - Lorena Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Silvia Lostia di Santa Sofia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Laura Puddu
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Francesca Fatteri
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Ghiani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Alice Lai
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (F.P.); (P.P.); (P.M.); (L.S.); (M.M.); (L.L.); (V.D.); (S.L.d.S.S.); (L.P.); (F.F.); (A.G.); (A.L.); (B.C.)
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5
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Zai CC, Squassina A, Tiwari AK, Pisanu C, Pinna M, Pinna F, Meloni A, Paribello P, Carpiniello B, Tondo L, Frye MA, Biernacka JM, Coombes BJ, Kennedy JL, Manchia M. A genome-wide association study of antidepressant-induced mania. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110800. [PMID: 37236419 DOI: 10.1016/j.pnpbp.2023.110800] [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: 01/25/2023] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 05/28/2023]
Abstract
Antidepressant-induced mania (AIM) is a side effect of antidepressant treatment that is characterized by mania or hypomania after the start of medication. It is likely polygenic, but its genetic component remains largely unexplored. We aim to conduct the first genome-wide association study of AIM in 814 bipolar disorder patients of European ancestry. We report no significant findings from our single-marker or gene-based analyses. Our polygenic risk score analyses also did not yield significant results with bipolar disorder, antidepressant response, or lithium response. Our suggestive findings on the hypothalamic-pituitary-adrenal axis and the opioid system in AIM require independent replications.
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Affiliation(s)
- Clement C Zai
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada; Institute of Medical Science, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, United States of America.
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Arun K Tiwari
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada
| | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Marco Pinna
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Lucio Bini Mood Disorders Center, Cagliari, Italy
| | - Federica Pinna
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
| | - Leonardo Tondo
- Lucio Bini Mood Disorders Center, Cagliari, Italy; McLean Hospital-Harvard Medical School, Boston, USA
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Joanna M Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - James L Kennedy
- Tanenbaum Centre for Pharmacogenetics, Molecular Brain Science Department, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Department of Psychiatry, University of Toronto, Canada; Institute of Medical Science, University of Toronto, Canada
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada; McLean Hospital-Harvard Medical School, Boston, USA
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6
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Manchia M, Paribello P, Pisanu C, Congiu D, Antoniades A, Vogazianos P, Tozzi F, Pinna F, Aristodimou A, Caria P, Dettori T, Frau DV, Cocco C, Noli B, Panebianco C, Pazienza V, Carpiniello B, Squassina A. A Pilot Interaction Analysis of Gut Microbiota and Peripheral Markers of Aging in Severe Psychiatric Disorders: A Role for Lachnoclostridium? Int J Mol Sci 2023; 24:17618. [PMID: 38139446 PMCID: PMC10744008 DOI: 10.3390/ijms242417618] [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: 11/16/2023] [Revised: 12/01/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023] Open
Abstract
Excessive predominance of pathological species in the gut microbiota could increase the production of inflammatory mediators at the gut level and, via modification of the gut-blood barrier, at the systemic level. This pro-inflammatory state could, in turn, increase biological aging that is generally proxied by telomere shortening. In this study, we present findings from a secondary interaction analysis of gut microbiota, aging, and inflammatory marker data from a cohort of patients with different diagnoses of severe mental disorders. We analyzed 15 controls, 35 patients with schizophrenia (SCZ), and 31 patients with major depressive disorder (MDD) recruited among those attending a community mental health center (50 males and 31 females, mean and median age 46.8 and 46.3 years, respectively). We performed 16S rRNA sequencing as well as measurement of telomere length via quantitative fluorescence in situ hybridization and high-sensitivity C-reactive protein. We applied statistical modeling with logistic regression to test for interaction between gut microbiota and these markers. Our results showed statistically significant interactions between telomere length and gut microbiota pointing to the genus Lachnostridium, which remained significantly associated with a reduced likelihood of MDD even after adjustment for a series of covariates. Although exploratory, these findings show that specific gut microbiota signatures overexpressing Lachnoclostridium and interacting with biological aging could modulate the liability for MDD.
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Affiliation(s)
- Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Claudia Pisanu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
| | - Donatella Congiu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
| | - Athos Antoniades
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Paris Vogazianos
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Federica Tozzi
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Federica Pinna
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Aristos Aristodimou
- Stremble Ventures Ltd., Limassol 4042, Cyprus; (A.A.); (P.V.); (F.T.); (A.A.)
| | - Paola Caria
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Tinuccia Dettori
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Daniela Virginia Frau
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (P.C.); (T.D.); (D.V.F.)
| | - Cristina Cocco
- NEF Laboratory, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (C.C.); (B.N.)
| | - Barbara Noli
- NEF Laboratory, Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (C.C.); (B.N.)
| | - Concetta Panebianco
- Gastreonterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (C.P.); (V.P.)
| | - Valerio Pazienza
- Gastreonterology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (C.P.); (V.P.)
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09127 Cagliari, Italy; (P.P.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09127 Cagliari, Italy
| | - Alessio Squassina
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Monserrato, Italy; (C.P.); (D.C.); (A.S.)
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7
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Tassan Mazzocco M, Pisanu C, Russo L, Acconcia C, Cambiaghi M, De Girolamo S, Squassina A, Cherchi L, Monzani E, Scebba F, Angeloni D, De Gregorio D, Nasini S, Dall'Acqua S, Sut S, Suprani F, Garzilli M, Guiso B, Pulcinelli V, Iaselli MN, Pinna I, Somaini G, Arru L, Corrias C, Paribello P, Pinna F, Gobbi G, Valtorta F, Carpiniello B, Manchia M, Comai S. Melatonin MT 1 receptors as a target for the psychopharmacology of bipolar disorder: A translational study. Pharmacol Res 2023; 198:106993. [PMID: 37972722 DOI: 10.1016/j.phrs.2023.106993] [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: 08/04/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/19/2023]
Abstract
The treatment of bipolar disorder (BD) still remains a challenge. Melatonin (MLT), acting through its two receptors MT1 and MT2, plays a key role in regulating circadian rhythms which are dysfunctional in BD. Using a translational approach, we examined the implication and potential of MT1 receptors in the pathophysiology and psychopharmacology of BD. We employed a murine model of the manic phase of BD (Clock mutant (ClockΔ19) mice) to study the activation of MT1 receptors by UCM871, a selective partial agonist, in behavioral pharmacology tests and in-vivo electrophysiology. We then performed a high-resolution Nuclear Magnetic Resonance study on isolated membranes to characterize the molecular mechanism of interaction of UCM871. Finally, in a cohort of BD patients, we investigated the link between clinical measures of BD and genetic variants located in the MT1 receptor and CLOCK genes. We demonstrated that: 1) UCM871 can revert behavioral and electrophysiological abnormalities of ClockΔ19 mice; 2) UCM871 promotes the activation state of MT1 receptors; 3) there is a significant association between the number of severe manic episodes and MLT levels, depending on the genetic configuration of the MT1 rs2165666 variant. Overall, this work lends support to the potentiality of MT1 receptors as target for the treatment of BD.
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Affiliation(s)
- Margherita Tassan Mazzocco
- IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Cagliari, Italy
| | - Luigi Russo
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Clementina Acconcia
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Marco Cambiaghi
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Sofia De Girolamo
- IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, Cagliari, Italy
| | - Laura Cherchi
- IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Elena Monzani
- IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesca Scebba
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Via G. Moruzzi, 56124 Pisa, Italy
| | - Debora Angeloni
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Via G. Moruzzi, 56124 Pisa, Italy; The Institute of Biorobotics, Scuola Superiore Sant'Anna, Via G. Moruzzi, 56124 Pisa, Italy
| | - Danilo De Gregorio
- IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Sofia Nasini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Stefano Dall'Acqua
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Stefania Sut
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mario Garzilli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Beatrice Guiso
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Vittoria Pulcinelli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Maria Novella Iaselli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Ilaria Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Laura Arru
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Carolina Corrias
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Gabriella Gobbi
- Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Flavia Valtorta
- IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita Salute San Raffaele University, Milan, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
| | - Stefano Comai
- IRCCS San Raffaele Scientific Institute, Milan, Italy; Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy; Neurobiological Psychiatry Unit, Department of Psychiatry, McGill University, Montreal, QC, Canada; Department of Biomedical Sciences, University of Padua, Padua, Italy.
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8
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Paribello P, Squassina A, Pisanu C, Meloni A, Dall'Acqua S, Sut S, Nasini S, Bertazzo A, Congiu D, Garzilli M, Guiso B, Suprani F, Pulcinelli V, Iaselli MN, Pinna I, Somaini G, Arru L, Corrias C, Pinna F, Carpiniello B, Comai S, Manchia M. Probing the Association between Cognition, Suicidal Behavior and Tryptophan Metabolism in a Sample of Individuals Living with Bipolar Disorder: A Secondary Analysis. Brain Sci 2023; 13:brainsci13040693. [PMID: 37190658 DOI: 10.3390/brainsci13040693] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Background and Objectives: Alterations in hot cognition and in the tryptophan metabolism through serotonin (5-HT) and kynurenine (KYN) pathways have been associated with an increased risk of suicidal behavior. Here, we aim at probing the association between Stroop test performances and tryptophan pathway components in a sample of individuals with bipolar disorder (BD). Materials and Methods: We explored the association between the Emotion Inhibition Subtask (EIS) performances of the Brief Assessment of Cognition for Affective Disorders (BAC-A) and plasmatic levels of 5-hydroxytriptophan (5-HTP), 5-HT, KYN, 3-hydroxykynurenine (3-HK), quinolinic acid (QA), and kynurenic acid (KYNA) among subjects reporting lifetime suicide ideation (LSI) vs. non-LSI and subjects reporting lifetime suicide attempts (LSA) vs. non-LSA. Results: In a sample of 45 subjects with BD, we found a statistically significant different performance for LSA vs. non-LSA in the color naming (CN) and neutral words (NW) EIS subtasks. There was a significant association between CN performances and plasma 5-HTP levels among LSI and LSA subjects but not among non-LSI or non-LSA. Conclusions: In our sample, patients with LSA and LSI presented lower performances on some EIS subtasks compared to non-LSA and non-LSI. Moreover, we found an inverse correlation between plasma 5-HTP concentration and some EIS performances in LSA and LSI but not among non-LSA or non-LSI. This may represent an interesting avenue for future studies probing this complex association.
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Affiliation(s)
- Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Stefano Dall'Acqua
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Stefania Sut
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Sofia Nasini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Antonella Bertazzo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
| | - Donatella Congiu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Monserrato, 09042 Cagliari, Italy
| | - Mario Garzilli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Beatrice Guiso
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Vittoria Pulcinelli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Maria Novella Iaselli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Ilaria Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Laura Arru
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Carolina Corrias
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
| | - Stefano Comai
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35131 Padova, Italy
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
- San Raffaele Scientific Institute, 20132 Milano, Italy
- Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 0A2, Canada
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9
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Fellendorf FT, Caboni E, Paribello P, Pinna M, D’Aloja E, Carucci S, Pinna F, Reininghaus EZ, Carpiniello B, Manchia M. Pharmacological Treatment of Bipolar Depression: A Review of Observational Studies. Pharmaceuticals (Basel) 2023; 16:ph16020182. [PMID: 37145986 PMCID: PMC9962032 DOI: 10.3390/ph16020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
The persistence of depressive morbidity is frequent in bipolar disorder, and the pharmacological management of this symptomatology often lacks effectiveness. This systematic review aimed to summarize the results of the naturalistic observational studies on the pharmacological treatment of bipolar depression published through April 2022. The certainty of evidence was evaluated according to the GRADE approach. In sum, 16 studies on anticonvulsants, 20 on atypical antipsychotics, 2 on lithium, 28 on antidepressants, and 9 on other compounds were found. Lamotrigine, quetiapine, aripiprazole, and ketamine were the most investigated compounds. Overall, the results support the recommendations regarding the effectiveness of lamotrigine and quetiapine. In contrast to the current recommendations, aripiprazole was shown to be effective and generally well tolerated. Additionally, SSRIs were shown to be effective, but, since they were associated with a possibly higher switch risk, they should be used as an adjunctive therapy to mood stabilizers. Lithium was only studied in two trials but was shown to be effective, although the serum concentrations levels were not associated with clinical response. Finally, ketamine showed divergent response rates with a low certainty of evidence and, so far, unclear long-term effects. Heterogeneity in diagnosis, sample sizes, study designs, reporting of bias, and side effects limited the possibility of a head-to-head comparison.
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Affiliation(s)
- Frederike T. Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, A-8036 Graz, Austria
| | - Edoardo Caboni
- Psychiatrische Universitätsklinik Zürich Zaft, University of Zürich, CH-8006 Zürich, Switzerland
| | - Pasquale Paribello
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Martina Pinna
- Forensic Psychiatry Unit, Health Agency of Cagliari, 09124 Cagliari, Italy
| | - Ernesto D’Aloja
- Section of Legal Medicine, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Sara Carucci
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09124 Cagliari, Italy
- Child and Adolescent Neuropsychiatry Unit, Department of Biomedical Sciences, “A. Cao” Paediatric Hospital, 09121 Cagliari, Italy
| | - Federica Pinna
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Eva Z. Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, A-8036 Graz, Austria
| | - Bernardo Carpiniello
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, 09124 Cagliari, Italy
| | - Mirko Manchia
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Science and Public Health, University of Cagliari, 09124 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Correspondence:
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10
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Manchia M, Paribello P. Precision psychiatry for suicide prevention. Eur Neuropsychopharmacol 2023; 69:1-3. [PMID: 36640480 DOI: 10.1016/j.euroneuro.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 12/23/2022] [Accepted: 12/28/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada.
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09124 Cagliari, Italy
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11
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Pisanu C, Squassina A, Paribello P, Dall’Acqua S, Sut S, Nasini S, Bertazzo A, Congiu D, Meloni A, Garzilli M, Guiso B, Suprani F, Pulcinelli V, Iaselli MN, Pinna I, Somaini G, Arru L, Corrias C, Pinna F, Carpiniello B, Comai S, Manchia M. Investigation of Genetic Variants Associated with Tryptophan Metabolite Levels via Serotonin and Kynurenine Pathways in Patients with Bipolar Disorder. Metabolites 2022; 12:1127. [PMID: 36422266 PMCID: PMC9694761 DOI: 10.3390/metabo12111127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 12/20/2023] Open
Abstract
The kynurenine pathway (KP) may play a role in the pathophysiology of bipolar disorder (BD). We conducted a genome-wide association study (GWAS) to identify genetic variants associated with the plasma levels of the metabolites of tryptophan (TRP) via the serotonin (5-HT) and kynurenine (KYN) pathways in 44 patients with BD and 45 healthy controls. We assessed whether variants that were differentially associated with metabolite levels based on the diagnostic status improved the prediction accuracy of BD using penalized regression approaches. We identified several genetic variants that were significantly associated with metabolites (5-HT, 5-hydroxytryptophan (5-HTP), TRP, and quinolinic acid (QA) or metabolite ratios (5-HTP/TRP and KYN/TRP) and for which the diagnostic status exerted a significant effect. The inclusion of genetic variants led to increased accuracy in the prediction of the BD diagnostic status. Specifically, we obtained an accuracy of 0.77 using Least Absolute Shrinkage and Selection Operator (LASSO) regression. The predictors retained as informative in this model included body mass index (BMI), the levels of TRP, QA, and 5-HT, the 5-HTP/TRP ratio, and genetic variants associated with the levels of QA (rs6827515, rs715692, rs425094, rs4645874, and rs77048355) and TRP (rs292212) or the 5-HTP/TRP ratio (rs7902231). In conclusion, our study identified statistically significant associations between metabolites of TRP via the 5-HT and KYN pathways and genetic variants at the genome-wide level. The discriminative performance of penalized regression models incorporating clinical, genetic, and metabolic predictors warrants a follow-up analysis of this panel of determinants.
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Affiliation(s)
- Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Pasquale Paribello
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Stefano Dall’Acqua
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Stefania Sut
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Sofia Nasini
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Antonella Bertazzo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
| | - Donatella Congiu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy
| | - Mario Garzilli
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Beatrice Guiso
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Federico Suprani
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Vittoria Pulcinelli
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Maria Novella Iaselli
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Ilaria Pinna
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Giulia Somaini
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Laura Arru
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Carolina Corrias
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Federica Pinna
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
| | - Stefano Comai
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, 35131 Padua, Italy
- Department of Biomedical Sciences, University of Padova, 35131 Padova, Italy
- San Raffaele Scientific Institute, 20132 Milano, Italy
- Department of Psychiatry, McGill University, Montreal, QC H3A 1A1, Canada
| | - Mirko Manchia
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09121 Cagliari, Italy
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, 09121 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 0A2, Canada
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12
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Cau F, Fanni D, Manchia M, Gerosa C, Piras M, Murru R, Paribello P, Congiu T, Coni P, Pichiri G, Piludu M, Van Eyken P, Gibo Y, La Nasa G, Orrù G, Scano A, Coghe F, Saba L, Castagnola M, Faa G. Expression of L1 Cell Adhesion Molecule (L1CAM) in extracellular vesicles in the human spinal cord during development. Eur Rev Med Pharmacol Sci 2022; 26:6273-6282. [PMID: 36111928 DOI: 10.26355/eurrev_202209_29651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE L1 cell adhesion molecule (L1CAM) is a glycoprotein characterized by three components: an extracellular region, a transmembrane segment, and a cytoplasmic tail. L1CAM is expressed in multiple human cells, including neurons. The neural cell adhesion molecule L1 has been implicated in a variety of neurologic processes, including neuritogenesis and cerebellar cell migration. The presence of L1CAM on the surface of nerve cells allows the adhesion of neurons among them. Furthermore, when it is bound to itself or to other proteins, L1-CAM induces signals inside the cell. The aim of this work was to study L1CAM expression in the human spinal cord during development, at different gestational ages, through immunohistochemistry. MATERIALS AND METHODS Immunohistochemical analysis for L1CAM was performed in five human spinal cord samples, including three embryos and two fetuses of different gestational ages, ranging from 8 to 12 weeks. RESULTS L1CAM expression was detected in all 5 spinal cords examined in this study. The adhesion molecule was found in the vast majority of cells. The highest levels of immunoreactivity for L1CAM were detected at the periphery of the developing organs, in the spinal cord zones occupied by sensory and motor fibers. In the alar and basal columns, immunoreactivity for L1CAM was characterized by a reticular pattern, being mainly expressed in axons. Strong reactivity of L1CAM was also found in extracellular vesicles. This extracellular localization might indicate the ability of L1CAM to mediate the transduction of extracellular signals that support axon outgrowth. CONCLUSIONS The high reactivity of L1cam in the axons of developing neurons in the fetal spinal cord confirms previous studies on the ability of L1CAM to promote axon sprouting and branching in the developing nervous system. In this work, a new actor is reported to have a role in the complex field of human spinal cord development: L1CAM, whose expression is highly found in the developing neuronal and glial precursors.
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Affiliation(s)
- F Cau
- Department of Medical Sciences and Public Health, Division of Pathology, AOU of Cagliari, University of Cagliari, Cagliari, Italy.
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13
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Carta A, Del Zompo M, Meloni A, Mola F, Paribello P, Pinna F, Pinna M, Pisanu C, Manchia M, Squassina A, Carpiniello B, Conversano C. Cost-Utility Analysis of Pharmacogenetic Testing Based on CYP2C19 or CYP2D6 in Major Depressive Disorder: Assessing the Drivers of Different Cost-Effectiveness Levels from an Italian Societal Perspective. Clin Drug Investig 2022; 42:733-746. [PMID: 35930170 PMCID: PMC9427916 DOI: 10.1007/s40261-022-01182-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2022] [Indexed: 12/05/2022]
Abstract
Background and Objectives Major depressive disorder (MDD) is a common and severe psychiatric disorder that has enormous economical and societal costs. As pharmacogenetics is one of the key tools of precision psychiatry, we analyze the cost–utility of test screening of CYP2C19 and CYP2D6 for patients suffering from major depressive disorder (MDD) and try to understand the main drivers that influence the cost–utility. Methods We developed two pharmacoeconomic nonhomogeneous Markov models to test the cost–utility, from an Italian societal perspective, of pharmacogenetic testing genetic to characterize the metabolizing profiles of cytochrome P450 (CYP) 2C19 and CYP2D6 in a hypothetical case study of patients suffering from major depressive disorder (MDD). The model considers different scenarios of adjustment of antidepressant treatment according to the patient’s metabolizing profile or treatment over a period of 18 weeks. The uncertainty of model parameters is tested through both a probabilistic sensitivity analysis and a one-way deterministic sensitivity analysis, and these results are used in a post-hoc analysis to understand the main drivers of three alternative cost-effectiveness levels (“poor,” “standard,” and “high”). These drivers are first evaluated from an exploratory multidimensional perspective and next from a predictive perspective as the probability that a patient belongs to a specific cost-effectiveness level is estimated on the basis of a restricted set of parameters used in the original pharmacoeconomic model. Results The models for CYP2C19 and CYP2D6 indicate that screening has an incremental cost-effectiveness ratio of 60,000€ and 47,000€ per quality-adjusted life year (QALY), respectively. The probabilistic sensitivity analysis shows that the treatments are cost-effective for a 75,000€ willingness to pay (WTP) threshold in 58% and 63% of the Monte Carlo replications, respectively. The post-hoc analysis highlights the factors that allow us to clearly discriminates poor cost-effectiveness from high cost-effectiveness scenarios and demonstrates that it is possible to predict with reasonable accuracy the cost-effectiveness of a genetic test and the associated therapeutic pattern. Conclusions Our findings suggest that screenings for both CYP2C19 and CYP2D6 enzymes for patients with MDD are cost-effective for a WTP threshold of 75,000€ per QALY, and provide relevant suggestions about the most important aspects to be further explored in clinical studies aimed at addressing the cost-effectiveness of genetic testing for patients diagnosed with MDD.
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Affiliation(s)
- Andrea Carta
- Department of Business and Economics, University of Cagliari, Cagliari, Italy
| | - Maria Del Zompo
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Anna Meloni
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Francesco Mola
- Department of Business and Economics, University of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Marco Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Claudio Conversano
- Department of Business and Economics, University of Cagliari, Cagliari, Italy.
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14
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Paribello P, Manchia M, Bosia M, Pinna F, Carpiniello B, Comai S. Melatonin and aggressive behavior: A systematic review of the literature on preclinical and clinical evidence. J Pineal Res 2022; 72:e12794. [PMID: 35192237 PMCID: PMC9285357 DOI: 10.1111/jpi.12794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 02/04/2022] [Accepted: 02/18/2022] [Indexed: 11/27/2022]
Abstract
The melatonin system and circadian disruption have well-established links with aggressive behaviors; however, the biological underpinnings have not been thoroughly investigated. Here, we aimed at examining the current knowledge regarding the neurobiological and psychopharmacological involvement of the melatonin system in aggressive/violent behaviors. To this end, we performed a systematic review on Embase and Pubmed/MEDLINE of preclinical and clinical evidence linking the melatonin system, melatonin, and melatoninergic drugs with aggressive/violent behaviors. Two blinded raters performed an independent screening of the relevant literature. Overall, this review included 38 papers distributed between clinical and preclinical models. Eleven papers specifically addressed the existing evidence in rodent models, five in fish models, and 21 in humans. The data indicate that depending on the species, model, and timing of administration, melatonin may exert a complex influence on aggressive/violent behaviors. Particularly, the apparent contrasting findings on the link between the melatonin system and aggression/violence (with either increased, no, or decreased effect) shown in preclinical models underscore the need for further research to develop more accurate and fruitful translational models. Likewise, the significant heterogeneity found in the results of clinical studies does not allow yet to draw any firm conclusion on the efficacy of melatonin or melatonergic drugs on aggressive/violent behaviors. However, findings in children and in traits associated with aggressive/violent behavior, including irritability and anger, are emerging and deserve empirical attention given the low toxicity of melatonin and melatonergic drugs.
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Affiliation(s)
- Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
- Unit of Clinical PsychiatryUniversity Hospital Agency of CagliariCagliariItaly
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
- Unit of Clinical PsychiatryUniversity Hospital Agency of CagliariCagliariItaly
- Department of PharmacologyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Marta Bosia
- Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
- School of MedicineVita Salute San Raffaele UniversityMilanItaly
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
- Unit of Clinical PsychiatryUniversity Hospital Agency of CagliariCagliariItaly
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly
- Unit of Clinical PsychiatryUniversity Hospital Agency of CagliariCagliariItaly
| | - Stefano Comai
- Division of NeuroscienceSan Raffaele Scientific InstituteMilanItaly
- Department of PsychiatryMcGill UniversityMontrealQuebecCanada
- Department of Pharmaceutical and Pharmacological SciencesUniversity of PaduaPaduaItaly
- Department of Biomedical SciencesUniversity of PaduaPaduaItaly
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15
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Silveri G, Schimmenti S, Prina E, Gios L, Mirandola M, Converti M, Fiorillo A, Pinna F, Ventriglio A, Galeazzi GM, Sherriff N, Zeeman L, Amaddeo F, Paribello P, Pinna F, Giallanella D, Gaggiano C, Ventriglio A, Converti M, Fiorillo A, Galeazzi GM, Marchi M, Arcolin E, Fiore G, Mirandola M, Schimmenti S, Silveri G, Prina E, Amaddeo F, Bragazzi NL. Barriers in care pathways and unmet mental health needs in LGBTIQ + communities. Int Rev Psychiatry 2022; 34:215-229. [PMID: 36151825 DOI: 10.1080/09540261.2022.2075256] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/18/2022]
Abstract
Lesbian, gay, bisexual, transgender, intersex, queer people and minority gender identities and sexualities (LGBTIQ+) are often stigmatized and experience discrimination in health care settings, leading to poorer mental health outcomes and unmet needs compared to heterosexual and cisgendered peers. It is thus imperative that mental health providers consider and address structural challenges in order to reduce mental health inequalities of this population. This narrative review assessed the barriers that may prevent access to care and the pathways for care in LGBTIQ + communities. PubMed, PsycInfo, Embase, and Scopus were searched for papers published between December 2021 and February 2022. A total of 107 papers were included with studies reflecting five themes: (1) Unmet mental health needs; (2) Young people; (3) Substance abuse and addiction; (4) Barriers and pathways to care; and (5) Interventions. Findings demonstrate that LGBTIQ + people experience stigmatization and higher rates of substance misuse and mental ill health, which may lead to barriers in accessing health care services, and fewer tailored interventions being provided. These findings have implications for policy, health care screening, and how specialist services are structured. Substantial gaps in the evidence-base exist, and future research should examine how mental health care providers can challenge social issues that maintain discriminatory and stigmatizing practices, and support LGBTIQ + individuals to sustain their resilience.
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Affiliation(s)
- Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Department of integrated activity of Mental Health and Pathological Dependencies, USL-IRCSS company of Reggio Emilia, Reggio Emilia, Italy
| | - Nigel Sherriff
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Laetitia Zeeman
- School of Sport and Health Sciences, University of Brighton, Brighton, UK.,Centre for Transforming Sexuality and Gender, University of Brighton, Brighton, UK
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Pasquale Paribello
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Giallanella
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Costanza Gaggiano
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental, University di Foggia, Foggia, Italy
| | | | - Andrea Fiorillo
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Mattia Marchi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Arcolin
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gianluca Fiore
- Department of Mental Health and Drug Abuse, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Simone Schimmenti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giada Silveri
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, Ontario, Canada
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16
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Pinna F, Paribello P, Somaini G, Corona A, Ventriglio A, Corrias C, Frau I, Murgia R, El Kacemi S, Galeazzi GM, Mirandola M, Amaddeo F, Crapanzano A, Converti M, Piras P, Suprani F, Manchia M, Fiorillo A, Carpiniello B. Mental health in transgender individuals: a systematic review. Int Rev Psychiatry 2022; 34:292-359. [PMID: 36151828 DOI: 10.1080/09540261.2022.2093629] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 10/16/2022]
Abstract
Several lines of evidence indicate the prevalence of mental health disorders in Transgender (TG) individuals is higher than that of cisgender individuals or the general population. In this systematic review, we aim to propose a summary of some of the most significant research investigating mental health disorders' prevalence among this population. We performed a double-blind systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting (PRISMA) on PUBMED/MEDLINE and SCOPUS, specifically using peer-reviewed articles examining the mental health status of transgender (TG) individuals. This review did not exclude any research based on publication date. The last search was performed in February 2022. The employed search strategy led to the selection of 165 peer-reviewed articles. The majority of these papers presented a cross-sectional design with self-reported diagnoses and symptoms, signaling a significant prevalence of mental health disorders amongst TG Individuals. Of the reviewed articles, 72 examined the prevalence of mood and anxiety disorders; 8 examined eating disorders; 43 examined the prevalence of suicidal or self-harm ideation or behaviors; 5 papers examined the prevalence of trauma and stress-related disorders; 10 examined the frequency of personality disorders; 44 examined substance use disorders; and 9 papers examined the prevalence of autism spectrum disorder. Finally, 22 studies reported on the prevalence of TG individuals diagnosed with co-morbid mental health disorders or unspecified mental disorders. Our findings coincide with existing research, which indicates TG individuals do experience a higher prevalence of mental health disorders than that of the general population or cisgender individuals. However, further research is needed to address the existing gaps in knowledge.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Alice Corona
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carolina Corrias
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Ilaria Frau
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Roberto Murgia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina El Kacemi
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Gian Maria Galeazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Dipartimento ad attività integrata di Salute Mentale e Dipendenze Patologiche, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Massimo Mirandola
- Department of Diagnostics and Public Health, Infectious Diseases Section, University of Verona, Verona, Italy.,School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, California, USA
| | - Manlio Converti
- Dipartimento di salute mentale, ASL Napoli 2 Nord, Naples, Italy
| | - Paola Piras
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Andrea Fiorillo
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
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17
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Piras M, Cau F, Manchia M, Paribello P, Saba L, Suri JS, Faa G, Pichiri G, Cerrone G, Scano A, Orrù G, La Nasa G, Coghe F, Castagnola M, Fanni D, Gerosa C. Strong ACE-2 expression in the choroidal vessels: do high choroid plexuses serve as a gateway for SARS-CoV-2 infection on the human brain? Eur Rev Med Pharmacol Sci 2022; 26:3025-3029. [PMID: 35503602 DOI: 10.26355/eurrev_202204_28633] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Previous studies have confirmed the key mechanism by which SARS-CoV-2 enters human cells. It is well established that ACE2 is the receptor that can mark the beginning of the infection. In light of this, the organs that express higher levels of ACE2 are generally considered at higher risk, while those with lower levels should be somehow more protected. This - if related to the scarcity of ace2-expressing cells in the brain - seems to contrast with the presence of a variety of neurological symptoms that follow infection with ace2. The aim of this work was to analyze ACE2 expression in the human brain, focusing on the choroid plexuses. PATIENTS AND METHODS Twenty brain samples were obtained at autopsy from ten human fetuses and from ten adult subjects. All samples were selected to contain the choroid plexus. Specimens were fixed in 10% formalin, routinely processed and paraffin embedded. 5-micron sections were stained with Hematoxylin and Eosin (H&E) and immunostained with a commercial anti-human ACE2 rabbit monoclonal antibody at 1:100 dilution. RESULTS We analyzed 20 samples by immunohistochemistry, and we noted that, as far as fetal samples are concerned, a strong reactivity for ACE2 was detected in the myxoid stroma of the choroid plexuses and in the endothelial cells in fetuses. The complete absence of the ACE2 marker was detected in epithelial cells, neurons and glial cells of the cerebral cortex, both in fetuses and in adults. Whereas a strong but selective reactivity for ACE2 was also detected in adult choroid plexuses, mainly localized in the endothelial cells of the choroid capillaries. CONCLUSIONS Our study shows a strong expression of ACE in the fetal and adult brain choroid plexuses. This new histopathological finding may clarify the susceptibility of the human brain to SARS-COV-2 infection. Our data indicate the choroid plexus as the entry gate of virus for in the human brain; therefore, the entrance of SARS-CoV-2 into the cerebrospinal fluid through the choroid plexuses might represent the mechanism utilized by this coronavirus to cause direct injury to brain cells.
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Affiliation(s)
- M Piras
- Department of Medical Sciences and Public Health, University of Cagliari, Electron Microscopy Laboratory, Division Pathological Anatomy, Cagliari, Italy.
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18
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Piras IS, Huentelman MJ, Pinna F, Paribello P, Solmi M, Murru A, Carpiniello B, Manchia M, Zai CC. A review and meta-analysis of gene expression profiles in suicide. Eur Neuropsychopharmacol 2022; 56:39-49. [PMID: 34923210 DOI: 10.1016/j.euroneuro.2021.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/30/2021] [Accepted: 12/03/2021] [Indexed: 12/12/2022]
Abstract
Suicide claims over 800,000 deaths worldwide, making it a serious public health problem. The etiopathophysiology of suicide remains unclear and is highly complex, and postmortem gene expression studies can offer insights into the molecular biological mechanism underlying suicide. In the current study, we conducted a meta-analysis of postmortem brain gene expression in relation to suicide. We identified five gene expression datasets for postmortem orbitofrontal, prefrontal, or dorsolateral prefrontal cortical brain regions from the Gene Expression Omnibus repository. After quality control, the total sample size was 380 (141 suicide deaths and 239 deaths from other causes). We performed the analyses using two meta-analytic approaches. We further performed pathway and cell-set enrichment analyses. We found reduced expression of the KCNJ2 (Potassium Inwardly Rectifying Channel Subfamily J Member 2), A2M (Alpha-2-Macroglobulin), AGT (Angiotensinogen), PMP2 (Peripheral Myelin Protein 2), and VEZF1 (Vascular Endothelial Zinc Finger 1) genes (FDR p<0.05). Our findings support the involvement of astrocytes, stress response, immune system, and microglia in suicide. These findings will require further validation in additional large datasets.
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Affiliation(s)
- Ignazio S Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Matthew J Huentelman
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa Ottawa Ontario; Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychosis Studies, King's College London, London, United Kingdom
| | - Andrea Murru
- Bipolar and Depression Disorders Unit, Institute of Neuroscience, Hospital Clinic, IDIBAPS CIBERSAM, University of Barcelona, Barcelona, Catalonia, Spain
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, NS, Canada.
| | - Clement C Zai
- Neurogenetics Section, Molecular Brain Science, Tanenbaum Centre for Pharmacogenetics, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, Institute of Medical Science, Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada; Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, United States
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19
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Pinna F, Suprani F, Deiana V, Lai L, Manchia M, Paribello P, Somaini G, Diana E, Nicotra EF, Farci F, Ghiani M, Cau R, Tuveri M, Cossu E, Loy E, Crapanzano A, Grassi P, Loviselli A, Velluzzi F, Carpiniello B. Depression in Diabetic Patients: What Is the Link With Eating Disorders? Results of a Study in a Representative Sample of Patients With Type 1 Diabetes. Front Psychiatry 2022; 13:848031. [PMID: 35782445 PMCID: PMC9243395 DOI: 10.3389/fpsyt.2022.848031] [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: 01/03/2022] [Accepted: 05/25/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE Comorbidity between diabetes and depression, and diabetes and eating disorders (ED) conveys significant diagnostic, clinical and therapeutic implications. The present study was conducted on a sample of adult outpatients affected by Type 1 Diabetes (T1DM) to assess lifetime prevalence of ED; current prevalence of depression and Disturbed Eating Behaviors (DEB) and their impact on glycemic control. We hypothesized that patients with depression would have higher rates of lifetime ED and current DEB. We hypothesized a significant and independent association between DEB and the prevalence of depression. MATERIALS AND METHODS The study was carried out using a cross-sectional design in a sample of 172 diabetic patients with T1DM aged from 17 to 55 years. Lifetime prevalence of ED according to DSM-5 criteria was assessed by means of the Module H modified of the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I). The following questionnaires were used: Beck Depression Inventory-IA version (BDI-IA) and Diabetes Eating Problems Survey-Revised (DEPS-R), to assess respectively the current presence of depression and DEB. Socio-demographic, clinical, and laboratory data were also collected. RESULTS High rates of depression (35.5%) and DEB (19.2%) were observed in our sample of 172 adult outpatients with T1DM. Lifetime history of ED was present in 20.9% of the sample and was more frequently diagnosed in patients with current depression (34.4% vs. 13.9%, p = 0.002). Higher levels of DEB at DEPS-R significantly increased the odds of depression (adjOR: 1.09; 95% CI: 1.03-1.15; p = 0.003). The presence of DEB was associated with poor glycemic control. On the other hand, no association was found between depression and metabolic compensation. CONCLUSION Adult patients with T1DM and depression should be screened for ED and DEB. Treating DEB could positively impact both mood and glycemic control in this population. Further studies should be carried out on a larger patient population using a longitudinal design and an accurate method of evaluation to explore the complex relationship between diabetes, depression, ED, and DEB. Future research should investigate treatment strategies for DEB in T1DM patients and their impact on both psychopathological and metabolic outcomes.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Valeria Deiana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Lorena Lai
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Giulia Somaini
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Enrica Diana
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | | | - Fernando Farci
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Mariangela Ghiani
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Rossella Cau
- Unit of Diabetology, Azienda Sanitaria Locale Cagliari, Quartu Sant'Elena, Italy
| | - Marta Tuveri
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Efisio Cossu
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elena Loy
- Endocrinology and Diabetes Unit, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Crapanzano
- Department of Counseling, San Francisco State University, San Francisco, CA, United States
| | - Paola Grassi
- Department of Education, Psychology and Philosophy, University of Cagliari, Cagliari, Italy
| | - Andrea Loviselli
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Fernanda Velluzzi
- Endocrinology and Obesity Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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20
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Isayeva U, Manchia M, Collu R, Primavera D, Deriu L, Caboni E, Iaselli N, Sundas D, Tusconi M, Pinna F, Paribello P, Scherma M, Pisanu C, Meloni A, Zai CC, Congiu D, Squassina A, Fratta W, Fadda P, Carpiniello B. Exploring the association between brain-derived neurotrophic factor levels and longitudinal psychopathological and cognitive changes in Sardinian psychotic patients. Eur Psychiatry 2022; 65:e71. [DOI: 10.1192/j.eurpsy.2022.2333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background and hypothesis
Schizophrenia spectrum disorders are among the most debilitating mental disorders and has complex pathophysiological underpinnings. There is growing evidence that brain-derived neurotrophic factor (BDNF) can play a role in its pathogenesis. The present study investigated the longitudinal variation of serum BDNF levels in a 24-month observational prospective cohort study of Sardinian psychotic patients and its relationship with psychopathological and cognitive changes. Furthermore, we examined whether genetic variation within the BDNF gene could moderate these relationships.
Study design
Every 6 months, 105 patients were assessed for their BDNF serum levels, as well as for a series of psychopathological, cognitive, and social measures. We performed a targeted analysis of four tag single nucleotide polymorphisms within the BDNF gene that were selected and analyzed using polymerase chain reaction. Longitudinal data were analyzed using mixed-effects linear regression models.
Study results
We observed a declining longitudinal trajectory of BDNF levels in psychotic patients in general, and in relation to the severity of depressive and negative symptoms. BDNF serum levels also declined in patients scoring lower in cognitive measures such as attention and speed of information processing and verbal fluency. The rs7934165 polymorphism moderated the significant association between verbal fluency and BDNF levels.
Conclusions
These findings in patients from real-world settings suggest a plausible role of peripheral BDNF levels as a marker of illness burden in schizophrenia spectrum disorders.
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21
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Pinna M, Manchia M, Pisanu C, Pinna F, Paribello P, Carta A, Meloni A, Conversano C, Del Zompo M, Mola F, Squassina A, Carpiniello B. Protocol for a pharmacogenetic study of antidepressants: characterization of drug-metabolizing profiles of cytochromes CYP2D6 and CYP2C19 in a Sardinian population of patients with major depressive disorder. Psychiatr Genet 2021; 31:186-193. [PMID: 34282075 DOI: 10.1097/ypg.0000000000000293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The effectiveness of antidepressants shows high interindividual variability ranging from full symptomatologic remission to treatment-resistant depression. Many factors can determine the variation in the clinical response, but a fundamental role is played by genetic variation within the genes encoding for the enzymes most involved in the metabolism of antidepressant drugs: the CYP2D6 and CYP2C19 isoforms of the cytochrome P450 system. This study is poised to clarify whether the different metabolizing phenotypes related to CYP2D6 and CYP2C19 could have an impact on the clinical efficacy of antidepressants and whether the frequency of these phenotypes of metabolization shows differences in the population of Sardinian patients compared to other Caucasian populations. The sample is being recruited from patients followed-up and treated at the Psychiatric Unit of the Department of Medical Science and Public Health, University of Cagliari and the University Hospital Agency of Cagliari (Italy). The study design includes three approaches: (1) a pharmacogenetic analysis of 80 patients diagnosed with MDD resistant to antidepressant treatment compared to 80 clinically responsive or remitted patients; (2) a prospective arm (N = 30) of the study where we will test the impact of genetic variation within the CYP2D6 and CYP2C19 genes on clinical response to antidepressants and on their serum levels and (3) the assessment of the socio-economic impact of antidepressant therapies, and estimation of the cost-effectiveness of the pharmacogenetic test based on CYP genes.
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Affiliation(s)
- Marco Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Carta
- Department of Business and Economics, University of Cagliari
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari
| | | | - Maria Del Zompo
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari
| | - Francesco Mola
- Department of Business and Economics, University of Cagliari
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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22
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Fanni D, Pinna F, Gerosa C, Paribello P, Carpiniello B, Faa G, Manchia M. Anatomical distribution and expression of CYP in humans: Neuropharmacological implications. Drug Dev Res 2021; 82:628-667. [PMID: 33533102 DOI: 10.1002/ddr.21778] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 10/21/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 12/14/2022]
Abstract
The cytochrome P450 (CYP450) superfamily is responsible for the metabolism of most xenobiotics and pharmacological treatments generally used in clinical settings. Genetic factors as well as environmental determinants acting through fine epigenetic mechanisms modulate the expression of CYP over the lifespan (fetal vs. infancy vs. adult phases) and in diverse organs. In addition, pathological processes might alter the expression of CYP. In this selective review, we sought to summarize the evidence on the expression of CYP focusing on three specific aspects: (a) the anatomical distribution of the expression in body districts relevant in terms of drug pharmacokinetics (liver, gut, and kidney) and pharmacodynamics, focusing for the latter on the brain, since this is the target organ of psychopharmacological agents; (b) the patterns of expression during developmental phases; and (c) the expression of CYP450 enzymes during pathological processes such as cancer. We showed that CYP isoforms show distinct patterns of expression depending on the body district and the specific developmental phases. Of particular relevance for neuropsychopharmacology is the complex regulatory mechanisms that significantly modulate the complexity of the pharmacokinetic regulation, including the concentration of specific CYP isoforms in distinct areas of the brain, where they could greatly affect local substrate and metabolite concentrations of drugs.
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Affiliation(s)
- Daniela Fanni
- Unit of Anatomic Pathology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Anatomic Pathology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Clara Gerosa
- Unit of Anatomic Pathology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Anatomic Pathology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Gavino Faa
- Unit of Anatomic Pathology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Anatomic Pathology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
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23
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Sani G, Manchia M, Simonetti A, Janiri D, Paribello P, Pinna F, Carpiniello B. The Role of Gut Microbiota in the High-Risk Construct of Severe Mental Disorders: A Mini Review. Front Psychiatry 2021; 11:585769. [PMID: 33510657 PMCID: PMC7835325 DOI: 10.3389/fpsyt.2020.585769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/15/2020] [Indexed: 12/20/2022] Open
Abstract
Severe mental disorders (SMD) are highly prevalent psychiatric conditions exerting an enormous toll on society. Therefore, prevention of SMD has received enormous attention in the last two decades. Preventative approaches are based on the knowledge and detailed characterization of the developmental stages of SMD and on risk prediction. One relevant biological component, so far neglected in high risk research, is microbiota. The human microbiota consists in the ensemble of microbes, including viruses, bacteria, and eukaryotes, that inhabit several ecological niches of the organism. Due to its demonstrated role in modulating illness and health, as well in influencing behavior, much interest has focused on the characterization of the microbiota inhabiting the gut. Several studies in animal models have shown the early modifications in the gut microbiota might impact on neurodevelopment and the onset of deficits in social behavior corresponding to distinct neurosignaling alterations. However, despite this evidence, only one study investigated the effect of altered microbiome and risk of developing mental disorders in humans, showing that individuals at risk for SMD had significantly different global microbiome composition than healthy controls. We then offer a developmental perspective and provided mechanistic insights on how changes in the microbiota could influence the risk of SMD. We suggest that the analysis of microbiota should be included in the comprehensive assessment generally performed in populations at high risk for SMD as it can inform predictive models and ultimately preventative strategies.
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Affiliation(s)
- Gabriele Sani
- Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Section of Psychiatry, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Simonetti
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Delfina Janiri
- Fondazione Policlinico Universitario “Agostino Gemelli” Istituto di ricovero e cura a carattere scientifico (IRCCS), Rome, Italy
- Section of Psychiatry, Department of Neuroscience, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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24
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Squassina A, Manchia M, Pisanu C, Ardau R, Arzedi C, Bocchetta A, Caria P, Cocco C, Congiu D, Cossu E, Dettori T, Frau DV, Garzilli M, Manca E, Meloni A, Montis MA, Mura A, Nieddu M, Noli B, Paribello P, Pinna F, Robledo R, Severino G, Sogos V, Del Zompo M, Ferri GL, Chillotti C, Vanni R, Carpiniello B. Telomere attrition and inflammatory load in severe psychiatric disorders and in response to psychotropic medications. Neuropsychopharmacology 2020; 45:2229-2238. [PMID: 32919410 PMCID: PMC7784910 DOI: 10.1038/s41386-020-00844-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 05/12/2020] [Revised: 08/14/2020] [Accepted: 08/26/2020] [Indexed: 12/15/2022]
Abstract
Individuals with severe psychiatric disorders have a reduced life expectancy compared to the general population. At the biological level, patients with these disorders present features that suggest the involvement of accelerated aging, such as increased circulating inflammatory markers and shorter telomere length (TL). To date, the role of the interplay between inflammation and telomere dynamics in the pathophysiology of severe psychiatric disorders has been scarcely investigated. In this study we measured T-lymphocytes TL with quantitative fluorescent in situ hybridization (Q-FISH) and plasma levels of inflammatory markers in a cohort comprised of 40 patients with bipolar disorder (BD), 41 with schizophrenia (SZ), 37 with major depressive disorder (MDD), and 36 non-psychiatric controls (NPC). TL was shorter in SZ and in MDD compared to NPC, while it was longer in BD (model F6, 137 = 20.128, p = 8.73 × 10-17, effect of diagnosis, F3 = 31.870; p = 1.08 × 10-15). There was no effect of the different classes of psychotropic medications, while duration of treatment with mood stabilizers was associated with longer TL (Partial correlation controlled for age and BMI: correlation coefficient = 0.451; p = 0.001). Levels of high-sensitivity C-Reactive Protein (hsCRP) were higher in SZ compared to NPC (adjusted p = 0.027), and inversely correlated with TL in the whole sample (r = -0.180; p = 0.042). Compared to NPC, patients with treatment resistant (TR) SZ had shorter TL (p = 0.001), while patients with TR MDD had higher levels of tumor necrosis factor-α (TNFα) compared to NPC (p = 0.028) and to non-TR (p = 0.039). Comorbidity with cardio-metabolic disorders did not influence the observed differences in TL, hsCRP, and TNFα among the diagnostic groups. Our study suggests that patients with severe psychiatric disorders present reduced TL and increased inflammation.
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Affiliation(s)
- Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy.
| | - Mirko Manchia
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Carlo Arzedi
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Alberto Bocchetta
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Paola Caria
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Cristina Cocco
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Eleonora Cossu
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Tinuccia Dettori
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Daniela Virginia Frau
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Mario Garzilli
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elias Manca
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Maria Antonietta Montis
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Mura
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mariella Nieddu
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Barbara Noli
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Renato Robledo
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Giovanni Severino
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
| | - Valeria Sogos
- Department of Biomedical Sciences, Section of Cytomorphology, University of Cagliari, Monserrato, Cagliari, Italy
| | - Maria Del Zompo
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042, Monserrato, Cagliari, Italy
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Gian Luca Ferri
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Monserrato, Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Roberta Vanni
- Department of Biomedical Sciences, Unit of Biology and Genetics, University of Cagliari, Monserrato, Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
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Fontana A, Manchia M, Panebianco C, Paribello P, Arzedi C, Cossu E, Garzilli M, Montis MA, Mura A, Pisanu C, Congiu D, Copetti M, Pinna F, Carpiniello B, Squassina A, Pazienza V. Exploring the Role of Gut Microbiota in Major Depressive Disorder and in Treatment Resistance to Antidepressants. Biomedicines 2020; 8:biomedicines8090311. [PMID: 32867257 PMCID: PMC7554953 DOI: 10.3390/biomedicines8090311] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 12/24/2022] Open
Abstract
Major depressive disorder (MDD) is a common severe psychiatric illness, exhibiting sub-optimal response to existing pharmacological treatments. Although its etiopathogenesis is still not completely understood, recent findings suggest that an altered composition of the gut microbiota might play a role. Here we aimed to explore potential differences in the composition of the gut microbiota between patients with MDD and healthy controls (HC) and to identify possible signatures of treatment response by analyzing two groups of MDD patients characterized as treatment-resistant (TR) or responders (R) to antidepressants. Stool samples were collected from 34 MDD patients (8 TR, 19 R and 7 untreated) and 20 HC. Microbiota was characterized using the 16S metagenomic approach. A penalized logistic regression analysis algorithm was applied to identify bacterial populations that best discriminate the diagnostic groups. Statistically significant differences were identified for the families of Paenibacillaceae and Flavobacteriaceaea, for the genus Fenollaria, and the species Flintibacter butyricus, Christensenella timonensis, and Eisenbergiella massiliensis among others. The phyla Proteobacteria, Tenericutes and the family Peptostreptococcaceae were more abundant in TR, whereas the phylum Actinobacteria was enriched in R patients. Moreover, a number of bacteria only characterized the microbiota of TR patients, and many others were only detected in R. Our results confirm that dysbiosis is a hallmark of MDD and suggest that microbiota of TR patients significantly differs from responders to antidepressants. This finding further supports the relevance of an altered composition of the gut microbiota in the etiopathogenesis of MDD, suggesting a role in response to antidepressants.
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Affiliation(s)
- Andrea Fontana
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (A.F.); (M.C.)
| | - Mirko Manchia
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Concetta Panebianco
- Division of Gastroenterology, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy;
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Carlo Arzedi
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Eleonora Cossu
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Mario Garzilli
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Maria Antonietta Montis
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Andrea Mura
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Claudia Pisanu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (D.C.)
| | - Donatella Congiu
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (D.C.)
| | - Massimiliano Copetti
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy; (A.F.); (M.C.)
| | - Federica Pinna
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, 09042 Cagliari, Italy; (M.M.); (P.P.); (C.A.); (E.C.); (M.G.); (M.A.M.); (A.M.); (F.P.); (B.C.)
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, 09042 Cagliari, Italy
| | - Alessio Squassina
- Unit of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, 09042 Cagliari, Italy; (C.P.); (D.C.)
- Department of Biomedical Sciences, Division of Neuroscience and Clinical Pharmacology, University Campus, S.P. 8, Sestu-Monserrato, Km 0.700, Monserrato, 09042 Cagliari, Italy
- Correspondence: (A.S.); (V.P.)
| | - Valerio Pazienza
- Division of Gastroenterology, Fondazione IRCCS Casa Sollievo della Sofferenza Hospital, 71013 San Giovanni Rotondo, Italy;
- Gastroenterology Unit, Fondazione I.R.C.C.S. “Casa Sollievo della Sofferenza” Hospital, Viale dei Cappuccini 1, 71013 San Giovanni Rotondo, Italy
- Correspondence: (A.S.); (V.P.)
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26
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Manchia M, Paribello P, Arzedi C, Bocchetta A, Caria P, Cocco C, Congiu D, Cossu E, Dettori T, Frau DV, Garzilli M, Manca E, Meloni A, Montis MA, Mura A, Nieddu M, Noli B, Pinna F, Pisanu C, Robledo R, Severino G, Sogos V, Chillotti C, Carpiniello B, Del Zompo M, Ferri GL, Vanni R, Squassina A. A multidisciplinary approach to mental illness: do inflammation, telomere length and microbiota form a loop? A protocol for a cross-sectional study on the complex relationship between inflammation, telomere length, gut microbiota and psychiatric disorders. BMJ Open 2020; 10:e032513. [PMID: 31988227 PMCID: PMC7045141 DOI: 10.1136/bmjopen-2019-032513] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Severe psychiatric disorders are typically associated with a significant reduction in life expectancy compared with the general population. Among the different hypotheses formulated to explain this observation, accelerated ageing has been increasingly recognised as the main culprit. At the same time, telomere shortening is becoming widely accepted as a proxy molecular marker of ageing. The present study aims to fill a gap in the literature by better defining the complex interaction/s between inflammation, age-related comorbidities, telomere shortening and gut microbiota in psychiatric disorders. METHODS AND ANALYSIS A cross-sectional study is proposed, recruiting 40 patients for each of three different diagnostic categories (bipolar disorder, schizophrenia and major depressive disorder) treated at the Section of Psychiatry and at the Unit of Clinical Pharmacology of the University Hospital Agency of Cagliari (Italy), compared with 40 age-matched and sex-matched non-psychiatric controls. Each group includes individuals suffering, or not, from age-related comorbidities, to account for the impact of these medical conditions on the biological make-up of recruited patients. The inflammatory state, microbiota composition and telomere length (TL) are assessed. ETHICS AND DISSEMINATION The study protocol was approved by the Ethics Committee of the University Hospital Agency of Cagliari (PG/2018/11693, 5 September 2018). The study is conducted in accordance with the principles of good clinical practice and the Declaration of Helsinki, and in compliance with the relevant Italian national legislation. Written, informed consent is obtained from all participants. Participation in the study is on a voluntary basis only. Patients will be part of the dissemination phase of the study results, during which a local conference will be organised and families of patients will also be involved. Moreover, findings will be published in one or more research papers and presented at national and international conferences, in posters or oral communications.
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Affiliation(s)
- Mirko Manchia
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pasquale Paribello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Carlo Arzedi
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Alberto Bocchetta
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Paola Caria
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Cristina Cocco
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Eleonora Cossu
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Tinuccia Dettori
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Daniela V Frau
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Mario Garzilli
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Elias Manca
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Cagliari, Italy
| | - Anna Meloni
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Maria A Montis
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Andrea Mura
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Mariella Nieddu
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Barbara Noli
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Renato Robledo
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giovanni Severino
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Valeria Sogos
- Department of Biomedical Sciences, Section of Cytomorphology, University of Cagliari, Cagliari, Italy
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Unit of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
- Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Maria Del Zompo
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Gian Luca Ferri
- Department of Biomedical Sciences, NEF Laboratory, University of Cagliari, Cagliari, Italy
| | - Roberta Vanni
- Unit of Biology and Genetics, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Sciences, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
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Pinna F, Manchia M, Paribello P, Carpiniello B. The Impact of Alexithymia on Treatment Response in Psychiatric Disorders: A Systematic Review. Front Psychiatry 2020; 11:311. [PMID: 32372987 PMCID: PMC7177022 DOI: 10.3389/fpsyt.2020.00311] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 01/31/2020] [Accepted: 03/27/2020] [Indexed: 12/31/2022] Open
Abstract
UNLABELLED Treatment of psychiatric disorders relies heavily on a trial and error approach, often prolonging the time required to obtain symptomatic improvements. The identification of reliable predictors of treatment response is instrumental to enact an individualized approach. Alexithymia represents a personality trait reflecting an intrinsic difficulty in recognizing the emotional components of subjective experiences. Thus, its modulating role on treatment outcome has gathered substantial attention during the past years. In the present paper, we aimed at exploring the available evidence for Alexithymia role in influencing the treatment outcome on a wide range of psychiatric conditions by means of a systematic review. DATA SOURCE We performed a systematic review in Medline and Scopus, augmented by tracking the reference list of the pertinent articles. INCLUSION CRITERIA To be included in this review, research studies had to assess alexithymia impact on a treatment intervention delivered to manage a primary psychiatric disorder. STUDY EVALUATION AND DATA SYNTHESIS After removing duplicates, titles were screened first, then abstracts, and last full texts were read, eventually leading to the inclusion or exclusion of the papers according to the criteria established before the online search. Then results of the search were downloaded in.xml format and uploaded in Rayyan, a free web software, that helps expedite the initial screening of abstracts and titles using a process of semi-automation while incorporating a high level of usability. After uploading, screening of the literature was performed in blind by two investigators. Disagreement between reviewers was resolved by joint discussion with a third senior investigator. The quality of evidence was assessed using the Newcastle Ottawa Scale. Thereafter, the data considered relevant was extracted and synthetized in this paper. RESULTS Our search yielded a total of 30 articles dealing with a wide range of psychiatric conditions and exploring both pharmacological and psychotherapeutic interventions. Several lines of evidence suggest a complex role for alexithymia in influencing the psychiatric treatment outcome, further underscoring the need for additional research in this area to better address the existing knowledge gaps.
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Affiliation(s)
- Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital of Cagliari, Cagliari, Italy
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28
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Manchia M, Squassina A, Pisanu C, Congiu D, Garzilli M, Guiso B, Suprani F, Paribello P, Pulcinelli V, Iaselli MN, Pinna F, Valtorta F, Carpiniello B, Comai S. Investigating the relationship between melatonin levels, melatonin system, microbiota composition and bipolar disorder psychopathology across the different phases of the disease. Int J Bipolar Disord 2019; 7:27. [PMID: 31814040 PMCID: PMC6900376 DOI: 10.1186/s40345-019-0163-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/24/2019] [Indexed: 01/27/2023] Open
Abstract
Background Bipolar disorder (BD) is characterized by recurrent episodes of depression and mania/hypomania alternating with intervals of well-being. The neurobiological underpinnings of BD are still veiled although there is evidence pointing to a malfunction of the circadian clock system that is regulated by the neuromodulator melatonin (MLT). Small sample size studies in BD patients have shown that changes in the levels of MLT are associated with shifts in illness status. Moreover, mood stabilizers (including lithium and valproic acid) influence the MLT system. Of interest, MLT also modulates intestinal microbiota, and recent work suggests an important role of microbiota alterations in neuropsychiatric disorders, including BD. This study is designed to explore whether the possible patterns of associations between changes in the levels of MLT and its precursors and BD mood phases are modulated by variants within the genes encoding for the elements of the MLT system and/or by the microbiota composition. Methods We will conduct a 2-year follow-up study in 50 BD patients during the three different mood phases of the disease. For each phase, we will perform a blood withdrawal for the analysis of MLT levels and of variants of the genes related to the MLT pathway between 8 and 10 a.m. after an overnight fasting, a stool specimen collection for the analysis of microbiota composition, and a detailed psychometric assessment for depression, mania, impulsivity and cognitive abilities. We will also recruit 50 healthy age-matched controls in whom we will perform a blood withdrawal between 8 and 10 a.m. after an overnight fasting, a stool specimen collection, and a psychometric assessment to exclude the presence of psychiatric disorders. Discussion In this cross sectional (case–control vs. BD comparisons) and longitudinal (24 months) study, we expect to clarify the link between the MLT system, microbiota and BD psychopathology. We expect to identify some typical BD symptomatic clusters that will be more strictly associated with variations in the MLT system. In a personalized medicine perspective, this subgroup of BD patients may benefit from a pharmacological therapy targeting the MLT system. Trial registration This study protocol was approved by the Ethics Committee of the University Hospital Agency of Cagliari (PG/2019/6277)
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Affiliation(s)
- Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Donatella Congiu
- Department of Biomedical Science, Section of Neuroscience and Clinical Pharmacology, University of Cagliari, Cagliari, Italy
| | - Mario Garzilli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Beatrice Guiso
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federico Suprani
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Vittoria Pulcinelli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Maria Novella Iaselli
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Flavia Valtorta
- San Raffaele Scientific Institute and Vita Salute University, Via Olgettina 58, 20132, Milan, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Stefano Comai
- San Raffaele Scientific Institute and Vita Salute University, Via Olgettina 58, 20132, Milan, Italy. .,Department of Psychiatry, McGill University, Montreal, QC, Canada.
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Carta MG, Paribello P, Nardi AE, Preti A. Current pharmacotherapeutic approaches for dysthymic disorder and persistent depressive disorder. Expert Opin Pharmacother 2019; 20:1743-1754. [DOI: 10.1080/14656566.2019.1637419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Mauro Giovanni Carta
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Egidio Nardi
- Medical School - Institute of Psychiatry, Federal University of Rio de Janeiro National Academy of Medicine, Rio de Janeiro, Brazil
| | - Antonio Preti
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
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30
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Affiliation(s)
- Mauro Giovanni Carta
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Antonio Preti
- Department of Health Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Carta MG, Paribello P, Anastasia A, De Berardis D, Nardi AE, Fornaro M. Pharmacological management of depression in patients with multiple sclerosis. Expert Opin Pharmacother 2018; 19:1533-1540. [PMID: 30207800 DOI: 10.1080/14656566.2018.1516207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The pharmacotherapeutic management of depression in patients with multiple sclerosis (MS) is a matter of debate that cannot be decided from the evidence available in the current literature. Therefore, its management essentially relies on the clinical experience of the prescribing clinician rather than on evidence-based approaches. AREAS COVERED This review provides a clinically oriented critical perspective on the connection between MS and major depressive disorder (MDD) or depression associated with bipolar disorder (BD), focusing on its optimal pharmacotherapy. Both clinical and pharmacological considerations are accounted in order to promote rational pharmacotherapy, both in terms of efficacy and tolerability. EXPERT OPINION Despite its clinical burden and relatively frequent occurrence, the interplay of MS and depression still requires further controlled trials to better clarify the appropriate pharmacotherapy across varying 'diseases categories' of MS itself, as well as discriminating between depressive symptoms that do not necessarily reach the threshold of either MDD or BD. Additional insight into new mood-tolerated neurological pharmacotherapy for MS is likewise warranted toward a more effective, immune- and patient-tailored pharmacotherapy, while promoting innovation in drug design, with the ultimate goal of enhancing the overall quality life of the affected individual, his/her caregivers, and to reduce the associated economic and social burden.
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Affiliation(s)
- Mauro Giovanni Carta
- a Department of Health Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | - Pasquale Paribello
- a Department of Health Sciences and Public Health , University of Cagliari , Cagliari , Italy
| | | | | | - Antonio Egidio Nardi
- d Medical School - Institute of Psychiatry , Federal University of Rio de Janeiro National Academy of Medicine , Rio de Janeiro , Brazil
| | - Michele Fornaro
- e Neuroscience, Reproductive Science and Odontostolmatology , Federico II University of Naples , Naples , Italy
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Bramanti A, D’Aloja E, Cabras F, Paribello P, Moro MF, Lindert J, Carta MG. The Elderly and the City: Lack of Knowledge on Violence Perception and Consequences on Daily Life. Clin Pract Epidemiol Ment Health 2018; 14:46-52. [PMID: 29541151 PMCID: PMC5838642 DOI: 10.2174/1745017901814010046] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 01/15/2018] [Revised: 02/13/2018] [Accepted: 02/13/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Two main demographic phenomena have substantially changed the condition of elderly: the growth of the urban population and the increase in longevity. OBJECTIVE The aim of the present review is to investigate how the elderly living in the cities perceive the sense of insecurity compared to those who reside in rural areas, and their Quality of Life (QoL). METHOD Studies published from January 2011 to August 2017 were identified on Google and PubMed combining the following terms: "elderly urban/rural QoL" or "old age urban/rural QoL". RESULTS We found 18 different papers published. However, there was only one study on how the elderly perceive the violence in the city. Studies on quality of life were not univocal. Studies on depressive disorders in old age were most homogeneous showing a condition worsening in the cities. A study on the perception of violence in US showed in residents of cities and neighborhoods with the entertainment arena and casinos an increase of criminality perception. In contrast, the crime decreased in both above-mentioned neighborhoods. CONCLUSION The condition of elderly in the cities is changed considerably in the recent years. It is estimated that this trend will increase in the coming years. We do not know how older people are experiencing these changes and how they perceive the persistence of violence in the cities. Future researches must satisfy this need by addressing the issue with appropriate methodological tools. This is a public health priority.
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Affiliation(s)
- Alessia Bramanti
- Istituto di Scienze Applicate e Sistemi Intelligenti, ISASI, Messina, Italy
- IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy
| | - Ernesto D’Aloja
- Department of Social Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federico Cabras
- Department of Social Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Pasquale Paribello
- Department of Social Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Jutta Lindert
- Soziale Arbeit und Gesundheit, University of Applied Sciences Emden/Leer, Emden, Germany
| | - Mauro Giovanni Carta
- Department of Social Sciences and Public Health, University of Cagliari, Cagliari, Italy
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